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Kennedy CL Alphaxrt Pty Ltd CO Cochlear Limited CQ HeartWare Pty Ltd CR Corin Australia Pty Ltd CT Coloplast Pty Ltd CU Cosuda Pty Ltd TG Future Medical Pty Ltd TK Tekmed Pty Ltd CZ Carl Zeiss Pty Ltd TN Newclip Technics Australia Pty Ltd TO Tornier Pty Ltd TS Trewavis Surgical Instruments Pty Ltd DD DJO Australasia Pty Ltd DE Device Technologies Australia Pty Ltd TU Terumo Australia DF Managing Diabetes Pty Ltd TW SWISSMED PTY LTD TX Teleflex Medical Australia DH DENTSPLY IH Pty Ltd TY Slade Health Pty Ltd TZ The Trustee for Adler Ortho Unit Trust DL DIVERSE DEVICES PTY LTD DO CARDINAL HEALTH AUSTRALIA 503 PTY LTD. DQ BIOQ PHARMA PTY LTD DR MEDIVANCE PTY LTD AUB Australian Biotechnologies DU SPINEART AUSTRALIA PTY. LTD. 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Pty Ltd OU Ortho Solutions Pty Ltd OW MERIT MEDICAL AUSTRALIA PTY LTD OX MERIL AUSTRALIA PTY LTD OY Osseointegration Holdings Pty Ltd JAA Johnson & Johnson Medical Pty Ltd PB Australian Pacific Medical Pty Ltd PC Precision Surgical Pty Ltd LEM Lions Eye Donation Service LEN Lions NSW Eye Bank PF Perios Pty Ltd PJ PurePlay Orthopaedics PK PX 210 PTY LTD PN Penumbra Neuro Australia Pty Ltd LEW Lions Eye Bank of Western Australia 1 Ophthalmic 3 Orthopaedic 6 Cardio-thoracic 41 Ophthalmic 13 Specialist Orthopaedic 17 Knee 18 Hip 19 Spinal 20 Cardiothoracic 21 General Miscellaneous 22 Ear, Nose & Throat 23 Plastic and Reconstructive 24 Vascular 25 Neurosurgical 26 Urogenital 27 Cardiac 28 Dermatologic 256 Voiding Dysfunction Prostheses 257 Stents For Treatment Of Coarctation Of The Aorta 259 Implant Ventricular Assist System 261 Sacroiliac Joint Fixation 262 Artificial Iris 263 Annular closure/reconstruction 264 Pectus Bar 265 Chordal Replacement Devices, fixed and adjustable 266 Remote Monitoring System 267 Catheter Delivery 290 Cardiac Ablation 123 SKELETAL RECONSTRUCTION 124 ANKLE AND FOOT 131 UPPER LIMB 140 ANTERIOR CHAMBER INTRAOCULAR LENSES 141 POSTERIOR CHAMBER INTRAOCULAR LENSES 142 INTRAOCULAR FLUIDS 143 CAPSULAR TENSION RINGS 144 GLAUCOMA DRAINAGE 145 EYELID PROSTHESES 146 LACRIMAL DUCT DRAINAGE PROSTHESES 147 ORBITAL PROSTHESES 148 RETINAL DETACHMENT PROSTHESES 149 FEMORAL COMPONENT: TOTAL KNEE ARTHROPLASTY 150 FEMORAL COMPONENT: UNI-COMPARTMENTAL KNEE ARTHROPLASTY 151 TIBIAL TRAY COMPONENT - TOTAL KNEE ARTHROPLASTY 152 TIBIAL TRAY COMPONENT: UNI-COMPARTMENTAL KNEE ARTHROPLASTY 153 TIBIAL INSERT: TOTAL KNEE ARTHROPLASTY 154 TIBIAL INSERT: UNI-COMPARTMENTAL ARTHROPLASTY 155 PATELLO FEMORAL REPLACEMENT - FEMORAL COMPONENT 156 PATELLAR COMPONENT 157 TUMOUR PRODUCTS 159 KNEE ACCESSORIES 161 FEMORAL COMPONENTS - PRIMARY AND REVISION 162 FEMORAL HEADS 163 ACETABULAR COMPONENTS 164 ACCESSORIES 165 Bone Screws 166 Accessories for bone screws and connector components 167 Connector 168 Hook 169 Plate 170 Rod 171 Plate-Rod 172 Washer/Staple 173 C-Ring 174 Fusion Cage 175 Disc Replacement 176 Vertebral Body Replacement 177 Interspinous Fixation 178 Mechanical Valves 179 Tissue Valves 180 Valve Conduits 181 Atrio-Ventricular Rings and Bands 182 Patches 183 Membranes 186 Grafts (Proximal Aorta) 187 BRACHYTHERAPY 188 DRUG DELIVERY DEVICES 189 ENTERAL TUBES 190 GASTRIC BANDS 191 HAEMOSTATIC DEVICES 192 LUMINAL STENTS 193 PULMONARY/PERITONEAL DEVICES 194 CLOSURE DEVICES 196 EAR 197 NOSE 198 THROAT 199 CRANIOMAXILLOFACIAL RECONSTRUCTION & FIXATION 200 CRANIOMAXILLOFACIAL IMPLANTS 201 DENTAL IMPLANTS 202 DISTRACTOR SYSTEMS 203 SOFT TISSUE & TISSUE EXPANDERS 204 MAMMARY IMPLANTS 206 Vascular Stents 207 Stent Grafts 208 Grafts 209 Vascular Patches 210 Vessel Bands 211 Embolic Protection Devices 212 Arterial Closure Devices 213 Occlusion Devices 214 Long Term Vascular Access Devices 215 Peritoneal Dialysis, Long Term Implantable Catheters 218 ANEURYSM CLIPS 219 DURA DEFECT REPAIR 220 HYDROCEPHALUS DEVICES 221 DEEP BRAIN STIMULATION (DBS) 222 NEUROSTIMULATION THERAPIES FOR PAIN MANAGEMENT 223 INTRATHECAL DRUG DELIVERY SYSTEM 224 NEUROSTIMULATION THERAPIES FOR SEIZURE CONTROL 225 NEURO INTERVENTION 226 Incontinence Prostheses 227 Ureteric Stents 229 Reconstructive Material 230 Penile Prostheses 231 Testicular Prostheses 232 Sacral Neuromodulation 233 Tubal Obstruction Devices 234 Nephrostomy Catheters 235 Vesicoureteral Reflux Prostheses 236 Single Chamber ICDs 237 Dual Chamber ICDs 238 ICDs with CRT 239 Single Chamber Pacemakers 240 Dual Chamber Pacemakers 241 CRT Pacemakers 242 ICD Leads 243 Pacemaker Leads 244 Pacemaker/ICD Adaptors 245 Pacemaker/ICD Extenders 246 Pacemaker/Lead Accessories 247 Coronary Stents 248 Special Purpose Percutaneous Cardiovascular Devices 249 Implantable Cardiac Event Recorders 251 Cardiac Assisted Fixation Devices 252 Skeletal Fixation Devices 253 Intracranial Pressure (ICP) Monitoring 255 Cerebrospinal Fluid (CSF) Diversion 2181 Left Atrial Appendage Closure 1219 Sinus Tarsi Implant 1228 Intramedullary Nails 1229 Intramedullary Nail Accessories 1231 Screws 1237 External Fixateurs 1241 Bone Graft Substitute 1269 Ankle joint component 1273 Wrist 1274 Finger Joint Articulations 1275 Elbow 1276 Shoulder - Humeral 1277 Shoulder - Glenoid 1278 Shoulder - Accessories 1279 Bone Cement 1324 Aphakic 1325 Phakic 1326 Rigid 1327 Foldable 1328 Pseudo-phakic, piggy-back 1329 Viscoelastic 1330 Non Viscous 1331 Simple 1332 Complex 1333 Ab Externo Long Tube /Reservoir 1334 Ab Externo 1335 Spacers 1336 Weights 1337 Intracanalicular 1338 Extracanalicular 1339 Intrascleral 1340 Extrascleral 1341 Fascial - solid and permeable 1342 Buckles, bands, tyres and sponges 1343 Clips and tacks 1344 Sleeves 1345 Intraocular Gases 1346 Intraocular Heavy Liquids 1347 Intraocular Silicone Oils 1348 Cemented, Alloy 1349 Cemented, Alloy, PMMA Coating 1350 Cemented, Non-Alloy 1351 Uncemented, Alloy 1352 Uncemented, Alloy, HA Coating 1353 Cemented, Alloy 1354 Cemented, Non-Alloy 1355 Uncemented, Alloy 1356 Cemented, All polyethylene 1357 Cemented, Alloy 1358 Cemented, Alloy, Moulded Polyethylene 1359 Cemented, Alloy, for Mobile Insert 1360 Uncemented, Alloy 1361 Uncemented, Alloy, Moulded Polyethylene 1362 Uncemented, Alloy, for Mobile Insert 1363 Cemented, Alloy Polyethylene 1364 Cemented, Alloy 1365 Cemented, Alloy, Moulded Polyethylene 1366 Cemented, Alloy, for Mobile Insert 1367 Uncemented, Alloy 1368 Uncemented, Alloy, for Mobile Insert 1369 Minimally Stabilised 1370 Posterior Stabilised 1371 Totally Constrained 1372 Tibial Insert: Uni-Compartmental Arthroplasty 1374 Alloy 1375 Non-Alloy 1376 Cemented, All Polyethylene 1377 Cemented, Polyethylene, Metal Backed 1378 Uncemented, Polyethylene, Metal Backed 1379 Polyethylene Insert for Mobile Patella 1380 Distal Femur 1381 Proximal Tibia 1382 Diaphyseal Extension Piece (Femoral or Tibial) 1383 Bone Anchorage Piece 1384 Tibial Inserts 1385 Augments 1386 Stems 1387 Couplers or adaptors, incorporating stem extenders, sleeves and other couplings 1390 Augments 1391 Axles for hinged prostheses 1392 Bolts 1393 Connectors for hinged prostheses 1394 Conversion modules 1395 End caps 1396 Offset couplers/adaptors 1397 Pegs, lugs, etc 1398 Screws 1399 Stems - straight or offset 1400 Stem Extenders, Sleeves and other couplings 1401 Temporary Spacers 1404 Cemented 1405 Cemented, Long Lengths (≥200mm) 1406 Uncemented 1407 Uncemented, HA Coated 1408 Uncemented, Long Lengths (≥200mm) 1409 Uncemented, Long Lengths, HA Coated (≤200mm) 1410 Uncemented, Modular 1411 Uncemented, Modular, HA Coated 1412 Uncemented, Modular, Long Lengths (Stem ≥200mm; Body ≥75mm; Cone ≥70mm; Spacer/Sleeve ≥50mm) 1413 Uncemented, Modular, HA Coated, Long Lengths (Stem ≥200mm; Body ≥75mm; Cone ≥70mm; Spacer/Sleeve ≥50mm) 1414 Calcar Replacement 1416 Monoblock Hemis 1417 Femoral Neck 1419 Conventional Femoral Heads, ≤32mm 1420 Conventional Femoral Heads, >32mm 1421 Metal on Metal Heads 1422 Resurfacing, Cemented 1424 Bipolar/Multipolar 1425 Cups, Cemented 1426 Shells, Uncemented 1427 Shells, Uncemented, HA 1428 Insert/Liner 1429 Bonded Shell/Liner 1431 Resurfacing Cup 1432 Acetabular Reconstruction Devices 1433 Augment 1434 Bolt 1435 Bone Screw 1436 Calcar Block 1437 Cement Restrictor 1438 Centraliser 1439 Claw 1440 Connector 1441 Dome Plug 1442 Head Taper Insert 1443 Neck Adapter 1444 Nut 1445 Pin 1446 Plug - Including Dome Plug 1447 Plug and Hood 1449 Ring 1450 Screw 1451 Sleeve 1452 Spacer- Unique 1453 Spike - Acetabular 1454 Trochanter Plate 1455 Trochanteric Replacement 1456 Washer 1457 Wire - Cobalt Chrome 1458 Wire - Stainless Steel 1460 Ankle joint 1461 Replacement of other joints of the foot including articulations 1462 Pedicle, Monoaxial 1463 Pedicle, Polyaxial 1464 Standard 1465 Nut/Set Screw/Locking Screw 1466 Collar/Sleeve 1467 Cap/Cover Plate 1468 Cap/Cover Plate, Complex 1469 Block/Screw head 1470 Cross Link Rod 1471 Hook/Clamp/Plate 1472 In-Line 1473 Offset 1474 Transverse (Rod-to-Rod) 1475 Hook 1476 Integral Fixation 1477 No Integral Fixation 1478 Standard 1479 Telescoping 1480 Dual Unit 1481 Plate Rod 1482 Washer 1483 Staple 1484 C-Ring 1485 Interbody, Integral Fixation 1486 Interbody, No Integral Fixation 1487 Facet Joint 1488 System 1489 End Plate 1490 Core 1492 Telescoping Cage 1493 Stackable Cage 1494 Mesh 1495 Mesh, End Plate 1496 Interspinous Fixation Device 2521 Tympanic Membrane Grafts 1497 Bi-Leaflet, rotatable 1498 Tilting Disc, rotatable 1499 Stented, anatomical 1500 Stented, non anatomical 1501 Non-Stented 1502 Mechanical Valve 1503 Tissue Valve, stented anatomical 1507 Tissue 1508 Synthetic 1509 Non-cardiovascular < 100cm² 1510 Non-cardiovascular ≥100cm² and <200cm² 1511 Non-cardiovascular ≥200cm² 1517 Modified Tube (end modified eg valsalva) 1518 Tube with one side branch 1519 Tube with multiple side branches (more than 1) 1520 Hepatic, Yttrium 90, Standard Dose 1521 Prostatic I-125 1522 Infusion Ports 1524 Infusion Pumps, Balloon Based 1525 Infusion Pumps, Battery Powered 1526 Cochlear Implants 1528 Speech Processors 1540 Infusion Pumps, Spring Powered 1541 Infusion Pump Accessories 1542 Pharmaceutical Beads 1544 Feeding Tubes 1545 Gastrostomy Tubes 1546 Jejunostomy Tubes 1547 Caecostomy Tubes 1548 Adjustable Gastric Band with Port 1551 Occluder Pin 1552 Powder 1553 Sponges 1554 Pliable Patches 1555 Matrix 1556 Biliary Stents 1557 Colonic Stents 1558 Oesophageal Stents 1560 Implantable Bone Conduction Hearing System 1561 Pancreatic Stents 1562 Enteral Stents 1563 Tracheobronchial Stents 1564 Nerve Repair Stents 1565 Ossicle/Middle Ear Prosthesis 1566 Ventilation Tube/Grommet 1567 Bone Cement 1568 Septal Button 1569 Tracheal Speaking Valve 1570 Vocal Chord Medialisation Implant 1571 Tracheal Stents 1573 Thyroplasty 1574 Cannula 1576 Injectable Material for Vocal Fold Augmentation / Laryngeal Reconstruction 2601 Hybrid stent graft (Branched) 1577 Drainage Catheters 1578 Endobronchial Valve 1579 Adhesion Barriers 1580 Internal Adhesives 1581 Ligating Devices 1582 Staples & Tackers 1585 Mesh - Metal 1586 Mesh - Non-metal 1587 Mesh - Composite 1588 Non-mesh 1589 Fracture or Reconstruction Plates 1590 Screws 1591 Ancillary Components 1592 Chin 1593 Cranium 1594 Ear 1595 Malar 1596 Mandible, Maxilla and Temperomandibular Joint (TMJ) 1597 Nose and Zygoma 1598 Orbit 1599 External Prostheses, Bone Attachment 1600 Abutment 1601 Zygomatic Bone Implant 1602 Endosseous Implant 1603 Complete 1604 Component 1605 Muscular 1606 Tissue Expanders 1607 Skin, Artificial 1608 Coupler 1609 Saline Filled 1610 Gel Filled 2641 Transcatheter Aortic Valve Implantation 1622 Bare Metal Stents 1624 Drug Eluting Stents 1625 Tube (Thoracic Aorta) 1626 Tube (Abdominal Aorta) 1627 Tube (Aorto-uni-iliac) 1628 Bifurcated 1629 Branched 1630 Fenestrated 1631 Accessory Component (Aortic) 1632 Accessory Component (Other including iliac limb and extension) 1633 Iliac Graft Plug 1634 Tube, Peripheral, Balloon Expandable 1635 Tube, Peripheral, Self Expandable 1636 Tube 1637 Bifurcated 1638 Branched or Fenestrated 1639 Tapered or End-modified 1640 Vascular Patches 1641 Vessel Bands 1642 Venous 1643 Arterial 1644 Arterial Closure Devices 1645 Particle 1646 Coil, Peripheral 1647 Polymer 1648 Complex Occlusion Devices, including detachable balloon, sphere or umbrella 1649 Percutaneous Catheters, Single Lumen 1650 Percutaneous Catheters, Multiple Lumen 1651 Percutaneous Catheters, Multiple Lumen for Haemodialysis 1652 Infuser Ports, Single Chamber 1653 Infuser Ports, Multiple Chamber 1654 Peritoneal Dialysis, Long Term Implantable Catheters 1655 Aneurysm Clip 1656 AVM Clip 1657 Repair, Graft, Small (≤10cm²) 1658 Repair, Graft, Medium (>10 to 50cm²) 1659 Repair, Graft, Large (>50 to 100cm²) 1660 Repair, Graft, Extra Large (>100cm²) 1661 Repair, Liquid Sealant (0 to 3ml) 1662 Repair, Liquid Sealant (>3 to 6ml) 1666 Valves 1667 Unitised shunt assembly, with proximal/distal catheter 1668 Catheter 1669 Antisyphon Device 1670 Reservoir/Priming Device 1671 Shunt Attachment 1672 Implantable Pulse Generator 1673 External Components 1674 Leads 1675 Microtargetting Electrodes 1676 Accessories 1677 Pulse Generators 1678 External Components 1679 Leads 1680 Lead Extension 1681 Implantable Infusion Pump 1682 Patient Programmer 1683 Intrathecal Catheter 1684 Accessories 1685 Vagal nerve stimulators 1687 Stent 1688 Coils 1689 Assist Devices 1690 Accessories 1691 Plugs 1692 Liquid 1693 Delivery Device For Occlusion Media 1694 Plates 1696 Inflatable 1698 Sling 1699 Injectable, Synthetic 1701 Fixed length 1702 Multi-length 1703 Urinary diversion 1706 Synthetic 1707 Biological 1709 Inflatable - Two component 1710 Inflatable - Three component 1711 Testicular prostheses 1712 Primary Cell Pulse Generator (non-rechargeable) 1713 External Components 1714 Lead 1715 Accessories 1716 Extraluminal 1718 Nephrostomy Catheters 1719 Vesicoureteral Reflux Prostheses 1721 Malleable 1722 29-42cc, 5-7 yrs longevity, Lead perf trends, Complex arrhythmia logging + memory features, adv data collect + storage 1723 Features of 8.1.1 plus auto test sensing parameters, auto capture threshold test, lead impedance test, wireless remote analysis 1724 29-42cc, 5-7 yrs longevity, Lead perf trends, Complex arrhythmia logging + memory features, adv data collect + storage 1725 Features of 8.2.1 plus auto test sensing parameters, auto capture threshold test, lead impedance test, wireless remote analysis 1726 Dual Chamber, Bivent pacing, Vent tachyarrhythmia treatment, programming enabling variation L vent & R vent stimulation timing & independent outputs 1727 Features of 8.3.1 plus auto test sensing parameters, auto capture threshold test, lead impedance test, wireless remote analysis 1730 SSIR with small/compact size, multi-programmability & longevity, & four or more advanced features 1732 DDDR/VDDR including rate responsive feature 1733 DDDR with four or more advanced features 1734 DDDR with continuous threshold monitoring in atrium + ventricle with ability to adapt pacing outputs accordingly, & with four or more advanced features 1736 Features of 8.6.1 plus continuous threshold monitoring in atrium & ventricle with ability to adapt pacing outputs accordingly 1737 Coronary Sinus 1738 Subcutaneous 1741 Transvenous/Steroid/Passive 1743 Transvenous/Steroid/Active 1745 Epicardial Patches 1746 Non-transvenous, Bi-Polar, Steroid 1747 Non-transvenous, Uni-Polar, Steroid 1748 Non-transvenous, Uni-Polar, Non-Steroid 1749 Transvenous, Uni-Polar, Passive, Steroid, Right Ventricular/Atrial 1751 Transvenous, Uni-Polar, Passive, Steroid, Left Ventricular 1753 Transvenous, Bi-Polar, Passive, Steroid, Right Ventricular/Atrial 1756 Transvenous, Bi-Polar, Active, Steroid, Right Ventricular/Atrial 1759 Transvenous, Multi-Polar, Passive, Steroid, Left Ventricular 1762 Transvenous, Active, Steroid, Left Ventricular 1763 Pacemaker/ICD Adaptors 1764 Pacemaker/ICD Adaptors 1765 Pacemaker/Lead Accessories 1766 Drug Eluting 1767 Bare Metal 1768 Cardiac Defect Occluders 1769 Vascular Occlusion Devices 1770 Implantable Cardiac Event Recorders 1771 Anastomosis Clip 1772 Surgical Accessories 1773 Staples 1774 Soft Tissue Fixation Devices 1776 Soft Tissue Substitute 1777 Meshes 1778 Tumour / Limb Deficiency 1779 Replacement Injection Ports 1781 Gastric Band without Port 1782 Polypropylene/Polyester Mesh 1783 Composite Mesh 1785 PTFE/ePTFE Mesh 1786 Permanently Adjustable 1790 Surgical closure devices (atrial appendage) 1791 Skeletal fixation, sternum 1792 Tissue Expander/Separator 1793 Drainage Shunts, Peritineovenous 1794 Transducer 1796 External Ventricular Drain 1797 Foam 1798 Complete Biomaterial Mesh 1799 Dynamic Wound Closure Devices 1800 Urethral Stents 1801 Prostatic Retractor 1802 Ab Interno Glaucoma Drainage Device 1803 Balloon Dilatation Catheters 1804 Uncovered 1805 Covered 1806 Insert Orientation Spacer Ring 1807 Anatomical Biomodel 1810 Biologically Engineered 1811 Hybrid stent graft (unbranched) 1812 Single Chamber, Subcutaneous 1813 Assisted Bladder Drainage 1814 Non Stackable Cage, other 1815 Rapid deployment aortic valve with dedicated single use tools 1816 Sublaminar Cable 1817 Nasal Valve Stent 1819 Ventricular Assist System 1820 Acetabular Stem or equivalent 1821 Sacroiliac Joint Fixation Device 1822 Foldable 1823 Annular closure/reconstruction device 1824 Pectus Bar 1825 Stabilisers 1826 Rod, Percutaneous Controlled Expansion 1828 Chordal Replacement Devices, fixed and adjustable 1829 Antibacterial Envelope 1830 External Components 1831 Patient Mobility Accessories 1832 Remote Monitoring System 1841 Atrio-Ventricular Ring or Band, Standard 1842 Atrio-Ventricular Ring or Band, Modified 1901 Non-mesh, non-resorbable 2945 Internal Fixator 2946 Radio frequency (RF) Ablation 2947 Cryoablation 6144 Finger, interphalangeal - proximal component 6145 Finger, interphalangeal - distal component 6146 Interpositional Devices 4111 Demineralised Bone Matrix, 2 – 5cc 4112 Demineralised Bone Matrix, >5cc - 10cc 4113 Demineralised Bone Matrix, >10cc 4114 Composite (Extracellular Collagen Matrix with DBM or Ceramic), 0 - 5cc 4115 Composite (Extracellular Collagen Matrix with DBM or Ceramic), >5cc - 10cc 4116 Composite (Extracellular Collagen Matrix with DBM or Ceramic), >10cc - 20cc 4117 Composite (Extracellular Collagen Matrix with DBM or Ceramic), >20cc 4118 Biologically Active Bone Inductor, 0 - 2.5mg 4119 Biologically Active Bone Inductor, >2.5mg - 5mg 4120 Biologically Active Bone Inductor, >5mg - 10mg 4121 Biologically Active Bone Inductor, >10mg 4122 Metal Scaffold 4123 Fixed 4124 Adjustable 4125 Cervical 4126 ThoracoLumbar / Lumbar / Lumbosacral 4127 Cervical 4128 ThoracoLumbar 4129 Occipital 4130 Lumbosacral / Sacral 4131 Laminoplasty Plate 4132 Thoracolumbar 6181 Chest Wall Reconstruction Plate Accessories 4133 Occipital 4134 Cervical 4135 ThoracoLumbar / Lumbar 4136 Integral Fixation 4137 No Integral Fixation 4138 End Plate 4141 Cardiovascular < 75cm² 4142 Cardiovascular ≥ 75cm² 4145 Initial 4147 Replacement 7221 Non-biological cartilage substitute 4150 Sound Processor 4151 Osseointegration 4152 Cover Screw 6201 <6cm2 6202 >6cm2 - <8cm2 4154 Stapes 6203 >8cm2 4155 Malleus 4156 Partial Ossicle Replacement (one or two) 4157 Total Ossicle Replacement (three) 4162 Standard Dose 4163 Single Seed or Partial Dose 4164 Single Lumen 4183 Insulin infusion pump (as 3.2.3.1) with integral calculator to determine boluses and active insulin 4185 Other Pharmacology 4186 Programmable/Reprogrammable Flow Rate and Bolus 4187 Device has capability to automatically adjust the insulin delivery based on continuous glucose monitoring data 4188 Fixed Flow Rate 4190 Kit 4191 Administration Cassette 4192 Administration Reservoir 4193 Administration Set 4194 Other 4195 Single Units 4196 Chains 4197 Initial 4198 Subsequent 4199 Absorbable ≤75cm² 4200 Absorbable >75cm² 4201 <0.2mm thick, 1-50cm² 4202 <0.2mm thick, 51-100cm² 4203 0.2-0.49mm thick, 1-10cm² 4204 0.2-0.49mm thick, 11-50cm² 4205 0.2-0.49mm thick, 51-200cm² 4206 0.2-0.49mm thick, >200cm² 4207 0.5-0.8mm thick, 1-10cm² 4208 0.5-0.8mm thick, 11-50cm² 4209 0.5-0.8mm thick, 51-200cm² 4210 0.5-0.8mm thick, >200cm² 4213 Liquid ≤6ml 4214 Liquid >6ml 4215 Non-liquid ≤50cm² 4216 Non-liquid >50cm² 4217 Accessory Extender 4218 Non-reinforced Wall 4219 <0.2mm thick, 1-10cm² 4220 <0.2mm thick, 11-25cm² 4221 0.2-0.49mm thick, 1-10cm² 4222 0.2-0.49mm thick, 11-25cm² 4223 0.2-0.49mm thick, 26-50cm² 4225 0.5-0.8mm thick, 1-10cm² 4226 0.5-0.8mm thick, 11-25cm² 4227 0.5-0.8mm thick, 26-50cm² 4228 0.5-0.8mm thick, 51-100cm² 4229 0.5-0.8mm thick, 101-200cm² 4230 >0.8mm thick, 1-10cm² 5255 Standard (screw size ≥4.5mm)(including blade) ≤ 6 holes 4231 >0.8mm thick, 11-25cm² 4232 >0.8mm thick, 26-50cm² 5256 Standard (screw size ≥4.5mm)(including blade) ≥ 7 to ≤ 15 holes 5257 Standard (screw size ≥4.5mm)(including blade) ≥ 16 holes 4233 >0.8mm thick, 51-100cm² 6281 Gel 10mL or Balloon 5258 Small (screw size 2.71mm – 4.49mm)(including blade) ≤ 6 holes 4234 Reinforced Wall, Uncovered/Bare Metal 5259 Small (screw size 2.71mm – 4.49mm)(including blade) ≥ 7 to ≤ 15 holes 4235 Reinforced Wall, Covered 5260 Small (screw size 2.71mm – 4.49mm)(including blade) ≥ 16 holes 4237 Reinforced Wall, Uncovered/Bare Metal 5261 Mini (screw size ≤2.7mm)(including blade) ≤ 6 holes 4238 Reinforced Wall, Covered 5262 Mini (screw size ≤2.7mm)(including blade) ≥ 7 to ≤ 15 holes 4239 0.5-0.8mm thick, 1-25cm² 5263 Mini (screw size ≤2.7mm)(including blade) ≥ 16 holes 5264 Dynamic - Hip ≤ 6 holes 4240 0.5-0.8mm thick, 26-50cm² 5265 Dynamic - Hip ≥ 7 to ≤ 15 holes 4241 >0.8mm thick 26-50cm² 5266 Dynamic - Hip ≥ 16 holes 4242 Pleural 5267 Dynamic - supracondylar ≤ 6 holes 4243 Intraperitoneal 5268 Dynamic - supracondylar ≥ 7 to ≤ 15 holes 5269 Dynamic - supracondylar ≥ 16 holes 5270 Periarticular anatomic - Clavicle plate ≤ 6 holes 4246 Spray 5271 Periarticular anatomic - Clavicle plate ≥ 7 to ≤ 15 holes 4247 Adhesive ≤2ml 5272 Periarticular anatomic - Clavicle plate ≥ 16 holes 4248 Adhesive >2-5ml 5273 Periarticular anatomic - Humerus ≤ 6 holes 4249 Adhesive >5ml 4250 Adhesive Accessory 5274 Periarticular anatomic - Humerus ≥ 7 to ≤ 15 holes 4251 Adhesive Peristrips 5275 Periarticular anatomic - Humerus ≥ 16 holes 4252 Pleurodesis Powder 5276 Periarticular anatomic - Radius ≤ 6 holes 4253 Resorbable 5277 Periarticular anatomic - Radius ≥ 7 to ≤ 15 holes 5278 Periarticular anatomic - Radius ≥ 16 holes 4254 Polymer 4255 Block 5279 Periarticular anatomic - Ulna ≤ 6 holes 5280 Periarticular anatomic - Ulna ≥ 7 to ≤ 15 holes 4256 Clips 5281 Periarticular anatomic - Ulna ≥ 16 holes 4257 Clip Applier 4258 Clips with Disposable Applier 5283 Periarticular anatomic - Pelvis ≤ 6 holes 4259 Clip Reload Cartridge 5284 Periarticular anatomic - Pelvis ≥ 7 to ≤ 15 holes 4260 Sutures 4261 <0.5mm thick, <4 holes 5285 Periarticular anatomic - Pelvis ≥ 16 holes 5286 Periarticular anatomic - Femur ≤ 6 holes 4263 <0.5mm thick, 4-7 holes 5287 Periarticular anatomic - Femur ≥ 7 to ≤ 15 holes 5288 Periarticular anatomic - Femur ≥ 16 holes 5289 Periarticular anatomic - Fibula ≤ 6 holes 4265 <0.5mm thick, 8-15 holes 5290 Periarticular anatomic - Fibula ≥ 7 to ≤ 15 holes 4266 <0.5mm thick, 16-32 holes 5291 Periarticular anatomic - Fibula ≥ 16 holes 4267 0.5-0.99mm thick, <4 holes 5292 Periarticular anatomic - Tibia ≤ 6 holes 5293 Periarticular anatomic - Tibia ≥ 7 to ≤ 15 holes 5294 Periarticular anatomic - Tibia ≥ 16 holes 5295 Periarticular anatomic - Calcaneal ≤ 6 holes 4271 0.5-0.99mm thick, 4-7 holes 5296 Periarticular anatomic - Calcaneal ≥ 7 to ≤ 15 holes 5297 Periarticular anatomic - Calcaneal ≥ 16 holes 5298 Periarticular anatomic - Foot 5299 Periarticular anatomic - Cable plate (hook/grip) ≤ 6 holes 5300 Periarticular anatomic - Cable plate (hook/grip) ≥ 7 to ≤ 15 holes 7348 Elbow 4277 0.5-0.99mm thick, 8-32 holes 7349 Ablation Catheter 5302 Periarticular anatomic - Cable plate with integrated cables - 2 or less, ≤ 6 holes 7350 Patch 7351 Mapping Catheter 5303 Periarticular anatomic - Cable plate with integrated cables - > 2, ≤ 6 holes 7352 Ablation Catheter 7353 Mapping Catheter 5306 Pump 5307 Occlusive cuff 4284 0.5-0.99mm thick, >32 holes 5308 Regulating Balloon 3261 Metal 5310 Accessory kit 4286 1.0-1.99mm thick, <4 holes 5311 System 4288 1.0-1.99mm thick, 4-7 holes 5314 Male 5315 Female 5316 1 ml 4293 1.0-1.99mm thick, 8-15 holes 5318 2 ml 5319 2.5 ml 5320 3 ml 4296 1.0-1.99mm thick, 16-32 holes 5321 Polyurethane 5322 Other synthetic 5323 Metal 4300 1.0-1.99mm thick, >32 holes 5324 Polyurethane 4301 2.0-2.99mm thick, 4-7 holes 5325 Other synthetic 5326 <500 sq cm 4303 2.0-2.99mm thick, 8-15 holes 5327 ≥500 sq cm 5328 <70 sq cm 5329 ≥70 sq cm 5330 Cylinder 4307 2.0-2.99mm thick, 16-32 holes 5331 Reservoir 5332 Pump 5333 Deactivation set 4310 2.0-2.99mm thick, >32 holes 5334 Accessory kit 4311 ≥3mm thick, 4-7 holes 5335 Pump and cylinder 4312 ≥3mm thick, 8-15 holes 5337 Programmer 4314 ≥3mm thick, 16-32 holes 5339 Permanent 5340 Trial 5341 Extension 4317 Staples, Non-bone (Reload) 5342 Implant/Revision Kits 4318 Staplers 4319 Staples, Reinforcer 5343 Other Accessories 5344 Clip 4320 Staples, Non-bone with Disposable Applier 5345 Band 4321 Diameter ≤1.24mm 5346 General Purpose 4323 Diameter 1.25-3.24mm 5348 General Purpose 5349 Special Purpose for specific indications 5351 Lead 4331 Tackers 4332 Pin 4333 Tack 4334 Washer 5358 Fixed Flow Rate 4335 Wedges and Burr Hole Covers 5359 Variable Flow Rate 4336 Anchor Bone 5360 Flexible/paediatric 5361 Radial/Ulnar 4337 Clamps 4338 Screws 5362 Dynamic distraction - electronic 4339 Locks 5363 End caps and extension caps 4340 Probe 5364 Wires 5365 Pins 5366 Cables 5367 Cables - with in-built locking device 4343 Complex 5368 Cables - with >1 locking device 5369 Wire forms (including washers/screws) - all sizes 4346 Polymer 5370 Cerclage bands 5371 Locking device for wires/cables 4348 Composite 5372 Hook/Grip for wires/cables 4349 Helical Rim 5373 Grooved Button for wires/cables 3326 Femoral, Proximal short (<220mm) 4350 Ear Base 4351 Complex 3327 Femoral, Proximal long (≥220mm) 3328 Femoral, Distal 4352 Polymer 3329 Tibial/Fibular 4353 Mandible, Full 6401 Simple fixture kit - Lower body (Uniplanar) 3330 Humeral 4354 Fossa Replacement 3331 Arthrodesis knee 4355 Mandibular Angle 3332 Arthrodesis ankle 4357 Condylar Device 4358 Plate 5382 No suture (including arrows) 4360 Nasal Dorsum 5384 Suture, Small anchors (≤2.3mm) 4361 Nasal Arch 5385 Suture, Medium anchors (2.4 – 3.9mm) 4362 Nasal Shell Shape 4363 Nasal Valve Support 5387 Suture, Large anchors (≥4mm) 4364 Naso-orbital Ethmoid Implant 3341 Intramedullary nail lag screw 5389 Button/thread/tape or Button/thread/button 5390 Button 4366 Complete Orbital Shape 5391 Interference Screw (± sleeve) 4367 Orbital Floor 4370 Rim 5394 Screw/Pin/Post 4371 Wedge for Orbit 5397 Biological (human or animal tissue derived) 4373 Endosseous Implant 4374 Abutment, Permanent 5398 Non-biological 5399 Metallic 4376 Abutment, Temporary or Healing 5400 Non Metallic 4377 Abutment Fixtures 5402 Spacer 5404 Central Screw 5405 Healing Cylinder 5406 Healing Screw 5407 Fixture 5408 Abutment 5409 Abutment Screw 4385 Permanent 4386 Temporary 5410 Oncology Humeral Stem 4387 Cover Screw/Cap 5411 Humeral Ancharge Piece 5412 Humerus Extension Piece 4389 Screws 4390 Plates 5414 Humerus Connection Piece 5415 Oncology Humeral Body 4392 Implants and Fixtures 5416 Wedge 4393 Graft Material <0.5ml 6441 at Schlemm's canal 3369 Standard ( ≥4.5mm) 5417 Humerus Connecting Screw 4394 Graft Material 0.5ml-<1.0ml 6442 external to Schlemm's canal 3370 Small (2.71mm – 4.49mm) 5418 Humerus Hex Socket Bolt 4395 Graft Material ≥1.0ml 3371 Mini (2.01 – 2.7 mm) 5419 Plug Screw Axis 3372 Micro (≤ 2.0mm) 4396 External Midface System 5421 Humeral Bearing 3373 Dynamic 4398 External Set 5422 Humeral Head/Cap 3374 Screw Washers 5423 Distal Humerus Flange 4399 Internal/Intraoral 5424 Sponge ≤10cm² 5425 Sponge 10-40cm² 5426 Sponge >40cm² 4402 Distractor Body 4403 Footplate 5428 Definition screw / Locking Screw 4406 Cross Bar/Rod 5431 Sheet ≤100cm2 5432 Sheet >100cm2 4408 Pin 4409 Screws 5433 Gel/Liquid 5434 ≤200cm² 4410 External Distractor Component 4411 Body Extension 5435 201-400cm² 4412 Calf Implant 5436 401-600cm² 4413 Gluteal 5437 >600-<2500cm² 4414 Skin or Mammary 5438 ≤200cm² 5439 201-400cm² 5440 401-600cm² 4418 Orbital 4419 <50cm² 4420 50-149cm² 4421 150-400cm² 4422 >400cm² 5446 ≤200cm² 4423 <500cc 5447 201-400cm² 5448 401-600cm² 5449 >600cm² 3401 Frame Complete - Monoplanar & Modular Frames 4426 ≥500cc 3402 Frame Component - Monoplanar, Clamp 5450 Single 5451 Double 3404 Frame Component - Monoplanar, Adaptor 5452 < 25cm² 5453 25-75cm² 3405 Frame Component - Full Circular Ring 4429 <500cc 3406 Frame Component - Partial Circular Ring 5454 >75cm² 4432 ≥500cc 5457 Wedges 5458 Humeral Collar Round Smooth 5459 Humeral Component for use with Hemi Head 4436 Adjustable 5460 Humeral Head Fixation Screw 4437 Multiple Lumen 5461 Humeral Component with Liner and re-attachment 5462 Humeral Collar Round Coated 5463 Humeral Stem 4439 Balloon Expandable 5464 Humeral Shaft 4440 Self Expandable, <150mm 5465 Humeral Intergral Shaft & Stem Coated 4441 Self Expandable, ≥150mm 5466 Humeral Intergral Shaft & Stem Coated Uncoated 4442 <180mm length 5467 Humeral Component with Liner 4443 ≥180mm length 4444 Body and 2 limbs 5468 Humeral Component with Reattachment for use with Hemi Head 4445 Body and 1 limb 5469 Glenoid / Glensophere component 5470 Humeral Hemi-Head 4446 Body only 4447 Thoracic 5471 Self-Expanding, large diameter for treatment of aortic dissection disease 5472 ≤200mm length 4448 Abdominal 5473 >200mm length 4449 ≤12mm diameter 4450 >12mm diameter 5474 Arthrodesis Other 4451 <150mm length 5475 Femoral Stem - Uncemented 4452 150-249mm length 4453 ≥250mm length 5477 Tibial Stem - Uncemented 4454 ≤10cm length 4455 11-20cm length 5479 Valgus Sleeve 4456 21-49cm length 4457 ≥50cm length 4458 0 - 100 sq cm 4459 101 - 150 sq cm 5483 Refill/Catheter Access Kits 4460 >150 sq cm 5484 Connectors and Cables 4461 Pledgets 5485 Cervical 5486 ThoracoLumbar / Lumbar 5487 Cervical 5488 Lumbar 4465 0.5ml 5489 Biliary 4466 1ml 5490 Ligating Bands with Disposable Applier 4467 2ml 5491 ≤200cm² 4468 Valve, Externally Adjustable 5492 201-400cm² 4469 Valve, Non-externally adjustable 5493 401-600cm² 4470 Connector 5494 601-800cm² 4471 Right Angled Guide 5495 >800cm² 5496 Surgical Guide 4472 Primary Cell Pulse Generator (non-rechargeable) 6521 Active Middle Ear Implants 4473 Rechargeable Pulse Generator 4474 Patient Programmer 5498 Surgical Guide 5499 Closure Set 4475 Recharger 5500 Extension Kit 4476 Permanent Lead 5501 Metal 4477 Lead Extension 5502 Paediatric 4478 Burr Hole Cover 4479 Connectors and cables 5503 601cm²-1000cm² 4480 Primary Cell Pulse Generator (non-rechargeable) 5505 >1000cm² 4481 Rechargeable Pulse Generator 5506 Catheter 5507 Detachment Controller 4483 Patient Programmer 4484 Patient Programmer Antenna 5508 Upper body kit 5509 Lower body kit 4485 On/Off switching device 5510 Pectoral 4486 Permanent Lead 4487 Trial Lead 5512 < 75cm² 5513 ≥ 75cm² 5514 Staples 5516 Multiple Branch 4492 Two piece 5517 Connectors and Cables 4493 Implantable pulse generator 5518 External Neurostimulator 4494 Catheters 4495 Coil detachment device 5519 In Flow Device 4496 >0.8mm thick, 101-200cm2 5520 Activator 4497 Recharger 5521 Sizing Catheter 4498 Intraoperative accessories 4499 Revision Kits 4500 Plug 4501 Intraoperative Accessories 4502 Lead Delivery System 4503 Revision Kit 4504 External Midface System 4505 Frame Component - Circular Frame Strut Device 5530 Thumb, carpometacarpal - proximal component 4506 Frame Component - Foot Plate 4507 Frame Component - Circular Frame, Nuts & Spacers 4508 Frame Component - Coupling Device 4509 Frame Component - Rods 4510 Frame Component - Pins 4511 Frame Component - Pin Clamp Assembly 4512 Frame Component - Pin Clamp Assembly Post 6561 Arthrodesis 4513 Articulating Hinge 6562 Self Expandable 4519 Fistula Closure 4521 Screw post/peg 4522 Screw Accessories - Nuts 4523 Screw Accessories - Locking Nuts / Insert 3645 Liner - fixed bearing 3646 Liner - mobile bearing 3664 Carpal component 3665 Radial component 3666 Carpal spacer 3667 Distal ulnar stem 3668 Distal ulnar head 6741 Hemi-mandible 6742 Xenografts, Small (≤10cm2) 6743 Xenografts, Medium (>10cm2 to 50cm2) 3673 Distal humeral component/s 3674 Proximal radial stem 3675 Proximal radial head/neck 3676 Proximal ulnar component 3678 Elbow pin 3681 Humeral component and head – monoblock, cemented 3701 Glenoid component, All poly 3702 Glenoid component, Metal backed 3703 Glenoid component & insert 3704 Glenoid insert 3712 Reconstruction screw 3713 Set screw/Locking bolt 5768 Pleural Sealant 5769 Cinched suture applier 3732 Screw Accessories - Caps 5782 Maxilla 5783 Zygoma Plate 3755 Halo-thoracic device 3756 Frame Component - Monoplanar, Body 3757 Frame Component - Circular Coupling Device 5854 External Neurostimulator 3887 Rigid 3888 Rigid 3889 Foldable 5938 Chest Wall Reconstruction Plates 3890 Microincision 3891 No edge modification 3892 Edge modification 3893 Presbyopia correcting 3894 Accommodative 3895 Monofocal 3896 Multi-focal 3897 Dual Fluids 3898 Cannulated 5947 ≥2500cm² 3899 Non-Cannulated 3900 Gold <1.8 grams 3901 Gold ≥1.8 grams 3902 Platinum 3903 Complex and permeable 3904 Multi-component 3905 Sponges 3906 Minimally Stabilised 3907 Posterior Stabilised 3908 Totally Constrained 3909 Minimally Stabilised 3910 Posterior Stabilised 3911 Minimally Stabilised 3912 Posterior Stabilised 3913 Totally Constrained 3914 Minimally Stabilised 3915 Posterior Stabilised 3917 Minimally Stabilised 3918 Posterior Stabilised 3919 PMMA Coating 3920 HA Coating 3921 PMMA Coating 3922 PMMA Coating 3923 HA Coating 3924 HA Coating 3925 HA Coating 3926 HA Coating 3927 Mobile 3928 Mobile 3929 Moulded 3930 Condylar only (only when combined with a proximal tibial replacement) 5978 Valve and gravitational unit, externally adjustable 3931 Condylar, including metaphyseal and/or diaphyseal 3932 Condylar only (only when combined with a proximal tibial replacement) 3933 Condylar, including metaphyseal and/or diaphyseal 3934 Incorporating Bone Fixation 3935 With Compression 5984 Integrated Delivery System 3936 Collar 5985 Delivery Catheter 3937 Adaptor 3938 Stem extender 3939 Unpolished 5987 Port 5988 Suture Fasteners 3940 Unpolished - precoat 3941 Polished 5991 Clavicle 3944 Polished and Unpolished, Conventional 3945 Grit Blast 5994 Cable plate with 1 or more cables, ≤ 6 holes 3946 Beaded 3947 Mesh 5996 Cable plate with 1 or more cables, ≥ 7 holes to ≤ 15 holes 3948 Plasma 5997 External Component 3949 Grit Blast 3950 Beaded 3951 Mesh 6000 Para/Thoraceulesis 3952 Plasma 6001 Percutaneous 3953 Grit Blast 3954 Beaded 6003 Tacks, Reload 6004 Adhesive Tackers 3957 Grit Blast 6008 Absorbable ≤50cm² 3960 Plasma 6009 Absorbable 51 cm² – 75cm² 3961 Grit Blast 6010 Absorbable >75cm² 3962 Beaded 6011 Self-expanding metal, Covered 3964 Plasma 3965 Unpolished and Polished 3966 Grit Blast 3967 Beaded 7041 Cyanoacrylate 3969 Plasma 3970 Unpolished and Polished 3971 Grit Blast 6021 Stem extension 3974 Plasma 6022 Vascular embolisation balloon 3975 Unpolished and Polished 6023 Surgical Guide 6024 Surgical Guide 3976 Grit Blast 6025 Biodegradable 6027 No SubGroup 3979 Plasma 6028 System Controller 3981 Short and Standard Length 6030 Battery Set 3982 Long Length (≥200mm) 6031 Stabilisation Belt 6032 Battery Clip Set 6033 Modular Belt 6034 Shower Bag 6036 Trial kit including leads 3988 Stainless Steel 7061 Distal Radio-Ulnar Plate 6037 Placement set 3989 Cobalt Chrome 3990 Alumina 3992 Ceramic Mix 6041 Thumb, carpometacarpal - distal component 3993 Ceramicised Metal 3994 Stainless Steel 3995 Cobalt Chrome 6044 Finger, metacarpophalangeal - proximal component 3996 Alumina 3998 Ceramic Mix 3999 Ceramicised Metal 4000 Metal 4004 Bipolar 4005 Tripolar/Multipolar 4006 Unmodified polyethylene 4007 Modified polyethylene 4008 Constrained, modified and unmodified polythylene 4009 Metal Shell 4010 Grit Blast 4011 Beaded 4012 Mesh 4013 Plasma 6061 Gel 3ml 4014 Porous Metal 4015 Grit Blast 4016 Beaded 4017 Mesh 4018 Plasma 4019 Porous Metal 4020 Unmodified polyethylene 4021 Modified polyethylene 4022 Ceramic 4023 Metal 4024 Constrained 4025 Ceramic Mix 4026 Unmodified polyethylene 4027 Modified polyethylene 4030 Ceramic Mix 4031 Metal 4032 Metal, HA Coated 4034 Shell 4035 Cage 4038 Hooks, Flanges, Blades 4040 Talar component 4041 Tibial component 4042 Tibial component, cemented/uncemented, fixed bearing 4044 Great toe, MTP, total, metatarsal component 4045 Great toe, MTP, total, phalangeal component 4046 Great toe, MTP, total, articular insert or liner 4047 Great toe, resurfacing hemi articulation, metatarsal 4048 Great toe, resurfacing hemi articulation, phalangeal 4049 Great toe, non articulating articulation (for silastic implant replacement) 4050 Tendon Spacer 4052 Accessories - bushing / insert / spool 6101 Suture with cinch 4053 Accessories - circlips 4055 Accessories - cement restrictor 4057 Humeral component - cemented 4058 Humeral component - uncemented 4059 Modular humeral component - metaphyseal, cemented 4060 Modular humeral component - metaphyseal, uncemented 4062 Modular humeral component - diaphyseal, uncemented, long (>220mm) 4063 Modular Humeral component - diaphyseal, cemented, short (≤220mm) 4064 Modular Humeral component - diaphyseal, uncemented, short (≤220mm) 4065 Bipolar humeral head 4066 Bipolar humeral shell 4067 Standard humeral head 4068 Resurfacing humeral head 4069 Humeral cup 4073 Special purpose/tumour prosthesis - tumour section 4076 Necks/collar (modular) 4078 Reverse glenoid component, Base plate, uncemented 4079 Glenosphere 4080 Humeral sleeve 4081 Humeral spacer 4082 Articular insert 4083 Taper assembly 4084 Eccentrical adaptor 4086 Reverse humeral tray 4087 Cement only 4088 Cement with Antibiotic 4089 Cement with Complex Delivery System 4090 Cement with Antibiotic and Complex Delivery System 4091 Accessories - Restrictors 4092 Ceramic, 0-5cc 4093 Ceramic, >5cc - 10cc 4094 Ceramic, >10cc - 20cc 6143 Finger, metacarpophalangeal - distal component 4095 Ceramic, >20cc Human Tissue NBB66 Tri Cortical Osteotomy NBB 3 0 0 1563 No Change 2007-12-01 2019-03-01 Human Tissue NBB67 Tendon - Tibialis Anterior NBB 3 277310 0 0 2911 No Change 2007-12-01 2019-03-01 Human Tissue NBB68 Tendon - Patellar with machined conical bone plug NBB 3 277310 0 0 3528 No Change 2007-12-01 2019-03-01 Human Tissue NBB69 Tendon - Achilles with machined conical bone block NBB 3 277310 0 0 3636 No Change 2007-12-01 2019-03-01 Human Tissue NBB65 Bone - Cortico-Cancellous Crunch (40/60) 15cc NBB 3 0 0 1169 No Change 2006-11-30 2019-03-01 Human Tissue NBB70 Tendon - Semi tendinosis NBB 3 277310 0 0 2912 No Change 2007-12-01 2019-03-01 Human Tissue NBB71 Tendon - Tibialis Posterior NBB 3 277310 0 0 2911 No Change 2010-08-01 2019-03-01 Human Tissue NBB72 Tendon - Patellar with Quads NBB 3 277310 0 0 2911 No Change 2010-08-01 2019-03-01 Human Tissue NBB73 Tendon - Peroneus Longus NBB 3 277310 0 0 2911 No Change 2010-08-01 2019-03-01 Human Tissue NCC01 Femoral Ring Super Critical CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 2182 No Change 2017-02-01 2019-03-01 Human Tissue NCC11 Femoral Strut (Freeze Dried) - various sizes NAA 3 277310 0 0 3703 No Change 2017-02-01 2019-03-01 Human Tissue NCC12 Patella Tendon with Pre-Shaped Bone Block Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 3596 No Change 2017-02-01 2019-03-01 Human Tissue NCC13 Cancellous Cube (Freeze Dried) 3cm3 cubes NAA 3 277310 0 0 1632 No Change 2017-02-01 2019-03-01 Human Tissue NCC14 Tibial Strut (Freeze Dried) - various sizes NAA 3 277310 0 0 3265 No Change 2017-02-01 2019-03-01 Human Tissue NCC15 Cancellous Cube – Super Critical Fluid CO2 Treated (Freeze Dried) 3cm3 cubes NAA 3 277310 0 0 1663 No Change 2017-02-01 2019-03-01 Human Tissue NCC16 Femur – Distal Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 3775 No Change 2017-02-01 2019-03-01 Human Tissue NCC17 Cortical Ring Super Critical Fluid CO2 Treated (Frozen) 5mm – 9mm NAA 3 277310 0 0 1947 No Change 2017-02-01 2019-03-01 Human Tissue NCC18 Cortical Strut Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 2574 No Change 2017-02-01 2019-03-01 Human Tissue NBB53 Humerus - Ring NBB 3 0 0 1874 No Change 2006-11-30 2019-03-01 Human Tissue NBB54 Fibula - Segment NBB 3 0 0 3053 No Change 2006-11-30 2019-03-01 Human Tissue NBB55 Femoral Shaft - Third NBB 3 0 0 2183 No Change 2006-11-30 2019-03-01 Human Tissue NBB56 Femoral Shaft - Segment NBB 3 277310 0 0 2248 No Change 2006-11-30 2019-03-01 Human Tissue NBB57 Femoral Shaft - Half NBB 3 0 0 3595 No Change 2006-11-30 2019-03-01 Human Tissue NBB59 Femoral Hemi-condyle NBB 3 277310 0 0 3027 No Change 2006-11-30 2019-03-01 Human Tissue NBB60 Bone - Cancellous Crunch 60cc NBB 3 0 0 3232 No Change 2006-11-30 2019-03-01 Human Tissue NBB61 Bone - Cancellous Crunch 30cc NBB 3 0 0 2131 No Change 2006-11-30 2019-03-01 Human Tissue NBB62 Bone - Cancellous Crunch 15cc NBB 3 0 0 1169 No Change 2006-11-30 2019-03-01 Human Tissue NBB63 Bone - Cortico-Cancellous Crunch (40/60) 60cc NBB 3 0 0 3232 No Change 2006-11-30 2019-03-01 Human Tissue NBB64 Bone - Cortico-Cancellous Crunch (40/60) 30cc NBB 3 0 0 2131 No Change 2006-11-30 2019-03-01 Human Tissue NCC02 Cortical Cancellous Block Super Critical Fluid CO2Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 1623 No Change 2017-02-01 2019-03-01 Human Tissue NCC03 Femoral Ring Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 2182 No Change 2017-02-01 2019-03-01 Human Tissue NCC04 Femoral Shaft (Freeze Dried) - various sizes NAA 3 277310 0 0 2248 No Change 2017-02-01 2019-03-01 Human Tissue NCC05 Fibular Ring (Frozen) - various sizes NAA 3 277310 0 0 1910 No Change 2017-02-01 2019-03-01 Human Tissue NCC06 Cervical Spacers – Lordotic Super Critical Fluid CO2Treated (Freeze Dried) 5mm – 9mm NAA 3 277310 0 0 1947 No Change 2017-02-01 2019-03-01 Human Tissue NCC07 Cervical Spacers - Lordotic (Freeze Dried) 5mm – 9mm NAA 3 277310 0 0 1910 No Change 2017-02-01 2019-03-01 Human Tissue NCC08 Femoral Head – Whole Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 3499 No Change 2017-02-01 2019-03-01 Human Tissue NCC09 HTO Wedge Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 1641 No Change 2017-02-01 2019-03-01 Human Tissue NCC10 Cortical Cancellous Block (Frozen) - various sizes NAA 3 277310 0 0 1592 No Change 2017-02-01 2019-03-01 Human Tissue QBB23 Femoral Shaft MAB 3 231769 0 0 2943 No Change 2005-10-31 2019-03-01 Human Tissue QBB25 Femur - Proximal half MAB 3 231769 0 0 3955 No Change 2005-10-31 2019-03-01 Human Tissue QBB27 Femoral Head MAB 3 231769 0 0 3353 No Change 2005-10-31 2019-03-01 Human Tissue QBB28 Femoral Head - Freeze Dried MAB 3 231769 0 0 3353 No Change 2005-10-31 2019-03-01 Human Tissue QBB30 Femoral Rings MAB 3 231769 0 0 2084 No Change 2005-10-31 2019-03-01 Human Tissue QBB31 Femoral Rings - Freeze Dried MAB 3 0 0 740 No Change 2005-10-31 2019-03-01 Human Tissue QBB32 Fibula - Entire MAB 3 231769 0 0 3473 No Change 2005-10-31 2019-03-01 Human Tissue QBB33 Hemipelvis - Acetabulum MAB 3 231769 0 0 3617 No Change 2005-10-31 2019-03-01 Human Tissue QBB34 Hemipelvis - iliac crest MAB 3 231769 0 0 3245 No Change 2005-10-31 2019-03-01 Human Tissue QBB35 Hemipelvis - Tricortical iliac wedge MAB 3 231769 0 0 1855 No Change 2005-10-31 2019-03-01 Human Tissue QBB36 Hemipelvis - Tricortical iliac wedge Freeze Dried MAB 3 231769 0 0 906 No Change 2005-10-31 2019-03-01 Human Tissue QBB37 Hemipelvis - Complete MAB 3 231769 0 0 5590 No Change 2005-10-31 2019-03-01 Human Tissue QBB39 Humeral Shaft MAB 3 231769 0 0 2111 No Change 2005-10-31 2019-03-01 Human Tissue QBB43 Humerus - Entire MAB 3 231769 0 0 3975 No Change 2005-10-31 2019-03-01 Human Tissue QHV04 Patch - Tricuspid MAB 6 0 0 2373 No Change 2005-10-31 2019-03-01 Human Tissue QHV05 Patch - Pericardium MAB 6 0 0 2607 No Change 2005-10-31 2019-03-01 Human Tissue QHV07 Conduit - Pulmonary large MAB 6 0 0 2607 No Change 2005-10-31 2019-03-01 Human Tissue QHV08 Conduit - Pulmonary + Valve MAB 6 0 0 8986 No Change 2005-10-31 2019-03-01 Human Tissue QHV09 Conduit - Aortic + Valve MAB 6 0 0 8577 No Change 2005-10-31 2019-03-01 Human Tissue QHV10 Valve - Mitral MAB 6 0 0 8577 No Change 2009-02-01 2019-03-01 Human Tissue QHV11 Thoracic Aorta MAB 6 0 0 2607 No Change 2009-02-01 2019-03-01 Human Tissue RNB01 Femoral Head RNB 3 0 0 2500 No Change 2005-10-31 2019-03-01 Human Tissue RNB02 Autologous Skull Flap RNB 3 0 0 1470 No Change 2008-07-01 2019-03-01 Human Tissue RPH01 Valve - Aortic RPH 6 0 0 6406 No Change 2005-10-31 2019-03-01 Human Tissue RPH02 Valve - Pulmonary RPH 6 0 0 6406 No Change 2005-10-31 2019-03-01 Human Tissue SAE01 Cornea SAE 41 0 0 2600 No Change 2005-10-31 2019-03-01 Human Tissue SAE02 Sclera SAE 41 0 0 290 No Change 2005-10-31 2019-03-01 Human Tissue SAE03 Cornea for Endothelial Keratoplasty SAE 41 0 0 3350 No Change 2014-02-01 2019-03-01 Human Tissue SHV01 Valve - Aortic SHV 6 246032 0 0 8953 No Change 2005-10-31 2019-03-01 Human Tissue SHV02 Valve - Pulmonary SHV 6 246032 0 0 8953 No Change 2005-10-31 2019-03-01 Human Tissue SHV03 Conduit - Arterial SHV 6 246032 0 0 3367 No Change 2007-06-01 2019-03-01 Human Tissue PBT25 Fibula - Entire PBT 3 0 0 3500 No Change 2005-10-31 2019-03-01 Human Tissue PBT28 Fibula - Segment PBT 3 229915 0 0 3250 No Change 2005-10-31 2019-03-01 Human Tissue PBT29 Hemipelvis - Acetabulum PBT 3 229915 0 0 3150 No Change 2005-10-31 2019-03-01 Human Tissue PBT30 Hemipelvis - Complete PBT 3 0 0 7000 No Change 2005-10-31 2019-03-01 Human Tissue PBT31 Hemipelvis - iliac crest PBT 3 229915 0 0 3250 No Change 2005-10-31 2019-03-01 Human Tissue PBT32 Hemipelvis - Tricortical iliac wedge PBT 3 0 0 1500 No Change 2005-10-31 2019-03-01 Human Tissue PBT33 Humerus - Entire with rotator cuff PBT 3 229915 0 0 5000 No Change 2005-10-31 2019-03-01 Human Tissue PBT34 Humerus - Proximal with rotator cuff PBT 3 0 0 4200 No Change 2005-10-31 2019-03-01 Human Tissue PBT35 Humerus - Proximal PBT 3 0 0 2800 No Change 2005-10-31 2019-03-01 Human Tissue PBT37 Bone - Milled <30g Freeze Dried PBT 3 0 0 750 No Change 2005-10-31 2019-03-01 Human Tissue PBT38 Bone - Milled 30-50g Freeze Dried PBT 3 0 0 900 No Change 2005-10-31 2019-03-01 Human Tissue PBT40 Patellar unit whole with or without tibial block PBT 3 229915 0 0 3250 No Change 2005-10-31 2019-03-01 Human Tissue PBT41 Rib (5cm) PBT 3 0 0 300 No Change 2005-10-31 2019-03-01 Human Tissue PBT44 Tibia - Proximal with Patella & Tendon PBT 3 0 0 5000 No Change 2005-10-31 2019-03-01 Human Tissue QBB45 Bone - Milled 20g MAB 3 231769 0 0 2609 No Change 2005-10-31 2019-03-01 Human Tissue QBB47 Patella MAB 3 0 0 972 No Change 2005-10-31 2019-03-01 Human Tissue QBB48 Tendon - Patellar MAB 3 231769 0 0 2691 No Change 2005-10-31 2019-03-01 Human Tissue QBB51 Tibia - Distal MAB 3 231769 0 0 2479 No Change 2005-10-31 2019-03-01 Human Tissue QBB52 Cortical Strut MAB 3 0 0 543 No Change 2005-10-31 2019-03-01 Human Tissue QBB53 Tibia Shaft MAB 3 231769 0 0 1299 No Change 2005-10-31 2019-03-01 Human Tissue QBB54 Tibia - Proximal MAB 3 231769 0 0 3098 No Change 2005-10-31 2019-03-01 Human Tissue QBB55 Tibia - Whole MAB 3 231769 0 0 5564 No Change 2005-10-31 2019-03-01 Human Tissue QBB56 Autologous Skull Flap - processed MAB 3 0 0 2450 No Change 2009-02-01 2019-03-01 Human Tissue QBB57 Tendon - Tibialis Posterior MAB 3 231769 0 0 2517 No Change 2009-02-01 2019-03-01 Human Tissue QBB58 Tendon - Tibialis Anterior MAB 3 231769 0 0 2517 No Change 2009-02-01 2019-03-01 Human Tissue QBB59 Tendon - Gracilis MAB 3 231769 0 0 2517 No Change 2009-02-01 2019-03-01 Human Tissue QBB60 Autologous Skull Flap MAB 3 231769 0 0 733 No Change 2009-02-01 2019-03-01 Human Tissue QBB61 Femoral Head - Autologous MAB 3 0 0 2667 No Change 2009-02-01 2019-03-01 Human Tissue QBB62 Tendon - Achilles MAB 3 0 0 2370 No Change 2009-02-01 2019-03-01 Human Tissue QBB63 Tendon - Patellar Hemi MAB 3 231769 0 0 2056 No Change 2009-02-01 2019-03-01 Human Tissue QBB64 Tibia - Whole with Patella MAB 3 231769 0 0 5590 No Change 2009-02-01 2019-03-01 Human Tissue QBB65 Tendon - Achilles Hemi MAB 3 231769 0 0 1878 No Change 2009-02-01 2019-03-01 Human Tissue QBB66 Femoral Shaft - Freeze Dried MAB 3 0 0 3106 No Change 2009-02-01 2019-03-01 Human Tissue PBT45 Tibia - Proximal PBT 3 229915 0 0 3250 No Change 2005-10-31 2019-03-01 Human Tissue PBT46 Tendon - Single (ant and post tibilias, FDL, EDL, hamstring, gracilis) PBT 3 229915 0 0 3800 No Change 2005-10-31 2019-03-01 Human Tissue PBT47 Meniscal Graft PBT 3 0 0 1921 No Change 2005-10-31 2019-03-01 Human Tissue PBT48 Cortical Strut >20cm PBT 3 229915 0 0 3700 No Change 2005-10-31 2019-03-01 Human Tissue PBT60 Osteotomy Wedge PBT 3 229915 0 0 3250 No Change 2010-02-01 2019-03-01 Human Tissue PBT61 Tendon - Achilles PBT 3 229915 0 0 3200 No Change 2010-02-01 2019-03-01 Human Tissue PBT62 Bone - Milled <5 gr (<10cc equivalent) PBT 3 229915 0 0 1650 No Change 2014-02-01 2019-03-01 Human Tissue PBT63 Bone - Milled 5-9 gr (10-18cc equivalent) PBT 3 229915 0 0 2650 No Change 2014-02-01 2019-03-01 Human Tissue PBT64 Bone - Milled 10-19 gr (20-38cc equivalent) PBT 3 229915 0 0 3350 No Change 2014-02-01 2019-03-01 Human Tissue PBT65 Proximal Femur with Femoral Head PBT 3 0 0 6300 No Change 2014-08-01 2019-03-01 Human Tissue PBT66 Milled Bone Pellets (x3) PBT 3 229915 0 0 3800 No Change 2016-08-01 2019-03-01 Human Tissue QBB01 Tendon - Achilles with bone block MAB 3 231769 0 0 2517 No Change 2005-10-31 2019-03-01 Human Tissue QBB67 Bone - Ronguered Chips Freeze Dried MAB 3 0 0 3113 No Change 2009-02-01 2019-03-01 Human Tissue QBB68 Bone - Ronguered Chips MAB 3 0 0 2494 No Change 2009-02-01 2019-03-01 Human Tissue QBB69 Tendon - EHL MAB 3 231769 0 0 2517 No Change 2009-02-01 2019-03-01 Human Tissue QBB70 Tendon - Semitendinosus MAB 3 231769 0 0 2517 No Change 2009-02-01 2019-03-01 Human Tissue QBB71 Skin 50cm² - frozen skin graft from human origin MAB 28 230058 0 0 291 No Change 2013-02-01 2019-03-01 Human Tissue QBB72 Skin 100cm² - frozen skin graft from human origin MAB 28 230058 0 0 560 No Change 2013-02-01 2019-03-01 Human Tissue QBB73 Skin 200cm² - frozen skin graft from human origin MAB 28 230058 0 0 827 No Change 2013-02-01 2019-03-01 Human Tissue QBB74 Demineralised bone matrix 5g MAB 3 231769 0 0 1697 No Change 2017-02-01 2019-03-01 Human Tissue QBB75 Demineralised bone matrix 2g MAB 3 231769 0 0 1075 No Change 2017-02-01 2019-03-01 Human Tissue QBB76 Engineered Bone QBB 3 0 0 4150 No Change 2018-02-01 2019-03-01 Human Tissue QBB77 Milled Bone <15g QBB 3 0 0 2088 No Change 2018-02-01 2019-03-01 Human Tissue QBB78 Demineralised Bone Matrix 1 g QBB 3 0 0 891 No Change 2018-02-01 2019-03-01 Human Tissue QEB01 Cornea MAB 41 0 0 2710 No Change 2005-10-31 2019-03-01 Human Tissue QEB02 Sclera MAB 41 0 0 349 No Change 2005-10-31 2019-03-01 Human Tissue QHV01 Valve - Aortic MAB 6 0 0 8986 No Change 2005-10-31 2019-03-01 Human Tissue QHV02 Valve - Pulmonary MAB 6 0 0 8986 No Change 2005-10-31 2019-03-01 Human Tissue QHV03 Patch - Mitral MAB 6 0 0 2373 No Change 2005-10-31 2019-03-01 Human Tissue QBB02 Tibial Shaft Freeze Dried MAB 3 231769 0 0 1143 No Change 2005-10-31 2019-03-01 Human Tissue QBB03 Bone - Milled 20g Freeze Dried MAB 3 231769 0 0 3306 No Change 2005-10-31 2019-03-01 Human Tissue QBB04 Disc - Freeze Dried MAB 3 231769 0 0 837 No Change 2005-10-31 2019-03-01 Human Tissue QBB05 Meniscus MAB 3 231769 0 0 1833 No Change 2005-10-31 2019-03-01 Human Tissue QBB08 Tibia - Proximal with Patella MAB 3 231769 0 0 3667 No Change 2005-10-31 2019-03-01 Human Tissue QBB09 Bone - Cancellous Cubes (6) Freeze Dried MAB 3 231769 0 0 2107 No Change 2005-10-31 2019-03-01 Human Tissue QBB10 Bone - Cancellous Strips (2) Freeze Dried MAB 3 231769 0 0 890 No Change 2005-10-31 2019-03-01 Human Tissue QBB11 Fascia Lata - per sq cm MAB 3 231769 0 0 7 No Change 2005-10-31 2019-03-01 Human Tissue QBB12 Cartilage - costal segments MAB 3 231769 0 0 259 No Change 2005-10-31 2019-03-01 Human Tissue QBB14 Elbow - joint MAB 3 231769 0 0 2889 No Change 2005-10-31 2019-03-01 Human Tissue QBB15 Radius MAB 3 231769 0 0 2957 No Change 2005-10-31 2019-03-01 Human Tissue QBB16 Ulna MAB 3 231769 0 0 2957 No Change 2005-10-31 2019-03-01 Human Tissue QBB20 Femur - Distal Half MAB 3 231769 0 0 3667 No Change 2005-10-31 2019-03-01 Human Tissue QBB22 Femur - Entire MAB 3 231769 0 0 5590 No Change 2005-10-31 2019-03-01 Human Tissue NCC19 Morsellised Bone (Freeze Dried) Packs of 5 – 10cc NAA 3 277310 0 0 2281 No Change 2017-02-01 2019-03-01 Human Tissue NCC20 Cervical Spacers – Lordotic Super Critical Fluid CO2Treated (Frozen) 5mm – 9mm NAA 3 277310 0 0 1947 No Change 2017-02-01 2019-03-01 Human Tissue NCC21 Tibial Strut Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 3329 No Change 2017-02-01 2019-03-01 Human Tissue NCC22 Patella Tendon with Bone Block – Whole with Quads – Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 2967 No Change 2017-02-01 2019-03-01 Human Tissue NCC23 Malleable Bone Segments (Freeze Dried) various sizes NAA 3 277310 0 0 2422 No Change 2017-02-01 2019-03-01 Human Tissue NCC24 Achilles Tendon with Pre-Shaped Bone Block Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 3707 No Change 2017-02-01 2019-03-01 Human Tissue NCC25 Humerus – Strut Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 2574 No Change 2017-02-01 2019-03-01 Human Tissue NCC26 Humeral Head – Whole Super Critical Fluid CO2 Treated, (Freeze Dried) NAA 3 277310 0 0 2099 No Change 2017-02-01 2019-03-01 Human Tissue NCC27 Cancellous Dowel - Frozen - various sizes NAA 3 277310 0 0 1632 No Change 2017-02-01 2019-03-01 Human Tissue NCC28 Cortical Segment Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 3206 No Change 2017-02-01 2019-03-01 Human Tissue NCC29 Hemipelvis – Segment Super Critical Fluid CO2 Treated (Freeze Dried) NAA 3 277310 0 0 1623 No Change 2017-02-01 2019-03-01 Human Tissue NCC30 Femoral Shaft Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 2292 No Change 2017-02-01 2019-03-01 Human Tissue NCC31 Tibia – Proximal (Freeze Dried) - various sizes NAA 3 277310 0 0 3400 No Change 2017-02-01 2019-03-01 Human Tissue NCC32 Humerus – Shaft Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 4198 No Change 2017-02-01 2019-03-01 Human Tissue NCC33 Hemipelvis – Whole Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 8832 No Change 2017-02-01 2019-03-01 Human Tissue NCC34 Femoral Condyle Whole (Frozen) Super Critical Fluid CO2 Treated NAA 3 277310 0 0 3541 No Change 2017-02-01 2019-03-01 Human Tissue NCC35 Cortical Segment Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 3206 No Change 2017-02-01 2019-03-01 Human Tissue NCC36 Malleable Bone Segments (Frozen) - various sizes NAA 3 277310 0 0 2422 No Change 2017-02-01 2019-03-01 Human Tissue NCC37 Cervical Spacers - Parallel Super Critical Fluid CO2 Treated (Freeze Dried) 5mm – 9mm NAA 3 277310 0 0 1947 No Change 2017-02-01 2019-03-01 Human Tissue NCC38 Semitendonosis Tendon Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 2968 No Change 2017-02-01 2019-03-01 Human Tissue NCC39 Femoral Strut Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 3775 No Change 2017-02-01 2019-03-01 Human Tissue NCC40 Cervical Spacers - Parallel Super Critical Fluid CO2Treated (Frozen) 5mm – 9mm NAA 3 277310 0 0 1947 No Change 2017-02-01 2019-03-01 Human Tissue NCC41 Morsellised Bone Super Critical Fluid CO2 Treated (Freeze Dried) Packs of 15 – 30cc NAA 3 277310 0 0 2580 No Change 2017-02-01 2019-03-01 Human Tissue NCC42 Hemipelvis – Segment (Frozen) - various sizes NAA 3 277310 0 0 1592 No Change 2017-02-01 2019-03-01 Human Tissue NCC43 Morsellised Bone (Freeze Dried) Packs of 15 – 30cc NAA 3 277310 0 0 2531 No Change 2017-02-01 2019-03-01 Human Tissue NCC44 Malleable Bone Segments Super Critical Fluid CO2Treated (Freeze Dried) NAA 3 277310 0 0 3541 No Change 2017-02-01 2019-03-01 Human Tissue NCC45 Femoral Condyle Whole (Freeze Dried) - various sizes NAA 3 277310 0 0 3473 No Change 2017-02-01 2019-03-01 Human Tissue NCC46 Femoral Head – Hemi (Freeze Dried) - various sizes NAA 3 277310 0 0 3499 No Change 2017-02-01 2019-03-01 Human Tissue NCC47 Tibial Strut (Frozen) - various sizes NAA 3 277310 0 0 3265 No Change 2017-02-01 2019-03-01 Human Tissue NCC48 Hemipelvis – Segment Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 1623 No Change 2017-02-01 2019-03-01 Human Tissue NCC49 Cortical Segment (Freeze Dried) - various sizes NAA 3 277310 0 0 3145 No Change 2017-02-01 2019-03-01 Human Tissue NCC50 Humerus – Proximal Super Critical Fluid CO2 Treated (Freeze Dried) NAA 3 277310 0 0 3762 No Change 2017-02-01 2019-03-01 Human Tissue NCC51 HTO Wedge (Freeze Dried) - Various sizes NAA 3 277310 0 0 1610 No Change 2017-02-01 2019-03-01 Human Tissue NCC52 Tibia – Proximal Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 3466 No Change 2017-02-01 2019-03-01 Human Tissue NCC53 Cervical Spacers - Lordotic (Frozen) 5mm – 9mm NAA 3 277310 0 0 1910 No Change 2017-02-01 2019-03-01 Human Tissue NCC54 Cancellous Block (Freeze Dried) - various sizes NAA 3 277310 0 0 1632 No Change 2017-02-01 2019-03-01 Human Tissue NCC55 Morsellised Bone 2.5-5mg NAA 3 277310 0 0 2132 No Change 2017-02-01 2019-03-01 Human Tissue NCC56 Cortical Ring (Frozen) 5mm – 9mm NAA 3 277310 0 0 1910 No Change 2017-02-01 2019-03-01 Human Tissue NCC57 Femoral Condyle Whole – Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 3086 No Change 2017-02-01 2019-03-01 Human Tissue NCC58 Humerus – Strut (Frozen) - various sizes NAA 3 277310 0 0 2525 No Change 2017-02-01 2019-03-01 Human Tissue NCC59 Cervical Spacers - Parrallell (frozen) 5mm – 9mm NAA 3 277310 0 0 1910 No Change 2017-02-01 2019-03-01 Human Tissue NCC60 Achilles Tendon Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 2611 No Change 2017-02-01 2019-03-01 Human Tissue NCC61 Hemipelvis – Segment (Freeze Dried) - various sizes NAA 3 277310 0 0 1592 No Change 2017-02-01 2019-03-01 Human Tissue NCC62 Femoral Head – Hemi Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 3499 No Change 2017-02-01 2019-03-01 Human Tissue NCC63 Cortical Strut Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 2574 No Change 2017-02-01 2019-03-01 Human Tissue NCC64 Humerus – Distal Segment (Freeze Dried) - various sizes NAA 3 277310 0 0 3145 No Change 2017-02-01 2019-03-01 Human Tissue NCC65 Femoral Ring (Freeze Dried) - various sizes NAA 3 277310 0 0 2140 No Change 2017-02-01 2019-03-01 Human Tissue PBT01 Tendon - Achilles with bone block PBT 3 229915 0 0 3800 No Change 2005-10-31 2019-03-01 Human Tissue PBT02 Tendon - Patellar split with bone plugs PBT 3 229915 0 0 3250 No Change 2005-10-31 2019-03-01 Human Tissue PBT03 Bone Plug/Dowel - Cancellous PBT 3 229915 0 0 3800 No Change 2005-10-31 2019-03-01 Human Tissue PBT06 Cortical Struts 10-15cm PBT 3 229915 0 0 3300 No Change 2005-10-31 2019-03-01 Human Tissue PBT07 Cortical Strut >15 - 20cm PBT 3 229915 0 0 3500 No Change 2005-10-31 2019-03-01 Human Tissue PBT08 Bone - Milled 20-29gr (40-58cc equivalent) PBT 3 229915 0 0 4050 No Change 2005-10-31 2019-03-01 Human Tissue PBT09 Bone - Milled 30 - 50gr (60 - 100cc equivalent) PBT 3 229915 0 0 4650 No Change 2005-10-31 2019-03-01 Human Tissue PBT10 Bone - Milled >50gr (100cc equivalent) PBT 3 229915 0 0 4950 No Change 2005-10-31 2019-03-01 Human Tissue PBT11 Cartilage - costal segments PBT 3 0 0 300 No Change 2005-10-31 2019-03-01 Human Tissue PBT13 Radius PBT 3 0 0 1800 No Change 2005-10-31 2019-03-01 Human Tissue PBT14 Ulna PBT 3 0 0 1500 No Change 2005-10-31 2019-03-01 Human Tissue PBT15 Fascia Lata - Large (15cm x 10cm) PBT 3 0 0 1590 No Change 2005-10-31 2019-03-01 Human Tissue PBT16 Fascia Lata - Small (10cm x 5cm) PBT 3 0 0 854 No Change 2005-10-31 2019-03-01 Human Tissue PBT17 Femur - Distal (Shaft & Condyles) PBT 3 0 0 4220 No Change 2005-10-31 2019-03-01 Human Tissue PBT18 Femur - Entire head removed PBT 3 0 0 8000 No Change 2005-10-31 2019-03-01 Human Tissue PBT19 Femoral Shaft/Tibial Shaft - Middle third PBT 3 0 0 3200 No Change 2005-10-31 2019-03-01 Human Tissue PBT20 Femur - Proximal (shaft, trochanter, neck) PBT 3 0 0 4220 No Change 2005-10-31 2019-03-01 Human Tissue PBT21 Femoral Hemi-condyle PBT 3 0 0 2900 No Change 2005-10-31 2019-03-01 Human Tissue PBT22 Femoral Head PBT 3 229915 0 0 3800 No Change 2005-10-31 2019-03-01 Human Tissue PBT24 Femoral Rings PBT 3 0 0 1800 No Change 2005-10-31 2019-03-01 Human Tissue SYN01 Bone - Demineralised Bone Matrix, DBX Putty, 5cc JAA 3 0 0 2650 No Change 2013-08-01 2019-03-01 Human Tissue SYN02 Bone - Demineralised Bone Matrix, DBX Putty, 10cc JAA 3 0 0 3400 No Change 2013-08-01 2019-03-01 Human Tissue SYN03 Skin < 25cm² - acellular dermal matrix allograft from human origin JAA 28 0 0 2200 No Change 2013-08-01 2019-03-01 Human Tissue SYN04 Skin 26 to 60cm² - acellular dermal matrix allograft from human origin JAA 28 0 0 3500 No Change 2013-08-01 2019-03-01 Human Tissue SYN05 Skin 61 to 120cm² - acellular dermal matrix allograft from human origin JAA 28 0 0 5700 No Change 2013-08-01 2019-03-01 Human Tissue SYN06 Skin 181 to 300cm² - acellular dermal matrix allograft from human origin JAA 28 211608 0 0 14000 No Change 2013-08-01 2019-03-01 Human Tissue SYN07 Skin > 300cm² - acellular dermal matrix allograft from human origin JAA 28 0 0 27000 No Change 2013-08-01 2019-03-01 Human Tissue SYN08 DBX Putty - 1.00cc JAA 3 0 0 1450 No Change 2014-08-01 2019-03-01 Human Tissue SYN09 DBX Putty - 2.5cc JAA 3 0 0 1800 No Change 2014-08-01 2019-03-01 Human Tissue SYN10 Bone, Cancellous Chips - 15cc JAA 3 0 0 1250 No Change 2015-08-01 2019-03-01 Human Tissue SYN11 Bone, Cancellous Granules - 15cc JAA 3 0 0 1250 No Change 2015-08-01 2019-03-01 Human Tissue SYN12 Bone, Cancellous Chips - 30cc JAA 3 0 0 1700 No Change 2015-08-01 2019-03-01 Human Tissue SYN13 Bone, Cancellous Granules - 30cc JAA 3 0 0 1700 No Change 2015-08-01 2019-03-01 Human Tissue SYN14 Skin 121 to 180cm² - acellular dermal matrix allograft from human origin JAA 28 211608 0 0 9900 No Change 2017-08-01 2019-03-01 Human Tissue TBV01 Valve - Aortic TBV 6 236613 0 0 9131 No Change 2005-10-31 2019-03-01 Human Tissue TBV02 Valve - Pulmonary TBV 6 236613 0 0 9131 No Change 2005-10-31 2019-03-01 Human Tissue TBV03 Conduit - Pulmonary TBV 6 236613 0 0 1972 No Change 2005-10-31 2019-03-01 Human Tissue TBV05 Tendon - Achilles TBV 3 238244 0 0 1916 No Change 2005-10-31 2019-03-01 Human Tissue TBV06 Tendon - Achilles with bone block TBV 3 238244 0 0 3344 No Change 2005-10-31 2019-03-01 Human Tissue TBV07 Bone Plug/Dowel - Cancellous TBV 3 238244 0 0 1219 No Change 2005-10-31 2019-03-01 Human Tissue TBV08 Bone Plug/Dowel - Tricortical TBV 3 238244 0 0 1295 No Change 2005-10-31 2019-03-01 Human Tissue AAA01 Humerus – Shaft Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 4128 No Change 2017-02-01 2019-03-01 Human Tissue AAA02 Femoral Ring AAA 3 277310 0 0 2277 No Change 2017-02-01 2019-03-01 Human Tissue AAA03 Femur – Distal Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 3471 No Change 2017-02-01 2019-03-01 Human Tissue AAA04 Tibia – Whole Super Critical Fluid CO2 Treated AAA 3 277310 0 0 7342 No Change 2017-02-01 2019-03-01 Human Tissue AAA05 Tendon Patch Super Critical Fluid CO2 Treated AAA 3 277310 0 0 4000 No Change 2017-02-01 2019-03-01 Human Tissue AAA06 Peroneus Longus Tendon AAA 3 277310 0 0 3125 No Change 2017-02-01 2019-03-01 Human Tissue AAA07 Tibia – Distal Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3471 No Change 2017-02-01 2019-03-01 Human Tissue AAA08 Radius – Whole AAA 3 277310 0 0 3541 No Change 2017-02-01 2019-03-01 Human Tissue AAA09 Femoral Condyle Half – Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3016 No Change 2017-02-01 2019-03-01 Human Tissue AAA10 Cancellous Cube – Super Critical Fluid CO2 Treated AAA 3 277310 0 0 1593 No Change 2017-02-01 2019-03-01 Human Tissue AAA11 Femoral Strut Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 3705 No Change 2017-02-01 2019-03-01 Human Tissue AAA12 Femur – Distal Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3471 No Change 2017-02-01 2019-03-01 Human Tissue AAA13 Cortical Sheet Super Critical Fluid CO2 Treated AAA 3 277310 0 0 1708 No Change 2017-02-01 2019-03-01 Human Tissue AAA14 Morsellised Bone (10-20 cc/g) AAA 3 277310 0 0 2707 No Change 2017-02-01 2019-03-01 Human Tissue AAA15 Cortical Cancellous Block AAA 3 277310 0 0 1674 No Change 2017-02-01 2019-03-01 Human Tissue AAA16 Peroneus Longus Tendon Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3187 No Change 2017-02-01 2019-03-01 Human Tissue AAA17 Humerus – Distal Segment Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 3136 No Change 2017-02-01 2019-03-01 Human Tissue AAA18 Humerus – Proximal (Freeze Dried) AAA 3 277310 0 0 3620 No Change 2017-02-01 2019-03-01 Human Tissue AAA19 Cortical Sheet AAA 3 277310 0 0 1522 No Change 2017-02-01 2019-03-01 Human Tissue AAA20 Tibial Strut Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3259 No Change 2017-02-01 2019-03-01 Human Tissue AAA21 Femoral Strut AAA 3 277310 0 0 3996 No Change 2017-02-01 2019-03-01 Human Tissue AAA22 Cancellous Cube – Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 1593 No Change 2017-02-01 2019-03-01 Human Tissue AAA23 Femur – Whole AAA 3 277310 0 0 9013 No Change 2017-02-01 2019-03-01 Human Tissue AAA24 Unicortical Cancellous Block Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 1553 No Change 2017-02-01 2019-03-01 Human Tissue TBV22 Femur - Distal (Shaft & Condyles) TBV 3 238244 0 0 5274 No Change 2005-10-31 2019-03-01 Human Tissue TBV23 Femur - Entire TBV 3 238244 0 0 8609 No Change 2005-10-31 2019-03-01 Human Tissue TBV24 Femoral Shaft - Middle Third TBV 3 238244 0 0 3072 No Change 2005-10-31 2019-03-01 Human Tissue TBV25 Femur - Proximal (shaft, trochanter, neck) TBV 3 238244 0 0 5238 No Change 2005-10-31 2019-03-01 Human Tissue TBV26 Femoral head TBV 3 238244 0 0 3415 No Change 2005-10-31 2019-03-01 Human Tissue TBV27 Fibula - Entire TBV 3 238244 0 0 8310 No Change 2005-10-31 2019-03-01 Human Tissue TBV28 Fibula - Segment (6cm) TBV 3 238244 0 0 1219 No Change 2005-10-31 2019-03-01 Human Tissue TBV29 Fibula - Segment (12cm) TBV 3 238244 0 0 1687 No Change 2005-10-31 2019-03-01 Human Tissue TBV30 Fibular Shaft TBV 3 238244 0 0 3146 No Change 2005-10-31 2019-03-01 Human Tissue TBV31 Hemipelvis - Acetabulum TBV 3 238244 0 0 4169 No Change 2005-10-31 2019-03-01 Human Tissue TBV44 Tibia - Proximal 7-15cm TBV 3 238244 0 0 3618 No Change 2005-10-31 2019-03-01 Human Tissue TBV45 Tibia - Proximal 16-25cm TBV 3 238244 0 0 3498 No Change 2005-10-31 2019-03-01 Human Tissue TBV46 Femoral Hemi-condyle TBV 3 238244 0 0 1880 No Change 2005-10-31 2019-03-01 Human Tissue TBV47 Tibia - Condyles only TBV 3 238244 0 0 2463 No Change 2005-10-31 2019-03-01 Human Tissue TBV48 Tibia - Distal TBV 3 238244 0 0 3124 No Change 2005-10-31 2019-03-01 Human Tissue TBV49 Humerus - Distal TBV 3 238244 0 0 3206 No Change 2005-10-31 2019-03-01 Human Tissue TBV50 Pericardium TBV 6 236613 0 0 2400 No Change 2005-10-31 2019-03-01 Human Tissue TBV43 Rib (5cm) TBV 3 238244 0 0 957 No Change 2005-10-31 2019-03-01 Human Tissue TBV51 Femur - Proximal with femoral head TBV 3 238244 0 0 5093 No Change 2005-10-31 2019-03-01 Human Tissue TBV52 Bone - Cancellous Bone Matrix, Lyophilised 40cc TBV 3 238244 0 0 3232 No Change 2007-07-01 2019-03-01 Human Tissue TBV53 Bone - Cancellous Bone Matrix, Lyophilised 80cc TBV 3 238244 0 0 3657 No Change 2007-07-01 2019-03-01 Human Tissue TBV54 Bone - Demineralised Bone Matrix, Lyophilised 5cc TBV 3 238244 0 0 1557 No Change 2007-12-01 2019-03-01 Human Tissue TBV55 Bone - Demineralised Bone Matrix, Lyophilised 10cc TBV 3 238244 0 0 2306 No Change 2007-12-01 2019-03-01 Human Tissue TBV56 Conduit - Aortic TBV 6 236613 0 0 1972 No Change 2009-08-01 2019-03-01 Human Tissue TBV57 Tendon - Tibialis Anterior TBV 3 238244 0 0 3344 No Change 2009-08-01 2019-03-01 Human Tissue TBV58 Tendon - Semitendinosus TBV 3 238244 0 0 3344 No Change 2017-02-01 2019-03-01 Human Tissue TBV59 Tendon - Peroneus Longus TBV 3 238244 0 0 3344 No Change 2017-02-01 2019-03-01 Human Tissue TBV60 Tendon - EHL TBV 3 238244 0 0 3344 No Change 2017-02-01 2019-03-01 Human Tissue TBV61 Tendon - Tibialis Posterior TBV 3 238244 0 0 3344 No Change 2017-02-01 2019-03-01 Human Tissue AAA25 Patella Tendon with Bone Block – Whole with Quads AAA 3 277310 0 0 3804 No Change 2017-02-01 2019-03-01 Human Tissue AAA26 Bone Dowel / Plug Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 1593 No Change 2017-02-01 2019-03-01 Human Tissue AAA27 Achilles Tendon with Pre-Shaped Bone Block Super Critical Fluid CO2 Treated AAA 3 277310 0 0 4001 No Change 2017-02-01 2019-03-01 Human Tissue AAA28 Morsellised Bone (Freeze Dried) (6-10cc) AAA 3 277310 0 0 2707 No Change 2017-02-01 2019-03-01 Human Tissue AAA29 Humerus – Proximal Super Critical Fluid CO2 Treated AAA 3 277310 0 0 4061 No Change 2017-02-01 2019-03-01 Human Tissue AAA30 Femoral Strut (Freeze Dried) AAA 3 277310 0 0 3633 No Change 2017-02-01 2019-03-01 Human Tissue AAA31 Humeral Head – Whole Super Critical Fluid CO2 Treated, (Freeze Dried) AAA 3 277310 0 0 2029 No Change 2017-02-01 2019-03-01 Human Tissue AAA32 Cervical Spacers - Parrallel AAA 3 277310 0 0 1840 No Change 2017-02-01 2019-03-01 Human Tissue AAA33 Hemipelvis – Segment (Freeze Dried) AAA 3 277310 0 0 1522 No Change 2017-02-01 2019-03-01 Human Tissue AAA34 Fibula – Whole Super Critical Fluid CO2 Treated AAA 3 277310 0 0 8138 No Change 2017-02-01 2019-03-01 Human Tissue AAA35 Cancellous Plug Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 1593 No Change 2017-02-01 2019-03-01 Human Tissue AAA36 Cortical Ring AAA 3 277310 0 0 1840 No Change 2017-02-01 2019-03-01 Human Tissue AAA37 Humerus – Strut AAA 3 277310 0 0 2700 No Change 2017-02-01 2019-03-01 Human Tissue AAA38 HTO Wedge (Freeze Dried) AAA 3 277310 0 0 1540 No Change 2017-02-01 2019-03-01 Human Tissue AAA39 Morsellised Bone Super Critical Fluid CO2 Treated (10-20g) AAA 3 277310 0 0 2761 No Change 2017-02-01 2019-03-01 Human Tissue AAA40 Patella Tendon with Bone Block – Whole Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3879 No Change 2017-02-01 2019-03-01 Human Tissue AAA41 Cortical Strut (Freeze Dried) AAA 3 277310 0 0 2455 No Change 2017-02-01 2019-03-01 Human Tissue AAA42 Femoral Shaft (Freeze Dried) AAA 3 277310 0 0 3271 No Change 2017-02-01 2019-03-01 Human Tissue TBV32 Hemipelvis - Complete TBV 3 238244 0 0 9035 No Change 2005-10-31 2019-03-01 Human Tissue TBV33 Hemipelvis - iliac crest TBV 3 238244 0 0 3802 No Change 2005-10-31 2019-03-01 Human Tissue TBV34 Hemipelvis - Tricortical iliac wedge TBV 3 238244 0 0 1668 No Change 2005-10-31 2019-03-01 Human Tissue TBV35 Humerus - Proximal with rotator cuff TBV 3 238244 0 0 3726 No Change 2005-10-31 2019-03-01 Human Tissue TBV36 Humerus - Proximal TBV 3 238244 0 0 3883 No Change 2005-10-31 2019-03-01 Human Tissue TBV37 Humeral Head TBV 3 238244 0 0 2453 No Change 2005-10-31 2019-03-01 Human Tissue TBV38 Ligament - Medial TBV 3 238244 0 0 2616 No Change 2005-10-31 2019-03-01 Human Tissue TBV39 Meniscus with Ligaments TBV 3 238244 0 0 3086 No Change 2005-10-31 2019-03-01 Human Tissue TBV40 Meniscus TBV 3 238244 0 0 1852 No Change 2005-10-31 2019-03-01 Human Tissue TBV41 Patella TBV 3 238244 0 0 1642 No Change 2005-10-31 2019-03-01 Human Tissue TBV42 Tendon - Patellar with bone plugs TBV 3 238244 0 0 3428 No Change 2005-10-31 2019-03-01 Human Tissue AAA43 Femoral Ring Super Critical CO2 Treated (Freeze Dried) AAA 3 277310 0 0 2112 No Change 2017-02-01 2019-03-01 Human Tissue AAA44 Femoral Head – Whole (Freeze Dried) AAA 3 277310 0 0 3430 No Change 2017-02-01 2019-03-01 Human Tissue TBV09 Bone - Chips/cubes 40cc TBV 3 238244 0 0 1532 No Change 2005-10-31 2019-03-01 Human Tissue TBV10 Bone - Chips/cubes 80cc TBV 3 238244 0 0 2659 No Change 2005-10-31 2019-03-01 Human Tissue TBV11 Bone - Milled 40cc TBV 3 238244 0 0 2231 No Change 2005-10-31 2019-03-01 Human Tissue TBV12 Bone - Milled 80cc TBV 3 238244 0 0 3470 No Change 2005-10-31 2019-03-01 Human Tissue TBV14 Cortical Strut TBV 3 238244 0 0 1312 No Change 2005-10-31 2019-03-01 Human Tissue TBV17 Cartilage - costal segments TBV 3 238244 0 0 833 No Change 2005-10-31 2019-03-01 Human Tissue TBV18 Elbow - joint TBV 3 238244 0 0 7059 No Change 2005-10-31 2019-03-01 Human Tissue TBV19 Radius TBV 3 238244 0 0 4327 No Change 2005-10-31 2019-03-01 Human Tissue TBV20 Ulna TBV 3 238244 0 0 4015 No Change 2005-10-31 2019-03-01 Human Tissue TBV21 Fascia Lata TBV 3 238244 0 0 1366 No Change 2005-10-31 2019-03-01 Human Tissue AAA51 Cortical Plate Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 1553 No Change 2017-02-01 2019-03-01 Human Tissue AAA52 Semitendonosis Tendon AAA 3 277310 0 0 3126 No Change 2017-02-01 2019-03-01 Human Tissue AAA53 Femoral Condyle Whole (Freeze Dried) AAA 3 277310 0 0 3403 No Change 2017-02-01 2019-03-01 Human Tissue AAA54 Cancellous Cube AAA 3 277310 0 0 1718 No Change 2017-02-01 2019-03-01 Human Tissue AAA55 Tibial Strut Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 3259 No Change 2017-02-01 2019-03-01 Human Tissue AAA56 Cancellous Plug Super Critical Fluid CO2 Treated AAA 3 277310 0 0 1593 No Change 2017-02-01 2019-03-01 Human Tissue AAA57 Gracilis Tendon Super Critical Fluid CO2 Treated AAA 3 277310 0 0 2445 No Change 2017-02-01 2019-03-01 Human Tissue AAA58 Cervical Spacers - Lordotic AAA 3 277310 0 0 1840 No Change 2017-02-01 2019-03-01 Human Tissue AAA59 Patella Tendon with Bone Block – Whole with Quads – Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3879 No Change 2017-02-01 2019-03-01 Human Tissue AAA60 Humerus – Shaft Super Critical Fluid CO2 Treated AAA 3 277310 0 0 4128 No Change 2017-02-01 2019-03-01 Human Tissue AAA61 Cortical Segment Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3135 No Change 2017-02-01 2019-03-01 Human Tissue AAA62 Humeral Head – Whole AAA 3 277310 0 0 2188 No Change 2017-02-01 2019-03-01 Human Tissue AAA63 Bone Dowel / Plug Super Critical Fluid CO2 Treated AAA 3 277310 0 0 1752 No Change 2017-02-01 2019-03-01 Human Tissue AAA64 Cancellous Block (Freeze Dried) AAA 3 277310 0 0 1562 No Change 2017-02-01 2019-03-01 Human Tissue AAA65 Tibia – Proximal (Freeze Dried) AAA 3 277310 0 0 3330 No Change 2017-02-01 2019-03-01 Human Tissue AAA66 Morsellised Bone (Freeze Dried) (1-5cc) AAA 3 277310 0 0 2432 No Change 2017-02-01 2019-03-01 Human Tissue AAA67 Cortical Strut Super Critical Fluid CO2 Treated AAA 3 277310 0 0 2504 No Change 2017-02-01 2019-03-01 Human Tissue AAA68 Malleable Bone Segments Super Critical Fluid CO2Treated AAA 3 277310 0 0 2400 No Change 2017-02-01 2019-03-01 Human Tissue TBV62 Bone – Cancellous Bone Matrix Lyophilised 20cc TBV 3 238244 0 0 2326 No Change 2017-08-01 2019-03-01 Human Tissue TBV63 Bone - Cancellous Bone Matrix Lyophilised 10cc TBV 3 238244 0 0 1963 No Change 2017-08-01 2019-03-01 Human Tissue AAA45 Cortical Ring (Freeze Dried) AAA 3 277310 0 0 1840 No Change 2017-02-01 2019-03-01 Human Tissue AAA46 Cortical Strut Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 2504 No Change 2017-02-01 2019-03-01 Human Tissue AAA47 Tibia – Proximal Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 3396 No Change 2017-02-01 2019-03-01 Human Tissue AAA48 Cancellous Plug (Freeze Dried) AAA 3 277310 0 0 1562 No Change 2017-02-01 2019-03-01 Human Tissue AAA49 Tibia – Proximal Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3396 No Change 2017-02-01 2019-03-01 Human Tissue AAA50 Ulna – Whole AAA 3 277310 0 0 4008 No Change 2017-02-01 2019-03-01 Human Tissue AAA69 Cervical Spacers - Parallel Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 1877 No Change 2017-02-01 2019-03-01 Human Tissue AAA70 Hemi Patella Tendon with Bone Block Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3879 No Change 2017-02-01 2019-03-01 Human Tissue AAA71 Semitendonosis Tendon Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3188 No Change 2017-02-01 2019-03-01 Human Tissue AAA72 Cortical Strut AAA 3 277310 0 0 2700 No Change 2017-02-01 2019-03-01 Human Tissue AAA73 Tricortical Cancellous Wedge AAA 3 277310 0 0 1674 No Change 2017-02-01 2019-03-01 Human Tissue AAA74 Bone Dowel / Plug AAA 3 277310 0 0 1562 No Change 2017-02-01 2019-03-01 Human Tissue AAA75 Anterior Tibialis Tendon AAA 3 277310 0 0 3125 No Change 2017-02-01 2019-03-01 Human Tissue AAA76 Tricortical Cancellous Wedge – Super Critical Fluid CO2 Treated AAA 3 277310 0 0 1553 No Change 2017-02-01 2019-03-01 Human Tissue AAA77 Cancellous Plug AAA 3 277310 0 0 1718 No Change 2017-02-01 2019-03-01 Human Tissue AAA88 Tendon Patch AAA 3 277310 0 0 3923 No Change 2017-02-01 2019-03-01 Human Tissue AAA89 Humerus – Distal Segment AAA 3 277310 0 0 3075 No Change 2017-02-01 2019-03-01 Human Tissue TBV64 Bone - Cancellous Bone Matrix Lyophilised 1 - 5cc TBV 3 238244 0 0 1495 No Change 2017-08-01 2019-03-01 Human Tissue AAA90 Morsellised Bone (1-4 cc/g) AAA 3 277310 0 0 2268 No Change 2017-02-01 2019-03-01 Human Tissue AAA91 Tibia – Distal Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 3471 No Change 2017-02-01 2019-03-01 Human Tissue AAA92 Bone Dowel / Plug (Freeze Dried) AAA 3 277310 0 0 1562 No Change 2017-02-01 2019-03-01 Human Tissue AAA93 Cortical Plate Super Critical Fluid CO2 Treated AAA 3 277310 0 0 1708 No Change 2017-02-01 2019-03-01 Human Tissue AAA94 Humerus – Proximal Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 3692 No Change 2017-02-01 2019-03-01 Human Tissue AAA95 Achilles Tendon with Bone Block AAA 3 277310 0 0 3923 No Change 2017-02-01 2019-03-01 Human Tissue AAA96 Femoral Head – Hemi Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3500 No Change 2017-02-01 2019-03-01 Human Tissue AAA97 Cortical Cancellous Block Super Critical Fluid CO2Treated (Freeze Dried) AAA 3 277310 0 0 1553 No Change 2017-02-01 2019-03-01 Human Tissue AAA98 Fibular Ring (Freeze Dried) AAA 3 277310 0 0 1840 No Change 2017-02-01 2019-03-01 Human Tissue AAA99 Cervical Spacers – Lordotic Super Critical Fluid CO2Treated (Freeze Dried) AAA 3 277310 0 0 1877 No Change 2017-02-01 2019-03-01 Human Tissue ABB01 Hemipelvis – Segment AAA 3 277310 0 0 1522 No Change 2017-02-01 2019-03-01 Human Tissue ABB02 Malleable Bone Segments Super Critical Fluid CO2Treated (Freeze Dried) AAA 3 277310 0 0 2400 No Change 2017-02-01 2019-03-01 Human Tissue ABB03 Cancellous Block Super Critical Fluid CO2 Treated AAA 3 277310 0 0 1593 No Change 2017-02-01 2019-03-01 Human Tissue ABB04 Tricortical Cancellous Wedge (Freeze Dried) AAA 3 277310 0 0 1522 No Change 2017-02-01 2019-03-01 Human Tissue ABB05 Fibula – Whole AAA 3 277310 0 0 8780 No Change 2017-02-01 2019-03-01 Human Tissue AAA78 Cervical Spacers - Parallel Super Critical Fluid CO2Treated 5mm-9mm AAA 3 277310 0 0 2065 No Change 2017-02-01 2019-03-01 Human Tissue AAA79 Humeral Head – Whole Super Critical Fluid CO2 Treated AAA 3 277310 0 0 2029 No Change 2017-02-01 2019-03-01 Human Tissue AAA80 Femur – Proximal Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 3705 No Change 2017-02-01 2019-03-01 Human Tissue AAA81 Tricortical Cancellous Wedge Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 1553 No Change 2017-02-01 2019-03-01 Human Tissue AAA82 HTO Wedge Super Critical Fluid CO2 Treated AAA 3 277310 0 0 1571 No Change 2017-02-01 2019-03-01 Human Tissue AAA83 Tibial Shaft AAA 3 277310 0 0 5416 No Change 2017-02-01 2019-03-01 Human Tissue AAA84 Tibia – Distal AAA 3 277310 0 0 3743 No Change 2017-02-01 2019-03-01 Human Tissue AAA85 Cortical Segment AAA 3 277310 0 0 3449 No Change 2017-02-01 2019-03-01 Human Tissue AAA86 Morsellised Bone – Super Critical Fluid CO2 Treated (1-4g) AAA 3 277310 0 0 2314 No Change 2017-02-01 2019-03-01 Human Tissue AAA87 Femoral Condyle Whole AAA 3 277310 0 0 3743 No Change 2017-02-01 2019-03-01 Human Tissue ABB46 Femoral Condyle Half (Freeze Dried) AAA 3 277310 0 0 2957 No Change 2017-02-01 2019-03-01 Human Tissue ABB47 Ulna – Whole Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3716 No Change 2017-02-01 2019-03-01 Human Tissue ABB48 Malleable Bone Segments (Freeze Dried) AAA 3 277310 0 0 2352 No Change 2017-02-01 2019-03-01 Human Tissue ABB49 Humerus – Shaft (Freeze Dried) AAA 3 277310 0 0 4048 No Change 2017-02-01 2019-03-01 Human Tissue ABB50 Unicortical Cancellous Block AAA 3 277310 0 0 1674 No Change 2017-02-01 2019-03-01 Human Tissue ABB51 Femur – Proximal (Freeze Dried) AAA 3 277310 0 0 3633 No Change 2017-02-01 2019-03-01 Human Tissue ABB52 Femur – Distal AAA 3 277310 0 0 3743 No Change 2017-02-01 2019-03-01 Human Tissue ABB53 Unicortical Cancellous Block Super Critical Fluid CO2 Treated AAA 3 277310 0 0 1553 No Change 2017-02-01 2019-03-01 Human Tissue ABB54 Radius – Whole Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3283 No Change 2017-02-01 2019-03-01 Human Tissue ABB06 Femoral Condyle Half – Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 3016 No Change 2017-02-01 2019-03-01 Human Tissue ABB07 Tibial Strut AAA 3 277310 0 0 3515 No Change 2017-02-01 2019-03-01 Human Tissue ABB08 Femoral Condyle Half AAA 3 277310 0 0 3253 No Change 2017-02-01 2019-03-01 Human Tissue ABB09 Cervical Spacers - Lordotic (Freeze Dried) AAA 3 277310 0 0 1840 No Change 2017-02-01 2019-03-01 Human Tissue ABB10 Fibular Ring Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 1877 No Change 2017-02-01 2019-03-01 Human Tissue ABB11 Posterior Tibialis Tendon Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3187 No Change 2017-02-01 2019-03-01 Human Tissue ABB12 Patella Tendon with Bone Blocks - Whole AAA 3 277310 0 0 3804 No Change 2017-02-01 2019-03-01 Human Tissue ABB13 Cortical Segment (Freeze Dried) AAA 3 277310 0 0 3075 No Change 2017-02-01 2019-03-01 Human Tissue ABB14 HTO Wedge AAA 3 277310 0 0 1694 No Change 2017-02-01 2019-03-01 Human Tissue ABB15 Humerus – Proximal AAA 3 277310 0 0 3620 No Change 2017-02-01 2019-03-01 Human Tissue ABB16 Femur – Whole Super Critical Fluid CO2 Treated AAA 3 277310 0 0 8354 No Change 2017-02-01 2019-03-01 Human Tissue ABB17 Humerus – Strut (Freeze Dried) AAA 3 277310 0 0 2455 No Change 2017-02-01 2019-03-01 Human Tissue ABB18 Humerus – Strut Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 2504 No Change 2017-02-01 2019-03-01 Human Tissue ABB19 Cancellous Block AAA 3 277310 0 0 1718 No Change 2017-02-01 2019-03-01 Human Tissue ABB20 Posterior Tibialis Tendon AAA 3 277310 0 0 3125 No Change 2017-02-01 2019-03-01 Human Tissue ABB21 Femoral Head Whole Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 3500 No Change 2017-02-01 2019-03-01 Human Tissue ABB22 Femoral Shaft Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3336 No Change 2017-02-01 2019-03-01 Human Tissue ABB23 Cortical Cancellous Block Super Critical Fluid CO2Treated AAA 3 277310 0 0 1553 No Change 2017-02-01 2019-03-01 Human Tissue ABB24 Humerus – Strut Super Critical Fluid CO2 Treated AAA 3 277310 0 0 2504 No Change 2017-02-01 2019-03-01 Human Tissue ABB25 Humerus – Distal Segment Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3450 No Change 2017-02-01 2019-03-01 Human Tissue ABB26 Cortical Plate AAA 3 277310 0 0 1522 No Change 2017-02-01 2019-03-01 Human Tissue ABB27 Achilles Tendon Super Critical Fluid CO2 Treated AAA 3 277310 0 0 4001 No Change 2017-02-01 2019-03-01 Human Tissue ABB28 Cervical Spacers – Lordotic Super Critical Fluid CO2Treated 5mm-9mm AAA 3 277310 0 0 2065 No Change 2017-02-01 2019-03-01 Human Tissue ABB29 Morsellised Bone Super Critical Fluid CO2 Treated (Freeze Dried) (11-20cc) AAA 3 277310 0 0 2482 No Change 2017-02-01 2019-03-01 Human Tissue ABB30 Cortical Sheet (Freeze Dried) AAA 3 277310 0 0 1522 No Change 2017-02-01 2019-03-01 Human Tissue ABB31 Humerus – Distal Segment (Freeze Dried) AAA 3 277310 0 0 3075 No Change 2017-02-01 2019-03-01 Human Tissue ABB32 Unicortical Cancellous Wedge (Freeze Dried) AAA 3 277310 0 0 1522 No Change 2017-02-01 2019-03-01 Human Tissue ABB33 Femoral Ring (Freeze Dried) AAA 3 277310 0 0 2070 No Change 2017-02-01 2019-03-01 Human Tissue ABB34 Femoral Head – Whole AAA 3 277310 0 0 3773 No Change 2017-02-01 2019-03-01 Human Tissue ABB35 Fibular Ring AAA 3 277310 0 0 2024 No Change 2017-02-01 2019-03-01 Human Tissue ABB36 Cortical Segment Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 3135 No Change 2017-02-01 2019-03-01 Human Tissue ABB37 Tibia – Proximal AAA 3 277310 0 0 3663 No Change 2017-02-01 2019-03-01 Human Tissue ABB38 Achilles Tendon with Pre-Shaped Bone Block AAA 3 277310 0 0 3923 No Change 2017-02-01 2019-03-01 Human Tissue ABB39 HTO Wedge – Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 1571 No Change 2017-02-01 2019-03-01 Human Tissue ABB40 Cortical Cancellous Block (Freeze Dried) AAA 3 277310 0 0 1522 No Change 2017-02-01 2019-03-01 Human Tissue ABB41 Femur – Distal (Freeze Dried) AAA 3 277310 0 0 3403 No Change 2017-02-01 2019-03-01 Human Tissue ABB42 Femoral Strut Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3705 No Change 2017-02-01 2019-03-01 Human Tissue ABB43 Malleable Bone Segments AAA 3 277310 0 0 2587 No Change 2017-02-01 2019-03-01 Human Tissue ABB44 Humerus – Shaft AAA 3 277310 0 0 4453 No Change 2017-02-01 2019-03-01 Human Tissue ABB45 Patella Tendon with Pre-Shaped Bone Block Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3526 No Change 2017-02-01 2019-03-01 Human Tissue ABB55 Femoral Condyle Whole Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 3471 No Change 2017-02-01 2019-03-01 Human Tissue ABB56 Morsellised Bone (Freeze Dried) AAA 3 277310 0 0 2211 No Change 2017-02-01 2019-03-01 Human Tissue ABB57 Femoral Shaft AAA 3 277310 0 0 3598 No Change 2017-02-01 2019-03-01 Human Tissue ABB58 Tibial Shaft (Freeze Dried) AAA 3 277310 0 0 4924 No Change 2017-02-01 2019-03-01 Human Tissue ABB59 Fascia Lata AAA 3 277310 0 0 3923 No Change 2017-02-01 2019-03-01 Human Tissue ABB60 Femoral Head – Hemi AAA 3 277310 0 0 3773 No Change 2017-02-01 2019-03-01 Human Tissue ABB61 Humerus – Whole Super Critical Fluid CO2 Treated AAA 3 277310 0 0 4199 No Change 2017-02-01 2019-03-01 Human Tissue ABB62 Femoral Head – Hemi (Freeze Dried) AAA 3 277310 0 0 3430 No Change 2017-02-01 2019-03-01 Human Tissue ABB63 Patella Tendon with Pre-Shaped Bone Block Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3879 No Change 2017-02-01 2019-03-01 Human Tissue ABB64 Anterior Tibialis Tendon Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3187 No Change 2017-02-01 2019-03-01 Human Tissue ABB65 Femoral Condyle Whole Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3471 No Change 2017-02-01 2019-03-01 Human Tissue ABB66 Tibial Strut (Freeze Dried) AAA 3 277310 0 0 3195 No Change 2017-02-01 2019-03-01 Human Tissue ABB67 Femoral Shaft Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 3336 No Change 2017-02-01 2019-03-01 Human Tissue ABB68 Femur – Proximal AAA 3 277310 0 0 3996 No Change 2017-02-01 2019-03-01 Human Tissue ABB69 Cortical Sheet Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 1553 No Change 2017-02-01 2019-03-01 Human Tissue ABB70 Cortical Ring Super Critical Fluid CO2 Treated 5mm-9mm AAA 3 277310 0 0 2065 No Change 2017-02-01 2019-03-01 Human Tissue ABB71 Cortical Plate (Freeze Dried) AAA 3 277310 0 0 1522 No Change 2017-02-01 2019-03-01 Human Tissue ABB72 Femoral Head – Hemi Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 3500 No Change 2017-02-01 2019-03-01 Human Tissue ABB73 Femur – Proximal Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3705 No Change 2017-02-01 2019-03-01 Human Tissue ABB93 Gracilis Tendon AAA 3 277310 0 0 2398 No Change 2017-02-01 2019-03-01 Human Tissue ABB94 Morsellised Bone Super Critical Fluid CO2 Treated (5-9g) AAA 3 277310 0 0 2482 No Change 2017-02-01 2019-03-01 Human Tissue ABB95 Fibular Ring Super Critical Fluid CO2 Treated AAA 3 277310 0 0 1877 No Change 2017-02-01 2019-03-01 Human Tissue ABB96 Hemipelvis – Whole AAA 3 277310 0 0 9452 No Change 2017-02-01 2019-03-01 Human Tissue ABB97 Achilles Tendon with Bone Block Super Critical Fluid CO2 Treated AAA 3 277310 0 0 4001 No Change 2017-02-01 2019-03-01 Human Tissue ABB98 Hemi Patella Tendon with Bone Block AAA 3 277310 0 0 3804 No Change 2017-02-01 2019-03-01 Human Tissue ABB99 Demineralized Bone Fibres (FZ) 1-4g ABB 3 277310 0 0 2750 No Change 2018-08-01 2019-03-01 Human Tissue ADD01 Demineralized Bone Fibres (FZ) 5-9g ABB 3 277310 0 0 3800 No Change 2018-08-01 2019-03-01 Human Tissue ADD02 Demineralized Bone Fibres (FZ) 10-15g ABB 3 277310 0 0 4600 No Change 2018-08-01 2019-03-01 Human Tissue ABB74 Patella Tendon with Pre-Shaped Bone Blocks AAA 3 277310 0 0 3804 No Change 2017-02-01 2019-03-01 Human Tissue ABB75 Femoral Head – Whole Super Critical Fluid CO2 Treated AAA 3 277310 0 0 3500 No Change 2017-02-01 2019-03-01 Human Tissue ABB76 Hemipelvis – Segment Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 1553 No Change 2017-02-01 2019-03-01 Human Tissue ABB77 Tibia – Distal (Freeze Dried) AAA 3 277310 0 0 3403 No Change 2017-02-01 2019-03-01 Human Tissue ABB78 Femoral Ring Super Critical Fluid CO2 Treated AAA 3 277310 0 0 2112 No Change 2017-02-01 2019-03-01 Human Tissue ABB79 Tibia – Whole AAA 3 277310 0 0 7921 No Change 2017-02-01 2019-03-01 Human Tissue ABB80 Cortical Ring Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 1877 No Change 2017-02-01 2019-03-01 Human Tissue ABB81 Hemipelvis – Whole Super Critical Fluid CO2 Treated AAA 3 277310 0 0 8762 No Change 2017-02-01 2019-03-01 Human Tissue ABB82 Humeral Head – Whole (Freeze Dried) AAA 3 277310 0 0 1989 No Change 2017-02-01 2019-03-01 Human Tissue ABB83 Humerus – Whole AAA 3 277310 0 0 4530 No Change 2017-02-01 2019-03-01 Human Tissue ABB84 Tibial Shaft Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 5021 No Change 2017-02-01 2019-03-01 Human Tissue ABB85 Cancellous Cube (Freeze Dried) AAA 3 277310 0 0 1562 No Change 2017-02-01 2019-03-01 Human Tissue ABB86 Morsellised Bone (5-9 cc/g) AAA 3 277310 0 0 2432 No Change 2017-02-01 2019-03-01 Human Tissue ABB87 Hemipelvis – Segment Super Critical Fluid CO2 Treated AAA 3 277310 0 0 1708 No Change 2017-02-01 2019-03-01 Human Tissue ABB88 Cancellous Block Super Critical Fluid CO2 Treated (Freeze Dried) AAA 3 277310 0 0 1593 No Change 2017-02-01 2019-03-01 Human Tissue ABB89 Cervical Spacers - Parrallel (Freeze Dried) AAA 3 277310 0 0 1840 No Change 2017-02-01 2019-03-01 Human Tissue ABB90 Tibial Shaft Super Critical Fluid CO2 Treated AAA 3 277310 0 0 5021 No Change 2017-02-01 2019-03-01 Human Tissue ABB91 Fascia Lata Super Critical Fluid CO2 Treated AAA 3 277310 0 0 4001 No Change 2017-02-01 2019-03-01 Human Tissue ABB92 Achilles Tendon AAA 3 277310 0 0 3923 No Change 2017-02-01 2019-03-01 Human Tissue ADD03 Demineralized Bone Fibres / Cortico-Cancellous Granules (FZ) 1-4g ABB 3 277310 0 0 2750 No Change 2018-08-01 2019-03-01 Human Tissue ADD04 Demineralized Bone Fibres / Cortico-Cancellous Granules (FZ) 5-9g ABB 3 277310 0 0 3800 No Change 2018-08-01 2019-03-01 Human Tissue ADD05 Demineralized Bone Fibres / Cortico-Cancellous Granules (FZ) 10-15g ABB 3 277310 0 0 4600 No Change 2018-08-01 2019-03-01 Human Tissue ADD06 Demineralized Bone Fibres (FD) 2-4cc ABB 3 277310 0 0 2750 No Change 2018-08-01 2019-03-01 Human Tissue ADD07 Demineralized Bone Fibres (FD) 5-9cc ABB 3 277310 0 0 3800 No Change 2018-08-01 2019-03-01 Human Tissue ADD08 Demineralized Bone Fibres (FD) 10-15cc ABB 3 277310 0 0 4600 No Change 2018-08-01 2019-03-01 Human Tissue ADD09 Demineralized Bone Fibres / Cortico-Cancellous Granules (FD) 2-4cc ABB 3 277310 0 0 2750 No Change 2018-08-01 2019-03-01 Human Tissue ADD10 Demineralized Bone Fibres / Cortico-Cancellous Granules (FD) 5-9cc ABB 3 277310 0 0 3800 No Change 2018-08-01 2019-03-01 Human Tissue ADD11 Demineralized Bone Fibres / Cortico-Cancellous Granules (FD) 10-15cc ABB 3 277310 0 0 4600 No Change 2018-08-01 2019-03-01 Human Tissue ADD12 Compressible Cancellous Block (FD) ABB 3 277310 0 0 3500 No Change 2018-08-01 2019-03-01 Human Tissue ADD13 Compressible Cancellous Block (FZ) ABB 3 277310 0 0 3500 No Change 2018-08-01 2019-03-01 Human Tissue ADD14 Compressible Cancellous Strip (FD) ABB 3 277310 0 0 3500 No Change 2018-08-01 2019-03-01 Human Tissue ADD15 Compressible Cancellous Strip (FZ) ABB 3 277310 0 0 3500 No Change 2018-08-01 2019-03-01 Human Tissue ADD16 Patella Quadriceps Tendon with Patellar Bone ABB 3 277310 0 0 3902 No Change 2018-08-01 2019-03-01 Human Tissue ADD17 Spinal Anterior Longitudonal Ligament Patch ABB 3 277310 0 0 4023 No Change 2018-08-01 2019-03-01 Human Tissue ADD18 Pre-Shaped Cancellous/Cortical Block (Various Sizes) ABB 3 277310 0 0 3200 No Change 2018-08-01 2019-03-01 Human Tissue ADD19 Engineered Cancellous Block with DBM Component (Various Sizes) ABB 3 277310 0 0 3200 No Change 2018-08-01 2019-03-01 Human Tissue ADD20 Bone allograft kit (Demineralized and Mineralized Bone Matrix) 5-10g / 5-10cc ABB 3 277310 0 0 6193 No Change 2018-08-01 2019-03-01 Human Tissue ADD21 Bone allograft kit (Demineralized and Mineralized Bone Matrix) 11-20g / 11-20cc ABB 3 277310 0 0 7259 No Change 2018-08-01 2019-03-01 Human Tissue ADD22 Pre-Shaped Hyaline Cartilage Segment ABB 3 277310 0 0 2750 No Change 2018-08-01 2019-03-01 Human Tissue ADD23 Cortical – Demineralized Bone Matrix 1-4g/1-4cc ABB 3 277310 0 0 2676 No Change 2018-08-01 2019-03-01 Human Tissue ADD32 Bone allograft kit (Demineralized and Mineralized Bone Matrix) 1-4g / 1-4cc ABB 3 277310 0 0 4376 No Change 2018-08-01 2019-03-01 Human Tissue ADD33 Demineralized Bone Matrix/Cortico-Cancellous Granules 1-4cc ABB 3 277310 0 0 2700 No Change 2018-08-01 2019-03-01 Human Tissue AUB02 Bone - Milled Femoral Head AUB 3 0 0 2457 No Change 2008-07-01 2019-03-01 Human Tissue AUB03 Femoral Head AUB 3 0 0 2354 No Change 2008-07-01 2019-03-01 Human Tissue AUB04 Bone – Cortico-Cancellous Crunch <30g AUB 3 0 0 2070 No Change 2010-08-01 2019-03-01 Human Tissue AUB05 Cortical Strut AUB 3 0 0 2451 No Change 2010-08-01 2019-03-01 Human Tissue AUB06 Tibia – Proximal third AUB 3 0 0 2562 No Change 2010-08-01 2019-03-01 Human Tissue AUB07 Spinal Ring AUB 3 0 0 1854 No Change 2010-08-01 2019-03-01 Human Tissue AUB08 Bone – Cortico-Cancellous Crunch <20g Sterile AUB 3 0 0 2215 No Change 2010-08-01 2019-03-01 Human Tissue ADD24 Cortical – Demineralized Bone Matrix 5-10g/5-10cc ABB 3 277310 0 0 3100 No Change 2018-08-01 2019-03-01 Human Tissue ADD25 Moulded Demineralized Fibres (Small) ABB 3 277310 0 0 3000 No Change 2018-08-01 2019-03-01 Human Tissue ADD26 Moulded Demineralized Fibres (Large) ABB 3 277310 0 0 3750 No Change 2018-08-01 2019-03-01 Human Tissue ADD27 Demineralized Bone Matrix/Cortico-Cancellous Granules 5-9cc ABB 3 277310 0 0 3800 No Change 2018-08-01 2019-03-01 Human Tissue ADD28 Demineralized Bone Matrix/Cortico-Cancellous Granules 10-15cc ABB 3 277310 0 0 4600 No Change 2018-08-01 2019-03-01 Human Tissue ADD29 Freeze Dried Cortico-Cancellous Bone Granules 2-4cc ABB 3 277310 0 0 2450 No Change 2018-08-01 2019-03-01 Human Tissue ADD30 Freeze Dried Cortico-Cancellous Bone Granules 5-9cc ABB 3 277310 0 0 2800 No Change 2018-08-01 2019-03-01 Human Tissue ADD31 Freeze Dried Cortico-Cancellous Bone Granules 10-15cc ABB 3 277310 0 0 3200 No Change 2018-08-01 2019-03-01 Human Tissue CAA07 Anterior Tibialis Tendon, Freeze Dried, Non-Irradiated CAA 3 0 0 3029 No Change 2018-02-01 2019-03-01 Human Tissue CAA08 Gracilis Tendon, Frozen, Non-Irradiated CAA 3 0 0 2586 No Change 2018-02-01 2019-03-01 Human Tissue CAA09 Gracilis Tendon, Freeze Dried, Non-Irradiated CAA 3 0 0 2222 No Change 2018-02-01 2019-03-01 Human Tissue CAA10 Achillies Tendon, Frozen, Non-Irradiated CAA 3 0 0 2971 No Change 2018-02-01 2019-03-01 Human Tissue CAA11 Revision Core, Various Sizes, Freeze Dried, Non-Irradiated CAA 3 0 0 2136 No Change 2018-02-01 2019-03-01 Human Tissue CAA12 Evans Wedge, Freeze dried, Non-Irradiated CAA 3 0 0 2339 No Change 2018-02-01 2019-03-01 Human Tissue CAA13 High Tibial Osteotomy Wedge Cortical Bone Wedges, (2-Piece), Freeze Dried, Non-Irradiated CAA 3 0 0 2134 No Change 2018-02-01 2019-03-01 Human Tissue CAA14 Brachymetatarsal Lengthening Graft Segment, Freeze Dried, Non-Irradiated CAA 3 0 0 2404 No Change 2018-02-01 2019-03-01 Human Tissue AUB09 Tendon - Achilles with bone plug AUB 3 0 0 2228 No Change 2010-08-01 2019-03-01 Human Tissue AUB10 Tendon AUB 3 0 0 2184 No Change 2010-08-01 2019-03-01 Human Tissue CAA01 Semitendinosis, Tendon, Frozen, Non-Irradiated CAA 3 0 0 2840 No Change 2018-02-01 2019-03-01 Human Tissue CAA02 Semitendinosus Tendon, Freeze Dried, Non-Irradiated CAA 3 0 0 2910 No Change 2018-02-01 2019-03-01 Human Tissue CAA03 Peroneus Longus Tendon, Frozen, Non-Irradiated CAA 3 0 0 2783 No Change 2018-02-01 2019-03-01 Human Tissue CAA04 Peroneus Longus Tendon, Freeze Dried, Non-Irradiated CAA 3 0 0 2420 No Change 2018-02-01 2019-03-01 Human Tissue CAA05 Fascia Lata, ≥ 120cm² ≤ 180cm², Frozen, Non-Irradiated CAA 3 0 0 2400 No Change 2018-02-01 2019-03-01 Human Tissue CAA06 Anterior Tibialis Tendon, Frozen, Non-Irradiated CAA 3 0 0 3102 No Change 2018-02-01 2019-03-01 Human Tissue CAA15 Milled Cancellous Chips, Freeze dried, Non-Irradiated CAA 3 0 0 1455 No Change 2018-02-01 2019-03-01 Human Tissue CAA16 Demineralized Cancellous Chips, Freeze dried, Non-Irradiated CAA 3 0 0 1449 No Change 2018-02-01 2019-03-01 Human Tissue CAA17 ENHANCE® Demineralized Cortical Fiber, 2.5cc, Dehydrated, Non-Irradiated CAA 3 0 0 1544 No Change 2018-02-01 2019-03-01 Human Tissue CAA18 Achilles Tendon, with Calcaneus, Frozen, Non-Irradiated CAA 3 0 0 2787 No Change 2018-02-01 2019-03-01 Human Tissue CAA19 Achilles Tendon, with Shaped Bone Blocks, Frozen, Non-Irradiated CAA 3 0 0 3450 No Change 2018-02-01 2019-03-01 Human Tissue CAA20 Patella Bone-Tendon-Bone, Hemi with Quadriceps, Frozen, Non-Irradiated CAA 3 0 0 3540 No Change 2018-02-01 2019-03-01 Human Tissue CAA21 Patella Bone-Tendon-Bone, Whole with Quadriceps, Frozen, Non-Irradiated CAA 3 0 0 5917 No Change 2018-02-01 2019-03-01 Human Tissue CAA22 ENHANCE® Demineralized Cortical Fiber, 5cc, Dehydrated, Non-Irradiated CAA 3 0 0 1962 No Change 2018-02-01 2019-03-01 Human Tissue CAA23 ENHANCE® Demineralized Cortical Fiber, 10cc, Dehydrated, Non-Irradiated CAA 3 0 0 2287 No Change 2018-02-01 2019-03-01 Human Tissue CAA24 Cotton Wedge, Freeze dried, Non-Irradiated CAA 3 0 0 2326 No Change 2018-02-01 2019-03-01 Human Tissue CAA25 Arch Wedge, Freeze dried, Non-Irradiated CAA 3 0 0 2089 No Change 2018-02-01 2019-03-01 Human Tissue CAA26 Proximal Metatarsal Lengthening Graft Segment, Freeze Dried, Non-Irradiated CAA 3 0 0 2374 No Change 2018-02-01 2019-03-01 Human Tissue CAA27 AlloPatchHD Acellular Human Dermis, ≤ 25cm² ≥ 1.8mm, Dehydrated, Non-Irradiated CAA 3 0 0 2733 No Change 2018-02-01 2019-03-01 Human Tissue CAA28 AlloPatchHD Acellular Human Dermis, ≥ 25cm² ≤1.7mm, Dehydrated, Non-Irradiated CAA 3 0 0 2777 No Change 2018-02-01 2019-03-01 Human Tissue CAA29 AlloPatchHD Acellular Human Dermis, ≥ 25cm² ≤ 1.7mm, Hydrated, Non-Irradiated CAA 3 0 0 2591 No Change 2018-02-01 2019-03-01 Human Tissue CAA30 AlloPatchHD Acellular Human Dermis, ≥ 25cm² ≥ 1.8mm, Hydrated, Non-Irradiated CAA 3 0 0 2762 No Change 2018-02-01 2019-03-01 Human Tissue CAA31 AlloPatchHD Acellular Human Dermis, ≤ 25cm² ≤ 1.7mm, Dehydrated, Non-Irradiated CAA 3 0 0 2391 No Change 2018-02-01 2019-03-01 Human Tissue CAA32 AlloPatchHD Acellular Human Dermis, ≤ 25cm² ≤1.7mm thick, Hydrated, Non- Irradiated CAA 3 0 0 2391 No Change 2018-02-01 2019-03-01 Human Tissue CAA33 AlloPatchHD Acellular Human Dermis - Meshed, ≤ 25cm² ≤0.7mm, Hydrated, Non-Irradiated CAA 3 0 0 2372 No Change 2018-02-01 2019-03-01 Human Tissue CAA34 AlloPatchHD Acellular Human Dermis, ≤25cm² ≥1.8mm, Hydrated, Non-Irradiated CAA 3 0 0 2731 No Change 2018-02-01 2019-03-01 Human Tissue CAA35 AlloPatchHD Acellular Human Dermis - Meshed, ≥ 26cm² ≤0.7mm, Hydrated, Non-Irradiated CAA 3 0 0 2869 No Change 2018-02-01 2019-03-01 Human Tissue CAA36 Patella Bone-Tendon-Bone, Hemi without Quadriceps, Frozen, Non-irradiated CAA 3 0 0 3629 No Change 2018-02-01 2019-03-01 Human Tissue CAA37 Patella Bone-Tendon-Bone, Hemi with 10.0mm Shaped Bone Blocks, Frozen, Non-Irradiated CAA 3 0 0 3500 No Change 2018-02-01 2019-03-01 Human Tissue CAA38 Quadriceps Tendon, with 10.0mm Shaped Bone Blocks, Frozen, Non-Irradiated CAA 3 0 0 2900 No Change 2018-02-01 2019-03-01 Human Tissue CAA39 Menisci with Tibial Plateau, Frozen, Non-irradiated CAA 3 0 0 5807 No Change 2018-02-01 2019-03-01 Human Tissue CAA40 Patella Bone-Tendon-Bone, Whole (Special) with Quadriceps, Frozen, Non-Irradiated CAA 3 0 0 6150 No Change 2018-02-01 2019-03-01 Human Tissue CAA42 Quadriceps Tendon, with Bone Block, Frozen, Non-Irradiated CAA 3 0 0 3172 No Change 2018-02-01 2019-03-01 Human Tissue CAA43 Quadriceps Tendon, without Bone Block, Frozen, Non-Irradiated CAA 3 0 0 3172 No Change 2018-02-01 2019-03-01 Human Tissue CAA44 Fascia Lata, ≥ 60cm² - ≤100cm² ≥, Freeze Dried, Non-Irradiated CAA 3 0 0 1869 No Change 2018-02-01 2019-03-01 Human Tissue CAA45 Fascia Lata, ≤ 60cm², Frozen, Non-Irradiated CAA 3 0 0 2110 No Change 2018-02-01 2019-03-01 Human Tissue CAA46 MPJ Arthrodesis Lengthening Graft Segment, Frozen, Non-Irradiated CAA 3 0 0 2721 No Change 2018-02-01 2019-03-01 Human Tissue CAA47 Bone-Tendon-Bone, Hemi with Quadriceps, Freeze Dried, Non-Irradiated CAA 3 0 0 3832 No Change 2018-02-01 2019-03-01 Human Tissue CAA41 Posterior Tibialis Tendon, Frozen, Non-Irradiated CAA 3 0 0 3098 No Change 2018-02-01 2019-03-01 Human Tissue LEW01 Cornea LEW 41 239107 0 0 2950 No Change 2005-10-31 2019-03-01 Human Tissue LEW02 Sclera LEW 41 239107 0 0 295 No Change 2005-10-31 2019-03-01 Human Tissue LEW03 Cornea for Endothelial Keratoplasty LEW 41 239107 0 0 3525 No Change 2012-08-01 2019-03-01 Human Tissue MAA01 Grafton Plus Demineralized Bone Matrix: Paste, 10cc MAA 3 229635 0 0 1539 No Change 2016-02-01 2019-03-01 Human Tissue MAA02 Grafton Plus Demineralized Bone Matrix: Paste, 1-5cc MAA 3 229635 0 0 581 No Change 2016-02-01 2019-03-01 Human Tissue MAA03 Grafton Demineralized Bone Matrix: Orthoblend, 15cc MAA 3 229633 0 0 1978 No Change 2016-02-01 2019-03-01 Human Tissue MAA04 Grafton Demineralized Bone Matrix: Matrix PLF, 2.5cm x 10cm x 0.8cm (2) MAA 3 229633 0 0 1978 No Change 2016-02-01 2019-03-01 Human Tissue MAA05 Grafton Demineralized Bone Matrix: Orthoblend, 5cc MAA 3 229633 0 0 581 No Change 2016-02-01 2019-03-01 Human Tissue MAA06 Grafton Demineralized Bone Matrix: Orthoblend, 10cc MAA 3 229633 0 0 1539 No Change 2016-02-01 2019-03-01 Human Tissue MAA07 Grafton Demineralized Bone Matrix: Flex, 1.5cm x 1.5cm x 0.25cm MAA 3 229634 0 0 581 No Change 2016-02-01 2019-03-01 Human Tissue MAA08 Grafton Demineralized Bone Matrix: Flex, >5cc to 10cc MAA 3 229634 0 0 1539 No Change 2016-02-01 2019-03-01 Human Tissue MVS09 Humerus - Proximal with rotator cuff MVS 3 0 0 2290 No Change 2005-10-31 2019-03-01 Human Tissue MVS11 Tibia - Proximal half MVS 3 0 0 2290 No Change 2005-10-31 2019-03-01 Human Tissue MVS13 Fibula - Segment (6cm) MVS 3 0 0 2290 No Change 2005-10-31 2019-03-01 Human Tissue MVS14 Fibula - Segment (12cm) MVS 3 0 0 2290 No Change 2005-10-31 2019-03-01 Human Tissue MVS15 Ulna MVS 3 0 0 2290 No Change 2005-10-31 2019-03-01 Human Tissue MVS16 Tibia - Whole MVS 3 0 0 2290 No Change 2005-10-31 2019-03-01 Human Tissue MVS17 Tibia - Distal MVS 3 0 0 2290 No Change 2005-10-31 2019-03-01 Human Tissue MVS18 Radius MVS 3 0 0 2290 No Change 2005-10-31 2019-03-01 Human Tissue MVS19 Humerus - Distal MVS 3 0 0 2290 No Change 2005-10-31 2019-03-01 Human Tissue MVS20 Humerus - Entire MVS 3 0 0 2290 No Change 2005-10-31 2019-03-01 Human Tissue MVS21 Rib (5cm) MVS 3 0 0 382 No Change 2005-10-31 2019-03-01 Human Tissue MVS23 Autologous Skull Flap MVS 3 0 0 1396 No Change 2006-03-24 2019-03-01 Human Tissue NAA01 Ulna – Whole Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 3786 No Change 2017-02-01 2019-03-01 Human Tissue NAA02 Gracilis Tendon Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 2293 No Change 2017-02-01 2019-03-01 Human Tissue MAA09 Grafton Demineralized Bone Matrix: Matrix PLF, 2.5cm x 5cm x 0.8cm (2) MAA 3 229636 0 0 1539 No Change 2016-02-01 2019-03-01 Human Tissue MAA10 Grafton Demineralized Bone Matrix: Matrix Strips, 1cm x 20cm x 0.8cm (2) MAA 3 229636 0 0 1978 No Change 2016-02-01 2019-03-01 Human Tissue MAA11 Grafton Demineralized Bone Matrix: Matrix Strips, 1cm x 10cm x 0.8cm (2) MAA 3 229636 0 0 1539 No Change 2016-02-01 2019-03-01 Human Tissue MAA13 Grafton Demineralized Bone Matrix: Flex, 2.5cm x 5cm MAA 3 229634 0 0 1099 No Change 2018-02-01 2019-03-01 Human Tissue MVS02 Femur - Distal (Shaft & Condyles) MVS 3 0 0 2290 No Change 2005-10-31 2019-03-01 Human Tissue MVS03 Femur - Entire MVS 3 0 0 2290 No Change 2005-10-31 2019-03-01 Human Tissue MVS04 Femur - Proximal (shaft, trochanter, neck) MVS 3 0 0 2290 No Change 2005-10-31 2019-03-01 Human Tissue MVS05 Femoral Head MVS 3 0 0 2370 No Change 2005-10-31 2019-03-01 Human Tissue MVS07 Fibula - Entire MVS 3 0 0 2290 No Change 2005-10-31 2019-03-01 Human Tissue MVS08 Hemipelvis - Complete MVS 3 0 0 2290 No Change 2005-10-31 2019-03-01 Human Tissue CAA48 Bone-Tendon-Bone, Hemi with 10.0mm Shaped Bone Blocks, Freeze Dried, Non-Irradiated CAA 3 0 0 3680 No Change 2018-02-01 2019-03-01 Human Tissue CAA49 Achilles Tendon, with Calcaneus, Freeze Dried, Non-Irradiated CAA 3 0 0 3121 No Change 2018-02-01 2019-03-01 Human Tissue CAA50 Achilles Tendon, without Calcaneus, Freeze Dried, Non-Irradiated CAA 3 0 0 2992 No Change 2018-02-01 2019-03-01 Human Tissue CAA51 Posterior Tibialis Tendon, Freeze Dried, Non-Irradiated CAA 3 0 0 3106 No Change 2018-02-01 2019-03-01 Human Tissue CAA52 Demineralized 80%Cortical/20%Cancellous Granules, Freeze dried, Non-Irradiated CAA 3 0 0 1500 No Change 2018-02-01 2019-03-01 Human Tissue CAA53 Meniscus with Hemi Plateau, Medial, Frozen, Non-Irradiated CAA 3 0 0 5680 No Change 2018-02-01 2019-03-01 Human Tissue CAA54 Fascia Lata, ≤ 60cm², Freeze Dried, Non-Irradiated CAA 3 0 0 1821 No Change 2018-02-01 2019-03-01 Human Tissue CAA55 Fascia Lata, ≥ 120cm² ≤ 180cm², Freeze-Dried, Non-Irradiated CAA 3 0 0 2259 No Change 2018-02-01 2019-03-01 Human Tissue CAA56 Meniscus with Hemi Plateau, Lateral, Frozen, Non-Irradiated CAA 3 0 0 6047 No Change 2018-02-01 2019-03-01 Human Tissue CAA57 Meniscus for Interpositional Arthroplasty, Frozen, Non-Irradiated CAA 3 0 0 3067 No Change 2018-02-01 2019-03-01 Human Tissue CSA01 Femoral Head CSA 3 0 0 802 No Change 2005-10-31 2019-03-01 Human Tissue DHR01 Femoral Head DHR 3 260540 0 0 4616 No Change 2005-10-31 2019-03-01 Human Tissue LEM01 Cornea LEM 41 0 0 2600 No Change 2005-10-31 2019-03-01 Human Tissue LEM02 Sclera LEM 41 0 0 300 No Change 2005-10-31 2019-03-01 Human Tissue LEM04 Cornea for Endothelial Lamellar Keratoplasty LEM 41 0 0 3260 No Change 2010-02-01 2019-03-01 Human Tissue LEN01 Cornea LEN 41 0 0 2493 No Change 2005-10-31 2019-03-01 Human Tissue LEN02 Sclera LEN 41 0 0 374 No Change 2005-10-31 2019-03-01 Human Tissue LEN03 Cornea For Lamellar LEN 41 0 0 1497 No Change 2005-10-31 2019-03-01 Human Tissue LEN04 Cornea for Endothelial Keratoplasty LEN 41 0 0 2938 No Change 2014-08-01 2019-03-01 Human Tissue NAA03 Femur – Proximal Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 3969 No Change 2017-02-01 2019-03-01 Human Tissue NAA04 Cortical Ring Super Critical Fluid CO2 Treated (Freeze Dried) 5mm – 9mm NAA 3 277310 0 0 1947 No Change 2017-02-01 2019-03-01 Human Tissue NAA05 Fibula – Whole Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 8208 No Change 2017-02-01 2019-03-01 Human Tissue NAA06 Bone Dowel / Plug Super Critical Fluid CO2 Treated (Freeze Dried) various sizes NAA 3 277310 0 0 1663 No Change 2017-02-01 2019-03-01 Human Tissue NAA07 Cancellous Dowel Plug Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 1663 No Change 2017-02-01 2019-03-01 Human Tissue NAA08 Cortical Sheet (Frozen) - various sizes NAA 3 277310 0 0 1592 No Change 2017-02-01 2019-03-01 Human Tissue NAA09 Peroneus Longus Tendon Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 2967 No Change 2017-02-01 2019-03-01 Human Tissue NAA10 Tibia – Distal Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 3541 No Change 2017-02-01 2019-03-01 Human Tissue NAA11 Cancellous Cube (Frozen) 3cm3 cubes NAA 3 277310 0 0 1632 No Change 2017-02-01 2019-03-01 Human Tissue NAA12 Cortical Strut (Freeze Dried) - various sizes NAA 3 277310 0 0 2525 No Change 2017-02-01 2019-03-01 Human Tissue NAA13 Achilles Tendon with Bone Block Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 3027 No Change 2017-02-01 2019-03-01 Human Tissue NAA14 Hemi Patella Tendon with Bone Block (Frozen) - various sizes NAA 3 277310 0 0 3528 No Change 2017-02-01 2019-03-01 Human Tissue NAA15 Femoral Condyle Half (Freeze Dried) - various sizes NAA 3 277310 0 0 3027 No Change 2017-02-01 2019-03-01 Human Tissue NAA16 Humeral Head – Whole (Freeze Dried) - various sizes NAA 3 277310 0 0 2059 No Change 2017-02-01 2019-03-01 Human Tissue NAA17 Tibial Strut Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 3329 No Change 2017-02-01 2019-03-01 Human Tissue NAA18 Cancellous Block (Frozen) - various sizes NAA 3 277310 0 0 1632 No Change 2017-02-01 2019-03-01 Human Tissue NAA19 Cortical Plate (Frozen) various sizes NAA 3 277310 0 0 1592 No Change 2017-02-01 2019-03-01 Human Tissue NAA20 Humerus – Strut (Freeze Dried) - various sizes NAA 3 277310 0 0 2525 No Change 2017-02-01 2019-03-01 Human Tissue NAA21 Tibia – Proximal Super Critical Fluid CO2 Treated (Freeze Dried) NAA 3 277310 0 0 3466 No Change 2017-02-01 2019-03-01 Human Tissue NAA22 Morsellised Bone Super Critical Fluid CO2 Treated (Frozen) Packs of 15mg – 30mg NAA 3 277310 0 0 2580 No Change 2017-02-01 2019-03-01 Human Tissue NAA23 Cortical Sheet Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 1623 No Change 2017-02-01 2019-03-01 Human Tissue NAA24 Femoral Head – Hemi (Frozen) - various sizes NAA 3 277310 0 0 3499 No Change 2017-02-01 2019-03-01 Human Tissue NAA25 Fibular Ring Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 1947 No Change 2017-02-01 2019-03-01 Human Tissue NAA34 Tibia – Whole Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 5523 No Change 2017-02-01 2019-03-01 Human Tissue NAA35 Tricortical Cancellous Wedge Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 1623 No Change 2017-02-01 2019-03-01 Human Tissue NAA36 Humerus – Shaft (Freeze Dried) - various sizes NAA 3 277310 0 0 4118 No Change 2017-02-01 2019-03-01 Human Tissue NAA37 Cervical Spacers - Parrallel (Freeze Dried) 5mm – 9mm NAA 3 277310 0 0 1910 No Change 2017-02-01 2019-03-01 Human Tissue NAA38 Cortical Cancellous Block Super Critical Fluid CO2Treated (Frozen) - various sizes NAA 3 277310 0 0 1623 No Change 2017-02-01 2019-03-01 Human Tissue NAA39 Bone Dowel / Plug (Freeze Dried) - various sizes NAA 3 277310 0 0 1632 No Change 2017-02-01 2019-03-01 Human Tissue NAA40 Femur – Distal Super Critical Fluid CO2 Treated (Freeze Dried) NAA 3 277310 0 0 3775 No Change 2017-02-01 2019-03-01 Human Tissue NAA41 Humerus – Proximal (Freeze Dried) - various sizes NAA 3 277310 0 0 3690 No Change 2017-02-01 2019-03-01 Human Tissue NAA26 Humerus – Whole Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 4269 No Change 2017-02-01 2019-03-01 Human Tissue NAA27 Cancellous Block Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 1663 No Change 2017-02-01 2019-03-01 Human Tissue NAA28 Fascia Lata Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 1253 No Change 2017-02-01 2019-03-01 Human Tissue NAA29 Tricortical Cancellous Wedge (Freeze Dried) - various sizes NAA 3 277310 0 0 1592 No Change 2017-02-01 2019-03-01 Human Tissue NAA30 Cancellous Dowel (Freeze Dried) - various sizes NAA 3 277310 0 0 1632 No Change 2017-02-01 2019-03-01 Human Tissue NAA31 Humerus – Distal Segment Super Critical Fluid CO2 Treated (Freeze Dried) NAA 3 277310 0 0 3206 No Change 2017-02-01 2019-03-01 Human Tissue NAA32 Morsellised Bone – Super Critical Fluid CO2 Treated Packs of 2.5gm – 5gm NAA 3 277310 0 0 2174 No Change 2017-02-01 2019-03-01 Human Tissue NAA33 Tibial Shaft Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 5091 No Change 2017-02-01 2019-03-01 Human Tissue NBB02 Tendon - Achilles with bone block NBB 3 277310 0 0 2969 No Change 2005-10-31 2019-03-01 Human Tissue NBB05 Bone Plug/Dowel - Cancellous NBB 3 277310 0 0 1632 No Change 2005-10-31 2019-03-01 Human Tissue NBB06 Radius NBB 3 277310 0 0 4030 No Change 2005-10-31 2019-03-01 Human Tissue NBB07 Ulna NBB 3 277310 0 0 3714 No Change 2005-10-31 2019-03-01 Human Tissue NBB09 Fascia Lata NBB 3 277310 0 0 1229 No Change 2005-10-31 2019-03-01 Human Tissue NBB10 Femur - Distal Half NBB 3 277310 0 0 3703 No Change 2005-10-31 2019-03-01 Human Tissue NBB11 Femur - Distal third NBB 3 0 0 3372 No Change 2005-10-31 2019-03-01 Human Tissue NBB12 Femur - Entire NBB 3 277310 0 0 8264 No Change 2005-10-31 2019-03-01 Human Tissue NBB13 Femoral Shaft - Middle Third NBB 3 0 0 3244 No Change 2005-10-31 2019-03-01 Human Tissue NBB14 Femur - Proximal third NBB 3 0 0 1690 No Change 2005-10-31 2019-03-01 Human Tissue NBB15 Femur - Proximal half NBB 3 277310 0 0 3893 No Change 2005-10-31 2019-03-01 Human Tissue NAA68 Cancellous Plug Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 1663 No Change 2017-02-01 2019-03-01 Human Tissue NAA69 Femoral Strut Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 3775 No Change 2017-02-01 2019-03-01 Human Tissue NAA70 Tibial Shaft Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 5091 No Change 2017-02-01 2019-03-01 Human Tissue NAA71 Patella Tendon with Bone Block – Whole Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 2917 No Change 2017-02-01 2019-03-01 Human Tissue NAA72 Tibia – Distal Super Critical Fluid CO2 Treated (Freeze Dried) NAA 3 277310 0 0 3541 No Change 2017-02-01 2019-03-01 Human Tissue NAA73 Radius – Whole Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 4109 No Change 2017-02-01 2019-03-01 Human Tissue NAA74 Cortical Ring (Freeze Dried) 5mm – 9mm NAA 3 277310 0 0 1910 No Change 2017-02-01 2019-03-01 Human Tissue NAA75 Humeral Head – Whole Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 2099 No Change 2017-02-01 2019-03-01 Human Tissue NAA84 Cortical Plate Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 1623 No Change 2017-02-01 2019-03-01 Human Tissue NAA85 Unicortical Cancellous Wedge Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 1623 No Change 2017-02-01 2019-03-01 Human Tissue NAA86 Tendon Patch (Frozen) - various sizes NAA 3 277310 0 0 3636 No Change 2017-02-01 2019-03-01 Human Tissue NAA87 Cancellous Block Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 1663 No Change 2017-02-01 2019-03-01 Human Tissue NAA88 Humerus – Shaft Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 4198 No Change 2017-02-01 2019-03-01 Human Tissue NAA89 Cortical Segment (Frozen) - various sizes NAA 3 277310 0 0 3145 No Change 2017-02-01 2019-03-01 Human Tissue NAA90 Humerus – Distal Segment Super Critical Fluid CO2 Treated (Frozen( NAA 3 277310 0 0 3206 No Change 2017-02-01 2019-03-01 Human Tissue NAA91 Hemi Patella Tendon with Bone Block Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 3596 No Change 2017-02-01 2019-03-01 Human Tissue NAA76 Anterior Tibialis Tendon Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 2967 No Change 2017-02-01 2019-03-01 Human Tissue NAA77 Femoral Condyle Whole Super Critical Fluid CO2 Treated (Freeze Dried) NAA 3 277310 0 0 3541 No Change 2017-02-01 2019-03-01 Human Tissue NAA78 Morsellised Bone Super Critical Fluid CO2 Treated (Frozen) Packs of 7.5gm – 15gm NAA 3 277310 0 0 2326 No Change 2017-02-01 2019-03-01 Human Tissue NAA79 Morsellised Bone (frozen) 15-30g NAA 3 277310 0 0 2531 No Change 2017-02-01 2019-03-01 Human Tissue NAA80 Femoral Condyle Half – Super Critical Fluid CO2 Treated (Freeze Dried) NAA 3 277310 0 0 3086 No Change 2017-02-01 2019-03-01 Human Tissue NAA81 Fibular Ring (Freeze Dried) - various sizes NAA 3 277310 0 0 1910 No Change 2017-02-01 2019-03-01 Human Tissue NAA82 HTO Wedge (Frozen) - various sizes NAA 3 277310 0 0 1610 No Change 2017-02-01 2019-03-01 Human Tissue NAA83 Cortical Sheet Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 1623 No Change 2017-02-01 2019-03-01 Human Tissue NAA92 HTO Wedge – Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 1641 No Change 2017-02-01 2019-03-01 Human Tissue NAA93 Fibular Ring Super Critical Fluid CO2 Treated (Freeze Dried) NAA 3 277310 0 0 1947 No Change 2017-02-01 2019-03-01 Human Tissue NAA94 Cortical Plate (Freeze Dried) - various sizes NAA 3 277310 0 0 1592 No Change 2017-02-01 2019-03-01 Human Tissue NAA95 Tibial Shaft (Freeze Dried) - various sizes NAA 3 277310 0 0 4994 No Change 2017-02-01 2019-03-01 Human Tissue NAA96 Femoral Head – Hemi Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 3499 No Change 2017-02-01 2019-03-01 Human Tissue NAA97 Femur – Distal (Freeze Dried) - various sizes NAA 3 277310 0 0 3703 No Change 2017-02-01 2019-03-01 Human Tissue NAA98 Femoral Head – Whole (Freeze Dried) - various sizes NAA 3 277310 0 0 3499 No Change 2017-02-01 2019-03-01 Human Tissue NAA99 Unicortical Cancellous Wedge Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 1623 No Change 2017-02-01 2019-03-01 Human Tissue NBB01 Tendon - Achilles NBB 3 277310 0 0 2562 No Change 2005-10-31 2019-03-01 Human Tissue NAA42 Cancellous Cube – Super Critical Fluid CO2 Treated (Frozen) 3cm3 cubes NAA 3 277310 0 0 1663 No Change 2017-02-01 2019-03-01 Human Tissue NAA43 Femur – Proximal Super Critical Fluid CO2 Treated (Freeze Dried) NAA 3 277310 0 0 3969 No Change 2017-02-01 2019-03-01 Human Tissue NAA44 Tibia – Distal (Freeze Dried) - various sizes NAA 3 277310 0 0 3473 No Change 2017-02-01 2019-03-01 Human Tissue NAA45 Cortical Cancellous Block (Freeze Dried) - various sizes NAA 3 277310 0 0 1592 No Change 2017-02-01 2019-03-01 Human Tissue NAA46 Femoral Strut (Frozen) - various sizes NAA 3 277310 0 0 3703 No Change 2017-02-01 2019-03-01 Human Tissue NAA47 Femoral Head Whole Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 3499 No Change 2017-02-01 2019-03-01 Human Tissue NAA48 Tricortical Cancellous Wedge – Super Critical Fluid CO2 Treated (Frozen) - various sizes NAA 3 277310 0 0 1623 No Change 2017-02-01 2019-03-01 Human Tissue NAA49 Humerus – Strut Super Critical Fluid CO2 Treated (Freeze Dried) NAA 3 277310 0 0 2574 No Change 2017-02-01 2019-03-01 Human Tissue NAA50 Humerus – Proximal Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 3762 No Change 2017-02-01 2019-03-01 Human Tissue NAA51 Posterior Tibialis Tendon Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 2967 No Change 2017-02-01 2019-03-01 Human Tissue NAA52 Femur – Proximal (Freeze Dried) - various sizes NAA 3 277310 0 0 3893 No Change 2017-02-01 2019-03-01 Human Tissue NAA53 Morsellised Bone Super Critical Fluid CO2 Treated (Freeze Dried) Packs of 5 – 10cc NAA 3 277310 0 0 2326 No Change 2017-02-01 2019-03-01 Human Tissue NAA54 Cortical Strut (Frozen) - various sizes NAA 3 277310 0 0 2525 No Change 2017-02-01 2019-03-01 Human Tissue NAA55 Femoral Shaft Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes NAA 3 277310 0 0 2292 No Change 2017-02-01 2019-03-01 Human Tissue NAA56 Femur – Whole Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 8424 No Change 2017-02-01 2019-03-01 Human Tissue NAA57 Cortical Plate Super Critical Fluid CO2 Treated (Frozen) various sizes NAA 3 277310 0 0 1623 No Change 2017-02-01 2019-03-01 Human Tissue NAA58 Malleable Bone Segments Super Critical Fluid CO2Treated (Frozen) NAA 3 277310 0 0 3541 No Change 2017-02-01 2019-03-01 Human Tissue NAA59 Tibia – Distal (Frozen) - various sizes NAA 3 277310 0 0 3473 No Change 2017-02-01 2019-03-01 Human Tissue NAA60 Femoral Condyle Whole (Frozen) - various sizes NAA 3 277310 0 0 3473 No Change 2017-02-01 2019-03-01 Human Tissue NAA61 Cortical Sheet (Freeze Dried) - various sizes NAA 3 277310 0 0 1592 No Change 2017-02-01 2019-03-01 Human Tissue NAA62 Unicortical Cancellous Wedge (Freeze Dried) - various sizes NAA 3 277310 0 0 1592 No Change 2017-02-01 2019-03-01 Human Tissue NAA63 Gracilis Tendon (Frozen) - various sizes NAA 3 277310 0 0 2250 No Change 2017-02-01 2019-03-01 Human Tissue NAA64 Tendon Patch Super Critical Fluid CO2 Treated (Frozen) NAA 3 277310 0 0 3707 No Change 2017-02-01 2019-03-01 Human Tissue NAA65 Bone Dowel / Plug Super Critical Fluid CO2 Treated (Frozen) various sizes NAA 3 277310 0 0 1663 No Change 2017-02-01 2019-03-01 Human Tissue NAA66 Morsellised Bone 7.5mg - 15mg NAA 3 277310 0 0 2281 No Change 2017-02-01 2019-03-01 Human Tissue NAA67 Unicortical Cancellous Wedge (Frozen) - various sizes NAA 3 277310 0 0 1592 No Change 2017-02-01 2019-03-01 Human Tissue NBB30 Humerus - Entire with rotator cuff NBB 3 0 0 4118 No Change 2005-10-31 2019-03-01 Human Tissue NBB31 Ligament - Medial NBB 3 0 0 2305 No Change 2005-10-31 2019-03-01 Human Tissue NBB33 Tendon - Patellar with bone plugs NBB 3 277310 0 0 2861 No Change 2005-10-31 2019-03-01 Human Tissue NBB35 Tibia - Plateau (prox 1/3) NBB 3 0 0 3258 No Change 2005-10-31 2019-03-01 Human Tissue NBB36 Tibia - Proximal NBB 3 277310 0 0 3400 No Change 2005-10-31 2019-03-01 Human Tissue NBB37 Tibia - Whole NBB 3 277310 0 0 5418 No Change 2005-10-31 2019-03-01 Human Tissue NBB38 Ulna - Shaft NBB 3 0 0 3170 No Change 2006-11-30 2019-03-01 Human Tissue NBB40 Ulna - Ring NBB 3 0 0 2399 No Change 2006-11-30 2019-03-01 Human Tissue NBB41 Tibial Shaft NBB 3 277310 0 0 4994 No Change 2006-11-30 2019-03-01 Human Tissue NBB42 Tibial Shaft - third NBB 3 0 0 3423 No Change 2006-11-30 2019-03-01 Prosthesis LV126 GENESYS PressFT Suture Anchor 2.6mm The ConMed Linvatec GENESYS PressFT (biocomposite) Suture Anchors are manufactured from polylactide copolymer (96L/4D PLA co-polymer) and beta-tricalcium phosphate (B-TCp), and are provided sterile, preloaded on a single-use driver and pre-threaded with either one or two Hi-Fi Sutures 2.6mm LV 13 123 1774 5385 AB 208881 501 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LV139 Y-Knot RC Suture Anchor The Y-Knot RC Suture Anchor is constructed from High Strength Flat Braided Suture. 2.8mm LV 13 123 1774 5385 136631 Changed Benefit 442 0 0 Update 2014-08-01 2019-03-01 Prosthesis LV142 Knee Preservation System - GraftMax Adjustable loop button for soft tissue fixation KS-ALB and KS BTB (LxWxH): 14mm x 4.5mm x 2mm KS-BCA (Cradle) (LxWxH): 21mm x 6mm x 2.8mm LV 13 123 1774 5389 136631 374 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LV143 TenoLok Soft tissue anchor with or without suture 5.0mm and 6.0mm LV 13 123 1774 5387 136631 Changed Benefit 442 0 0 Update 2016-02-01 2019-03-01 Prosthesis LV122 Sequent Meniscal Repair Device - 3 Implant The Sequential Meniscal Repair Device is pre-loaded with polyetheretheketone (PEEK) implants threaded onto one size #0 (3.5 metric) HiFi suture. 5.1mm x 1.3mm LV 13 123 1774 5387 120427 Changed Benefit 442 0 0 Update 2012-08-01 2019-03-01 Prosthesis LV123 Press FT PEEK Suture Anchor Press FT PEEK Suture Anchor - preloaded on a single driver 2.6mm LV 13 123 1774 5385 136631 Changed Benefit 442 0 0 Update 2013-02-01 2019-03-01 Prosthesis LV124 PressFT PEEK Suture Anchor 2.1mm The ConMed Linvatec PressFT Suture Anchors are manufactured from PEEK and are provided, preloaded on a single use driver and pre-threaded with either one or two Hi-Fi Sutures. 2.1mm LV 13 123 1774 5384 136631 Changed Benefit 294 0 0 Update 2013-02-01 2019-03-01 Prosthesis LV125 GENESYS PressFT Suture Anchor 2.1mm The ConMed Linvatec GENESYS PressFT (biocomposite) Suture Anchors are manufactured from polylactide copolymer (96L/4D PLA co-polymer) and beta-tricalcium phosphate (B-TCp), and are provided sterile, preloaded on a single-use driver and pre-threaded with either one or two Hi-Fi Sutures 2.1mm LV 13 123 1774 5384 AB 208881 503 0 0 No Change 2013-08-01 2019-03-01 Human Tissue NBB44 Tibia - Whole with Patellar Tendon NBB 3 0 0 7059 No Change 2006-11-30 2019-03-01 Human Tissue NBB45 Tibia - Ring NBB 3 0 0 1874 No Change 2006-11-30 2019-03-01 Human Tissue NBB46 Tibia - Proximal with Patellar Tendon NBB 3 0 0 5158 No Change 2006-11-30 2019-03-01 Human Tissue NBB47 Radius - Shaft NBB 3 0 0 3850 No Change 2006-11-30 2019-03-01 Human Tissue NBB49 Radius - Ring NBB 3 0 0 2399 No Change 2006-11-30 2019-03-01 Human Tissue NBB50 Humeral Shaft NBB 3 277310 0 0 4118 No Change 2006-11-30 2019-03-01 Human Tissue NBB51 Humeral Shaft - Half NBB 3 0 0 2162 No Change 2006-11-30 2019-03-01 Prosthesis LV103 Matryx Interference Screw Matryx (SR-96L/4D PLA with ß-TCP) Inteference Screw 7.3 x 20mm; 7.3 x 25mm; 7.3 x 30mm; 8 x 20mm; 8 x 25mm; 8 x 30mm; 9 x 20mm; 9 x 25mm; 9 x 30mm; 9 x 38mm; 10 x 25mm; 10 x 33mm; 10 x 38mm; 11 x 25mm; 11 x 33mm; 11 x 38mm LV 13 123 1774 5391 AB 139664 457 0 0 No Change 2007-12-01 2019-03-01 Human Tissue NBB43 Tibial Shaft - half NBB 3 0 0 3170 No Change 2006-11-30 2019-03-01 Prosthesis LV109 XO Button with Continuous Loop Titanium suspensor, fixation device for femoral fixation in ACT and PCL repairs 4.5mm x 13.5mm with Continuous Loop lengths 15-60mm LV 13 123 1774 5389 136631 374 0 0 No Change 2008-07-01 2019-03-01 Prosthesis LV112 CrossFT Suture Anchor PEEK Optima Suture Anchor with multiple sutures with or without needles 4.5mm, 5.5mm & 6.5mm diameters LV 13 123 1774 5387 136631 Changed Benefit 442 0 0 Update 2010-02-01 2019-03-01 Prosthesis LV113 PopLok Suture Anchor PEEK Optima Suture Anchor with or without sutures 2.8mm, 3.3mm, 3.5mm & 4.5mm diameters LV 13 123 1774 5387 136631 Changed Benefit 442 0 0 Update 2010-02-01 2019-03-01 Prosthesis LV114 Super Revo-FT,ThRevo-FT Fully Threaded Suture Anchor pre-threaded with two or three sutures with or without needles 5mm LV 13 123 1774 5387 136631 Changed Benefit 442 0 0 Update 2010-02-01 2019-03-01 Prosthesis LV115 Sequent Meniscal Repair Device The Sequent Meniscal Repair Device is pre-loaded with polyetheretherketone (PEEK) implants threaded onto one size #0 (3.5 metric) HiFi® suture. The device sequentially deplos the implants and suture that are tightened down to create multiple stitches to create fixation points along a soft tissue tear 7 (5.1mm x 1.3mm Implants) LV 13 123 1774 5384 MI 120427 755 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LV116 Sequent Meniscal Repair Device The Sequent Meniscal Repair Device is pre-loaded with polyetheretherketone (PEEK) implants threaded onto one size #0 (3.5 metric) HiFi® suture. The device sequentially deplos the implants and suture that are tightened down to create multiple stitches to create fixation points along a soft tissue tear 4 (5.1mm x 1.3mm Implants LV 13 123 1774 5387 120427 Changed Benefit 442 0 0 Update 2012-02-01 2019-03-01 Prosthesis LV117 CrossFT Suture Anchor Polyester PEEK Optima Suture Anchor with Multiple Polyester Sutures 4.5mm, 5.5mm and 6.5mm LV 13 123 1774 5387 136631 Changed Benefit 442 0 0 Update 2012-02-01 2019-03-01 Prosthesis LV118 Genesys CrossFT Micro TCP Soft Tissue Suture Anchor with multiple sutures with or without needles 4.5mm, 5.5mm, 6.5mm diameters LV 13 123 1774 5387 AB 194022 501 0 0 No Change 2012-08-01 2019-03-01 Prosthesis LV119 Y-Knot Suture Anchor Y-Knot All Suture Anchor 1.3mm to 1.8mm LV 13 123 1774 5384 136631 Changed Benefit 294 0 0 Update 2012-08-01 2019-03-01 Prosthesis LV120 GENESYS Matryx Interference Screw, diameter 7 - 11mm GENESYS Matryx Interference Screw - cannulated bioabsorbable 7.0x20mm,7.0x25mm,7.0x30mm,8.0x20mm,8.0x25mm,8.0x30mm,8.0x35mm,9.0x20mm,9.025mm,9.0x30mm,9.0x35mm,10x20mm,10x25mm,10x30mm,10x35mm,11x20mm,11x25mm,11x25mm,11x25mm,11x25mm,11x30mm,11x35mm,11x40mm LV 13 123 1774 5391 AB 194179 457 0 0 No Change 2012-08-01 2019-03-01 Prosthesis LV121 GENESYS Matrix Interference Screw, diameter 5-6.5mm. GENESYS Matrix Interference Screw - Cannulated,bioabsorbable 5.0mm diameter x15,20,25,30mm lengths 5.5mm diameter x15,20,25,30mm lengths 6.0mm diameter x15,20,25,30mm lengths 6.5mm diameter x15,20,25,30mm lengths LV 13 123 1774 5391 AB 101275 457 0 0 No Change 2012-08-01 2019-03-01 Human Tissue NBB16 Femoral Head NBB 3 277310 0 0 3499 No Change 2005-10-31 2019-03-01 Human Tissue NBB17 Femoral Rings NBB 3 277310 0 0 2140 No Change 2005-10-31 2019-03-01 Human Tissue NBB18 Fibula - Entire NBB 3 277310 0 0 8052 No Change 2005-10-31 2019-03-01 Human Tissue NBB21 Hemipelvis - Acetabulum NBB 3 0 0 3759 No Change 2005-10-31 2019-03-01 Human Tissue NBB22 Hemipelvis - iliac crest NBB 3 0 0 3500 No Change 2005-10-31 2019-03-01 Human Tissue NBB23 Hemipelvis - Tricortical iliac wedge NBB 3 277310 0 0 1592 No Change 2005-10-31 2019-03-01 Human Tissue NBB24 Hemipelvis - Complete NBB 3 277310 0 0 8663 No Change 2005-10-31 2019-03-01 Human Tissue NBB25 Humerus - Distal NBB 3 277310 0 0 3145 No Change 2005-10-31 2019-03-01 Human Tissue NBB26 Humeral Head Addition NBB 3 277310 0 0 2059 No Change 2005-10-31 2019-03-01 Human Tissue NBB27 Humerus - Proximal NBB 3 277310 0 0 3690 No Change 2005-10-31 2019-03-01 Human Tissue NBB28 Humerus - Proximal half with rotator cuff NBB 3 0 0 3595 No Change 2005-10-31 2019-03-01 Human Tissue NBB29 Humerus - Entire NBB 3 277310 0 0 4188 No Change 2005-10-31 2019-03-01 Prosthesis ME196 Figulla Flex II ASD Occluder Occlutech Flexx II ASD Occlusion device Figulla Flex II ASD Waist Ø (mm): Size 4,5,6,7.5,9,10.5,12,13.5,15,16.5,18,21,24,27,30,33,36,39,40 ME 27 248 1768 o 201602 8262 0 0 No Change 2016-08-01 2019-03-01 Prosthesis ME197 Figulla Flex II PFO Occluder The Figulla® Flex II PFO is an implant for closure of a patent foramen ovale (PFO) defect in the heart and is deployed via a minimally invasive catheter delivery system. The Figulla® Flex PFO is intended for patients with substantiated Right-Left-Shunt in the contrast agent echocardiography under Valsalva maneuver and presence of a "cryptogenic", paradoxical thromboembolism. Figulla Flex II PFO Disc Ø (mm): 23/25, 16/18, 27/30, 31/35 ME 27 248 1768 o 201603 8262 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LV144 DuraClip™ Repositionable Hemostasis Clip A single use repositionable hemostasis clip which is intended to be used for placement within the gastrointestinal tract. 165cm Length and 235cm Length LV 21 194 1581 4258 Endoscopic 274973 134 0 0 No Change 2016-08-01 2019-03-01 Prosthesis 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 MC 24 207 1632 L (long length, >150mm) 197541 Changed Benefit 4133 0 0 Update 2012-08-01 2019-03-01 Prosthesis MC997 Endurant II AAA Stent Graft Bifurcation Endurant II Endoluminal Stent Graft System - Bifurcated Graft Proximal diameters: 23 to 36mm; Distal diameters: 13 to 20mm; Covered lengths: 124 to 166mm MC 24 207 1628 4445 197540 8507 0 0 No Change 2012-08-01 2019-03-01 Prosthesis MC998 Endurant II AAA Aorto-Uni-Iliac Endurant II Endoluminal Stent Graft System - AUI Proximal diameter: 23 to 36mm; Distal daimeter: 14mm; Covered length: 102mm MC 24 207 1627 197539 9690 0 0 No Change 2012-08-01 2019-03-01 Prosthesis BT176 Protego T & TD T - Quadripolar Single Coil ICD lead with passive fixation, fractal/steroid coating, Silglide and DF4 connector TD - Quadripolar Dual Coil ICD lead with passive fixation, fractal/steroid coating, Silglide and DF4 connector T - Length: 65cm, Electrode spacing 15mm, 7.8F TD - Length: 65cm, 75cm; Electrode spacing 16mm & 65cm, 18mm @ 65cm & 75cm, 7.8 F BT 27 242 1741 e 227616 227617 6480 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BT178 Orsiro Sirolimus Coronary Artery Stent, Drug Eluting Co/Cr Alloy coated in PLLA Stent diameters ø 2.25 -4.0mm Lengths: 9-40mm BT 27 247 1766 5346 220414 2484 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BT179 Cardio Messenger II-S 3G Bedside/Remote transmitter w/ ICD device life network access to Biotronik standard home monitoring data management service. Bedside Device - 203 x 136mm x 80mm, 450 grams BT 27 266 1832 201691 1568 0 0 No Change 2015-08-01 2019-03-01 Prosthesis BT224 AlCath Flutter Flux G eXtra Mapping and Ablation Cardiac Catheter, Gold Tip(G) High Thermal Conduction Ablation, Advanced 3D irrigation (eXtra), FullCircle Deflection, Optimised stability,control & length for flutter 7F ,95cm , 3.5mm Gold tip BT 27 290 2946 7349 Biotronik 221411 New Listing 3280 0 0 Insert 2019-03-01 2019-03-01 Prosthesis BT222 AlCath G FullCircle Mapping and Ablation Cardiac Catheter, Gold Tip(G) High Thermal Conduction Ablation, FullCircle Deflection, Standard or Long Tip. 7F, 110cm , 4 mm Tip Gold (G) and 8mm (LT) Long Tip Gold(G) BT 27 290 2946 7349 Biotronik 281003 New Listing 3280 0 0 Insert 2019-03-01 2019-03-01 Prosthesis BT223 AlCath Flux G eXtra Mapping and Ablation Cardiac Catheter, Advanced 3D irrigation (eXtra), Gold Tip(G) High Thermal Conduction Ablation, FullCircle Deflection 7F , 110cm , 3.5mm irrigated gold tip BT 27 290 2946 7349 Biotronik 193331 New Listing 3280 0 0 Insert 2019-03-01 2019-03-01 Prosthesis BT225 AlCath Flutter LT G Mapping and Ablation Cardiac Catheter, Gold Tip(G) High Thermal Conduction Ablation, FullCircle Deflection, Long 8mm Tip (LT), Optimised stability,control & length for flutter 7F , 95cm , 8mm(LT) gold tip BT 27 290 2946 7349 Biotronik 221412 New Listing 3280 0 0 Insert 2019-03-01 2019-03-01 Prosthesis BB143 Vascugraft Easy Glide - Standard Wall with Helix Short Taper Dia 6 - 8mm, length 40 - 70cm BB 24 208 1639 142665 831 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB144 Vascugraft Easy Glide - Thin Wall Straight Dia 6 - 8mm, length 40 - 70cm BB 24 208 1636 4456 142665 Changed Benefit 827 0 0 Update 2005-10-31 2019-03-01 Prosthesis BB145 Vascugraft Thin Wall Centred Helix Tapered Dia 4 - 7mm, length 70cm BB 24 208 1639 142665 831 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB146 Vascugraft Easy Glide - Thin Wall Straight with Helix Support Dia 6 - 8mm, length 40 - 80cm BB 24 208 1636 4456 R (ringed) 142665 1444 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB155 Vascugraft Standard Tapered Dia 4 - 7mm, length 30 - 70cm BB 24 208 1639 142665 831 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB156 Vascugraft Standard Wall with Tapered Centre Helix Dia 4 - 8mm, length 40 - 45cm BB 24 208 1639 142665 831 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB157 Vascugraft Standard Wall Stepped Taper Dia 4 - 8mm, length 40 - 45cm BB 24 208 1639 142665 831 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB158 Aesculap Cervical System Titanium with locking mechanism Dia 4 - 4.5mm, length 10 - 28mm BB 19 165 1464 Expansion Screw / Expansion Head Screw 134538 289 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB169 Vena Cava Filter System PHYNOX Introducer system, 'J' Guidewire, Seldinger needle, disposable scalpel Diameter 28 mm BB 24 211 1642 135820 2231 0 0 No Change 2005-10-31 2019-03-01 Prosthesis 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 BB 24 214 1652 133738 450 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB181 OPTILENE MESH Polypropylene Mesh 5x30cm, 5 pieces BB 21 194 1782 5434 138532 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB182 OPTILENE MESH Polypropylene Mesh 20x30cm, 5 pieces BB 21 194 1782 5436 138532 218 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB183 OPTILENE MESH Polypropylene Mesh 7.5x7.5cm, 5 pieces BB 21 194 1782 5434 138532 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB184 OPTILENE MESH Polypropylene Mesh 15x15cm, 5 pieces BB 21 194 1782 5435 138532 81 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB185 OPTILENE MESH Polypropylene Mesh 30x30cm, 5 pieces BB 21 194 1782 5437 138532 261 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE612 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. DE 20 186 1811 216894 19000 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE613 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, 130mm Flare Length: 20, 35mm Diameter: 36 Flare Diameter: 40 Design: single- or double-flared DE 24 206 1622 5471 249572 Changed Benefit 4418 0 0 Update 2018-02-01 2019-03-01 Prosthesis BB186 OPTILENE MESH Polypropylene Mesh 5 x 10cm, 5 pieces BB 21 194 1782 5434 138532 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB190 OPTILENE MESH Polypropylene Mesh 4.5x10cm BB 21 194 1782 5434 138532 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB187 OPTILENE MESH Polypropylene Mesh 10 x 15cm, 5 pieces BB 21 194 1782 5434 138532 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB188 OPTILENE MESH Polypropylene Mesh 4.5x10cm, 5 pieces BB 21 194 1782 5434 138532 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB189 OPTILENE MESH Polypropylene Mesh. 7.5 x 15cm, 5 pieces BB 21 194 1782 5434 138532 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB191 OPTILENE MESH Polypropylene Mesh 6x14cm, 5 pieces BB 21 194 1782 5434 138532 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB192 Premilene Mesh Premilene Nonabsorbable Polypropylene Surgical Suture Material Low Profile. Self-Forming Plug-Small, 5 pieces BB 21 194 1691 138532 Changed Benefit 250 0 0 Update 2005-10-31 2019-03-01 Prosthesis AL040 AcrySof IQ PanOptix Presbyopia Correcting IOL Trifocal posterior chamber, UV absorbing, foldable, acrylic, aspheric, single piece lens with apodised diffractive trifocal optic and blue light protection. The apodised diffractive trifocal optic (anterior) provides two diffractive focal points (+3.25D near focus and 2.17D intermediate focus). +6.0 to +30.0D in 0.5 Diopter increments and +31.0 to +34.0D in 1.0 Diopter increments AL 1 141 1327 3893 at, vblf 92318 712 0 0 No Change 2015-08-01 2019-03-01 Prosthesis BB193 Premilene Mesh Premilene Nonabsorbable Polypropylene Surgical Suture Material Low Profile. Self-Forming Plug-Medium, 5 pieces BB 21 194 1691 138532 Changed Benefit 250 0 0 Update 2005-10-31 2019-03-01 Prosthesis BB194 Premilene Mesh Premilene Nonabsorbable Polypropylene Surgical Suture Material Low Profile. Self-Forming Plug-Large, 5 pieces BB 21 194 1691 138532 Changed Benefit 250 0 0 Update 2005-10-31 2019-03-01 Prosthesis BB195 OPTILENE MESH Polypropylene Mesh Self-Forming Plug-Large, 5 pieces BB 21 194 1691 138532 Changed Benefit 250 0 0 Update 2005-10-31 2019-03-01 Prosthesis BB196 E.motion Total Knee System Posterior Stabilised Knee Component cemented F2 - F8 Right Left BB 17 149 1348 3907 Revision 96481 5501 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB198 Emotion Total Knee System (TKS) Tibial Insert Tibial Insert, UHMWPE, mobile T1 to T8 Size: 10 to 24mm BB 17 153 1369 96482 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB199 Emotion Total Knee System (TKS) Tibial Insert Tibial Insert, UHMWPE, mobile, posterior stabilised with peg T1 to T8 Sizes: 10 to 24mm BB 17 153 1370 96482 Changed Benefit 1073 0 0 Update 2005-10-31 2019-03-01 Prosthesis BB200 Emotion Total Knee System (TKS) Tibial and Femoral Stems Tibial and femoral stems, CoCr, cemented or uncemented Short, D: 10mm to 20mm , Medium, D: 10mm to 20mm, Long, D: 10mm to 20mm BB 17 159 1399 96481 Changed Benefit 1126 0 0 Update 2005-10-31 2019-03-01 Prosthesis BT180 Eluna 8 SR-T Single Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional, IS-1 connector 53 x 39 x 6.5 mm, 11cm3 , 24grams BT 27 239 1730 i 265540 4268 0 0 No Change 2016-02-01 2019-03-01 Prosthesis BT181 Eluna 8 DR-T Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional, IS-1 connector 53 x 44.5 x 6.5 mm, 12cm3, 25grams BT 27 240 1734 i 265541 8237 0 0 No Change 2016-02-01 2019-03-01 Prosthesis CR252 Unity Knee – Patella Patella Cemented Sizes 1 – 5 CR 17 156 1376 223558 Changed Benefit 537 0 0 Update 2017-08-01 2019-03-01 Prosthesis AL042 CyPass System The CyPass System consists of the CyPass Micro-Stent, which is contained in a loading device (Loader), and the CyPass Applier. 6.35mm length AL 1 144 1802 6442 300140 1330 0 0 No Change 2017-02-01 2019-03-01 Prosthesis AL043 AcrySof IQ PanOptix Toric Presbyopia Correcting IOL Trifocal posterior chamber, toric, UV absorbing, foldable, acrylic, aspheric, single piece lens with apodised diffractive trifocal optic and blue light protection. The apodised diffractive trifocal optic (anterior) provides two diffractive focal points (+3.25D near focus and 2.17D intermediate focus). +6.0 to +30.0D in 0.5 Diopter increments and +31.0 to +34.0D in 1.0 Diopter increments. Cylinder: +1.0; +1.50; +2.25; +3.00 and +3.75 D AL 1 141 1327 3893 at, t1, vblf 92318 1021 0 0 No Change 2017-02-01 2019-03-01 Prosthesis AL044 Clareon AutonoMe The Clareon Aspheric Hydrophobic Acrylic Lens is an ultraviolet and blue light filtering foldable single-piece posterior chamber intraocular lens, provided in the AutonoMe Pre-loaded Delivery System. +6.0 to +25.0 D AL 1 141 1327 3892 at, pl, vblf 92318 333 0 0 No Change 2018-02-01 2019-03-01 Prosthesis AM001 AMS 800 Artificial Urinary Sphincter Cuff Occlusive Cuff 13 Cuff sizes from 3.5 to 11.0 cm: Size: 3.5, 4, 4.5, 5, 5.5, 6, 6.5, 7, 7.5, 8, 9, 10, 11cm AM 26 226 1696 5307 131706 2483 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI241 Gentle Threads Ligament Fixation Screws Screw, Graft Interference, PGA/PLA 7mm, 8mm, 9mm, 10mm BI 13 123 1774 5391 154007 Changed Benefit 181 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI246 Arthrotek Ligament Fixation System Bone Mulch Screws, Titanium 10.5mm x (20-35mm) BI 13 123 1774 5394 116765 451 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI262 EBI XFIX Dynafix System Bone Screw, Cortical, tapered, Cancellous, Stainless Steel 2.4mm to 6.00mm diameter BI 13 123 1231 3369 145253 65 0 0 No Change 2005-10-31 2019-03-01 Prosthesis CR253 Unity Knee - Augments Tibial Full and Half block Augments, Femoral distal and posterior augments All components available in Size: 1-9; Thickness: 5 and 10mm Tibia: Full, LM-RL, RM-LL, CR 17 159 1390 274559 1148 0 0 No Change 2017-08-01 2019-03-01 Prosthesis CR254 Unity Knee – Stem Extenders Tibial Stem extenders and offset couplings -cemented 3mm, 6mm Diameter Ø10-18 Length 60 and 100mm Offset and straight CR 17 159 1400 274747 698 0 0 No Change 2017-08-01 2019-03-01 Prosthesis CR255 HLS Noetos Revision Knee augments Distal and Posterior Femoral and tibial Wedges and blocks, CoCr 1 to 6 Thickness 4, 8 and 12 CR 17 159 1390 237173 1148 0 0 No Change 2017-08-01 2019-03-01 Prosthesis CR256 HLS KneeTec Extension Stem Extension Stem for use with HLS KneeTec Tibial Tray 10mm, 14mm CR 17 159 1399 Changed Benefit 1126 0 0 Update 2017-08-01 2019-03-01 Prosthesis CR257 Meije Duo Femoral Head Delta Ceramic <32 Femoral Head Ceramic Short, Med, Long, Extra Long, 22.2mm or 32mm CR 18 162 1419 3992 207890 1845 0 0 No Change 2017-08-01 2019-03-01 Prosthesis CT005 Titan Inflatable Penile Prosthesis (Resist Coated) - Assembly Kit Assembly kit for three component penile prosthesis (Resist Coated) Standard & Narrow -base CT 26 230 1710 5334 A 140111 Changed Benefit 655 0 0 Update 2007-12-01 2019-03-01 Prosthesis CT007 Genesis Penile Prosthesis (Resist Coated) Malleable Penile Prosthesis (Resist Coated) Dia: 9.5 mm (14 - 23cm lengths), Dia: 11mm (16 - 25cm lengths), Dia: 13mm (18 - 27cm lengths) CT 26 230 1721 A 140302 855 0 0 No Change 2007-12-01 2019-03-01 Prosthesis CT008 Titan Inflatable Penile Prosthesis (Resist Coated) - Cylinders Cylinders for three component penile prosthesis (Resist Coated) 10, 12, 14, 16, 18, 20, 22cm CT 26 230 1710 5330 A 140111 Changed Benefit 3638 0 0 Update 2007-12-01 2019-03-01 Prosthesis CT009 Titan Inflatable Penile Prosthesis (Resist Coated) - Cylinders & Pump Preconnected Preconnected Cylinders & pump for three component penile prosthesis (Resist Coated) 10, 12, 14, 16, 18, 20, 22cm (in both infrapubic & scrotal models) CT 26 230 1710 5335 A 140111 8070 0 0 No Change 2007-12-01 2019-03-01 Prosthesis CT010 Titan Inflatable Penile Prosthesis (Resist Coated) - Lock-out Valve Reservoir Reservoir for three component penile prosthesis (Resist Coated) 60, 75, 100ml CT 26 230 1710 5331 A 140111 1881 0 0 No Change 2007-12-01 2019-03-01 Prosthesis AM004 AMS 700 Series Inflatable Penile Prostheses with Inhibizone Cylinders 700 Series with InhibiZone 12, 14, 15, 16, 18, 21cm AM 26 230 1710 5330 A 125444 Changed Benefit 3638 0 0 Update 2005-10-31 2019-03-01 Prosthesis AM021 AMS 800 Artificial Urinary Sphincter Cuff Silicone cuff for artificial urinary sphincter. For the implantation of the second cuff for the AMS 800 13 Cuff sizes from 3.5 to 11.0 cm: Size: 3.5, 4, 4.5, 5, 5.5, 6, 6.5, 7, 7.5, 8, 9, 10, 11cm AM 26 226 1696 5307 131706 2483 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AM022 AMS 700 Series Inflatable Penile Prostheses Cylinders 700 Series (Non InhibiZone) 12, 14, 15, 16, 18, 21cm AM 26 230 1710 5330 106606 3344 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AM028 AMS 800 Artificial urinary sphincter Pressure Regulating Balloon Pressure Regulating Balloon 51 - 60cm, 61 -70cm, 71 - 80cm AM 26 226 1696 5308 131706 1954 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AM029 AMS 800 Artificial Urinary Sphincter Pump Control Pump One size AM 26 226 1696 5306 131706 4700 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AM030 AMS 800 Artificial Urinary Sphincter Accessory Kit Accessory Kit One Size AM 26 226 1696 5310 131706 Changed Benefit 655 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI271 EBI XFIX Dynafix System Wire Straight or Olive with Washer, Chrome Cobalt 0.9-3.2mm, <400mm BI 13 123 1772 5365 TH 210294 217978 227787 27 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI280 Septopal Chain Septopal Beads PMMA, Stainless Steel 30 bead chain BI 21 188 1542 4196 159233 Changed Benefit 713 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI304 Rush Intramedullary Pins Stainless Steel 3.2mm x (100-250mm) BI 13 123 1772 5365 138206 27 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI306 Rush Intramedullary Pins Stainless Steel (6 - 6.4mm) x (280 - 440mm) BI 13 123 1772 5365 138206 27 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI320 Arthrotek Harpoon System Suture Anchor, Stainless Steel, Ti 1 to 5 BI 13 123 1774 5385 117747 Changed Benefit 442 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI345 Copeland Shoulder System Humeral Component, Chrome Cobalt Small, Std, Large (no specific size) BI 13 131 1276 4068 137045 3040 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI348 W Lorenz Osteosynthesis System L-Plate, 2mm System, Left or Right. Titanium 2 x 2 hole, Mini or Low Profile BI 23 199 1589 4271 119508 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI349 W Lorenz Osteosynthesis System Plate, Compression Straight, 2mm System. Titanium 4 hole BI 23 199 1589 4271 Compression 119508 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI351 W Lorenz Osteosynthesis System L-Plate, 2mm System, Left or Right. Titanium 2 x 2 hole, long BI 23 199 1589 4271 119508 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI353 W Lorenz Osteosynthesis System Plate, Burr Hole, 1mm, 1.5mm, 2mm system 13mm, 17mm, 18.5mm BI 23 199 1589 4271 Burr 128460 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI360 W Lorenz Osteosynthesis System Bone Screw, Cross or Centre Drive, Std or Self Drilling; Titanium 2.0mm x (4 - 7) mm BI 23 199 1590 4323 128459 42 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI365 W Lorenz Osteosynthesis System Bone Screw, Cross or Centre Drive; Titanium 2.0mm x (9 - 19) mm BI 23 199 1590 4323 128459 42 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI399 Lactosorb Resorbable Craniomaxillofacial Fixation System Panel or Sheet, Solid or Holed, PGA/PLA 0.25mm x 25x25mm BI 23 199 1586 4221 143959 439 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI401 Lactosorb Resorbable Craniomaxillofacial Fixation System Cover, Solid or Holed, PGA/PLA 0.25mm x 50x50mm BI 23 199 1586 4222 143959 663 0 0 No Change 2005-10-31 2019-03-01 Prosthesis CT011 Titan Inflatable Penile Prosthesis (Resist Coated) - Pump Pump for three component penile prosthesis (Resist Coated) One Size CT 26 230 1710 5332 A 140111 Changed Benefit 4432 0 0 Update 2007-12-01 2019-03-01 Prosthesis CT012 Titan Inflatable Penile Prosthesis (Resist Coated) - True-lock Plug True Lock Plug for deactivation of three component penile prosthesis (Resist Coated) One Size CT 26 230 1710 5333 140111 Changed Benefit 128 0 0 Update 2007-12-01 2019-03-01 Prosthesis CT013 Aris Transobturator Sling System Sling System for female stress urinary incontinence One Size CT 26 226 1698 5315 157074 160738 Changed Benefit 822 0 0 Update 2009-08-01 2019-03-01 Prosthesis CT015 Virtue Male Sling System Male sling system with quadratic fixation One Size CT 26 226 1698 5314 187095 5432 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DE596 Sierra OCT Rod Sierra Pre-contoured OCT Rods 3.5mm diameter 20-80mm length DE 19 170 1478 275794 Changed Benefit 426 0 0 Update 2018-02-01 2019-03-01 Prosthesis DE597 Sierra OCT Locking Cap Locking Cap and Set Screw 1 size each DE 19 166 1465 275794 164 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE598 Sierra OCT Hook Posterior Cervical Hook 4.5 and 6.0mm Hooks DE 19 168 1475 275794 789 0 0 No Change 2018-02-01 2019-03-01 Prosthesis AM036 AMS 700 Series Inflatable Penile Prostheses with InhibiZone Pump 700 Series with InhibiZone One Size AM 26 230 1710 5332 A 125444 Changed Benefit 4432 0 0 Update 2005-10-31 2019-03-01 Prosthesis AM037 AMS 700 Series Inflatable Penile Prostheses with InhibiZone Pump & Cylinders Preconnected 700 Series with InhibiZone 12, 14, 15, 16, 18, 21cm AM 26 230 1710 5335 A 125444 8070 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AM038 AMS 700 Series Inflatable Penile Prostheses InhibiZone Reservoir 700 Series InhibiZone 50, 65, 100ml AM 26 230 1710 5331 A 125444 1881 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AM040 AMS 700 Series Inflatable Penile Prostheses with InhibiZone Deactivation Package 700 Series with InhibiZone One Size AM 26 230 1710 5333 125444 Changed Benefit 128 0 0 Update 2005-10-31 2019-03-01 Prosthesis AM041 AMS Ambicor AMS Ambicor Inflatable Penile Prostheses AMS Ambicor Inflatable Penile Prostheses 12.5mm in 14, 16 & 18cm length, 14mm in 16, 18 & 20cm length, 15.5mm in 18, 20 & 22cm length AM 26 230 1709 A 131717 9893 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AM042 AMS 700 Series Inflatable Penile Prostheses Pump 700 Series (Non InhibiZone) One Size AM 26 230 1710 5332 106606 Changed Benefit 4076 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI417 Lactosorb Resorbable Craniomaxillofacial Fixation System Cover, Solid or Holed, PGA/PLA (0.5 or 0.8mm) x 25 x 25mm BI 23 199 1586 4225 143959 585 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI418 Lactosorb Resorbable Craniomaxillofacial Fixation System Panel, Lactosorb. 1.5mm System. PGA/PLA 25 x 50mm (5 x 10 hole) BI 23 199 1586 4226 143959 921 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI457 Lorenz 2.4mm Locking Reconstruction System Screw, Locking Reconstruction Modular. Titanium 2.4 x (6-18)mm BI 23 199 1590 4323 Locking 128459 88 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI472 Pectus Bar Pectus Bar, Stainless Steel 80-432mm BI 20 264 1824 149413 1193 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI415 Lactosorb Resorbable Craniomaxillofacial Fixation System Bone Screw, 2 Pack, Endobrow, Lactosorb. PGA/PLA 2 x 5mm BI 23 199 1590 4323 Resorbable 143957 137 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI483 Pectus Bar Stabilizer, Triangular or Elongated, Stainless Steel One size only BI 20 264 1825 149413 480 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI487 Mimix Calcium Phosphate Bone Void Filler Calcium Phosphate 5 grams BI 13 123 1241 4092 143778 722 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE599 Sierra Occipital Plate Occipital Plate 25-35 30-40 35-45 40-50 DE 19 169 1477 4129 275794 Changed Benefit 2166 0 0 Update 2018-02-01 2019-03-01 Prosthesis DE603 PleuraFlow® Active Clearance Technology® (ACT) Pleural drainage catheter 20; 24; 28;32FR DE 21 193 1577 4242 218317 404 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE604 HaemoCer Haemostatic Powder Absorbable Polysaccharide Haemostat 5gms DE 21 191 1552 205062 237 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE605 HaemoCer Haemostatic Powder Absorbable Polysaccharide Haemostat 2gms DE 21 191 1552 205062 95 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE606 Cor-Knot® Device Kit The Cor-Knot Device kit contains two Cor Knot devices which deliver and crimp a titanium fastener around a suture placed using routine suture placement techniques, trimming any excess suture tails Each kit contains two Cor- Knot sterile devices DE 21 194 1581 4257 219812 268 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE607 On-X Prosthetic Heart Valve Bileaflet Mechanical Heart Valve 19-33mm DE 20 178 1497 123500 123501 123502 123503 5700 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE608 iFuse Implant System-Implant iFuse Implant System-Implant 4-10.75 mm; length 30-90 mm DE 19 261 1821 no suffix 212886 1925 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE609 Cor-Knot Mini Device Kit The Cor-Knot Mini Device Kit contains two Cor-Knot Mini Devices which deliver and crimp a titanium fastener around a suture placed using routine suture placement techniques, trimming any excess suture tails. 2 x Cor-Knot Mini Sterile Devices (14cm length shaft) in each kit DE 21 194 1581 4257 219812 268 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE610 Cor-Knot®Quick Load single The Cor-Knot®Quick Load houses one sterile Cor-Knot®Titanium Fastener for use with the Cor-Knot®device kit One size DE 21 194 1582 5988 219813 55 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE611 Cor-Knot®Quick Load 6 Pouch The Cor-Knot®Quick load 6 contains six single sterile Cor-Knot® Titanium Fasteners for use with the Cor-Knot® device kit One size DE 21 194 1582 5988 219813 331 0 0 No Change 2018-02-01 2019-03-01 Prosthesis AM043 AMS 700 Series Inflatable Penile Prostheses Pump & Cylinders Preconnected 700 Series (Non InhibiZone) 12, 14, 15, 16, 18, 21cm AM 26 230 1710 5335 106606 Changed Benefit 7419 0 0 Update 2005-10-31 2019-03-01 Prosthesis AM044 AMS 700 Series Inflatable Penile Prostheses Reservoir non Inhibizone 700 Series (Non InhibiZone) 50, 65, 100ml AM 26 230 1710 5331 106606 1705 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AM045 AMS 700 Series Inflatable Penile Prostheses Accessory Kit 700 Series (Non InhibiZone) One Size AM 26 230 1710 5334 106606 Changed Benefit 655 0 0 Update 2005-10-31 2019-03-01 Prosthesis AM046 AMS 700 Series Inflatable Penile Prostheses Deactivation Package 700 Series (Non InhibiZone) One Size AM 26 230 1710 5333 106606 Changed Benefit 128 0 0 Update 2005-10-31 2019-03-01 Prosthesis AM048 AdVance XP Male Sling System Sub-urethral sling implant for treatment of male stress urinary incontinence. Made from polypropylene monofilament mesh Arm width: 1.2cm, Centre width: 3.55cm, Total Length: 35.5cm, 43.5cm AM 26 226 1698 5314 297821 5432 0 0 No Change 2007-12-01 2019-03-01 Prosthesis BI488 Mimix Calcium Phosphate Bone Void Filler Calcium Phosphate 10 grams BI 13 123 1241 4093 143778 1140 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI489 Mimix Calcium Phosphate Bone Void Filler Calcium Phosphate 20 grams BI 13 123 1241 4094 143778 1425 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI559 TMJ System Mandibular Component, Left or Right, Titanium (40 - 60mm), 5-13 hole BI 23 200 1596 4358 145265 Changed Benefit 6703 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI569 TMJ System Fossa Component, Left or Right; Titanium, UHMWPE Small, Medium Large BI 23 200 1596 4354 145265 5704 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI591 W Lorenz Osteosynthesis System Chin Plates, Paulus, 2mm System, Titanium 4 - 12mm BI 23 199 1589 4271 Complex 128458 240 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BT161 Linox Smart ProMRI S DX Pentapolar, single-coil ICD lead with floating atrial dipole. Permanent, transvenous implantation in the right ventricle. MRI conditional use Length: 65cm. Distance of dipole from tip: 15cm or 17cm BT 27 242 1743 224813 6480 0 0 No Change 2014-08-01 2019-03-01 Prosthesis AM050 Urinary Control System Pump Pump with InhiboZone Antibiotic Surface Treatment One size only. AM 26 226 1696 5306 A 165326 5076 0 0 No Change 2010-02-01 2019-03-01 Prosthesis AM051 AMS 800 Urinary Control System with InhibiZone - cuff Occlusive Cuff with InhibiZone Antibiotic Surface Treatment 13 Cuff sizes from 3.5 to 11.0 cm AM 26 226 1696 5307 A 165326 Changed Benefit 2708 0 0 Update 2010-02-01 2019-03-01 Prosthesis BB137 Vascugraft Standard with Centred Helix Dia 4 - 8mm, length 70 - 90cm BB 24 208 1636 4457 R (ringed) 142665 Changed Benefit 1548 0 0 Update 2005-10-31 2019-03-01 Prosthesis BB138 Vascugraft Standard with Short Taper Dia 4 - 8mm, length 30 - 70cm BB 24 208 1639 142665 831 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB139 Vascugraft Standard with Short Taper Dia 4 - 8mm, length 80cm BB 24 208 1639 142665 831 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB140 Aesculap Cervical System Titanium Alloy All Sizes >55mm BB 19 169 1477 4127 >55mm 134538 1636 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB141 Vascugraft Easy Glide - Standard Wall Straight Dia 6mm, length 70 - 80cm BB 24 208 1636 4457 142665 Changed Benefit 922 0 0 Update 2005-10-31 2019-03-01 Prosthesis BB142 Vascugraft Easy Glide - Standard Wall Straight Dia 6mm, length 40 - 60cm BB 24 208 1636 4456 142665 Changed Benefit 827 0 0 Update 2005-10-31 2019-03-01 Prosthesis BT162 Corox ProMRI OTW (-S) (-L) BP Bipolar, steroid eluting coronary sinus pacing lead with fractal coating Lengths: 77, 87cm BT 27 243 1759 224812 Changed Benefit 4493 0 0 Update 2014-08-01 2019-03-01 Prosthesis BT163 Solia T Sub 6F, steoid-eluting transvenous, endocardial, bipolar passive-fixation lead MRI conditional Lengths: 53, 60cm; Diameter: 5.6Fr BT 27 243 1753 224798 898 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BT164 Solia S Sub 6F, steroid-eluting, transvenous, endocardial, bipolar active fixation lead with an extendable/retractable, electrically active screw. MRI conditional Lengths: 45, 53, 60cm; Diameter: 5.6Fr BT 27 243 1756 224786 898 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BT165 Protego ProMRI SD Dual-shock coil ICD lead with active fixation helix and DF4 connector, MRI conditional Length: 65, 75cm; 16mm, 18mm electrode spacing BT 27 242 1743 e 224816 6480 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BT167 Iperia 7 VR-T Single Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional, DF-4, IS-1 connector 65mm x 52mm x 11mm, 31cm3, 80grams BT 27 236 1723 a, d, e 231880 Changed Benefit 32162 0 0 Update 2015-02-01 2019-03-01 Prosthesis BT168 Iperia 7 DR-T Dual Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional, DF-4, IS-1 connector 65mm x 56mm x 11mm, 32cm3, 82grams BT 27 237 1725 a,d,e 231884 Changed Benefit 34474 0 0 Update 2015-02-01 2019-03-01 Prosthesis BT170 Itrevia 7 VR-T Single Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional, DF-1, IS-1 connector 65mm x 55mm x 11 mm, 33cm3, 80grams BT 27 236 1723 a, d 231882 Changed Benefit 31622 0 0 Update 2015-02-01 2019-03-01 Prosthesis BT171 Itrevia 7 VR-T DX Single Chamber ICD, ventricular capture control, physiological rate adaption, additional atrial detection (DX),automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional, DF-1, IS-1 connector 65mm x 55mm x 11mm, 33cm3, 81grams BT 27 236 1723 a, d 231888 Changed Benefit 31622 0 0 Update 2015-02-01 2019-03-01 Prosthesis MN238 CARTO: SMARTTOUCH/ SMARTTOUCH SF Contact Force Sensing Catheter: with/without Porous Tip One size only MN 27 290 2946 7349 Johnson and Johnson 184035 198574 233354 233355 New Listing 3700 0 0 Insert 2019-03-01 2019-03-01 Prosthesis CR258 Unity Knee - Cruciate Retaining Femur Cemented Femoral Component Cemented - Cruciate Retaining Size 1 – 9, Left and Right CR 17 149 1348 3906 223554 2951 0 0 No Change 2018-02-01 2019-03-01 Prosthesis CR259 Unity Knee – Posterior Stabilised Femur Cemented Femoral Component Cemented - Posterior Stabilised Size 1 – 9, Left and Right CR 17 149 1348 3907 223555 3041 0 0 No Change 2018-02-01 2019-03-01 Prosthesis CR260 Unity Knee - Cruciate Retaining Insert Tibial Insert Cruciate Retaining Size 1 – 9, Thickness 9-20MM CR 17 153 1369 223556 1019 0 0 No Change 2018-02-01 2019-03-01 Prosthesis CR261 Unity Knee – Posterior Stabilised Insert Tibial Insert Posterior Stabilised Size 1 – 9, Thickness 9-20MM CR 17 153 1370 223557 Changed Benefit 1073 0 0 Update 2018-02-01 2019-03-01 Prosthesis CR262 Unity Knee – Tibial Tray Tibial Tray Cemented Sizes 1 – 9 CR 17 151 1357 223558 1923 0 0 No Change 2018-02-01 2019-03-01 Prosthesis CR263 Unity Knee – Patella Patella Cemented Sizes 1 – 5 CR 17 156 1376 223558 Changed Benefit 537 0 0 Update 2018-02-01 2019-03-01 Prosthesis SJ404 Inquiry Optima Diagnostic Catheter mapping catheter 5F-8F SJ 27 290 2946 7351 Abbott 136233 New Listing 2549 0 0 Insert 2019-03-01 2019-03-01 Prosthesis SJ405 Reflexion Spiral Variable Radius Catheter mapping catheter 5F-8F SJ 27 290 2946 7351 Abbott 145053 New Listing 2549 0 0 Insert 2019-03-01 2019-03-01 Prosthesis SJ406 Advisor mapping catheter mapping catheter 5F-8F SJ 27 290 2946 7351 Abbott 282187 New Listing 2549 0 0 Insert 2019-03-01 2019-03-01 Prosthesis SJ407 Afocus II EB Inquiry Steerable Catheter mapping catheter 5F-8F SJ 27 290 2946 7351 Abbott 136211 New Listing 2549 0 0 Insert 2019-03-01 2019-03-01 Prosthesis SJ408 EnSite Patch Surface Electrodes Patch/Kit SJ 27 290 2946 7350 Abbott 195707 274633 New Listing 350 0 0 Insert 2019-03-01 2019-03-01 Prosthesis SJ409 FlexAbility Ablation Catheter Sensor Enabled and Non-Sensor Enabled D, F, J, D-F, F-J, D-D, F-F, J-J SJ 27 290 2946 7349 Abbott 279829 231489 231490 279828 New Listing 3500 0 0 Insert 2019-03-01 2019-03-01 Prosthesis SJ410 TactiCath™ Contact Force Ablation Catheter Sensor Enabled and Non-Sensor Enabled catheter DD, DF, FF, FJ, JJ, D, F. SJ 27 290 2946 7349 Abbott 295544 229891 295543 New Listing 3500 0 0 Insert 2019-03-01 2019-03-01 Prosthesis BT172 Itrevia 7 DR-T Dual Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional, DF-1, IS-1 connector 65mm x 55mm x 11mm, 33cm3, 81grams BT 27 237 1725 a,d 231886 Changed Benefit 33934 0 0 Update 2015-02-01 2019-03-01 Prosthesis BT173 Itrevia 7 HF-T Triple Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional, DF-1, IS-1 connector 65mm x 58.5mm x 11mm, 34cm3, 83grams BT 27 238 1727 a,d 231892 37440 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BT174 Sentus OTW BP L Bipolar, steroid eluting coronary sinus pacing lead with fractal coating Lengths: 77cm, 87 cm, 97cm 4.8F BT 27 243 1759 230846 Changed Benefit 4493 0 0 Update 2015-02-01 2019-03-01 Prosthesis BT175 Protego S Tripolar ICD lead with active fixation Length: 61cm, 65cm, 75cm BT 27 242 1743 e 227618 6480 0 0 No Change 2015-02-01 2019-03-01 Prosthesis MI301 Arctic Front Advance Cardiac CryoAblation Catheter A flexible, over-the-wire balloon catheter used to ablate cardiac tissue 23mm, 28mm MI 27 290 2947 7352 201541 New Listing 5100 0 0 Insert 2019-03-01 2019-03-01 Prosthesis MI300 PVAC Gold Phased RF catheter The Pulmonary Vein Ablation Catheter (PVAC) Gold is a three-dimensional, anatomically designed, multi-electrode phased RF catheter used to map, pace, and ablate the pulmonary veins. 9Fr MI 27 290 2946 7349 Medtronic, single unit 235158 New Listing 6399 0 0 Insert 2019-03-01 2019-03-01 Prosthesis MI302 Achieve / Achieve Advance Mapping Catheter Intra-cardiac electrophysiology circular mapping catheter 15mm, 20mm, 25mm MI 27 290 2947 7353 188676 231648 286735 New Listing 1299 0 0 Insert 2019-03-01 2019-03-01 Prosthesis BT221 AlCath Force Mapping and Ablation Cardiac Catheter, Advanced 3D irrigation (eXtra), Gold Tip(G) High Thermal Conduction Ablation, FullCircle Deflection with Optical Contact Force Sensor 7F, 110cm , 3.5mm tip BT 27 290 2946 7349 Biotronik 279638 New Listing 3280 0 0 Insert 2019-03-01 2019-03-01 Prosthesis CR264 Unity Knee - Augments Tibial Full and Half block Augments, Femoral distal and posterior augments All components available in Size: 1-9; Thickness: 5 and 10mm Tibia: Full, LM-RL, RM-LL, CR 17 159 1390 274559 1148 0 0 No Change 2018-02-01 2019-03-01 Prosthesis CR265 Unity Knee – Stem Extenders Tibial Stem extenders and offset couplings -cemented 3mm, 6mm Diameter Ø10-18 Length 60 and 100mm Offset and straight CR 17 159 1400 274747 698 0 0 No Change 2018-02-01 2019-03-01 Prosthesis CR266 TO089 Dynacup Titanium Screws Cancellous bone screw, Titanium 7 Lengths from 20mm to 55mm CR 18 164 1435 230108 121 0 0 No Change 2018-08-01 2019-03-01 Prosthesis CT001 Excel Inflatable Penile Prosthesis (Resist Coated) Two-piece inflatable penile prosthesis (Resist Coated) Cylinder lengths 10,12,14,16,18,20,22cm & six rear-tip extenders (two each 1, 2 & 3cm) CT 26 230 1709 A 140110 9893 0 0 No Change 2007-12-01 2019-03-01 Prosthesis CT003 Saline Filled Testicular Prosthesis Testicular Prosthesis Extra Small, Small, Medium, Large CT 26 231 1711 140205 620 0 0 No Change 2007-12-01 2019-03-01 Prosthesis CT004 Soft Solid Testicular Prosthesis Gel filled Testicular Prosthesis Small, Medium, Large & Extra Large CT 26 231 1711 179463 620 0 0 No Change 2007-12-01 2019-03-01 Prosthesis EL033 Baxter Augmentation / Substitution Material, Human or Animal Origin, Sterile Pericardial Patch. Edwards Pericardial Patch. Bovine Pericardium. 10cm x 15cm EL 20 182 1507 5454 154067 722 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ER452 LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Connector, in line LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Connector, in line, parallel and domino, accommodates rods of 5.0, 5.5, 6.0 and 6.35 in diameter length (14-40mm) x width (8-16mm) ER 19 167 1472 286123 Changed Product name, Product description, Benefit 732 0 0 Update 2017-08-01 2019-03-01 Prosthesis ER453 LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Connector, offset LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Connector, offset; open or closed; standard or knurled; standard or hex profile dia (6.2-6.5mm) x length (overall) (26-67mm) ER 19 167 1473 286123 Changed Product name, Product description, Product sizes, Benefit 732 0 0 Update 2017-08-01 2019-03-01 Prosthesis ER454 Paragon 28 Titan 3-D Wedge Paragon 28 Titan 3-D Cotton or Evans Wedge, Anatomical, Titanium metal scaffold for angular correction, Sterile 5-8 mm (Cotton); 6-12 mm (Evans) ER 13 123 1772 5457 290444 1513 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ER455 Cascadia Cervical Interbody System Cascadia Interbody spacer, Porous Ti 5-13mm heights ER 19 174 1486 4134 193652 2409 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ER457 LnK Anterior Cervical Plate System-Plate LnK Anterior Cervical Plate System-Plate, 1-3 levels width 17mm x length (13-54mm) ER 19 169 1477 4127 286127 1251 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ER458 LnK Anterior Cervical Plate System-Plate, >55mm LnK Anterior Cervical Plate System-Plate, >55mm, 3-4 levels width 17mm x length (57-93 mm) ER 19 169 1477 4127 >55mm 286127 1636 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ER459 LnK Anterior Cervical Plate System/CastleLoc-P Anterior Cervical Plate System-Screw LnK Anterior Cervical Plate System/CastleLoc-P Anterior Cervical Plate System-Screw, self tapping or self drilling; fixed or variable dia (3.5-4.0mm) x length (12-24mm) ER 19 165 1464 286127 Changed Product name, Product description, Product sizes, Benefit 193 0 0 Update 2017-08-01 2019-03-01 Prosthesis ER461 Endoskeleton TC Titanium coated anterior interbody fusion device for the lumbar spine, sterile or non-sterile, nanoLock (TM) surface technology 12-16 x 14-18mm ER 19 174 1486 4134 285244 2409 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ER462 Endoskeleton TL Titanium Lateral Interbody fusion cage, sterile or non-sterile also with NanoLock™ surface technology, sterile Length: 40-60mm, Width 18-26mm, Height 8-16mm ER 19 174 1486 4135 285244 Changed Product description, Product sizes 3465 0 0 Update 2017-08-01 2019-03-01 Prosthesis ER469 Endoskeleton TAS Titanium coated lumbar cage with integrated fixation, also with NanoLock (TM) surface technology, non-sterile or sterile. 32-40 x 21-27 mm ER 19 174 1485 5486 285244 6256 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ER470 Endoskeleton TCS Titanium Stand Alone ADCF Cage, sterile or non-sterile also with Nanolock™ surface technology, sterile 12-16mm Length, 14-18mm Width, 5-12mm Heights ER 19 174 1485 5485 285244 Changed Product description, Product sizes, Benefit 4379 0 0 Update 2017-08-01 2019-03-01 Prosthesis ER471 CAPRI Small Expandable Corpectomy Cage System Vertebral Body Replacement (13-16) x (16-20) mm – height 18-74mm ER 19 176 1492 4137 ThoracoLumbar 291618 4139 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER472 Chesapeake Cervical PEEK Cervical fusion cage with integrated fixation Heights 5-12mm ER 19 174 1485 5485 159146 Changed Benefit 4379 0 0 Update 2018-02-01 2019-03-01 Prosthesis ER473 KEYS Polyaxial Screw Polyaxial screw 6.0 -7.0mm diameter, length 25-50mm ER 19 165 1464 Complex 154442 250 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER474 KEYS Supplemental Screw Dual lead thread bone screw 5.5 - 6.0mm diameter, length 20-40mm ER 19 165 1464 Dual Thread 154442 462 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER475 KEYS Anterior Staple Staple 13-18mm ER 19 172 1483 154442 395 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER476 Yukon OCT System Polyaxial Posterior Cervical Screws 3.5-5.0 diameter, length 10-50mm ER 19 165 1463 159828 1280 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER465 Europ standard cemented condyle Knee cemented condyle 1 to 6, right and left ER 17 149 1348 3906 286030 2951 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ER463 Endoskeleton TA Titanium anterior interbody fusion device for the lumbar spine, sterile or non-sterile, also with Nano Lock™ surface technology, sterile 32-40 x 21-27mm Width 32-40mm, Length 21-27mm, Height 10-17mm, 20,25,30,35,40,45,50,55,60,65mm, 0˚ & 7˚angles ER 19 174 1486 4135 285244 Changed Product description, Product sizes 3465 0 0 Update 2017-08-01 2019-03-01 Prosthesis ER464 Europ Knee Prostheses-Cemented Patella Europ Knee Prostheses, Cemented Patella compatible with all Europ System knees Diameters 25,29,32,35,38 mm ER 17 156 1376 287819 Changed Product name, Product description, Product sizes, Benefit 537 0 0 Update 2017-08-01 2019-03-01 Prosthesis ER466 Europ standard Polyethylene (UHMW) insert Knee insert SMALL (thickness: 7,9,11,13,15mm) MEDIUM (thickness: 7,9,11,13,15mm) LARGE (thickness: 7,9,11,13,15mm) ER 17 153 1369 286032 1019 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ER467 Europ Standard Uncemented Condyle Knee Uncemented Condyle 1 to 6, right and left ER 17 149 1351 3914 286031 3309 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ER468 Europ Standard & Postero Cemented Monobloc Plate Knee Cemented Monobloc plate 1 to 6 ER 17 151 1357 286032 1923 0 0 No Change 2017-08-01 2019-03-01 Prosthesis DE615 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, 130mm Flare Length: 20, 30, 35mm Diameter: 28, 32 Flare Diameter: 32, 36 Design: single- or double-flared DE 24 206 1622 4440 LD (large diameter, >25mm) 249572 Changed Benefit 2822 0 0 Update 2018-02-01 2019-03-01 Prosthesis DE614 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 DE 24 206 1622 4440 249572 1710 0 0 No Change 2018-02-01 2019-03-01 Prosthesis HC023 Butterfly Plate Cervical Plate L:55-86mm HC 19 169 1477 4127 >55mm 201492 1636 0 0 No Change 2014-02-01 2019-03-01 Prosthesis HC024 Perfect-C The Perfect-C implant is a stand-alone anterior cervical interbody fusion device. Height - 5mm - 8mm HC 19 174 1485 5485 262490 Changed Benefit 4379 0 0 Update 2016-08-01 2019-03-01 Prosthesis HC021 Butterfly Plate Cervical Plate L : 21-55mm HC 19 169 1477 4127 201492 1251 0 0 No Change 2014-02-01 2019-03-01 Prosthesis HC022 PM cage Cervical cage L :4-11mm HC 19 174 1486 4134 201493 2409 0 0 No Change 2014-02-01 2019-03-01 Prosthesis HC025 Screw The Screw is used with the Perfect-C implant to obtain cortical fixation. Length 14 - 18mm HC 19 165 1464 262490 Changed Benefit 193 0 0 Update 2016-08-01 2019-03-01 Prosthesis HC026 G2S Cannulated Polyaxial Screw Cannulated Polyaxial screw W:5.5-7.5mm HC 19 165 1463 Cannulated 274075 1338 0 0 No Change 2017-02-01 2019-03-01 Prosthesis HC027 G2S Nut locking nut Nut HC 19 166 1465 274075 164 0 0 No Change 2017-02-01 2019-03-01 Prosthesis HC028 G2S rods Rod L: 40-154mm HC 19 170 1478 274075 Changed Benefit 426 0 0 Update 2017-02-01 2019-03-01 Prosthesis HC029 Bone substitute Synethetic Resorbable Bone Graft H;4-20mm HC 13 123 1241 4095 283972 1482 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HC030 ISIS Cage The ISIS CAGE is used in the treatment of the anatomical abnormalities of vertebrae typically due to degenerative intervertebral discs. The device can be of several different geometric forms and is implanted between the bones or bone grafts of the spine providing mechanical stability and sufficient space for therapeutic spinal bone fusion to occur. This process helps to relieve pressure on pinched nerves and prevents vertebral slipping. Height:8-15mm Width: 11mm Length:24mm Degrees: 0, 4 and 8 HC 19 174 1486 4135 Paired 280801 Changed Benefit 2888 0 0 Update 2018-08-01 2019-03-01 Prosthesis DE616 RH006 Vitalitec Titanium Hemostatic Clips The SLS titanium (grade 1) hemostatic clips are designed to securely grip the vessel in order to provide a complete and final occlusion atraumatically. Micro, Small, Small/Medium, Medium, Medium/Large and Large. 6 clips per cartridge DE 21 194 1581 4256 194411 11 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE617 Vitalitec Titanium Hemostatic Clips The SLS titanium (grade 1) hemostatic clips are designed to securely grip the vessel in order to provide a complete and final occlusion atraumatically. Small & Medium Clips (24 clips per pouch - 6 clips per cartridge, 4 cartridges per pouch) DE 21 194 1581 4256 194411 44 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE618 Vitalitec Titanium Hemostatic Clips The SLS titanium (grade 1) hemostatic clips are designed to securely grip the vessel in order to provide a complete and final occlusion atraumatically. Micro, Small, Small/Medium, Medium (9 clips per cartridge) DE 21 194 1581 4256 194411 17 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE619 Vitalitec Titanium Hemostatic Clips The SLS titanium (grade 1) hemostatic clips are designed to securely grip the vessel in order to provide a complete and final occlusion atraumatically. Small and Medium (27 clips per pouch - 9 clips per cartridge, 3 cartridges per pouch) DE 21 194 1581 4256 194411 50 0 0 No Change 2018-02-01 2019-03-01 Prosthesis EF026 Arix Locking Screw Locking Screw 2.01 – 2.7 mm EF 13 123 1231 3371 LK 239817 147 0 0 No Change 2018-02-01 2019-03-01 Prosthesis EF027 Arix Foot System Locking Plates ≥ 7 to ≤ 15 holes EF 13 123 1694 5262 VAL 239812 952 0 0 No Change 2018-02-01 2019-03-01 Prosthesis EF028 Arix Foot System Locking Plates ≤ 6 holes EF 13 123 1694 5261 VAL 239812 1197 0 0 No Change 2018-02-01 2019-03-01 Prosthesis EF025 Arix Foot Systems Calcaneus Locking Plates ≥ 7 to ≤ 15 holes EF 13 123 1694 5296 VAL 239812 1462 0 0 No Change 2018-02-01 2019-03-01 Prosthesis EF029 Bone Screw Cortical Bone Screw 2.01mm – 2.7mm EF 13 123 1231 3371 239817 84 0 0 No Change 2018-02-01 2019-03-01 Prosthesis EF030 Arix Bone Screw Cannulated Compression Screw 2.71mm – 4.49mm EF 13 123 1231 3370 CN,DT 239817 379 0 0 No Change 2018-02-01 2019-03-01 Prosthesis EF031 Bone Screw Cannulated Screw ≥ 4.5mm EF 13 123 1231 3369 CN 239817 191 0 0 No Change 2018-02-01 2019-03-01 Prosthesis EF032 Arix Bone Screw Cannulated Compression Screw 2.01 - 2.7mm EF 13 123 1231 3371 CN,DT 239817 381 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER478 Paragon 28 Olive Wires Paragon 28 Olive wire (Gorilla Plating System), smooth or threaded, standard or short tip dia 1.3-1.8 mm ER 13 123 1772 5365 OL 290442 Changed Benefit 121 0 0 Update 2018-02-01 2019-03-01 Prosthesis ER477 Paragon 28 K wires Paragon 28, K wire (for Phantom, Gorilla and Monster systems), smooth, grooved or threaded, trocar/double trocar dia 0.9-3.0 mm, length (100-250 mm) ER 13 123 1772 5365 290442 Changed Product description, Product sizes 27 0 0 Update 2018-02-01 2019-03-01 Prosthesis ER479 Paragon 28 Gorilla Plating System-Plate, small (≤ 6 holes), variable angle locking Paragon28 Gorilla, small titanium compression plates; universal; variable angle locking; compression; various shapes Length 15-35 mm; thickness 1.15 - 2.0 mm; multi screw diameter purchage 2.7/3.5/4.2mm ER 13 123 1694 5258 VAL 289248 784 0 0 No Change 2018-02-01 2019-03-01 Prosthesis HC019 KM Occipital Plate Occipital Plate Rod 3-5mm HC 19 170 1480 4133 201492 Changed Benefit 2166 0 0 Update 2014-02-01 2019-03-01 Prosthesis HC020 KM Rod Rod 40-400mm HC 19 170 1478 201492 Changed Benefit 426 0 0 Update 2014-02-01 2019-03-01 Prosthesis EF033 Arix Foot System Locking Plates ≤ 6 holes EF 13 123 1694 5261 VAL 239812 1197 0 0 No Change 2018-08-01 2019-03-01 Prosthesis EG001 Capsular Tension Rings Clear PMMA Implant 10/08, 12/10, 13/11mm EG 1 143 1331 145740 151 0 0 No Change 2005-10-31 2019-03-01 Prosthesis EG009 Artisan Anterior Chamber Intraocular Lens Aphakia Model Composition: PMMA 5.00mm Optic Diameter x 8.5 in overall length EG 1 140 1324 3887 ifc 92476 214 0 0 No Change 2005-10-31 2019-03-01 Prosthesis EG010 Artiflex Anterior Chamber Intraocular Lens Optic: Hydrophobic Polysiloxane. Haptic: PMMA 6mm optic diameter x 8.5 in overall length EG 1 140 1325 3889 92476 618 0 0 No Change 2006-03-24 2019-03-01 Prosthesis EG012 Artisan Anterior Chamber IOL Phakic Intraocular Lens Myopic / Hyperopic 5.00mm Optic Diameter x 8.5 in overall length; EG 1 140 1325 3888 92476 Changed Benefit 581 0 0 Update 2010-02-01 2019-03-01 Prosthesis EG014 REVERSO Multifocal Intraocular lens -3 to +3 EG 1 141 1328 3896 226270 667 0 0 No Change 2015-02-01 2019-03-01 Prosthesis EG015 ARTIS T PL Preloaded Toric Intraocular lens +18 to +25D / C +1.50D EG 1 141 1327 3890 at, pl, t1 226270 Changed Benefit 626 0 0 Update 2015-02-01 2019-03-01 Prosthesis EG016 ARTIS PL E Preloaded Intraocular lens 0 to 35D EG 1 141 1327 3890 at, pl 226270 308 0 0 No Change 2015-02-01 2019-03-01 Prosthesis EG017 LUXIOL 60 Preloaded Intraocular lens +10 to +35D EG 1 141 1327 3890 at, pl 226270 308 0 0 No Change 2015-02-01 2019-03-01 Prosthesis EG018 RINGJECT Preloaded Capsular tension ring 12/10, 13/11 EG 1 143 1331 pl 145740 231 0 0 No Change 2015-02-01 2019-03-01 Prosthesis EG019 Artisan Toric (Custom) T1 AC Iris clip IOL Toric 5.00mm Optic Diameter x 7.5 Overall EG 1 140 1325 3888 t1, ifc 92476 Changed Benefit 983 0 0 Update 2015-02-01 2019-03-01 Prosthesis EG020 Artisan Toric (Custom) T2 AC Iris clip IOL Toric 5.00mm Optic Diameter x 7.5 Overall EG 1 140 1325 3888 t2, ifc 92476 1242 0 0 No Change 2015-02-01 2019-03-01 Prosthesis EG021 GOT Multi Tamponade gas for retinal surgery 75ml EG 1 148 1345 297730 71 0 0 No Change 2018-08-01 2019-03-01 Prosthesis EG022 Perfluorocarbons HPF8 Perfluoro-n-octane and HPF10 Perfluorodecalin 5ml and 7ml EG 1 148 1346 252153 228 0 0 No Change 2018-08-01 2019-03-01 Prosthesis EG023 RS-OIL Highly purified Silicone Oil 10ml EG 1 148 1347 297730 185 0 0 No Change 2018-08-01 2019-03-01 Prosthesis EG024 RS-Blue Trypan Blue for the reversible staining of human tissue during surgery 0.7ml Syringe EG 1 142 1330 252154 46 0 0 No Change 2018-08-01 2019-03-01 Prosthesis EJ001 Staar foldable silicone intraocular lens: Model AQ 5010V Polyimide haptics 6.3mm optic - low diopters 14.0mm length EJ 1 141 1327 3891 135694 Changed Benefit 231 0 0 Update 2017-02-01 2019-03-01 Prosthesis EJ002 Preloaded Aspheric Intraocular Lens Silicone intraocular lens 6.0mm EJ 1 141 1327 3892 at, pl 100462 135694 308 0 0 No Change 2017-02-01 2019-03-01 Prosthesis EJ003 Staar foldable silicone IOLs: Models AQ2010V, AQ2017V and AO2003V Plate haptics 6.0mm; Polymide haptics 5.5 or 6.3mm optic; 10.8mm to 13.5mm length EJ 1 141 1327 3892 135694 265 0 0 No Change 2017-02-01 2019-03-01 Prosthesis 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 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 EL 20 181 1841 158660 158661 158662 158663 2090 0 0 No Change 2005-10-31 2019-03-01 Prosthesis EL031 Carpentier-Edwards Perimount Pericardial Bioprosthesis - Models 2900/6900 Carpentier-Edwards Perimount Plus Pericardial Bioprosthesis Mitral - Model 6900P Carpentier-Edwards Pericardial Bioprosthesis. Composition: Bovine Pericardium; Elgiloy Alloy; Silicone Rubber, Polytetrafluoroethylene Models 2900/6900 19-33mm, Model 6900P 25, 27, 29, 31, 33mm EL 20 179 1500 154064 154073 4750 0 0 No Change 2005-10-31 2019-03-01 Prosthesis IG093 Newdeal Screws/Lock Screws Screws - Cancellous, Cancellous cannulated, cortical, cortical cannulated plus Lock screws Cancellous/Cancellous cannulated - Diameter 6.5mm, Length 20mm - 100mm + Lock Screw, Cortical - Diameter 5.0mm, Length 25mm - 45mm + Lock Screw, Cortical - Diameter 4.5mm, Length 14mm - 65mm + Lock Screw, Cortical - Diameter 3.5mm, Length 14mm - 32mm + Lo IG 13 123 1231 3370 CN,LK 173963 271 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IG096 Basal Osteotomy Plate Titanium 5 Deg, Left and Right, 10Deg, Left and Right IG 13 123 1694 5258 173932 214 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IG100 Panta Arthrodesis Nail Ankle Nail, Titanium Diameter 10 -13 mm Length - 150-240 mm IG 13 123 1228 3332 173962 Changed Benefit 4493 0 0 Update 2011-02-01 2019-03-01 Prosthesis IG102 Panta Arthrodesis Nail End Cap, Titanium One Size IG 13 123 1229 5363 173962 96 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IG103 Uni-Clip Compression Staple Stainless Steel, Notched and Non-Notched Width 11-30mm, Length 13-32mm IG 13 123 1773 5514 173961 Changed Benefit 127 0 0 Update 2011-02-01 2019-03-01 Prosthesis IG105 Hallu Break-off screw Titanium with break-off barrel Diameter 2.7mm, Length 11-14mm IG 13 123 1231 3371 Breakoff 173963 304 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IG106 B-BOP Plantar Basal Osteotomy Plate (Sterile) Titanium, 4 hole plate for fixation of osteotomy of the base of the first metatarsal Moderate Correction(5°) Left, Right. Severe Correction (10°) Left, Right IG 13 123 1694 5258 Com 173932 594 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IG107 Bold Compression Screw Cannulated Titanium Diameter 3.0-3.70mm, length 10-34mm IG 13 123 1231 3370 CN,DT 173963 379 0 0 No Change 2011-02-01 2019-03-01 Prosthesis JJ900 CONCORDE Spine System Interbody Fusion Device for paired insertion 7-18mm SY 19 174 1486 4135 Paired 149723 Changed Benefit 2888 0 0 Update 2012-08-01 2019-03-01 Prosthesis JJ903 Echelon Disposable stapling device 45-60mm JJ 21 194 1582 4318 Endoscopic 155639 384 0 0 No Change 2012-08-01 2019-03-01 Prosthesis JJ904 Echelon Stapler 45 - 60mm JJ 21 194 1582 4318 Endoscopic, Articulating/Roticulating 155639 384 0 0 No Change 2012-08-01 2019-03-01 Prosthesis JJ912 Intrafix Interference System Non absorbable screw/sheath 6 to 12mm diameter SY 13 123 1774 5391 133430 Changed Benefit 181 0 0 Update 2013-08-01 2019-03-01 Prosthesis JJ913 Summit Spinal System Screws and nuts One size SY 19 166 1465 92307 164 0 0 No Change 2013-08-01 2019-03-01 Prosthesis MA111 Balansys Patella Component All Polyethylene, UHMWPE, cemented Dia 25, 28, 31, 34, 37mm MA 17 156 1376 211143 211442 Changed Benefit 537 0 0 Update 2005-10-31 2019-03-01 Prosthesis MA311 balanSys Tibial Mobile Insert Tibial Insert, Mobile bearing, UHMWPE, XS/8mm to F/20.5mm MA 17 153 1369 211084 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MA312 balanSys Tibial Baseplate Tibial Baseplate for Mobile Bearing Insert, cemented, CoCr 59mm to 85mm MA 17 151 1359 211085 Changed Benefit 2147 0 0 Update 2005-10-31 2019-03-01 Prosthesis MA108 balanSys Femoral Component Femoral component, cemented, CoCr XS TO F Left and Right MA 17 149 1348 3906 206062 2951 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MA419 SeleXys Acetabular UHMWPE Liner UHMWPE 44mm-72mm MA 18 163 1428 4020 274137 720 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MA448 Affinis Total Shoulder Humeral Head - CoCr Diameter 39, 41, 43, 45, 47, 49, 51, 53mm MA 13 131 1276 4067 220762 1261 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MA450 Affinis Total Shoulder Glenoid - UHMWPE Size 1 to 4 MA 13 131 1277 3701 219394 1895 0 0 No Change 2005-10-31 2019-03-01 Prosthesis IG069 Bold Compression Screw Cannulated titanium 3mm diam 10-34mm length IG 13 123 1231 3370 CN,DT 173963 379 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IG070 ICOS Screw: Ideal Compression Screw Cannulated titanium 4.0mm diam 26-60mm length, 6.5mm diam 40-150mm length IG 13 123 1231 3370 CN,DT 173963 379 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IG073 K-Wire (Kirschner) Stainless steel 70mm, 100mm, 200mm length IG 13 123 1772 5365 173964 27 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IG068 Surfix Screw plus Surfix Lock-Screw Locking screws with an independent lock-screw head that screw into fixation plates. This combination effects dynamic compression. 3.5mm: 10-28mm IG 13 123 1231 3370 LK 173963 145 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IG075 Solustaple Standard Staple Stainless steel 90 deg & 26 degree 8 & 10mm length IG 13 123 1773 5514 173961 Changed Benefit 127 0 0 Update 2011-02-01 2019-03-01 Prosthesis IG081 Hallu-Fix Plates Hallu-C and Hallu-S titanium plates for first MTP arthrodesis Length: 40 - 55mm 3 sizes: 1, 2, 3 for left or right IG 13 123 1694 5298 173932 Changed Benefit 428 0 0 Update 2011-02-01 2019-03-01 Prosthesis JJ936 Expedium Spine System Monoaxial Screw 4 - 10mm Diameter SY 19 165 1462 97391 895 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ937 Summit Spinal system Polyaxial Screws 3.5 to 4mm SY 19 165 1463 92307 1280 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ940 Moss Miami Spinal System Polyaxial Screw 4.35 to 8mm diameter SY 19 165 1463 128257 97391 1280 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ941 Moss Miami Spinal System Monoaxial Screw 5-8mm Diameter SY 19 165 1462 128257 145290 895 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ942 Moss Miami Spinal System Inner and outer screw, nuts and set screws 3 - 6.5mm SY 19 166 1465 128257 145010 164 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ943 Isola Spine System Nuts, Set screws and locking screws 3/8, 5/16 and 1/4 inch, 6.35-120mm SY 19 166 1465 128257 128268 148371 97391 164 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ944 Expedium Spine System Polyaxial screws 4.35 - 12mm diameter SY 19 165 1463 145290 97391 1280 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ945 GRYPHON BR Instability Anchor Suture Anchor 2.4-3.0mm SY 13 123 1774 5385 AB 165434 165465 501 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ946 GRYPHON PEEK Instability Anchor Suture Anchor 2.4-3.0mm SY 13 123 1774 5385 165465 Changed Benefit 442 0 0 Update 2013-08-01 2019-03-01 Prosthesis JJ947 Healix Anchor System PEEK anchor system 4.5 - 6.5mm anchor diameter JJ 13 123 1774 5387 215753 Changed Benefit 442 0 0 Update 2013-08-01 2019-03-01 Prosthesis LH508 Martin Osteosynthesis 1.5mm System Mesh thin 50cm2 Mesh, Titanium 0.2-0.49mm thick, 11-50cm2 LH 23 199 1585 4204 202851 Changed Benefit 683 0 0 Update 2014-02-01 2019-03-01 Prosthesis LH509 Martin Osteosynthesis 1.5mm System Mesh 50cm2 Mesh, Titanium 0.5-0.8mm thick, 11-50cm2 LH 23 199 1585 4208 202851 497 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LH510 Martin Osteosynthesis 1.5mm System Mesh 64cm2 Mesh, Titanium 0.5-0.8mm thick, 51-200cm2 LH 23 199 1585 4209 202851 1146 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LH507 Martin Osteosynthesis 1.5mm System Burr hole plate Burr Hole Plate, Titanium 0.6mm thick, 4-7 holes LH 23 199 1589 4271 Burr 202851 166 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LH511 Martin Osteosynthesis 1.5mm System Mesh 200cm2 Mesh, Titanium 0.5-0.8mm thick, >200cm2 LH 23 199 1585 4210 202851 2187 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LH512 Martin Osteosynthesis 1.5mm System 3D Mesh 200cm2 3D Mesh, Titanium 0.2-0.49mm thick, 51-200cm2 LH 23 199 1585 4205 202851 1365 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LH513 Martin Osteosynthesis 1.5mm System Mesh 1mm 4-7 hole plate Plate, Titanium 1.0-1.99mm thick, 4-7 holes LH 23 199 1589 4288 202851 161 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LH514 Martin Osteosynthesis 1.5mm System 1mm 8-15 hole plate Plate, Titanium 1.0-1.99mm thick, 8-15 holes LH 23 199 1589 4293 202851 Changed Benefit 409 0 0 Update 2014-02-01 2019-03-01 Prosthesis LH515 Martin Osteosynthesis 1.5mm System 1mm 16-32 hole plate Plate, Titanium 1.0-1.99mm thick, 16-32 holes LH 23 199 1589 4296 202851 199 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LH516 Martin Osteosynthesis 1.5mm System Screw Self retaining, Titanium 3-7mm length, 1.5-1.8mm diam LH 23 199 1590 4323 212844 42 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LH517 DSS HPS Cross Connector Complete system of clamps, set screws and connector bar, Titanium 40 - 66mm gap LH 19 167 1474 4124 186733 Changed Benefit 1299 0 0 Update 2014-02-01 2019-03-01 Prosthesis LH519 DSS Spinal System Monoaxial Pedicle Screw - cannulated 5-9mm Diam x 30-60mm length LH 19 165 1462 186733 895 0 0 No Change 2014-08-01 2019-03-01 Prosthesis LH520 Kasios TLIF Kage PL Interbody Fusion Cage 7 - 14mm height LH 19 174 1486 4135 178660 3465 0 0 No Change 2014-08-01 2019-03-01 Prosthesis LH527 MIDCAL Ring Adjustable Gastric Ring 65-80 mm circumference LH 21 190 1781 229709 Changed Benefit 2328 0 0 Update 2015-02-01 2019-03-01 Prosthesis LH528 LiquiBand Fix8 Hernia Mesh Fixation System, preloaded into applicator 33 tacks LH 21 194 1582 6004 Synthetic, Endoscopic 233374 509 0 0 No Change 2015-02-01 2019-03-01 Prosthesis MA451 BalanSys UNI femoral component Uni Femoral component, cemented CoCr A, B,C,D,E MA 17 150 1353 212827 2058 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MA452 BalanSys UNI tibial baseplate Uni tibial baseplate for fixed bearing insert, cemented, CoCr 1,2,3,4,5 MA 17 152 1364 212824 1387 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MA454 BalanSys UNI tibial Insert Uni tibial insert, UHMWPE, fixed 5,6,7,9 MA 17 154 1372 212830 707 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MA457 Balansys Femoral Component Femur, CoCr with Ti vacuum plasma spray coating XS TO F Left and Right MA 17 149 1351 3914 206063 3309 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MA462 twinSys Non Cemented Femoral Stem Titanium, grit blast, fully HA Various offsets and sizes under 200mm length MA 18 161 1407 3949 274437 3779 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MA463 twinSys Cemented Femoral Stem stainless steel, highly polished, triple tapered 8 sizes in standard and lateral version (Size 9, 10, 11, 12, 13, 14, 15, 16) MA 18 161 1404 3941 274206 1845 0 0 No Change 2006-03-24 2019-03-01 Prosthesis HK005 Palacos or Palamed bone cement Single mix PMMA 40g HK 13 123 1279 4087 152109 157 0 0 No Change 2007-12-01 2019-03-01 Prosthesis HK008 Copal G+C High-viscosity, radiopaque bone cement with gentamicin and clindamycin 40g HK 13 123 1279 4088 176198 Changed Benefit 166 0 0 Update 2011-08-01 2019-03-01 Prosthesis HK011 Copal G + V Specialised cement with gentamicin and vancomycin for use in septic revisions 40g HK 13 123 1279 4088 228234 Changed Benefit 166 0 0 Update 2015-02-01 2019-03-01 Prosthesis HK012 PALACOS® fast R+G Fast setting, high viscosity, radiopaque bone cement with gentamicin 40g HK 13 123 1279 4088 248254 Changed Benefit 166 0 0 Update 2015-08-01 2019-03-01 Prosthesis HK013 Palacos or Palmed Bone Cement with Gentamicin Single mix PMMA with Gentamicin 20,40 gms HK 13 123 1279 4088 133411 Changed Benefit 166 0 0 Update 2015-08-01 2019-03-01 Prosthesis IG083 Newdeal Reinforced Bendable Osteosynthesis Plates Stainless Steel 2 - 4 Holes 2 holes, 4 holes/77mm, 4 holes/112mm IG 13 123 1694 5255 LK 173932 798 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IG084 Newdeal Bendable Osteosynthesis Plates Composition - 316L Stainless Steel. To be used only with Newdeal screws/lock screws. 3-6 holes IG 13 123 1694 5255 LK 173932 798 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IG085 Newdeal Bendable Osteosynthesis Plates Stainless steel bendable plates 7 - 9 holes 7-9 holes IG 13 123 1694 5256 LK 173932 931 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IG086 Newdeal Distal Humeral Plates Composition - 316L Stainless Steel. To be used only with Newdeal screws/lock screws 4 holes IG 13 123 1694 5255 173932 Changed Benefit 542 0 0 Update 2011-02-01 2019-03-01 Prosthesis IG087 Newdeal Femoral Osteosynthesis Plates Composition - 316L Stainless Steel. To be used only with Newdeal screws/lock screws 8/9/10 hole, left and right IG 13 123 1694 5255 Com 173932 Changed Benefit 922 0 0 Update 2011-02-01 2019-03-01 Prosthesis MA469 Mathys CoCr Femoral Head Hip Prosthesis Femoral Head CoCrMo ≤32mm 28 mm & 32mm, (S,M,L,XL,XXL) MA 18 162 1419 3989 274272 703 0 0 No Change 2006-11-30 2019-03-01 Prosthesis MA475 twinSys Non Cemented Long Femoral Stem Titanium, grit blast, fully HA, long Various offsets and sizes > 200mm length (14 & 15) MA 18 161 1409 3957 122260 5053 0 0 No Change 2007-06-01 2019-03-01 Prosthesis MA477 BalanSys UNI tibial baseplate Uni Tibial baseplate for mobile insert, cemented, CoCr with convex surface 1, 2, 3, 4, 5 MA 17 152 1366 212829 Changed Benefit 1566 0 0 Update 2007-12-01 2019-03-01 Prosthesis MA478 BalanSys UNI tibial Insert Uni tibial insert, UHMWPE, mobile convex for the uni convex tibial baseplate 5, 6, 7, 9 MA 17 154 1372 212828 707 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MA467 Mathys Unipolar Femoral Head Stainless steel, unipolar head 42 mm - 58mm MA 18 162 1420 3994 212967 Changed Benefit 713 0 0 Update 2006-11-30 2019-03-01 Prosthesis MA479 Affinis Shoulder System Affinis Fracture Stem - diaphyseal, cemented, short 6/125, 9/125, 12/125, 12/125, 9/200, 12/200 MA 13 131 1276 4063 219731 3800 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MA480 Affinis Humeral Head Affinis Humeral Head - Ceramic 39 to 53 MA 13 131 1276 4067 Cer 215480 215501 1449 0 0 No Change 2007-12-01 2019-03-01 Prosthesis JJ948 Healix Anchor System PEEK anchor with suture 2.9 - 3.9mm anchor diameter SY 13 123 1774 5385 155607 155608 Changed Benefit 442 0 0 Update 2013-08-01 2019-03-01 Prosthesis JJ949 HEALIX Anchor System Biocryl Rapide anchor with suture 4.5-6.5mm SY 13 123 1774 5387 AB 160908 160909 160910 160911 501 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ950 HEALIX BR Anchor Biocryl Rapide anchor with suture 3.4 to 3.9mm SY 13 123 1774 5385 AB 160908 160909 160910 160911 501 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ951 RigidLoop Cortical Fixation Loop 15-60mm, Xlarge, adjustable SY 13 123 1774 5389 215753 374 0 0 No Change 2014-02-01 2019-03-01 Prosthesis JJ952 Rigidfix ACL Cross Pin PEEK Pin 3.3mm diameter SY 13 123 1774 5394 133430 451 0 0 No Change 2014-08-01 2019-03-01 Prosthesis JJ953 Attune Knee System Cruciate Retaining Cemented Femur 1-10 including narrow SY 17 149 1348 3906 220502 2951 0 0 No Change 2014-08-01 2019-03-01 Prosthesis JJ954 Attune Knee System Posterior Stabilised Cemented Femur 1-10 including narrow SY 17 149 1348 3907 220504 3041 0 0 No Change 2014-08-01 2019-03-01 Prosthesis JJ955 Attune Knee System Cruciate Retaining Insert 1-10 SY 17 153 1369 220506 1019 0 0 No Change 2014-08-01 2019-03-01 Prosthesis HO006 Sapphire Infusion System The Sapphire Infusion System is a new device for ambulatory infusion and acute pain management. It is an infusion pump designed for the volumetric delivery of medications to patients at a programmable rate. Sapphire is the first pump to offer an intuitive, full colour touch screen interface in an ambulatory package, along with best-in-class +/-2.5% product delivery accuracy Size (in), Weight (oz) 5.6 x 3.8 x 1.9 in. 14.7 oz (including battery) HO 21 188 1525 4185 201499 Changed Benefit 4703 0 0 Update 2013-08-01 2019-03-01 Prosthesis HO007 Sapphire Infusion Cassette and Set The Sapphire Infusion Cassette and set is a one piece microfibre infusion set with non vented spike, pinch clamp, administration cassette, female luer lock, entrance with a back check valve, pinch clamp and spin male leur lock for use with the sapphire infusion system. The materail components are made from PVC-Non DEHP (tubing, connectors), silicon (Y site and tubing and polypropylene (valves) 210cm HO 21 188 1541 4191 200689 27 0 0 No Change 2014-02-01 2019-03-01 Prosthesis HW001 Hardinge Cement Restrictor PMMA 6,9 and 12 Leaf HW 18 164 1437 203847 Changed Benefit 105 0 0 Update 2005-10-31 2019-03-01 Prosthesis LH484 DSS HP Spinal System - Pedicle Screw Cannulated Pedicle Screw, Titanium (5 - 10)mm diam x (30 - 110(mm length LH 19 165 1463 Cannulated 186733 1338 0 0 No Change 2012-08-01 2019-03-01 Prosthesis LH485 DSS Spinal System Rod, Titanium alloy 5.5mm diameter rod Length: 20mm to 300mm LH 19 170 1478 186733 Changed Benefit 426 0 0 Update 2012-08-01 2019-03-01 Prosthesis LH486 DSS HP Spinal System - Set Screw Set Screw one size LH 19 166 1465 186733 167570 Changed Product sizes 164 0 0 Update 2012-08-01 2019-03-01 Prosthesis LH490 M6C Artificial Cervical Disc The M6 artificial cervical disc is an intervertebral disc prosthesis designed to maintain motion of a functional spinal unit when the native disc is diseased. Footprints: 12.5mm x 15mm 15mm x 15mm 14mm x 17mm 16mm x 17mm Heights: 6mm & 7mm LH 19 175 1488 5487 177101 6256 0 0 No Change 2013-02-01 2019-03-01 Prosthesis LH492 Standard Approach Mesh Pre-contoured titanium mesh implants for 11 standard approaches. 0.6mm thick LH 23 199 1585 4210 202842 2187 0 0 No Change 2013-02-01 2019-03-01 Prosthesis LH494 Aneurism Clip - Elgiloy Sugita Clips, Elgiloy. Cobalt Chrome alloy. One size each LH 25 218 1655 100108 245 0 0 No Change 2013-02-01 2019-03-01 Prosthesis LH529 ALIF Spine Truss System Cage 8-20mm height LH 19 174 1486 4135 252733 3465 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LH530 Cervical Spine Truss System Cage 5-16mm Height LH 19 174 1486 4134 252733 2409 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LH531 M6L Artificial Lumbar Disc Intervertebral Artificial Disc – Lumbar (Medium, Large, Xlarge) footprint, 3 - 16 degrees lordosis LH 19 175 1488 5488 177102 9192 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LV145 CrossFt Knotless Screw in knotless anchor 4.0mm CrossFT Knotless Anchor 4.0mm CrossFT Knotless Anchor (w/ 1 blue Hi-Fi tape) 4.0mm CrossFT Knotless Anchor (w/ 1 white/black Hi-Fi tape) 4.75mm CrossFT Knotless Anchor 4.75mm CrossFT Knotless Anchor (w/ 1 blue Hi-Fi tape) 4.75mm CrossFT Knotless Anchor (w/ 1 white/black Hi-Fi tape) 5.5mm CrossFT Knotless Anchor 5.5mm CrossFT Knotless Anchor (w/ 1 blue Hi-Fi tape) 5.5mm CrossFT Knotless Anchor (w/ 1 white/black Hi-Fi tape) LV 13 123 1774 5387 136631 Changed Benefit 442 0 0 Update 2017-02-01 2019-03-01 Prosthesis MA016 CCA Cemented Femoral Stem SS, straight, not polished 7.50mm -17.5mm MA 18 161 1404 3939 274203 Changed Benefit 1625 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ916 Mountaineer Spinal System Inner screws and out nuts One size only SY 19 166 1465 128255 128257 145290 164 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ917 Mountaineer Spinal System Connectors 3.5 to 6.35mm SY 19 167 1472 97391 Changed Benefit 732 0 0 Update 2013-08-01 2019-03-01 Prosthesis JJ920 Moss Miami Spinal System Axial Connector 4/4mm to 5/7mm SY 19 167 1472 145010 97391 Changed Benefit 732 0 0 Update 2013-08-01 2019-03-01 Prosthesis JJ922 Kuroska Fixation Screw System Interference screw 7 to 9mm SY 13 123 1774 5391 136374 Changed Benefit 181 0 0 Update 2013-08-01 2019-03-01 Prosthesis JJ915 Expedium Spine System Si and Unitised Screw Set 4.35 -7.5mm SY 19 166 1465 145290 97391 164 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ923 Songer Cable System Double loop Cable with 2 crimps One size only SY 13 123 1772 5368 144675 485 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ924 Songer Cable System Flanged crimp/flat bar or 2 hole bar One size only SY 13 123 1772 5371 144675 Changed Benefit 104 0 0 Update 2013-08-01 2019-03-01 Prosthesis JJ925 Songer Cable System Cable and Crimp One size only SY 13 123 1772 5371 144675 Changed Benefit 104 0 0 Update 2013-08-01 2019-03-01 Prosthesis IG088 Newdeal Distal Femoral Varus Osteotomy Plate Stainless steel periarticular anatomically shaped plate fixed with 3 locking screws into femoral condyle 1 Size IG 13 123 1694 5255 Com 173932 Changed Benefit 922 0 0 Update 2011-02-01 2019-03-01 Prosthesis IG089 Newdeal Femoral Varus and De-rotation Osteotomy Plates Stainless steel periarticular anatomic plate fixed with locking screws into proximal femur Newdeal Femoral Varus and De-rotation Osteotomy Plates - 3 holes, Newdeal Femoral Varus and De-rotation Osteotomy Plates - 4 holes, Newdeal Reinforced Femoral Newdeal and De-rotation Osteotomy Plates - left and right IG 13 123 1694 5255 Com 173932 Changed Benefit 922 0 0 Update 2011-02-01 2019-03-01 Prosthesis IG090 Newdeal Proximal Humeral Plate Composition - 316L Stainless Steel. To be used only with Newdeal screws/lock screws 6 holes IG 13 123 1694 5255 Com, LK 173932 1178 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IG091 Newdeal HTO Plates Stainless steel anatomically shaped plates for high tibial osteotomy;4 or 5 holes Opening wedge HTO plates, left and right. Closing wedge HTO plates, left and right. Reinforced closing wedge HTO plates, left and right IG 13 123 1694 5255 Com, LK 173932 1178 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IG092 Newdeal Lock Screws For use with Newdeal bone screws and plates Diameter 2.7mm - 6.5mm IG 13 123 1231 3370 LK 173963 145 0 0 No Change 2011-02-01 2019-03-01 Prosthesis LH499 Sequent VIA Microcatheter A sterile single lumen device with one distal tip marker Lengths: 133-161cm Diameters: 0.53-0.84mm; 0.91-1.27mm; 0.84-1.14mm LH 25 225 1689 4494 207388 665 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LH502 Martin Osteosynthesis 1.5mm System 2 hole plate Plate, 0.6mm thick, titanium 2-4 hole LH 23 199 1589 4267 202851 93 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LH495 Martin Level One Fixation Plate, titanium <0.5mm thick, 4 to 7 holes LH 23 199 1589 4263 Burr 202851 185 0 0 No Change 2013-02-01 2019-03-01 Prosthesis LH503 Martin Osteosynthesis 1.5mm System 4-7 hole plate Plate, 0.6mm thick, Titanium 4-7 hole LH 23 199 1589 4271 202851 166 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LH504 Martin Osteosynthesis 1.5mm System 8-15 hole plate Plate, Titanium <0.5mm thick, 8-15 holes LH 23 199 1589 4265 202851 274 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LH505 Martin Osteosynthesis 1.5mm System 8-32 hole plate Plate, 0.6mm thick, Titanium 8-32 hole LH 23 199 1589 4277 202851 199 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LH506 Martin Osteosynthesis 1.5mm System 16-32 hole plate Plate, Titanium <0.5mm thick, 16-32 holes LH 23 199 1589 4266 202851 Changed Benefit 371 0 0 Update 2014-02-01 2019-03-01 Prosthesis MA018 Intramedullary Plug Cement Restricter Small to Extra Large MA 18 164 1437 241997 Changed Benefit 105 0 0 Update 2005-10-31 2019-03-01 Prosthesis MA019 CBC Non Cemented Femoral Stem Titanium, grit blast, non HA, 5-20mm MA 18 161 1406 3945 274273 3401 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MA020 Mathys Ceramic Femoral Head Ceramic, Bionit (alumina) diameter 28-32mm MA 18 162 1419 3990 210564 Changed Benefit 1758 0 0 Update 2005-10-31 2019-03-01 Prosthesis MA024 CCE Acetabular Reinforcing Ring Titanium, grit blast, acetabular reconstruction cage with proximal rim Dia 42 - 58mm MA 18 163 1432 4035 211196 1253 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MA025 Mathys Bipolar Femoral Head Stainless steel with fixed UHMWPE insert 28mm Inner diameter, 42-58mm outer diameter MA 18 162 1424 4004 212427 753 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MA027 CCB Cemented UHMWPE Cup UHMWPE, low & full profile 28/32 ID - 42/64 OD MA 18 163 1425 4006 211096 659 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MA028 Mathys Stainless Steel Femoral Heads Stainless Steel, 22-32mm MA 18 162 1419 3988 210158 703 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW011 ABG Hip System Bone screw - Titanium, used with ABG11 Cups 12,15,20,25,30,35,40,45 and 50mm lengths HW 18 164 1435 128022 121 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW012 ABG Hip System Spikes - Titanium, used with ABG11 Cups 7mm, 8mm, 9mm lengths HW 18 164 1453 128022 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW014 ABG 11Cup with Hydroxyapatite Titanium, grit blast and HA for UHMPE insert Sizes 42mm to 74mm OD in 2mm increments HW 18 163 1427 4015 145518 2373 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW015 ABG 11Cup with Hydroxyapatite Titanium, grit blast and HA for ceramic insert Sizes 44mm to 66mm OD in 2mm increments HW 18 163 1427 4015 145516 2373 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW017 Stryker Biolox Forte Alumina Femoral Head Hip - Femoral Head 28, 32mm HW 18 162 1419 3990 217828 Changed Benefit 1758 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW006 Stryker Intramedullary/Bone Plugs Bone Plugs 6 - 24mm small,medium,large HW 13 123 1279 4091 289666 Changed Benefit 241 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ926 MiniLok Anchor System Suture Anchor 2.3mm SY 13 123 1774 5384 AB 140353 503 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ927 Panalok RC Anchor System Suture Anchor 2.9mm SY 13 123 1774 5385 AB 143375 143376 143379 501 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ928 Bioknotless Anchor System Suture Anchor 3.9mm SY 13 123 1774 5385 AB 143371 501 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ929 BioKnotless RC Anchor System Suture Anchor One size only SY 13 123 1774 5387 AB 143373 501 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ930 RapidLoc Anchor System Suture top Hat Straight 12 degree and 27 degree SY 13 123 1774 5387 AB 136223 501 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ931 Spiralok Anchor System Suture Anchor 5-6.5mm SY 13 123 1774 5387 AB 136227 501 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ932 SmartSet PMMA bone cement 20 to 40g SY 13 123 1279 4087 96550 157 0 0 No Change 2013-08-01 2019-03-01 Prosthesis JJ933 SmartSet Bone cement with antibiotic 20 to 40g SY 13 123 1279 4088 119257 63146 Changed Benefit 166 0 0 Update 2013-08-01 2019-03-01 Prosthesis HW025 Austin Moore Endoprosthesis Long Stem - Vitallium cobalt chrome Head size 38 to 63 HW 18 161 1416 136586 Changed Benefit 541 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW026 Austin Moore Endoprosthesis Standard Stem - Vitallium 105-165mm length, Head size: 38 to 57 HW 18 161 1416 128023 Changed Benefit 541 0 0 Update 2005-10-31 2019-03-01 Prosthesis IG065 Integra Total Wrist Fusion System - Cortical Screw Cortical screw for use with the integra Total Wrist Fusion Plates 2.7mm diameter: 10-32mm length IG 13 123 1231 3371 176758 84 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW024 ABG11 Hip Stem Prosthesis(Various) Titanium, Plasma coated with HA Stem sizes 1 - 8 Left, 1 - 8 Right HW 18 161 1407 3952 169250 4394 0 0 No Change 2005-10-31 2019-03-01 Prosthesis IG066 Integra Total Wrist Fusion System Cortical Screw for use with the Integra Total Wrist Fusion Plates 3.5mm diameter: 10-32mm length IG 13 123 1231 3370 176758 82 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IG067 Surfix screw plus Surfix Lock-Screw Locking screws with an independent lock-screw head 2.7mm: 10-32mm IG 13 123 1231 3370 LK 173963 145 0 0 No Change 2011-02-01 2019-03-01 Prosthesis ME206 Endoscopic Universal Handle The Endoscopic Universal Handle is a single patient delivery system, supplied sterile and used with the Linear Cutter Stapler reloading unit ranges which can be applied in abdominal, gynaecological, paediatric and thoracic surgical procedures for resection, transection and creation of anastomosis. 30mm, 45mm, and 60mm staple lengths. 2.5mm, 3.5mm, and 4.8mm staple sizes. ME 21 194 1582 4318 Endoscopic, Articulating/Roticulating 283316 384 0 0 No Change 2017-02-01 2019-03-01 Prosthesis BI656 W Lorenz Osteosynthesis System Plate, Orbital, 1.5mm, 2.0mm System, Titanium 6 hole BI 23 199 1589 4271 128458 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI658 W Lorenz Osteosynthesis System Plate, Orbital. 1.5mm System, 2mm System. Titanium 8-10 hole BI 23 199 1589 4277 128458 199 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI677 W Lorenz Osteosynthesis System Plate, Neuro Straight, 1.5mm System, Titanium 2 hole (medium or long) BI 23 199 1589 4267 128458 93 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI702 Par 5 Protrusio Acetabular System Screws - Titanium Metal 6.5mm BI 18 164 1435 98098 121 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI714 RapidFlap Cranial Clamp Clamp, Burr Hole or Craniotomy Line, Titanium 12, 16, 20mm BI 23 199 1591 4337 128460 93 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI719 W Lorenz Osteosynthesis System Neuro Sub-Temporal Plate, Titanium medium BI 23 199 1589 4277 128458 199 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BT195 Ilivia 7 DR-T Dual Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional and AutoDetect, DF-4, IS-1 connector 65mm x 56mm x 11mm, 32cm3, 82grams BT 27 237 1725 a,d,e 290407 Changed Benefit 34474 0 0 Update 2017-08-01 2019-03-01 Prosthesis BT196 Ilivia 7 HF-T QP Triple Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, LV Multipole pacing, Home Monitoring, MRI conditional and AutoDetect, DF-4,IS-1, IS-4 quadripolar connector, 65mm x 58.5mm x 11mm, 36cm3, 87grams BT 27 238 1727 a,d,e 290410 37980 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BT197 Intica 7 VR-T DX Single Chamber ICD, ventricular capture control, physiological rate adaption, additional atrial detection (DX),automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional and AutoDetect, DF-1, IS-1 connector 65mm x 55mm x 11mm, 33cm3, 82grams BT 27 236 1723 a, d 290406 Changed Benefit 31622 0 0 Update 2017-08-01 2019-03-01 Prosthesis BI721 W Lorenz Osteosynthesis System Plate, Burr Hole, 1.5mm System, Titanium 22mm, 25mm BI 23 199 1589 4271 Burr 128458 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI723 Mandibular Fracture System Screw, High Torque 2.0/2.4 Mandibular Fracture, Titanium 2.7 x (6-20)mm BI 23 199 1590 4323 128459 42 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI726 Mandibular Fracture System Screw, High Torque (HT), Emergency, 2.0/2.4 Mandibular Fracture System, Titanium Dia 2.3mm x 4.0, 5.0, 7.0, 9.0, 11.0, 13.0, 15.0mm Lengths BI 23 199 1590 4323 128459 42 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI728 W.Lorenz Osteosynthesis System Neuro Square or Rectangular Plate, titanium 1.5mm system, 4 hole BI 23 199 1589 4271 119508 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI733 W.Lorenz Osteosynthesis System Bone Screw, Self Drilling, Cross Drive, Titanium 1.5 mm (dia) x 6.0, 7.0mm [lengths] BI 23 199 1590 4323 128459 42 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI734 W.Lorenz Osteosynthesis System Bone Screw, Self Drilling, Cross Drive, Titanium 1.5 mm (dia) x 3.5, 4.0, 5.0mm, [lengths] BI 23 199 1590 4323 128459 42 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI735 W.Lorenz Osteosynthesis System Bone Screw, Cross or Centre Drive; Titanium 2.3mm x (5 - 9) mm BI 23 199 1590 4323 128459 42 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI742 TMJ System Screw, Cross Drive Mandibular Component, Titanium (2.7 - 3.2mm) x (8 - 12mm) BI 23 199 1590 4323 128459 42 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI744 Mandibular Fracture System Screw, High Torque 2.0/2.4 Mandibular Fracture, Titanium 2.0 x (9-17)mm BI 23 199 1590 4323 128459 42 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI748 Mandibular Fracture System Screw, High Torque (HT), 2.0/2.4 Mandibular Fracture System, Titanium Dia 2.4 x 6.0mm, 8.0, 10.0, 12.0, 14.0, 16.0, 18.0mm Lengths BI 23 199 1590 4323 128459 42 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI754 Mandibular Fracture System Plates, Compression, 2.0 Mandibular Fracture System, Titanium 4 hole BI 23 199 1589 4288 Compression 128458 161 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI756 Mandibular Fracture System Plates, Compression, 2.0 Mandibular Fracture System, Titanium 4-6 hole BI 23 199 1589 4288 Compression 128458 161 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ME207 TRU-CLOSE THORACIC VENT Device for the treatment of spontanious, traumatic or iatrogenic simple pneumothorax.Allowing for amubulation during resolution and the aspiration of small amount of fluids Catheter outer diameter = 11 French, catheter length = 10cm Catheter outer diameter = 11 French, catheter length = 13cm Catheter outer diameter = 13 French, catheter length = 10cm Catheter outer diameter = 13 French, catheter length = 13cm ME 21 193 1577 4242 181784 404 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ME208 Redax Unico Percutaneous Drainage Kit Percutaneous Drainage Kit 9-12 CH ME 21 193 1577 4242 204898 150 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ME209 Leo+ Leo+ Stent D 2.0mm L 12mm, 18mm, 25mm. D 2.5mm L 12mm, 18mm, 25mm, 30mm, 35mm. D 3.0mm L 12mm, 18mm, 25mm, 35mm D 3.5mm L 12mm, 18mm, 25mm, 30mm, 35mm, 50mm. D 4.5mm L 15mm, 20mm, 25mm, 30mm, 40mm, 50mm, 75mm. D 5.5mm L 25mm, 30mm, 35mm, 50mm, 60mm, 75mm. ME 25 225 1687 197947 7125 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ME210 SONIC Microcatheter Micro catheter DMSO compatible Dia: 1.2fr or 1.5fr Length: 165cm or 190cm ME 25 225 1689 4494 155392 665 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BT185 Sentus ProMRI OTW QP L & S Quadripolar, steroid eluting left ventricular lead with standard/short pole spacing's and fractal coating. IS4 Connector & MRI Conditional for CRT Lengths: 77cm, 87 cm, 97cm 4.8F BT 27 243 1759 312683 Changed Product description, Benefit 4493 0 0 Update 2016-08-01 2019-03-01 Prosthesis BT186 BioMonitor 2-AF Implantable Cardiac Monitor Implantable cardiac monitor for continuous remote monitoring of patients with Atrial Fibrillation (AF) or unexplained syncope 88.4 mm x 15.2 mm x 6.2 mm , 10.1g , 5cm3 BT 27 249 1770 i 278935 3120 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BT187 CardioMessenger Smart 3G Bedside/Remote transmitter w/ pacemaker/ICD device life network access to Biotronik standard home monitoring data management service. Length - 130mm, Width - 65mm, Height - 13mm Weight - 75g BT 27 266 1832 273716 1568 0 0 No Change 2016-08-01 2019-03-01 Prosthesis ME211 Balt Remodelling Balloon Remodelling Balloon Kit, includes a 200cm tapered Hybrid Guidewire. SCOPERNIC10: 10mm balloon length, max fill volume 0.30ml; SCOPERNIC15: 15mm balloon length, max fill volume 0.35ml; SCOPERNIC20: 20mm balloon length, max fill volume 0.40ml; SCOPERNIC30: 30mm balloon length, max fill volume 0.50ml; SECLIPSE7: Balloon length 7mm, balloon dia 4 to 6mm, max fill vol 0.20ml; SECLIPSE9: Balloon length 9mm, balloon dia 4 to 6mm, max fill vol 0.25ml; SECLIPSE12: Balloon length 12mm, balloon dia 4 to 6mm, max fill vol 0.30ml; SECLIPSE15: Balloon length 15mm, balloon dia 4 to 6mm, max fill vol 0.40ml; SECLIPSE20 Balloon length 20mm, balloon dia 4 to 6mm, max fill vol 0.50ml. Packaging includes one HYBRID1214D guidewire, 200cm long, with Proximal Stainless Steel and distal nitinol. ME 25 225 1689 4494 170159 170160 665 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ME212 VASCO+ A progressive step braided micro-catheter with radio-opaque markers on the distal tip used to assist in the treatment of aneurysms and other neurological disorders. Distal outer Diameter: 1.5 - 5F Proximal Outer Diameter: 2.4F - 5F Length: 135 - 155mm ME 25 225 1689 4494 155391 665 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BT188 Eluna 8 HF-T Triple Chamber CRT-Pacemaker, capture management all chambers, physiological rate adaption, atrial overdrive pacing, event triggered IEMG transmission. Wandless telemetry, Home Monitoring, MRI conditional, IS-1 connector 53 x 49 x 6.5 mm, 14cm3, 25grams BT 27 241 1736 i 283279 9734 0 0 No Change 2017-02-01 2019-03-01 Prosthesis BT190 Biotronik BK & BS Sealing Caps & Blind Plugs BK BS Lead Sealing Caps BS Device Blind Plugs BK-IS: IS1/DF1 Caps BK-IS4/DF4:IS4/DF4 Caps BS-IS4: BS-IS4 Blind Plugs BT 27 246 1765 151988 283118 Changed Benefit 58 0 0 Update 2017-02-01 2019-03-01 Prosthesis BT198 Intica 7 HF-T QP Triple Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, LV Multipolar pacing, Home Monitoring, MRI conditional and AutoDetect, DF-1,IS-1, IS-4 quadripolar connectors 65mm x 60.5mm x 11mm, 36cm3, 86grams BT 27 238 1727 a,d 290412 37440 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BT199 Edora 8 HF-T QP Triple Chamber CRT-Pacemaker, capture management all chambers, physiological rate adaption, quadripolar LV pacing, atrial overdrive pacing, event triggered IEMG transmission, Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional, IS-4 IS-1 connectors 53 x 53 x 6.5 mm, 15cm3, 31.2 grams BT 27 241 1736 i 290558 9734 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BT191 Edora 8 HF-T Triple Chamber CRT Pacemaker, capture management all chambers, physiological rate adaption, atrial overdrive pacing, event triggered IEMG transmission, Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional, IS-1 connector 53 x 52 x 6.5 mm, 14 cm3, 26.9 grams BT 27 241 1736 i 290556 9734 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BT192 Intica 7 VR-T Single Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional and AutoDetect, DF-1, IS-1 connector W x H x D (mm) 65 x 55 x 11, Volume: 33cc, Mass: 82g BT 27 236 1723 a, d 290405 Changed Benefit 31622 0 0 Update 2017-08-01 2019-03-01 Prosthesis BT193 Edora 8 DR-T Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional, IS-1 connector 48 x 44 x 6.5 mm, 11 cm3, 23.2 grams BT 27 240 1734 g 290553 8482 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ME213 Fargo Guiding Catheters Outer Ø Proximal . 4.2F - 6.0F Outer Ø Distal : 3.9F - 6.0F Inner Ø: 1.02mm (.040") - 1.78mm (.070") Total Length: 95cm - 135cm Distall tip Length: 2.5cm -15cm ME 25 225 1689 4494 161937 665 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ME214 Double Lumen Occlusion Balloon Double lumen occlusion balloon DIAMETER: 6mm; LENGTHS: 7mm - 30mm ME 25 225 1689 4494 263592 263593 665 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ME215 Copernic RC Venous remodelling balloon Diameter: 8.0 - 10mm Balloon Length: 80mm Catheter Length: 160mm ME 25 225 1689 6022 170159 1641 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ME216 NEPHRO-CATH Nephrostomy Drainage Catheter Nephrostomy Drainage Catheter Diameters: 8fr to 14fr sizes; Lengths 27cm through to 29cm ME 26 234 1718 98030 114 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ME217 Frankenman Circular Stapler Curved intraluminal stapler preloaded with titanium staples. 21mm; 25mm; 28mm; 32mm ME 21 194 1582 4320 Circular 292060 Changed Benefit 697 0 0 Update 2017-08-01 2019-03-01 Prosthesis AO021 Stabileyes Capsular Tension Ring Polymethylmethacrylate (PMMA) Implant 12mm ring, and 13mm ring AO 1 143 1331 104818 151 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AO024 Tecnis® One Piece (ZCB00) One piece intraocular lens with edge modification and 360 degree square edge +5 to +34 diopter powers in 0.5d increments. Overall diameter 13mm, Optic size 6mm AO 1 141 1327 3892 at 170331 300 0 0 No Change 2008-07-01 2019-03-01 Prosthesis CT029 Vortek Double Loop Ureteral Stents Vortek Double Loop Ureteral Stents have a double layered structure which make them easy to insert over guidewire, the stiffness of each size has been adapted in order to keep the mechanical properties. 4.8, 6, 7 & 8 Fr with steerable or simple pusher with or without guidewire O/O or O/C CT 26 227 1701 5322 142924 224254 188 0 0 No Change 2016-08-01 2019-03-01 Prosthesis CT030 Biosoft Minute Stent Biosoft minute double loop ureteral stent. Ready to use; the stent is in place over the guidewire and connected to the steerable pusher. Duration of implantation: 6 months. 6 - 8 Fr 24 - 30 cm length CT 26 227 1701 5322 142925 224219 188 0 0 No Change 2016-08-01 2019-03-01 Prosthesis CT031 Vortek TUMOR STENT Double loop ureteral stent Vortek Tumor Stent is reinforced with stiffness of material offering excellent resistance to compression. 7-8Fr 26-30cm in length CT 26 227 1701 5322 224254 188 0 0 No Change 2016-08-01 2019-03-01 Prosthesis CT032 Silicone Double Loop Ureteral Stent Silicone Double Loop Ureteral Stent with guidewire and pusher 6 - 8Fr 16cm - 30cm CT 26 227 1701 5322 142923 188 0 0 No Change 2016-08-01 2019-03-01 Prosthesis AO026 TECNIS® Multifocal Intraocular Lens (ZMA00) Posterior chamber lens with UV light-absorbing, foldable acrylic, 3-piece with a diffractive posterior optic and a modified anterior surface technology with edge modification and 360 degree square edge. +5 to +34 diopter powers in 0.5d increments. Overall diameter 13mm, Optic size 6mm AO 1 141 1327 3893 at 170331 677 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BB201 e.MOTION Total Knee Tibial baseplate, cemented, CoCR with polished surface for mobile insert T1-T8, left and right BB 17 151 1359 Revision 96481 3489 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB204 Columbus Total Knee System (TKS) Tibial Baseplate Tibial baseplate, cemented, CoCr for fixed insert T1 to T5 BB 17 151 1357 Revision 96481 3265 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB205 Columbus Total Knee System (TKS) Femoral Component Femoral component, cemented, CR, CoCr F1 - F8, Left and Right BB 17 149 1348 3906 279465 2951 0 0 No Change 2005-10-31 2019-03-01 Prosthesis CT021 Supris Retropubic Sling Supris Retropubic Sling System for female urinary incontinence One size CT 26 226 1698 5315 160738 Changed Benefit 822 0 0 Update 2016-08-01 2019-03-01 Prosthesis CT023 Biosoft Duo Multi Length Hydro-Coated Ureteral Stents Biosoft Duo Multi Length Hydro-Coated Stents for drainage of upper urinary tract. 4.8, 6. 7 Fr CT 26 227 1702 5325 142925 188 0 0 No Change 2016-08-01 2019-03-01 Prosthesis CT024 PU-R Double Loop Ureteral Stents Double Loop Ureteral Stents in Rigid Polyurethane, with pusher. With or without guidewire depending on the model. Various in 4.8, 6, 7, 8Fr. Various in 24, 26, 28, 30cm lengths. Various in O/O or O/C. Various with or without guidewire. With either streerable or simple pusher CT 26 227 1701 5321 142907 133 0 0 No Change 2016-08-01 2019-03-01 Prosthesis CT020 Restorelle XL Smartmesh Smartmesh, Type 1, macroporous, soft, knitted, monofilament polypropylene mesh 30cm x 30cm CT 26 229 1706 5327 190172 643 0 0 No Change 2013-02-01 2019-03-01 Prosthesis ME218 Frankenman Haemorrhoidal (CPH) Stapler Circular stapler for rectal prolapse and haemorrhoids preloaded with titanium staples Outside diameter: 32.5mm; 34.5mm ME 21 194 1582 4320 Circular 205330 Changed Benefit 697 0 0 Update 2017-08-01 2019-03-01 Prosthesis ME219 Frankenman Linear Cutter Stapler Single use, reloadable, linear cutter stapler containing titanium staples 61mm; 81mm; 100mm ME 21 194 1582 4320 205319 205331 342 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ME220 Frankenman Linear Stapler Reloads Linear stapler single use reload with titanium staples 32mm; 46mm; 60mm; 90mm ME 21 194 1582 4317 207254 Changed Benefit 226 0 0 Update 2017-08-01 2019-03-01 Prosthesis ME221 Frankenman Linear Stapler Linear stapler preloaded with titanium staples 32mm; 46mm; 60mm; 90mm ME 21 194 1582 4320 205319 205331 342 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AM054 AMS Spectra Concealable Penile Prosthesis AMS Spectra Concealable Penile Prosthesis 9.5 mm x 12cm AMS Spectra 9.5 mm x 16cm AMS Spectra 9.5 mm x 20cm AMS Spectra 12 mm x 12cm AMS Spectra 12 mm x 16cm AMS Spectra 12 mm x 20cm AMS Spectra 14 mm x 12cm AMS Spectra 14 mm x 16cm AMS Spectra 14 mm x 20cm AMS Spectra 9.5mm Spectra Rear AM 26 230 1721 165751 776 0 0 No Change 2010-08-01 2019-03-01 Prosthesis AN003 Animas Insulin Infusion Sets (INFUSION SET, COMFORT, 23", HOSP 10, INFUSION SET, COMFORT 43", HOSP 10. Inset II, 6mm and 9mm. Inset 30, 13mm) Needle guard, soft cannula, adhesive tape, introducer needle, cannula housing, tubing, connector needle, circular protective cap and disconnect cover. Packs of 10 AN 21 188 1541 4193 96785 7 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AN004 Animas Insulin Infusion Set (INFUSION SET, COMFORT, 23", STD 5/5 AND INFUSION SET, COMFORT, 43" STD 5/5) Needle guard, soft cannula, adhesive tape, introducer needle, cannula housing, tubing, connector needle, circular protective cap and disconnect cover. Packs of 10 AN 21 188 1541 4193 96785 7 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AN006 Animas IR 1200/2020 Insulin Infusion Cartridge (Insulin Infusion Pump IR1200/2020 Series) Sterile, indicated as reservoir for insulin by the Animas Infusion Pump, not intended for use with any other infusion device. Cartridge Capacity - 2.0mL or 200 units. Packs of 10 AN 21 188 1541 4192 96120 8 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB206 Columbus Total Knee System (TKS) Femoral Component Femoral component, cemented, CoCr, posterior stabilised F1 - F8, Left and Right BB 17 149 1348 3907 279467 3041 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB207 Columbus Total Knee System (TKS) Tibial Insert Tibial Insert, UHMWPE, fixed T1 - T5 BB 17 153 1369 96481 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB209 Columbus Total Knee System (TKS) Tibial Insert Tibial Insert, UHMWPE, fixed, posterior stabilised with included screw for fixation to baseplate T1 - T5 BB 17 153 1370 96481 Changed Benefit 1073 0 0 Update 2005-10-31 2019-03-01 Prosthesis BB210 Columbus Total Knee System (TKS) Tibial Stems Tibial Stem (cap), cemented or uncemented, short (mini) (obturator stem) CoCr, usually required when stem not used Small & Large D: 12mm & D: 14mm BB 17 159 1395 96481 649 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB218 Kopitnik Microneurosurgical AVM Clips Composition: Phynox (Cobalt-base-alloy) 2mm, 3mm, 4mm, 5mm - straight. 2mm, 3mm, 4mm, 5mm - curved. BB 25 218 1656 101731 Changed Benefit 257 0 0 Update 2005-10-31 2019-03-01 Prosthesis BB224 Aesculap Spinal System Polyaxial Screw - titanium alloy All sizes BB 19 165 1463 134538 1280 0 0 No Change 2005-10-31 2019-03-01 Prosthesis CT016 Restorelle M Smartmesh Smartmesh, Type 1, macroporous, soft, knitted, monofilament polypropylene mesh. 15cm x 10cm CT 26 229 1706 5326 190172 The provision of the prosthesis is only to be funded when used in conjunction with MBS Item No. 35597. See rule 5B for effect of Condition. Changed Benefit 294 0 0 Update 2012-02-01 2019-03-01 Prosthesis CT017 Restorelle Y Smartmesh Smartmesh for vaginal vault prolapse repair for abdominal, laproscopic or robotic sacrocolpopexy. 24cm x 4cm and 27cm x 4cm. CT 26 229 1706 5326 ap 190172 643 0 0 No Change 2012-02-01 2019-03-01 Prosthesis CT019 Restorelle L Smartmesh Smartmesh, Type 1, macroprous, soft, knitted, monofilament polypropylene mesh 24cm x 8cm CT 26 229 1706 5326 190172 Changed Benefit 294 0 0 Update 2013-02-01 2019-03-01 Prosthesis BB228 Aesculap Spinal System Cross Connector All Sizes BB 19 167 1474 4123 134538 404 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB229 Aesculap Spinal System Cross, Domino, Axial, Lateral Connector All Sizes BB 19 167 1474 4124 134538 Changed Benefit 1299 0 0 Update 2005-10-31 2019-03-01 Prosthesis BB230 Aesculap Spinal System Set Screw - titanium All sizes BB 19 166 1465 134538 164 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB232 Emotion Total Knee System (TKS) Femoral Component Femoral Component, uncemented, CoCr Titanium plasma spray (Plasmapore), HA coated F1 - F8, Left and Right BB 17 149 1352 3917 96481 3667 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB233 Emotion Total Knee System (TKS) Tibial Baseplate Tibial baseplate, uncemented, CoCr, Titanium plasma spray (Plasmapore) with polished insert surface, HA coated for mobile insert T1 - T8 BB 17 151 1362 3924 96481 Changed Benefit 2997 0 0 Update 2005-10-31 2019-03-01 Prosthesis BB235 Biolox Delta Ceramic Liner Biolox Delta Liner 28, 32, 36 & 40mm BB 18 163 1428 4025 134535 2303 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB236 Polyethylene Acetabular Cup Unmodified Polyethylene 22.2mm-32mm articulations; 40mm-64mm diameters BB 18 163 1425 4006 134535 659 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB237 Plasmacup PE insert UMHPE unmodified liner 44mm-68mm diameters, 22.2mm-32mm articulations BB 18 163 1428 4020 134535 720 0 0 No Change 2005-10-31 2019-03-01 Prosthesis CT025 Stenostent Double Loop Ureteral Stents STENOSTENT® Double loop ureteral stent in silicone open/open, total reinforcement with connectable pusher and fixed core guidewire 16 - 30cm CT 26 227 1701 5322 SP 142923 Changed Benefit 222 0 0 Update 2016-08-01 2019-03-01 Prosthesis CT026 Biosoft Duo Double Loop Ureteral Stents Biosoft Duo double loop ureteral stents supplied with simple or steerable pusher, with or without guidewire and with or without flush catheter depending on the model. Duration of Implantation: 12 months 6 - 9 Fr 20 - 30 cm Either O/O or O/C CT 26 227 1701 5322 142925 224254 188 0 0 No Change 2016-08-01 2019-03-01 Prosthesis CT027 Vortek Single Loop Ureteral Stents Vortek Single Loop Ureteral Stents for drainage and urine collection 6, 7, 8 Fr 90cm length CT 26 227 1701 5322 142924 224254 188 0 0 No Change 2016-08-01 2019-03-01 Prosthesis CT028 Pyelostent Double Loop Ureteral Stent Pyelostent, Silicone stent for long-term implantation (up to 12 months) 26 - 30cm CT 26 227 1701 5322 SP 142923 Changed Benefit 222 0 0 Update 2016-08-01 2019-03-01 Prosthesis BB238 Acetabular Fixation Screws Isotan 16mm-68mm BB 18 164 1435 98978 121 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB239 BiContact Cementless Femoral stem, grit blast and HA 8-21 BB 18 161 1407 3949 134536 3779 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB240 BiContact cemented Cemented stem cobal chrome 8-18 BB 18 161 1404 3941 134536 1845 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB241 Emotion Total Knee System (TKS) Tibial Stem Tibial Stem (cap), cemented or uncemented, short (mini) (obturator stem) CoCr, usually required when stem not used 12mm, 14mm & 16mm in cemented and uncemented BB 17 159 1395 96481 649 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB242 Columbus Total Knee System (TKS) Tibial Stem Tibial Stem, cemented or uncemented, CoCr 12mm & 14mm, in uncemented, 12mm & 14mm in cemented. BB 17 159 1399 96481 Changed Benefit 1126 0 0 Update 2005-10-31 2019-03-01 Prosthesis BB243 Plasmacup Titanium, plasma, HA 44mm-68mm BB 18 163 1427 4018 134535 2373 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB244 Coroflex Blue Cobalt Chromium Alloy L605 2-4mm diameter, 8-25mm length BB 24 206 1622 4439 112447 1710 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB246 Metal Head Isodur CoCr Femoral Head 22.5mm, 26mm, 28mm, 32mm BB 18 162 1419 3989 123313 703 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB247 Reconstruction Shell Isotan 52-64mm, left and right BB 18 163 1432 4034 134535 2783 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB245 Distal centraliser PMMA 7mm - 18mm BB 18 164 1438 123313 139 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB249 Bipolar Head Bipolar shell plus liner 38 - 60mm BB 18 162 1424 4004 134535 753 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB250 Biolox Delta Ceramic Head Biolox Delta Ceramic Head 28 & 32mm diameter BB 18 162 1419 3992 126457 1845 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB252 Aesculap Interbody Cage TLIF Interbody Cage All sizes BB 19 174 1486 4135 122641 273761 3465 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB253 Columbus Total Knee System (TKS) Tibial Baseplate Tibial Baseplate, Cemented, CoCr for mobile insert, polished insert surface T1- T5 BB 17 151 1359 Revision 96481 3489 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB255 Columbus Total Knee System (TKS) Tibial Insert Tibial Insert, UHMWPE, Mobile T1- T5 BB 17 153 1369 96481 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MA481 Affinis Shoulder System Affinis Fracture Stem - metaphyseal, uncemented 15.5, Part 2- 18 MA 13 131 1276 4060 219732 2451 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MA482 Ceramys Ceramic Femoral Head Ceramic, zirconia alumina combination 28 L, 28 M, 28 S, 32 XL, 32 L, 32 M, 32 S MA 18 162 1419 3992 236457 1845 0 0 No Change 2007-12-01 2019-03-01 Prosthesis AN008 Collatamp G Biodegradable collagen implant with gentamicin 10cm x 10cm x 0.5cm, 20cm x 5cm x 0.5cm AN 21 191 1555 4216 Antibiotic 156287 292 0 0 No Change 2010-08-01 2019-03-01 Prosthesis AN009 Collatamp G Biodegradeable collagen implant with gentamicin 5cm x 5cm x 0.5cm AN 21 191 1555 4215 Antibiotic 156287 Changed Benefit 128 0 0 Update 2010-08-01 2019-03-01 Prosthesis AN011 Animas Vibe/One Touch Vibe Plus Insulin Pump Ambulatory insulin infusion pump with real-time continuous glucose monitoring (CGM) capability 8.26 x 5.08 x 2.18cm AN 21 188 1525 4183 DE, SS 96120 8502 0 0 No Change 2012-02-01 2019-03-01 Prosthesis AN014 t:slim X2 Insulin Pump Ambulatory insulin infusion pump with real-time continuous glucose monitoring (CGM) capability One size only. AN 21 188 1525 4183 DE, SS 304861 8502 0 0 No Change 2018-08-01 2019-03-01 Prosthesis AN015 Autosoft, Varisoft, TruSteel Infusion Set For use with insulin infusion pump 6 - 17mm AN 21 188 1541 4193 304861 7 0 0 No Change 2018-08-01 2019-03-01 Prosthesis AO001 Intraocular Lens: Model AC 51L Duralens PMMA, Anterior Chamber IOL 6.00 mm Optic Diameter x 13.0mm in overall length AO 1 140 1324 3887 m 144532 169 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB274 Excia Hip System plasma titanium, HA 8mm-18mm BB 18 161 1407 3952 123313 4394 0 0 No Change 2006-03-24 2019-03-01 Prosthesis BI604 W Lorenz Osteosynthesis System Sheet, 1mm System. Titanium 85x50x0.2mm BI 23 199 1585 4204 128458 Changed Benefit 683 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI605 W Lorenz Osteosynthesis System Plate, Matrix, 1.0 or 1.5mm System, Titanium 6 hole BI 23 199 1589 4271 128458 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI617 W Lorenz Osteosynthesis System Plate, Straight, 1mm System. Titanium 4 hole BI 23 199 1589 4271 128458 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI620 W Lorenz Osteosynthesis System Plate, Straight, low profile, 2.0mm System, Titanium 4 - 8 hole BI 23 199 1589 4271 128458 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI621 W Lorenz Osteosynthesis System Plate, L , 2.5mm or 2m system, Titanium 2 x2 or 3x3 hole BI 23 199 1589 4271 128458 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI622 W Lorenz Osteosynthesis System Z-Shape Plate, Left or Right, 1.5mm or 2mm System. Titanium 2 x 2 hole BI 23 199 1589 4271 128458 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI623 W Lorenz Osteosynthesis System T-Plate, Left or Right, 1.5mm System. Titanium 3x3 hole, 7x7 hole BI 23 199 1589 4271 128458 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI624 W Lorenz Osteosynthesis System T-Plate 90 degrees, Left or Right, 2mm System. Titanium 2x5hole, 3x3hole, 2x3hole BI 23 199 1589 4271 128458 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI625 W Lorenz Osteosynthesis System Plate, Y, Double Y, X, 1.5mm System or 2.0mm System, Titanium One size only BI 23 199 1589 4271 128458 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI627 W Lorenz Osteosynthesis System Plate, Straight, 1.5mm System, Titanium 4 or 6 hole BI 23 199 1589 4271 128458 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI638 W Lorenz Osteosynthesis System Plate, Orbital. 1mm System, Titanium One size only BI 23 199 1589 4271 128458 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI641 W Lorenz Osteosynthesis System Plate, Matrix. 1mm System, 1.5mm System. Titanium 2 x 4 hole BI 23 199 1589 4277 128458 199 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI645 W Lorenz Osteosynthesis System Mesh panel, 1.5mm System Titanium (41-83) x (39-54mm) (0.3 or 0.2mm) BI 23 199 1585 4204 128458 Changed Benefit 683 0 0 Update 2005-10-31 2019-03-01 Prosthesis AO002 Sensar AR40 Monofocal Acrylic IOL, Sensar OptiEdge AR40e Foldable Acrylic IOL Soft Acrylic, Foldable, UV Absorbing, Posterior Range available from -10D to +30D. 6 mm Optic Diameter x 13mm in overall length. AO 1 141 1327 3892 99891 265 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AO008 Healon, Intraocular Viscoelastic Fluid Sodium Hyaluronate 10mg/ml Healon 0.55ml & 0.85ml AO 1 142 1329 144891 72 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AO009 Healon 5, Intraocular Viscoelastic Fluid HEALON5- Sodium hyaluronate 23mg/ml . 0.6ml AO 1 142 1329 hmw 144893 Changed Benefit 77 0 0 Update 2005-10-31 2019-03-01 Prosthesis AO010 Healon GV Intraocular Viscoelastic Fluid Sodium Hyaluronate 14mg/mL 0.55ml and 0.85ml AO 1 142 1329 hmw 144892 Changed Benefit 77 0 0 Update 2005-10-31 2019-03-01 Prosthesis AO012 Baerveldt Glaucoma Implant BG 101-350, Baerveldt Glaucoma Implant BG 103-425, Baerveldt Glaucoma Implant BG 103-250 Non-valved artificial drainage device, composition silicone - smooth, tumble-polished finish Surface area 250, 350, 425mm2 AO 1 144 1333 168768 404 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AO014 TECNIS® Intraocular Lens (Z9002 & ZA9003) Foldable Intraocular Lenses - Ultraviolet light absorbing posterior chamber intraocular lenses, Silicone/Acrylic 5-10 dioptre in 1.0 dioptre increments; 10.5 - 30 dioptre in 0.5 increments AO 1 141 1327 3892 at 99891 300 0 0 No Change 2005-10-31 2019-03-01 Prosthesis IG130 Spider Limited Wrist Fusion System - 2.8mm bone screws Stainless steel screws for Spider Plate Diameter 2.8mm, length 10-18mm IG 13 123 1231 3370 177622 82 0 0 No Change 2012-02-01 2019-03-01 Prosthesis IG131 TIBIAXYS Distal Tibia System - Ankle Arthrodesis - Lateral anterior plate Titanium lateral anterior plate with 8 holes; left or right 3mm thick, 92mm long IG 13 123 1694 5259 Com, VAL 173932 1229 0 0 No Change 2012-02-01 2019-03-01 Prosthesis IG132 TIBIAXYS Distal Tibia System - Ankle Arthrodesis - Medial anterior plate Titanium medial anterior plate with 6 holes; left or right 3mm thick, 77mm long IG 13 123 1694 5258 Com, VAL 173932 1164 0 0 No Change 2012-02-01 2019-03-01 Prosthesis IG133 Snap-Off screws Titanium break-off barrel screws for Hallu-Fix Diameter 2.7mm; length 10-34mm IG 13 123 1231 3371 Breakoff 173963 304 0 0 No Change 2012-02-01 2019-03-01 Prosthesis IG134 Snap-Off screws Titanium break-off barrel screws for Hallu-Fix Diameter 3.0mm, Length 10 - 18mm IG 13 123 1231 3370 Breakoff 173963 302 0 0 No Change 2012-02-01 2019-03-01 Prosthesis EL061 Carpentier-Edwards Physio Tricuspid Annuloplasty Ring 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, 36mm EL 20 181 1842 196111 2280 0 0 No Change 2013-02-01 2019-03-01 Prosthesis EL062 EDWARDS INTUITY Elite Aortic Valve System Rapid Deployment Aortic Valve System 19mm - 27mm EL 20 179 1815 b (bovine) 261673 Changed Benefit 8978 0 0 Update 2016-02-01 2019-03-01 Prosthesis EL063 Edwards SAPIEN 3 Transcatheter Heart Valve Transcatheter, balloon expanded aortic heart valve with Commander Delivery System 23mm, 26mm and 29mm EL 27 267 2641 284496 22932 0 0 No Change 2017-08-01 2019-03-01 Prosthesis EM021 Biomesh P1/P3 Reinforcement Mesh Macro porous 100% polypropylene mesh for laproscopic and open surgical approaches 8 x 13cm EM 21 194 1782 5434 131113 76 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EM022 Biomesh P1/P3 Reinforcement Mesh Macro porous 100% polypropylene mesh for laproscopic and open surgical approaches 15 x 15cm EM 21 194 1782 5435 131113 81 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EM023 Biomesh P1/P3 Reinforcement Mesh Macro porous 100% polypropylene mesh for laproscopic and open surgical approaches 2.3 x 10cm EM 21 194 1782 5434 131113 76 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EM024 Biomesh P1/P3 Reinforcement Mesh Macro porous 100% polypropylene mesh for laproscopic and open surgical approaches 5 x 10cm EM 21 194 1782 5434 131113 76 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EM025 Biomesh P1/P3 Reinforcement Mesh Macro porous 100% polypropylene mesh for laproscopic and open surgical approaches 7 x 15cm, 10 x 15cm EM 21 194 1782 5434 131113 76 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EO056 Aptus Foot Calcaneus Plates Left and right plates, small, medium and large EO 13 123 1694 5296 VAL 141170 1462 0 0 No Change 2012-02-01 2019-03-01 Prosthesis EO057 Aptus 2.2 Cannulated Headless Compression Screws APTUS® Cannulated Compression Screws 2.2 diameter. Short and long threaded 10mm to 30mm EO 13 123 1231 3371 CN,DT 141171 381 0 0 No Change 2012-02-01 2019-03-01 Prosthesis EO058 Aptus 3.0 Cannulated Headless Compression Screw Aptus 3.0 Cannulated Headless Compression Screw 3.0 diameter. Short and long threaded 10mm to 40mm EO 13 123 1231 3370 CN,DT 141171 379 0 0 No Change 2012-02-01 2019-03-01 Prosthesis IG135 Spin screw: Snap-off screws Titanium break-off barrel screws Diameter 2.0 mm, Length 11 -14mm IG 13 123 1231 3372 Breakoff 173963 281 0 0 No Change 2012-02-01 2019-03-01 Prosthesis IG136 Uni-CP Compression plating system 4 hole U design 4 hole, 3 interaxis sizes: 17,19,21mm IG 13 123 1694 5258 Com, LK 173932 850 0 0 No Change 2012-08-01 2019-03-01 Prosthesis IG137 Panta Arthrodesis Nail Partially threaded lag Screw, Titanium Diameter 5 mm Length - 20 - 110 mm IG 13 123 1229 3341 173962 199 0 0 No Change 2013-08-01 2019-03-01 Prosthesis IG138 Panta Arthrodesis Nail Fully threaded lag Screw, Titanium Diameter 5 mm Length - 20 - 110 mm IG 13 123 1229 3712 173962 Changed Benefit 222 0 0 Update 2013-08-01 2019-03-01 Prosthesis JJ956 Attune Knee System Posterior Stabilised Insert 1-10 SY 17 153 1370 213019 220507 Changed Benefit 1073 0 0 Update 2014-08-01 2019-03-01 Prosthesis JJ957 Attune Knee System Fixed Bearing Cemented Tibial Tray 1-10 SY 17 151 1357 220503 1923 0 0 No Change 2014-08-01 2019-03-01 Prosthesis JJ958 Attune Knee System Mobile Bearing Cemented Tibial Tray 1-10 SY 17 151 1359 191589 Changed Benefit 2147 0 0 Update 2014-08-01 2019-03-01 Prosthesis EO060 Aptus Wrist Arthrodesis STT Fusion Plate 2.0 system EO 13 123 1694 5261 Com, VAL 141170 1577 0 0 No Change 2012-02-01 2019-03-01 Prosthesis EO061 Aptus Wrist Arthrodesis RSL Fusion Plate 7 to 15 holes EO 13 123 1694 5262 Com, VAL 141170 1332 0 0 No Change 2012-02-01 2019-03-01 Prosthesis EO062 Aptus Wrist Arthrodesis Total Wrist Fusion Plate, Straight, long bend and short bend >16 holes EO 13 123 1694 5263 Com, VAL 141170 Changed Benefit 1587 0 0 Update 2012-02-01 2019-03-01 Prosthesis EO063 Aptus Elbow Olecranon Plates Right, Left, Straight and Tension > 7 to < 15 holes EO 13 123 1694 5280 VAL 141170 1439 0 0 No Change 2012-02-01 2019-03-01 Prosthesis EO059 Aptus Elbow Olecranon Tension Plate Ulna < 6 holes EO 13 123 1694 5279 VAL 141170 1439 0 0 No Change 2012-02-01 2019-03-01 Prosthesis EO067 Aptus Wrist 2.5 TriLock Distal Radius Small Fragment Plates 2.5mm diameter system EO 13 123 1694 5276 VAL 141170 1439 0 0 No Change 2012-02-01 2019-03-01 Prosthesis EO068 APTUS Wrist 2.5 TriLock Distal Radius Plates, Adaptive, Volar, Dorsal, Correction, Extra-articular 2.5mm diameter system EO 13 123 1694 5277 VAL 141170 1439 0 0 No Change 2012-02-01 2019-03-01 Prosthesis HW145 GMRS (Global Modular Replacement System) MRH (Modular Rotating Hinge) Kinematic Rotating Hinge (KRH) Femoral Bushings & Bumpers GMRS, MRH, KRH Rotating Hinge Femoral Bushings & Bumpers UHMWPE, (Duration) Small & standard HW 17 159 1393 128026 3089 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW143 MRH (Modular Rotating Hinge) (Modular Rotating Hinge) Femoral Component MRH Rotating Hinge Femoral component, CoCr (Vitallium), cemented, w/attachable stem, Fixed Left, Right HW 17 149 1348 3908 Revision, Hinged 139145 6038 0 0 No Change 2005-10-31 2019-03-01 Prosthesis IG108 Newdeal Surfix Style Screws Titanium bone screw +locking screw for the fixation of specific Newdeal bone plates Diameter 3.5mm, Length 10-50mm; Diameter 4.5mm, length 14-65mm; Diameter 6.5, length 20-100mm IG 13 123 1231 3370 CN,LK 173963 271 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW144 KRH (Kinematic Rotating Hinge) Tibial Bearing Component KRH Rotating Hinge Tibial bearing component, CoCr, Mobile Small and Medium 11mm/15mm by 110mm/180mm HW 17 159 1393 128028 3089 0 0 No Change 2005-10-31 2019-03-01 Prosthesis IG109 Qwix Screw Self drilling, self tapping, cannulated, titanium screws. Diameter 3.0mm-7.5mm, length 10mm-120mm IG 13 123 1231 3370 CN,DT 173963 379 0 0 No Change 2011-02-01 2019-03-01 Prosthesis JJ960 Orbit Galaxy Microcoil Length 1.5 to 30cm SY 25 225 1688 219194 219195 1430 0 0 No Change 2014-08-01 2019-03-01 Prosthesis JJ961 BioIntrafix Tibial soft tissue fastner screw/sheath 30mm and 6 to 10mm SY 13 123 1774 5391 AB, HA 136255 163254 457 0 0 No Change 2014-08-01 2019-03-01 Prosthesis JJ963 DePuy Hip Systems Distal femoral centralisers 8 to 20mm SY 18 164 1438 137671 97695 139 0 0 No Change 2015-02-01 2019-03-01 Prosthesis JJ964 Global Shoulder System Glenoid component 40 to 56mm including XL SY 13 131 1277 3701 129404 138288 1895 0 0 No Change 2015-02-01 2019-03-01 Prosthesis JJ965 Global Shoulder System Humeral heads 40–56mm SY 13 131 1276 4067 132151 138288 1261 0 0 No Change 2015-02-01 2019-03-01 Prosthesis JJ959 Attune Knee System All Poly Cemented Patella 29-41mm SY 17 156 1376 208794 220505 Changed Benefit 537 0 0 Update 2014-08-01 2019-03-01 Prosthesis JJ966 Global Shoulder System Humeral Stem 6-16mm SY 13 131 1276 4058 138288 3325 0 0 No Change 2015-02-01 2019-03-01 Prosthesis JJ967 Delta Shoulder System Glenosphere 36 to 42 SY 13 131 1277 4079 126914 137537 Changed Benefit 2176 0 0 Update 2015-02-01 2019-03-01 Prosthesis JJ968 Delta Shoulder System Humeral Spacer 36 to 42 +9mm SY 13 131 1278 4081 126913 137537 144505 950 0 0 No Change 2015-02-01 2019-03-01 Prosthesis CU003 Neofuser Pump Continuous flow rate ambulatory and disposable silicone balloon infusion pump Volume 100ml, 275ml, 450ml CU 21 188 1524 5358 Set Changed Benefit 241 0 0 Update 2017-02-01 2019-03-01 Prosthesis CU004 Neofuser Vario Pump Variable flow rate ambulatory and disposable silicone balloon infusion pump Volume 60ml, 100ml, 180ml, 275ml, 450ml CU 21 188 1524 5359 Set Changed Benefit 347 0 0 Update 2017-02-01 2019-03-01 Prosthesis CU005 Neofuser Bolus Pump Ambulatory and disposable silicone balloon infusion pump with bolus function Volume 100ml, 275ml, 450ml CU 21 188 1524 5359 Bolus 416 0 0 No Change 2017-02-01 2019-03-01 Prosthesis CZ012 Z-HYALIN Viscoelastic Cohesive Viscoelastic Solution - sodium hyaluronate 10mg/ml. (previously called Ophthalin) Volume 1.0ml CZ 1 142 1329 150016 72 0 0 No Change 2008-07-01 2019-03-01 Prosthesis DE620 Park Modified Pectus Bar Park Modified Pectus bar available in titanium alloy and stainless steel 6" - 152mm, 7" - 178mm, 8" - 203mm, 9" - 228mm, 10" - 254mm, 11" - 279mm, 12" - 305mm, 13" - 330mm, 14" - 356mm, 15" = 381mm, 16" - 406mm, 17" - 432mm DE 20 264 1824 224584 1193 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE621 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 DE 20 264 1825 224584 480 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER480 Paragon 28 Gorilla Plating System-Plate, small (≤ 6 holes);variable angle locking, complex Paragon28 Gorilla, small titanium compression plates; universal; variable angle locking; compression; various complex shapes thickness 1.3 - 2.0 mm; multi screw diameter purchase ER 13 123 1694 5258 Com, VAL 289248 1164 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER481 Paragon 28 Gorilla Plating System-Plate, small ( ≥ 7 to ≤ 15 holes); variable angle locking Paragon 28 Gorilla Plating System-Plate, small, titanium, malleus/column rescue/stradle/arch (proximal or distal) Thickness 1.5/2.0 mm ; multi screw diameter purchase 2.7/3.5/4.2mm ER 13 123 1694 5259 VAL 289248 849 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER482 Paragon 28 Gorilla Plating System-Plate, small ( ≥ 7 to ≤ 15 holes); variable angle locking, complex Paragon 28 Gorilla Plating System-Plate, small, titanium, malleus/column rescue/stradle/arch (proximal or distal), variable angle locking, complex Thickness 1.5mm; multi screw diameter purchase ER 13 123 1694 5259 Com, VAL 289248 1229 0 0 No Change 2018-02-01 2019-03-01 Prosthesis IG111 Universal2 Carpal Poly Component Polyethylene carpal component to restore proper carpal height in Universal2 total wrist implant xs-standard, xs +1, xs+2, small - standard, small +1, small +2, Med-standard, med+1, med+2; large-standard, large+1, large+2 IG 13 131 1273 3666 160521 Changed Benefit 2043 0 0 Update 2011-08-01 2019-03-01 Prosthesis IG110 Universal2 Carpal Component Carpal plate (titanium) with fixed central peg and porous coating xs, small, med, large IG 13 131 1273 3664 160521 1710 0 0 No Change 2011-08-01 2019-03-01 Prosthesis IG112 Universal2 Radial Component Radial Implant (cobalt chrome) with integral stem and porous coating x-small - left & right, small - left & right, medium - left & right, large - left & right IG 13 131 1273 3665 160521 3111 0 0 No Change 2011-08-01 2019-03-01 Prosthesis IG113 Bone Screws Titanium screws (2) for use with the Universal2 Total Wrist System only 4.5mm x (15, 20, 25, 30, 35mm) IG 13 123 1231 3369 160521 65 0 0 No Change 2011-08-01 2019-03-01 Prosthesis IG114 TIBIAXYS Distal Tibial Osteotomy System: Medial right/lateral left osteotomy plate: lateral right/medial left osteotomy plate Titanium contoured right and left design plates for wedge osteotomy of distal tibia 8 hole; Lateral plates 75.2mm length IG 13 123 1694 5259 Com, VAL 173932 1229 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LH537 Klementine PL Fixation Screw, Self Tapping (3.5 - 3.7)mm dia x 13-17mm length LH 19 165 1464 178660 Changed Benefit 193 0 0 Update 2015-08-01 2019-03-01 Prosthesis LH540 Precice Intramedullary Limb Lengthening System Precice End Cap 0-20mm length LH 13 123 1229 5363 244568 96 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LH541 Precice Intramedullary Limb Lengthening System Precice Locking Screw Diameter (3.5 -5.0)mm diameter x (20- 75)mm length LH 13 123 1229 3713 244568 Changed Benefit 143 0 0 Update 2016-02-01 2019-03-01 Prosthesis LH542 Precice Intramedullary Limb Lengthening System , Nail Precice Intramedullary Nail (8.5 -12.5)mm diameter x (130- 365)mm length LH 13 123 1228 5362 244568 244569 16741 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LH543 Posterior Spine Truss System Interbody Fusion Device TLIF Cage (9-12)mm x (22-40)mm LH 19 174 1486 4135 252733 Changed Product sizes 3465 0 0 Update 2016-02-01 2019-03-01 Prosthesis LH546 Lateral Spine Truss System Interbody spacer, Porous Ti 8-16mm high LH 19 174 1486 4135 252733 3465 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LH552 Dipromed ClearMesh Composite Transparent composite mesh Oval: (9 - 11) cm x (13-15)cm Circular: 4.5 - 15cm diameter LH 21 194 1783 5438 Coated 267206 Changed Benefit 371 0 0 Update 2016-08-01 2019-03-01 Prosthesis DE622 Park Bridge Stabiliser Stablisation of Pectus Bar - optional use for multiple bar placement 3 sizes: 6 hole - 60mm, 8 hole 80mm, 10 hole - 100mm DE 20 264 1825 224584 480 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE623 Park Claw Fixator, Clip and Nut Stabiliser Stabilisation 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. DE 20 264 1825 224584 480 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE624 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). DE 20 265 1828 No Suffix 262630 256 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE625 Malibu Spinal System Monoaxial Screw Monoaxial Bone Screw 4.5mm x 25mm - 9.5mm x 80mm DE 19 165 1462 275794 895 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE626 Malibu Spinal System Polyaxial Screw Polyaxial screw 4.5mm x 20mm - 8.5mm x 110mm in 5mm increments DE 19 165 1463 275794 1280 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER483 Paragon 28 Gorilla Plating System-Plate, mini (≤ 6 holes); variable angle locking Paragon 28 Gorilla Plating System-Plate, titanium mini plate, compression, variable angle locking, variable sizes and shapes thickness 1.1/1.3 mm; multi screw diameter purchase 2.0/2.5mm or 2.7/3.5/4.2 mm ER 13 123 1694 5261 VAL 289248 1197 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER484 Paragon 28 Gorilla Plating System-Plate, mini (≤ 6 holes);variable angle locking, complex Paragon 28 Gorilla Plating System-Plate, titanium mini plate, compression, variable angle locking, complex thickness 1.1mm; multi screw diameter purchase ER 13 123 1694 5261 Com, VAL 289248 1577 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER485 Paragon 28 Gorilla Plating System-Plate, mini (≥ 7 to ≤ 15 holes); variable angle locking Paragon 28 Gorilla Plating System-Plate, mini, Titanium, compression, variable angle locking, various shapes (e.g. straight/oblique, right/left) thickness 1.1 mm, multi screw diameter purchase 2.0/2.5mm ER 13 123 1694 5262 VAL 289248 952 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER486 Paragon 28 Gorilla Plating System-Plate, mini (≥ 7 to ≤ 15 holes); variable angle locking, complex Paragon 28 Gorilla Plating System-Plate, mini, Titanium, compression, variable angle locking, complex shapes thickness 1.1mm; multi screw diameter purchase ER 13 123 1694 5262 Com, VAL 289248 1332 0 0 No Change 2018-02-01 2019-03-01 Prosthesis IG116 TIBIAXYS Distal Tibial Osteotomy System - Fibula plate Titanium 4 or 6 hole fibula plate 4 hole plate - 48.7mm length; 6 hole plate - 68.5mm length IG 13 123 1694 5258 VAL 173932 784 0 0 No Change 2012-02-01 2019-03-01 Prosthesis IG117 UNI-CP Compression plating system 2 or 4 hole stainless steel compression plate, with 3 plate configurations (2 or 4 hole 'straight' design, 4 hole T-design) 2 or 4 hole, 4 interaxis sizes: 17, 20, 25 and 30mm IG 13 123 1694 5258 Com, LK 173932 850 0 0 No Change 2012-02-01 2019-03-01 Prosthesis IG118 HALLU-Lock MTP Arthrodesis System - HALLU-Lock C Plate Titanium contoured plate for 1st MTP arthrodesis, fixation of fractures and osteotomies 4, 5 or 6 holes; sizes 0 to 3, length 35 to 50mm IG 13 123 1694 5261 VAL 173932 1197 0 0 No Change 2012-02-01 2019-03-01 Prosthesis IG115 TIBIAXYS Distal Tibial Osteotomy System - Medial osteotomy plate Inverted T-shape medial osteotomy plate to fit medial malleolus 8 hole; 70mm IG 13 123 1694 5259 VAL 173932 849 0 0 No Change 2012-02-01 2019-03-01 Prosthesis IG119 HALLU-Lock MTP Arthrodesis System - HALLU-Lock S Plate Titanium contoured Hallu-Lock S plate for revision of Keller osteotomy, failed arthroplasty, failed fusion 7 holes, sizes 0 to 3, length 40 to 55mm IG 13 123 1694 5259 Com, VAL 173932 1229 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LH568 Kasios TCP TCP Bone graft substitute Granules 10cc LH 13 123 1241 4093 141918 1140 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LH569 Kasios KAGE Cervical interbody cage, PEEK Height 3mm - 10mm LH 19 174 1486 4134 178660 186610 192697 269594 269595 2409 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LH570 EIT ALIF Cage Lumbar Cage with Titanium 8-18mm heights LH 19 174 1486 4135 227327 3465 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LH571 EIT PLIF Cage Lumbar Cage with Titanium 7-16mm Heights LH 19 174 1486 4135 Paired 227327 Changed Benefit 2888 0 0 Update 2017-02-01 2019-03-01 Prosthesis LH567 i-Factor Flex & Flex FR Peptide Enhanced Bone Graft – 25mm P-15, ABM, Osteoinductive, Osteoconductive bone graft substitute 50mm x 25mm x 4mm, 100mm x 25mm x 4mm LH 13 123 1241 4095 AUG 176753 231653 5700 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LH572 Steritalc Sterile granules of talc implanted in pleural space to act as permanent adhesive 3 grams & 4 grams LH 21 194 1580 4252 143613 139 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LH573 EIT TLIF Cage Titanium Lumbar Cage 7-15mm heights LH 19 174 1486 4135 227327 3465 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER488 Titan Spine Bone Screws-locking Titan Spine Endoskeleton TCS Bone Screws-locking dia (3.5-3.8mm) x length (13-20mm) ER 19 165 1464 Complex 285244 Changed Product sizes 250 0 0 Update 2018-08-01 2019-03-01 Prosthesis ER489 Cayman United Plate Thoracolumbar Plate 16-24 ER 19 169 1476 4126 290395 To be reimbursed only when used as posterior supplemental fixation with other implants. Changed Benefit 2118 0 0 Update 2018-08-01 2019-03-01 Prosthesis ER490 Cayman United Bone Screw Bone Screw Length 20-60mm ER 19 165 1464 Dual Thread 290395 462 0 0 No Change 2018-08-01 2019-03-01 Prosthesis ER491 Yukon OCT Spinal System Occipital Screw (4.5-5.75)mm dia x (6-16)mm length ER 19 165 1464 159828 Changed Benefit 193 0 0 Update 2018-08-01 2019-03-01 Prosthesis ER492 Paragon 28 Proximal Rotational Metatarsal Osteotomy (“PROMO”) Plating System PROMO left or right contoured plates designed specifically around the angle of the osteotomy, allowing space for optimal cross screw trajectory. Plates are used with Paragon 28 Baby Gorilla or Mini Monster screws. Size 1-4, osteotomy angles 13-55° ER 13 123 1694 5261 VAL 289248 1197 0 0 No Change 2018-08-01 2019-03-01 Prosthesis ER487 Titan Spine Bone Screws Titan Spine Bone Screws-Endoskeleton TCS/TAS, standard dia (3.5-6.5mm) x length (13-35mm) ER 19 165 1464 285244 Changed Product sizes, Benefit 193 0 0 Update 2018-08-01 2019-03-01 Prosthesis ER493 Ozark Plate Level 1-5, ≤55 mm Plate level 1 -5, ≤55 mm 16-55 mm ER 19 169 1476 4125 290395 Changed Benefit 1348 0 0 Update 2018-08-01 2019-03-01 Prosthesis ER494 Ozark Plate Level 1-5 , >55mm Plate Level 1-5 , >55mm 56-110 mm ER 19 169 1476 4125 >55mm 290395 1636 0 0 No Change 2018-08-01 2019-03-01 Prosthesis JT004 Sublime Line Mammary Implant Smooth, Microthane or textured surface. Round or oval based with anatomical or central projection Low Profile, Moderate Profile, High Profile and Extra High Profile. Sizes 500-1035cc. JT 23 204 1610 4432 Pre-shaped 171783 1170 0 0 No Change 2012-02-01 2019-03-01 Prosthesis JT005 Polytech Smooth Tissue Expander with integrated or remote magnetic valve Smooth with integrated or remote valve The tissue expanders vary in maximum volume from 100 - 960mls JT 23 203 1606 4414 168188 Changed Benefit 653 0 0 Update 2014-02-01 2019-03-01 Prosthesis JT006 Polytech Textured Mammary or Tissue Expander with integrated or remote magnetic valve Textured with integrated or remote valve. The tissue expanders vary in maximum volume from 100 - 960mls JT 23 203 1606 4414 Textured 168188 1024 0 0 No Change 2014-02-01 2019-03-01 Prosthesis JT007 Polytech Textured Mammary Expander with integrated or remote magnetic valve Textured with integrated or remote magnetic valve. Anatomically shaped with reinforced inner base The mammary expanders vary in maximum volume from 200 - 960mls JT 23 203 1606 4414 Textured 168188 1024 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER495 Ozark Cervical Plate System Screw Screw, fixed or variable angle (4-4.5)mm diameter x (10-26)mm length ER 19 165 1464 290395 Changed Benefit 193 0 0 Update 2018-08-01 2019-03-01 Prosthesis ER496 Senza II IPG Kit Implantable Pulse Generator Kit One size only ER 25 222 1677 4481 Unlimited Deep Discharge Battery, 10kHz Stimulation 186043 24700 0 0 No Change 2018-08-01 2019-03-01 Prosthesis ER497 Endoskeleton TO Interbody Fusion Device Titanium lumbar posterior interbody fusion cage, sterile or non-sterile, also with NanoLock™ surface technology, sterile (22-31mm) x (8-16mm); 0-4 degrees ER 19 174 1486 4135 Paired 285244 Changed Product description, Benefit 2888 0 0 Update 2018-08-01 2019-03-01 Prosthesis ER498 Endoskeleton TT Interbody Fusion Device Titanium posterior interbody fusion cage, parallel or lordotic, sterile or non-sterile, also with NanoLock™ surface technology, sterile Height 7-14mm; 30-35mm x11mm, 0˚ or 4˚ angles ER 19 174 1486 4135 285244 Changed Product description, Product sizes 3465 0 0 Update 2018-08-01 2019-03-01 Prosthesis ER499 ER420 Paragon 28 Gorilla Plating System-Plate, mini (≥ 16 holes);variable angle locking Paragon 28 Gorilla Plating System-Plate, mini, titanium, compression, variable angle locking, various shapes and sizes (small-extra large) thickness 1.1-2.0 mm; multi screw diameter purchase ER 13 123 1694 5263 VAL 289248 Changed Benefit 1207 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH553 Dipromed ClearMesh Composite Transparent composite mesh Oval: (14 - 18)cm x (19 - 24)cm, Circular: 20cm diameter LH 21 194 1783 5439 Coated 267206 759 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LH554 Dipromed ClearMesh Composite Transparent composite mesh Oval: 20x30cm LH 21 194 1783 5440 Coated 267206 Changed Benefit 1017 0 0 Update 2016-08-01 2019-03-01 Prosthesis LH555 Dipromed ClearMesh Composite Transparent composite mesh Oval: (26 - 30)cm x 34cm LH 21 194 1783 5503 Coated 267206 1066 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LH556 Dipromed ClearMesh Composite Transparent composite mesh 30x40cm LH 21 194 1783 5505 Coated 267206 3040 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LH557 IOS Fixator Kit Complete kit of fixator, 6x bone pins, 6 x set screws, 6 x collets, drill bit. long, short LH 13 123 1237 6401 266632 3420 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LH558 Atlas (Anterior Odontoid Fixation System) Cannulated Bone Screw (4.0 - 4.5)mm diameter x (28-55)mm length LH 19 165 1464 Cannulated 275605 202 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LH559 KGBone Synthetic bone substitute, custom-fit for KAGE cervical interbody cage 4mm-10mm LH 13 123 1241 4092 141920 722 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LH560 JectOS Injectable synthetic bone graft substitute 5cc LH 13 123 1241 4092 141918 722 0 0 No Change 2016-08-01 2019-03-01 Prosthesis DE627 Malibu Spinal System Polyaxial Reduction Screw Malibu Spinal System Polyaxial or Uni Planar Reduction Screw 4.5mm x 25mm - 40mm in 5mm increments 5.5mm x 25mm - 50mm in 5mm increments 6.5mm x 35mm - 55mm in 5mm increments 7.5mm x 35mm - 55mm in 5mm increments DE 19 165 1463 275780 1280 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE628 Zuma bone screw Bone screw 5.5mm - 6.0mm x 20mm - 35mm DE 19 165 1464 275780 Changed Benefit 193 0 0 Update 2018-02-01 2019-03-01 Prosthesis DE629 Zuma-C Bone Screw Variable angle bone screw 4.0-4.5mm x 10-18mm DE 19 165 1464 275779 Changed Benefit 193 0 0 Update 2018-02-01 2019-03-01 Prosthesis DE630 Zuma-C Locking Cover Screw Locking Cover 6-12mm DE 19 166 1465 275779 164 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE631 Malibu Spinal System Locking Cap Locking cap with integral set screw 5.5mm and 6.35mm DE 19 166 1465 275794 164 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE632 Zuma Spinal System Locking Cover Locking Cover 10mm - 20mm DE 19 166 1467 275780 408 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE633 Malibu Spinal System In-line Connector In-line Connector 5.5mm and 6.35mm DE 19 167 1472 275794 Changed Benefit 732 0 0 Update 2018-02-01 2019-03-01 Prosthesis DE634 Malibu Spinal System Lateral Connector Lateral Connector 30mm - 60mm DE 19 167 1474 4123 275794 404 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE635 Malibu Spinal System CrossBar CrossBar 5.5mm and 6.35mm diameter rods 23mm - 75mm length options DE 19 167 1474 4124 275794 Changed Benefit 1299 0 0 Update 2018-02-01 2019-03-01 Prosthesis DE636 Malibu Spinal System Hooks Hook 5.5mm x 5.5mm - 9.0mm x 9.5mm DE 19 168 1475 275794 789 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER500 ER420 Paragon 28 Gorilla Plating System-Plate, mini (≥ 16 holes);variable angle locking, complex Paragon 28 Gorilla Plating System-Plate, mini, titanium, compression, variable angle locking, various complex shapes and sizes, left or right thickness 2.0mm; multi screw diameter purchase ER 13 123 1694 5263 Com, VAL 289248 Changed Benefit 1587 0 0 Update 2018-08-01 2019-03-01 Prosthesis ER501 OQ002 Hydrus Microstent Intracanalicular scaffold, made from a biocompatible alloy, for the treatment of primary open angle glaucoma 8 mm in length ER 1 144 1802 6441 smp 301403 1330 0 0 No Change 2018-08-01 2019-03-01 Prosthesis ET001 Ferx Ella Esophageal Stent Kit includes esophageal stent, introducer, balloon catheter Diam 20mm, Length 80 - 160mm ET 21 192 1558 4238 95573 3325 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW029 Duration Polyethelene cemented acetabular component Duration Poly Cup - Enhanced Polyethylene 22 - 36 mm ID HW 18 163 1425 4007 136585 Changed Benefit 823 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW030 Contemporary Hip System Range Exeter Contemporary Flanged modified Enhanced Polyethylene ID: 26, 28, 32. OD 46, 48, 50, 52, 54, 56, 58, 60 HW 18 163 1425 4007 Flange 136585 Changed Benefit 845 0 0 Update 2005-10-31 2019-03-01 Prosthesis IG120 Surfix Locking Screws Locking screws with an independent lock-screw head 3mm; 10-24mm length IG 13 123 1231 3370 LK 173963 145 0 0 No Change 2012-02-01 2019-03-01 Prosthesis IG121 BOLD 2.5mm Compression Screw Cannulated, double threaded compression screw Diameter 2.5mm, length 10-30mm IG 13 123 1231 3371 CN,DT 173963 381 0 0 No Change 2012-02-01 2019-03-01 Prosthesis IG127 Spider Limited Wrist Fusion System - Spider Plate Recessed, circular stainless steel plate 8 holes IG 13 123 1694 5259 Com 177622 659 0 0 No Change 2012-02-01 2019-03-01 Prosthesis IG128 Spider Limited Wrist Fusion System Recessed, circular stainless steel plate 6 hole IG 13 123 1694 5258 Com 177622 594 0 0 No Change 2012-02-01 2019-03-01 Prosthesis IG126 Surfix Locking Screws Locking screws with an independent lock-screw head 2.7mm, 10 - 24mm length IG 13 123 1231 3371 LK 173963 147 0 0 No Change 2012-02-01 2019-03-01 Prosthesis IG129 Spider Limited Wrist Fusion System - 2.4mm bone screws Stainless steel screws for Spider plate Diameter 2.4mm, length 8-14mm IG 13 123 1231 3371 177622 84 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LH575 EIT Cervical Cage Cervical Cage with Titanium 4-10mm heights LH 19 174 1486 4134 227327 2409 0 0 No Change 2017-02-01 2019-03-01 Prosthesis MA483 Ceramys Large Ceramic Femoral Head Ceramic, zirconia alumina combination, large diameters 36 XL, 36 L, 36 M, 36 S MA 18 162 1420 3998 236457 2022 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MA484 Ceramys Ceramic Revision Femoral Head Ceramic, zirconia alumina combination, supplied with titanium taper sleeve 28 L, 28 M, 28 S, 28 XL, 32 L, 32 M, 32 S, 32 XL, 28, 32 MA 18 162 1419 3992 Sleeve 274113 2022 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MA485 Ceramys Large Ceramic Revision Femoral Head Ceramic, zirconia alumina combination, large diameters, supplied with titanium taper sleeve 36 L, 36 M, 36 S, 36 XL, 36 MA 18 162 1420 3998 Sleeve 274113 Changed Benefit 2196 0 0 Update 2007-12-01 2019-03-01 Prosthesis MA486 SeleXys Acetabular Ceramys Ceramic Liner Ceramys ceramic (zirconia & alumina combination) 28/AA, 28/BB, 28/CC, 28/DD, 32/CC, 32DD, 32/EE, 32/FF,36/EE, 36/FF, 36/GG, 386HH,36/II, 36/JJ, 36/KK, /36/LL MA 18 163 1428 4025 274136 2303 0 0 No Change 2007-12-01 2019-03-01 Prosthesis LH574 GSS & Dumon Silicone tracheal and bronchial stents 10 - 20mm diameter, 20 - 110mm length LH 22 198 1571 Silicone 143612 Changed Product name, Product description, Product sizes 950 0 0 Update 2017-02-01 2019-03-01 Prosthesis DE638 Malibu Spinal System Rods Rod 5.5mm x 30mm - 600mm 6.35mm x 100mm DE 19 170 1478 275794 Changed Benefit 426 0 0 Update 2018-02-01 2019-03-01 Prosthesis DE639 Zuma-C Implant Integrated low-profile titanium anterior fixation plate with PEEK Optima Interbody spacer 13x12x16mm - 17x13x12mm DE 19 174 1485 5485 275779 Changed Benefit 4379 0 0 Update 2018-02-01 2019-03-01 Prosthesis DE640 Zuma implant with integral plate PEEK Interbody cage with integral plate 26mm x 24mm, 32mm x 25mm, 38mm x 26mm Height 10mm - 18mm DE 19 174 1485 5486 275780 6256 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE641 ESNOPER Glaucoma Implant Glaucoma Drainage Implant 3.00mm x 1.40mm x 2.85mm DE 1 144 1334 3899 290207 404 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE637 Malibu Spinal System ESS CoNiCr Rods Rod CoNiCr Precontored 5.5mm x 100mm - 600mm DE 19 170 1478 275794 Changed Benefit 426 0 0 Update 2018-02-01 2019-03-01 Prosthesis DE642 Dorsal Midfoot Fusion Plate Plate for fusion Small, Medium, Large DE 13 123 1694 5260 Com 284416 1141 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE643 Dual Syndesmosis Tightrope Plate Buttress plate for syndesmosis repair 1 size (2 Hole Plate) DE 13 123 1694 5258 284416 292241 214 0 0 No Change 2018-08-01 2019-03-01 Prosthesis JT008 Testicular Implants Testicular Implants with needle guide or reinforced cap for fixation The Testicular Implants with needle guide or reinforced cap are available in 5 different sizes ranging from 5, 12, 21, 27 and 36 grams. JT 26 231 1711 168141 620 0 0 No Change 2015-02-01 2019-03-01 Prosthesis 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. KA 24 215 1654 132378 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis 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. KA 24 215 1654 132378 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis 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. KA 24 215 1654 132378 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE644 Proximal 1st Metatarsal Osteotomy Plate 1st Metatarsal Osteotomy Plate Petite - Left and Right Side Specific Standard - Left and Right Side Specific DE 13 123 1694 5258 Com, LK 284416 850 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE645 Padlock clip Defect closure system Diameter - 9.5 - 14mm Length - 162cm DE 21 194 1581 4258 Endoscopic, OTS 295460 950 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE646 DynaNite Nitinol Staple for Osteotomy Fixation Width (9mm-25mm) Length (7mm-20mm) DE 13 123 1773 5514 MM 307923 Changed Benefit 507 0 0 Update 2018-08-01 2019-03-01 Prosthesis DE647 DC Bead LUMI Drug delivery embolisation system 70-150 microns (black) 100-300 microns (yellow) DE 21 188 1542 4195 307152 Changed Benefit 1853 0 0 Update 2018-08-01 2019-03-01 Prosthesis DE648 Oculentis FEMTIS FB-313 Foldable one-piece monofocal acrylic plate haptic IOL for fixation in the capsulorhexis Optic Size 5.7mm, Overall length 10.5mm. Available Diopters: +-15.0D to 30.0D (0.5D steps) DE 1 141 1327 3892 at 198807 300 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE649 Cerclage System Pre-tied Cerclage System One Size Only DE 13 123 1772 5367 280539 485 0 0 No Change 2018-08-01 2019-03-01 Prosthesis HW031 Definition PM Femoral Component Femoral Stem - Vitallium Stem sizes 1 - 7 HW 18 161 1404 3940 128023 1845 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW032 Stryker CoCr Femoral Head Hip - Femoral Head 22, 26, 28, 30, 32mm HW 18 162 1419 3989 128024 703 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW034 Definition PM Femoral Component Distal Centraliser - PMMA - Ring Centraliser 11-22mm HW 18 164 1438 141275 139 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW038 V40 Orthinox Head Stainless Steel 22 - 28mm dia HW 18 162 1419 3988 211859 703 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW040 Exeter Hip System Stainless Steel (Orthinox) polished long 37.5 and 44mm offsets HW 18 161 1405 3944 205392 3120 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW041 Exeter Hip System Stainless Steel (Orthinox) Stem Sizes 0-6, Offsets 30, 33, 35.5, 37.5, 44, 50 & 56mm HW 18 161 1404 3941 SCP 205392 Changed Benefit 1845 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW043 Brunswick Cup Polyethylene 44, 48, 50, 52, 54, 56mm OD HW 18 163 1425 4008 128021 Changed Benefit 732 0 0 Update 2005-10-31 2019-03-01 Prosthesis LH561 Kasios TCP TCP Bone graft substitute Granules 5cc LH 13 123 1241 4092 141918 722 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LH562 i-FACTOR Putty Peptide Enhanced Bone Graft P-15, ABM, Osteoinductive, Osteoconductive bone graft substitute 0 - 5.0mL LH 13 123 1241 4092 AUG 169831 1026 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LH563 Jectos 20cc Injectible synthetic bone graft substitute 20cc LH 13 123 1241 4094 141919 1425 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LH564 i-Factor Flex & Flex FR Peptide Enhanced Bone Graft – 25mm P-15, ABM, Osteoinductive, Osteoconductive bone graft substitute 25mm x 25mm x 4mm LH 13 123 1241 4095 AUG 176753 231653 5700 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LH565 JectOS 10cc Injectable synthetic bone graft substitute 10cc LH 13 123 1241 4093 141919 1140 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LH566 i-FACTOR Putty Peptide Enhanced Bone Graft P-15, ABM, Osteoinductive, Osteoconductive bone graft substitute 5.0ml - 10ml LH 13 123 1241 4093 AUG 169831 2185 0 0 No Change 2016-08-01 2019-03-01 Prosthesis EL039 Edwards Perimount Magna Model 3000 Carpentier-Edwards Perimount Magna composition: Glutaraldehyde treated bovine pericardium/elgiloy wireform stent/polyester band/silicone rubber suture ring/polytetrafluoroethylene cloth/polyester cloth. 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 EL 20 179 1500 154072 4750 0 0 No Change 2005-10-31 2019-03-01 Prosthesis EL049 McCarthy-Edwards IMR Etlogix Annuloplasty Ring (Model: 4100) Rigid mitral annuloplasty ring with an assymetric design 24mm, 26mm, 28mm, 30mm, 32mm, 34mm, 36mm EL 20 181 1842 114193 2280 0 0 No Change 2005-10-31 2019-03-01 Prosthesis EL050 Edwards MC3 Tricuspid Ring Annuloplalsty System (Model: 4900) 3D rigid annuloplasty ring with a tricuspid specific design 26mm, 28mm, 30mm, 32mm, 34mm, 36mm EL 20 181 1842 118648 2280 0 0 No Change 2005-10-31 2019-03-01 Prosthesis 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 EL 20 179 1499 154459 4750 0 0 No Change 2009-02-01 2019-03-01 Prosthesis HW047 Exeter Hip System X-Change Bone Screws - Stainless Steel 3.5mm X 10, 15, 20, 25, 30, 35mm HW 18 164 1435 128022 16232 121 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW064 Kerboull - Vitallium Petrusio cage 44, 48, 52, 56, 60mm OD HW 18 163 1432 4035 128021 16237 1253 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW072 Vitalock Acetabular system 12 Crossfire liner UHMPE 22mm,26mm,28mm, 32mm ID HW 18 163 1428 4021 72106 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW084 Duracon Knee System Augment Locking Screw Augment Locking Screw, CoCr (Vitallium) 5mm, 10mm HW 17 159 1398 142278 126 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW085 Duracon Knee System Modular Stabilizer Box Modular Stabilizer Box, CoCr (Vitallium) Small, Medium, Medium-Large, Large, Extra-Large HW 17 159 1394 142278 16234 1060 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW086 Duracon Knee System Tibial Baseplate Tibial baseplate, uncemented, beaded, CoCr (Vitallium) Small, Medium, Large, Extra-Large HW 17 151 1360 141151 2058 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ969 Global Shoulder System Humeral Stem 6-16mm SY 13 131 1276 4057 137608 138093 138288 Changed Benefit 3771 0 0 Update 2015-02-01 2019-03-01 Prosthesis JJ970 Global Shoulder System CTA humeral head Sizes 44-56mm SY 13 131 1276 4067 EL 138288 5220 0 0 No Change 2015-02-01 2019-03-01 Prosthesis JJ971 DELTA Xtend Monoblock Humeral Stem 8-14mm SY 13 131 1276 4057 Reverse 126913 6460 0 0 No Change 2015-02-01 2019-03-01 Prosthesis JJ972 Delta/Global Shoulder System Distal humeral stem 6-16mm SY 13 131 1276 4063 126913 190146 3800 0 0 No Change 2015-02-01 2019-03-01 Prosthesis JJ973 Delta Shoulder System Ephiphysis 1 – 4 in 26-42mm SY 13 131 1276 4060 126913 143529 2451 0 0 No Change 2015-02-01 2019-03-01 Prosthesis JJ974 Delta Shoulder System Metaglene Standard, Revision, +10 to +15mm SY 13 131 1277 4078 126913 126914 1991 0 0 No Change 2015-02-01 2019-03-01 Prosthesis JT003 Sublime Line Mammary Implant Smooth, Microthane or textured surface. Round or oval based with anatomical or central projection. Low Profile, Moderate Profile, High Profile and Extra High Profile. Sizes 45-495cc. JT 23 204 1610 4429 Pre-shaped 171783 975 0 0 No Change 2012-02-01 2019-03-01 Prosthesis 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 EL 20 179 1499 156355 4750 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EL059 Carpentier-Edwards PHYSIO ll Mitral Annuloplasty Ring PHYSIO II is a semi rigid mitral annuloplasty ring, with an improved saddle shape and global disease based design 24, 26, 28, 30, 32, 34, 36, 38, 40mm EL 20 181 1842 170274 2280 0 0 No Change 2011-02-01 2019-03-01 Prosthesis EL060 Carpentier-Edwards PERIMOUNT Magna Mitral Ease Tissue Valve 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 EL 20 179 1500 196126 4750 0 0 No Change 2012-08-01 2019-03-01 Prosthesis EL057 Geoform Geoform annuloplasty ring Model 4200 with Holder 26, 28, 30 and 32mm EL 20 181 1842 152587 2280 0 0 No Change 2009-02-01 2019-03-01 Prosthesis HW091 Duracon Knee System Tibial Insert Minimally stabilised, AP Lipped tibial insert, UHMWPE, (Duration) Small, Medium, Large, Extra-Large in each thickness 9mm, 11mm, 13mm, 16mm, 19mm, 22mm, 25mm HW 17 153 1369 128028 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW092 Duracon Knee System Tibial Insert Posterior stabilised tibial insert, with reinforcing pin, UHMWPE, (Duration) Small, Medium, Large, Extra-Large in each thickness 9mm, 11mm, 13mm, 16mm, 19mm, 22mm, 25mm HW 17 153 1370 128028 Changed Benefit 1073 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW097 Duracon Knee System Tibial Baseplate Screw Tibial baseplate screw, CoCr (Vitallium) 6.2mm diameter in 15mm, 20mm, 25mm, 30mm, 35mm, 40mm, 50mm, 55mm, 60mm lengths HW 17 159 1398 141151 16234 126 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW098 Duracon Knee System Stems TS (Total Stabilizer) Stems, CoCr (Vitallium), uncemented 40mm, 80mm, 155mm lengths HW 17 159 1399 142278 16234 Changed Benefit 1126 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW099 Duracon Knee System Tibial Augments Tibial Augments Full wedge (angled) & Full block (flat), CoCr (Vitallium), cemented Left & right, full & angled, 5mm & 10mm HW 17 159 1390 142278 1148 0 0 No Change 2005-10-31 2019-03-01 Prosthesis 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. KA 24 215 1654 132379 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis KA005 Swan Neck or Swan neck Tenckhoff Peritoneal Dialysis Catheter Adult-left, Adult-right, Adult, 2 cuff-left, Adult, 2 cuff-right 20 to 25cm external segment or 43cm 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. KA 24 215 1654 132378 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LH533 High V+ Cement with Delivery Kit PMMA Cement including Delivery Kit 20gm LH 13 123 1279 4089 239816 450 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LH534 Oxiplex/AP Absorbable Adhesion Barrier Gel Combination of Polyethylene Oxide (PEO) and Sodium Carboxylmethylcellulose stabilised with Calcium and made isotonic with Sodium Chloride. Kit contains 2 x 20ml Sterile syringes , 1 x Applicator 2 x 20ml Sterile Syringes, 1 x Applicator LH 21 194 1579 5433 Complex 152224 1235 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LH536 Klementine PL Interbody fusion cage 4.5 - 8.5mm height LH 19 174 1485 5485 178660 Changed Benefit 4379 0 0 Update 2015-08-01 2019-03-01 Prosthesis HW102 Duracon Knee System Tibial Insert Minimally stabilised, tibial insert to match PCA femur with Duracon baseplate, UHMWPE (Duration) Small, Medium, Large, Extra-Large in each thickness 9mm, 11mm, 13mm, 16mm, 19mm, 22mm, 25mm, 28mm, 31mm HW 17 153 1369 141151 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW105 Duracon Knee System Patella Component Patella component, UHMWPE (Duration), cemented Small, Medium, Large, Xlarge HW 17 156 1376 139146 Changed Benefit 537 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW108 Scorpio Knee System Patella Component Patella component, Metal backed, CoCr, uncemented, beaded, PA (Hydroxyapatite), Moulded UHMWPE (N2VAC), Fixed Small, Medium, Large, Xlarge HW 17 156 1378 3929 139146 16236 Changed Benefit 716 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW140 Kinemax Knee System Patella Component Patella component Symmetric & Asymmetric, UHMWPE (Duration), cemented Small, Medium, Large HW 17 156 1376 139146 Changed Benefit 537 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW141 MRH (Modular Rotating Hinge) Tibial Baseplate MRH Tibial baseplate, CoCr (Vitallium), fixed insert with central hole for hinged insertion, w/attachable stem Small, Medium, Large HW 17 151 1357 Revision, Hinged 128028 Changed Benefit 3712 0 0 Update 2005-10-31 2019-03-01 Prosthesis CT034 PU-S Double Loop Ureteral Stents Double Loop Ureteral Stents in Soft Polyurethane, with pusher and guidewire. Various in 6 and 7Fr. Various in 24, 26, 28 cm lengths. Various in O/O or O/C. With either Steerable or simple pusher. CT 26 227 1701 5321 142907 133 0 0 No Change 2016-08-01 2019-03-01 Prosthesis CT035 Vortek Hydro-Coated Double Loop Ureteral Stents Vortek Hydro-Coated Double Loop Ureteral Stents with simple or steerable pusher and with or without guidewire 4.8 - 7Fr 22 - 30cm lengths CT 26 227 1701 5322 224254 188 0 0 No Change 2016-08-01 2019-03-01 Prosthesis CU001 BeeLINE MotIV Infusion Pump (275ml) External infusion pump, spring powered, fixed flow rate, 275ml set: set includes reservoir, introducer needle, tubing set, priming/flushing syringes, saturation catheter, dressing, syringes. 30min - 7 day infusion 275ml infuser reservoir = 19cm (7.5") x 7cm (2.8") CU 21 188 1540 4188 Set 167182 247 0 0 No Change 2011-08-01 2019-03-01 Prosthesis CU002 BeeLINE MotIV Infusion Pump (100ml) External infusion pump, spring powered, fixed flow rate, 100ml set: set includes reservoir, introducer needle, tubing set, priming/flushing syringes, saturation catheter, dressing, syringes. 30min - 7 day infusion 100ml infusor reservoir = 13cm (5.1") x 7cm (2.8") CU 21 188 1540 4188 Set 167182 247 0 0 No Change 2011-08-01 2019-03-01 Prosthesis BI770 Exceed Acetabular System Acetabular shell, solid, plasma, HA Shell sizes 40-70mm BI 18 163 1427 4018 108359 2373 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI773 W Lorenz Osteosynthesis System Neuro sub-temporal plate, 1.5 system, titanium Small BI 23 199 1589 4277 128458 199 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI775 EBI XFIX DynaFix System Distal radius fixator, wristfix, sterile, complete One size only BI 13 123 1237 3401 Mini 145253 1952 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI776 EBI XFIX DynaFix System OptiROM Articulating Fixator Complete Small and Large BI 13 123 1237 4513 CDD 145253 3866 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI777 EBI XFIX DynaFix System Mini fixator/lengthener with comp/dist Small, Medium, Long, 100mm, 150mm BI 13 123 1237 3401 Small, 3D, CDD 217978 2755 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI792 Lorenz 2.4mm Locking Reconstruction System Condyle left or right, chrome cobalt (CoCr) One size only BI 23 200 1596 4357 128458 1506 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI811 Offset Tibial Tray System Tibial baseplate, Cemented, Titanium, which allows for attachment of the offset adaptor 59-91mm BI 17 151 1357 Revision 98451 3265 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI819 EBI XFIX Dynafix System Multi Axial Correction and Metaphyseal Arc Module complete with T-clamp 4-8cm, Xsmall - Adult BI 13 123 1237 3756 CDD 145253 2517 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI820 EBI XFIX DynaFix System Screw, HA coated, cortical, cancellous Dia 2-6mm BI 13 123 1237 4510 145253 142 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI827 EBI XFIX Vision System Rod connectors, stainless steel/aluminium Dia 9.5mm BI 13 123 1237 4508 145253 Changed Benefit 732 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI828 EBI XFIX Vision System Clamp/Rod, stainless steel/aluminium 4mm/6mm, 3-5 hole, 50-150mm BI 13 123 1237 4505 145253 950 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI829 EBI XFIX Vision System Screw, Transfixing, Stainless steel 4 - 6mm diameter BI 13 123 1231 3369 145253 65 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI830 EBI XFIX Vision System Ring Connector Assembly, stainless steel/aluminium 1 or 2 bolt model BI 13 123 1237 4509 Standard 145253 147 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI831 EBI XFIX Vision System Post, Bone Screw, Telescoping, stainless steel One size only BI 13 123 1237 4508 145253 Changed Benefit 732 0 0 Update 2005-10-31 2019-03-01 Prosthesis MG037 Micromedics Ventilation Tubes Silicone and fluroplastic ventilation tubes Lumen size: 0.76mm, 1.0mm, 1.14mm, 1.27mm, 1.42mm MG 22 196 1566 199400 19 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MG038 Glubran 2 Synthetic cyanoacrylic surgical glue: N-Butyl (2) cyanoacrylate and methacryloxysulfolane co-monomer 0.25 ml, 0.5 ml, 1 ml MG 21 194 1580 4247 Synthetic 158438 Changed Benefit 277 0 0 Update 2012-02-01 2019-03-01 Prosthesis MG044 Gluban 2 Rigid Spray Device Rigid spray device for application of Gluban 2 Cannula length: 5cm, 40cm MG 21 194 1580 4250 Rigid Delivery System 279302 148 0 0 No Change 2014-08-01 2019-03-01 Prosthesis MG045 Everest Ligating Clip Titanium clip Small, Medium, Medium-Large, Large (6 per cartridge) MG 21 194 1581 4256 235137 11 0 0 No Change 2015-08-01 2019-03-01 Prosthesis MG046 Everest Ligating Clip Titanium clip Small, Medium (24 per cartridge) MG 21 194 1581 4256 235137 44 0 0 No Change 2015-08-01 2019-03-01 Prosthesis BI832 EBI XFIX Vision System Rods, Bars, stainless steel/aluminium/ or carbon fibre (radiolucent) Dia 9.5mm, 150-400mm length BI 13 123 1237 4509 Standard 145253 147 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI834 EBI XFIX DynaFix System Screw, VS Osteotomy System, Ti 6mm x (30mm-110mm) BI 13 123 1231 3369 146250 65 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI835 Bio-Modular Shoulder System Extended Articular Surface Humeral Head, CrCo 40 - 54mm BI 13 131 1276 4067 137045 1261 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI843 EBI XFIX DynaFix System Plate, VS Osteotomy Ti 4 hole, 6 hole BI 13 123 1694 5255 Com 146249 Changed Benefit 922 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI849 EBI XFIX DynaFix System OptiROM Passive Distractor Module One Size Only BI 13 123 1237 4513 145253 428 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI851 EBI XFIX Dynafix System Rail Clamp (Rotational Serrated T-clamp, Swivel, Translational, Uniplaner Adjustable) Ex Small, Small, Adult, 4-6mm BI 13 123 1237 3402 145253 1579 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MH010 Silhouette Ureteral Stent The Silhouette Ureteric Stent is manufactured with a soft material that provides superior comfort. It has superior column strength through a coil-reinforced body providing effortless placement. The tight coils prevent migration. The smaller outside dia Multiple French Sizes & Lengths MH 26 227 1701 5321 116728 133 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MH012 Silhouette System Ureteral Stent Set Coil reinforced body. SL-6 hydrophilic coating. UroWire 0.035" 3-in-1 guidewire with kink resistant nitinol core. Design divided into 3 sections: silver section (front end) floppy SL - 6 hydrophilic coating; Blue section (mid) super stiff PTFE (not hydrophicaly coated); and Green section (back) flexible Mulitple French Sizes & Lengths MH 26 227 1701 5322 116727 116728 188 0 0 No Change 2007-06-01 2019-03-01 Prosthesis MH013 Paediatric Silhouette System Set Coil reinforced body. SL-6 hydrophilic coating. UroWire 0.035" 3-in-1 guidewire with kink resistant nitinol core. Design divided into 3 sections: silver section (front end) floppy SL - 6 hydrophilic coating; Blue section (mid) super stiff PTFE (not hydrophilicaly coated); and Green section (back) flexible 4F, 8 - 12cm MH 26 227 1701 5322 P 116727 116728 233 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BI852 EBI XFIX Dynafix System Rail Clamp (Rotational Serrated T-clamp, Swivel, Translational, Uniplaner, Adjustable) Ex Small, Small, Adult, 4-6mm BI 13 123 1237 4511 3D 145253 3181 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI853 EBI XFIX Dynafix System CD Clicker Ex Small, Small, Adult, 5-20cm BI 13 123 1237 4508 145253 Changed Benefit 732 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI854 EBI XFIX Dynafix System Rail Accessory (Adaptor, CD Support, Dynamization, Bridge) Ex Small, Small, Adult, 4-6mm BI 13 123 1237 4508 145253 Changed Benefit 732 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI856 EBI XFIX Dynafix System Monoplanar Transport Rail, radiolucent (carbon fibre) 100-420mm BI 13 123 1237 3756 145253 1900 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI860 Oxford Meniscal Knee System Uni Tibial Baseplate Uni Tibial Baseplate, uncemented Titanium plasma sprayed surface (Porous plasma spray PPS) with HA (Phase III) (38-53) x (26-34)mm BI 17 152 1368 3926 126863 1789 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ME225 Frankenman Endoscopic Linear Cutter Reload The Endoscopic Linear Cutter Reload has applications in resection, transection and/or anastomosis of tissue in open or laparoscopic procedures. Cartridge Reload - 30mm, 45mm, 60mm staple lengths. Open leg length: 2.0mm - 4.5mm, closed staple height: 0.75mm - 2.0mm. ME 21 194 1582 4317 Endoscopic, Articulating/Roticulating 207254 Changed Benefit 347 0 0 Update 2018-08-01 2019-03-01 Prosthesis ME226 Optima Coil System Implantable embolization Coil comprised of platinum-tungsten alloy attached to a proximal stainless steel hypo-tube and distal body coil delivery pusher with a radiopaque distal positioning marker and a proximal fluorosafe marker. Various sizes as attached. ME 25 225 1688 302253 1430 0 0 No Change 2018-08-01 2019-03-01 Prosthesis ME227 Optima XCEL Detachment Controller The EXCEL Detachment Controller is used to detach the Pusher from the Coil after the coil is deployed, it is compatible with all Optima Coil configurations and is used to detach all coils needed for a single patient. one size ME 25 225 1689 4495 301584 Changed Benefit 333 0 0 Update 2018-08-01 2019-03-01 Prosthesis MG018 HAGA Access Port Access Port contains Titanium and Silicone Standard MG 21 190 1779 122934 589 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MG030 Haemostatic Ligating Clips Titanium Ligating Clips Small - Large (6 Clips per cartridge) MG 21 194 1581 4256 143311 11 0 0 No Change 2009-02-01 2019-03-01 Prosthesis MG031 Haemostatic Ligating Clips Titanium Ligating Clips Small, medium (24 clips per pouch) MG 21 194 1581 4256 143311 44 0 0 No Change 2009-08-01 2019-03-01 Prosthesis MG034 Glubran 2 Applicators Dispensing tip/Drop control device for applying Glubran 2. 5-6 and 7-8 French MG 21 194 1580 4250 Applicator Tip 162589 24 0 0 No Change 2010-08-01 2019-03-01 Prosthesis MG035 Glubran 2 Catheter for Laparoscopy Catheter for laparoscopic application of Glubran 2. One size only MG 21 194 1580 4250 Extender 162589 29 0 0 No Change 2010-08-01 2019-03-01 Prosthesis MG036 Glubran 2 Spray Device Spray device for application of Glubran 2 32cm length MG 21 194 1580 4250 Complex Delivery Device 279302 57 0 0 No Change 2010-08-01 2019-03-01 Prosthesis MH014 Direct Drive laparoscopic clip applier with TiGold titanium clips Single-use, sterile 10mm laparscopic clip applier with 20 medium-large size titanium clips 10mm shaft diameter with medium-large size clips. MH 21 194 1581 4258 Laparoscopic 116980 381 0 0 No Change 2008-07-01 2019-03-01 Prosthesis MH015 Epix™ Disposable Laparoscopic Clip Applier w/ TiGold M/L titanium clips Epix™ Disposable Laparoscopic Clip Applier w/ TiGold M/L titanium clips 5mm 5mm MH 21 194 1581 4258 Laparoscopic 116980 381 0 0 No Change 2012-02-01 2019-03-01 Prosthesis AO027 TECNIS® Multifocal 1-Piece Lens, Models ZMB00, ZKB00, ZLB00 A multifocal posterior chamber lens with UV-blocking, foldable acrylic, 1-piece with a diffractive posterior optic and a modified anterior surface technology with edge modification and a 360 degree square edge. 6.0mm Optic Diameter x 13.0mm in overall length. +5.0 Diopter to +34.0 Diopter in 0.5 Diopter increments. ZMB00 +4.00 Diopter add, ZKB00 +2.75 add, AO 1 141 1327 3893 at 170331 677 0 0 No Change 2010-08-01 2019-03-01 Prosthesis AO032 Healon Endocoat Viscoelastic 0.85ml AO 1 142 1329 198813 72 0 0 No Change 2012-08-01 2019-03-01 Prosthesis AO033 TECNIS® Multifocal Toric Toric Multifocal Intraocular Lens Available +5.0 Diopters to +34.0 Diopters in 0.5 Diopter increments. Cylinder powers 1.50D, 2.25D, 3.00D and 4.00D (as measured on the IOL plane). AO 1 141 1327 3893 at, t1 181845 Changed Benefit 986 0 0 Update 2012-08-01 2019-03-01 Prosthesis AO034 TECNIS® iTec 1-Piece Pre-Loaded IOL 1-piece IOL Posterior Chamber Intraocular lens, incorporates a proprietary wavefront-designed aspheric optic with a squared posterior optic edge designed to provide a 360 degree barrier. The edge of the optic has a frosted design to reduce potential edge glare effects. Supplied pre-loaded in a screw style disposable injector. +5.0 to +34.0 diopter powers in 0.5 diopter increments. Overall diameter 13mm, Optic size 6mm AO 1 141 1327 3892 at, pl 203780 308 0 0 No Change 2013-02-01 2019-03-01 Prosthesis AO036 TECNIS® Multifocal 1-Piece IOL with iTec Preloaded delivery system Preloaded 1-Piece Multifocal posterior chamger IOL +5.0 to 34.0 diopter powers in 0.5 diopter increments Overall diamter 13mm, Optic size 6mm AO 1 141 1327 3893 at, pl 220330 Changed Benefit 694 0 0 Update 2014-08-01 2019-03-01 Prosthesis AO037 TECNIS® Symfony Extended Range of Vision (ZXR00) Extended Range of Vision Posterior Chamber IOL +5.0 to 34.0 diopter powers in 0.5 diopter increments Overall diamter 13mm, Optic size 6mm AO 1 141 1327 3893 at 170331 677 0 0 No Change 2014-08-01 2019-03-01 Prosthesis AO038 TECNIS Symfony Toric Extended Range of Vision (ZXT00) Extended Range of Vision Toric Multifocal Posterior Chamber IOL +6 to +30 in 0.5d steps Available Cyl powers +1.0d, 1.5d, 2.25d, 3.00d, 3.75d, 4.5d, 5.25d, 6.00d AO 1 141 1327 3893 at, t1 181845 Changed Benefit 986 0 0 Update 2015-02-01 2019-03-01 Prosthesis AO040 TECNIS® Toric 1-Piece IOL 1-piece IOL Posterior chamber Intraocular lens, incorporates a proprietary wavefront designed toric aspheric optic with a squared posterior optic edge designed to provide a 360 degree barrier. The edge of the optic has a frosted design to reduce potential edge glare effects. +5.0 to +34.0 diopter powers in 0.5 diopter increments. Cylinder power: 7.00 diopter, 8.00 diopter (as measured at the IOL plane). Overall diameter 13mm, Optic size 6mm. AO 1 141 1327 3892 at, t2 181845 858 0 0 No Change 2015-02-01 2019-03-01 Prosthesis AO041 Tecnis Toric 1-Piece IOL 1-piece IOL Posterior chamber Intraocular lens , incorporates a proprietary wavefront designed toric aspheric optic with a squared posterior optic edge designed to provide 360 degree barrier. The edge of the optic has a frosted design to reduce potential edge glare effects. +5.0 to +34.0 diopter powers in 0.5 diopter increments. Cylinder power: 1.00 diopter, 1.50 diopter, 2.25 diopter, 3.00 diopter, 3.75 diopter, 4.00 diopter, 4.50 diopter, 5.25 diopter and 6.00 diopter (as measured at the IOL plane). Overall diameter 13mm, Optic size 6mm. AO 1 141 1327 3892 at, t1 181845 Changed Benefit 609 0 0 Update 2016-08-01 2019-03-01 Prosthesis MA487 balanSys Femoral Component Femoral component, cemented, CoCr, posterior stabilised XS to F, Left and Right MA 17 149 1348 3907 206047 3041 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MA489 balanSys Tibial Insert Tibial insert, posterior stabilised UHMWPE 59/8mm to 85/23mm MA 17 153 1370 211054 Changed Benefit 1073 0 0 Update 2007-12-01 2019-03-01 Prosthesis MA490 balanSys Knee System / Femoral Component, CR, cemented, TiNbN coated Balansys Femoral Component/ CR cemented, TiNbN coated XS to F, left and right MA 17 149 1348 3906 206173 2951 0 0 No Change 2009-02-01 2019-03-01 Prosthesis MA493 Balansys Knee System / Femoral Component, PS, cemented, TiNbN coated Balansys Femoral Component/PS cemented, TiNbN coated, CoCrMo, TiNbN XS to F, Left and Right MA 17 149 1348 3907 206174 3041 0 0 No Change 2009-02-01 2019-03-01 Prosthesis MA496 SeleXys Acetabular PC Shell Uncemented Ti acetabular shell, beaded, non HA 42mm - 72mm in 2mm increments MA 18 163 1426 4011 274135 2204 0 0 No Change 2009-02-01 2019-03-01 Prosthesis AO042 Tecnis Toric 1-Piece Pre-Loaded IOL 1-piece IOL Posterior chamber Intraocular lens , incorporates a proprietary wavefront designed toric aspheric optic with a squared posterior optic edge designed to provide 360 degree barrier. The edge of the optic has a frosted design to reduce potential edge glare effects. +5.0 to +34.0 diopter powers in 0.5 diopter increments. Cylinder power: 1.00 diopter, 1.50 diopter, 2.25 diopter, 3.00 diopter, 3.75 diopter, 4.00 diopter, 4.50 diopter, 5.25 diopter and 6.00 diopter (as measured at the IOL plane). Overall diameter 13mm, Optic size 6mm. AO 1 141 1327 3892 at, pl, t1 181845 Changed Benefit 626 0 0 Update 2016-08-01 2019-03-01 Prosthesis MA500 Modular Revision Stem Titanium, grit blast, non HA 14mm x 140mm - 24mm x 140mm MA 18 161 1410 3961 Stem 274204 2742 0 0 No Change 2009-02-01 2019-03-01 Prosthesis MA501 Modular Revision Stem - Long Titanium, grit blast, non HA 14mm x 200mm - 24 x 200mm MA 18 161 1412 3971 Stem 274204 4060 0 0 No Change 2009-02-01 2019-03-01 Prosthesis MA502 RM Pressfit Acetabular Cup Acetabular component - Bonded Shell / Liner - polyethylene modified. Ti coated monoblock, bearing surface is Vit E stabilised highly cross linked polyethylene 28, 32, 36mm (Articulation); 44 to 70mm (Cup size) MA 18 163 1429 4027 274133 2988 0 0 No Change 2010-08-01 2019-03-01 Prosthesis MA503 Selexys Acetabular Cup Liner Insert / Liner, modified polyethylene. Highly crossed link polyethylene, stabilised with Vit E. Articulation 28, 32, 36mm; Cup size AA to LL (42 to 70mm) MA 18 163 1428 4021 274134 1019 0 0 No Change 2010-08-01 2019-03-01 Prosthesis MA506 Balansys Revision Knee Femoral component, contrained A to E, right to left MA 17 149 1348 3907 Revision 209536 5501 0 0 No Change 2011-02-01 2019-03-01 Prosthesis MA507 Balansys Revision Knee, Stems Ti uncemented Stem, straight and offset, complete with locking screw 80 to 200mm, straight and offset 4mm MA 17 159 1399 257054 Changed Benefit 1126 0 0 Update 2011-02-01 2019-03-01 Prosthesis AP002 Mira: Scleral Implants Silicone Sponge- Retinal Implant Used in Scleral Buckling (Silicone Elastomer Sponge) Sponge- Mira 502 Cylinder 2mm, Mira 5025 Cylinder 2.5mm, Mira 503 Cylinder 3mm, Mira 504 Cylinder 4mm, Mira 505 Cylinder 5mm, Mira 505G Grooved cylinder 5mm, Mira 505T Packer tunnel cylinder 5mm, Mira 510 Half cylinder 5mm, Mira 515 Brucker two-thirds cylinder 5mm, Mira 501 Masciulli oval 2.5mm by 4mm, Mira 506 Vaiser oval 3mm by 5mm, Mira 506G Vaiser grooved oval 3mm by 5mm, Mira 507 oval 5.5mm by 7.5mm, Mira 507G Grooved oval 5.5mm by 7.5mm, Mira 507T Packer tunnel oval 5.5mm by 7.5mm, Mira 511 Half oval 7.5mm, Mira 517 Brucker two-thirds oval 7.5mm, Mira 509 Fuller flat oval 3.5mm by 7.5mm, Mira 509G Fuller grooved flat oval 3.5mm by 7.5mm, Mira 518 Frederick grooved flat oval 2.5mm by 12mm, Mira 508 Frederick flat oval 4mm by 12mm, Mira 508G Frederick grooved flat oval 4mm by 12mm, Mira 513 Snyder 3+ meridional 7mm by 4mm, Mira 514 Snyder 4+ meridional 8mm by 5mm, Mira 516G Tapered groove 6.4mm, Mira 519G Tapered groove 7.5mm by 3.2mm. AP 1 148 1342 3905 143682 Changed Benefit 86 0 0 Update 2005-10-31 2019-03-01 Prosthesis BB275 Excia Hip System Cemented stem cobalt chromium 9mm-18mm BB 18 161 1404 3939 123313 Changed Benefit 1625 0 0 Update 2006-03-24 2019-03-01 Prosthesis MA508 Balansys Revision Knee, Augments Revision Femoral/Tibial Augments, complete with screws 5 and 10mm MA 17 159 1390 257053 1148 0 0 No Change 2011-02-01 2019-03-01 Prosthesis MA509 Balansys Revision Knee, Tibial Plateau Revision Tibial Baseplate, modular 64 to 85 MA 17 151 1357 Revision 209537 3265 0 0 No Change 2011-02-01 2019-03-01 Prosthesis MA510 Balansys Revision Knee, Tibial Insert Tibial insert, contrained, with stabilising screw for reinforcement 64/10.5 to 85/23 MA 17 153 1370 210625 Changed Benefit 1073 0 0 Update 2011-02-01 2019-03-01 Prosthesis MA513 RM Acetabular Cup, Polyethylene Titanium bonded UHMWPE Cup, with and without lugs 46 to 64mm MA 18 163 1429 4026 209312 212648 212649 2636 0 0 No Change 2011-08-01 2019-03-01 Prosthesis MA514 Acetabular Screws Titanium cancellous bone screws varying lengths and sizes MA 18 164 1435 241996 121 0 0 No Change 2011-08-01 2019-03-01 Prosthesis MA515 Balansys Tibial Baseplate Tibial Baseplate cemented, CoCr 59mm to 85mm MA 17 151 1357 211082 1923 0 0 No Change 2011-08-01 2019-03-01 Prosthesis MA516 BalanSys Tibial Insert Tibial Insert, ultra congruent and minimally stabilised, UHMWPE 59/8mm to 85/20.5mm MA 17 153 1369 211081 211087 1019 0 0 No Change 2011-08-01 2019-03-01 Prosthesis BB288 Aesculap Vertebral Body System Vertebral Body System, Titanium Alloy All sizes BB 19 176 1492 4137 ThoracoLumbar 132297 4139 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BB289 CranioFix Absorbable Double sided Cranial clamp, absorbable polyester 11mm, 16mm BB 23 199 1591 4337 125104 93 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BB290 T-Bar Yasargil Aneurysm Clip T-Bar Yarsargil Aneurysm Clip, Titanium, Permanent Standard Fenestrated 5mm-9mm, 45 Deg BB 25 218 1655 Complex 123979 359 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BB277 Excia Hip System Cement plug 8mm-18mm BB 18 164 1446 123313 141 0 0 No Change 2006-03-24 2019-03-01 Prosthesis BB278 Aesculap Interbody Cage ACDF Interbody cage All sizes BB 19 174 1486 4134 122641 273761 2409 0 0 No Change 2006-03-24 2019-03-01 Prosthesis BB291 T-Bar Yasargil Aneurysm Clip T-Bar Yarsargil Aneurysm Clip, Titanium, Permanent Standard Fenestrated 5mm-13mm, 90 Deg BB 25 218 1655 Complex 123979 359 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BB292 T-Bar Yasargil Aneurysm Clip T-Bar Yarsargil Aneurysm Clip, Pyhnox Cobalt Alloy, Permanent Standard Fenestrated 5mm-9mm, 45 Deg BB 25 218 1655 Complex 123979 359 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BB293 T-Bar Yasargil Aneurysm Clip T-Bar Yarsargil Aneurysm Clip, Pyhnox Cobalt Alloy, Permanent Standard Fenestrated 5mm-13mm, 90 Deg BB 25 218 1655 Complex 123979 359 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BB294 Aesculap Ligating Clips Aesculap Ligating Clips- Ligation Clips Titanium; PL561T- Large; 6 clips/cartridge BB 21 194 1581 4256 136103 11 0 0 No Change 2007-12-01 2019-03-01 Prosthesis BB295 Metha - modular short stem Short stem, plasma, HA 1 -6 BB 18 161 1407 3952 Removable Neck 126457 4394 0 0 No Change 2007-12-01 2019-03-01 Prosthesis BB296 Metha - Modular neck adaptors Modular neck adaptors made from CoCr CCD - 130°, 135 °, 140°; Offset - 0mm, -5mm ,+5mm; Version - 7.5° left ante/right retro, 0 °, 7.5 ° left retro/right ante BB 18 161 1417 126457 Changed Benefit 1078 0 0 Update 2007-12-01 2019-03-01 Prosthesis BB297 Aesculap Ligating Clips Aesculap Ligating Clips Titanium PL565T - Small; 6 clips/cartridge BB 21 194 1581 4256 136103 11 0 0 No Change 2007-12-01 2019-03-01 Prosthesis BB298 Aesculap Ligating Clips Aesculap Ligating Clips Titanium PL566T - small cardiopack of 24 BB 21 194 1581 4256 136103 44 0 0 No Change 2007-12-01 2019-03-01 Prosthesis BB299 Aesculap Ligating Clips Aesculap Ligating Clips Titanium PL567T - medium; 6 clips/cartridge BB 21 194 1581 4256 136103 11 0 0 No Change 2007-12-01 2019-03-01 Prosthesis BI861 Oxford Meniscal Knee System Uni Tibial Insert Uni Tibial Insert conforming surface, mobile bearing, UHMWPE (Phase III) (Small - Extra Large) x (3-9) BI 17 154 1372 126863 707 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI864 Orthopaedic Salvage System Stem, Cemented or Porous, Ti (9-19)mm diameter x (90-300)mm length BI 17 157 1386 98449 2716 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BT202 Intica 7 HF-T Triple Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional and AutoDetect, DF-1, IS-1 connector 65mm x 58.5mm x 11mm, 34cm3, 83grams BT 27 238 1727 a,d 290411 37440 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BT203 Edora 8 SR-T Single Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDect, MRI conditional, IS-1 connector 48 x 40 x 6.5 mm, 10 cm3 , 20.8 grams BT 27 239 1730 i 290550 4268 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BB300 Aesculap Ligating Clips Aesculap Ligating Clips Titanium PL568T - medium/large; 6 clips/cartridge BB 21 194 1581 4256 136103 11 0 0 No Change 2007-12-01 2019-03-01 Prosthesis BB301 Challenger Ligating Clips Challenger Ligating Clips Titanium Multifire PL572T - small/medium BB 21 194 1581 4259 136103 60 0 0 No Change 2007-12-01 2019-03-01 Prosthesis BB302 Biolox Delta Ceramic Head Biolox Delta Ceramic Head 36 & 40mm diameter BB 18 162 1420 3998 123313 2022 0 0 No Change 2007-12-01 2019-03-01 Prosthesis BB303 Position HTO Implant System - Locking Screws Titanium cancellous and cortical screw, locking head for solid plate fixation. 30mm-78mm x 4.5mm & 6.0mm diameter. BB 13 123 1231 3369 LK 150084 128 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BB304 Aesculap CranioPlate System/ Plate Neuro, 2 hole straight Cranial fixation system, internal fracture, non biodegradable. Consists of screws, plates Plate Neuro, 2 hole 11 & 16mm straight BB 23 199 1589 4267 140600 93 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BB305 Aesculap CranioPlate System/Plate Neuro, 6 hole rectangular Cranial fixation system, internal fracture, non biodegradable. Consists of screws, plates. Plate Neuro, 6 hole 10 x 17 mm rectangular BB 23 199 1589 4271 140600 166 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BB306 Aesculap CranioPlate System/ Plate Neuro, 4 hole square Cranial fixation system, internal fracture, non biodegradable. Consists of screws, plates. Plate Neuro, 4 hole 10mm square BB 23 199 1589 4271 140600 166 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BB307 Aesculap CranioPlate System/ Plate Neuro, 4 hole straight Cranial fixation system, internal fracture, non biodegradable. Consists of screws, plates. Plate Neuro, 4 hole 17 & 20 mm straight BB 23 199 1589 4271 140600 166 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BB308 Aesculap CranioPlate System/ Plate Neuro, 6 hole double Y Cranial fixation system, internal fracture, non biodegradable. Consists of screws, plates. Plate Neuro, 6 hole 15 & 17mm, double Y shape BB 23 199 1589 4271 140600 166 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BB309 Aesculap CranioPlate System/ Plate neuro, 5 hole Y Cranial fixation system, internal fracture, non biodegradable. Consists of screws, plates Plate Neuro, 5 hole 17mm, Y shape BB 23 199 1589 4271 140600 166 0 0 No Change 2008-07-01 2019-03-01 Prosthesis MA518 Balansys Tibial Baseplate Tibial Baseplate cemented, CoCr, TiNbN coated 59mm to 85mm MA 17 151 1357 211083 1923 0 0 No Change 2011-08-01 2019-03-01 Prosthesis MA522 Affinis Shoulder System Stem Cementless - Titanium, adjustable cone 6, 7.5, 9, 10.5, 12, 13.5 and 15mm MA 13 131 1276 4058 219395 3325 0 0 No Change 2011-08-01 2019-03-01 Prosthesis MA523 Affinis Shoulder System Stem Cemented - adjustable cone 6, 9, 12 and 15mm MA 13 131 1276 4057 215496 219396 Changed Benefit 3771 0 0 Update 2011-08-01 2019-03-01 Prosthesis MA524 Modular Revision Stem Proximal body, grit Blasted Titanium 50-70mm MA 18 161 1410 3961 Body 274207 2514 0 0 No Change 2011-08-01 2019-03-01 Prosthesis MA525 Modular Revision Stem Proximal Body, Long, Grit Blasted Titanium 80mm-110mm MA 18 161 1412 3971 Body 274207 Changed Benefit 3392 0 0 Update 2011-08-01 2019-03-01 Prosthesis MA517 Bionit Ceramic Femoral Head Femoral Head, Ceramic 36 to 54mm MA 18 162 1420 3996 210564 1806 0 0 No Change 2011-08-01 2019-03-01 Prosthesis MA526 Affinis Inverse Stem, cemented Humeral component - cemented. Monoblock primary stem for reverse inlay 6,9,12,15mm MA 13 131 1276 4057 Reverse 215275 6460 0 0 No Change 2012-08-01 2019-03-01 Prosthesis BB310 Aesculap CranioPlate System/ Plate Neuro, 8 hole rectangular Cranial fixation system, internal fracture, non biodegradable. Consists of screws, plates. Plate Neuro, 8 hole 10 x 24 mm rectangular BB 23 199 1589 4277 140600 199 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BB311 Position HTO Implant System - HTO Plate Titanium Osteotomy Plate, internal fixation plate used in proximal tibial repositioning osteotomy. One size BB 13 123 1694 5255 Com, LK 150084 1178 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BB312 Position HTO Implant System - Spacer Block with Fixation Screw Osteotomy Spacer Block, solid titanium. Consists of block and fixation screw. 5mm - 16mm BB 13 123 1694 5255 LK 150084 798 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BI762 Mandibular Fracture System Plates, 2.4 Mandibular Fracture System, Titanium 16 - 24 Hole BI 23 199 1589 4296 128458 199 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI768 Mandibular Fracture System Screw, IMF 2./2.4 Mandibular Fracture, Titanium 2.0 x(5 - 13)mm BI 13 123 1231 3371 128459 84 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MA527 Affinis Inverse Stem, uncemented Monoblock Humeral Stem 6 to 15 mm MA 13 131 1276 4058 Reverse 215274 Changed Benefit 6013 0 0 Update 2012-08-01 2019-03-01 Prosthesis ME222 Frankenman Linear Cutter Reloads Single use, linear cutter reload cartridge containing titanium staples 61mm; 81mm; 100mm ME 21 194 1582 4317 207254 Changed Benefit 226 0 0 Update 2017-08-01 2019-03-01 Prosthesis ME223 NG075 General Purpose Drainage Catheter Abscess Drainage Catheters 6FR x 12CM through to 28FR x 50CM ME 21 193 1577 4243 98030 Changed Benefit 404 0 0 Update 2018-02-01 2019-03-01 Prosthesis ME224 Frankenman Endoscopic Linear Cutter The Endoscopic Linear Cutter and Reloads have applications in resection, transection and/or anastomosis of tissue in open or laparoscopic procedures. Stapler Unit - 280mm, 330mm, 380mm, 430mm, 480mm in 12.5mm shaft OD. Reloadable Cartridges - 30mm, 45mm, 60mm staple lengths. ME 21 194 1582 4318 Endoscopic, Articulating/Roticulating 205331 384 0 0 No Change 2018-08-01 2019-03-01 Prosthesis CZ027 AT TORBI 709M HIGH CYLINDER BITORIC - ZEISS Micro Incision Aspheric (aberration neutral) IOL: Foldable square edged, single piece IOL for capsular bag fixation 6mm optic, 11mm overall diameter. Diopter range: Sph -10.0 to +32.0D, +7.0 to 12.0D (all 0.5D steps) CZ 1 141 1327 3890 at, t2 151348 857 0 0 No Change 2010-08-01 2019-03-01 Prosthesis CZ028 CT ASPHINA 409MP Preloaded, micro incision, aspheric (aberration neutral), foldable square-edged single piece intraocular lens for capsular bag fixation. Diopter range: 0.0 to 32.0D; Optic size: 6.0mm; Overall length: 11.0mm CZ 1 141 1327 3890 at, pl 134490 308 0 0 No Change 2011-08-01 2019-03-01 Prosthesis CZ030 CT ASPHINA 404 Small incision, foldable, single piece, monofocal, aspheric (aberration neutral), square-edged, hydrophilic acrylic (with hydrophobic surface properties) intraocular lens for capsular bag fixation. (Monofocal lens for powers outside standard 409MP MICS range). Diopter range: -10.0 to 42.0, Optic size: 6.0mm, Overall length: 11.0mm CZ 1 141 1327 3892 at 151348 300 0 0 No Change 2011-08-01 2019-03-01 Prosthesis CZ031 AT TORBI 709MP (Standard Range) Bitoric, preloaded, micro incision, aspheric (aberration neutral), foldable, square-edged, single-piece IOL for capsular bag fixation Diopter range: Sph -10.0 to 32.0, Cyl +1.0 to 6.5 Optic size: 6.0mm, Overall length: 11.0mm CZ 1 141 1327 3890 at, pl, t1 151348 Changed Benefit 626 0 0 Update 2011-08-01 2019-03-01 Prosthesis CZ033 AT LISA 809MP Preloaded, micro incision, aspherical bifocal, square edged, single-piece IOL for capsular bag fixation. The anterior aspheric bifocal surface has an asymmetric light distribution 65/35 for distance/near vision, and 3.75D add for the near focus. Diopter range: 0.0 to 32.0 Optic size: 6.0mm. Overall length: 11.0mm CZ 1 141 1327 3893 at, pl 151348 Changed Benefit 694 0 0 Update 2011-08-01 2019-03-01 Prosthesis CZ034 AT LISA tri 839MP Trifocal (aspheric) micro incision, single-piece IOL for capsular bag fixation, implantable with preloaded injector system. The trifocal (anterior) optic provides two diffractive focal points (+3.33D near focus and +1.66D intermediate focus) with asymmetric light distribution 50% distance / 20% intermediate / 30% near vision. Diopter range: 0.0 to +32.0D (0.5D increments). Optic size: 6.0mm. Overall Length: 11.0mm CZ 1 141 1327 3893 at, pl 134490 Changed Benefit 694 0 0 Update 2012-08-01 2019-03-01 Prosthesis CZ035 AT LISA toric 909MP ZEISS pre-loaded, micro incision, multifocal toric IOL. Aspheric toric anterior surface, diffractive bifocal posterior surface with asymmetric light distribution (65% distance/ 35% near), and 3.75D addition for near focus. 6mm optic, 11mm diameter. Diopter range: Sph +6.0D to 24.0D, Cyl +1.0 to 4.0D (all 0.5D steps) CZ 1 141 1327 3893 at, pl, t1 151348 Changed Benefit 1003 0 0 Update 2012-08-01 2019-03-01 Prosthesis ET042 Soft Gastric Banding System Sterile long term implant for the treatment of obesity. Supplied in kit format with catheter, port and huber needles One size only ET 21 190 1548 96737 3135 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ET045 Boubella Esophageal Stent Self expandable stainless steel wire stent with anti-reflux valve Length 90 - 195mm ET 21 192 1558 4238 95573 3325 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ET050 ARGUS Adjustable Male Sling made of silicone adjustable self fixating columns and urethral cushion One size only ET 26 226 1698 5314 118082 5432 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ET051 Surgiwrap Bio Absorbable Antiadhesion Barrier All sizes with and without suture holes ET 21 194 1579 5432 Complex, Bioresorbable 91233 1235 0 0 No Change 2006-03-24 2019-03-01 Prosthesis ET053 Macroplastique Sterile, textured, highly cross linked polydimethylsiloxane elastomer implants suspended in a bio-excretable carrier gel. 2.5ml Implants ET 26 226 1699 5319 146732 1262 0 0 No Change 2007-12-01 2019-03-01 Prosthesis ET054 Memokath Prostatic - Urethral Stents Memokath Models: 028S, 028SW, 028T, 028TW, 044T, 044TW, 045T, 045TW, 045TTW 5mm - 90mm ET 26 256 1800 5501 141653 2351 0 0 No Change 2008-07-01 2019-03-01 Prosthesis CZ036 AT LISA tri Toric 939MP Trifocal (aspheric), bitoric, micro incision, single-piece IOL for capsular bag fixation, implantable with preloaded injector system. The trifocal (anterior) optic provides two diffractive focal points (+3.33D near focus and + 1.66D intermediate focus) with asymmetric light distribution 50% distance / 20% intermediate / 30% near vision, Diopter range -10.00 to +28.0 and +1 to +4.0 DC Optic size: 6..00mml; Overall length: 11.mm CZ 1 141 1327 3893 at, pl, t1 151348 Changed Benefit 1003 0 0 Update 2013-02-01 2019-03-01 Prosthesis DE650 Oculentis FEMTIS Comfort FB-313MF15 Foldable one-piece multifocal acrylic plate haptic IOL for fixation in the capsulorhexis Optic Size 5.7mm, Overall length 10.5mm. Available Dioptres: +15.0D to 30.0D (0.5D steps) DE 1 141 1327 3893 at 198807 677 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE651 Mesh Plate Plate for Fracture fixation and Arthrodesis Short Long DE 13 123 1694 5255 284416 Changed Benefit 542 0 0 Update 2018-08-01 2019-03-01 Prosthesis DE652 Vu aPOD Prime NanoMetalene ALIF Cage PEEK titanium ALIF with NanoMetalene surface technology Height: 10,12,14,16, 18 and 20mm Lordosis : 10, 15, 20 and 30 degrees Footprints: 31 x 24mm, 35 x 27mm, 39 x 30mm DE 19 174 1485 5486 298002 6256 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DF002 DANAR Insulin Pump The DANAR Insulin Pump is a small device about the size of a pager. It holds up to 300 units of insulin, which is delivered continuously through a small tube to the patient. The DANAR Insulin Pump also has an integrated blood glucose meter and remote control via bluetooth communication. 75 x 45 x 19mm, 60grams DF 21 188 1525 4183 DE, SS 146421 8502 0 0 No Change 2010-08-01 2019-03-01 Prosthesis DF003 DANA RS Diabecare insulin pump DANA RS insulin pump is a BLE (bluetooth low energy) insulin pump which can be connected to and controlled from a BLE Smart Phone. Smart Phone connection is via a secure (alpha-numeric) pairing code, creating a large easy to read display for set-up and control of the DANA RS insulin pump. 75mm x 45mm x 19mm (63grams) DF 21 188 1525 4183 DE, SS 252214 8502 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DH001 Astra Tech Implant System Cover Screws Cover Screw Diameter range 3.0 - 5.4 DH 23 201 1600 4387 153161 51 0 0 No Change 2012-08-01 2019-03-01 Prosthesis DH002 Astra Tech Implant System Fixtures Tx/EV Titanium fixture with microthreaded cervical neck Diameter 3.0 - 5.7mm, Length 6-17mm DH 23 201 1602 4392 212688 351 0 0 No Change 2012-08-01 2019-03-01 Prosthesis BT206 Ilivia 7 VR-T Single Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI Conditional and AutoDetect, DF-4, IS-1 connector 65mm x 54mm x 11mm, 31cm3, 81grams BT 27 236 1723 a, d, e 290404 Changed Benefit 32162 0 0 Update 2017-08-01 2019-03-01 Prosthesis BT207 Ilivia 7 HF-T Triple Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional and AutoDetect, DF-4, IS-1 connector 65mm x56mm x 11 mm, 33cm3, 82grams BT 27 238 1727 a,d,e 290409 37980 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BT208 Intica 7 DR-T Dual Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional and AutoDetect, DF-1, IS-1 connector 65mm x 55mm x 11mm, 33cm3, 82grams BT 27 237 1725 a,d 290408 Changed Benefit 33934 0 0 Update 2017-08-01 2019-03-01 Prosthesis BT209 Plexa ProMRI DF-1 S Tripolar MR conditional ICD lead with active fixation Diameter 7.8 F ; Length 65cm ,75cm BT 27 242 1743 298206 6480 0 0 No Change 2018-02-01 2019-03-01 Prosthesis BT210 Plexa ProMRI DF-1 SD Quadripolar MR conditional ICD lead with active fixation Diameter 7.8F ; Lengths/Dist.Prox Shock coil to Tip - 65/16cm, 65/18cm, 75/18cm BT 27 242 1743 298207 6480 0 0 No Change 2018-02-01 2019-03-01 Prosthesis BT211 Plexa ProMRI DF-1 S DX Pentapolar MR conditional ICD lead with active fixation Diameter 7.8F; Length/Dist Dipole to Tip 65/15 cm , 65/17 cm. BT 27 242 1743 298208 6480 0 0 No Change 2018-02-01 2019-03-01 Prosthesis BT212 Plexa ProMRI S Tripolar MR conditional ICD lead with active fixation Diameter 7.8F ; Length 65cm , 75cm BT 27 242 1743 e 298187 6480 0 0 No Change 2018-02-01 2019-03-01 Prosthesis BT213 Plexa ProMRI SD Quadripolar MR conditional ICD lead with active fixation Diamter 7.8F , Length/Dist prox. shock coil to tip 65/16cm, 65/18cm, 75/18cm BT 27 242 1743 e 298343 6480 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DE653 Vu aPOD Prime Bone Screw Locking Bone Screw 6.0 and 6.5mm diameter 20, 25 and 30mm length DE 19 165 1464 298002 Changed Benefit 193 0 0 Update 2018-08-01 2019-03-01 Prosthesis DE654 Nano Corkscrew FT Suture Anchor Suture Anchor 1.7mm x 5mm DE 13 123 1774 5384 126657 Changed Benefit 294 0 0 Update 2018-08-01 2019-03-01 Prosthesis DE655 NovaBone BioGlass Bioactive synthetic bone graft - calcium phospo-silicate 0.25 - 5cc DE 13 123 1241 4092 AUG 302473 302472 1026 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE656 NovaBone BioGlass Bioactive synthetic bone graft - calcium phospho-silicate 8cc-10cc DE 13 123 1241 4093 AUG 302473 302474 302472 2185 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE657 NovaBone BioGlass Bioactive synthetic bone graft - calcium phospho-silicate 15cc - 20cc DE 13 123 1241 4094 AUG 302475 4370 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE658 Shoreline ACS TruProfile Cage Cervical ACDF Cage Footprints: 16 x 14mm, 18 x 15mm and 20 x 15mm Lordosis: 7, 10 and 15 degrees Heights: 5,6,7,8,9,10,11 and 12mm DE 19 174 1486 4134 298002 2409 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE659 Shoreline ACS TruProfile Cervical Plate Anterior cervical plating system Holes: 2, 3 and 4 Length: 5-12mm DE 19 169 1477 4127 298002 1251 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DH003 Astra Tech Implant System Healing Abutments Healing Abutments Implant Diameter: Range 3.0 - 5.4mm Healing Abutment Diameter Range from 3.5 - 6.5 DH 23 201 1600 4386 212101 Changed Benefit 68 0 0 Update 2012-08-01 2019-03-01 Prosthesis DH004 Astra Tech Implant System Abutments Temporary Abutment Diameter range: 3.3 - 7.0mm DH 23 201 1600 4386 212101 Changed Benefit 68 0 0 Update 2012-08-01 2019-03-01 Prosthesis EO069 APTUS Wrist 2.5 TriLock Distal Radius Plates, Volar, Dorsal, Correction 2.5mm diameter system EO 13 123 1694 5278 VAL 141170 1691 0 0 No Change 2012-02-01 2019-03-01 Prosthesis EO070 APTUS Wrist 2.5 TriLock Y Plate 2.5mm diameter system EO 13 123 1694 5280 VAL 141170 1439 0 0 No Change 2012-02-01 2019-03-01 Prosthesis EO072 APTUS Screws Aptus Locking Screws 1.5mm - 2.0mm Diameter EO 13 123 1231 3372 DT,LK 141171 294 0 0 No Change 2012-02-01 2019-03-01 Prosthesis EO073 APTUS Screws Aptus Locking Screws 2.5mm Diameter EO 13 123 1231 3371 DT,LK 141171 318 0 0 No Change 2012-02-01 2019-03-01 Prosthesis EO074 APTUS Screws Aptus Locking Screws 2.8mm - 3.5mm Diameter EO 13 123 1231 3370 DT,LK 141171 316 0 0 No Change 2012-02-01 2019-03-01 Prosthesis ET055 Memokath Ureteric Stent Memokath Model 051CW. 30mm - 200mm ET 26 227 1701 5323 Therm 141654 3589 0 0 No Change 2008-07-01 2019-03-01 Prosthesis ET056 Soft Basket Band. INFUSION PORT. TITANIUM PORT 9.8CMS/13.3CMS ET 21 190 1779 148776 589 0 0 No Change 2009-02-01 2019-03-01 Prosthesis ET057 VICTO Artificial Urinary Sphincter VICTO Artificial Urinary Sphincter with conditional occlusion, inflatable hydraulic device. Four cuff sizes: 3.7cm, 4.0cm, 4.5cm, and 5.0cm. ET 26 226 1696 5311 203685 9500 0 0 No Change 2009-02-01 2019-03-01 Prosthesis ET064 AMI HAL-RAR Flexi Procedure Kit Doppler guided Haemorrhoidal Arterial Ligation and Recto-Anal Repair System. HAL Haemorrhoidal Ligating sutures, doppler/ultrasound proctoscope, flexiprobe, knot pusher One size, several components ET 21 194 1581 4258 Doppler Guided, Endoscopic 144489 Changed Benefit 907 0 0 Update 2011-08-01 2019-03-01 Prosthesis ET065 HAL-RAR HAL-Ligating Suture, AMI HAL-Ligating suture, prosthetic component of AMI HAL-RAR Doppler System One size ET 21 194 1581 4260 180973 Changed Benefit 93 0 0 Update 2011-08-01 2019-03-01 Prosthesis BT214 Evity 8 DR-T Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional, IS-1 connector IS-1 (2x) 11 cm3/ 23.2 g 48 mm × 44 mm × 6.5 mm BT 27 240 1734 g 290554 8482 0 0 No Change 2018-02-01 2019-03-01 Prosthesis BT215 Evity 8 SR-T Single Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDect, MRI conditional, IS-1 connector IS-1 (1x) 10 cm3/ 20.8g 48 mm × 40 mm × 6.5 mm BT 27 239 1730 i 290551 4268 0 0 No Change 2018-02-01 2019-03-01 Prosthesis BT216 Solia JT Sub 6F, steroid-eluting, transvenous, endocardial, bipolar passive fixation lead. MRI conditional Lengths: 45, 53 cm; Diameter: 5.6Fr BT 27 243 1753 294253 898 0 0 No Change 2018-02-01 2019-03-01 Prosthesis BT217 Biotronik Lead Fixation Sleeves EFH Lead Fixation Sleeves EFH-7F,8F,16,20,22,25,27 BT 27 246 1765 250355 Changed Benefit 58 0 0 Update 2018-08-01 2019-03-01 Prosthesis BU001 Nexis osteosynthesis screws Bone screw titanium alloy snap off Diameter 2mm, Length 11-16mm BU 13 123 1231 3372 Breakoff 281 0 0 No Change 2016-02-01 2019-03-01 Prosthesis DE660 Shoreline ACS Bone Screws Self drilling and self tapping bone screws 3.5 and 4.0mm diameters 10-18mm length DE 19 165 1464 298002 Changed Benefit 193 0 0 Update 2018-08-01 2019-03-01 Prosthesis DE661 Shoreline ACS Locking Cover Locking cover for fixation of bone screws 5-12mm DE 19 166 1465 298002 164 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE662 Shoreline ACS NoProfile Cage Cervical cage with no anterior profile Footprints: 16 x 14mm and 18 x 15mm Heights: 6 -12 mm 7 Degrees Lordosis DE 19 174 1485 5485 298002 Changed Benefit 4379 0 0 Update 2018-08-01 2019-03-01 Prosthesis DE663 Malibu Integrated Locking Cap and Set Screw Integrated Locking Cap and Set Screw 1 size DE 19 166 1465 275794 164 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE664 Mariner Pedicle Screw Shank Posterior Fixation System 4.5, 5.5, 6.5, 7.5 and 8.5mm Diameters 25-110mm Length DE 19 165 1463 Shank 275794 640 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE665 Mariner Pedicle Screw Modular Head Polyaxial, Extended, Deformity and Trauma Heads One size each DE 19 166 1469 275794 Changed Benefit 732 0 0 Update 2018-08-01 2019-03-01 Prosthesis DE666 Mariner Set Screw Set Screw 1 size DE 19 166 1465 275794 164 0 0 No Change 2018-08-01 2019-03-01 Prosthesis EO075 APTUS Screws Cortical Screws 1.5mm - 2.0mm Diameter EO 13 123 1231 3372 141171 Changed Benefit 60 0 0 Update 2012-02-01 2019-03-01 Prosthesis EO076 APTUS Screws Cortical Screws 2.3mm - 2.5mm Diameter EO 13 123 1231 3371 141171 84 0 0 No Change 2012-02-01 2019-03-01 Prosthesis EO077 APTUS Screws Cortical Screws 2.71mm – 4.49mm EO 13 123 1231 3370 206157 82 0 0 No Change 2012-02-01 2019-03-01 Prosthesis EO078 Aptus Elbow Distal Humerus Plpates, Lateral,Middle and Posterolateral 2.8mm EO 13 123 1694 5274 VAL 141170 Changed Benefit 1643 0 0 Update 2012-08-01 2019-03-01 Prosthesis EO079 Aptus Elbow Distal Humerus Plates Posterolateral 2.8mm System EO 13 123 1694 5275 VAL 141170 Changed Benefit 1643 0 0 Update 2012-08-01 2019-03-01 Prosthesis EO080 APTUS Foot TriLock Plates 2.8 EO 13 123 1694 5258 Com, VAL 141170 1164 0 0 No Change 2012-08-01 2019-03-01 Prosthesis EO081 APTUS Foot TriLock Plates 2.8 EO 13 123 1694 5259 Com, VAL 141170 1229 0 0 No Change 2012-08-01 2019-03-01 Prosthesis EO082 APTUS Hand and Foot TriLock Plates 1.2 - 2.3 EO 13 123 1694 5261 Com, VAL 141170 1577 0 0 No Change 2012-08-01 2019-03-01 Prosthesis EO084 APTUS Hand Fixation Plates 1.2 - 2.3 EO 13 123 1694 5261 141170 627 0 0 No Change 2012-08-01 2019-03-01 Prosthesis HW168 Kinemax Knee System Full Tibial Augment Full Tibial Block, CoCr (Vitallium), cemented xs-xl, 10mm thickness HW 17 159 1390 142278 16236 1148 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW169 Kinemax Knee System Hemi Tibial Augment Half block, CoCr (Vitallium), cemented LM/RL & LL/RM xs-xl in 5 & 10mm thickness HW 17 159 1390 142278 16236 1148 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW171 Duracon Knee System / Kinemax Knee System stem Stem, femoral & tbial, CoCr, (Vitallium), cemented 40mm, 80mm, 155mm for each size HW 17 159 1399 141151 Changed Benefit 1126 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW174 Kinemax Knee System Tibial Insert Minimally stabilised tibial insert, UHMWPE, (Duration) 8, 10, 12, 15, 18, 21, 25mm per size HW 17 153 1369 141151 16236 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW182 PCA Modular Knee System Patella Component Patella component, UHMWPE, (Duration), cemented Small, Medium, Large, Extra Large HW 17 156 1376 139146 Changed Benefit 537 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW192 HMRS (Howmedica Modular Replacement System) Hex Head Cortical Bone Screw, Self Tapping HMRS Hex Head Cortical Bone Screw, Self Tapping, CoCr (Vitallium) for prosthesis fixation 16-30mm in 2mm increments and 35-70mm in 5m increments HW 17 159 1398 142278 126 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE668 Mariner CrossBar Adjustable Cross link Small 33-41mm Medium 39-52mm Large 50-75mm DE 19 167 1474 4124 275794 Changed Benefit 1299 0 0 Update 2018-08-01 2019-03-01 Prosthesis DE669 icotec Pedicle System Polyaxial Screw Polyaxial Pedicle Screw Size(s):* 5.5, 6.5 and 7.5mm diameter 25-60mm length DE 19 165 1463 283853 283854 To be reimbursed only when used in patients with spinal tumours 1280 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE670 icotec Pedicle System Rod Pre-bent and straight rods 5.5 mm diameter 40-160mm Length DE 19 170 1478 283853 283854 To be reimbursed only when used in patients with spinal tumours Changed Benefit 426 0 0 Update 2018-08-01 2019-03-01 Prosthesis DE671 icotec Pedicle System Set Screw Set screw one size only DE 19 166 1465 283853 283854 To be reimbursed only when used in patients with spinal tumours 164 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE672 icotec Pedicle System Cross Link Adjustable cross link 30-34mm 33-42mm 40-53mm 50-70mm DE 19 167 1474 4124 283853 283854 Changed Benefit 1299 0 0 Update 2018-08-01 2019-03-01 Prosthesis DE667 Mariner Rod Pre-contoured and straight rods 5.5mm diameter 30mm - 450mm Length DE 19 170 1478 275794 Changed Benefit 426 0 0 Update 2018-08-01 2019-03-01 Prosthesis EO085 APTUS Hand Fixation Plates 1.2 - 2.3 EO 13 123 1694 5262 141170 382 0 0 No Change 2012-08-01 2019-03-01 Prosthesis EO086 APTUS Hand Fixation Plates 1.2 - 2.3 EO 13 123 1694 5263 141170 Changed Benefit 637 0 0 Update 2012-08-01 2019-03-01 Prosthesis EO087 Aptus Shoulder (Proximal Humerus Plates) Proximal Humerus Fixation plates 3.5mm System EO 13 123 1694 5275 VAL 141170 Changed Benefit 1643 0 0 Update 2013-08-01 2019-03-01 Prosthesis EO088 Aptus Shoulder (Spiral Blades ) Spiral Blades Proximal Humerus 3.5mm System EO 13 123 1231 4521 141170 126 0 0 No Change 2013-08-01 2019-03-01 Prosthesis EO089 Aptus K-wires K-wires 0.8mm - 2.2mm Diameter, various lengths EO 13 123 1772 5365 200263 27 0 0 No Change 2013-08-01 2019-03-01 Prosthesis EO090 APTUS SpeedTip C-Snap System APTUS SpeedTip C-Snap Screws 2.0mm diameter EO 13 123 1231 3372 Breakoff, DT 206157 452 0 0 No Change 2015-02-01 2019-03-01 Prosthesis EO091 APTUS SpeedTip C System APTUS SpeedTip C Screws 2.0mm diameter EO 13 123 1231 3372 DT 206157 231 0 0 No Change 2015-02-01 2019-03-01 Prosthesis EO092 APTUS SpeedTip C System APTUS SpeedTip C Screws 2.8mm diameter EO 13 123 1231 3370 DT 206157 253 0 0 No Change 2015-02-01 2019-03-01 Prosthesis ET066 Insorb Subcuticular Stapler A subcuticular (dermal) surgical delivery system loaded with resorbable staples/prostheses Each staple is 5mm x 3mm ET 21 194 1582 4320 178665 342 0 0 No Change 2012-02-01 2019-03-01 Prosthesis ET067 OTSC Clip The OTSC Clip is a superelastic Nitinol clip which compresses the tissue between its teeth. Therefore it enables hemostasis as well as closing of perforations OTSC Clip is available in three sizes: 9mm, 10mm and 11mm ET 21 194 1581 4258 Endoscopic, OTS 185054 185057 950 0 0 No Change 2012-08-01 2019-03-01 Prosthesis ET068 OTSC System Has two components: 1. The OTSC Clip is a superelastic Nitinol clip which compresses the tissue between its teeth; enables hemostasis as well as closing performations. 2. Grasping and Anchoring Tool. Ovesco Twin Graspers – to approximate wound edges.. Ovesco Anchor- to grasp fibrous tissue or fistulas OTSC Clip is available in three sizes: 9mm, 10mm and 11 mm. Ovesco Twin Graspers : 165mm or 220mm Ovesco Anchor: 165mm ET 21 194 1581 4258 Endoscopic, OTS 18057 185054 185056 185058 2775 0 0 No Change 2012-08-01 2019-03-01 Prosthesis BU003 Nexis osteosynthesis screws Bone screw titanium alloy (headed) Diameter 2.9-4mm, Length 10-60mm BU 13 123 1231 3370 CN 235765 208 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BU004 Airlock Bone screw Bone Screws Titanium Alloy (Locking screws) Diameter 3-3.5mm, Length 8-30mm BU 13 123 1231 3370 LK 235767 145 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BU007 Airlock Bone screw Bone Screws Titanium Alloy (non locking screws) Diameter 3-3.5mm, Length 8-30mm BU 13 123 1231 3370 235767 82 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BU008 Arcad osteosynthesis memory staples Memory metal implants 8 to 25mm BU 13 123 1773 5514 MM 235764 Changed Benefit 507 0 0 Update 2016-08-01 2019-03-01 Prosthesis BU009 Nexis osteosynthesis screws Bone screw titanium alloy (compressive) Diameter 2.9-4 mm, Length 10-60mm BU 13 123 1231 3370 CN,DT 235765 379 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BU010 Nexis osteosynthesis screws Bone screw titanium alloy (compressive) Diameter 2.3mm, Length 10-30mm BU 13 123 1231 3371 CN,DT 235765 381 0 0 No Change 2016-08-01 2019-03-01 Prosthesis ET069 SX - ELLA Stent Esophageal HV (HV Stent Plus) The SX-ELLA Atent Esophageal HV (HV Stent Plus) is a self-expandable, fully covered nitinol stent, pre-loaded on a delivery system. The stent is designed to provide relief from malignant or benign strictures in the oesophagus, or treating anastomic leaks. HV Stent Plus includes an anti-migration collar & is also available with an anti-reflux valve Stent body diameter = 20mm; Stent flares = 25mm diameter; Stent nominal length = 85/110/135/150mm ET 21 192 1558 4238 95573 3325 0 0 No Change 2012-08-01 2019-03-01 Prosthesis ET070 SX- ELLA Stent Danis The Danis Procedure Pack Basic contains the SX-ELLA Stent Danis, a nitinol wire that is compressed & preloaded within a delivery system, along with various instruments necessary for the stent implantation. The Stent Denis is a removable stent system for the treatment of bleeding esophageal varices. It is intended to be implanted and then removed within seven days of the date of implantation in order to avoid the risk of in-growth into the stent mesh One size: Stent flares diameter 30mm; Stent body diameter 25mm; Nominal length 135mm ET 21 192 1558 4238 95573 3325 0 0 No Change 2012-08-01 2019-03-01 Prosthesis ET072 Eclipse Piston Stapes: Nitinol, Fluroplastic Diameter 0.5mm: 3.75mm - 6.00mm Diameter 0.6mm: 3.75mm - 6.00mm ET 22 196 1565 4154 170281 99 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BU012 Nexis osteosynthesis screws Bone screw titanium alloy (compressive) Diameter 5-7 mm, Length 26-120mm BU 13 123 1231 3369 CN,DT 235765 362 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BU013 Lync Intramedullary Implant Lync is a titanium intramedullary implant 12mm to 20mm Length, Angled 0 degrees and 10 degrees BU 13 123 1228 5474 235763 548 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BU014 Airlock Bone plate System Osteosynthesis bone plate system Left and right thickness 1.3mm to 1.35 mm, Length from 16mm to 55mm BU 13 123 1694 5298 LK 235766 Changed Benefit 693 0 0 Update 2016-08-01 2019-03-01 Prosthesis CZ013 Z-HYALIN Plus Viscoelastic Cohesive Viscoelastic Solution - sodium hyaluronate 15mg/ml. (previously called Opthalin Plus) Volume 1.0ml CZ 1 142 1329 150017 72 0 0 No Change 2008-07-01 2019-03-01 Prosthesis CZ015 AT LISA 809M ZEISS micro incision, aspheric multifocal IOL. Diffractive bifocal anterior surface with asymmetric light distribution (65% distance / 35% near), 3.75D addition for near focus. 6mm optic, 11mm diameter. Diopter range 0.0D to +32.0D (0.5D steps) CZ 1 141 1327 3893 at 151348 677 0 0 No Change 2009-02-01 2019-03-01 Prosthesis ET073 Eclipse Malleus Piston Malleus & Stapes: Nitinol, Fluoroplastic Diamater 0.6mm: 5.5mm-8.00mm ET 22 196 1565 4156 170281 342 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW153 Kinemax Knee System & Modular Rotating Hinge Distal & Posterior Femoral Augments & Spacers Distal & posterior femoral blocks & spacers, CoCr (Vitallium), cemented Kinemax: Full, Distal & Posterior Augments: xs-xl; 5mm /10mm MRH Distal Femoral Augments xs-xl; 5mm / 10mm HW 17 159 1390 139145 1148 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW160 Kinemax Knee System Tibial Insert Minimally stabilised, tibial insert, Low Stress, UHMWPE (Duration) 8, 10, 12, 15, 18, 21, 25mm per size HW 17 153 1369 141151 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW161 Kinemax Knee System Tibial Insert Totally constrained tibial insert, with metal post, UHMWPE (Duration) 8, 10, 12, 15, 18, 21, 25mm per size HW 17 153 1371 141151 16236 Changed Benefit 1118 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW162 Interax Knee System Patella Patella, resurfacing, all UHMWPE (Duration) 8, 10, 12, 15, 18, 21mm per size HW 17 153 1369 128027 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW167 Kinemax Knee System Tibial Fixation Peg Tibial Fixation Peg, CoCr (Vitallium), 20mm HW 17 159 1397 141151 16236 126 0 0 No Change 2005-10-31 2019-03-01 Prosthesis EO093 APTUS SpeedTip CCS APTUS SpeedTip CCS 5.0/7.0 5.0mm diameter and 7.0mm diameter. Short and long thread EO 13 123 1231 3369 CN,DT 206157 362 0 0 No Change 2015-08-01 2019-03-01 Prosthesis EO094 APTUS Hand and Foot TriLock Plates 1.2 - 2.3 EO 13 123 1694 5262 Com, VAL 206157 1332 0 0 No Change 2016-02-01 2019-03-01 Prosthesis EO095 MODUS Orthognathics Indication-specific solutions for maxillary and mandibular orthognathic surgeries 1.5mm - 2.0mm EO 23 199 1589 4271 Complex 181396 240 0 0 No Change 2016-08-01 2019-03-01 Prosthesis EO096 MODUS Orthognathic Indication-specific solutions for maxillary and mandibular orthognathic surgeries 1.5mm - 2.0mm EO 23 199 1589 4277 Complex 181396 273 0 0 No Change 2016-08-01 2019-03-01 Prosthesis EO097 MODUS Orthognathics Indication-specific solutions for maxillary and mandibular orthognathic surgeries 2.0mm EO 23 199 1589 4288 Complex 181396 341 0 0 No Change 2016-08-01 2019-03-01 Prosthesis EO098 MODUS Orthognathics Indication-specific solutions for maxillary and mandibular orthognathic surgeries 2.0mm EO 23 199 1589 4293 Locking 181396 629 0 0 No Change 2016-08-01 2019-03-01 Prosthesis CZ016 CT ASPHINA 409M ZEISS Micro Incision Aspheric (aberration neutral) IOL: Foldable, square-edged, single piece IOL for capsular bag fixation 6mm optic, 11mm overall diameter. Diopter range 0.0 to +32.0D (0.5D steps from 10.0 to 30.0D, 1.0D outside this range) CZ 1 141 1327 3890 at 151348 300 0 0 No Change 2009-02-01 2019-03-01 Prosthesis CZ017 CT ASPHINA 509M ZEISS Micro Incision Aspheric (aberration correcting) IOL: Foldable, square-edged, single piece IOL for capsular bag fixation 6mm Optic, 11mm overall diameter. Diopter range 0.0 to +32.0D (0.5D steps from 10.0 to 30.0D, 1.0D outside this range) CZ 1 141 1327 3890 at 151348 300 0 0 No Change 2009-02-01 2019-03-01 Prosthesis CZ019 TWINVISC Viscoelastic TWINVISC includes a cohesive and a dispersive viscoelastic in one syringe, separated by a valve. Dispersive: sodium hyaluronate (2.2%). Cohesive: sodium hyaluronate (1%) Total volume 1.4 ml CZ 1 142 1329 3897 160685 99 0 0 No Change 2009-08-01 2019-03-01 Prosthesis CZ020 AT TORBI 709M STANDARD RANGE BITORIC - ZEISS Micro Incision Aspheric (abberation neutral) IOL: Foldable, square-edged, single piece IOL for capsular bag fixation 6mm optic, 11mm overall diameter. Diopter range: Sph -10.0 to +32.0D, Cyl +1.0 to 6.5D (all 0.5D steps) CZ 1 141 1327 3890 at, t1 151348 Changed Benefit 609 0 0 Update 2010-02-01 2019-03-01 Prosthesis EO099 MODUS Orthognathics Indication-specific solutions for maxillary and mandibular orthognathic surgeries 2.0mm EO 23 199 1589 4293 181396 Changed Benefit 409 0 0 Update 2016-08-01 2019-03-01 Prosthesis EO100 APTUS K-wires Olive K-wires 1.6mm EO 13 123 1772 5365 OL 200263 Changed Benefit 121 0 0 Update 2017-08-01 2019-03-01 Prosthesis ER005 Nevro Spinal Cord Stimulation System (SCSS) - IPG Kit The Implantable Pulse Generator (IPG) is a rechargeable implantable device. It is capable of stimulating the spinal cord nerves through the electrodes of the leads connected to any combination of the output terminals, using one programmable current source. N/A ER 25 222 1677 4481 Unlimited Deep Discharge Battery, 10kHz Stimulation 186043 24700 0 0 No Change 2011-08-01 2019-03-01 Prosthesis ER006 Nevro Spinal Cord Stimulation System (SCSS) - Lead Kit The percutaneous lead is intended to be single use and interfaces with the Implantable Pulse Generator, lead extender OR cable, and lead accessories. Spacing: 1-9mm spacing, 1-9mm in 1mm increments; Length: 30-90cm in 5cm increments ER 25 222 1679 4486 8 electrodes 185992 Changed Benefit 4018 0 0 Update 2011-08-01 2019-03-01 Prosthesis ER007 Nevro Spinal Cord Stimulation System (SCSS) - Lead Extension Kit The lead extender is intended to be used when the implant site for the Implantable Pulse Generator is too far from the stimulation site to directly connect the stimulation lead. Length: 15cm-60cm, in increments of 5cm ER 25 222 1680 185993 Changed Benefit 1434 0 0 Update 2011-08-01 2019-03-01 Prosthesis ET028 Promedon Testicular Prosthesis Silicone Elastomer Small - 31 x 23 mm, Medium - 37 x 28 mm, Large - 42 x 32 mm, Xlarge ET 26 231 1711 136709 620 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ET031 Serenocem Cement Reaction bonded polymer composite formed by the neutralisation gelletation of a basic inorganic ionomer One size only - box of 2 ET 22 196 1567 80933 1482 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ET037 SX-Ella Endovascular Stent Uncovered, self-expanding nitinol stent Dia 6-16mm, length 22-77mm ET 24 206 1622 4440 145499 1710 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ET038 SX-Ella Biliary Stent Uncovered, self-expanding nitinol stent Dia 8-12mm, length 50-77mm ET 21 192 1556 4235 144490 2874 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ET039 SX-Ella Tips Stent Uncovered, self-expanding nitinol stent Dia 10-14mm, length 52-77mm ET 21 192 1556 4234 144490 2114 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ET040 Vox Implants Vox Implants are solid, irregularly textured, medical grade Polydimethylsiloxane Elastomer implants suspended in a hydrogel carrier One size only ET 22 198 1576 146733 7790 0 0 No Change 2005-10-31 2019-03-01 Prosthesis CZ022 VISTHESIA 1.5% VISCOANAESTHETIC syringe contains sodium hyaluronate (NaHA, 1.5%) and lidocaine hydrochloride (1%). Also contains two topical ampoules with NaHA (0.3%) and lidocaine (2%) 0.8ml syringe & 2x0.3ml ampoules CZ 1 142 1329 198088 72 0 0 No Change 2010-08-01 2019-03-01 Prosthesis CZ024 AT LISA toric 909M ZEISS micro incision, multifocal toric IOL (high cyl range). Aspheric toric anterior surface, diffractive bifocal posterior surface with asymmetric light distribution (65% distance / 35% near), 3.75D addition for near focus. 6mm optic, 11mm diameter. Diopter range: Sph -10.0D to +32.0D, Cyl +7.0 to 12.0D (all 0.5D steps) CZ 1 141 1327 3893 at, t2 151348 1235 0 0 No Change 2010-08-01 2019-03-01 Prosthesis CZ025 AT LISA toric 909M ZEISS micro incision, multifocal toric IOL (standard cyl range). Aspheric toric anterior surface, diffractive bifocal posterior surface with asymmetric light distribution (65% distance / 35% near), 3.75D addition for near focus. 6mm optic, 11mm diameter. Diopter range: Sph -10.0D to +32.0D, Cyl +1.0 to 6.5D (all 0.5D steps) CZ 1 141 1327 3893 at, t1 151348 Changed Benefit 986 0 0 Update 2010-08-01 2019-03-01 Prosthesis LH604 OO007 ACS Knee System - TCP coated tibial component Tibial base plate, TCP coated for use with mobile bearing insert, TiN coated Sizes 2-7 LH 17 151 1362 3924 265621 Changed Benefit 2997 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH605 OO012 ACS Knee System - PE patella implant ACS PE patella 26mm, 29mm, 32mm, 35mm LH 17 156 1376 265637 Changed Benefit 537 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH606 OO013 ACS Knee System - Cementless mobile bearing patella ACS Cementless mobile bearing patella 2, 3, 4, 5, 6 LH 17 156 1378 3928 265636 1210 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH607 OO014 ACS Knee System - Cemented mobile bearing patella ACS cemented mobile bearing patella 2, 3, 4, 5, 6 LH 17 156 1377 3927 265638 1210 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH608 OO016 ACS Knee System - ACS SC Revision Femoral component, Cemented Cemented femoral component, Cemented Left/Right Sizes 2/2.5/3/4/5/6 LH 17 149 1348 3908 Revision 265609 5590 0 0 No Change 2018-08-01 2019-03-01 Prosthesis MA528 Affinis Inverse revision stem, cemented Monoblock Revision Humeral Stem 6x180 to 12x230mm MA 13 131 1276 4057 Reverse 224955 6460 0 0 No Change 2012-08-01 2019-03-01 Prosthesis MA529 Affinis Inverse Revision stem, uncemented Monoblock Revision Humeral Stem 6 to 12 x180 to 230mm MA 13 131 1276 4058 Reverse 238292 Changed Benefit 6013 0 0 Update 2012-08-01 2019-03-01 Prosthesis IG165 JJ303 Cranioplastic Kit Cranioplastic cement 30grams IG 23 199 1588 4254 283611 234 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG166 JJ436 Codman Hakim Programmable Valves Programmable valve with reservoir One Size Only IG 25 220 1666 4468 Reservoir/Priming function 140904 149291 Changed Benefit 2252 0 0 Update 2018-08-01 2019-03-01 Prosthesis IG167 JJ437 Codman Hakim Programmable Valves with Siphonguard 18 different pressure settings and SIPHONGUARD technology One Size Only IG 25 220 1666 4468 Antisyphon function, Reservoir/Priming function 140904 Changed Benefit 2727 0 0 Update 2018-08-01 2019-03-01 Prosthesis IG168 JJ440 Codman Hakim Precision Valve, Right Angle Reservoir features 5 operating pressures 10, 40, 70, 100, and 130mmH2O IG 25 220 1666 4469 Reservoir/Priming function 140904 1387 0 0 No Change 2018-08-01 2019-03-01 Prosthesis KA006 Tenckhoff Peritoneal Dialysis Catheter, Curl Adult, 2 cuffs 57 to 62cm 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. KA 24 215 1654 132378 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis KA007 Mahurkar Subclavian Catheter Kit Chronic haemodialysis, long term vascular access for haemodialysis and apheresis. Constructed of radiopaque silicone rubber. 36, 40cm KA 24 214 1651 129836 114 0 0 No Change 2005-10-31 2019-03-01 Prosthesis 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 KA 24 214 1649 129836 107 0 0 No Change 2005-10-31 2019-03-01 Prosthesis KG006 Rayner "Sulcoflex" Aspheric Multi-focal Pseudophakic Secondary IOL Acrylic, Aspheric Multi-focal Pseudophakic Secondary IOL: Sulcus-Fixated with Undulating Haptics and Posterior Haptic Angulation 6.5mm / 13.5mm - 5.00D+5.00D sphere with + 3.00 Addition KG 1 141 1328 3896 at 100926 703 0 0 No Change 2009-08-01 2019-03-01 Prosthesis KG007 Rayner Sulcoflex Aspheric Toric Pseudophakic Secondary IOL (Premium) Acrylic, Aspheric, Toric Pseudophakic Secondary IOL: Sulcus fixated with undulating Haptics and Posterior Haptic Angulation (Premium) SE -7.00 to +7.00 in 0.5 D steps; Cyl +1.00 to +6.00 in 0.5D steps KG 1 141 1328 3895 at, t1 100926 597 0 0 No Change 2009-08-01 2019-03-01 Prosthesis KG008 Rayner "Sulcoflex" Pseudophakic I.O.L. Sulcoflex Aspheric Pseudophakic I.O.L -5D to +5D KG 1 141 1328 3895 at 100926 312 0 0 No Change 2009-08-01 2019-03-01 Prosthesis KG009 Rayner "M-Flex" Mulitfocal Foldable IOL Acrylic, Foldable, Single piece multi-zoned refractive aspheric multifocal with Amon-Apple 360 Degree Square edge, Anti Vaulting Haptics 6.5mm Optic-Overall diameter 12.5mm: +3D or + 4D Addition: +14D to +25D in 1.0D increments: +8.5D to +23.5D in 0.5D increments KG 1 141 1327 3893 at 100926 677 0 0 No Change 2009-08-01 2019-03-01 Prosthesis MA530 Affinis Inverse locking screw Locking Metaglene screw 24x4.0mm to 48x4.0mm MA 13 123 1231 3369 LK 241996 128 0 0 No Change 2012-08-01 2019-03-01 Prosthesis MA531 Affinis Fixation Screw Fixation Screw Long one size only MA 13 131 1278 5428 257052 1159 0 0 No Change 2012-08-01 2019-03-01 Prosthesis MA532 Affinis Inverse inlay Humeral Cup 36+0 to 42+6mm MA 13 131 1276 4069 215500 774 0 0 No Change 2012-08-01 2019-03-01 Prosthesis MA533 Affinis Inverse glenosphere Glenosphere 36 to 42mm MA 13 131 1277 4079 215499 Changed Benefit 2176 0 0 Update 2012-08-01 2019-03-01 Prosthesis MA534 Affinis Inverse Metaglene Metaglene, uncemented. Ti plasma plus CaP coating one size only MA 13 131 1277 4078 215497 1991 0 0 No Change 2012-08-01 2019-03-01 Prosthesis MA535 Affinis Inverse revision metaglene Revision Metaglene, Ti plasma plus CaP Coating one size only MA 13 131 1277 4078 224964 1991 0 0 No Change 2012-08-01 2019-03-01 Prosthesis MA536 Affinis Fracture Inverse Metaphyseal body with Ti plama spray plus CaPcoating- includes humeralcup with CoCr bearing surface 39 to 42 MA 13 131 1276 4060 224971 2451 0 0 No Change 2012-08-01 2019-03-01 Prosthesis KG010 Rayner M-Flex Toric (Standard) Acrylic, Foldable, Single Piece, Multi-zoned Refractive Aspheric Toric Mulitfocal with Amon-Apple enhanced 360 degree Square edge, Anti Vaulting Haptics 5.75mm / 12.0mm: 6.25mm / 12.5mm +3.00D or +4.00D Addition FAR: +14.0D to +32.00D in 0.5 STEPS: +2.00D +3.00D +4.00D Cylinder. NEAR: +14.0D to 27.0D in 0.5 STEPS: +2.00D +3.00D +4.00D Cylinder KG 1 141 1327 3893 at, t1 100926 Changed Benefit 986 0 0 Update 2009-08-01 2019-03-01 Prosthesis KG011 Rayner "M-Flex" Toric (Non Standard) Acrylic, Foldable, Single Piece, Muli-Zoned Refractive, Toric Multifocal with Amon-Apple enhanced 360 Degree square edge, Anti-vaulting Haptics, Patient Specific. 5.75/12.0mm: 6.25/12.5mm +3.00D to +4.00D Addition FAR: +14.0D to +32.0D in 0.5D Increments: NEAR: +14.0D to +27.0D in 0.50D Increments Cylinder: 1.0D to 1.5D and 2.5D to 6.00D in 0.5 increments KG 1 141 1327 3893 at, t1 100926 Changed Benefit 986 0 0 Update 2009-08-01 2019-03-01 Prosthesis LH576 Tracheobronxane Silmet Nitinol wire - tracheal and bronchial stents - Dumon 12 - 20mm diameter, 20 - 90mm length LH 22 198 1571 Nitinol 143612 2375 0 0 No Change 2017-02-01 2019-03-01 Prosthesis HW201 HMRS (Howmedica Modular Replacement System) Fixed Hinged Knee Axle Pin HMRS Fixed Hinged Knee Axle Pin, CrCo, (Vitallium), uncemented, Fixed One size only HW 17 159 1391 128026 651 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW202 Howmedica Modular Resection System Wedge - Vitallium One size only HW 13 123 1778 5416 128026 Changed Benefit 200 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW213 Howmedica Modular Resection System Humeral Bearing - Vitallium One size only HW 13 123 1778 5421 128026 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW214 Howmedica Modular Resection System Humeral Head Fixed - Vitallium One size only HW 13 131 1276 4067 142278 1261 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW216 Howmedica Modular Resection System Distal Humerus Cone - Vitallium One size only HW 13 123 1778 5423 128026 4130 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW217 Howmedica Modular Resection System Distal Humerus Flange - Vitallium One size only HW 13 123 1778 5423 128026 4130 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW218 Howmedica Modular Resection System Humerus Connection Piece - Vitallium One size only HW 13 123 1778 5414 128026 4351 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW219 Howmedica Modular Resection System Humerus Connecting Screw - Vitallium One size only HW 13 123 1778 5417 128026 620 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LH578 Pine Adjustable Cross Link Rod - Rod Connector 30-80mm LH 19 167 1474 4124 274913 Changed Benefit 1299 0 0 Update 2017-08-01 2019-03-01 Prosthesis LH579 CP Stent CP Stent Uncovered 16,22,28,34,39,&45mm length LH 27 257 1804 121892 1296 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LH580 CP Stent CP Stent Covered 16,22,28,34,39,&45mm length LH 27 257 1805 121892 2160 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LH581 CP Stent CP Stent Uncovered, mounted on BIB balloon 16,22,28,34,39,&45mm length LH 27 257 1804 Balloon- in-Balloon 121892 2296 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LH582 CP Stent CP Stent Covered, mounted on BIB balloon 16,22,28,34,39,&45mm length LH 27 257 1805 Balloon-in-Balloon 121892 3160 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LH583 EIT SMART ALIF Cellular Titanium Cage with Graft Hole 8-20mm height LH 19 174 1486 4135 227327 3465 0 0 No Change 2018-02-01 2019-03-01 Prosthesis LH584 EIT SMART ACDF Cellular Titanium Cage with Graft Hole 4-12mm height LH 19 174 1486 4134 227327 2409 0 0 No Change 2018-02-01 2019-03-01 Prosthesis LH585 EIT SMART PLIF Cellular Titanium Cage with Graft Hole 8-16mm LH 19 174 1486 4135 Paired 227327 Changed Benefit 2888 0 0 Update 2018-02-01 2019-03-01 Prosthesis MA538 Affinis Inverse inlay spacer Humeral offset spacer. Supplied with screw +9mm MA 13 131 1278 4084 224412 1159 0 0 No Change 2012-08-01 2019-03-01 Prosthesis MA539 Affinis Inverse Lag Screw Metaglene Lag screw 18x4.5mm to 38 x 4.5 mm MA 13 123 1231 3369 241996 65 0 0 No Change 2012-08-01 2019-03-01 Prosthesis MA541 optimys Stem Ti with Ti Plasma spray and CaP coating 1 to 12, standard and lateral MA 18 161 1407 3952 287920 4394 0 0 No Change 2014-08-01 2019-03-01 Prosthesis MA537 Affinis Inverse head adaptor Adaptor for conversion tohemi prostheses, includes fixation screw One size only MA 13 131 1278 4084 224965 1159 0 0 No Change 2012-08-01 2019-03-01 Prosthesis MA542 Mathys CoCr Femoral Head CoCr Femoral Head 36mm, S to XXL MA 18 162 1420 3995 274272 835 0 0 No Change 2014-08-01 2019-03-01 Prosthesis MA543 Affinis Shoulder System – Humeral Stem Humeral stem and trunion, uncemented, Ti with Ti Plasma Spray and CaP coating 1-6 MA 13 131 1276 4058 215479 3325 0 0 No Change 2015-02-01 2019-03-01 Prosthesis HW221 Howmedica Modular Resection System Humerus Extension Piece - Vitallium 5, 15, 30, 45, 60, 75, 90, 105, 120, 135, 150, 165mm HW 13 123 1778 5412 128026 4173 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW222 Howmedica Modular Resection System Humeral Anchorage Piece - Vitallium 9, 10, 11, 12mm HW 13 123 1778 5411 128026 4539 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW223 Howmedica Modular Resection System Ulna Joint - Vitallium One size only HW 13 131 1275 4055 128026 3594 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW224 Howmedica Modular Resection System Humeral Axis - Vitallium One size only HW 13 131 1275 3678 128026 788 0 0 No Change 2005-10-31 2019-03-01 Prosthesis IG141 Duraseal Dural Sealant DuraSeal is a Synthetic, absorbable, Polyethylene Glycon, hydrogel sealant used as an adjunct to sutured dural repair to achieve watertight closure. 5ml of hydrogel sealant IG 25 219 1662 233618 Changed Benefit 793 0 0 Update 2014-08-01 2019-03-01 Prosthesis HW220 Howmedica Modular Resection System Humerus Hex Socket Bolt - Vitallium One size only HW 13 123 1778 5418 128026 Changed Benefit 537 0 0 Update 2005-10-31 2019-03-01 Prosthesis IG142 DuraSeal Xact Spinal Dural Sealant Xact Dural Sealant for spine. Packaged in sterile single use disposable tray. 3ml IG 25 219 1661 233759 760 0 0 No Change 2014-08-01 2019-03-01 Prosthesis IG143 Silicone Blocks Netterville Phonoform Block - Right, Left, Wedge & Strip Right - One size only, Left - One size only, Wedge - One size only & Strip - One size only IG 22 198 1570 235425 261 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IG144 Katalyst Bipolar Radial Head System - Head Katalyst Bipolar Radial Head System (head and stem) to restore the support and bearing surface of the radial head in fracture, arthritis or failed prior radial head implantation 18mm, 21mm and 24mm IG 13 131 1275 3675 177627 Changed Benefit 1267 0 0 Update 2016-02-01 2019-03-01 Prosthesis IG145 Katalyst Bipolar Radial Head System - Stem Katalyst Bipolar Radial Head System (head and stem) to restore the support and bearing surface of the radial head in fracture, arthritis or failed prior radial head implantation. 6.5mm and 7.5mm IG 13 131 1275 3674 177627 1259 0 0 No Change 2016-02-01 2019-03-01 Prosthesis IG146 JJ130 Aneurysm Clips Stainless steel alloy AVM Micro Clip Blade length 1-5mm IG 25 218 1656 150175 Changed Benefit 257 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH586 EIT SMART TLIF Cellular Titanium Cage with Graft Hole 7-15mm heights LH 19 174 1486 4135 227327 3465 0 0 No Change 2018-02-01 2019-03-01 Prosthesis LH587 Cervical Spine Truss System - Stand Alone Cage Cage and optional locking plate/locking screw cage 6 - 12mm height, screw locking plate 6-12mm height. LH 19 174 1485 5485 252733 Changed Benefit 4379 0 0 Update 2018-02-01 2019-03-01 Prosthesis LH588 Cervical Spine Truss System - Stand Alone Screw Variable head locking screw (3.5-3.85) mm diam x (12-16) mm length LH 19 165 1464 252733 Changed Benefit 193 0 0 Update 2018-02-01 2019-03-01 Prosthesis LH589 Cervical Spine Truss System - Stand Alone Starloc Screw Starloc Screw (3.5-3.85)mm diam x (12-16mm Length LH 19 165 1464 Dual Thread 252733 462 0 0 No Change 2018-02-01 2019-03-01 Prosthesis LH590 Pedicle Screw Polyaxial Screw (5.5 - 7.5)mm x (35-55) mm LH 19 165 1463 288089 To be reimbursed only when used in patients with spinal tumours 1280 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG147 JJ131 Aneurysm Clips Stainless steel Graft Clip (with teflon graft) Blade 2-5mm diameter, 3-7mm length IG 25 218 1655 Complex 150172 359 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG148 JJ134 Aneurysm Clips Stainless Steel clip, various shapes including mini 2-20mm IG 25 218 1655 150097 245 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG149 JJ141 Aneurysm Clips Fenestrated Clips Length 21-25mm IG 25 218 1655 Complex 150097 359 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG150 JJ142 Aneurysm Clips Fenestrated Clips Length 6-21mm IG 25 218 1655 Complex 150097 359 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG151 JJ155 Aneurysm Clips Stainless Steel, various shapes 21-25mm length IG 25 218 1655 150097 245 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG152 JJ157 Hakim Precision Valve System Precision valve standard with reservoir, peritoneal and ventricular catheters Very low to very high including micro IG 25 220 1666 4469 Distal catheter, Proximal catheter, Reservoir/Priming function 149290 Changed Benefit 1701 0 0 Update 2018-08-01 2019-03-01 Prosthesis IG153 JJ158 Hakim Programmable Valve System Valve only One size only IG 25 220 1666 4468 149291 1919 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG155 JJ160 Hakim Catheter Kit with Bactiseal Silicone Silicone antibiotic impregnated catheter kit Kit IG 25 220 1668 Antibiotics, Distal, Proximal 156961 641 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG156 JJ164 Siphonguard CSF Control Device PET shell anti-siphon device for shunt One size only IG 25 220 1669 165962 836 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG154 JJ159 Hakim Programmable Valve System Standard system. Silicone casing with catheter; stainless steel ruby ball in cone mechanism with variable pressure Peritoneal Catheter length 80 cm, Ventricular catheter length 14 cm IG 25 220 1666 4468 Distal catheter, Proximal catheter, Reservoir/Priming function 149291 2565 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG157 JJ218 HOLTER Intracranial Pressure Shunt HOLTER Ventricular Catheter, packaged sterile, silicone rubber 3 - 7cm and 15cm IG 25 220 1668 Proximal 150090 176 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG158 JJ219 Hakim Programmable Valve System Fixed pressure hydrocephalus shunt, packaged sterile, stainless steel and ruby valve mechanism, silicone rubber ventricular and peritoneal catheters. In line or right angled with reservoir. Valve can be reprogrammed non-invasively 18 pressure settings a One size only IG 25 220 1666 4468 Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function 140904 149291 3040 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG159 JJ220 Hakim Precision Valve System Fixed pressure valve with reservoir, siphonguard, ventricular and peritoneal catheters Very low to very high including micro IG 25 220 1666 4469 Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function 149290 1786 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG160 JJ221 Hakim Precision Valve System Fixed pressure hydrocephalus shunt, packaged sterile, stainless steel and ruby valve mechanism, silicone rubber ventricular and peritoneal catheters. In line or right angled with reservoir. Opening pressure H20; Very high 130mm, high 100mm, medium 70mm One size only IG 25 220 1666 4469 Distal catheter, Proximal catheter, Reservoir/Priming function 149290 Changed Benefit 1701 0 0 Update 2018-08-01 2019-03-01 Prosthesis IG161 JJ227 Codman Medos Straight Ventricular Catheter 14cm, packaged sterile, silicone rubber 14cm IG 25 220 1668 Proximal 150085 176 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG162 JJ229 Codman Medos Peritoneal Catheter 85cm, packaged sterile, silicone rubber 85cm IG 25 220 1668 Distal 149295 176 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG163 JJ261 ACCU-FLO Intracranial Pressure shunt ACCU-FLO catheter, packaged sterile, silicone rubber 91cm in length IG 25 220 1668 Distal 150089 176 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG164 JJ263 ACCU-FLO Intracranial Pressure shunt ACCU-FLO barium ventricular catheter, packaged sterile, silicone rubber One size only IG 25 220 1668 Proximal 150088 176 0 0 No Change 2018-08-01 2019-03-01 Prosthesis MA544 balanSys RP Tibial Plateau TiNbN Tibial Baseplate for Mobile Bearing Insert, cemented, CoCr with TiNbN Coating 59mm to 85mm MA 17 151 1359 211086 Changed Benefit 2147 0 0 Update 2015-02-01 2019-03-01 Prosthesis MA545 Ligamys DIS Suture with button UHMWPE braid with Ti alloy button One size MA 13 123 1776 5398 232098 That an Artificial Ligament should only be funded for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available. 4217 0 0 No Change 2017-02-01 2019-03-01 Prosthesis MA546 Ligamys Monoblock Dynamic spring system with clamping cone One size MA 13 123 1774 5394 230046 451 0 0 No Change 2018-02-01 2019-03-01 Prosthesis MA547 Affinis Glenoid cemented vitamys Cemented glenoid - vitamys UHMWPE Sizes 1 - 4 MA 13 131 1277 3701 238288 1895 0 0 No Change 2018-08-01 2019-03-01 Prosthesis MB003 Adjustable Continence Therapy for Women ACT Device: Prosthesis designed for the treatment of female SUI comprising of a single silicone balloon attached via a conduit to titanium and rubber ports allowing for post operative adjustment. 6 - 14cm MB 26 226 1786 5450 163939 3938 0 0 No Change 2010-08-01 2019-03-01 Prosthesis KA011 Permcath Dual Lumen Catheter Chronic Haemodialysis, long term vascular access for haemodialysis and aphaeresis. Constructed of radiopaque silicone rubber. 36cm, 40cm KA 24 214 1651 cu (cuffed) 151056 297 0 0 No Change 2005-10-31 2019-03-01 Prosthesis 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. 10 Fr-12Fr, 13cm-30 cm, Straight/Curved/PreCurved Exten. KA 24 214 1651 178965 180135 114 0 0 No Change 2005-10-31 2019-03-01 Prosthesis KA013 Permcath Dual Lumen Catheter Chronic haemodialysis, long term vascular access for haemodialysis and aphaeresis. Constructed of radiopaque silicone rubber. 28, 36, 40cm KA 24 214 1651 cu (cuffed) 151056 297 0 0 No Change 2005-10-31 2019-03-01 Prosthesis 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 KA 24 214 1651 148909 114 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LH592 Locking Element Locking Element for Screws and Connectors std or 45 degree LH 19 166 1465 288089 To be reimbursed only when used in patients with spinal tumours 164 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH593 Rods, Curved curved and S shaped rods, carbon fiber reinforced polymer 6.0mm x (30-300)mm length LH 19 170 1478 Shaped 288089 To be reimbursed only when used in patients with spinal tumours Changed Benefit 577 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH594 Rods Straight 6mm x (32-300)mm LH 19 170 1478 288089 To be reimbursed only when used in patients with spinal tumours Changed Benefit 426 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH591 Pedicle Screw Cannulated Screw, Carbon Fiber Reinforced Polymer (6.5-7.5)mm x (35-55) mm length LH 19 165 1463 Cannulated 288089 To be reimbursed only when used in patients with spinal tumours 1338 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH595 Aerstent Self Expandable Tracheal and Bronchial Stent Straight or Y, (10-24) mm diameter LH 22 198 1571 Nitinol 297568 2375 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH596 Liquiband Surgical Surgical Adhesive 0.8gm ampoule LH 21 194 1580 4247 Synthetic 151324 45 0 0 No Change 2018-08-01 2019-03-01 Prosthesis MB004 Adjustable Continence Therapy device for women ACT Device: prosthesis designed for the treatment of female SUI comprising of silicone balloons x 2 attached via a conduit to titanium and rubber ports allowing for post operative adjustment. 6 - 14cm MB 26 226 1786 5451 163939 Changed Benefit 7876 0 0 Update 2010-08-01 2019-03-01 Prosthesis MB005 Adjustable Continence Therapy for Men ProACT Device: prosthesis designed for the treatment of male SUI comprising of silicone balloons x2 attached via a conduit to titanium and rubber ports allowing for post operative adjustment. 6 - 14cm MB 26 226 1786 5451 163939 Changed Benefit 7876 0 0 Update 2010-08-01 2019-03-01 Prosthesis MB006 Adjustable Continence Therapy for Men ProACT Device: Prosthesis designed for the treatment of male SUI comprising of a single silicone balloon attached via a conduit to titanium and rubber ports allowing for post operative adjustment. 6 - 14cm MB 26 226 1786 5450 163939 3938 0 0 No Change 2010-08-01 2019-03-01 Prosthesis KA018 Palindrome Haemodialysis catheter 14.5Fr, 15 Fr, 16Fr; 19, 23, 28, 33, 55cm Insertion Lengths, with 36, 40, 45, 50, 72cm Overall length, with side slots, symmetric tip KA 24 214 1651 cu (cuffed) 148910 184449 297 0 0 No Change 2009-02-01 2019-03-01 Prosthesis KA019 Mahurkar Triple Lumen Catheter Mahurkar Triple Lumen Catheter Curved/Straight/Pre-Curved Extension Kit 12Fr, 12.5 Fr; 13cm-30cm KA 24 214 1651 180135 114 0 0 No Change 2009-02-01 2019-03-01 Prosthesis KA020 Mahurkar 13.5Fr Q-Plus Dual Lumen Catheter Mahurkar 13.5Fr Q-Plus Dual Lumen Catheter Kit 13.5 Fr, 13cm-30cm, Straight/Curved/PreCurved Exten. KA 24 214 1651 100496 180135 114 0 0 No Change 2009-02-01 2019-03-01 Prosthesis KG001 Rayner C-Flex Hydrophilic HEMA-MMA copolymer, foldable with injector 5.75mm dia optic, 12.00mm dia overall KG 1 141 1327 3892 100926 265 0 0 No Change 2005-10-31 2019-03-01 Prosthesis KG002 Superflex Hydrophilic HEMA-MMA copolymer, foldable with injector 6.25mm dia optic, 12.5mm dia overall KG 1 141 1327 3892 100926 265 0 0 No Change 2005-10-31 2019-03-01 Prosthesis KG003 Rayner Standard Toric C-Flex Hydrophilic HEMA-MMA copolymer, foldable with injector 5.00mm dia optic, 12.00mm dia overall, cyls 2.0D to 6.0D in 2D increments KG 1 141 1327 3892 t1 100926 Changed Benefit 575 0 0 Update 2005-10-31 2019-03-01 Prosthesis KG004 Rayner Premium Toric C-Flex HEMA-MMA copolymer, foldable with injector 5.75mm dia optic, 12.00mm dia overall, cyls 1.5D to 11.0D in 0.5D increments KG 1 141 1327 3892 t2 100926 Changed Benefit 823 0 0 Update 2005-10-31 2019-03-01 Prosthesis KG005 Rayner Sulcoflex Aspheric Toric Pseudophakic Secondary I.O.L - Standard Acrylic, Aspheric, Toric Pseudophakic Secondary IOL : Sulcus fixated with undulating Haptics and Posterior Haptic Angulation (Standard) SE -3 to +3 in 0.5 D steps Cyl +1 to +3 in 1D steps KG 1 141 1328 3895 at, t1 100926 597 0 0 No Change 2009-08-01 2019-03-01 Prosthesis HW195 HMRS (Howmedica Modular Replacement System) Plug screw Axis HMRS Plug Screw Axis, UHMWPE, (Duration) for fixation of HMRS Axis within HMRS bearing component of HMRS Distal Femur / Proximal Tibia and HMRS Femoral / Tibial Joint. One size only HW 17 159 1398 128026 126 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW196 HMRS (Howmedica Modular Replacement System) Tibial Joint (Baseplate) HMRS Tibial Joint (baseplate) - uncemented, CoCr (Vitallium), porous coated, w/medial & lateral flanges moulde agaibnst tibia w/bar bolt fixation, and metal cHydroxyapatitember for axis of hinge 5553 HW 17 157 1381 3932 128028 Changed Benefit 7247 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW194 Howmedica Modular Resection System Femoral Joint - Vitallium One size only HW 17 157 1380 3931 139145 Changed Benefit 7163 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW199 Howmedica Modular Resection System Circlip - Vitallium One size only HW 13 131 1275 4053 128026 70 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW200 Howmedica Modular Resection System Plug Screw Axis - Vitallium One size only HW 13 123 1778 5419 166620 206 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LH597 LiquiBand Topical Topical Skin Adhesive 0.25g – 0.8g ampoule LH 21 194 1580 4247 Synthetic 151324 Changed Benefit 277 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH598 EIT LLIF System Lateral Lumbar Interbody Cage 8-16mm height LH 19 174 1486 4135 227327 3465 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH599 EIT SMART LLIF system Lateral Lumbar Interbody Cage 8-16mm Height LH 19 174 1486 4135 227327 3465 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH600 OO001 ACS Knee System - Femoral component cemented Cemented resurfacing femoral component for use in knee athroplasty Left/Right 1-7 LH 17 149 1348 3906 265601 2951 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH601 OO002 ACS Knee System - Femoral component porous coated Porous coated resurfacing femoral component Left/Right 1-6 LH 17 149 1351 3914 265596 3309 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH602 OO003 ACS Knee System - Femoral component Ti/TCP coated Tricalcium phosphate coated resurfacing femoral component for use in knee arthroplasty Left/Right 1-6 LH 17 149 1352 3917 265602 3667 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH603 OO004 ACS Knee System - Posterior stabilised femoral component porous coated Posterior stabilised, porous coated, femoral component for use in knee arthroplasty Left/Right 1-6 LH 17 149 1351 3915 265604 3399 0 0 No Change 2018-08-01 2019-03-01 Prosthesis AP004 Mira: Scleral Implants Solid Silicone-Sleeve. Retinal Implant used in Scleral Buckling (Dimethylmethylvinyl Siloxane Copolymer) Sleeves-Mira 70 Sleeve 1mm I.D., Mira 71 Sleeve 1mm I.D., Mira 72 McNutt Sleeve 1.57mm I.D., Mira 270 Sleeve 0.76mm I.D. AP 1 148 1342 143682 43 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AP006 Mira: Scleral Implants Solid Silicone-Band/Strip/Boat/Clip. Retinal Implant used in Scleral Buckling (Dimethylmethylvinyl Siloxane Copolymer) Bands-Mira 40 Circling Band 2mm, Mira 240 Circling Band 2.5mm. Strips-Mira 41 Strip 3.5mm, Mira 42 Strip 4mm, Mira 20 Strip 4mm, Mira 219 Strip 4.5mm, Mira 31 Strip 4.5mm, Mira 32 Strip 5mm, Mira 225 Oval Strip 5mm, Mira 220 Strip 6mm. Boats-Mira 60 Boat 2mm, Mira 260 Boat 2.5mm. Clips-Mira 50 Double Tantalum Clip 2mm, Mira 250 Double Tantalum Clip 2.5mm, Mira 51 Singla Tantalum Clip 3.5mm, Mira 52 Joondeph Single Tantalum Clip 4mm AP 1 148 1342 143682 43 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS001 Endoclip Disposable Loading Unit; MultApplier Disposable loading unit. Single use loading unit with 8 titanium clips; Disposable clip cartridge with 8 titanium clips One size only AS 21 194 1581 4259 65335 60 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS033 Power Stapler and Staples (Powered LDS*) LDS Instrument & Cartridges (Disposable Loading Unit) One size only AS 21 194 1582 4320 149334 342 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI868 Orthopaedic Salvage System Diaphyseal Segment or Diaphyseal Coupler, Stacking Adapter and Locking Screws, Ti Diaphyseal Segment 1-23cm, Diaphyseal coupler 10-30cm BI 17 157 1382 98449 3944 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI871 Vanguard unicondylar Knee System Tibial Component, CoCr UHMWPE (A-E) x (5-8) BI 17 152 1365 98385 1789 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI875 Endo II Head Modular Head - CoCr 41 mm through 61mm BI 18 162 1420 3995 98972 835 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI866 Orthopaedic Salvage System Femoral or Tibial Augment, Ti 'Femoral Sleeve - One Size; OR Femoral Flange - One Size; OR Tibial Block Augment 10-20mm; OR Tibial Augment Sleeve - Small/Large BI 17 157 1385 98451 1912 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI876 Endo II Head Modular Head Taper Insert - CoCr -6mm to +6mm BI 18 164 1442 98972 457 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI877 Freedom 36 mm Modular Head Modular Head 36mm, -6mm to +9mm BI 18 162 1420 3995 98097 835 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS045 PROTACK*; Endoscopic Tacker Device; ENDO UNIVERSAL* Endoscopic; Titanium Surgical Tacker 20 tacks; 30 tacks; 5mm; 4mm, 4.8mm (10 staples). AS 21 194 1582 4331 Endoscopic 139264 402 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS046 Endo GIA Stapling System Endoscopic/thoroscopic 12mm; One size only. AS 21 194 1582 4318 Endoscopic, Articulating/Roticulating 178675 384 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS052 Chemosite Implantable Venous Access System Port - Single Lumen (ChemoSite*) 7-9 french; 10.5 french. AS 21 188 1522 4164 53869 461 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS055 Mesh Polyproplene; Monofilament Polyproplylene. Multifilament Polypropylene; Monofilament Polypropylene. 7.6cm x 12.7cm Surgipro* mesh (3 x 5 inch) AS 21 194 1782 5434 129777 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS056 Mesh Polyproplene; Monofilament Polyproplylene. Multifilament Polypropylene; Monofilament Polypropylene. 35.6cm x 22.9cm Surgipro* mesh (14 x 9 inch). AS 21 194 1782 5437 129777 261 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS057 Mesh Polyproplene; Monofilament Polyproplylene. Multifilament Polypropylene; Monofilament Polypropylene. 2.5cm x 10.2cm Surgipro* mesh (1 x 4 inch) AS 21 194 1782 5434 129777 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS068 Surgipro Non Absorbable Polypropylene Hernia Mate Plug System Polypropylene Medium and Large AS 21 194 1691 129777 Changed Benefit 250 0 0 Update 2005-10-31 2019-03-01 Prosthesis AS074 ENDOCLIP* Titanium Surgical Stapler 10mm (ML, M, L)-(20 clips) AS 21 194 1581 4258 Laparoscopic 149289 381 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI878 Freedom Constrained Liner Constrained Acetabular Liner - UHMWPE, Ti 23mm to 62mm in 1mm increments BI 18 163 1428 4024 98098 1613 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI884 Comprehensive Fracture Stem Fracture Stem Cobalt Chrome, Titanium 4,6,8,10,12,14mm BI 13 131 1276 4057 104347 Changed Benefit 3771 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI885 ROCC Tibial Insert Tibial Insert, mobile bearing, rotating platform, UHMWPE 1-6 (tray size), 10-20mm (bearing size) BI 17 153 1370 104298 Changed Benefit 1073 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI886 Vanguard Total Knee System Femoral Component, CR, uncemented, anatomic, CoCr, Ti 55, 57.5, 60, 62.5, 65, 67.5, 70, 75, 80 Left and Right BI 17 149 1351 3914 98449 3309 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI887 ROCC Femoral Component Femoral Component, uncemented, Titanium plasma sprayed surface (Porous plasma spray PPS) with HA 1-8 BI 17 149 1352 3918 104300 Changed Benefit 3757 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI888 Vanguard Total Knee System Tibial Bearing, CR, curved or lipped, UHMWPE 59, 63/67, 71/75, 79/83, 87/91 widths, 10, 12, 14, 16, 18, 20mm thicknesses BI 17 153 1369 98451 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MB010 Panther Linear Stapler, Panther Linear Cutter Stapler and reloads The PANTHER SSAB surgical stapler and SADB Reloading Staples Unit place two double staggered rows of titanium staples & simultaneously cut and divided tissue between the two double rows. The stapler is available in 60mm, 80mm, and 100mm lengths, and in two staple sizes, 3.8mm and 4.8mm to accommodate various tissue thickness. Each stapler may be reloaded up to 7 times for a total of 8 firings on one patient in one operation. FLSL Linear Stapler/Reloading Unit 30mm 3.5/4.8mm; 45mm 3.5/4.8mm; 60mm 3.5/4.8mm; 90mm 3.5/4.8mm staple height. SSAB Linear Cutter Stapler/Reloading unit 60mm 3.8/4.8mm; 80mm 3.8/4.8mm; 100mm 3.8/4.8mm height MB 21 194 1582 4317 188257 Changed Benefit 226 0 0 Update 2012-08-01 2019-03-01 Prosthesis MB011 Panther Circular Stapler The Panther circular stapler places circular, double staggered rows of titanium staples in the tissue and resects the excess tissue to create a circular anastomosis. The instrument is activated when handle is squeezed firmly. There are five diameters which are able to be deployed form the device - 24mm, 26mm, 29mm, 32mm, or 34mm There are five sizes of the FCLWBE and FCSME: 24mm, dual safety; 26mm, dual safety; 29mm, dual safety; 32mm, dual safety and 34mm, dual safety MB 21 194 1582 4320 Endoscopic, Circular 188257 Changed Benefit 722 0 0 Update 2012-08-01 2019-03-01 Prosthesis MI003 Medtronic DBS Tunneling Tool Accessory Kit DBS Tunneling Tool Accessory Kit One size only MI 25 221 1676 4498 121281 166 0 0 No Change 2011-02-01 2019-03-01 Prosthesis MI029 Medtronic Ascenda Spinal Segment Revision Kit Intrathecal Catheter Spinal Segment Revision Kit One Size MI 25 223 1684 4503 192043 570 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MI030 Medtronic Ascenda Pump Segment Revision Kit Intrathecal Catheter Pump Segment Revision Kit One Size MI 25 223 1684 4503 192044 570 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MI031 Medtronic Activa SC Neurostimulator for Deep Brain Stimulation Single channel neurostimulator for Deep Brain stimulation New or Old Header choice MI 25 221 1672 4472 188034 188274 Changed Benefit 8598 0 0 Update 2012-02-01 2019-03-01 Prosthesis MI032 Medtronic Extension for Deep Brain Stimulation Extension for Deep Brain Stimulation 40cm, 60cm, 95cm MI 25 221 1674 4477 160116 1995 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MI033 Sprint Quattro Secure 6947M Lead Active fixation, true bipolar, dual coil defibrillation leads with silicone backfill and DF-4 connector 45-110cm MI 27 242 1743 e 191092 191093 236884 6480 0 0 No Change 2012-02-01 2019-03-01 Prosthesis AS076 ENDO TA* reloading unit Titanium Surgical Stapler DLU 30mm -2.5, 30mm-3.5 AS 21 194 1582 4317 147670 Changed Benefit 226 0 0 Update 2005-10-31 2019-03-01 Prosthesis AS077 ENDO GIA* Titanium Surgical Stapler 30 - 35mm AS 21 194 1582 4320 Endoscopic 147527 509 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS081 ENDO GIA* reloading unit Titanium Surgical Stapler DLU 30 - 35mm; 45mm; 60mm. AS 21 194 1582 4317 147526 Changed Benefit 226 0 0 Update 2005-10-31 2019-03-01 Prosthesis AS091 VERSA TACK* stapler Titanium Surgical Stapler 4, 4.8mm (10 staples) AS 21 194 1582 4331 138338 252 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS092 ENDO - Herna reloading unit; VERSA TACK* reloading unit. Titanium Surgical Stapler DLU 4mm, 4.8mm (10 staples). AS 21 194 1582 4317 138338 Changed Benefit 226 0 0 Update 2005-10-31 2019-03-01 Prosthesis AS095 STATTACK™ STATTACK™ Titanium Helical Tacker One size only AS 21 194 1582 4331 139264 252 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS110 DFS Disposable Fascia Stapler Stainless Steel One Size Only AS 21 194 1582 4320 129787 342 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS075 ENDO TA* Titanium Surgical Stapler 30mm AS 21 194 1582 4320 Endoscopic 147624 509 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS122 Parietene-Monofilament Polypropylene mesh Parietene-Monofilament Polypropylene standard mesh / light mesh 20 x 20 cm AS 21 194 1782 5435 125428 81 0 0 No Change 2006-11-30 2019-03-01 Prosthesis BI889 Orthopaedic Salvage System Proximal Femoral Component, Letson or Finn, Anatomic, Ti 7cm Left or Right BI 18 161 1410 3965 Body, Tumour 98097 Changed Benefit 4526 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI897 Vanguard Total Knee System Femoral Component, Posterior Stabilised, Cemented, anatomic, CoCr. 55, 57.5, 60, 62.5, 65, 67.5, 70, 75, 80 Left and Right BI 17 149 1348 3907 98449 3041 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI898 Vanguard Total Knee System Femoral Component, CR, Cemented, anatomic, CoCr. 55, 57.5, 60, 62.5, 65, 67.5, 70, 75, 80 Left and Right BI 17 149 1348 3906 SCP 218494 Changed Benefit 2951 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI899 ROCC Patellar Component All poly Patella, cemented, UHMWPE, anatomically shaped 1-8 BI 17 156 1376 226054 Changed Benefit 537 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI900 Vanguard Tibial Baseplate Tibial Baseplate, uncemented, Titanium plasma sprayed surface (Porous plasma spray PPS) with HA for mobile insert 59-91mm BI 17 151 1362 3924 223411 226056 Changed Benefit 2997 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI904 Vanguard Total Knee System Tibial Bearing, PS, PS+. UHMWPE (59 to 91)mm width x (10 to 24)mm thickness BI 17 153 1371 98451 Changed Benefit 1118 0 0 Update 2005-10-31 2019-03-01 Prosthesis AS123 Parietene-Monofilament Polypropylene mesh Parietene-Monofilament Polypropylene standard mesh / light mesh/ X-shaped mesh 30 X 30 cm, 30 x 32 cm AS 21 194 1782 5437 125428 261 0 0 No Change 2006-11-30 2019-03-01 Prosthesis AS124 Parietene-Monofilament Polypropylene mesh Parietene-Monofilament Polypropylene mesh Plug and Patch 06 x 12 cm AS 21 194 1691 125428 Changed Benefit 250 0 0 Update 2006-11-30 2019-03-01 Prosthesis BB313 Aesculap CranioPlate System/ Plate Neuro, Burr hole cover 12 & 16mm Cranial fixation system, internal fracture, non biodegradable. Consists of screws, plates. Plate Neuro, 6 hole x 16 & 20mm Burr hole cover BB 23 199 1589 4271 140600 166 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BB314 Aesculap CranioPlate System/ Screws Neuro Emergency, self tapping, 1.8mm x 3 & 5mm Cranial fixation system, internal fracture, non biodegradable. Consists of screws, plates. Screws Neuro, Emergency, self tapping, magazine of 8, 1.8mm x 3 & 5mm lengths BB 23 199 1590 4323 140600 42 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BB315 Aesculap CranioPlate System/Plate Neuro Cranial fixation system, internal fracture, non biodegradable. Plate Neuro, 65 x 90 mm and 68 x 91mm 0.3mm & 0.6mm Mesh BB 23 199 1585 4209 140600 1146 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BI933 Vanguard SSK Knee System Femoral Component, CoCr, Ti 55 to 80mm BI 17 149 1348 3908 Revision 98449 5590 0 0 No Change 2006-11-30 2019-03-01 Prosthesis BI934 Lactosorb Distraction System Plate, drive screw and distractor, PGA/PLLA, Ti Small, Medium, Large BI 23 202 1603 4399 Single Vector & Resorbable 153694 Changed Benefit 3412 0 0 Update 2006-11-30 2019-03-01 Prosthesis BI939 Vanguard SSK Knee System Tibial Bearing Insert, PSC, UHMWPE 59-75mm x (10-24mm) BI 17 153 1371 98451 Changed Benefit 1118 0 0 Update 2006-11-30 2019-03-01 Prosthesis BI951 Vanguard Total Knee System Femoral Component, Posterior Stabilised, anatomic, Plasma Porous Coated, CoCr & Ti alloy 55-80 BI 17 149 1351 3915 98449 3399 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BI952 Vanguard Total Knee System Femoralor Tibial Augments, anatomic, distal or posterior, Ti alloy 5-15mm x 55-80mm BI 17 159 1390 98449 1148 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BB316 Aesculap CranioPlate System/Screws Neuro, self-drilling, 1.5 x 3, 4 & 5mm Cranial fixation system, internal fracture, non biodegradable. Consists of screws, plates. screws neuro, self drilling, magazine of 8, 1.5mm x 3, 4 & 5 mm lengths BB 23 199 1590 4323 140600 42 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BB317 Aesculap CranioPlate System/ Plate Neuro, 16 hole straight Cranial fixation system, internal fracture, non biodegradable. Consists of screws, plates. Plate Neuro, 16 hole 63mm straight BB 23 199 1589 4277 140600 199 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BB318 Plasmacup Delta 36mm combination plasmacup HA coated shell & Biolox Delta liner 32mm x 44mm - 46mm diameter 36mm x 48mm - 54mm diameter BB 18 163 1429 4030 134535 4587 0 0 No Change 2009-02-01 2019-03-01 Prosthesis BB319 Emotion Total Knee System Femoral Stem Extension Revision nut for Femur Extension Stem One size only BB 17 159 1400 96481 698 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BB320 Emotion Total Knee System Tibial and Femoral Augments Medial/Lateral Tibial, Distal Femoral and Postero-Distal Augments 4mm to 12mm BB 17 159 1390 96481 1148 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BB321 Pneumatic Challenger Multifire Clips Challenger TI-P SM-Ligat. Clips 12 Cartridge (PL574T) Challenger TI-P ML-Ligat. Clips 12 Cartridge (PL579T) small-medium, medium-large BB 21 194 1581 4259 136103 60 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BB322 Aesculap-Miethke PaediGAV/GAV gravitational shunt (with catheter) Single valve, (anti-siphon) gravitational shunt, titanium construction (MRI safe to 3 tesla), with incorporated distal catheter, supplied sterile 23mm long , 4.6mm diameter, 5cmH2O - 40cmH2O, Catheter - di=1.2mm, do=2.5cm, 1200mm long BB 25 220 1667 Antisyphon function 181718 Changed Benefit 1568 0 0 Update 2012-02-01 2019-03-01 Prosthesis BB323 Aesculap-Miethke SHUNTASSISTANT/PAEDI - SHUNTASSISTANTgravitational unit Single valve, anti-siphon gravitational unit to treat standing pressure over drainage in conjunction with existing shunts in children and adults, titanium construction (MRI safe to 3 tesla). 19.5mm long and 23.7mm long , 4.0mm diameter and 4.6mm diameter , 10cmH2O and 15-35cmH2O BB 25 220 1669 181718 836 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BI921 EBI Paediatric Locking Nail System Femoral Locking Nail - titanium; 28 -42cm x 5.5 - 6.5mm BI 13 123 1228 3327 114472 1370 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI922 EBI Paediatric Locking Nail System Screw Pilot Double Thread - titanium; 20 - 68mm x 4.0mm BI 13 123 1229 3341 114472 199 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI923 EBI Paediatric Locking Nail System Nail end cap, titanium 5.5mm - 6.5mm BI 13 123 1229 5363 114472 96 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI924 Lactosorb Resorbable Craniomaxillofacial Fixation System Orbital Floor Plate, 1.5mm System, PGA/PLA Left or right BI 23 200 1598 4367 143958 868 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI920 EZLoc Femoral fixation Device Ligament Anchor, Ti, PE 7-8; 9-10mm x Short, std or long. BI 13 123 1774 5389 117747 374 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI929 RibFix/Sternalock Screws Ti 2.4-2.7mm x 7-20mm BI 13 123 1231 3371 LK 128459 147 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BI930 Sternalock ≤ 6 holes, various shapes ≤ 6 holes BI 13 123 1694 5258 Com, LK 128458 850 0 0 No Change 2006-03-24 2019-03-01 Prosthesis BB324 Aesculap-Miethke GAV/paediGAV gravitational shunt Single valve, anti-siphon gravitational shunt, titanium construction (MRI safe to 3 tesla) 24mm and 27mm long, 4.0mm and 4.6mm diameter, 4cmH2O and 5cmH2O-40cmH2O BB 25 220 1666 4469 Antisyphon function 181718 1140 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BB325 Aesculap-Miethke DualSwitch shunt Non-adjustable valve with preset values for treatment of patients susceptible to complication due to tumour cells or high protein levels. Treats patients in both supine and upright position. Titanium construction MRI compatible to 3 tesla 28mm diameter, 5.7mm profile, 510-50cmH2O pressure setting BB 25 220 1666 4469 181718 Changed Benefit 1054 0 0 Update 2012-02-01 2019-03-01 Prosthesis BB326 Aesculap-Miethke Shunt inline Flushing reservoir Titanium, (MRI safe 3 tesla), radio- opaque with low overall height for easy and safe positioning of ventricular catheter. Allows CSF extraction and drug injection by syringe through silicone dome. Solid Titanium base ensures syringes will not penetrate. Radio-opaque titanium. 14mm diameter,4.8mmheight; 20mm diameter, 5.65mm height. For catheters - id = 1.2mm,od = 2.5mm BB 25 220 1670 181719 356 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BU015 Arcad osteosynthesis memory staples Stainless steel static staples 8 to 10 mm BU 13 123 1773 5514 235764 Changed Benefit 127 0 0 Update 2016-08-01 2019-03-01 Prosthesis BU016 MAGNEZIX Pin and Screw Bioabsorbable bone pin and screw. Diameter 1.5, 2.0, 2.7 and 3.2mm Length 8 - 50mm Diameter 2.0, 2.7 and 3.5mm Length 6 - 40mm BU 13 123 1772 5365 AB 283491 Changed Benefit 265 0 0 Update 2017-02-01 2019-03-01 Prosthesis BU017 MAGNEZIX CS 2.0 Absorbable compression screw. Diameter 2.0mm BU 13 123 1231 3372 CN,DT 283491 357 0 0 No Change 2017-02-01 2019-03-01 Prosthesis BU018 MAGNEZIX CS 2.7 Compression screw for bone fixation. Diameter 2.7mm Length 10 - 34mm BU 13 123 1231 3371 CN,DT 283491 381 0 0 No Change 2017-02-01 2019-03-01 Prosthesis BU019 MAGNEZIX CS 3.2 Compression screw for bone fixation. Diameter 3.2mm Length 10-40mm BU 13 123 1231 3370 CN,DT 283491 379 0 0 No Change 2017-02-01 2019-03-01 Prosthesis BU020 MAGNEZIX CS 4.8 Compression screw for bone fixation. Diameter 4.8mm Length 24 - 70mm BU 13 123 1231 3369 CN,DT 283491 362 0 0 No Change 2017-02-01 2019-03-01 Prosthesis BU021 Memofix Threaded Titanium Suture Anchor Diameter 3mm BU 13 123 1774 5385 288706 Changed Benefit 442 0 0 Update 2018-02-01 2019-03-01 Prosthesis BB327 Aesculap-Miethke Shunt Burr hole port Titanium, (MRI safe 3 tesla), radio-opaque with low overall height for easy and safe positioning of ventricular catheter. Allows CSF extraction and drug injection by syringe through silicone dome. Solid Titanium base ensures syringes will not penetrate, supplied sterile. Radio- opaque titanium. 14mm diameter, 4.8mm height; 20/9.5mm diameter, 5.65mm height. For catheters - id =1.2mm, od =2.5mm BB 25 220 1670 181719 356 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BB328 Miethke Titanium connectors & deflectors Titanium, (MRI safe 3 tesla), deflector allows 90 degree deflection of the ventricular catheter in the burr hole without kinking, adjustable on length of catheter, suture fixture hole Radio-opaque titanium, connector diameter: 1,9mm for use with catheters of id = 1.2mm; of id 1.2mm; od = 2.5mm BB 25 220 1671 4470 181719 36 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BB329 Miethke Peritoneal Catheter Peritoneal catheter, barium impregnated, radio-opaque silicon 2) Peritoneal catheter with integrated barium strip d 1.2mm od =2.5mm; 600,900 1200mm long BB 25 220 1668 Distal 181747 176 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BI865 Orthopaedic Salvage System Femoral Component, Resurfacing or Segmental, CoCr,Ti 30 - 70mm BI 17 157 1380 3931 98449 Changed Benefit 7163 0 0 Update 2005-10-31 2019-03-01 Prosthesis MI004 Medtronic RestoreSensor Implantable Neurostimulator 16 Electrode Rechargeable implantable neurostimulator for pain management with AdaptiveStim 22cm3 MI 25 222 1677 4481 Adaptive Stimulation 177594 22800 0 0 No Change 2011-02-01 2019-03-01 Prosthesis MI005 Medtronic myStim Patient Programmer (Model 37744) Patient programmer for implantable neurostimulator One size only MI 25 222 1678 4483 177036 1425 0 0 No Change 2011-02-01 2019-03-01 Prosthesis MI006 Medtronic External Patient Recharger System Model 37754 Patient recharger system for implantable neurostimulator One size only MI 25 222 1678 4497 121279 1279 0 0 No Change 2011-02-01 2019-03-01 Prosthesis MI007 Hancock II Aortic Valve Aortic bioprosthesis 21mm to 29mm MI 20 179 1499 145757 4750 0 0 No Change 2011-02-01 2019-03-01 Prosthesis MI008 Hancock II Mitral Valve Mitral bioprosthesis 25mm to 33mm MI 20 179 1499 145759 4750 0 0 No Change 2011-02-01 2019-03-01 Prosthesis MI009 Hancock II Ultra Aortic Valve Small aortic root bioprosthesis 21mm to 29mm MI 20 179 1499 145757 4750 0 0 No Change 2011-02-01 2019-03-01 Prosthesis MI010 Maris Plus Peripheral Self-Expanding Stent System Nitinol, self expanding, peripheral stent system Diameter: 6.0-12.0mm; Length: 30-120mm MI 24 206 1622 4440 165614 1710 0 0 No Change 2011-02-01 2019-03-01 Prosthesis MI011 Maris Plus Peripheral Self-Expanding Stent System Nitinol, self expanding, peripheral stent system Diameter: 6.0-12.0mm; Length: 150mm MI 24 206 1622 4441 165614 Changed Benefit 2822 0 0 Update 2011-02-01 2019-03-01 Prosthesis MI012 Consulta CRT-P Cardiac Resynchronisation Therapy Pacemaker, Model C3TR01 One size only MI 27 241 1736 g 174342 9734 0 0 No Change 2011-02-01 2019-03-01 Prosthesis MI013 Attain Ability Plus 4296/ Attain Ability Plus SureScan MRI 4296 Over the wire electrode left ventricular lead 78cm, 88cm MI 27 243 1759 284542 Changed Benefit 4493 0 0 Update 2011-02-01 2019-03-01 Prosthesis MI014 Attain Ability Straight 4396/ Attain Ability Straight 4396 SureScan MRI Over the wire dual left ventricular lead 78cm, 88cm MI 27 243 1759 284519 Changed Benefit 4493 0 0 Update 2011-02-01 2019-03-01 Prosthesis MI018 Reservoir CSF Reservoir, Port, Neonatal, Snap assembly Various MI 25 220 1670 129650 145332 145336 356 0 0 No Change 2011-02-01 2019-03-01 Prosthesis 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) MI 24 211 1643 192541 1995 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MI036 CD HORIZON Fenestrated Screw Fenestrated multi-axial screw Diameter:4.5 - 10.5mm, Length: 30 - 80mm MI 19 165 1463 Cannulated 187126 1338 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MI037 Resolute Integrity Zotarolimus-Eluting Coronary Stent System Cobalt-alloy, ABT-578, BioLinx Polymer Small Vessel - Diameter: 2.25mm-2.75mm; Length: 8.0mm-30.0mm Medium Vessel - Diameter: 3.0mm-4.0mm; Length: 9.0mm-38.0mm MI 27 247 1766 5346 188598 2484 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MI038 Medtronic Neurostimulation Accessories (Wrenches and screws) Accessories for implant of neurostimulation lead One size only MI 25 222 1690 4501 121280 Changed Benefit 160 0 0 Update 2012-02-01 2019-03-01 Prosthesis MI019 Strata Valve with Bioglide Adjustable CSF Valve with five symmetric performance level steps, surface of valve bonded with hydrogel 13-16mm x 35-47mm MI 25 220 1666 4468 Antisyphon function, Coating, Reservoir/Priming function 129681 2831 0 0 No Change 2011-02-01 2019-03-01 Prosthesis MI022 Shunt Component Connector Connectors, fixation tabs Various MI 25 220 1671 4470 128403 128523 134760 95539 36 0 0 No Change 2011-02-01 2019-03-01 Prosthesis MI027 Medtronic Ascenda Intrathecal Catheter Intrathecal Catheter 114cm, 140cm MI 25 223 1683 4492 Reinforced 192057 192058 1045 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MI028 Medtronic Ascenda Component Accessory Kits Accessories for implantable drug pumps The Ascenda Kit consists of single-use aids integral for implanting the Intrathecal Catheter (App 028), which are only suitable for use with the patient in whom the intrathecal catheter is implanted. Kit includes: - Anchor with anchor dispenser - Anchor removal tool - Catheter connector with 2 attached coils. The Ascenda provides better stabilization and reduced catheter dislodgement due to a newly designed anchor and dispensing tool. One size MI 25 223 1684 133523 133763 Changed Benefit 155 0 0 Update 2012-02-01 2019-03-01 Prosthesis MI039 Medtronic Neurostimulation Accessories (Needles) Accessories for implant of neurostimulation lead Various MI 25 222 1690 4501 121280 Changed Benefit 160 0 0 Update 2012-02-01 2019-03-01 Prosthesis AP003 Mira: Scleral Implants Solid Silicone-Tire/Meridional/Wedge/Pad. Retinal Implant used in Scleral Buckling (Dimethylmethylvinyl Siloxane Copolymer) Tires-Mira 286 Wendel Symmetrical Oval Tire 6mm, Mira Symmetrical Oval Tire 7mm, Mira 287WG Murray wide (3.5mm) grooved symmetrical tire, 10mm wide, Mira 288 ross symmetrical grooved tire, low profile 10mm wide by 2.5mm, Mira 289 Symmetrical oval tire 10mm, Mira 277Symmetrical tire 7mm, Mira 279 Symmetrical tire 9mm, Mira 78G Grooved symmetrical tire 10mm, Mira 281 Symmetrical tire 12.5mm, Mira 275 Munsen Asymmetrical tire 6mm, Mira 276 Asymmetrical tire 7mm, Mira 278 Brockhurst asymmetrical tire 8.5mm, Mira 280LG Large grooved asymmetrical tire 10mm, Mira 77G Grooved hemisphere 26mm. Meridional- Mira 106 Meridional Implant 6mm by 10.5mm, Mira 112 Curved Meridional implant 12mm by 12mm, Mira 103 Meridional implant 4mm by 15mm. Wedge- Mira 135 Pruett maxi wedge 14mm, Mira Pruett midi wedge 12mm, Mira 190 Spencer sub-implant 5mm by 10mm. Pad- Mira 80 Pad 4mm by 8mm, Mira 22 Button 5mm by 5mm AP 1 148 1342 143682 43 0 0 No Change 2005-10-31 2019-03-01 Prosthesis CZ043 COMBIVISC COMBIVISC consists of two ophthalmic viscoelastic devices. One prefilled syringe of dispersive viscoelastic 3% (0.85ml) and one prefilled syringe of cohesive viscoleastic 1.5% (1.0ml), along with one 25 gauge Viscoflow cannula and one 27 gauge Viscoflow cannula, that can be used jointly or independently in surgical interventions to remove cataracts and implant a prosthetic lens. COMBIVISC dispersive 3% 0.85ml 25G cannula COMBIVISC cohesive 1.5% 1ml 27G cannula Supplied as a single unit pack, comprising a single syringe of the COMBIVISC Dispersive and a single syringe of the COMBIVISC Cohesive Also supplied as a multipack containing five sealed pouched units CZ 1 142 1329 3897 293592 99 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DD001 Linear Hip Stem Linear Hip Stem Standard or Lateral Offset (reduced neck) Sizes 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 17 and 19 (standard and lateral offsets) DD 18 161 1406 3946 215998 3823 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD002 Turon Shoulder System - Humeral Neck Turon - Humeral Neck Neutral and 7.5 Degree DD 13 131 1276 4076 216043 Changed Benefit 998 0 0 Update 2010-02-01 2019-03-01 Prosthesis CZ038 AT LISA tri toric 939M low cylinder Trifocal (aspheric), bitoric, micro incision, single-piece IOL for capsular bag fixation. The trifocal (anterior) optic provides two diffractive focal points (+3.33D near focus and +1.66D intermediate focus) with asymmetric light distribution 50% distance / 20% intermediate / 30% near vision. Diopter range: -10.00 to + 32.0 DS and +1 to +6.5DC Optic Size: 6.0mm. Overall Length: 11.0mm CZ 1 141 1327 3893 at, t1 151348 Changed Benefit 986 0 0 Update 2013-08-01 2019-03-01 Prosthesis CZ039 AT LISA tri toric 939M high powered cylinder Trifocal (aspheric), bitoric, micro incision, single-piece IOL for capsular bag fixation. The trifocal (anterior) optic provides two diffractive focal points (+3.33D near focus and +1.66D intermediate focus) with asymmetric light distribution 50% distance / 20% intermediate / 30% near vision. Diopter range: -10.00 to + 32.0 DS and +7 to +12 DC Optic Size: 6.0mm. Overall Length: 11.0mm CZ 1 141 1327 3893 at, t2 151348 1235 0 0 No Change 2013-08-01 2019-03-01 Prosthesis CZ040 CT SPHERIS 209M Micro incision, Spherical aberrated, foldable square-edged single-piece intraocular lens for capsular bag fixation. Diopter range :0.00 to + 32.0. Optic Size : 6mm Overall Length : 11mm CZ 1 141 1327 3890 151348 265 0 0 No Change 2015-02-01 2019-03-01 Prosthesis DD018 3D Knee System Femoral Component Femoral Component, uncemented, beaded, CoCr Size 2 to 12 DD 17 149 1351 3914 161909 3309 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD019 3D Knee System Tibial Baseplate Tibial Baseplate, cemented, CoCr Size 1 to 12 DD 17 151 1357 161909 1923 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD020 3D Knee System Tibial Baseplate Tibial Baseplate, uncemented, beaded, CoCr and Titanium Size 1 to 12 DD 17 151 1360 161909 2058 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD021 3D Knee System Tibial Insert Tibial insert, UHMWPE, fixed with lateral pivot with locking screw Size 1 to 12, 9mm to 19mm DD 17 153 1369 161909 1019 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD022 3D Knee System Patellar component All poly, cemented patella, 3 pegs Size 26 to 38mm DD 17 156 1376 161909 Changed Benefit 537 0 0 Update 2010-02-01 2019-03-01 Prosthesis DD023 FMP Acetabular Shell Titanium, non HA, beaded, variable screw holes 42-80mm DD 18 163 1426 4011 210540 210541 210542 2204 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD025 FMP Acetabular Screws Titanium, cancellous screws 25mm to 50mm DD 18 164 1435 161911 121 0 0 No Change 2010-02-01 2019-03-01 Prosthesis ER011 K2M Spinal Systems Axial connectors, in-line, parallel, open and closed face 3.5 – 6.5mm rods ER 19 167 1472 154442 159828 Changed Benefit 732 0 0 Update 2011-08-01 2019-03-01 Prosthesis ER013 K2M Spinal Systems Lumbar Thoracic or Cervical Hooks; open or closed Various blade and throat sizes ER 19 168 1475 154442 159828 789 0 0 No Change 2011-08-01 2019-03-01 Prosthesis ER014 Denali Spinal System / Polyaxial Pedicle Screw Polyaxial Pedicle Screw Diameter: 3.5 - 8.5mm, Length: 10 - 100mm ER 19 165 1463 154443 1280 0 0 No Change 2011-08-01 2019-03-01 Prosthesis ER016 Pyrenees Cervical Plate System - Screw Self-drilling, self-tapping and bone reduction screws (3.5 - 4.7)mm diam x (10-20)mm length ER 19 165 1464 Dual Thread 154444 462 0 0 No Change 2011-08-01 2019-03-01 Prosthesis ER017 Mesa Spinal System / Polyaxial Pedicle Screw Polyaxial Pedicle Screw, Titanium (3.5 - 12.5)mm diam, lengths (10-110)mm ER 19 165 1463 Integrated Locking Mechanism 154442 1444 0 0 No Change 2011-08-01 2019-03-01 Prosthesis ER018 Mesa/Denali/Everest Rod Straight and Contoured, CoCr, Ti Rods Length: 25mm - 600 mm; Diameter: 3.5mm - 6.5 mm ER 19 170 1478 154442 Changed Benefit 426 0 0 Update 2011-08-01 2019-03-01 Prosthesis ER019 K2M Spinal Systems Transverse Connector 3.5 – 5.5mm rod /rail diameter 14 - 93mm width ER 19 167 1474 4124 154442 Changed Benefit 1299 0 0 Update 2011-08-01 2019-03-01 Prosthesis EU011 Europ standard & Postero cemented Patella Europ Standard & Postero Cemented Patella Diameters 25,29,32,35mm EU 17 156 1376 171851 Changed Benefit 537 0 0 Update 2012-02-01 2019-03-01 Prosthesis EU012 Europ knee cancellous screw Knee cancellous screws diameter: 6.5mm lengths 25,30,35,40,45,50mm EU 17 159 1398 171851 126 0 0 No Change 2012-08-01 2019-03-01 Prosthesis ET083 Full-Thickness Resection Device (FTRD) The FTRD System Set is used for diagnostic and therapeutic full-thickness resection via flexible endoscopy in the colon and rectum. The FTRD System Set is designed to ensure that the transection of tissue happens only after the defect has been completely closed. The FTRD clip is and 11mm nitinol clip. Also supplied with the FTRD marking probe (220cm) and FTRD Grasper (220cm). ET 21 194 1581 4258 Endoscopic, OTS 235539 2775 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER035 Caspian OC screw The Caspian OC screw is used to fixate the Caspian OC plate to the occiput 4.5mm diameter. 6-16mm length in 1mm increments 5.25mm diameter. 6-16mm length in 1mm increments ER 19 165 1464 Dual Thread 159828 462 0 0 No Change 2011-08-01 2019-03-01 Prosthesis ER036 Nevro Spinal Cord Stimulation System (SCSS) - Coiled Lead Blank Kit The Coiled Lead Blank made out of stainless steel is optionally used during surgery to clear a path for the introduction of the SCS Lead into the epidural space. The coiled lead blank is a tool used to help clear obstructions within the cannula of the insertion needle and may be used by the physician to verify access to the epidural space. N/A ER 25 222 1690 4501 181179 Changed Benefit 160 0 0 Update 2012-02-01 2019-03-01 Prosthesis ER037 Nevro Spinal Cord Stimulation System (SCSS) - Insertion Needle Kit The Insertion Needle is used during implant surgery to introduce the Lead between the vetebra into the epidural space. The insertion needle is a two part needle that contains a cannula and stylet to facilitate access to the spinal canal for lead placement Length: 5-15cm, in increments of 1cm ER 25 222 1690 4501 180426 Changed Benefit 160 0 0 Update 2012-02-01 2019-03-01 Prosthesis EU014 Europ standard Polyethylene (UHMW) insert Knee insert SMALL (thickness: 7,9,11,13,15mm) MEDIUM (thickness: 7,9,11,13,15mm) LARGE (thickness: 7,9,11,13,15mm) EU 17 153 1369 171851 1019 0 0 No Change 2012-08-01 2019-03-01 Prosthesis HW227 HMRS (Howmedica Modular Replacement System) Rotating Hinge Distal Femur Component HMRS Rotating Hinge Distal Femur, CoCr (Vitallium) uncemented, porous coated, Fixed 120, 140, 160mm HW 17 157 1380 3931 139145 Changed Benefit 7163 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW228 HMRS (Howmedica Modular Replacement System) Rotating Hinge Axle HMRS Rotating Hinge Axle - uncemented, CoCr (Vitallium) One size only HW 17 159 1393 128026 3089 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW229 HMRS (Howmedica Modular Replacement System) Rotating Hinge Femoral Bushing HMRS Rotating Hinge Femoral Bushing - UHMWPE, (Duration) One size only HW 17 159 1393 242298 3089 0 0 No Change 2005-10-31 2019-03-01 Prosthesis EU013 Europ standard cemented condyle Knee cemented condyle 1 to 6, right and left EU 17 149 1348 3906 171851 2951 0 0 No Change 2012-08-01 2019-03-01 Prosthesis DO002 S.M.A.R.T. Flex Vascular Stent System A fully connected, laser cut nitinol stent 5-8mm diameter, 30-120mm length DO 24 206 1622 4440 223910 1710 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DO003 PALMAZ® BLUE™ .018 Peripheral Stent System L605 Cobalt Chromium Alloy Balloon Expandable Stent 12, 15, 18, 24mm length 4, 5, 6, 7mm diameter DO 24 206 1622 4439 187122 1710 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DO004 S.M.A.R.T. Flex Vascular Stent System A fully connected, laser cut nitinol stent 5-8mm diameter, 150-200mm length DO 24 206 1622 4441 223910 Changed Benefit 2822 0 0 Update 2017-02-01 2019-03-01 Prosthesis DO005 BioMatrix Flex Drug Eluting Coronary Stent System Coronary Artery Stent, Drug Eluting (8 - 38)mm length x (2.25 - 4.0)mm diameter DO 27 247 1766 5346 216541 2484 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DO006 InCraft AAA Stent-Graft System - Aortic Bifurcate Bifurcated main body 22-34mm diameter, 86-94mm length DO 24 207 1628 4446 231895 5504 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ET074 ATOMS System The ATOMS System is a long term, adjustable prostheses that substitutes urinary sphincter function in incontinent males. It is a hydraulic system comprising of a suburethral sphincter cushion/cuff which can be adjusted hydraulically intra-operatively or post-operatively through an implanted titanium port. Fixation arms and attachment sutures hold the implant in situ. 1 size only - ATS 5011 (Length of Implant 560mm, width of tape 12mm, dimensions of cushion 40x45mm, max. filling volume of cushion 25mL). Titanium port-reservoir with hydraulic tubing, one size. ET 26 226 1786 5451 154803 Changed Benefit 7876 0 0 Update 2014-02-01 2019-03-01 Prosthesis ET075 AMI ATOMS Infusion Port Hydraulic Infusion port for use with AMI ATOMS System - seperate 22mm Diameter, 9.8mm High ET 26 226 1786 5987 148776 950 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ET076 Triune Vent Tube A tympanostomy (myringotomy) tube Lumen size 0.76mm - 1.35mm ET 22 196 1566 170820 19 0 0 No Change 2015-02-01 2019-03-01 Prosthesis ET077 ELLA BD Stent The ELLA BD Stent is a self-expanding biodegradable stent made of polydiaxanone designed to slowly degrade when in contact with living tissue. Full degradation of stent occurs within 11-12 weeks of implantation. It is designed for dilation and treatment of benign oesophageal lesions. Stent body diameters=20mm-25mm; Stent flares diameters=25mm-31mm; Stent nominal length=60/80/100/135mm ET 21 192 1558 6025 232514 4750 0 0 No Change 2015-08-01 2019-03-01 Prosthesis DD027 R120 Uncemented Femoral Stem Femoral Stem porous/HA coated, Modular, CrCo, standard lengths Size 1 to 6 DD 18 161 1406 3945 Removable Neck 161911 3401 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DH005 Ankylos C/X Implants Screw implant with cover screw (included) and pre-mounted placement head Diameter range 3.5 - 7.0 mm, Length 8-17mm DH 23 201 1602 4392 212688 351 0 0 No Change 2014-08-01 2019-03-01 Prosthesis DH006 Ankylos Temporary Abutments Temporary and healing abutments Diameter 3.3mm - 7mm DH 23 201 1600 4386 212101 Changed Benefit 68 0 0 Update 2014-08-01 2019-03-01 Prosthesis DH007 Ankylos Permanent Abutments Permanent Abutments Diameter range: 3.3mm - 5.7mm, height range: 7.5mm - 11.1mm DH 23 201 1600 4385 224096 171 0 0 No Change 2014-08-01 2019-03-01 Prosthesis DH008 XiVE and Friadent Abutments, Locators Permanent Abutments Diameter (mm): 3.0 – 5.5 Gingiva height (mm): 1 - 5 Angulation: 0 - 15 degrees DH 23 201 1600 4386 125836 191874 224096 Changed Benefit 68 0 0 Update 2017-08-01 2019-03-01 Prosthesis DD026 R120 Cemented Femoral Stem CoCr, unpolished, tapered, collared, separate neck Size 1 to 6 DD 18 161 1404 3939 Removable Neck 161911 Changed Benefit 1625 0 0 Update 2010-02-01 2019-03-01 Prosthesis DH009 XiVE Implants Dental implants, Endosseous Diameter (mm): 3.0 - 5.5 Length (mm): 8 - 18 DH 23 201 1602 4392 212688 285989 351 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BS359 IntellaMap™ Orion High Resolution Mapping Catheter High resolution 64-electrode steerable mapping catheter 8.5F, 115cm BS 27 290 2946 7349 Boston Scientific 271032 New Listing 2700 0 0 Insert 2019-03-01 2019-03-01 Prosthesis BS360 Rhythmia™ Location Reference Patch Kit Rhythmia™ Location Reference Patch Kit (Box of 1) 50mm diameter BS 27 290 2946 7350 Boston Scientific 282996 New Listing 299 0 0 Insert 2019-03-01 2019-03-01 Prosthesis BS361 IntellaNav™ MiFi™ Open-Irrigated Ablation Catheter IntellaNav™ Open-Irrigated, MiFi™ Mini-electrode Technology, Nav-abled 110cm, shaft size 7.5F BS 27 290 2946 7349 Boston Scientific 300198 New Listing 2700 0 0 Insert 2019-03-01 2019-03-01 Prosthesis MN240 LASSO/ PENTARAY Circular/High Density Various MN 27 290 2946 7351 Johnson and Johnson 121901 122187 145997 203362 231772 278955 278956 New Listing 2200 0 0 Insert 2019-03-01 2019-03-01 Prosthesis MN239 CARTO Reference External Reference One size only MN 27 290 2946 7350 Johnson and Johnson 157549 New Listing 499 0 0 Insert 2019-03-01 2019-03-01 Prosthesis ER020 Aleutian PLIF Posterior lumbar spacer, PEEK (22-28)mm long x (8.5-10)mm wide x (4-17)mm high x (0-18) degree lordosis ER 19 174 1486 4135 Paired 159146 Changed Benefit 2888 0 0 Update 2011-08-01 2019-03-01 Prosthesis ER021 Aleutian Anterior Anterior/lateral lumbar interbody spacer (30-60)mm wide x (18-28)mm long x (8-21)mm height ER 19 174 1486 4135 159146 3465 0 0 No Change 2011-08-01 2019-03-01 Prosthesis ER022 Aleutian TLIF Transforaminal lumbar interbody spacer (8.5-12)mm wide x (22-36)mm long x (4-17)mm height x (6-18) degree lordotic angle ER 19 174 1486 4135 159146 3465 0 0 No Change 2011-08-01 2019-03-01 Prosthesis ER023 Cayman Thoracolumbar Plate System / Bone Screw Self tapping screw, Ti Length: 20mm to 60mm Diameter: 5mm and 7mm, titanium ER 19 165 1464 Dual Thread 159150 462 0 0 No Change 2011-08-01 2019-03-01 Prosthesis ER024 Cayman Thoracolumbar Plate System / Plate Thoracolumbar Plate, Titanium 21mm to 109mm ER 19 169 1476 4126 159150 Changed Benefit 2118 0 0 Update 2011-08-01 2019-03-01 Prosthesis ER025 Denali cannulated polyaxial screw Cannulated polyaxial pedicle screw Diameter: 5.5mm, 6.5mm and 7.5mm Length: 35 to 55mm ER 19 165 1463 Cannulated 154442 1338 0 0 No Change 2011-08-01 2019-03-01 Prosthesis DO007 Palmaz Genesis Peripheral Stent on Opta Pro (Large) Stainless steel balloon expandable stent mounted on an Opta Pro Balloon. Diameter 4-12mm, length 11-79mm DO 24 206 1622 4439 188675 1710 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DO008 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 DO 24 211 1643 116900 1995 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DO009 Mynx Vascular Closure Device Water-soluble synthetic sealant made of a polyethylene glycol (PEG) The sealant is resorbed by the body within 30 days 5F, 6/7F DO 24 212 1644 201265 369 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DO010 Precise Pro Rx Nitinol Stent System Nitinol self expanding stent Diameter: 5, 6, 7, 8, 9, 10mm; Length: 20, 30, 40mm DO 24 206 1622 4440 149399 1710 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DO011 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 DO 24 206 1622 4440 151010 1710 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DO012 EXOSEAL (TM) Vascular Closure Device Vascular Closure Device 5 - 7F DO 24 212 1644 176723 369 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ET081 A.M.I. B-Band Adjustable gastric banding implant for stabilising the gastroenterostomy stoma. The A.M.I B-Band is a soft gastric bypass band which serves as a restrictive component in gastric bypass surgery. Restriction is achieved by placing the device around the remaining stomach pouch in order to prevent long term dilation of the gastrojejunostomy and to ensure a controlled emptying of the stomach pouch. Adjustable band length: 4.0cm - 7.5cm. Band height: 10mm ET 21 190 1781 96737 Changed Benefit 2328 0 0 Update 2016-02-01 2019-03-01 Prosthesis ET082 PureRegen Gel Sinus PureRegen Gel Sinus is a gel adhesion barrier comprised of a hyaluronic acid based hydrogel. The product does not contain any medicinal, human or animal components. It is removed from the application site by natural elimination. 2ml, 5ml, 6ml, 8ml, 10ml, 20ml. ET 21 194 1579 5433 Sinus 264407 119 0 0 No Change 2016-08-01 2019-03-01 Prosthesis DH010 XiVE, Friadent, Healing, Gingiva cover screws Cover Screws Diameter (mm): 3.0 - 6.5 Gingiva height (mm): 1 - 6 DH 23 201 1600 4387 125837 212101 51 0 0 No Change 2017-08-01 2019-03-01 Prosthesis DL001 iVolution Self-expanding nitinol stent system Diameters: 5-10mm Lengths: 40-100mm Catheter Length: 80-140cm DL 24 206 1622 4440 281201 1710 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DL002 iVolution ≥150mm Self-expanding nitinol stent system Diameters: 5-8mm Lengths: 150-200mm Catheter Length: 80-140cm DL 24 206 1622 4441 Changed Benefit 2822 0 0 Update 2017-02-01 2019-03-01 Prosthesis DL003 MB026 WIRION Embolic Protection System Temporary arterial embolic protection system Blood vessel diameter: 3.5 - 6.0mm Filter unit length: 22.5mm Pore size: 120μ Crossing profile: 3.2F Guide catheter/Sheath: 6F Delivery catheter length: 145cm Retrieval catheter length: 146cm DL 24 211 1643 280883 1995 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DO001 BioFreedom Drug Coated Coronary Stent System Coronary Artery Stent, Drug Coated Diameter: 2.25mm to 4.0mm Length: 8mm to 36mm DO 27 247 1766 5346 280282 2484 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DO013 SMART Nitinol Stent System Long 150mm stent, 6F compatible 6-8mm diameter, 150mm length, 120cm delivery system DO 24 206 1622 4441 151011 Changed Benefit 2822 0 0 Update 2017-02-01 2019-03-01 Prosthesis DO014 InCraft AAA Stent-Graft System - Iliac Limb/Extension Contralateral/Ipsilateral lliac limbs and extensions 10-24mm diameter, 80-140mm length DO 24 207 1632 231895 3143 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DO015 SMART Nitinol Stent System Long 120mm Stent, 6F compatible 6-8mm diameter, 120mm stent length, 120cm delivery system DO 24 206 1622 4440 151011 1710 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DO016 Palmaz Genesis Peripheral Stent on Opta Pro (Medium) Stainless steel balloon expandable stent mounted on an Opta Pro Balloon Diameter 4-8mm, length 12-39mm DO 24 206 1622 4439 188675 1710 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DO017 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 30mm DO 24 211 1642 186230 2231 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER027 Caspian OCT Spinal System - Rod cervico-thoracic posterior rigid fixation system - Rod Diameter: 3.5mm Length: 1.80mm - 240mm ER 19 170 1478 159828 Changed Benefit 426 0 0 Update 2011-08-01 2019-03-01 Prosthesis ER030 Pyrenees Cervical Plate System Cervical Plate 18mm to 54mm ER 19 169 1476 4125 154444 Changed Benefit 1348 0 0 Update 2011-08-01 2019-03-01 Prosthesis ER031 Pyrenees Cervical Plate System Cervical Plate 57mm to 110mm ER 19 169 1476 4125 >55mm 154444 1636 0 0 No Change 2011-08-01 2019-03-01 Prosthesis ER032 ARI Anterior Staple System - Staple A non-cervical anterolateral thoracolumbar screw stabilization as an adjunct to fusion. Single Hole Design and Dual Hole Design: 13mm, Left & Right; 16mm, Left & Right; 18mm, Left & Right. ER 19 172 1483 154442 395 0 0 No Change 2011-08-01 2019-03-01 Prosthesis ER033 ARI Anterior Staple System - Washer The ARI Anterior Staple System - washer One size only ER 19 172 1482 154442 226 0 0 No Change 2011-08-01 2019-03-01 Prosthesis ER034 K2M Spinal Systems- Occipital Plate Occipital Plate for posterior occipital/cervical/thoracic fixation 24-50mm ER 19 169 1477 4129 159828 Changed Benefit 2166 0 0 Update 2011-08-01 2019-03-01 Prosthesis DO018 Palmaz Blue .014 Renal Stent System (on Aviator Plus) CoCr balloon expandable stent 12, 15, 18, 24mm Lengths 40, 50, 60, 70mm diameters 80, 142cm shaft lengths DO 24 206 1622 4439 190149 1710 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DO019 Incraft AAA Stent Graft System - Aortic Extension Aortic Extension Aortic Extension Diameter (mm): 22, 26, 30, 34 DO 24 207 1631 4448 231895 2427 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER008 Nevro Spinal Cord Stimulation System (SCSS) - Charger Kit The Charger is a battery powered rechargeable device intended to recharge the Implantable Pulse Generator (IPG) battery transcutaneously N/A ER 25 222 1678 4497 181182 1279 0 0 No Change 2011-08-01 2019-03-01 Prosthesis ER009 Nevro Spinal Cord Stimulation System (SCSS) - Patient Remote Kit The patient remote control is a handheld, battery operated unit able to communicate via radiofrequency (RF) with the Implantable Pulse Generator and trial stimulator N/A ER 25 222 1678 4485 185994 1330 0 0 No Change 2011-08-01 2019-03-01 Prosthesis ER010 K2M Spinal Systems Offset connectors, Open or Closed Length: 10mm - 100mm, Degree connector angle: -15 - +15 ER 19 167 1473 154442 159828 Changed Benefit 732 0 0 Update 2011-08-01 2019-03-01 Prosthesis BU022 Memofix Threaded Titanium Suture Anchor Diameter 4mm to 5mm BU 13 123 1774 5387 288706 Changed Benefit 442 0 0 Update 2018-02-01 2019-03-01 Prosthesis BU023 Airlock Plating System Airlock Plating System None Plates 2 - 6 Holes BU 13 123 1694 5258 LK 235766 470 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BV001 Evolution Medial Pivot Knee System Cemented, grit blasted, prosterior stabilised, femoral component 1-8 Left, Right BV 17 149 1348 3907 259355 3041 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV002 Evolution Medial Pivot Knee System Tibial component, CoCr, cemented 1-8 Standard, Plus Left, Right BV 17 151 1357 234319 1923 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV003 Evolution Medial Pivot Knee System Cemented, grit blasted, minimally stabilised, femoral component 1-8 Left, Right BV 17 149 1348 3906 225086 2951 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV004 Evolution Medial Pivot Knee System Minimally stabilised, fixed, tibial insert, UHMWPE 1-8 Standard, Plus Left, Right 10-24mm BV 17 153 1369 234318 1019 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV005 Evolution Medial Pivot Knee System Posterior stabilised, fixed tibial insert, UHMWPE 1-8 Standard, Plus Left, Right 10-24mm BV 17 153 1370 259432 Changed Benefit 1073 0 0 Update 2016-08-01 2019-03-01 Prosthesis BV008 Advance Medial Pivot Knee System Stemmed condular medial pivot component, cemented, grit blasted, minimally stabilised, femoral component, CoCr, usually used with a anterior lipped insert 1, 2, 3, 4, 5 All in Left & Right BV 17 149 1348 3906 Revision 236060 5411 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV009 Advance Medial Pivot Knee System Cemented, grit blasted, totally constrained, femoral component, CoCr 1, 2, 3, 4, 5 BV 17 149 1348 3908 Revision 220420 5590 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV010 Advance Medial Pivot Knee System totally constrained, UHMWPE, fixed tibial insert with reinforcing peg 1, 2, 3, 4, 5, 6 in 10 - 30mm in 2mm increments BV 17 153 1371 238894 Changed Benefit 1118 0 0 Update 2016-08-01 2019-03-01 Prosthesis BV006 Advance Medial Pivot Knee System Revision tibial component, titanium, cemented with offset stem 1, 1+, 2, 2+, 3, 3+, 4, 4+, 5, 5+ in Left & Right BV 17 151 1357 Revision 278300 3265 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV011 Advance Medial Pivot Knee System All Poly Patella, Recessed, Onlay, Tri-Peg, Low-Dome, High-Dome 25-41mm BV 17 156 1376 278303 278304 Changed Benefit 537 0 0 Update 2016-08-01 2019-03-01 Prosthesis BV015 Advance Medial Pivot Knee System Revision tibial component, titanium, cemented 0+, 1, 1+, 2, 2+, 3, 3+, 4, 4+, 5, 5+, 6 BV 17 151 1357 Revision 238912 3265 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV017 Cancellous Bone Screw Option bone screw for tibial component 6.5mm x 1.5 - 6cm in 0.5cm increments long BV 17 159 1398 247558 126 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV018 Advance Medial Pivot Knee System Tibial component, CoCr, cemented 1-6 Standard, Plus BV 17 151 1357 237079 1923 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV019 Advance Medial Pivot Knee system Posterior stabilised, fixed tibial insert, UHMWPE 1-6 10-25mm BV 17 153 1370 238893 Changed Benefit 1073 0 0 Update 2016-08-01 2019-03-01 Prosthesis BV020 Advance Medial Pivot Knee System Minimally stabilised, fixed, tibial insert, UHMWPE 0-6 Left, Right 10-25mm BV 17 153 1369 278296 278297 1019 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV021 Advance Medial Pivot Knee System Cemented, grit blasted, minimally stabilised, femoral component 1, 2, 3, 4, 5, 6, 7 & 8 BV 17 149 1348 3906 278299 2951 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV022 Advance Medial Pivot Knee System Uncemented, beaded, non HA, CoCr, usually used with a anterior lipped insert 1, 2, 3, 4, 5, 6 BV 17 149 1351 3914 236923 3309 0 0 No Change 2016-08-01 2019-03-01 Prosthesis DD005 Turon Shoulder System - Humeral Stems Turon Humeral Stem, Primary and Revision 6-16mm x 115mm and 6-16mm x 200mm DD 13 131 1276 4057 210938 215958 Changed Benefit 3771 0 0 Update 2010-02-01 2019-03-01 Prosthesis DD003 Turon Shoulder System - Humeral Head Turon Standard Humeral Head, Standard and Offset 38-54mm x 14-26mm DD 13 131 1276 4067 215957 1261 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD006 Foundation Hip System 450, 460 Foundation Non-porous, cemented Stem 8, 9, 10.5, 12, 13.5, 15, and 16.5 DD 18 161 1404 3939 161911 Changed Benefit 1625 0 0 Update 2010-02-01 2019-03-01 Prosthesis DD004 Turon Shoulder System - All-Poly Glenoid Turon - All-Poly Glenoid, Keeled and Pegged 38mm, 42mm, 46mm, 50mm, 54mm DD 13 131 1277 3701 210954 210955 1895 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD007 Foundation Hip System, 440, 470, 480 Foundation Porous, Press Fit, fracture Stem with or without collar 8, 9, 10.5, 12, 13.5, 15, 16.5, 18.0 DD 18 161 1406 3945 161911 3401 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD017 3D Knee System Femoral Component Femoral Component, cemented, CoCr Size 2 to 12 DD 17 149 1348 3906 161909 2951 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BV023 Advance Medial Pivot Knee System Tibial component, beaded, titanium 0-6 Standard, Plus BV 17 151 1360 Revision 278306 3399 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV024 Profemur Hip System Primary stem, tapered wedge, plasma coated 1-12 Standard, Extended BV 18 161 1406 3948 224478 240572 3954 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV025 Dynasty Acetabular System /poly liner A-Class Crosslinked Liner STD, Lipped 28-36mm B-K BV 18 163 1428 4021 272312 272313 1019 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV026 Procotyl L System /poly liner Rim-Lock A-Class Crosslinked Liners Standard, Lipped 28-36mm B-G BV 18 163 1428 4021 265521 265522 1019 0 0 No Change 2016-08-01 2019-03-01 Prosthesis CZ037 CT ASPHINA 509MP Preloaded, micro incision, aspheric (aberration correcting), foldable square-edged single-piece intraocular lens for capsular bag fixation Diopter range: 0.0 to + 32.0D; Optic Size: 6.0mm; Overall length: 11.0mm CZ 1 141 1327 3890 at, pl 134490 308 0 0 No Change 2013-02-01 2019-03-01 Prosthesis CZ041 CT LUCIA 202 Foldable, 3-piece, monofocal, square-edged, hydrophobic acrylic intraocular lens. Diopter size: 4.0 to 34.0 DS. Optic size: 6mm. Overall length: 13mm CZ 1 141 1327 3892 151348 Changed Product name 265 0 0 Update 2016-08-01 2019-03-01 Prosthesis CZ042 AT LARA 829MP Extended depth of focus (EDoF), micro incision, single-piece IOL for capsular bag fixation, implantable with preloaded injector system, aberration neutral aspheric optical design Diopter range: -10.0 D to +32.0 D, 0.5 increments Optic size: 6mm Overall length: 11mm CZ 1 141 1327 3893 at, pl 151348 Changed Benefit 694 0 0 Update 2017-08-01 2019-03-01 Prosthesis IQ008 Octane & Decalin Perfluorocarbon retinal tamponade medium, intraoperative 5ml & 7ml, Sterile IQ 1 148 1346 152235 228 0 0 No Change 2009-02-01 2019-03-01 Prosthesis KG012 Rayner "C-Flex" and Superflex" Aspheric IOL Aspheric Intra Ocular Lenses with Amon-Apple enhanced 360 Degree square edge, Anti-vaulting Haptics C-Flex -970C + 22.5D to +34D Superflex-920H - 10D to +22D KG 1 141 1327 3892 at 100926 300 0 0 No Change 2009-08-01 2019-03-01 Prosthesis KG013 Rayner Super Premium Toric I.O.L. Acrylic foldable toric single piece I.O.L -10.0D to 0.00D Sphere: 1D to 11.00D Cylinder in 0.25 steps +31.00D to +35.00 Spit: 1D to 11.00D Cylinder in 0.25steps KG 1 141 1327 3892 t2 100926 Changed Benefit 823 0 0 Update 2010-08-01 2019-03-01 Prosthesis KG014 ALTO Prosthesis Adjustable Length Titanium Ossicular Chain Reconstruction Prosthesis Head Size 2.5mm x 3.5mm; Length 2.0mm - 8.0mm; Distal Diameter 0.8mm - 1.2mm KG 22 196 1565 4157 170281 384 0 0 No Change 2012-02-01 2019-03-01 Prosthesis KG015 Rayner C-flex Advance Aspheric IOL Mini incision pre-loaded aspheric IOL Power range +8.0 - +34.0 dioptres in 0.5 increments KG 1 141 1327 3890 at, pl 220612 308 0 0 No Change 2015-08-01 2019-03-01 Prosthesis KG016 RayOne Toric Aspheric preloaded Single piece preloaded aspheric toric acrylic IOL, UV absorbing, 360 square edge, anti-vaulting haptics 6mm optic, +8 ro +30 sphere, +1 to +6 cylinder in 0.5 steps KG 1 141 1327 3892 at, pl, t1 220612 Changed Benefit 626 0 0 Update 2017-08-01 2019-03-01 Prosthesis MI094 Invisx Locks Invisx polymer cranial fixation system One size MI 23 199 1591 4337 132355 93 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI108 Sprint Quattro Secure S DF4 Dexamethasone acetate and dexamethasone sodium phosphate steroid-eluting, tripolar, screw-in, ventricular lead with RV defibrillation coil electrode 49 - 97 cm MI 27 242 1743 e 212486 236885 6480 0 0 No Change 2013-08-01 2019-03-01 Prosthesis MI109 VIVA QUAD XT CRT-D IS4/DF4 ICD with CRT. PhysioCurve Design, AdaptivCRT Algorithm, CardioSync Optimisation, VextorExpress, LV Automated Test, Optimised Battery Chemistry, Smart Shock Technology 2.0, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management and Atrial Therapies. IS4 DF4 35cm³ 81g MI 27 238 1727 a,d,e 203840 37980 0 0 No Change 2013-08-01 2019-03-01 Prosthesis MI110 VIVA QUAD S CRT-D IS4/DF4 ICD with CRT. PhysioCurve Design, CardioSync Optimisation, VectorExpress, V Automated Test, Optimised Battery Chemistry, Smart Shock Technology 2.0. Complete Capture management. IS4 DF4 35cm³ 81g MI 27 238 1727 a,d,e 203841 37980 0 0 No Change 2013-08-01 2019-03-01 Prosthesis MI111 Evera XT VR DF4 Single Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, Optimised Battery Chemistry, Smart Shock Technology 2.0, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management. DF4 33cm³ 77g MI 27 236 1723 a, d, e 208027 Changed Benefit 32162 0 0 Update 2013-08-01 2019-03-01 Prosthesis KG017 RayOne Ashperic preloaded Preloaded aspheric intraocular lens, hydrophilic acrylic, UV absorbing, 360 square edge, anti-vaulting haptics 6mm optic, range sphere -10 to +34 KG 1 141 1327 3892 at, pl 220612 308 0 0 No Change 2017-08-01 2019-03-01 Prosthesis KG018 T-Flex Aspheric - Toric <7 diopter Acrylic foldable posterior chamber IOLs, aspheric, toric <7 diopter Standard - Spheres: +6.0 to +30.0 D (spherical equivalent) Cylinders: +1.0 to +6.0 D Made to Order - Spheres: -10.0 to +35.0 D (subject to spherical equivalent) Cylinders: +1.0 to +6.0 D KG 1 141 1327 3892 at, t1 100926 Changed Benefit 609 0 0 Update 2018-08-01 2019-03-01 Prosthesis KG019 T-Flex Aspheric - Toric ≥7 diopter Acrylic foldable posterior chamber IOLs, aspheric, toric ≥7 diopter Standard Spheres: +6.0 to +30.0 D (spherical equivalent) Cylinders: +1.0 to +6.0 D Made to Order Spheres: -10.0 to +35.0 D (subject to spherical equivalent) Cylinders: +7.0 to +11.0 D KG 1 141 1327 3892 at, t2 100926 858 0 0 No Change 2018-08-01 2019-03-01 Prosthesis KG020 RayOne Hydrophobic IOL Hydrophobic acrylic IOL, preloaded injector system, micro incision, aspheric, UV filtering, single piece. Power range: -10.0 D to +7.0 D (1.0 D increments, including plano) +8.0 D to +30.0 D (0.5 D increments) +31.0 D to +32.0 D (1.0 D increments) Shapes: Biconvex (positive powers), Plano, Concave (negative powers) KG 1 141 1327 3892 at, pl 100926 308 0 0 No Change 2018-08-01 2019-03-01 Prosthesis KH033 G5 Polyaxial Pedicle Screw Polyaxial Pedicle Screw, Titanium Alloy Diameter: 4.0 -7.5 Length: 25 -55mm KH 19 165 1463 187961 1280 0 0 No Change 2013-02-01 2019-03-01 Prosthesis KH034 G5 Locking Cap/Screw setscrew, titanium alloy one size only KH 19 166 1465 187961 164 0 0 No Change 2013-02-01 2019-03-01 Prosthesis KH035 G5 Rod Rod, titanium alloy 50 - 550mm KH 19 170 1478 187961 Changed Benefit 426 0 0 Update 2013-02-01 2019-03-01 Prosthesis KH036 G5 Crosslink Adjustable Adjustable crosslink (Straight or curved), titanium alloy Straight or curved; Span 28 -70mm KH 19 167 1474 4124 187961 Changed Benefit 1299 0 0 Update 2013-02-01 2019-03-01 Prosthesis KH037 G5 Crosslink Fixed Fixed crosslink, Titanium alloy Span 16 -26 mm KH 19 167 1474 4123 187961 404 0 0 No Change 2013-02-01 2019-03-01 Prosthesis KG021 DV271 RayOne Trifocal Diffractive step trifocal with smooth transition and reduced light loss 0.0 D to +30.0D (increments 0.5D) KG 1 141 1327 3893 at, pl 220612 Changed Benefit 694 0 0 Update 2018-08-01 2019-03-01 Prosthesis KI001 HALYARD* MIC*Percutaneous Endoscopic Gastrostomy (P.E.G) Feeding Tubes / Kits, Enfit and Non-Enfit Sterile enteral feeding tube with accessories 14Fr, 20Fr, 24Fr KI 21 189 1545 4197 248293 195 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LH638 OO094 MUTARS - Genux stems Genux cemented. Press fit stems 130-240mm length, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20mm wide LH 17 159 1399 241989 Changed Benefit 1126 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH639 OO097 MUTARS - Genux Hinged knee femoral component Cemented Hinge Knee Size 3,4,5 left and right LH 17 149 1348 3908 Revision, Hinged 223514 6038 0 0 No Change 2018-08-01 2019-03-01 Prosthesis MB012 In-Flow The In-Flow is a urethral prosthesis designed to enable normal bladder drainage and toilet habits in women with chronic voiding dysfunction. The In-Flow system consists of an implantable silicone catheter containing a miniature valve-pump and a remote controlled magnet or "Activator" which causes a spinning mechanism to "draw" urine from the bladder. 3.0cm to 7.0cm in .5cm increments MB 26 256 1813 5519 174521 134 0 0 No Change 2013-08-01 2019-03-01 Prosthesis MB013 Allium Bulbar Urethral Stent Round Nitinol stent with co-polymer covering and supplied premounted on a delivery tool. 50, 55, 60, 80 mm MB 26 256 1800 5501 205004 2351 0 0 No Change 2013-08-01 2019-03-01 Prosthesis MI112 Evera XT VR DF1/ Evera MRI XT VR SureScan DF1 Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, Optimised Battery Chemistry, SmartShock Technology 2.0, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management. DF1 33cm³ 77g MI 27 236 1723 a, d 281609 Changed Benefit 31622 0 0 Update 2013-08-01 2019-03-01 Prosthesis MI113 Evera S VR DF4 Single Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, Optimised Battery Chemistry, Smart Shock Technology 2.0, DF4 33cm³ 77g MI 27 236 1723 a, d, e 208024 Changed Benefit 32162 0 0 Update 2013-08-01 2019-03-01 Prosthesis AS130 Parietex-Multifilament Polyester Mesh Parietex-Multifilament Polyester Mesh Plug 6 cm, 8 cm AS 21 194 1691 125428 Changed Benefit 250 0 0 Update 2006-11-30 2019-03-01 Prosthesis AS134 DST Series EEA Or Vil Accessory 21mm, 25mm AS 21 194 1582 4318 Endoscopic 140293 384 0 0 No Change 2007-12-01 2019-03-01 Prosthesis AS143 Parietex Composite 1510FX Dual sided polyester meshes with a resorbable adhesion -prevention hydrophilic film 15x10cm square AS 21 194 1783 5438 Coated 214997 Changed Benefit 371 0 0 Update 2008-07-01 2019-03-01 Prosthesis AS147 Parietex Composite 3728FX Dual sided polyester meshes with a resorbable adhesion-prevention hydrophilic film 37x28cm oval AS 21 194 1783 5505 Coated 214997 3040 0 0 No Change 2008-07-01 2019-03-01 Prosthesis AS151 Parietex Composite Hiatal Hernia Mesh Composite Mesh 8x8cm, 9x8cm, 8.5x8cm AS 21 194 1783 5438 Coated 149415 Changed Benefit 371 0 0 Update 2008-07-01 2019-03-01 Prosthesis AS152 Parietene Composite 12 Dual sided polypropylene mesh with resorbable adhesion-prevention hydrophilic film 12cm round AS 21 194 1783 5438 Coated, Contoured 149421 Changed Benefit 428 0 0 Update 2008-07-01 2019-03-01 Prosthesis HW230 HMRS (Howmedica Modular Replacement System) & MRH (Modular Rotating Hinge) Rotating Hinge Bumper HMRS & MRH Rotating Hinge Bumper - (Duration) UHMWPE HMRS: 0°, 3°, 5° MRH: 0°, 3° HW 17 159 1393 139145 3089 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW231 GMRS (Global Modular Replacement System) & MRH (Modular Rotating Hinge) Tibial Rotating Component GMRS & MRH Tibial Rotating Hinge component (not baseplate) separated from femoral component by bumper and rotates on top of tibial insert , Fixed GMRS-small MRH/crossover MRH - xs-xl & l-xl HW 17 159 1393 128028 3089 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW232 HMRS (Howmedica Modular Replacement System) Rotating Hinge Tibial Insert HMRS Rotating Hinge Tibial insert, UHMWPE (Duration), Fixed 6, 10, 14mm HW 17 153 1369 139145 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW233 KRH (Kinemax Knee System Rotating Hinge) & MRH (Modular Rotating Hinge) Rotating Hinge Sleeve KRH & MRH Rotating Hinge Tibial Sleeve, UHMWPE, (Duration) houses Rotating Hinge Tibial Rotating component sHydroxyapatiteft One size only HW 17 159 1400 128028 698 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW234 HMRS (Howmedica Modular Replacement System) Stemmed Tibial Baseplate HMRS stemmed tibial baseplate, CoCr (Vitallium), uncemented, porous coated, w/large connecting stem attached for diaphyseal fixation, Fixed One size only HW 17 157 1381 3932 128028 Changed Benefit 7247 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW247 Howmedica Modular Resection System Oncology Femoral Stem - Vitallium 127mm and 203mm length 11, 13, 15, 17mm diameter HW 17 157 1386 139145 2716 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW248 MRH (Modular Rotating Hinge) & GMRS (Global Modular Replacement System) Tibial Inserts MRH & GMRS Tibial insert, (Duration) UHMWPE, for MRH and GMRS Tibial baseplate, CoCr (Vitallium), Fixed with central hole for Hinge xsmall - xlarge HW 17 153 1369 142278 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW250 MRS (Modular Replacement System) Tibial Stem MRS Tibial Stem - cemented, CoCr (Vitallium), Fixed 127mm in 9, 11, 13mm diameter HW 17 157 1386 142278 16234 2716 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MB014 Allium Round Posterior Urethral Stent Round Nitinol stent with copolymer covering and supplied premounted on a delivery tool. For longer term temporary treatment of bladder outlet obstruction caused by male stenotic posterior urethra or stenotic bladder-neck. The RPS has a body length of 40mm and a main body calibre of 45Fr MB 26 256 1800 5501 205004 2351 0 0 No Change 2013-08-01 2019-03-01 Prosthesis MB015 Allium Triangle Prostatic Urethral Stent Round Nitinol stent with copolymer covering and supplied premounted on a delivery tool. For longer term temporary treatment of bladder outlet obstruction caused by enlarged prostate. Body lengths 30, 40, 50, 60, 65mm main body calibre 45Fr MB 26 256 1800 5501 205004 2351 0 0 No Change 2013-08-01 2019-03-01 Prosthesis MB016 Allium Ureteral Stent Round Nitinol stent with copolymer covering and supplied premounted on a delivery tool. Intended to be inserted into the lower ureter to allow free flow of urine from the kidney to the bladder. 8mm x 100mm, 8mm x 120mm, 10mm x 100mm, 10mm x 120mm MB 26 227 1701 5323 Therm 205005 3589 0 0 No Change 2013-08-01 2019-03-01 Prosthesis HW251 MRS (Modular Replacement System) Tibial Insert Tibial insert UHMWPE (Duration) for MRS Metal Encapsulated Rotating Hinge Tibial component, Mobile. Small and Medium in 11, 13, 16, 21mm HW 17 157 1384 141151 2058 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW254 HMRS Oncology Humeral Head/Cap Cobalt Chromium 40, 44mm, Cap HW 13 123 1778 5422 128450 4047 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW255 Howmedica Modular Resection System Oncology Humeral Body - Titanium 40 - 140mm in 20mm increments HW 13 123 1778 5415 128450 166620 3916 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW256 HMRS Oncology Humeral Stem Cobalt Chromium 7x75mm, 7x115mm, 9x75mm, 9x115mm, 11x115mm, 25mmx75mm, 25mmx100mm, 50mmx75mm, 50mmx100mm,75mmx100mm, 100mmx50mm HW 13 123 1778 5410 128450 16234 5486 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW274 Stryker Plating System Locking Insert/Plug Assembly 4.0mm to 5 mm HW 13 123 1231 4523 269713 295226 252 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW298 Asnis Guided Screw System Washer, Stainless Steel One size only HW 13 123 1231 3374 119849 93 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW299 Asnis Guided Screw System Washer - Titanium 4, 5, 6.5,8mm HW 13 123 1231 3374 119849 16235 93 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MB017 SpaceOAR System The SpaceOAR System consists of components for preparation of a synthetic, absorbable hydrogel spacer and a delivery mechanism packaged in a single kit. The hydrogel spacer creates a temporary space between the prostate and rectum during radiation therapy. 10CC MB 21 187 1792 6281 179172 Changed Benefit 1853 0 0 Update 2013-08-01 2019-03-01 Prosthesis MB020 In-Flow - Activator Activator (Remote Control) One size only MB 26 256 1813 5520 174521 112 0 0 No Change 2013-08-01 2019-03-01 Prosthesis MB021 In-Flow - Sizing Catheter Sizing Catheter One size only MB 26 256 1813 5521 174521 67 0 0 No Change 2013-08-01 2019-03-01 Prosthesis MB022 Zephyr Hydraulic Penile Implant This hydraulic penile implant is made from silicone elastomer and comprises of two inflatable cylinders. a reservoir and a pump. All sizes contained in one system pack. (13, 16, 19 cm) MB 26 230 1709 A 216415 9893 0 0 No Change 2014-02-01 2019-03-01 Prosthesis MB023 Allium Biliary Stent Endoscopic or Transhepatic biliary stent made of nitinol with copolymer covering and unraveling technology for atraumatic removal Stent length - 60, 80, 100, 120mm. Diameter - 8, 10mm. Anchor optional MB 21 192 1556 4235 205006 2874 0 0 No Change 2014-02-01 2019-03-01 Prosthesis AS153 Parietene Composite 1510 Dual sided polypropylene mesh with resorbable adhesion-prevention hydrophilic film 15x10cm Square AS 21 194 1783 5438 Coated 149421 Changed Benefit 371 0 0 Update 2008-07-01 2019-03-01 Prosthesis AS154 Parietene Composite 1515 Dual sided polypropylene mesh with resorbable adhesion-prevention hydrophilic film 15x15cm AS 21 194 1783 5439 Coated 149421 759 0 0 No Change 2008-07-01 2019-03-01 Prosthesis AS155 Parietene Composite 2015 Dual sided polypropylene mesh with resorbable adhesion-prevention hydrophilic film 20x15cm Oval AS 21 194 1783 5439 Coated 149421 759 0 0 No Change 2008-07-01 2019-03-01 Prosthesis AS156 Parietene Composite 2520 Dual sided polypropylene mesh with resorbable adhesion-prevention hydrophilic film 25x20cm Oval AS 21 194 1783 5440 Coated 149421 Changed Benefit 1017 0 0 Update 2008-07-01 2019-03-01 Prosthesis AS157 Parietene Composite 3020 Dual sided polypropylene mesh with resorbable adhesion-prevention hydrophilic film 30x20cm Oval AS 21 194 1783 5440 Coated 149421 Changed Benefit 1017 0 0 Update 2008-07-01 2019-03-01 Prosthesis KI002 Halyard* MIC* Percutaneous Endoscopic Gastrostomy (P.E.G) Feeding BASIC Tubes/Kits Enfit and Non-Enf Sterile enteral feeding tube with accessories 14 Fr, 20 Fr, 24 Fr KI 21 189 1545 4197 248293 195 0 0 No Change 2005-10-31 2019-03-01 Prosthesis KI003 HALYARD* MIC* Percutaneous Endoscopic Gastrostomy Feeding Tube Accessories Sterile Accesory 14 Fr, 20 Fr, 24 Fr KI 21 189 1545 4198 261430 Changed Benefit 86 0 0 Update 2005-10-31 2019-03-01 Prosthesis KI004 HALYARD* MIC-KEY Low Profile Balloon Gastrostomy Feeding Tubes/Kits, ENFit and Non-ENFit Sterile Low Profile Enteral Feeding Tube with accessories 14FR to 24 Fr ; 0.8cm to 5.0cm KI 21 189 1545 4197 260222 195 0 0 No Change 2005-10-31 2019-03-01 Prosthesis KI005 HALYARD MIC-KEY Low Profile Balloon Feeding Accessories Accessories 30.5cm, 60.9cm, 5.1cm KI 21 189 1545 4198 261430 Changed Benefit 86 0 0 Update 2005-10-31 2019-03-01 Prosthesis KI006 HALYARD* MIC* Gastric-Jejunal Feeding Tubes Medical Grade Silicone Construction, Silicone Internal Retention Balloon, SECUR-LOK* External Retention ring, Universal Jejunal Feeding Port Connector, Gastric Decompression Port, Multiple Gastric & Jejunal Exit Ports, Tungsten Weighted Jejunal Portion, Tapered Distal Tip, Radiopaque Stripe, Sterile 16-22 French - 45cm jejunal length - 7-10ml balloon KI 21 189 1546 Port 248294 475 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MB024 TraceIT Gel System TraceIT System is intended to create a temporary space within soft tissue during radiation therapy. 10mL MB 21 187 1792 6281 268092 Changed Benefit 1853 0 0 Update 2016-08-01 2019-03-01 Prosthesis MB025 TraceIT Gel System TraceIT System is intended to create a temporary space within soft tissue during radiation therapy. 3mL MB 21 187 1792 6061 268092 Changed Benefit 903 0 0 Update 2016-08-01 2019-03-01 Prosthesis MB027 Zephyr Hydraulic Phalloplasty Penile Implant Hydraulic phalloplasty penile implant 120-210 mm MB 26 230 1709 A 216415 9893 0 0 No Change 2017-08-01 2019-03-01 Prosthesis MB028 Allium URS Long Ureteral stent Fully covered, flexible, extra long ureteral stent 9 mm diameter 200 mm length MB 26 227 1701 5323 Therm 205005 3589 0 0 No Change 2018-08-01 2019-03-01 Prosthesis MC002 Medtronic Sprint Quattro Lead Model 6944RV/SVC 65cm; Model 6944RV/SVC 75cm; or Model 6944RV/SVC 100cm; Medtronic Sprint Quattro Lead Model 6944RV/SVC 58cm Silicone and polyurethane 65-100cm MC 27 242 1741 142172 6480 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BB333 Miethke Port / Reservoir The ports / reservoirs are all made of titanium and are radiopaque. They have a low overall height for easy and safe positioning and fixation of the ventricular catheter. They allow CSF extraction and drug injection by inserting a syringe through the silicone dome. The solid titanium base prevents penetration with a syringe needle. There are 6 different types: Burrhole port, CSF port, Burrhole reservoir, Sprung reservoir, Flushing reservoir, Control reservoir. Burrhole port: FV030T: Diameter 20mm, Height 5.65mm. FV040T: Diameter 14mm, Height 4.8mm (for pediatric application). CSF port: FV060T: Diameter 20mm, Height 5.65mm. Burrhole reservoir: FV028T: Diameter 20mm, Height 5.65mm. FV029T: Diameter 20mm, Height 5.65mm with adjustable connector. FV039T: Diameter 14mm, Height 4.8mm (for pediatric application). Sprung reservoir: FV043T: Diameter 20mm, Height 5.65mm. Flushing reservoir: FV033T: Diameter 20mm, Height 5.65mm. FV035T: Diameter 14mm, Height 4.8mm (for pediatric application). Control reservoir: FV047T: Diameter 20mm, Height 5.65mm. BB 25 220 1670 181719 356 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW305 Dall Miles Cable Grip System - Stainless Steel Stainless Steel Plate:5 hole - Stainless Steel 6 inches HW 13 123 1694 5286 144003 16231 1140 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW306 Dall Miles Cable Grip System - Stainless Steel Stainless Steel Plate:7 hole - Stainless Steel 8 inches HW 13 123 1694 5303 144003 16231 2470 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW302 Dall Miles Cable Grip System - Stainless Steel Stainless Steel: Trochanter Grip - Stainless Steel Small, Medium, Large HW 13 123 1772 5372 144002 144003 Changed Benefit 524 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW307 Dall Miles Cable Grip System - Stainless Steel Stainless Steel Plate:9 hole - Stainless Steel 10 inches HW 13 123 1694 5287 144003 16231 1140 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW308 Dall Miles Cable Grip System - Stainless Steel Stainless Steel Plate:11 hole - Stainless Steel 12 inches HW 13 123 1694 5287 144003 16231 1140 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW309 Dall Miles Cable Grip System - Vitallium Vitallium: Cable - Vitallium 1.6 and 2mm HW 13 123 1772 5366 141273 16234 341 0 0 No Change 2005-10-31 2019-03-01 Prosthesis KI007 HALYARD MIC* Gastrostomy Feeding Tube; HALYARD MIC* Bolus Gastrostomy Tube Medical Grade Silicone Construction. Silicone Internal Inflatable Retention Balloon, SECU-LOK* External Retention Ring, Universal Feeding Port Connector, Medication Port, Dual Exit Ports, Tapered Distal Tip, Radiopaque Strip, Sterile. 12fr - 3-5ml balloon, 14fr - 3-5ml balloon, 16fr - 3-5ml balloon, 18fr - 7-10ml balloon, 20fr - 7-10ml balloon, 22fr - 7-10ml balloon, 24fr - 7-10ml balloon, 26fr - 7-10ml balloon, 28fr - 7-10ml balloon, 30fr - 7-10ml balloon, KI 21 189 1545 4198 248293 Changed Benefit 86 0 0 Update 2005-10-31 2019-03-01 Prosthesis LH609 OO017 ACS Knee System - ACS LS Revision Femoral component, Cemented Cemented femoral component, revision, for use with stems Left/Right Sizes 2/3/4/5/6 LH 17 149 1348 3906 Revision 265605 5411 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH610 OO018 ACS Knee System - PS Femoral component, cemented ACS posterior stabilised femoral component, cemented Size 2,2.5,3,4,5,6 left/right LH 17 149 1348 3907 265603 3041 0 0 No Change 2018-08-01 2019-03-01 Prosthesis MC005 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 MC 20 181 1841 135737 2090 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC008 Medtronic Capsurefix Model 5568 Pacing Leads Bipolar, steroid, active fixation pacing lead 30 - 85cm MC 27 243 1756 142169 898 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC009 Medtronic Epicardial Pacing Leads IS-1 Model 5071 Silicone 35 - 53cm MC 27 243 1748 136181 824 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC010 Medtronic Capsure SP Novus Model 5092 Bipolar, steroid, pasive fixation pacing lead 45 -110cm MC 27 243 1753 142170 898 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC011 Capsure EPI steroid eluting bipolar epicardial lead Model 4968 - ventricle Silicone 25 - 60cm MC 27 243 1746 134287 1235 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC012 Medtronic Hancock Valved Conduit Model 100/150 Porcine bioprosthesis, dacron 12, 14, 16, 18, 20, 22, 25, 30mm. MC 20 180 1503 p 145757 6460 0 0 No Change 2005-10-31 2019-03-01 Prosthesis 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 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 MC 20 178 1498 135736 4845 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC015 Freestyle bioprosthesis Models 995xx, 995MSxx 19 - 35mm MC 20 179 1501 p 145752 4845 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC026 Medtronic Transvene SVC Lead Model 6937; Model 6937-35, Model 6937-52, Model 6937-58, Model 6937-110; Silicone; 35 - 110cm x 660mm MC 27 242 1737 136182 1685 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MI073 Medtronic MicroTargeting Electrodes Microelectrodes used for intra-operative recording of neuronal activity for DBS Various MI 25 221 1675 133616 1425 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI074 Sacral Nerve Stimulation Lead 4 Electrode tined lead 28 - 41cm MI 26 232 1714 5339 tined 98338 4199 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BB330 Miethke Reservoir with integrated catheter The reservoirs are all made of titanium and are radiopaque. They have a low overall height for easy and safe positioning and fixation of the ventricular catheter. They allow CSF extraction and drug injection by inserting a syringe through the silicone dome. The solid titanium base prevents penetration with a syringe needle. The reservoirs come with integrated catheters. There are 4 different types of reservoirs with integrated catheters: Burrhole reservoir, sprung reservoir, flushing reservoir and control reservoir. Burrhole reservoir: FV027T - Diameter 20mm, Height 5.65mm, with integrated catheter 600mm. FV054T - Diameter 14mm, Height 4.8mm, with integrated catheter 200mm (pediatric). Sprung reservoir: FV044T - Diameter 20mm, Height 5.65mm, with integrated catheter 600mm. Flushing reservoir: FV034T - Diameter 20mm, Height 5.65mm, with integrated 600mm. FV081T - Diameter 14mm, Height 4.8mm, with integrated catheter 600mm (pediatric). Control reservoir: FV048T - Diameter 20mm, Height 5.65mm, with integrated catheter 600mm. BB 25 220 1670 Integrated Catheter 181719 475 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI075 Middle Ear Prostheses Total Ossicular Reconstruction Implants 0.6-0.8mm x 3.0-4.0mm x 7.0-8.0mm MI 22 196 1565 4157 125831 384 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI076 Middle Ear Prostheses Partial Ossicular Reconstruction Implant - malleus + incus 0.6-2.5 x 2.2-8.8 x 3.5 -10mm MI 22 196 1565 4156 125831 342 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI077 Medtronic Ventilation Tube Medium to long term, antimicrobial vent tube 1.02 - 1.52mm x 1.3-12.0mm MI 22 196 1566 126695 21 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI078 Medtronic Ventilation Tubes Medium to Long term vent tube 0.76-1.52mm x0.9-12.0mm MI 22 196 1566 126695 19 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI079 Middle ear prostheses Stapes 0.4-1.17mm x 0.9-4.0 x 4.0 x4.0-10.2mm; 4.0 - 4.75mm MI 22 196 1565 4154 125831 99 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI080 Strata NSC LP Shunt Kit Strata NSC LP Shunt Kit with Lumbar Catheter and Peritoneal Catheter, Small Lumen One size only MI 25 220 1666 4468 Distal catheter, Lumboperitoneal, Proximal catheter, Reservoir/Priming function 165018 Changed Benefit 2878 0 0 Update 2013-02-01 2019-03-01 Prosthesis AS161 Parietene ProGrip Mesh (PRE-SHAPED) Pre-Cut, slit mesh with self gripping overlapping flap - right or left 12 x 8cm elliptic AS 21 194 1783 5438 Coated, Contoured 149430 Changed Benefit 428 0 0 Update 2009-02-01 2019-03-01 Prosthesis AS162 Parietene ProGrip Mesh (FLAT) Mesh with self gripping FLAT 15 x 9cm RECTANGLE AS 21 194 1783 5438 Coated 149430 Changed Benefit 371 0 0 Update 2009-02-01 2019-03-01 Prosthesis AS164 Parietex Multifilament Polyester Mesh Parietex-Multifilament Polyester Standard Mesh/Bidimensional rigid, Three dimensional 13 x 09 cms, 15 x 10 cms AS 21 194 1782 5434 125428 76 0 0 No Change 2009-08-01 2019-03-01 Prosthesis AS165 Parietex Multifilament Polyester Mesh Anatomical Parietex-Multifilament Polyester Standard Mesh/Bidimensional Rigid, Three dimensional 15 x 15 cms AS 21 194 1782 5435 125428 81 0 0 No Change 2009-08-01 2019-03-01 Prosthesis AS170 Parietex-Multifilament Polyester Mesh Parietex-Multifilament Polyester Standard Mesh/Bi-dimensional, Bi-dimensional Rigid, Three dimensional 20 x 20cm AS 21 194 1782 5435 125428 81 0 0 No Change 2009-08-01 2019-03-01 Prosthesis AS182 Permacol™ Biological Implant Flat sheet of acellular porcine three-dimensional, crosslinked, dermal collagen. 3 x 3cm, 5 x 5cm, 2 x 20cm, 5 x 10cm, 4 x 18cm, 10 x 10cm, 10 x 15cm, 6 x 3cm, 10 x 15cm AS 21 194 1798 5491 Coated 172202 747 0 0 No Change 2012-08-01 2019-03-01 Prosthesis AS183 Permacol™ Biological Implant Flat sheet of acellular porcine three-dimensional, crosslinked, dermal collagen. 15 x 20cm AS 21 194 1798 5492 Coated 172202 1412 0 0 No Change 2012-08-01 2019-03-01 Prosthesis AS184 Permacol™ Biological Implant Flat sheet of acellular porcine three-dimensional, crosslinked, dermal collagen. 18 x 28cm and 20 x 30cm AS 21 194 1798 5493 Coated 172202 Changed Benefit 3278 0 0 Update 2012-08-01 2019-03-01 Prosthesis AS186 Endo GIA™ Reload with TriStaple™ Technology Covidien's Endo GIA™ Reload with TriStaple™ Technology provides outstanding performance across a broader range of tissue thickness, thereby simplifying the cartridge selection process. With its stepped cartridge face, TriStaple™ Technology delivers graduated compression, optimising interaction between the tissue and the stapler 30mm, 45mm, 60mm AS 21 194 1582 4317 Endoscopic, Articulating/Roticulating 181429 186247 Changed Benefit 347 0 0 Update 2013-02-01 2019-03-01 Prosthesis HW311 Dall Miles Cable Grip System - Vitallium Vitallium: Trochanter Grip - Vitallium Small, Medium and Large HW 13 123 1772 5372 144003 16234 Changed Benefit 524 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW313 Stryker Plating System Cable Plug 4.0mm to 5.0mm HW 13 123 1772 5373 119660 139635 Changed Benefit 176 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW317 Rutherford Staple Ellison Arched Staple, Vitallium 9,12,15mm x 23mm HW 13 123 1773 5514 139631 Changed Benefit 127 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW310 Dall Miles Cable Grip System - Vitallium Vitallium: Sleeve - Vitallium 1.6 and 2mm HW 13 123 1772 5371 141273 16234 Changed Benefit 104 0 0 Update 2005-10-31 2019-03-01 Prosthesis IG169 JJ740 Duraform Dural Graft Implant - 1" x 1" (2.5x2.5cm) Collagen-based dural graft implant 1'x1' (2.5x2.5cm) IG 25 219 1657 Biological 151908 342 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG170 JJ743 Duraform Dural Graft Implant - 3" x 3" (7.5 x 7.5cm) Collagen-based dural graft implant 3" x 3" (7.5 x 7.5cm) IG 25 219 1659 Biological 151908 1064 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG171 JJ744 Duraform Dural Graft Implant - 4" x 5" (10x12.5cm) Collagen-based dural graft implant 4" x 5" (10x12.5cm) IG 25 219 1660 Biological 151908 Changed Benefit 1796 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH611 OO019 ACS Knee System - ACS SC Revision Tibial component, Cemented Revision MB base plate for use with augments and straight or offset stems Sizes 2,3,4,5,6 LH 17 151 1359 Revision 265619 3489 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH612 OO020 ACS Knee System-ACS Revision tibial component, cemented Revision base plate, cemented, for use with augments and straight or offset stems Left and Right, Sizes 2,3,3.5,4,5,6 LH 17 151 1357 Revision 265611 3265 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH613 OO021 ACS Knee System-ACS Revision tibial component, cementless porous coated Revision tibial component, cementless porous coated, for use with augments and straight or offset stems. Left and Right, Sizes 2,3,3.5,4,5,6 LH 17 151 1360 Revision 265612 3399 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH614 OO026 ACS Knee System-ACS spacer (tibial and femoral) ACS tibial and femoral augments for use with mobile bearing and Revision FB tibial base plates Left and Right, medial, lateral, posterior and distal. LH 17 159 1390 221737 1148 0 0 No Change 2018-08-01 2019-03-01 Prosthesis MI082 Strata Valve NSC PSM Range Strata NSC, Strata NSC Burr Hole Valve. Adjustable cerebrospinal fluid (CSF) flow valve. Polypropylene and acetal plastic base. Silicone elastomer dome. 13-20mm x 23-35mm MI 25 220 1666 4468 Reservoir/Priming function 129681 169054 Changed Benefit 2252 0 0 Update 2013-02-01 2019-03-01 Prosthesis MI083 TiMesh Titanium rigid Fixation Bone Grafting and Plating System FlexMesh 1.5mm - 2.2mm system. Composition: Titanium 148 - 154mm x 148 - 154mm, 0.6mm MI 23 199 1585 4210 128523 2187 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI084 TiMesh Rigid Fixation Bone Grafting and Plating System FlexMesh 1.0 - 1.5mm system. Composition: Titanium 51 to 100cm² area, 0.3mm thickness MI 23 199 1585 4205 128523 1365 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI081 Durepair Dura Substitute, Collagen 1"-2" x 2"-3" MI 25 219 1658 Biological 134482 518 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI085 TiMesh Rigid Fixation Bone Grafting and Plating System FlexMesh 1.0 - 2.2mm system. Composition : Titanium 51 to 100cm² area, 0.6mm thickness MI 23 199 1585 4209 128523 1146 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BB331 Miethke Ventricular catheter with deflector Ventricular catheters (with deflector) are used to drain CSF out of the ventricle. All catheters are made of radiopaque silicone. The deflectors allow 90 degree deflection of the ventricular catheter in the burrhole without kinking the catheter. All deflectors are made of titanium. The deflectors are adjustable on the catheter, have suture fixation holes and are radiopaque. Ventricular catheter with deflector: Inside diameter 1.2mm, Outside diameter 2.5mm. FV075P: Ventricular catheter 180mm, graduated. Deflector: Large. FV078P: Ventricular catheter 250mm, graduated. Deflector: Large. Ventricular catheter with deflector (for pediatric application): Inside diameter 1.2mm, Outside diameter 2.5mm. FV076P: Ventricular catheter 180mm, graduated. Deflector: Small. BB 25 220 1668 Proximal 196110 176 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BB332 Miethke proGAV Adjustable valve with intergrated gravitational unit. Titanium, MR safe up to 3 tesla. Adjustable valve: Diameter 18mm, Opening pressure 0-20 cmH2O, Height 4.5mm. Gravitational unit: Length 14.9mm, Height 4.6mm. BB 25 220 1666 4468 Antisyphon function, Reservoir/Priming function 181718 Changed Benefit 2727 0 0 Update 2013-02-01 2019-03-01 Prosthesis IG173 JJ856 Burr Hole Button Reservoirs Various ventriculostomy reservoirs Standard, dome, flat profile and large IG 25 220 1670 140900 149297 149298 356 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG174 JJ857 HOLTER Intracranial Pressure Shunt HOLTER distal peritoneal catheter/Salmon, packaged sterile, silicone 90cm IG 25 220 1668 Distal 149299 176 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG172 JJ855 Codman-Medos Non-programmable Valve System Lumbar/peritoneal catheter, James and Holter designs 25-80cm IG 25 220 1667 149300 150123 Changed Benefit 428 0 0 Update 2018-08-01 2019-03-01 Prosthesis IG175 JJ858 Codman Hakim Precision Valves Valves with Siphonguard and Reservoir 10-130mm H2O including micro IG 25 220 1666 4469 Antisyphon function, Reservoir/Priming function 140904 Changed Benefit 1473 0 0 Update 2018-08-01 2019-03-01 Prosthesis IG176 JJ860 Duraform Collagen-based dural graft implant 2.5 x 7.5cm (1" x 3") to 5 x 5cm (2" x 2") IG 25 219 1658 Biological 151908 518 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG177 JJ861 Codman Hakim Precision Fixed Pressure Valve Fixed Pressure Valve with Bactiseal ventricular and peritoneal catheters, reservoir and siphonguard: Opening pressures: 10-130mmH2O Standard and Micro IG 25 220 1666 4469 Antibiotics, Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function 164772 2071 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH615 OO027 ACS Knee System - ACS double taper adapter ACS offset adapters for use with ACS FB, MB tibial and femoral components and stems 0, +2mm, +4mm, +6mm. LH 17 159 1396 265635 265644 1208 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH616 OO029 ACS Knee System - ACS Screws Screw for spacers and augments 2 sizes LH 17 159 1398 221737 126 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH617 OO030 Mutars RS revision system - bolt RS bolt 40,50,65,75,90,100,115,125mm LH 18 164 1434 250156 Changed Benefit 352 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH618 OO031 Mutars RS revision system - bone screws RS bone screw 25mm, 30mm, 40mm, 42mm, 45mm, 50mm, 55mm, 60mm LH 18 164 1435 237075 121 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH619 OO032 IC- Head Biolox delta Biolox delta ceramic head 28 and 32mm. Small, medium and large. LH 18 162 1419 3992 288475 1845 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH620 OO033 IC-Head Biolox delta Biolox delta ceramic head 36mm. S, M, L and XL. LH 18 162 1420 3999 288475 2022 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH621 OO034 IC-Head CoCrMo IC Head, CoCrMo 22,28,32mm - S-M-L-XL LH 18 162 1419 3989 291215 703 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH622 OO035 Bi-polar head Bipolar head 38mm - 62mm LH 18 162 1424 4004 271212 753 0 0 No Change 2018-08-01 2019-03-01 Prosthesis MI086 Strata Shunt Assembly Assembly: Strata Shunt, Strata Burr Hole Shunt, Strata Snap Shunt. Adjustable CSF Valve with five symmetric performance level steps, includes integral (distal) peritoneal catheter. 90-120cm, 35-50mm MI 25 220 1666 4468 Antisyphon function, Distal catheter, Reservoir/Priming function 129681 134740 169061 2902 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI087 Strata Valve Strata Valve, Strata Burr Hole Valve,. Adjustable CSF Valve with five symmetric performance level steps. 13-20mm x 35-50mm MI 25 220 1666 4468 Antisyphon function, Reservoir/Priming function 129681 169054 Changed Benefit 2727 0 0 Update 2013-02-01 2019-03-01 Prosthesis MI088 Macropore Protective Sheets 1 to 10cm² area; 0.5mm thick MI 23 199 1586 4225 153970 585 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI089 Macropore Straight Plates 8 -20 hole MI 23 199 1589 4277 Resorbable 153968 153969 153970 210 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI090 Macropore Screws 1.75 - 2.75 x 2.24 - 3.24mm MI 23 199 1590 4323 Resorbable 154246 137 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI091 TiMesh Rigid Straight Plate 8 -32 holes MI 23 199 1589 4277 128523 199 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI092 TiMesh Internal Drive Screws Diameter: 1.5 - 1.8mm MI 23 199 1590 4323 128524 42 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI093 TiMesh Rescue Screws Diameter: 1.8 - 2.4mm MI 23 199 1590 4323 128524 42 0 0 No Change 2013-02-01 2019-03-01 Prosthesis AS171 Parietex-Multifilament Polyester Mesh Parietex-Multifilament Polyester Standard Mesh/Bi-dimensional, Bi-dimensional Rigid, Three dimensional 30 x 30cm AS 21 194 1782 5437 125428 261 0 0 No Change 2009-08-01 2019-03-01 Prosthesis AS172 Mesh Polyproplene; Monofilament Polyproplylene; SURGIPRO* Non Absorbable Monofilament Polypropylene Mesh Multifilament Polypropylene; Monofilament Polypropylene; SURGIPRO, Non-Asborbable Polypropylene Monofilament Mesh. 15.3cm x 15.3cm Surgipro* mesh (6 x 6 inch); SPMM46: 10.2cm x 15.3cm (4 x 6 inch). AS 21 194 1782 5434 129777 76 0 0 No Change 2009-08-01 2019-03-01 Prosthesis AS173 Mesh Polyproplene; Monofilament Polyproplylene; SURGIPRO* Non Absorbable Monofilament Polypropylene Mesh Multifilament Polypropylene; Monofilament Polypropylene; SURGIPRO, Non-Asborbable Polypropylene Monofilament Mesh. 15.3cm x 15.3cm Surgipro* mesh (6 x 6 inch) AS 21 194 1782 5435 129777 81 0 0 No Change 2009-08-01 2019-03-01 Prosthesis AS174 Parietene-Monofiliment Polypropylene Mesh Parietene-Monofiliment Polypropylene standard mesh/light mesh 6 x 11cm, 15 x 10cm AS 21 194 1782 5434 125428 76 0 0 No Change 2009-08-01 2019-03-01 Prosthesis AS176 Parietene-Monofilament Polypropylene Mesh Parietene-Monofilament Polypropylene standard mesh/light mesh 15 x 15cm AS 21 194 1782 5435 125428 81 0 0 No Change 2009-08-01 2019-03-01 Prosthesis AS179 EEA Haemorrhoid and Prolapse Stapler Stapling instrument for control of rectal prolapse and haemorrhoid disease. 33mm Circular Stapling line, 3.5 mm and 4.8mm Staple leg length. AS 21 194 1582 4320 Circular 164442 Changed Benefit 697 0 0 Update 2010-08-01 2019-03-01 Prosthesis IG178 JJ862 Codman Hakim Precision Fixed Pressure Valve Fixed Pressure Valve with Bactiseal ventricular and peritoneal catheters and reservoir: Opening pressures: 10-130mmH2O Standard and Micro IG 25 220 1666 4469 Antibiotics, Distal catheter, Proximal catheter, Reservoir/Priming function 164772 Changed Benefit 1986 0 0 Update 2018-08-01 2019-03-01 Prosthesis IG179 JJ883 Hakim Ventricular Catheter Set with Bactiseal Silicone ventricular catheter, antibiotic impregnated 15cm IG 25 220 1668 Antibiotics 156961 Changed Benefit 446 0 0 Update 2018-08-01 2019-03-01 Prosthesis IG180 JJ884 Hakim Peritoneal Catheter Set with Bactiseal Silicone peritoneal catheter, antibiotic impregnated 80cm IG 25 220 1668 Antibiotics 156961 Changed Benefit 446 0 0 Update 2018-08-01 2019-03-01 Prosthesis IG181 JJ906 MicroSensor Monitoring System Ventricular catheter with transducer Catheter length 38cm IG 25 253 1794 Catheter 150087 1235 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG182 JJ907 Codman External Ventricular Drain (EVD) Catheter External Ventricular Drain 1.5mm & 1.9mm diameter IG 25 255 1796 123031 176 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG183 JJ908 Codman Bactiseal External Ventricular Drain (EVD) Catheter Antibiotic impregated External Ventricular Drain 1.5mm & 1.9mm lumen diameter IG 25 255 1796 Antibiotics 132024 Changed Benefit 446 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH623 OO036 IC Polaric head IC Polaric head 38, 40, 42, 44, 46, 48, 50, 52, 54, 56, 58 LH 18 163 1428 4024 281540 1613 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH624 OO037 IC Reinforcement cage Acetabular Reinforcement cage Left and Right. 44mm, 50mm, 56mm, 62mm LH 18 163 1432 4035 169691 1253 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH625 OO038 IC titanium ring Acetabular recontrusction ring 42mm, 44mm, 46mm, 48mm, 50mm, 52mm, 54mm, 56mm, 58mm LH 18 163 1432 4035 169691 1253 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH626 OO040 Mutars RS revision system - metaphyseal component RS metaphyseal component 0mm, 50mm, 40mm tapered, 50mm tapered LH 18 161 1411 3969 Cone 223511 3093 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH627 OO041 Mutars RS revision system - cementless stem HA RS Cementless stem HA 12/14/16/18/20mm dia stems, 150 - 190mm length LH 18 161 1407 3952 236460 4394 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH628 OO042 Mutars RS revision system - cementless stem HA long RS Cementless stem HA long 12/14/16/18/20mm dia stems, 200 to 250mm length LH 18 161 1409 3960 236460 5624 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH629 OO043 IC bone screw Cancellous bone screw 6.5mm x 15/20/25/30/35/40/45/50/55/60/65/70/75/80/85mm length. LH 18 164 1450 237075 176 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH630 OO044 IC Cerclage System IC Bone Cerclage System, pure titanium 8mm wide LH 13 123 1772 5370 197728 447 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG185 MN108 Codman Certas Programmable Valve - with reservoir and catheter Programmable valve with reservoir and catheters 30-210mmH2O IG 25 220 1666 4468 Distal catheter, Reservoir/Priming function 186232 186234 2427 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG186 MN109 Codman Certas Programmable Valve - with Reservoir and Siphonguard Programmable valve with Reservoir and Siphonguard 30-210mmH2O IG 25 220 1666 4468 Antisyphon function, Reservoir/Priming function 190248 Changed Benefit 2727 0 0 Update 2018-08-01 2019-03-01 Prosthesis IG187 MN110 Codman Certas Programmable Valve - with Reservoir, Siphonguard and catheter Programmable valve with reservoir, siphonguard and catheters 30-210mmH2O IG 25 220 1666 4468 Antisyphon function, Distal catheter, Reservoir/Priming function 186233 186235 2902 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG184 JJ934 Codman Hydrocephalus Connectors Metal and plastic connectors 8mm to 20mm length IG 25 220 1671 4470 140901 150104 36 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG188 MN111 Codman Certas Programmable Valve - with reservoir Programmable valve with reservoir 30-210mmH2O IG 25 220 1666 4468 Reservoir/Priming function 190248 Changed Benefit 2252 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH631 OO048 MUTARS Stems MUTARS Stems 120/130/160/200/240 lengths, 11/12/13/14/15/16/17/18/19/20/21/22/23 diameters LH 17 157 1386 236017 244312 244314 244315 245434 245435 2716 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH632 OO056 MUTARS - PE Inlay MUTARS - PE Inlay xsmall, Small, Standard, Large LH 17 157 1384 227770 2058 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH633 OO057 MUTARS - Patella Mutars PE Patella Standard Large LH 17 156 1376 227773 Changed Benefit 537 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH634 OO082 MUTARS - Arthrodesis stems Arthrodesis tibial and femoral stems, cvd, straight, cemented/cementless 11-20mm x 100 - 250mm length LH 13 123 1778 5475 236019 3724 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH635 OO089 MUTARS - Genux Locking screw for locking mechanism Locking screw, axel, for Genux hinge locking mechanism 1 Size LH 17 159 1391 250192 651 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH636 OO090 MUTARS - Genux Locking screws Locking screws for augments Various LH 17 159 1392 221737 273 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH637 OO093 MUTARS - Genux offset adapter Offset Adapter 0, 2.5mm, 5mm, 7.5mm LH 17 159 1396 250452 1208 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IG189 MN158 MicroSensor Monitoring System Skull bolt with ICP transducer 0.7mm sensor lead diameter IG 25 253 1794 Skull Bolt 149558 Changed Benefit 998 0 0 Update 2018-08-01 2019-03-01 Prosthesis IQ002 Ocuvis and Ocumax 2% Hydroxypropylmethylcellulose 20mg/mL hydroxypropylmethyl cellulose for intraocular use. Pre-loaded in a sterile syringe with one cannula for injection, in a sterile Tyvek pouch 2mL sterile IQ 1 142 1329 104427 72 0 0 No Change 2005-10-31 2019-03-01 Prosthesis IQ003 Tetraflex Acrylic single piece, foldable accommodating intraocular lens with sqare edge design, custom control precision and closed loop haptic design Available in dioptric powers from +5.0 to +36.0, 1D steps: +31.0 to +36.0; 0.5D steps: +5.0 to +18.0 and +25.0 to +30.0; 0.2D steps; +18.0 to +25.0 IQ 1 141 1327 3894 pa 120330 642 0 0 No Change 2006-03-24 2019-03-01 Prosthesis IQ004 Softec Acrylic, single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation and aberration technology Available in dioptric powers from -5.0 to +36.0, 1D steps: -5.0 to +10.0 and +31.0 to +36.0; 0.5D steps: +10.5 to +18.0 and +25.0 to +29.5; 0.25D steps: +18.0 to +25.0 IQ 1 141 1327 3892 at 120330 300 0 0 No Change 2006-03-24 2019-03-01 Prosthesis IQ005 Densiron Heavy Tamponade Liquid Medium, Postoperative 10 ml, Sterile IQ 1 148 1347 HO 152234 228 0 0 No Change 2009-02-01 2019-03-01 Prosthesis IQ006 Siluron 1000 & Siluron 5000 Silicone Oils 10 ml, Sterile IQ 1 148 1347 152234 185 0 0 No Change 2009-02-01 2019-03-01 Prosthesis BB334 Miethke Titanium connectors - right angled / shaped In general, titanium connectors are preferably used with catheters of internal diameter 1.2m and external diameter 2.5mm. Step-down connectors are designed for connecting standard catheters to lumbar catheters. L-P connectors are designed for connecting two lumbar catheters to each other. Titanium connector: Connector diameter, 1.9mm. L-shape: FV051T: 1pc Y-shape: FV015T: 1 pc, FV016T: 5 pcs, FV017T: 10 pcs. T-shape: FV018T: 1 pc, FV019T: 5 pcs, FV020T: 10 pcs. X-shape: FV021T: 1 pc, FV022T: 5 pcs, FV023T: 10 pcs. Y-shape: FV056T: 1 pc. U-shape: FV057T: 1 pc. F-shape: FV058T: 1 pc. L-shape: FV059T: 1 pc. Titanium connector, step-down: Connector diameters: 1.9mm to 1.4mm: L-shape: FV052T: 1 pc. Titanium connector, L-P drainage: Connector diameters 1.4mm to 1.4mm: L-shape: FV053T: 1 pc. BB 25 220 1671 4471 194850 190 0 0 No Change 2013-02-01 2019-03-01 Prosthesis DD047 Revelation Hip System - Femoral Component, Ti, Grit Blast, non HA, standard & lateral offset Non modular femoral hip stem, designed for uncemented use, left & right specific with 130 degree neck angle & 12 degrees of built-in anteversion. Proximal circumferential "3D" beading, a highly polished neck & highly polished distal stem 16 stems: 8 sizes Left & 8 sizes Right - 8.0, 9.0, 10.5, 12.0, 13.5, 15.0 & 16.5 DD 18 161 1406 3946 161911 3823 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD048 CLP Hip System - Femoral Component, Ti, Grit Blast, non HA, standard and lateral offset Non modular femoral hip stem, designed for uncemented use, and to be used with CoCro or Ceramic heads in total hip arthroplasty, or Bipolar heads in hemi-arthroplasty 14 x standard offset components and 12 lateral offset components DD 18 161 1406 3945 161911 3401 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD049 Foundation Unipolar System - CoCr Unipolar Femoral Heads CoCr unipolar femoral heads, 40mm to 64mm. Unipolar Femoral Heads 40mm to 64mm in 2mm increments DD 18 162 1420 3995 161911 835 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BV029 Procotyl L Delta Ceramic Liner Rim-Lock Biolox Delta Ceramic Liners 28-40mm A-G BV 18 163 1428 4025 273669 2303 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV030 WMT Perfecta Hip System PMMA cement Plug 9 - 21mm in 1mm increments BV 18 164 1446 143863 141 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV031 Profemur L Profemur L Hip Stem 1 - 11 Standard, Extended BV 18 161 1407 3949 218787 234444 3779 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV032 Dynasty Acetabular System/ Actebular Shell Beaded Acetabular shell non HA 46-76mm B-K BV 18 163 1426 4011 272232 272252 2204 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV033 Procotyl L Acetabular Cup Beaded, Titanium HA coated cup 42 - 68mm A-G BV 18 163 1427 4016 285236 Changed Benefit 2556 0 0 Update 2016-08-01 2019-03-01 Prosthesis BV034 Profemur Xm Femoral Stem Femoral Stem, CoCr, Cemented, Polished 0-4 BV 18 161 1404 3941 Removable Neck 234445 1845 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV028 Delta Modular Heads Biolox Delta Heads 33-40mm Short, Medium, Long BV 18 162 1420 3998 240574 2022 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BB335 Miethke proGAV with distal catheter Adjustable valve with a gravitational unit and a distal catheter Adjustable valve: diameter 18mm, opening pressure 0-20 cmH2O, height 4.5mm Gravitational unit: length 14.9mm, height 4.6mm, opening pressure 0-35 cm H2O Distal catheter: length 1200mm, inside diameter 1.2mm, outside diameter 2.5mm BB 25 220 1666 4468 Antisyphon function, Distal catheter, Reservoir/Priming function 181718 2902 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BB336 Miethke Ventricular Catheter with stylet Ventricluar catheters (with stylet) are used to drain CSF out of the ventricle. All catheters are made of radiopaque silicone. Inside diameter 1.2mm, Outside diameter 2.5mm. FV074P: 180mm, graduated. FV077P: 250mm, graduated. BB 25 220 1668 Proximal 196110 176 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BB337 Miethke proGAV Shunt System Shunt system containing an adjustable valve with a gravitational unit, a distal catheter, a ventricular catheter and a reservoir. Adjustable valve: diameter 18mm, opening pressure 0-20 cmH2O, height 4.5mm. Gravitational unit: length 14.9mm, height 4.6mm, opening pressure 0-35 cmH2O. Distal catheter: length 1200mm, inside diameter 1200mm, inside diameter 1.2mm, outside diameter 2.5mm. Reservoir: diameter 14/20mm. Ventricular catheter: 180/250mm. BB 25 220 1666 4468 Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function 181718 3040 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BV036 Bone Screw Cancellous Bone Screw Titanium 6.5mm x 1.5 – 6 cm in 0.5cm increments BV 18 164 1435 247558 121 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV037 Advance Medial Pivot Stem Cap Modular Tibial Base Stem Cap N/A BV 17 159 1395 196521 649 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV038 Delta Modular Heads Biolox Delta Heads 28-32mm Short, Medium, Long BV 18 162 1419 3992 240574 1845 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV039 Cement Centraliser Profemur XM Cement Centraliser N/A BV 18 164 1438 247578 139 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV035 Femoral Head Femoral Head CoCr 22.25-32mm Short-XLong -3.5-+10.5mm BV 18 162 1419 3989 262372 263792 703 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV040 Profemur Hip System Primary stem, tapered wedge, plasma coated, fixed neck 1-10 Extended, Neutral BV 18 161 1406 3948 240573 3954 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BV041 Profemur Modular Neck Titanium, CoCr Femoral Necks Neutral, Ante/Retro Varus/ Valgus 1,2 Short, X-Long Angle 0-15 Degrees BV 18 161 1417 234443 234446 Changed Benefit 1078 0 0 Update 2016-08-01 2019-03-01 Prosthesis BV042 Evolution Medial Pivot Knee System Uncemented, beaded, CoCr 1-8 Left, Right BV 17 149 1351 3914 290173 3309 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BB338 Miethke proGAV with pre-attached reservoir Shunt system containing an adjustable valve with a gravitational unit and a reservoir. Adjustable valve: diameter 18mm, opening pressure 0-20 cmH20, height 4.5mm. Gravitational unit: length 14.9mm, height 4.6mm, opening pressure 0-35 cmH2O Reservoir: diameter 14/20mm. BB 25 220 1666 4468 Antisyphon function, Distal catheter, Reservoir/Priming function 181718 2902 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BI953 Stage One Select Hip Mould Modular Spacer Mould, Stainless Steel, Silicon. Stem 9 - 17mm Head 43 - 64 Head BI 18 164 1452 98097 1371 0 0 No Change 2007-12-01 2019-03-01 Prosthesis BI956 Offset Tibial Tray System Offset Adapter for connection to tibial stems and baseplate, titanium 0mm, 2.5mm, 5mm, 7.5mm Offset BI 17 159 1396 98451 1208 0 0 No Change 2007-12-01 2019-03-01 Prosthesis BI961 Tibial Tray System Tibial Tray System - Primary, one piece, highly polished, uncemented, HA, plasma porous coated 59-91 BI 17 151 1360 3923 138208 Changed Benefit 2416 0 0 Update 2008-07-01 2019-03-01 Prosthesis BI962 Vanguard Total Knee System Femoral Component, Cruciate Retaining, Anatomic, HA, Plasma Porous Coated, CoCr & Ti alloy 55 - 80 BI 17 149 1352 3917 131310 3667 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BI963 Compress Compliant Prestress System Anchor Assembly: Plug, Transverse pin, spindle, nut, cap. 10-24mm femoral canal diameter, BI 17 157 1383 3935 177878 9267 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BI964 Compress Compliant Prestress System Medullary Centering Sleeve 13-25mm BI 17 157 1387 3936 177878 Changed Benefit 4024 0 0 Update 2008-07-01 2019-03-01 Prosthesis BI965 Compress Compliant Prestress System Femoral Adapter OSS or Finn Adapter BI 17 157 1387 3937 177878 1520 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BI966 Oxford Meniscal Knee System Femoral Component, Porous HA Coated CoCr, Ti, HA Small - Extra Large BI 17 150 1355 3920 126863 2236 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BI968 ToggleLoc Femoral Fixation Device 15mm-60mm BI 13 123 1774 5385 116765 Changed Benefit 442 0 0 Update 2009-02-01 2019-03-01 Prosthesis BI969 JuggerStitch Meniscal Repair Device one size BI 13 123 1774 5384 117747 Changed Benefit 294 0 0 Update 2009-02-01 2019-03-01 Prosthesis BI971 Regenerex Ringloc+ Acetabular shell, solid, limited hole or multi hole, Porous Ti Alloy 48 to 72mm OD BI 18 163 1426 4014 98098 2944 0 0 No Change 2009-02-01 2019-03-01 Prosthesis BI972 E-Poly HXLPE Liner Highly cross linked PE liner, stabilised with Vit E 28mm to 44mm in 4mm increments BI 18 163 1428 4021 98098 1019 0 0 No Change 2009-02-01 2019-03-01 Prosthesis BI973 Modular Head Implants Femoral Modular Head 22 - 32mm diameter, - 6 to =12mm neck, collared, no collar BI 18 162 1419 3989 98097 703 0 0 No Change 2009-02-01 2019-03-01 Prosthesis BV043 Advance Medial Pivot Knee System Tibial, femoral Augment, wedge, block, offset Distal, posterior Screw fixation 1-7 5-15mm Standard, plus BV 17 159 1390 196520 1148 0 0 No Change 2018-02-01 2019-03-01 Prosthesis BV044 Advance Medial Pivot Knee System Uncemented, Cemented Stems Femoral, Tibial 55-200mm 10-23mm BV 17 159 1399 196521 Changed Benefit 1126 0 0 Update 2018-02-01 2019-03-01 Prosthesis BV045 Evolution Medial Pivot Knee System Revision Tibial Base Augment Sizes 3 - 7 5mm - 15mm Medial, Lateral Left, Right BV 17 159 1390 196520 1148 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BV046 Evolution Medial Pivot Knee System Revision Stem Extension Adapter 25mm - 50mm BV 17 159 1400 196521 698 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BV047 Evolution Medial Pivot Knee System Revision Offset Stem Adapter 4mm - 8mm x 25mm BV 17 159 1396 196521 1208 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BV048 Evolution Medial Pivot Knee System Revision Stems - Cemented, Canal Filling 17mm - 18mm x 25mm - 75mm 10mm - 24mm x 100m - 150mm BV 17 159 1399 196521 Changed Benefit 1126 0 0 Update 2018-08-01 2019-03-01 Prosthesis BV049 Evolution Medial Pivot Knee System Revision System Screws Pass Through, Stem Extension, Side Lock BV 17 159 1398 196521 126 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BV050 Evolution Medial Pivot Knee System Revision Stem Cap one size BV 17 159 1395 196521 649 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BV051 Evolution Medial Pivot Knee System Revision Tibial Base Modular Keel Medium, Large BV 17 159 1400 196521 698 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BW001 5.5mm Knotless Anchor Soft-tissue anchor, non-bioabsorbable 5.5mm BW 13 123 1774 5382 274097 234 0 0 No Change 2016-08-01 2019-03-01 Prosthesis DD057 Reverse Shoulder - Glenoid Baseplate Reverse Glenoid Component, Baseplate 6.5mm x 30mm DD 13 131 1277 4078 210932 1991 0 0 No Change 2015-08-01 2019-03-01 Prosthesis DD058 Reverse Shoulder – Glenosphere Head Glenosphere 32mm to 40mm, neutral or -4mm offset DD 13 131 1277 4079 210932 Changed Benefit 2176 0 0 Update 2015-08-01 2019-03-01 Prosthesis DP001 Reef Femoral Wing Titanium grit blasted with HA trochanteric replacement/augment Sizes 1-3 SY 18 164 1455 143075 879 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP003 LCS Complete Knee System femoral component Femoral component, uncemented, CoCr, beaded (Porocoat) Sizes small to large+ SY 17 149 1351 3914 SCP 131657 Changed Benefit 3309 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP004 LCS Complete Knee System femoral component Femoral cemented, CoCr Sizes small to large+ SY 17 149 1348 3906 SCP 131657 Changed Benefit 2951 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP005 Reef Hip Proximal Body & Neck Titanium neck combined with small proximal body of varying size, grit blast, HA. With locking screw 25-35mm SY 18 161 1411 3966 Body 143075 2742 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP009 Reef Hip Femoral Stem Titanium modular femoral stem with optional distal locking, grit blast and full HA coating Length 225 - 375mm SY 18 161 1413 3976 Stem 143075 4412 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BW002 5.5mm Anchor with 2 x #2 suture Soft-tissue anchor, non-bioabsorbable 5.5mm BW 13 123 1774 5387 274097 Changed Benefit 442 0 0 Update 2016-08-01 2019-03-01 Prosthesis BW003 2.9mm RōG Anchor with 1 x #2 suture Soft-tissue anchor, non-bioabsorbable 2.9mm BW 13 123 1774 5385 274097 Changed Benefit 442 0 0 Update 2016-08-01 2019-03-01 Prosthesis BX214 TISSEEL Two Component Fibrin Sealant Syringe Active ingedients:Sealer Protein Solution & Thrombin Solution - deep-frozen 2.0 ml (containing 1.0 ml of Sealer Protein Solution and 1.0 ml of Thrombin Solution) BX 21 194 1580 4247 Biological 147141 Changed Benefit 352 0 0 Update 2005-10-31 2019-03-01 Prosthesis BX215 TISSEEL Two Component Fibrin Sealant Syringe Active ingedients:Sealer Protein Solution & Thrombin Solution - deep-frozen 4.0 ml (containing 2.0 ml of Sealer Protein Solution and 2.0 ml of Thrombin Solution) BX 21 194 1580 4248 Biological 147141 Changed Benefit 647 0 0 Update 2005-10-31 2019-03-01 Prosthesis BX216 TISSEEL Two Component Fibrin Sealant Syringe Active ingedients:Sealer Protein Solution & Thrombin Solution - deep-frozen 10.0 ml (containing 5.0 ml of Sealer Protein Solution and 5.0 ml of Thrombin Solution) BX 21 194 1580 4249 Biological 147141 1295 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BX245 Patient Control Module Sterile infusor devices, spring or elastomeric driven Module 0.5ml dose, Module 2 ml dose BX 21 188 1541 4191 168892 27 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DD028 R120 Femoral Neck CoCr, varying offsets & versions 32-38mm length, varying degrees DD 18 161 1417 161911 Changed Benefit 1078 0 0 Update 2010-02-01 2019-03-01 Prosthesis DD029 Foundation Shoulder System Humeral Stem, Ti 6mm to 16mm DD 13 131 1276 4058 161910 3325 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD030 Foundation Shoulder System Humeral Head, CrCo 38mm to 54mm DD 13 131 1276 4067 161910 1261 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD031 Foundation Shoulder System Pegged & Keeled Glenoid, compression moulded UHMWPE 38mm to 54mm DD 13 131 1277 3701 161910 1895 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD032 Reverse Shoulder System Humeral Stem, Ti 6mm to 12mm DD 13 131 1276 4058 210915 210917 3325 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD035 Reverse Shoulder System Humeral Socket Insert - UHMWPE 32mm to 40mm DD 13 131 1276 4069 210914 210933 774 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD036 Reverse Shoulder System Humeral Socket Shell - Ti Neutral, +4mm, +8mm offset DD 13 131 1276 4059 210937 Changed Benefit 2314 0 0 Update 2010-02-01 2019-03-01 Prosthesis DD038 R120 Metal Femoral Head R120 Metal Femoral Head >32mm 36mm DD 18 162 1420 3995 161911 835 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BI976 Vanguard E-Poly CR Tibial bearing Vitamin E infused Highly Cross linked Polyethylene /cruciate Retaining Tibial bearing. 59 to 91 x (10 -18mm) BI 17 153 1369 98451 1019 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BI977 Regenerex Tibial Tray Tibial Baseplate, modular. Regenerex porous coat, Ti Alloy 59, 63, 67, 71, 75, 79, 83 mm BI 17 151 1360 98451 2058 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BI978 Regenerex Tibial Tray Stem, PressFit, Ti Alloy 40, 80mm BI 17 159 1399 98451 Changed Benefit 1126 0 0 Update 2009-08-01 2019-03-01 Prosthesis BI974 Modular Head Implants Femoral Modular Head 36mm diameter , - 6 to + 12mm neck, collared, no collar BI 18 162 1420 3995 98097 835 0 0 No Change 2009-02-01 2019-03-01 Prosthesis BI975 Vanguard E-Poly PS bearing Vitamin E infusion Highly Cross linked Polythylene Posterior Stabilised Tibial Bearing 59 - 91 x (10 - 18mm) BI 17 153 1370 98451 Changed Benefit 1073 0 0 Update 2009-08-01 2019-03-01 Prosthesis BI981 Echo Hip System Bi Metric Femoral Stem Echo Bi Metric Cementless Titanium Femoral Component 7 - 17mm BI 18 161 1406 3948 98097 3954 0 0 No Change 2009-08-01 2019-03-01 Prosthesis DD039 R120 Metal Femoral Head R120 Metal Femoral Head <32mm 28mm, 32mm DD 18 162 1419 3989 161911 703 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD040 R120 Ceramic Femoral Head R120 Ceramic, Biolox Femoral Head > 32mm 36mm DD 18 162 1420 3996 161911 1806 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD041 R120 Ceramic Femoral Head R120 Ceramic, Biolox Femoral Head <32mm 28mm - 3.5mm to +3.5mm 32mm - 4.0mm to +4.0mm DD 18 162 1419 3990 161911 Changed Benefit 1758 0 0 Update 2010-02-01 2019-03-01 Prosthesis DD042 Foundation Unipolar System - CoCr Unipolar Sleeves Unipolar sleeves are used in conjunction with Unipolar CoCr Femoral Heads to provide -3.5mm, +0mm, +3.5mm, +7.0mm & +10mm neck length options when used in conjunction with a femoral hip component in hemi-arthroplasty operations. -3.5mm,+0mm (neutral), +3.5mm, +7mm & +10mm DD 18 164 1451 161911 228 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD043 FMP Acetabular System - Acetabular cup insert, metal on metal Modular metal on metal liner, available in 28mm ID, 34mm ID, 38mm ID, to fit FMP Acetabular Cup system 28mm ID, 34mm ID, 38mm ID, to fit FMP Acetabular Cups from 48 mm to 70mm OD DD 18 163 1428 4023 Sandwich 161911 2022 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD044 FMP Acetabular System - Acetabular Cup Insert UHMWPE Acetabular cup inserts, UHMWPE compression moulded and cross-linked. 28-44mm Internal Diameters available in 0-degree (neutral), 10-degree hooded and 20-degree hooded options and +5mm offset options ID of 28mm - 44mm to suit Acetabular shells of OD 40mm-80mm 0,10,20-degree hooded and non-hooded. +5mm Offset DD 18 163 1428 4021 209548 1019 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD045 FMP Acetabular System - Constrained Liner Locking Ring 28mm constrained liner locking ring, manufactured from titanium, is used with the FMP constrained acetabular liners. one size, to fit all 28mm ID constrained liners DD 18 164 1449 161911 150 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD046 FMP Acetabular System - Constrainer Liner 28mm constrained liner and titanium locking ring is used with the FMP acetabular system to treat recurrent dislocation. 28mm ID, from MP5 to MP12 (40mm through to 70mmOD) DD 18 163 1428 4024 161911 1613 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD050 FMP Acetabular System - CoCro Femoral Heads CoCro femoral heads in 22mm and 32mm diameters to fit with FMP acetabular liners and FMP acetabular shells 22mm in +0,+4,+8mm and 32mm in -4.0, +4, +8, +12mm, diameters DD 18 162 1419 3989 210902 703 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DD051 FMP Femoral Head CoCr Femoral Head 22-32mm DD 18 162 1421 161911 2109 0 0 No Change 2010-08-01 2019-03-01 Prosthesis DD052 FMP Femoral Head CoCr Femoral Head 34-38mm DD 18 162 1421 161911 2109 0 0 No Change 2010-08-01 2019-03-01 Prosthesis DD054 Replacement retaining screw for glenoid head Replacement retaining screw for glenoid head 6.5mm x 30mm DD 13 123 1231 3369 212521 65 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DD055 Glenoid Baseplate Non Locking Bone Screw Glenoid Baseplate Non Locking Bone Screw 3.5mm diameter, length 14-34mm in 2mm increments DD 13 123 1231 3370 212470 82 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DD056 Glenoid Baseplate Locking Bone Screws Glenoid Baseplate Locking Bone Screws 5.0mm diameter, length 14-38mm in 4mm increments DD 13 123 1231 3369 LK 212469 128 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DP014 Duraloc & Pinnacle Constrained Inserts UHMWPE, constrained liner with titanium alloy locking ring Inner diameter 28-44mm, 36-76mm outer diameter SY 18 163 1428 4024 Cup & Ring 97696 98086 1613 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP026 LCS Complete Knee System rotating platform tibial Insert Tibial insert, for rotating platform, UHMWPE Sizes small to large+ SY 17 153 1369 138289 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP031 MBT Knee System tibial baseplate Tibial baseplate, uncemented, CoCr, beaded (Porocoat) for rotating platform, (keeled and non keeled) Sizes 1 - 7 SY 17 151 1362 98092 2639 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP032 MBT Knee System tibial baseplate Tibial baseplate, cemented, CoCr, for rotating platform, (keeled and non keeled) Sizes 1 - 7 SY 17 151 1359 98092 Changed Benefit 2147 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP035 MBT Knee System tibial baseplate Tibial baseplate, uncemented, CoCr, HA (Duofix), beaded (Porocoat) for rotating platform, ( non keeled only) Size 1-7 SY 17 151 1362 3924 143525 Changed Benefit 2997 0 0 Update 2005-10-31 2019-03-01 Prosthesis BI983 Max-Ti Modular Protrusio Cage Acetabular Support Component, Porous Ti Alloy 52, 56, 60, 64, 68 and 72mm Left and 52, 56, 60, 64, 68 and 72 mm Right BI 18 163 1432 4035 98096 1253 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BI984 Max-Ti Modular Protrusio Cage Acetabular Augment, Porous Ti Alloy Dome Augment (1 Hole Large, 2 Hole Large, 1 Hole Small), iliac flange Augment (6 mm) BI 18 164 1433 98096 1230 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BI985 W Lorenz Osteosynthesis System Plates Straight, 1.5, 2.0 or 1.0mm System 15 - 32 holes BI 23 199 1589 4277 128458 199 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BI989 W Lorenz Osteosynthesis System Plate Straight, 2mm System 8 - 15 hole BI 23 199 1589 4277 128458 199 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BI994 Lactosorb Resorbable Craniomaxillofacial Fixation System Bone Screw Lactosorb, single screw (multiple screws per pack) PGA/PLA 1.5mm dia BI 23 199 1590 4323 Resorbable 143957 137 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BI995 Lactosorb Resorbable Craniomaxillofacial Fixation System Bone Screw Lactosorb, single screw (multiple screws per pack) PGA/PLA 2.0mm dia BI 23 199 1590 4323 Resorbable 143957 137 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BI996 Lactosorb Resorbable Craniomaxillofacial Fixation System Bone Screw Lactosorb,single screw (multiple screws per pack) PGA/PLA 2.5mm dia BI 23 199 1590 4323 Resorbable 143957 137 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BL005 Storz (Coburn) Intraocular Lens 121UV; L122UV PMMA Anterior Chamber Lens PMMA Anterior Chamber Intraocular lens 1 piece 13.75mm length. 6.0mm optic size, diopter range 3-30d. L122UV: 6.0mm optic, 13.75mm length, power range; 5.0 to 30.0 Diopters BL 1 140 1324 3887 97880 133 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BL008 Ocucoat Intraocular Fluid 20mg/mL hydroxypropylmethyl cellulose for intraocular use 1ml and 2ml Sterile BL 1 142 1329 140513 72 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BL015 Amvisc Plus injection 15mg/mL Sodium Hyaluronate for intraocular use 0.5mL and 0.8mL BL 1 142 1329 161187 72 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BL016 Oxane LMWC Fractioned Silicone Oil Purified fractioned silicone oil 10mL BL 1 148 1347 108429 185 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BL017 Perfluo-octane (Oktaline) Okta-Line Perfluorocarbon Liquid for use as a retinal surgery additive 5mL BL 1 148 1346 108429 228 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BV027 Femoral Head Femoral Head CoCr 33-36mm Short-XLong BV 18 162 1420 3995 262372 835 0 0 No Change 2016-08-01 2019-03-01 Prosthesis HW379 Souter Strathclyde Elbow Revision Humeral - Custom, Long Stem A, B, C, D HW 13 131 1275 3673 16236 166620 4387 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW380 Souter Strathclyde Elbow Revision Ulnar - Custom, Long stem Small, Medium HW 13 131 1275 3676 16236 166619 3398 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW381 Radial Head Prostheses Radial Head - Small, Medium, Large 8 - 15mm HW 13 131 1275 3675 166613 Changed Benefit 1267 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW384 Xia Spine System Polyaxial Screw Dia: 4mm - 10.5mm Length: 20mm - 100mm HW 19 165 1463 139620 1280 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW385 Xia Spine System Monoaxial Screw Dia 4.5 - 8.5mm Length 25 - 60mm HW 19 165 1462 139620 49029 895 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW386 Xia Spine System Rod Clamp - Parallel, Axial One size only HW 19 167 1472 139620 49029 Changed Benefit 732 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW389 Xia / Mantis Spine System Rod Diameter: 5.5mm - 6mm. Length: 20mm - 600mm HW 19 170 1478 139620 Changed Benefit 426 0 0 Update 2005-10-31 2019-03-01 Prosthesis ER124 Stimulan Kit/Rapid Cure-5 cc Calcium Sulphate synthetic rapid cure bone void filler kit. 5cc ER 13 123 1241 4092 123765 722 0 0 No Change 2013-02-01 2019-03-01 Prosthesis ER125 Stimulan Kit/Rapid Cure-10cc Calcium Sulphate synthetic rapid cure bone void filler kit 10 cc ER 13 123 1241 4093 123765 1140 0 0 No Change 2013-02-01 2019-03-01 Prosthesis ER126 Stimulan Kit/Rapid Cure-20cc Calcium Sulphate synthetic rapid cure bone void filler kit. 20cc ER 13 123 1241 4094 123765 1425 0 0 No Change 2013-02-01 2019-03-01 Prosthesis ER127 Stimulan kit -5cc Calcium Sulphate synthetic bone void filler kit 5cc ER 13 123 1241 4092 123765 722 0 0 No Change 2013-02-01 2019-03-01 Prosthesis ER128 Stimulan kit-10cc Calcium Sulphate synthetic bone void filler kit 10cc ER 13 123 1241 4093 123765 1140 0 0 No Change 2013-02-01 2019-03-01 Prosthesis EU015 Europ Standard Uncemented Condyle Knee Uncemented Condyle 1 to 6, right and left EU 17 149 1351 3914 171851 3309 0 0 No Change 2012-08-01 2019-03-01 Prosthesis EU016 Europ Standard & Postero Cemented Monobloc Plate Knee Cemented Monobloc plate 1 to 6 EU 17 151 1357 171851 1923 0 0 No Change 2012-08-01 2019-03-01 Prosthesis DP107 CMW Bone Cement CMW Bone Cement Various without Antibiotic 20, 40 grams SY 13 123 1279 4087 96550 157 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP108 CMW Antibiotic Bone Cement CMW Bone Cement Various with Antibiotic 20, 40 grams SY 13 123 1279 4088 33482 63146 Changed Benefit 166 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP121 Solution Calcar Replacement Femoral Stem CoCr calcar replacement stem, uncemented, beaded (Porocoat) Size 7-10 inch (175 - 250mm) SY 18 161 1414 3982 98085 6063 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP045 Isola System (Stainless Steel) Double Wire One size only SY 13 123 1772 5364 97391 11 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP124 DePuy Femoral Head CoCr Femoral Head Various Tapers & Neck Lengths 22-32 mm SY 18 162 1419 3989 136384 145009 136290 703 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP143 PFC Sigma Knee System tibial stems Tibial stems cemented and fluted uncemented, titanium Sizes 30-150mm SY 17 159 1399 238732 Changed Benefit 1126 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP148 PFC Sigma Knee System femoral component Femoral component, uncemented, CoCr, Beaded Size 1-6 SY 17 149 1351 3914 131657 3309 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP149 PFC Sigma Knee System femoral component Femoral component, cemented, CoCr, posterior stabilised Size 1-6 including narrow sizes SY 17 149 1348 3907 131657 97699 3041 0 0 No Change 2005-10-31 2019-03-01 Prosthesis EV003 Katana Connector Adjustable XXSmalll to Large EV 19 167 1474 4124 236041 Changed Benefit 1299 0 0 Update 2015-08-01 2019-03-01 Prosthesis EV004 Katana Monoaxial Screw Monoaxial Pedicle Screw 4.5 - 7.5mm diameter 25 - 55mm length EV 19 165 1462 236041 895 0 0 No Change 2015-08-01 2019-03-01 Prosthesis EV005 Katana Setscrew The Katana Pedicle Screw System is intended to provide immobilization and stabilisation of spinal segments in skeletally mature patients, as an adjunct to fusion in the thoracic, lumbar and sacral spine. standard EV 19 166 1465 236041 164 0 0 No Change 2015-08-01 2019-03-01 Prosthesis EV006 Katana Polyaxial Screw Polyaxial Pedicle Screw 4.5 – 9.5mm diameter 25 - 100mm length EV 19 165 1463 Cannulated 236041 1338 0 0 No Change 2015-08-01 2019-03-01 Prosthesis EV007 Katana Rods Pre-Lordosed and Straight Rods - Ti and CoCr Curved and Straight Rods Length: 25mm – 160mm EV 19 170 1478 236041 Changed Benefit 426 0 0 Update 2015-08-01 2019-03-01 Prosthesis EV008 Evolution ACDF Plate Bone Screw Bone screw 4.0mm diameter 10-20mm, 4.5mm diameter 10-20mm EV 19 165 1464 248233 Changed Benefit 193 0 0 Update 2015-08-01 2019-03-01 Prosthesis DP155 PFC Sigma Knee System femoral stem bolts Bolts to connect femoral stem, straight and offset Neutral +/- 2mm SY 17 159 1392 131657 273 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP150 PFC Sigma Knee System TC3 femoral component Femoral component, cemented, CoCr, totally constrained Size 1-6 SY 17 149 1348 3908 Revision 131657 97698 98088 5590 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP152 PFC Sigma Knee System Cemented, all poly, patella 25-50mm SY 17 156 1376 108414 Changed Benefit 537 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP158 PFC Sigma Knee System femoral augments Distal and posterior femoral augments, CoCr , with screws Sizes 1 - 6. 4-16mm SY 17 159 1390 131657 137608 1148 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP161 PFC Sigma Knee System tibial augments Tibial wedges (full and hemi) and hemi blocks, CoCr, with screw Size 1-6 SY 17 159 1390 136903 98092 1148 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP162 PFC Sigma Knee System tibial insert Tibial insert for AMK Duofix tibial baseplate with locking post and clip, UHMWPE Sizes 1 - 6. 8-30mm SY 17 153 1369 138289 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP166 PFC Sigma Knee System tibial insert Tibial Insert, rotating platform UHMWPE Sizes 1 - 6. 8-30mm SY 17 153 1369 137608 138289 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis EV009 Evolution ACDF Plate Anterior Cervical Plate 1 level Plate (20mm-32mm), 2 level plate (34mm – 50mm) EV 19 169 1476 4125 247573 Changed Benefit 1348 0 0 Update 2015-08-01 2019-03-01 Prosthesis EV010 Evolution ACDF Cage Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. small, large – flat EV 19 174 1486 4134 248234 2409 0 0 No Change 2015-08-01 2019-03-01 Prosthesis EV011 Evolution ACDF Cage Bone Screw Bone screw for fusion cages 4.0 diameter, 12-16mm; 4.5 diameter, 12-16mm EV 19 165 1464 248233 Changed Benefit 193 0 0 Update 2015-08-01 2019-03-01 Prosthesis EV012 Evolution ACDF Contoured Cage Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. small, large - contoured EV 19 174 1486 4134 248234 2409 0 0 No Change 2015-08-01 2019-03-01 Prosthesis DP167 Thompson Hip Stainless steel (Ortron 90), Thompson unipolar monoblock femoral component head size 40-54 SY 18 161 1416 97395 Changed Benefit 541 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP168 Austin Moore Hip Prosthesis Stainless steel (Ortron 90), AMP unipolar monoblock femoral component Head size 38-60mm SY 18 161 1416 97395 Changed Benefit 541 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP171 Hastings Bipolar Prosthesis Bipolar femoral head, CoCr with fixed UHMWPE insert Size 36 - 56 SY 18 162 1424 4004 136384 753 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP173 PLAD Acetabular Rim Augment Metal & polyethylene curved plate for screw attachment to UHMWPE cemented cups. Includes 4 screws. 22- 28mm SY 18 164 1433 97696 1230 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP175 Charnley Hip Long Femoral Stem Stainless steel Ortron 90 stem 10"- 15" (250-375mm) SY 18 161 1405 3944 97395 3120 0 0 No Change 2005-10-31 2019-03-01 Prosthesis EV013 Evolution ACDF Standalone Cage Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. Standard – 6 and 9 degrees, height 4-10mm EV 19 174 1485 5485 248234 Changed Benefit 4379 0 0 Update 2015-08-01 2019-03-01 Prosthesis EV014 Evolution ALIF Cage ThoracoLumbar ALIF Cage Small (34x25mm) 8 - 18 degrees, 10 - 18mm Medium (38x29mm) 8 - 18 degrees, 10 - 18mm Medium Long (38x34mm) 8 - 18 degrees, 10 - 18mm Large (42x30mm) 8 - 18 degrees, 10 - 18mm X Large (42x34mm) 8 - 18 degrees, 10 - 22mm XX Large (42x38mm) 13 degrees, 12 - 18mm EV 19 174 1485 5486 248234 6256 0 0 No Change 2015-08-01 2019-03-01 Prosthesis EV015 Evolution ALIF Cage Screw ThoracoLumbar Cage Bone Screw 5.5mm Diameter, 20-35mm; 6.5mm Diameter, 20-35mm EV 19 165 1464 248233 Changed Benefit 193 0 0 Update 2015-08-01 2019-03-01 Prosthesis EV016 Evolution TM2 Cage Thoraco Lumbar ALIF cage standard EV 19 174 1485 5486 248234 6256 0 0 No Change 2015-08-01 2019-03-01 Prosthesis EV017 Shuriken Cage Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. 7-13mm height; 30-35mm length; 6-18 degrees lordosis EV 19 174 1486 4135 236041 3465 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER038 Nevro Spinal Cord Stimulation System (SCSS) - Tunneling Tool Kit The Tunneling Tool creates a subcutaneous tunnel from the Implantable Pulse Generator (IPG) site to the midline incision. The tunneling tool is passed subcutanously to deliver the leads from needle insertion site to the IPG site Length: 20-50cm, in increments of 1cm ER 25 222 1690 4501 180556 Changed Benefit 160 0 0 Update 2012-02-01 2019-03-01 Prosthesis ER039 Nevro Spinal Cord Stimulation System (SCSS) - Cable Kit The cables are used during the Lead implant procedure and patient trial to make electrical and mechanical connections between the Trial Stimulator and the Lead or Lead extension. There is a separate adaptor cable that allows the use of the Medtronic lead with the Nevro Senza System N/A ER 25 222 1690 4501 181180 Changed Benefit 160 0 0 Update 2012-02-01 2019-03-01 Prosthesis ER040 Nevro Spinal Cord Stimulation System (SCSS) - Lead Anchor Kit The Lead Anchors are used to anchor the lead to the fascia or supraspinous ligament. Lead Anchors are designed to slide freely over the lead length to the required fixation position and sutures are then tied around the anchor clamping the sleeve in place on the lead. N/A ER 25 222 1690 4501 180541 Changed Benefit 160 0 0 Update 2012-02-01 2019-03-01 Prosthesis ER041 Nevro Spinal Cord Stimulation System (SCSS) - Torque Wrench Kit The Torque Wrench is used to tighten the set screws that lock the lead into the Implantable Pulse Generator or to lock the lead into a lead extension N/A ER 25 222 1690 4501 181181 Changed Benefit 160 0 0 Update 2012-02-01 2019-03-01 Prosthesis ER042 Nevro Spinal Cord Stimulation System (SCSS) - IPG Port Plug Kit The Implantable Pulse Generator (IPG) Port Plug is provided to seal the port of the IPG that is not is use. N/A ER 25 222 1690 4500 190837 Changed Benefit 160 0 0 Update 2012-02-01 2019-03-01 Prosthesis ER043 Nevro Spinal Cord Stimulation System (SCSS) - IPG Template Kit The Implantable Pulse Generator (IPG) Template is an aid for the physician to assist in the proper sizing of the IPG pocket. N/A ER 25 222 1690 4501 185414 Changed Benefit 160 0 0 Update 2012-02-01 2019-03-01 Prosthesis EV018 Katana Hook The Katana Pedicle Screw System is intended to provide immobilization and stabilisation of spinal segments in skeletally mature patients, as an adjunct to fusion in the thoracic, lumbar and sacral spine. Pedicle, wide blade, narrow blade, thoracic supralaminar, thoracic angled, lumbar infralaminar, extended body, offset. EV 19 168 1475 236041 789 0 0 No Change 2016-02-01 2019-03-01 Prosthesis EV019 Katana Staple The Katana Pedicle Screw System is intended to provide immobilization and stabilisation of spinal segments in skeletally mature patients, as an adjunct to fusion in the thoracic, lumbar and sacral spine. 13-25mm, Caudal, Rostral, Single EV 19 172 1483 236041 395 0 0 No Change 2016-02-01 2019-03-01 Prosthesis EV020 Fukiya ACDF Cage Fukiya Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. 6-9 degrees, 5-10mm. Small, Medium, Large, Extra large EV 19 174 1486 4134 236042 2409 0 0 No Change 2016-02-01 2019-03-01 Prosthesis EV021 Revolution ACDF Plate Anterior Cervical Plate Double and Mini Plates. Level 1 20 - 34mm, Level 2 Plate 36 - 50mm EV 19 169 1476 4125 273279 Changed Benefit 1348 0 0 Update 2016-08-01 2019-03-01 Prosthesis EV022 Revolution ACDF Plate Screw Anterior Cervical Bone Screws Fixed and Variable Angle. Diameter 4 - 4.5mm. Length 10 - 20mm EV 19 165 1464 236041 Changed Benefit 193 0 0 Update 2016-08-01 2019-03-01 Prosthesis ER044 Nevro Spinal Cord Stimulation System (SCSS) - Stylet Kit The Stylets are used to push and "steer" the stimulation Lead into place. These are standard configurations offered across industry offering the implanter the flexibility to maneuver the leads through the epidural space to the desired implant location. Offered in Straight, Curved or Tapered versions. Diameter: 0.3mm or 0.35, Length:30-90cm in 5cm increments, Angle: 15-30 degrees in 5 degree increments ER 25 222 1690 4501 180653 Changed Benefit 160 0 0 Update 2012-02-01 2019-03-01 Prosthesis ER045 Aleutian Lateral Lateral Interbody Spacer (16-22)mm width x (25-60)mm length x (6-20)mm height, (0-15) degreee lordotic angle ER 19 174 1486 4135 159146 3465 0 0 No Change 2012-02-01 2019-03-01 Prosthesis ER046 Chesapeake Spinal System Thoracolumbar Cage Peek/Ti Footprint: 24mm - 30mm x 30mm - 40mm Height: 11mm - 21mm ER 19 174 1485 5486 159146 6256 0 0 No Change 2012-02-01 2019-03-01 Prosthesis ER047 Chesapeake Spinal System - Fixation Screw Locking screw for the Chesapeake Spinal System Diameter: 3.5mm, 3.85mm. 5.5mm Lengths: 12mm to 35mm ER 19 165 1464 Dual Thread 154444 462 0 0 No Change 2012-02-01 2019-03-01 Prosthesis ER049 Everest Spinal System -Pedicle Screw Polyaxial Pedicle Screw, Ti Diameter: 4.5mm-10.5mm, Length: 25mm - 110mm (open or closed) ER 19 165 1463 193653 1280 0 0 No Change 2012-08-01 2019-03-01 Prosthesis ER051 Blue Ridge Hybrid Cervical Plate System - Plate Low profile, anterior cervical plate. Locking, titanium 22- 53mm ER 19 169 1476 4125 154444 Changed Benefit 1348 0 0 Update 2012-08-01 2019-03-01 Prosthesis ER052 Blue Ridge Hybrid Cervical Plate System - Plate Low profile, anterior cervical plate. Locking, titanium. 56-92mm ER 19 169 1476 4125 >55mm 290395 1636 0 0 No Change 2012-08-01 2019-03-01 Prosthesis ER053 Blue Ridge Hybrid Cervical Plate System - Screw Screw, Self-starting or Self-tapping (4.0 - 4.3) mm Diameter x (12- 18)mm Length ER 19 165 1464 154444 Changed Benefit 193 0 0 Update 2012-08-01 2019-03-01 Prosthesis ER054 Nile CoCr Wire System CoCr wire 1.0mm ER 13 123 1772 5364 183361 11 0 0 No Change 2012-08-01 2019-03-01 Prosthesis HW319 Rutherford Staple Ellison Soft Tissue Retainer, Vitallium 8,11,14mm HW 13 123 1773 5514 139631 16229 Changed Benefit 127 0 0 Update 2005-10-31 2019-03-01 Prosthesis EV023 Shinto PLIF Cage Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. Angle 8 - 22 degrees Length 21 - 26mm Height 5 - 13mm EV 19 174 1486 4135 236042 3465 0 0 No Change 2016-08-01 2019-03-01 Prosthesis HW320 Antibiotic Simplex Bone Cement with Tobramycin Polymethyl Methacrylate, Styrene Copolymer, Barium Sulfate 40 grams HW 13 123 1279 4088 158560 Changed Benefit 166 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW318 Rutherford Staple Ellison Flat Staple, Vitallium 8,11,14 x 23mm HW 13 123 1773 5514 139631 16229 Changed Benefit 127 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW322 Surgical Simplex P Radiopaque Bone Cement Polymethyl Methacrylate, Styrene Copolymer, Barium Sulfate 40 grams HW 13 123 1279 4087 141277 157 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW333 Omega Plus Compression Hip Screw System Lag Screw - Standard - Stainless Steel 50-130mm length HW 13 123 1231 3373 119660 222 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ER102 Nevro Spinal Cord Stimulation System (SCSS) - Pocket Adaptor Kit - S8 The Pocket Adaptor is intended to be used when replacing a previously implanted Pulse Generator with the Nevro Implantable Pulse Generator. The Pocket Adaptor interfaces the Nevro Implantable Pulse Generator to another manufacturer's previously implanted compatible lead or lead extension. Length of 10cm to 60cm, in increments of 1cm. ER 25 222 1680 199081 Changed Benefit 1434 0 0 Update 2012-08-01 2019-03-01 Prosthesis ER103 GeneX GeneX paste 10cc ER 13 123 1241 4093 158711 1140 0 0 No Change 2012-08-01 2019-03-01 Prosthesis ER104 GeneX GeneX/GeneX DS paste 2.5 and 5cc ER 13 123 1241 4092 158711 722 0 0 No Change 2012-08-01 2019-03-01 Prosthesis ER105 GeneX GeneX putty 10cc ER 13 123 1241 4093 155298 1140 0 0 No Change 2012-08-01 2019-03-01 Prosthesis ER106 GeneX GeneX putty 5cc ER 13 123 1241 4092 155298 722 0 0 No Change 2012-08-01 2019-03-01 Prosthesis ER107 GeneX GeneX putty 2.5cc ER 13 123 1241 4092 155298 722 0 0 No Change 2012-08-01 2019-03-01 Prosthesis HW335 Omega Plus Compression Hip Screw System Compression Screw - Stainless Steel 25mm length HW 13 123 1231 3732 119660 76592 117 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW334 Omega Plus Compression Hip Screw System Lag Screw - Super - Stainless Steel 50-130mm length HW 13 123 1231 3373 119660 76592 222 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW337 Stryker Plating System Screws Ti or StST 4.5-6.5mm HW 13 123 1231 3369 119660 25735 65 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW368 Osteo Kirschner Wire K wire - Stainless Steel Diameter 1.0 - 2.0mm HW 13 123 1772 5365 143230 27 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW375 Howmedica Mainstay Soft Tissue Anchor Zip anchor - Titanium Sip 4.5 anchor with #5 suture and #2 suture 2 strands, zip 3.5 anchor with #2 suture and #0 suture 2 strands, zip 2.7 anchor with #0 suture HW 13 123 1774 5382 139736 16234 234 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW377 Souter Strathclyde Elbow Humeral - Long stem, left and right Medium, Large HW 13 131 1275 3673 16236 166620 4387 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW378 Souter Strathclyde Elbow Ulnar - Retentive, non retentive 50 - 90mm (Non), 70 - 90mm (Retentive) HW 13 131 1275 3676 16236 166619 3398 0 0 No Change 2005-10-31 2019-03-01 Prosthesis KT017 Martin Distraction Osteogenesis Rigid External Distraction (Polley RED II) Distractor System, Component, Screws/Pins (other than bone screws), titanium 45-55mm KT 23 202 1604 4408 113786 96619 144 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT018 Martin Distraction Osteogenesis Rigid External Distraction (Polley RED II) Distractor System, Complete, External, Midface, Aluminium, Carbon Fibre one size only KT 23 202 1603 4396 Multivector 113786 Changed Benefit 7897 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT019 Martin Distraction Osteogenesis Distractor System, Complete, other, titanium 15-60 mm distraction length KT 23 202 1603 4399 Multivector 113786 Changed Benefit 3022 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT020 Martin Distraction Osteogenesis Rigid External Distraction (Polley RED II) Distractor System, Component, Other, titanium, aluminium 1.5-1.58mm KT 23 202 1604 4410 113786 Changed Benefit 1424 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT021 Martin Distraction Osteogenesis Rigid External Distraction (Polley RED II) Distractor System, Component, Footplate, titanium 1.5mm KT 23 202 1604 4403 113786 152 0 0 No Change 2015-02-01 2019-03-01 Prosthesis MI053 5019 Adaptor Adapts DF-4 lead to enable use of additional leads for high defibrillation thresholds One size MI 27 244 1763 198624 360 0 0 No Change 2012-08-01 2019-03-01 Prosthesis MI055 Medtronic Pocket Sizer Implant accessory designed to aid in the creation of a pocket for Medtronic implantable neurostimulators. One size only MI 25 222 1690 4501 194276 Changed Benefit 160 0 0 Update 2012-08-01 2019-03-01 Prosthesis MI057 Atlantis Anterior Cervical Plate System - Bone Screw Screws - Self-Tapping / Self-Drilling and Fixed / Variable Angle Diameter: 4.0mm - 4.5mm; Length 11mm - 17mm MI 19 165 1464 169514 Changed Benefit 193 0 0 Update 2012-08-01 2019-03-01 Prosthesis MI058 Bryan Cervical Disc Cervical intervertebral disc prosthesis consisting of a polyurethane nucleus designed to fit between two titanium alloy shells 14mm-18mm MI 19 175 1488 5487 100706 6256 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI059 Prestige Cervical Disc Cervical intervertebral disc prosthesis with ball-and-trough designed articulation 5mm - 8mm x 12mm - 18mm MI 19 175 1488 5487 100706 6256 0 0 No Change 2013-02-01 2019-03-01 Prosthesis IQ015 PreciSAL 302A Acrylic, single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology and blue light filter. Available in dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0 IQ 1 141 1327 3892 at, vblf 183558 Changed Benefit 317 0 0 Update 2013-08-01 2019-03-01 Prosthesis IQ016 PreciSAL P302A Preloaded Acrylic, single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology and blue light filter. Available in dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0 IQ 1 141 1327 3892 at, pl, vblf 183558 333 0 0 No Change 2013-08-01 2019-03-01 Prosthesis IQ017 PreciSAL Toric T302AC Acrylic single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology, toric correction on anterior surface with cylinder marks to indicate flat meridian plus the cylinder axis to allow alignment for astigmatic correction, and UV filter. Available in spherical dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; Cylinder powers from 1.0D to 6.0D IQ 1 141 1327 3892 at, pl, t1 183558 Changed Benefit 626 0 0 Update 2014-02-01 2019-03-01 Prosthesis 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 MI 24 207 1626 202471 Changed Benefit 4608 0 0 Update 2013-02-01 2019-03-01 Prosthesis 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 MI 24 207 1631 4448 292372 2427 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI062 Capstone Control TLIF vertebral Body Spacer Length: 27-32mm MI 19 174 1486 4135 126313 3465 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI063 Capstone Control PLIF Vertebral Body Spacer Length: 22-26mm MI 19 174 1486 4135 Paired 126313 Changed Benefit 2888 0 0 Update 2013-02-01 2019-03-01 Prosthesis MI064 Crescent Spinal System Titanium height: 7-16mm MI 19 174 1486 4135 126313 3465 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI065 Clydesdale Spinal System Lateral vertebral body spacer (PEEK & PTC) Length: 40mm - 60mm MI 19 174 1486 4135 126313 3465 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI066 Fuse Spinal system PLIF Vertebral Body Spacer Length: 24.5mm MI 19 174 1486 4135 Paired 200709 Changed Benefit 2888 0 0 Update 2013-02-01 2019-03-01 Prosthesis MI067 Injex Anchor Kit Neurostimulation Anchor Kit One Size MI 25 222 1690 4501 133358 Changed Benefit 160 0 0 Update 2013-02-01 2019-03-01 Prosthesis MI068 Loop Spinal System TLIF Vertebral Body Spacer Length: 32.5mm -37.5mm MI 19 174 1486 4135 200709 3465 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI069 VIVA XT CRT-D DTBA2D1 Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, SmartShock Technology, OptiVol 2.0 Fluid Status Monitoring, Complete Capture Management Specifications (DF1), and AdaptivCRT 35cc, 82g MI 27 238 1727 a,c,d 203212 37440 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI070 VIVA XT CRT-D DTBA2D4 Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, SmartShock Technology, OptiVol 2.0 Fluid Status Monitoring, Complete Capture Management Specifications (DF4), and AdaptivCRT 35cc, 82g MI 27 238 1727 a,c,d,e 203211 37980 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MI071 VIVA S CRT-D DTBB2D1 Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, SmartShock Tehnology, OptiVol 2.0 Fluid Status Monitoring and Complete Capture Management Specifications (DF1) 35cc, 82g MI 27 238 1727 a,c,d 203210 37440 0 0 No Change 2013-02-01 2019-03-01 Prosthesis IQ018 PreciSAL Toric PT302AC Pre-loaded acrylic single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology, toric correction on anterior surface with cylinder marks to indicate flat meridian plus the cylinder axis to allow alignment for astigmatic correction, and UV filter. Available in spherical dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; Cylinder powers from 1.0D to 6.0D IQ 1 141 1327 3892 at, pl, t1 183558 Changed Benefit 626 0 0 Update 2014-02-01 2019-03-01 Prosthesis IQ019 PreciSAL Toric T302A Acrylic single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology, toric correction on anterior surface with cylinder marks to indicate flat meridian plus the cylinder axis to allow alignment for astigmatic correction, and UV and blue light filters. Available in spherical dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; Cylinder powers from 1.0D to 6.0D IQ 1 141 1327 3892 at, t1, vblf 183558 642 0 0 No Change 2014-02-01 2019-03-01 Prosthesis AS187 Permacol™ Biological Implant Flat sheet of acellular porcine three-dimensional, crosslinked, dermal collagen. 20 x 40cm AS 21 194 1798 5494 Coated 172202 4275 0 0 No Change 2013-02-01 2019-03-01 Prosthesis AS188 Permacol™ Biological Implant Flat sheet of acellular porcine three-dimensional, crosslinked, dermal collagen. 20 x 50cm AS 21 194 1798 5495 Coated 172202 5225 0 0 No Change 2013-02-01 2019-03-01 Prosthesis AS189 Protege GPS Peripheral and Carotid Stents Protege RX Peripheral Stent Protege RX Carotid Stent Diameter 6-10mm Length 20mm - <150mm AS 24 206 1622 4440 124533 124534 1710 0 0 No Change 2013-08-01 2019-03-01 Prosthesis MI072 VIVA S CRT-D DTBB2D4 Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, SmartShock Tehnology, OptiVol 2.0 Fluid Status Monitoring and Complete Capture Management Specifications (DF4) 35cc, 82G MI 27 238 1727 a,c,d,e 203209 37980 0 0 No Change 2013-02-01 2019-03-01 Prosthesis AS190 Onyx DSMO/Liquid Embolic Material 18, 20, 34 (formulations) AS 24 213 1692 151837 2185 0 0 No Change 2013-08-01 2019-03-01 Prosthesis AS191 Onyx System DSMO Liquid Embolic Material 500 Formulation AS 24 213 1692 ids (integral delivery system) 151837 Changed Benefit 4703 0 0 Update 2013-08-01 2019-03-01 Prosthesis IQ020 PreciSAL Toric PT302A Pre-loaded acrylic single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology, toric correction on anterior surface with cylinder marks to indicate flat meridian plus the cylinder axis to allow alignment for astigmatic correction, and UV and blue light filters. Available in spherical dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; Cylinder powers from 1.0D to 6.0D IQ 1 141 1327 3892 at, pl, t1, vblf 183558 659 0 0 No Change 2014-02-01 2019-03-01 Prosthesis KT022 Martin Distraction Osteogenesis Rigid External Distraction (Polley RED II) Distractor System, Component, Cross Bar, aluminium.carbon fibre one size only KT 23 202 1604 4406 113786 965 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT023 Martin Level One Fixation Mesh, Titanium 0.50 to 0.80mm thick, 51 to 100cm² area KT 23 199 1585 4209 109878 1146 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT024 Martin Micro Plate Osteosynthesis System 1.5mm system Straight Plate Titanium 2 hole, 0.6mm profile KT 23 199 1589 4267 96620 93 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT025 Martin Level One Fixation Screw Titanium diameter <1.24mm KT 23 199 1590 4321 96619 Changed Benefit 68 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT026 Martin Level One Fixation Mesh, Titanium <0.2mm, 51 to 100cm² area KT 23 199 1585 4202 109878 Changed Benefit 371 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT027 Martin Level One Fixation Mesh, Titanium <0.2mm thick, 1 to 10cm² area KT 23 199 1585 4201 109878 161 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LH640 OO098 MUTARS Genux Hinge locking mechanism Connecting piece; connecting distal femoral and proximal tibial replacement. Genux Hinge Component LH 17 159 1393 234172 3089 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH641 OO099 Mutars RS revision system- Metaphyseal component RS metaphyseal component 25mm LH 18 161 1410 3964 Body 237292 2742 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH642 OO101 Mutars Attachment Tube Mutars attachment tube 35/55mm LH 13 123 1777 5400 197729 Changed Benefit 274 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH643 OO102 IC Intramedullary Plug Intramedullary Plug 9mm, 14mm LH 18 164 1437 208322 Changed Benefit 105 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH673 OO134 MUTARS ulna anchorage MUTARS ulna anchorage left/right 70mm LH 13 131 1275 3676 221739 3398 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH674 OO135 MUTARS Glenoid MUTARS Glenoid 1 size LH 13 123 1778 5469 227161 7111 0 0 No Change 2018-08-01 2019-03-01 Prosthesis MC027 Model 6721 Unipolar Epicardial Patch Leads S/M/L Model 6721S-50, Model 6721M-50, Model 6721L-50; Silicone 370, 660, 840mm MC 27 242 1745 136183 1685 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC052 Medtronic Capsure VDD2 Model 5038 AV Pacing Lead Silicone; Contents: 1 x lead with anchoring sleeve, stylet & guide, 1 x vein lifter, 2 x fixation tools, extra stylets 11.5cm, 13.5cm, 15.5cm MC 27 243 1753 k 142171 1112 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC053 Capsure EPI steroid eluting unipolar epicardial lead Model 4965 ventricle Silicone 25 - 50cm MC 27 243 1747 134427 1112 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS196 Solitaire Solitaire Neurovascular Remodelling Device is a self-expanding, fully retrievable device which can be delivered and deployed by a single operator. Diameter: 3-6mm Length: 15-40mm AS 25 225 1687 155038 7125 0 0 No Change 2013-08-01 2019-03-01 Prosthesis AS197 LRS Actuator LRS Actuator is a sterile, hand held mechanical unit with a thumb slide that detaches the coil. When the slider is retracted while the pusher is loaded, it releases the coil into the targeted vaculature. Coils cannot be deployed without the use of the actuator. Length 5.75", Diameter 1", Weight 28 grams AS 25 225 1689 4495 150013 Changed Benefit 333 0 0 Update 2013-08-01 2019-03-01 Prosthesis AS198 ev3 Occlusion Balloon Catheters Single lumen balloon catheter to temporarily occlude the central lumen allowing inflation of the balloon during neurosurgical and vascular procedures. 3-7mm diameter; 7-30mm length AS 25 225 1689 4494 152746 665 0 0 No Change 2013-08-01 2019-03-01 Prosthesis AS199 Protege™GPS™ Self-expanding Billary Stent System Nitinol self expanding stent pre-mounted on 6F OTW delivery system Diameter (mm) 6 -14, Length (mm) 20 - 150 AS 21 192 1556 4234 189741 2114 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LH644 OO103 ACS Knee Minimmaly Stabilised Tibial Insert ACS PE Insert 10, 12.5, 15, 17.5, 20mm LH 17 153 1369 265624 265632 265640 265641 265643 1019 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH645 OO104 ACS Knee - Posterior Stabilised Tibial Insert ACS Posterior Stabilised Tibial PE Insert 10, 12.5, 15, 17.5, 20mm LH 17 153 1370 265625 265626 265639 265642 Changed Benefit 1073 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH646 OO105 Mutars Diaphyseal connecting piece Mutars Diaphyseal connecting piece 100mm -120mm LH 17 157 1387 3937 221740 284221 284224 1520 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH647 OO106 Mutars Distal Femur Mutars Distal Femur Left/Right 90mm -110mm LH 17 157 1380 3931 225901 227769 284225 284226 284581 Changed Benefit 7163 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH648 OO107 Mutars Diaphyseal extension piece Mutars Diaphyseal extension piece 30/100mm LH 17 157 1387 3938 284236 3936 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH649 OO108 Mutars Tumour System Mutars diaphyseal implant 100mm length x 11-19mm LH 17 157 1382 221740 284222 3944 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH650 OO109 Mutars – tibial plateau Tibial plateau for hinged knee X small, small, standard, large LH 17 157 1381 3932 225903 284585 Changed Benefit 7247 0 0 Update 2018-08-01 2019-03-01 Prosthesis MC094 Stimulator Accessory Kit - Pisces Quad; Pisces Z Lead Revision Kit; Pisces Quad Revision Kit; Octad Revision Kit Model 3550-10 revision kit. 1 x boot, 1 x twistlock anchor, 2 x silicone anchors, 1 x hex wrench, 1 x epidural needle 15 gauge, 1 x percutaneous extension (inline) with set screws, 1 x ball-tipped (bent) 28cm stylet for Pisces-Quad lead, 1 x ball-tipped ( One size only MC 25 222 1690 4499 239412 518 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC135 Medtronic Specify Lead 8 electrode surgical lead kit One size only MC 25 222 1679 4486 8 electrodes 114947 Changed Benefit 4018 0 0 Update 2005-10-31 2019-03-01 Prosthesis MC137 Medtronic A/Asia, Synergy Dual Channel Implantable Pulse Generator Model 7427, Active Implantable Stimulators. DCI - Pulse Generator: Synergy Dual Channel Implantable Pulse Generator Model 7427. Materials - Titanium One size only MC 25 222 1677 4480 134477 Changed Benefit 18193 0 0 Update 2005-10-31 2019-03-01 Prosthesis MC153 Talent AAA Aorto Uni lliac Stent Graft Talent Endoluminal Stent Graft System - AUI Tapered System. 22 - 36mm x 75 - 310mm MC 24 207 1627 138461 9690 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC158 Talent Aortic Extension Stent Graft Talent Endoluminal Stent Graft - Aortic Extension 22 - 36mm x 26 - 30mm MC 24 207 1631 4448 138461 2427 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC185 Sacral Nerve Stimulation Unilateral Interstim Temporary test stimulation lead Various MC 26 232 1714 5340 137441 373 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC186 Sacral Nerve Stimulation Accessories Foramen Needle. (box of 6) Sterile individual units. Stainless steel. One size only; 9-12.5cm MC 26 232 1715 5343 121280 Changed Benefit 123 0 0 Update 2005-10-31 2019-03-01 Prosthesis MC203 Talent Occluder System Nitinol stents attached to polyester graft sealed both ends Standard Sizes, 8 - 24mm x 31 - 35mm MC 24 207 1633 138461 2427 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC206 Talent Thoracic Stent Graft Talent Endoluminal Stent Graft - Thoracic Stent Graft System 22 - 46mm x 130mm MC 24 207 1625 4442 138461 10476 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC208 Medtronic Sprint Quattro Secure Lead Model 6947 (MRI SureScan) Leads, Defibrillator, Implantable, Silicone, polyurethane, platinized tantalum coils, steroid eluting tip, including MRI compatible versions 58-100cm MC 27 242 1743 286980 6480 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC225 Attain Over the Wire Model 4193 Titanium, polyurethane 78-88cm MC 27 243 1751 134291 Changed Benefit 2246 0 0 Update 2005-10-31 2019-03-01 Prosthesis IQ022 PresiSAL Multifocal M302A Acrylic single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation. Aberration technology, pupil independent diffractive anterior surface with a near sight correction addition of up to +3.5D, and UV and blue light fliters. Available in sperical dioptric powers from 0.0D to +30.0D. 1D steps: 0.0D to +10.0D; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0.0 to +28.0; near sight correction addition up to +3.5D on all spherical dioptric powers. IQ 1 141 1327 3893 at, vblf 183558 712 0 0 No Change 2014-08-01 2019-03-01 Prosthesis IQ023 PreciSAL Multifocal M302AC Acrylic single piece, foldable intraocular lens with anterior and posterior optic-haptic edge, 360 degree optic square edge design, precision power calculation, abreration technology, pupil independent diffractive anterior surface with a near sigh correction addition of up to +3.5D, and UV Filter. Available in spherical dioptric powers from 0.0D to +30.0D. 1D steps: 0.0D to+10.0D; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; near sight correction addition up to +3.5D on all spherical dioptric powers. IQ 1 141 1327 3893 at 183558 677 0 0 No Change 2014-08-01 2019-03-01 Prosthesis MC229 Medtronic Capsure SP Novus Model 5594 Lead Bipolar, steroid, passive fixation pacing lead 30-100cm MC 27 243 1753 134288 898 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC244 Medtronic Australasia DBS Lead Model 3389, Medtronic quadripolar Itrel II- 7424DBS, Active Implantable Stimulator & Ancillary Equipment Deep brain stimulation lead with four platinum iridium electrodes Models 3387 and 3389. Electrode spacing is 1.5mm apart for Model 3387 and 0.5mm apart for Model 3389. PTFE, polyurethane, platinum/iridium, nickel alloy, tungsten 28 - 40cm MC 25 221 1674 4476 137138 Changed Benefit 3943 0 0 Update 2005-10-31 2019-03-01 Prosthesis MC246 DF-I Y-Adaptor/Extender Model 6726 25cm & 37cm Silicone Lengths 25cm, 37cm MC 27 244 1763 129883 360 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC247 Patient Activators Hand held device Models 7434 & 7435 to be used with Itrel III and Synergy Implantable Pulse Generators One size only MC 25 222 1678 4483 137439 1425 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC251 Implantable Subcutaneous Defibrillator Lead Model 6996SQ 41cm, 58cm, 85cm Silicone and Platinum Alloy Lengths 41-85cm inclusive MC 27 242 1738 132315 3370 0 0 No Change 2005-10-31 2019-03-01 Prosthesis KI009 HALYARD* MIC* Jejunal Feeding Tube Sterile jejunal enteral feeding tube 12, 14, 16, 18, 20, 22, 24 Fr, 7-10ml balloon volume KI 21 189 1546 Port 248294 475 0 0 No Change 2005-10-31 2019-03-01 Prosthesis KI010 Corflo Max 20fg PEG Kit "Pull Type" Sterile enteral feeding tube with accessories 20fg KI 21 189 1544 196774 169 0 0 No Change 2017-08-01 2019-03-01 Prosthesis KT001 UNIQOS Biomodelled Customised Orbital Floor Mesh UNIQOS Biomodelled Customised Orbital Floor Mesh Customised - patient specific KT 23 200 1598 4367 Biomodelled 109878 4095 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT002 UNIQOS custom Threadlock TS Mandible Reconstruction Plates UNIQOS Custom Threadlock TS Mandible Reconstruction Plates Custom-Patient Specific KT 23 200 1596 4358 Biomodelled 96619 4095 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KI008 HALYARD MIC-KEY Low Profile Baloon Jejunal Feeding Tube 100% medical grade silicone tube. 40/60 tungsten weighted jejunal post pyloric feeding tube. Gastric drainage ports, jejunal feeding ports 14 and 18Fr, 0.8 to 4.5cm stomal length KI 21 189 1546 Port 248294 475 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC254 CapSure Sense pacemaker lead Models 4073 Titanium Nitride 30 - 85cm MC 27 243 1749 134289 898 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC264 Septal Button Silicone 3cm MC 22 197 1568 169825 142 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC268 Medtronic Vent Tubes Fluoroplastic 0.76 - 1.52mm x 2.1 - 9.5mm x 1.0 - 12.0mm MC 22 196 1566 126695 19 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC269 Medtronic Vent Tubes Activent Antimicrobial Ventilation Tube 1.02 - 1.27mm x 0.9 - 2.4mm MC 22 196 1566 126695 21 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC293 Vertex Spinal System Occipital Plate 24 - 40 mm length MC 19 169 1477 4129 169514 Changed Benefit 2166 0 0 Update 2005-10-31 2019-03-01 Prosthesis MC294 Vertex Spinal System Occipital Buttons Bolt 6 - 30 mm Length MC 19 166 1469 169514 Changed Benefit 732 0 0 Update 2005-10-31 2019-03-01 Prosthesis MC296 Vertex Spinal System Occipital Screws 3.0 - 5.0 mm diameter, 4 - 30 mm length MC 19 165 1464 169514 Changed Benefit 193 0 0 Update 2005-10-31 2019-03-01 Prosthesis KT003 UNIQOS Custom Patient Specific Craniofacial Implant, PEEK Titanium UNIQOS Custom Patient Specific Craniofacial Implant, PEEK Titanium Custom - Patient Specific KT 23 200 1593 4343 Biomodelled 200232 Changed Benefit 9682 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT004 UNIQOS Patient Specific Anatomical Biomodel Patient specific antomical biomodel Custom-Patient Specific KT 23 200 1807 200232 1950 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT005 UNIQOS Patient Specific Surgical guides UNIQOS Patient Specific Surgical guides Custom - Patient specific KT 23 200 1596 5498 Biomodelled 200232 2584 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT006 Zurich II Modular Distractors Distractor System, Component, Dual fixation plates, pair Mesh-large and small design; Cloverleaf design KT 23 202 1604 4403 Dual Plate 113786 1279 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT007 Martin Level One Fixation Plate, titanium =>3mm thick, 8 to 15 holes KT 23 199 1589 4312 Locking 96620 614 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT008 Martin Level One Fixation Temporary condylar impant, titanium 5cm KT 23 200 1596 4357 99620 1506 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT009 Martin Level One Fixation Plate, titanium 1 to 1.99mm thick, <4 holes KT 23 199 1589 4286 96619 112 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT010 Martin Level One Fixation Plate, titanium <0.5mm thick, 4 to 7 holes KT 23 199 1589 4263 Burr 96619 185 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LH651 OO110 Mutars – end piece Mutars – end piece 1 size LH 17 159 1395 221738 284235 649 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH652 OO111 Mutars – Genux Augments Mutars – Genux Augments Size, small, 3,4,5, 5mm, 10mm, 15mm, 20mm LH 17 157 1385 221737 284269 1912 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH653 OO112 Mutars – Metaphyseal component Mutars – Genux metaphyseal tibial spacer Right/Left 25mm, 35mm, 45mm, 50mm LH 17 157 1385 221737 284267 284269 1912 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH654 OO113 Mutars – Proximal Tibia Mutars – Proximal Tibia 100mm LH 17 157 1381 3932 227164 284586 Changed Benefit 7247 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH655 OO114 Mutars – reducer Mutars – reducer 20mm/30mm LH 17 157 1387 3937 237292 284271 1520 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH656 OO115 Mutars – Proximal tibia connecting piece Mutars – Proximal tibia connecting piece 105mm, 125mm LH 17 157 1387 3937 244316 284223 1520 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH657 OO117 Mutars Proximal Femur Mutars Proximal Femur 50/70mm length LH 18 161 1410 3965 Body, Tumour 227163 284591 Changed Benefit 4526 0 0 Update 2018-08-01 2019-03-01 Prosthesis KT011 Martin Distraction Osteogenesis Distractor System, Complete, internal/intraoral, titanium 10 to 20 mm KT 23 202 1603 4399 Single Vector 113786 1906 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT012 Martin Level One Fixation Resorb x & SonicWeld Rx Mesh, PDLLA (resorbable) 1.0 to 1.99mm thick, 4 to 7 holes KT 23 199 1589 4288 Resorbable 143326 Changed Benefit 253 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT013 Martin Level One Fixation Resorb x & SonicWeld Rx Mesh, PDLLA (resorbable) 0.20 to 0.49mm thick, 26 to 50cm² area KT 23 199 1586 4223 143326 1453 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT014 Martin Level One Fixation Plate, titanium 0.5-0.99mm thick, 4-7 holes KT 23 199 1589 4271 Complex 96619 96620 240 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT015 Martin Level One Fixation Resorb x & SonicWeld Rx Mesh, PDLLA (resorbable) >0.80mm thick, 11 to 25cm² area KT 23 199 1586 4231 143326 926 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT016 Martin Distraction Osteogenesis Distractor System, Complete, other, titanium 1.5mm KT 23 202 1603 4396 Single Vector 113786 Changed Benefit 6922 0 0 Update 2015-02-01 2019-03-01 Prosthesis LH658 OO118 Mutars RS revision system - Proximal component RS proximal component 127 degrees, 32/42mm, 135 degrees, 32/42mm LH 18 161 1417 Complex (Neck) 238834 284587 1517 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH659 OO119 MUTARS - Arthrodesis Tibial component MUTARS - Arthrodesis Tibial component 45mm LH 13 123 1778 5477 242292 284589 6242 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH660 OO120 MUTARS - Arthrodesis femoral component MUTARS - Arthrodesis femoral component 45mm left and right LH 13 123 1778 5479 242292 284584 6242 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH661 OO121 MUTARS - Arthrodesis body Arthrodesis Body 120mm LH 13 123 1778 5402 242292 284220 6242 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH662 OO122 ACS Knee system, ACS stems, straight and offset ACS tibial and femoral stems 12/14/16/18/20/22mm dia stems, 25/50/75/100/150/200mm length LH 17 159 1399 241989 265633 265634 Changed Benefit 1126 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH663 OO123 MUTARS Distal Humerus MUTARS Distal Humerus 50mm, 30mm LH 13 131 1275 3673 221739 284227 4387 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH664 OO124 MUTARS Humerus diaphyseal implant MUTARS Humerus diaphyseal implant 8-9 mm diameter, 100mm length LH 13 123 1778 5412 221739 284242 4173 0 0 No Change 2018-08-01 2019-03-01 Prosthesis MC301 Model 3830 PACING LEADS Active fixation pacemaker lead Composition: Insulation is polyurethane, Electrodes are Titanium Nitride coated Platinum, the screw is steriod-coated 59 - 75 cm MC 27 243 1756 j 131307 1872 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC305 Low Profile Impedance Extension Kit for DBS Model 7482 Silicone Rubber 25, 40, 51, 66, 95cm MC 25 221 1674 4477 156265 96927 1995 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MI040 Medtronic Infusion Pump Accessories Accessories for refill/catheter access of infusion pumps Various MI 25 223 1684 5483 133764 38 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MI042 Medtronic Lead End Cap Kit Model: 5867-3M Lead End Cap Kit One size only MI 27 246 1765 129420 Changed Benefit 58 0 0 Update 2012-02-01 2019-03-01 Prosthesis MI043 Medtronic DF-1 Port Pin Plug Kit: Model 6719; Medtronic IS-1 Port Pin Plug Kit: Model 6725 DF-1 unipolar connector port pin plug, one per kit One size per model MI 27 246 1765 129420 Changed Benefit 58 0 0 Update 2012-02-01 2019-03-01 Prosthesis MI044 Medtronic Upsizing Sleeve: Model 5866-45, Model 5866-46 5866-45: IS1 UNI Lead to 5/6mm UNI IPG; 5866-46: IS1 UNI Lead to 5mm UNI IPG or 5mm Bifurcated BI IPG 18-25mm MI 27 246 1765 129420 Changed Benefit 58 0 0 Update 2012-02-01 2019-03-01 Prosthesis 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 AS 24 211 1643 151258 1995 0 0 No Change 2013-08-01 2019-03-01 Prosthesis AS193 Axium Detachable Coil System Platinum alloy coils (including coils enlaced with PGLA filaments and Nylon Fibers) attached to a composite implant delivery pusher with a radiopaque positioning marker. The proximal end of the pusher is loaded into the Actuator which detaches the coil. Diameter: 1.5 - 25mm; Length: 1 - 50cm AS 25 225 1688 149398 162494 162495 194132 194407 194408 1430 0 0 No Change 2013-08-01 2019-03-01 Prosthesis AS194 EverFlex Peripheral Stent EverFlex is a self expanding Nitinol stent premounted on an OTW delivery system. Diameter 5-8, Length 20-120mm AS 24 206 1622 4440 151132 215979 1710 0 0 No Change 2013-08-01 2019-03-01 Prosthesis AS195 EverFlex Peripheral Stent EverFlex is a self expanding Nitinol stent premounted on an OTW delivery system. Diameter 5-8mm, Length 150-200mm AS 24 206 1622 4441 215979 Changed Benefit 2822 0 0 Update 2013-08-01 2019-03-01 Prosthesis HW390 XIA Spine System Cross Link Length 20mm - 99mm HW 19 167 1474 4124 139620 49029 Changed Benefit 1299 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW391 Xia Spine System Connector - Axial, Dual, Offset 4.5mm - 6mm HW 19 167 1473 139620 49029 Changed Benefit 732 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW392 Xia Spine System Sacral Block One size only HW 19 167 1473 139620 49029 Changed Benefit 732 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW393 Xia Spine System Bone Screw One size only HW 19 165 1464 139620 49029 Changed Benefit 193 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW394 Stryker large ceramic femoral head Biolox Forte 36mm - 60mm HW 18 162 1420 3996 217828 1806 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW395 V40 Orthinox Head Stainless Steel >32mm HW 18 162 1420 3994 211859 Changed Benefit 713 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW405 Xia Spine System Hooks Laminar and Pedicle Hooks HW 19 168 1475 139620 49029 789 0 0 No Change 2009-08-01 2019-03-01 Prosthesis HW406 Aria Spinal System / Peek DLIF Interbody Spacer PEEK DLIF Interbody Spacer H: 8-18mm L: 40-60mm W: 18-22mm 0-8 degree lordosis HW 19 174 1486 4135 178870 3465 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW407 Aviator Anterior Cervical Plating System - Plate longer than 55mm Anterior Cervical Plate - Integral Locking Three and four level greater than 55mm in length HW 19 169 1476 4125 >55mm 94635 1636 0 0 No Change 2011-02-01 2019-03-01 Prosthesis LH665 OO125 MUTARS Glenosphere MUTARS glenosphere 40mm LH 13 123 1778 5469 227771 7111 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH666 OO126 MUTARS Humerus Head MUTARS Humerus Head 50mm LH 13 123 1778 5422 223513 284244 4047 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH667 OO128 MUTARS Humerus connecting part MUTARS Humerus connecting part 80mm LH 13 123 1778 5414 244561 284241 4351 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH668 OO129 MUTARS extension piece MUTARS humerus extension piece 20mm/40mm/60mm LH 13 123 1778 5412 244561 284403 4173 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH669 OO130 MUTARS humerus reducer MUTARS humerus reducer 10/100mm LH 13 123 1778 5414 244561 284590 4351 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH670 OO131 MUTARS humerus screw MUTARS humerus screw 15mm,35mm,55mm,75mm LH 13 123 1778 5404 246973 250513 1767 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH671 OO132 MUTARS Proximal ulna MUTARS Proximal ulna 60mm LH 13 131 1275 3676 221739 284268 3398 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH672 OO133 MUTARS humeral stem MUTARS humeral stems 7-16mm diameter 75mm length LH 13 123 1778 5410 238835 244655 250512 5486 0 0 No Change 2018-08-01 2019-03-01 Prosthesis HW408 Aviator Anterior Cervical Plating System - Plate Anterior Cervical Plate - Integral Locking One, two and three level up to 55mm in length HW 19 169 1476 4125 94635 Changed Benefit 1348 0 0 Update 2011-02-01 2019-03-01 Prosthesis HW409 Aviator Anterior Cervical Plating System - Screw Anterior Cervical Plate System - Screw 4 - 4.35mm diameter, 10 - 18mm length HW 19 165 1464 94635 Changed Benefit 193 0 0 Update 2011-02-01 2019-03-01 Prosthesis HW410 Enophthalmos Wedge Regular left and right. Large left and right. (Models 9541 - 9544) Regular: 22 x 31 x 7mm. Large: 28 x 40 x 7.5mm HW 23 200 1598 4371 152165 Changed Benefit 448 0 0 Update 2011-02-01 2019-03-01 Prosthesis HW411 Complete Orbital Shape Porus Polyethylene. Complete and 2 / 3 orbit shapes. Inferior 2 / 3 left and right. Models 9567, 9568 Inferior: 83 x 78mm HW 23 200 1598 4366 152165 Changed Benefit 1892 0 0 Update 2011-02-01 2019-03-01 Prosthesis IQ009 Softec HDY Acrylic, single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology and blue light filter Available in dioptric powers from -5.0 to + 36.0, 1D steps: -5.0 to +10.0 and +31.0 to +36.0; 0.5D steps: +10.5 to +18.0 and +25.0 to 29.5; 0.25D steps: + 18.0 to +25.0 IQ 1 141 1327 3892 at, vblf 120330 Changed Benefit 317 0 0 Update 2010-02-01 2019-03-01 Prosthesis MI046 Bipolar Lead Adaptor Kit Model 2872 Two IS-1 BI Leads to IS-1 BI IPG One size only MI 27 244 1763 129420 360 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MI048 Intrathecal catheter accessory Tunnelling rods - Stainless steel 38-60cm MI 25 223 1684 121281 Changed Benefit 155 0 0 Update 2012-02-01 2019-03-01 Prosthesis MI049 Medtronic Neurostimulation Screening Cable Screening Cable One size only MI 25 222 1690 5484 119991 190 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MI050 Synergy IPG Connector Plug Synergy IPG Connector Plug Various MI 25 222 1690 4500 240576 Changed Benefit 160 0 0 Update 2012-02-01 2019-03-01 Prosthesis MI051 Medtronic Neurostimulation Tunnelling Tools Tunnelling Tools Various MI 25 222 1690 4501 121281 Changed Benefit 160 0 0 Update 2012-02-01 2019-03-01 Prosthesis MI045 Adaptor Kits Bipolar lead adaptors 14cm, 15cm, 17cm MI 27 244 1763 137315 360 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MI052 Medtronic Neurostimulation Accessory Kits EZ Anchor, Boot and Anchor Kit Various MI 25 222 1690 4501 240576 Changed Benefit 160 0 0 Update 2012-02-01 2019-03-01 Prosthesis IQ012 EasyGas Endotamponade Gases for Retinal Surgery, EasyGas SF6, C2F6 or C3F8, each supplied in a 60ml syringe, sterile 60ml dispensed in a single dose, sterile syringe IQ 1 148 1345 197089 71 0 0 No Change 2013-02-01 2019-03-01 Prosthesis IQ013 PreciSAL 302AC Acrylic, single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology and UV light filter. Available in dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to + 17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0 IQ 1 141 1327 3892 at 183558 300 0 0 No Change 2013-08-01 2019-03-01 Prosthesis IQ014 PreciSAL P302AC Preloaded Acrylic, single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology and UV light filter. Available in dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to + 17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0 IQ 1 141 1327 3892 at, pl 183558 308 0 0 No Change 2013-08-01 2019-03-01 Prosthesis AS200 VisiPro™ Balloon-Expandable Biliary Stent System Stainless Steel balloon expandable stent mounted onto a non-compliant balloon catheter Diameter (mm) 5 - 10, Length (mm) 12 -57 AS 21 192 1556 4234 189741 2114 0 0 No Change 2013-08-01 2019-03-01 Prosthesis AS201 Marksman Microcatheters The MARKSMAN Microcatheter is a variable stiffness, single lumen catheter designed to access small, tortuous vascular areas. The outer surface of the catheter's distal segment is coated with a hydrophilic material to provide lubricity during use. The catheter also incorporates a PTFE liner to facilitate movement of delivery devices passed through its lumen and has a radiopaque marker at the distal tip to facilitate fluoroscopic visualization. The distal tip of the catheter is shapeable. Outer Diameter: 2.8F Inner Diameter: 0.027" Length: 105-160 cm AS 25 225 1689 4494 193795 665 0 0 No Change 2013-08-01 2019-03-01 Prosthesis AS202 Apollo Micro Catheters For the delivery of therapeutic agents (e.g. embolisation coils and liquid embolics); and diagnostic agents such as contrast media. Proximal outer diameter 2.7F; distal outer diameter 1.5F; inner diameter 0.013 inch; total length 165 cm; tip length 1.5, 3 or 5 cm. AS 25 225 1689 4494 215658 665 0 0 No Change 2014-02-01 2019-03-01 Prosthesis AS203 Parietex Optimed Composite Mesh with Accumesh Positioning System Composite mesh with endomechanical positioning system with expandable frame and articulation control to facilitate insertion, deployment and placenment of the mesh. 15cm round with medium positioning system AS 21 194 1783 5438 Coated, Complex delivery System 219331 570 0 0 No Change 2014-08-01 2019-03-01 Prosthesis AS204 Parietex Optimised Composite Mesh with Accumesh Positioning System Composite mesh with endomechanical positioning system with expandable frame and articulation control to facilitate insertion, deployment and placenment of the mesh. 20cm round and 20 x 15cm square with medium positioning system AS 21 194 1783 5439 Coated, Complex delivery System 219331 959 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BB346 Arcadius L Stand-Alone Interbody Device Titanium Coated PEEK ALIF CAGE 4 degree, 9 degree & 14 degree lordosis with width 35mm x Depth 25mm X Height 10/12/14/16/18/20mm. 4 degree, 9 degree & 14 degree lordosis with Width 40mm x Depth 29mm x Height 10/12/14/16/18/20mm. BB 19 174 1485 5486 122641 221528 6256 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BB347 activ C Cervical Disc Prosthesis Cervical disc prosthesis consisting of superior and inferior endplates, plasmapore coated with anatomical adapted footprint and shape. XS=16Wx13Lx5H or 6H; S=16Wx14Lx5H OR 6H; M=17WX15LX5H or 6H; L=18Wx16Lx5H or 6H; XL=19Wx17Lx5H or 6H; XXL=19Wx18Lx5H or 6H BB 19 175 1488 5487 181018 6256 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BB348 e.motion Total Knee System FP/UC Femoral Component cemented e.motion mobile bearing FP/UC Femoral Component cemented 1-8, Left and right BB 17 149 1348 3906 96481 2951 0 0 No Change 2015-08-01 2019-03-01 Prosthesis BB349 Easypump Disposable Elastomeric infusion pump system LT: Filling Volume: 60ml - 400ml, Flow Rate: 0.5ml/h - 10ml/h ST: Filling Volume: 50ml - 500ml, Flow Rate: 50ml/h - 500ml/h BB 21 188 1524 5358 221448 79 0 0 No Change 2015-08-01 2019-03-01 Prosthesis BB350 EnduRo Rotating Hinge Knee Femoral Component The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to treat complex revision knee arthroplasty as well as unstable knees. 1-3 Right 1-3 Left BB 17 149 1348 3908 Revision, Hinged 96481 6038 0 0 No Change 2016-02-01 2019-03-01 Prosthesis BB351 Enduro Rotating Hinge Knee Femoral Stem locking nut neutral The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to treat complex revision knee arthroplasty as well as unstable knees. 1 size neutral (for all femoral stems) BB 17 159 1400 96481 698 0 0 No Change 2016-02-01 2019-03-01 Prosthesis BB352 EnduRo Rotating Hinge Knee Meniscal component includes Rotation Axle, PEEK bushing and Tibial locking nut The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to treat complex revision knee arthoplasty as well as unstable knees Meniscal Components to match Femoral component 1-3 10mm-24mm includes rotation axle, PEEK bushing and Tibial locking nut. BB 17 153 1371 Axle included 96481 1770 0 0 No Change 2016-02-01 2019-03-01 Prosthesis BL018 DK Line 100% purified perfluorodecalin Perfluorodecalin 7ml BL 1 148 1346 108429 228 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BL022 SofPort Advanced Optic (AO) Posterior chamber, foldable silicone IOL with anterior optic-haptic square edge, posterior optic-haptic square edge, 360-degree optic square edge and asperic optic for aberration control 0 D to 30.0 D BL 1 141 1327 3892 at 98915 300 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BL023 Akreos Advanced Optic Posterior chamber, foldable acrylic IOL, with anterior optic-haptic square edge, posterior optic-haptic square edge, 360 degree optic square edge and aspheric optic for aberration control 0 D to 30.0 D BL 1 141 1327 3892 at 98915 300 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BL024 Oxane HD Silicone oil - RMN3 mixture 10ml BL 1 148 1347 108429 185 0 0 No Change 2006-03-24 2019-03-01 Prosthesis BL026 Akreos AO Micro Incision Lens Micro Incision, posterior chamber, foldable acrylic, aphakic, anterior & posterior edge modification, preloaded, with aberration control, intraocular lens 6mm optic overall diameter 11.0mm(10D-15D), 10.7mm (15.50-22D), 10.5mm (22.50-30D) BL 1 141 1327 3890 at, pl 98915 308 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BL030 enVista The enVista, Model MX60, is an ultra-violet-absorbing, posterior chamber, hydrophobic acrylic one-piece foldable intraocular lens (IOL) Has an aspheric lens optic, square posterior edge, modified C haptics and available in dioptric powers ranging from +0.0 to +34.0D. Overall diameter 12.5mm, optic body diameter 6.0mm in dioptric powers ranging from +0.0 to +34D 0.0D to 10.0D in 1 Diopter increments 11.0D to 30.0D in 0.5 Diopter increments 31.0D to 34.0D in 1 Diopter increments BL 1 141 1327 3892 at 98915 300 0 0 No Change 2011-02-01 2019-03-01 Prosthesis BL032 enVista Toric The enVista toric (Model MX60T) is a one-piece glistening-free hydrophobic foldable IOL. The enVista Toric, model MX60T IOL has a Toric aspheric lens optic, a square posterior edge and modified C haptics, an overall diameter of 12.5mm and an optic body of 6.0mm. It is available in multiple spherical and cylindrical powers. Overall diameter is 12.5mm for the entire lens power range, with spherical equivalent powers from +6.0 to +30.0 Diopters in 0.5 Diopter steps and cylinder powers from +1D to 6D Diopters (at the IOL plane). BL 1 141 1327 3892 at, pl, t1 98915 Changed Benefit 626 0 0 Update 2012-08-01 2019-03-01 Prosthesis AS205 Kangaroo Skin Level Cage Gastrostomy Kit Skin level non-balloon internal retention bolster gastrostomy kit, including gastrostomy tube, accessory bolus and continuous feeding tubes syringes for inflation and flushing. Patient handbook 12fg x 1.2cm, 12fg x 1.5cm, 12fg x 2.0cm, 12fg x 2.5cm, 12fg x 3.0cm, 12fg x 3.5cm, 12fg x 4.0cm, 12fg x 4.5cm, 12fg x 5.0cm, 16fg x 1.5cm, 16fg x 1.7cm, 16fg x 2.0cm, 16fg x 2.4cm, 16fg x 2.7cm, 16fg x 3.0cm, 16fg x 3.5cm, 20fg x 1.5cm, 20fg x 2.0cm, 20fg x 2.5cm, 20fg x 3.0cm, 20fg x 3.5cm, 20fg x 4.0cm, 20fg x 4.5cm AS 21 189 1545 4197 185673 195 0 0 No Change 2014-08-01 2019-03-01 Prosthesis AS206 Kangaroo Gastrostomy Feeding Tubes 100% silicone gastrostomy with internal retention balloon 12fg, 14fg, 16fg, 18fg, 20fg, 22fg, 24fg MI 21 189 1545 4198 185454 Changed Benefit 86 0 0 Update 2014-08-01 2019-03-01 Prosthesis BL034 FineVision Micro F Posterior chamber, UV absorbing, foldable, aspheric, acrylic, single piece lens with apodised diffractive , trifocal optic and blue light protection An overall diameter of 10.75mm and optic diameter of 6.15mm. From 0 to +35 dopters with 0.5 diopter increments. BL 1 141 1327 3893 at, vblf 211587 712 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BL035 MICRO+ AY 123 Preloaded, posterior chamber, UV absorbing, foldable, aspheric, acrylic, single piece lens with blue light protection. An overall diameter of 10.75mm and optic diamter of 6.15mm. From 0 to +35 diopters with 0.5 diopter increments. BL 1 141 1327 3892 at, pl, vblf 211587 333 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BL036 FineVision Toric POD FT Posterior chamber, toric, trifocal diffractive (aspheric), UV and blue light blocker, single piece acrylic IOL. An overall diameter of 11.40mm and optic diameter of 6.00mm. From 0 to +35 Diopters with 0.5 diopter increments. BL 1 141 1327 3893 at, t1, vblf 211587 1021 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BB339 Miethke proSA with differential pressure unit (miniNAV) and distal catheter proSA is an adjustable gravitational unit for the treatment of hydracephalus. The proSA valve can be combined with any differential pressure valve. miniNAV is a very small differential pressure unit, which is often used with proSA. The valves are made from titanium and are MR safe up to 3 tesla. The distal catheter is made of silicone. Adjustable gravitational unit: height 4.5mm, diameter 18mm, opening pressure 0-40 cmH2O. Differential pressure unit (miniNAV): length 14.7mm, diameter 2.8mm. Distal catheter: length 1200mm, inside diameter 1.2mm, outside diameter 2.5mm. BB 25 220 1666 4468 Antisyphon function, Distal catheter, Reservoir/Priming function 181718 2902 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BL037 MicroPure 123 Preloaded, posterior chamber, UV absorbing, foldable, aspheric, acrylic, single piece hydrophobic glistening-free Intra Ocular Lens. Overall diameter of 10D to 24.5D: 11.00mm 25D to 30D: 10.75mm Optic diameter of 10D to 24.5D: 6.00mm 25D to 30 D: 5.75mm Power from 10D to 30D with 0.5 diopter increments. BL 1 141 1327 3892 at, pl, vblf 211587 333 0 0 No Change 2015-08-01 2019-03-01 Prosthesis BB340 Miethke proSA with differential pressure unit (miniNAV) proSA is an adjustable gravitational unit for the treatment of hydrocephalus. The proSA valve can be combined with any differential pressure valve. miniNAV is a very small differential pressure unit, which is often used with proSA. The valves are made from titanium and are MR safe up to 3 tesla. Adjustable gravitational unit: height 4.5mm, diameter 18mm, opening pressure 0-40 cmH2O. Differential pressure unit (miniNAV): length 14.7mm, diameter 2.8mm. BB 25 220 1666 4468 Antisyphon function, Reservoir/Priming function 181718 Changed Benefit 2727 0 0 Update 2014-02-01 2019-03-01 Prosthesis BB341 Miethke proSA with proGAV and distal catheter proSA is an adjustable gravitational unit. proGAV is an adjustable differential pressure unit. They are combined to treat pediatric and adult hydrocephalus. The valves are made from titanium and are MR safe up to 3 tesla. The distal catheters are made of silicone. Adjustable gravitational unit (proSA): diameter 18mm Adjustable differential pressure unit (proGAV): diameter 18mm Distal catheter: length 1200mm, inside diameter 1.2mm, outside diameter 2.5mm Distal catheter (connection between both valves): inside diameter 1.2mm, outside diameter 2.5mm FV783T: proSA adjustable between 0-40 cmH2O, proGAV adjustablebetween 0-20 cmH2O BB 25 220 1666 5978 Distal Catheter 181718 4014 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BB342 Miethke proSA with proGAV proSA is an adjustable gravitational unit. proGAV is an adjustable differential pressure unit. They are combined to treat pediatric and adult hydrocephalus. The valves are made from titanium and are MR safe up to 3 tesla. They are connected by a distal catheter, which is made of silicone. Adjustable gravatational unit (proSA): diameter 18mm Adjustable differential pressure unit (proGAV): diameter 18mm Distal catheter: inside diameter 1.2mm, outside diameter 2.5mm FV782T: proSA adjustable between 0-40 cmH2O proGAV adjustable between 0-20 cmH2O BB 25 220 1666 5978 181718 3838 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BB343 Miethke proSA with proGAV with reservoir and distal catheter Shunt system containing an adjustable gravitational unit and an adjustable differential pressure unit (proGAV) with distal catheters and a ventircular catheter, combined with a deflector, a pediatric prechamber or a reservoir. There are two types of reservoirs: Control reservoir and pediatric Burrhole reservoir. The shunt system is used for the treatment of pediatric and adult hydrocephalus. The valves, the prechamber, the deflector and the reservoirs are made from titanium. The catheters are made from silicone. The shunt system is MR safe up to 3 tesla. Adjustable gravitational unit (proSA): height 4.5mm, diameter 18mm Adjustable differential pressure unit (proGAV): diameter 18mm Distal catherter: length 1200mm, inside diameter 1.2mm, outside diameter 2.5mm Distal catheter for connections: inside diameter 1.2mm, outside diameter 2.5mm 1) FV784T proSA with proGAV and pediatric burrhole reservoir and distal catheter: proSA adjustable between 0-40 cmH2O, proGAV adjustable between 0-20 cmH2O, Pediatric burrhole reservoir: Diameter 14mm 2) FV785T proSA with proGAV and pediatric prechamber and distal catheter: proSA adjustable between 0-40 cmH2O, proGAV adjustable between 0-20 cmH2O, Pediatric prechamber: diameter 14mm BB 25 220 1666 5978 Distal Catheter, Reservoir/Priming Function 181718 4346 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BN004 Omniflow II Vascular Prosthesis Bioengineered Vascular Prosthesis 3-8 mm x 20 cm BN 24 208 1636 4455 Biologically Engineered 155500 1653 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BN020 Omniflow II Vascular Prostheses - Straight Vascular Patch 1.5cm x 5cm (less than 8 sq. Cm) BN 24 209 1640 4458 155500 Changed Benefit 184 0 0 Update 2010-02-01 2019-03-01 Prosthesis BN021 Omniflow II Vascular Prostheses - Straight Vascular Patch 2.5cm x 10cm (more than 8 sq. cm BN 24 209 1640 4458 155500 Changed Benefit 184 0 0 Update 2010-02-01 2019-03-01 Prosthesis BN026 Omniflow II Vascular Prosthesis Biosynthetic vascular prosthesis for peripheral revascularisation and vascular access 9 and 10mm internal diameter, 20 to 40cm length BN 24 208 1636 4456 155500 Changed Benefit 827 0 0 Update 2011-02-01 2019-03-01 Prosthesis BX247 Intermate Sterile infusor devices, elastomeric driven SV 200 - 200ml/hr, nominal 100ml vol. max 105 mL. SV 100 - 100ml/hr, nominal 100ml vol. max 105 mL. LV 250, 250ml/hr, 275ml vol. SV 50 - 50ml/hr, nominal 100ml vol. max 105mL. LV 100 - 100ml/hr, 275ml vol. LV 50, 50ml/hr, 275ml vol BX 21 188 1524 5358 168893 79 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BX249 Multirate with PCM Sterile infusor devices, elastomeric driven Multirate 5, 7 or 12 ml/hr with PCM BX 21 188 1524 5359 Bolus 168893 416 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BX252 CoSeal Surgical Sealant Composition: two synthetic polyethelene glycols (PEG's), COH102 and COH206, premixed and filled into one syringe, a dilute hydrogen chloride solution and a sodium phosphate/sodium carbonate solution 2ml BX 21 194 1580 4247 Synthetic 114966 Changed Benefit 277 0 0 Update 2005-10-31 2019-03-01 Prosthesis BX259 FloSeal Hemostatic Matrix FloSeal is a proprietary combination of collagen-derived particles and topical thrombin. Comes with a syringe with needle or needle free vial adapter. It is not sponge, but is a high viscosity gel for haemostasis. Clinical proven to control bleeding from capillary oozing to arterial spurting, FloSeal functions on w 10ml BX 21 191 1555 4214 Complete Biomaterial 192294 950 0 0 No Change 2007-12-01 2019-03-01 Prosthesis BX260 ADEPT Adhesion Reduction Solution ADEPT Adhesion Reduction Solution is a single use, sterile fluid for intraperitoneal administration. ADEPT is intended to be used as an instillate for the reduction of adhesions following abdominal surgery. 1500ml BX 21 194 1579 4246 145487 Changed Benefit 238 0 0 Update 2008-07-01 2019-03-01 Prosthesis BX261 Tisseel Duplospray MIS WITH SNAPLOCK Applicator 20cm Two component Fibrin Sealant containing human derived fibrinogen and thrombin. A 20cm long dual lumen metal cannula BX 21 194 1580 4250 Extender 115590 29 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BX262 TISSEEL DUPLOCATH 180cm Two component Fibrin Sealant containing human derived fibrinogen and thrombin. A 180cm long double lumen flexible application catheter BX 21 194 1580 4250 Extender 131001 29 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BX263 COSEAL Spray Accessory Kit A hydrogel that acts as a sealant by adhering to itself and the tissues it contacts. COSEAL is designed to completely seal suture lines along vascular reconstructions to prevent fluids from leaking. One size available BX 21 194 1580 4250 Extender 115590 29 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BX264 TISSEEL DUPLOTIP WITH SNAPLOCK 20g x 26.4cm Two component Fibrin Sealant containing derived fibrinogen and thrombin. A 26.4cm long dual umen applicator BX 21 194 1580 4250 Extender 115590 29 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BX253 CoSeal Surgical Sealant Composition: two synthetic polyethelene glycols (PEG's), COH102 and COH206, premixed and filled into a syringe, a dilute hydrogen chloride solution and a sodium phosphate sodium carbonate solution 4ml BX 21 194 1580 4248 Synthetic 114966 555 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BX254 CoSeal Surgical Sealant Composition: two synthetic polyethelene glycols (PEG's), COH102 and COH206, premixed and filled into a syringe, a dilute hydrogen chloride solution and a sodium phosphate sodium carbonate solution 8ml BX 21 194 1580 4249 Synthetic 114966 1036 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BX258 FloSeal Hemostatic Matrix FloSeal is a proprietary combination of collagen-derived particles and topical thrombin. Comes with a syringe with needle or needle free vial adapter. It is not sponge, but is a high viscosity gel for haemostasis. Clinical proven to control bleeding from capillary oozing to arterial spurting. 5ml BX 21 191 1555 4213 Complete Biomaterial 192294 665 0 0 No Change 2007-12-01 2019-03-01 Prosthesis BL038 B+L FINEVISION HP (POD F GF) POD F GF test intraocular lens (IOL) is a foldable IOL with a quadripode “POD” open-loop design intended for capsular bag implantation. The IOL is made of the proprietary hydrophobic glistening-free (GFree®) material containing a UV-blocker and additional blue blocker. The material is a hydrophobic acrylic copolymer of medical quality which includes a UV (wavelength < 400 nm) absorbing filter and a blue light-filtering chromophore which is covalently bounded to the hydrophobic material. The optical part of the test POD F GF lens is biconvex and aspherical partially compensating the positive spherical aberration of the cornea. The optic bears a diffractive TRIFOCAL element on its anterior side (toward patient pupil), allowing for presbyopia correction and spectacle independence for near and intermediate visions. The add-power at the IOL plane for the near vision is + 3.5 diopters and for the intermediate vision + 1.75 diopters. POD F GF is intended for implantation in the capsular bag after human lens extraction after cataract. The IOL material is capable of being folded prior to insertion, allowing placement through an incision (2.0-2.2 mm) smaller than the optic diameter of the lens. After surgical insertion into the eye, the lens unfolds to ReSTOR the optical performance. The supporting haptics provide for proper positioning and fixation of the IOL optic within the eye. Optic diameter: 6.00mm Total diameter: 11.40mm From Ø to +35 Diopters, with 0.5 Diopter increments BL 1 141 1327 3893 at, vblf 211587 712 0 0 No Change 2018-02-01 2019-03-01 Prosthesis BL039 Preloaded Capsular Tension Ring Capsular tension ring preloaded (acrylic) 13/11mm BL 1 143 1331 pl 235588 231 0 0 No Change 2018-02-01 2019-03-01 Prosthesis ER136 Triple Lumen Peripherally Inserted Central Catheter Power injectable with Pressure Activated Safety Valve (PASV) technology 6F x 55cm ER 24 214 1650 pi (power injection) 175080 178780 179150 202561 203830 203831 Changed Benefit 203 0 0 Update 2013-08-01 2019-03-01 Prosthesis ER137 Chesapeake Cervical Cage with intergral fixation Height: 5mm - 15mm ER 19 174 1485 5485 193652 Changed Benefit 4379 0 0 Update 2013-08-01 2019-03-01 Prosthesis ER138 Santorini Solid Corpectomy Cage System Cage, fixed height, Peek (12x14) or (16x20) mm footprint x (18-62) mm height ER 19 176 1814 198786 3470 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER139 Signus Pedicles Screw System - Rod Titanium Rod- as part of the Signus Pedicle Screw System Construct 6.0mm x 30mm - 100mm in 5mm increments 6.0mm x 108mm - 204mm in 12 mm increments ER 19 170 1478 216751 Changed Benefit 426 0 0 Update 2014-02-01 2019-03-01 Prosthesis ER140 Signus Pedical Screw System-Cross Link Cross Link-as part of Signus Pedicle Screw System Construct MP 0150-0038-38 mm; MP-0150-0042-42 mm;MP-0150-0050-50 mm ER 19 167 1474 4123 216751 404 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BX265 TISSEEL DUPLOTIP WITH SNAPLOCK 5mm x 31.8 cm Two component Fibrin Sealant containing human derived fibrinogen and thrombin "Black Beauty". A 31.8cm long dual lumen applicator BX 21 194 1580 4250 Rigid Delivery System 115590 148 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BX266 TISSEEL DUPLOSPRAY MIS APPLICATOR REPLACEMENT TIPS Two component Fibrin Sealant containing human derived fibrinogen and thrombin. Packs of 10 sterile packs each containing 2 tips and an installation tool BX 21 194 1580 4250 Applicator Tip 115590 24 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BX267 TISSEEL DUPLOSPRAY MIS WITH SNAPLOCK APPLICATOR 40 cm Two component Fibrin Sealant containing human derived fibrinogen and thrombin, with or without a malleable tip. A 40 cm long dual lumen metal cannula BX 21 194 1580 4250 Rigid Delivery System 115590 148 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BX268 TISSEEL DUPLOCATH 35cm MIC/MIS Two component Fibrin Sealant containing human derived fibrinogen and thrombin. A 35cm long double lumen flexible application catheter BX 21 194 1580 4250 Laparoscopic Extender 131001 57 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BX269 TISSEEL Easyspray Set Two component Fibrin Sealant containing human derived fibrinogen and thrombin. One size BX 21 194 1580 4250 Extender 131001 29 0 0 No Change 2008-07-01 2019-03-01 Prosthesis DP360 Duraloc Acetabular Shells Titanium, beaded, (Porocoat) non HA, with or without holes &/or spikes Size 36-76 SY 18 163 1426 4011 97696 98086 2204 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP363 Control Cable Control Cable sleeve One size only SY 13 123 1772 5371 99178 Changed Benefit 104 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP364 Control Cable with Sleeve Control Cable with sleeve One size only SY 13 123 1772 5367 99178 485 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP394 Moss Miami (Titanium) Pre-Cut Rod 5.5mm x 30 - 90mm SY 19 170 1478 145010 Changed Benefit 426 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP400 Moss Miami (Titanium) Rod - Standard 5.5mm x 12 - 48cm SY 19 170 1478 145010 Changed Benefit 426 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP410 Moss Miami (Titanium) Hooks - Pedicle 3-5 mm SY 19 168 1475 145010 789 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP411 Moss Miami (Titanium) Hooks - Laminar as Wide or Narrow or Angled or Reduced Distance Supra-laminar or Offset or Extended Body One size only SY 19 168 1475 145010 789 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ER163 Signus Anterior Cervical Plate - Bone Screws Provides stability in patients undergoing anterior cervical spine fusion procedures. It consists of a pre-contoured titanium plate, secured onto the spinal vertebrae by either fixed or variable angle colour coded screws. These screws have an integral lock 4.0 & 4.5mm diameter x 12-16mm length ER 19 165 1464 Expansion Screw / Expansion Head Screw 122274 289 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER164 Signus Athlet VBR System - Main Body Peek Vertebral Body Replacement System (Main body) 12, 18, 24, 30, 36 and 42mm lengths ER 19 176 1493 129772 4235 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER165 Signus Athlet VBR System - End Body Peek Vertebral Body Replacement System (End body) 4, 6, 8mm heights ER 19 176 1493 129772 4235 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER166 Signus Anterior Cervical Plate - L1-L2 Pre-contoured titanium plate, secured onto the spinal vertebrae by either fixed or variable angle colour coded screws. 22mm - 54mm ER 19 169 1477 4127 122274 1251 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER167 Signus Anterior Cervical Plate - L3-L4 Pre-contoured titanium plate, secured onto the spinal vertebrae by either fixed or variable angle colour coded screws. 56mm - 100mm ER 19 169 1477 4127 >55mm 122274 1636 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BX270 COSEAL Applicator Tips 7 cm COSEAL, which is listed on the Prostheses List, is a hydrogel that acts as a sealant by adhering to itself and the tissues it contacts. COSEAL is designed to completely seal suture lines along vascular reconstructions to prevent fluids from leaking. A 7cm long applicator tip BX 21 194 1580 4250 Applicator Tip 114966 24 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BX271 TISSEEL DUPLOTIP with SNAPLOCK 20g x 10.4cm Two component Fibrin Sealant containing human derived fibrinogen and thrombin. 10.4cm long dual lumen applicator BX 21 194 1580 4250 Extender 115590 29 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BX272 TISSEEL DUPLOCATH 25cm Two component Fibrin Sealant containing human derived fibrinogen and thrombin. A 25cm long double lumen flexible application catheter BX 21 194 1580 4250 Extender 131001 29 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BX273 Floseal Endoscopic Applicator Used as an adjunct to haemostasis when control of bleeding by ligature or conventional surgical procedures is ineffective or impractical. A 41cm - 47cm long disposable cannulated applicator, with or without malleable tip. BX 21 194 1580 4250 Rigid Delivery System 115590 148 0 0 No Change 2008-07-01 2019-03-01 Prosthesis DD059 RSP Monoblock Humeral Stem Cemented RSP Monoblock Humeral Stem cemented 6 x 101mm, 7 x 101mm, 8 x 101mm, 10 x 101mm, 12 x 101mm 6 x 175mm, 8 x 175mm,10 x 175mm, 12 x 175mm DD 13 131 1276 4057 Reverse 283578 283579 6460 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DP418 Moss Miami (Titanium) Hooks - Translation One size only SY 19 168 1475 145010 789 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP427 Surgical Titanium Mesh System Various shapes 10- 26 x 15 -150mm SY 19 176 1494 98094 3470 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP438 Surgical Titanium Mesh System Mesh - Oblong 12 - 13 x 15 -17mm x 10 - 20mm SY 19 176 1494 98094 3470 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP445 CMW Antibiotic Bone cement with vacuum mixing system 40 to 100g SY 13 123 1279 4090 57350 450 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP412 Moss Miami (Titanium) Transverse Connector - Complete One size only SY 19 167 1474 4124 142432 145010 Changed Benefit 1299 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP446 CMW Bone Cement with vaccum mixing system 40 to 100g SY 13 123 1279 4089 141068 450 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP447 Biosel 2 BIOSEL II Dose 5G (Calcium Phosphates) 5g SY 13 123 1241 4092 141028 722 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP448 BIO Stop G Biostop Restrictor (Gelatin, Glkycerol, PHBM, Water) size 8-20 SY 18 164 1437 126998 Changed Benefit 105 0 0 Update 2005-10-31 2019-03-01 Prosthesis DD060 RSP Monoblock Humeral Stem Uncemented RSP Monoblock Humeral Stem Uncemented 6 x 101mm, 7 x 101mm, 8 x 101mm, 10 x 101mm,12 x 101mm 6 x 175mm, 8 x 175mm, 10 x 175mm, 12 x 175mm DD 13 131 1276 4058 Reverse 283578 283579 Changed Benefit 6013 0 0 Update 2017-02-01 2019-03-01 Prosthesis DD061 RSP Hemi Adaptor Adaptor for conversion of Reverse Shoulder Prostheses (RSP) to a hemi arthroplasty prosthesis One size only DD 13 131 1278 4084 302695 1159 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DD062 RSP Humeral Stem Adapter RSP Humeral Stem Adapter for conversion to hemiarthroplasty prostheses 6 & 12mm DD 13 131 1278 4084 302694 1159 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DD063 RSP Spacer Spacer 8mm DD 13 131 1278 4084 284539 1159 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DD064 Turon to RSP Conversion Module Conversion Module Neutral and Offset DD 13 131 1278 4086 302688 829 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE055 Stainless Steel Square Wedge Tibial Osteotomy Plate Steel Square Wedge Tibial Osteotomy Plate with 4 non locking holes 3mm - 17.5mm DE 13 123 1694 5255 Com 140686 140710 Changed Benefit 922 0 0 Update 2005-10-31 2019-03-01 Prosthesis DE059 Arthrex Meniscal Dart PLA 10mm - 14mm DE 13 123 1774 5382 AB 140552 294 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE062 Ligament Staples Cobalt Chromium Molybdenium Alloy 6mm - 16mm DE 13 123 1773 5514 140711 Changed Benefit 127 0 0 Update 2005-10-31 2019-03-01 Prosthesis EV024 NAJA ligament correction system NAJA is dedicated to the correction and stabilization of the spine during fusion of the instrumented levels. It consists of: - A braid allowing correction and stabilization of the levels, after tensioning - A malleable lamella allowing guidance of the braid during surgery and attached to the braid through a shrink sleeve. These parts are not intended to a long term implantation - A connector designed to be fixed on a rod and holding the tension on the braid. Because of its conception, and in order to obtain symmetric constructions, two versions are available of the implant: one for the left size, one for the right side. 5.5mm diameter, left side and right side. EV 19 166 1816 273278 789 0 0 No Change 2016-08-01 2019-03-01 Prosthesis EV025 Eurospine ACDF Cage Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. Flat or angled 6 - 9 degrees. Anterior width 17 - 19mm Posterior width 14 - 15mm Height 5 - 10mm EV 19 174 1486 4134 273756 2409 0 0 No Change 2016-08-01 2019-03-01 Prosthesis EV026 Revolution Standalone ACDF cage Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. Standard – 6 and 9 degrees, height 4-10mm EV 19 174 1485 5485 236042 Changed Benefit 4379 0 0 Update 2016-08-01 2019-03-01 Prosthesis EV027 Revolution Standalone ACDF bone screw Anterior cervical fusion cage system Standalone screw Diameter 4 - 4.5mm Length 12 -17mm EV 19 165 1464 Dual Thread 236041 462 0 0 No Change 2016-08-01 2019-03-01 Prosthesis DE126 Chondral Dart Polylactide Compositition Length 18mm DE 13 123 1774 5382 AB 140552 294 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE127 Bio-Transfix Composition Poly (L-lactide) Diameter 5mm, length 50mm DE 13 123 1774 5394 AB 140563 462 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE163 Bio-Post & Washers PLLA composition Implant 35mm - 50mm, Washers 16mm DE 13 123 1231 3374 140794 93 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE166 Bio-Tenodesis Screw Soft Tissue Fixation 3mm-9mm DE 13 123 1774 5391 AB 140566 230210 230211 457 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE167 Bio-Interference Screw Composition - PLLA, delta tapered Dia6.5 - 10.5mm to 8 - 12mm x 28 - 35mm length DE 13 123 1774 5391 AB 140566 457 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE168 Univers 3D Shoulder Prostheses Stem 6-12mm DE 13 131 1276 4058 121575 3325 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE169 Univers 3D Shoulder Prostheses Glenoid Metal Back Small, Medium, Large DE 13 131 1277 3702 140706 2109 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE170 Univers 3D Shoulder Prostheses Glenoid PE-Inlay Small, Medium, Large DE 13 131 1277 3704 140706 1862 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ER141 Signus Pedicle Screw System-Set Screw Set Screw - as part of Signus Pedicle Screw System Construct N/A ER 19 166 1465 216751 164 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER142 Aleutian Cervical Interbody System Cage, Convex, or Lordotic. PEEK Height: 5 -15mm ER 19 174 1486 4134 193652 Changed Product sizes 2409 0 0 Update 2014-02-01 2019-03-01 Prosthesis ER143 Signus Pedicle Screw System-Pedicle Screw Polyaxial Signus Pedicle Screw 4.5 - 7.5mm x 30 - 70mm ER 19 165 1463 216751 1280 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER144 Signus Pedicle Screw System-Pedicle Screw Polyaxial Cannulated Signus Pedicle Screw System-Pedicle Screw Polyaxial Cannulated 4.5 - 7.5mm x 30 - 70mm ER 19 165 1463 Cannulated 216751 1338 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER149 Tetris Lumbar Fusion Implant System Titanium or peek, spinal implant Footprint:9 x 24mm, 9 x 20mm Heights: 7mm to 15mm Lordosis: 0, 4 and 8 ER 19 174 1486 4135 Paired 122274 Changed Benefit 2888 0 0 Update 2014-02-01 2019-03-01 Prosthesis ER150 Signus - Semial Composition - PEEK Height (ant) 7.80, 10.40, 13.20; Diameter 38, 43, 48; Height (post) 5.4, 8.0, 8.1, 10.8; Angle 5.00, 10.40 ER 19 174 1486 4135 122274 3465 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE171 Univers 3D Shoulder Prostheses Metal Head 40/14 - 54/23 DE 13 131 1276 4067 121575 1261 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE172 Univers 3D Shoulder Prostheses Cemented glenoid Small, Medium, Large DE 13 131 1277 3701 140706 1895 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE173 Univers Fracture Prostheses Shaft 8-13mm DE 13 131 1276 4058 121575 3325 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE174 Univers Fracture Prostheses Metal head 43/15 - 51/22 DE 13 131 1276 4067 121575 1261 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ER151 Nubic Cervical Fusion Implant in interbody fusion of the Cervical Spine 4x13x14mm, 5x13x14mm, 6x13x14mm, 7x13x14mm, 8x13x14mm ER 19 174 1486 4134 122274 2409 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER153 Kainos Granules 1 x 2cm3 ER 13 123 1241 4092 122272 722 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER154 Kainos Granules 1 x 3cm3 ER 13 123 1241 4092 122272 722 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER155 Kainos Granules 1x5cm3 ER 13 123 1241 4092 122272 722 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER156 Kainos Granules 1x6cm3 ER 13 123 1241 4093 122272 1140 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER157 Kainos Granules 1x10cm3 ER 13 123 1241 4093 122272 1140 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER158 Kainos Granules 1x16cm3 ER 13 123 1241 4094 122272 1425 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER159 Kainos Granules 1x20cm3 ER 13 123 1241 4094 122272 1425 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER160 Kainos Granules 1x30cm3 ER 13 123 1241 4095 122272 1482 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER161 Kainos Blocks 4-8x13x14 ER 13 123 1241 4092 122272 722 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER162 Signus Mobis Lumbar TLIF Cage Peek-Optima Lumbar intervertebral TLIF cage 6, 7, 8, 9, 10, 11, 12, 13, 14, 16, 18mm heights ER 19 174 1486 4135 122272 3465 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE182 Lid Load Gold Eyelid Weights; Gold 1.8, 2.0, 2.2, 2.4, 2.6, 2.8 grams DE 1 145 1336 3901 141197 760 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE183 Lid Load Gold Eyelid Weights; Gold 0.6, 0.8, 1.0, 1.2, 1.4, 1.6 grams DE 1 145 1336 3900 141197 404 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP180 Charnley Standard Femoral Stem Stainless steel, (Ortron 90) fixed & attachable femoral heads Sizes less than 200mm SY 18 161 1404 3939 97395 Changed Benefit 1625 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP188 Self Centering Bipolar Head Bipolar femoral head, CoCr with UHMWPE insert 39-65mm outer diameter SY 18 162 1424 4004 138290 235557 753 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP203 Elite Plus Femoral Stem Stainless steel, Ortron 90, cemented femoral stem, unpolished CDH, Size 1-7 and all offsets SY 18 161 1404 3939 97395 Changed Benefit 1625 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP510 Brantigan I/F Cage PLIF C/F Cage Straight / Wedge SY 19 174 1486 4135 Paired 98094 Changed Benefit 2888 0 0 Update 2005-10-31 2019-03-01 Prosthesis ER130 Nevro Spinal Cord Stimulation System (SCSS) - Pocket Adaptor Kit - M8 The Pocket Adaptor is intended to be used when replacing a previously implanted Pulse Generator with the Nevro Implantable Pulse Generator. The Pocket Adaptor interfaces the Nevro Implantable Pulse Generator to another manufacturer's previously implanted compatible lead or lead extension Length of 10cm to 60cm, in increments of 1cm ER 25 222 1680 204062 Changed Benefit 1434 0 0 Update 2013-02-01 2019-03-01 Prosthesis ER134 Single Lumen Peripherally Inserted Central Catheter Power injectable with Pressure Activated Safely Valve (PASV) technology 3F x55cm, 4F x 55cm, 5F x 55cm ER 24 214 1649 pi (power injection) 175080 178780 179150 203831 Changed Benefit 148 0 0 Update 2013-08-01 2019-03-01 Prosthesis ER135 Dual Lumen Peripherally Inserted Central Catheter Power injectable with Pressure Accivated Safety Valve (PASV) technology 5F x55cm, 6F x 55cm ER 24 214 1650 pi (power injection) 175080 178780 179150 203831 Changed Benefit 203 0 0 Update 2013-08-01 2019-03-01 Prosthesis DP480 DePuy Spinal Wire Wire with Button or Beaded Wire 18 - 24 gauge wire SY 13 123 1772 5365 OL 139772 97391 97395 99178 Changed Benefit 121 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP212 Elite Plus Long Femoral Stem Stainless steel, Ortron 90, cemented femoral stem, unpolished Sizes 3-5 (200-250mm) SY 18 161 1405 3944 97395 3120 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP222 DePuy Custom Made Acetabular Liners UHMWPE custom liner for obsolete DePuy shells Made to order SY 18 163 1428 4020 97696 720 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP223 Thackray Mesh Stainless Steel Ortron 90 mesh 200x200mm SY 13 123 1777 5399 138290 902 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP224 Charnley & Wroblewski Trochanteric Spring Wire Stainless steel wire for trochanteric attachment 0.5-3.00mm, 18 to 20g SY 18 164 1458 99178 Changed Benefit 219 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP233 Hardinge Cement Restrictor Hardinge cement Restrictor (ea) One size only SY 18 164 1437 137671 Changed Benefit 105 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP238 LCS Classic and Universal Knee System meniscal bearing tibial Insert Tibial inserts, meniscal bearing medial and lateral (by 2 per procedure) Sizes small to large+. 10-20mm SY 17 153 1369 136903 138289 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP250 Duraloc Cup Locking System Titanium locking Ring for Duraloc insert, seperately listed, only for revision Size 36-76mm SY 18 164 1449 98086 150 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP254 SROM Noiles Knee System femoral component Rotating Hinge, cemented, CoCr femoral component. Sizes xxsmall-large SY 17 149 1348 3908 Hinged 131657 6038 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP255 SROM Noiles Knee System bumper and hinge bearing replacements Replacements for UHMWPE axis bearings and bumpers, for hinged prosthesis Sizes xxsmall - medium. SY 17 159 1397 131657 132151 97698 97981 98088 98092 126 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP257 SROM Noiles Knee System tibial insert Tibial insert, rotating platform, hinged, with metal axis ring incorporated and polyethylene axis bearings XXSml - Large SY 17 153 1371 138289 97698 98088 Changed Benefit 1118 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP264 SROM Noiles Knee System patella All poly, cemented patella Sizes 25 - 38mm SY 17 156 1376 108414 Changed Benefit 537 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP269 SROM Noiles Knee System femoral augments Distal or posterior and combined distal and posterior femoral augments Sizes xxsmall - xlarge. 5-10mm SY 17 159 1390 131657 1148 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP270 SROM Noiles Knee System tibial insert Tibial insert, UHMWPE, posterior stabilised, rotating platform Xsm-lrg. 10-30mm SY 17 153 1370 138289 Changed Benefit 1073 0 0 Update 2005-10-31 2019-03-01 Prosthesis DE068 Interference Screws ARTHREX Non-sheathed 7 x 28mm - 12 x 28mm DE 13 123 1774 5391 AB 98527 457 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE069 Interference Screws Bio-Cortical - PLA 8 x 17 - 11 x 17mm and 8 x 20 - 10 x 20mm DE 13 123 1774 5391 AB 140566 457 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE070 TransFix Implant Screw System - Arthrex Titanium alloy 40mm & 50 mm DE 13 123 1774 5394 98527 451 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE071 Washer Screw Washer 6mm - 18mm DE 13 123 1231 3374 140690 280276 93 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE072 Bio-Interference Screw PLA 7mm - 9mm DE 13 123 1774 5391 AB 140566 457 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE078 Osteotomy Plates Osteotomy, Femoral - Stainless Steel 7.5mm - 17.5 mm DE 13 123 1694 5287 140710 1140 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE094 Anterior Posterior Sloped Stainless Steel Tibial Osteotomy Plate Anterior Posterior Sloped Stainless Steel Tibial Osteotomy Plate with 4 non locking holes 5 - 15mm length DE 13 123 1694 5255 Com 140710 Changed Benefit 922 0 0 Update 2005-10-31 2019-03-01 Prosthesis IR002 NeoZoline Otological Ventilation Tubes Armstrong, Collar Button, Shepard, Reuter, Donaldson, Paparella, Shah 1.10mm, 1.14mm, 1.27mm, 1.40mm, 0.76mm IR 22 196 1566 33794 19 0 0 No Change 2013-08-01 2019-03-01 Prosthesis IS010 BiFlex 677AB Hydrophilic Acrylic Foldable Aspheric Monofocal Lens (without Blue light Filter) Posterior chamber IOL, 360° Special Square Edge, Aspheric – Coma optimized Optic diameter: 6.0 mm ±0.10 mm, Overall diameter: 13.0 mm ±0.20 mm Powers available: -10.0 - +9.0 D ±0.25 D increment: 1.0 D +10.0 - +25.0 D ±0.25 D increment: 0.5 D +25.5 - +30.0 D ±0.5 D increment: 0.5 D +31.0 - +45.0 D ±0. D increment: 1.0 D IS 1 141 1327 3892 at 221834 300 0 0 No Change 2015-02-01 2019-03-01 Prosthesis IS018 Jetring Preloaded PMMA (polymethyl methacrylate) capsular tension ring. JETRING 11ACB Right Overall diameter: 13.0 mm ±0.20 mm Compressed diameter: 11,0 mm ±0.20 mm Haptic: ø0.17 mm ±0.02 mm Haptic design: straight, open modified C-loop JETRING 12ACB Right Overall diameter: 14.5 mm ±0.20 mm Compressed diameter: 12,0 mm ±0.20 mm Haptic: ø0,20 mm ±0.02 mm Haptic design: straight, open modified C-loop IS 1 143 1331 pl 229360 231 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IS019 Medicontur BiFlex 677MY Hydrophilic Acrylic Foldable Multifocal Lens with Blue light Filter Posterior chamber IOL, 360° Special Square Edge, Aspheric – Coma optimized Optic diameter: 6.0 mm ±0.10 mm, Overall diameter: 13.0 mm ±0.20 mm Powers available: -10.0 - +9.0 D ±0.25 D increment: 1.0 D +10.0 - +25.0 D ±0.25 D increment: 0.5 D +25.5 - +30.0 D ±0.5 D increment: 0.5 D +31.0- +45.0 D ±0. D increment: 1.0 D IS 1 141 1327 3893 at, vblf 221834 712 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IS020 Medicontur BiFlex Preloaded 677PMY Hydrophilic Acrylic Foldable Multifocal Lens with Blue light Filter Posterior chamber IOL, 360° Special Square Edge, Aspheric – Coma optimized Optic diameter: 6.0 mm ±0.10 mm, Overall diameter: 13.0 mm ±0.20 mm Powers available: -10.0 - +9.0 D ±0.25 D increment: 1.0 D +10.0 - +25.0 D ±0.25 D increment: 0.5 D +25.5 - +30.0 D ±0.5 D increment: 0.5 D +31.0- +45.0 D ±0. D increment: 1.0 D IS 1 141 1327 3893 at, pl, vblf 221834 728 0 0 No Change 2015-08-01 2019-03-01 Prosthesis KT058 Martin Level One Fixation Resorb X & SonicWeld RX Mesh, PDLLA (resorbable) 0.50 to 0.80mm thick, 1 to 10cm² KT 23 199 1586 4225 14336 585 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT059 Martin Level One Fixation Plate Martin Level One Fixation 1.0-1.99mm thick, 4-7 holes KT 23 199 1589 4288 96619 161 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT060 Martin Level One Fixation Mesh, Titanium 0.9-0.49mm thick, 11-50cm² KT 23 199 1585 4204 109878 Changed Benefit 683 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT061 Martin Level One Fixation Plate, Titanium ≥3mm thick, 16 to 32 Holes KT 23 199 1589 4314 Locking 96619 Changed Benefit 1384 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT062 Martin Level One Fixation Mesh, Titanium 0.5-0.8mm thick, 11-50cm² KT 23 199 1585 4208 109878 497 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT063 Martin Level One Fixation Orthodontic skeletal anchorage plate 0.5 to 0.99mm thick, 2 to 7 holes KT 23 201 1602 4390 96619 220 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT064 Martin Level 1 Fixation Orthodontic Screw 1.5 - 2.0mm KT 23 201 1602 4389 96619 76 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IS022 Medicontur BiFlex 677TAY Hydrophilic Acrylic Foldable Toric Lens with Blue light Filter Posterior chamber IOL, 360° Special Square Edge, Aspheric – Coma optimized – Toric Optic diameter: 6.0 mm ±0.05 mm, Overall diameter: 13.0 mm ±0.10 mm Powers available: -10.0 - +30.0 D ±0.25 D increment: 0.5 D +31.0 - +35.0 D ±0.5 D increment: 1.0 D Cylinders available: +1.5 D - +7.0 D increment: 0.75 D IS 1 141 1327 3892 at, t1, vblf 221834 642 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IS023 Medicontur BiFlex 677TAY Hydrophilic Acrylic Foldable Toric Lens with Blue light Filter Posterior chamber IOL, 360° Special Square Edge, Aspheric – Coma optimized – Toric Optic diameter: 6.0 mm ±0.05 mm, Overall diameter: 13.0 mm ±0.10 mm Powers available: -10.0 - +30.0 D ±0.25 D increment: 0.5 D +31.0 - +35.0 D ±0.5 D increment: 1.0 D Cylinders available: +7.0 D - +9.0 D increment: 0.75 D +9.0 D - +10.0 D increment: 1.0 D IS 1 141 1327 3892 at, t2, vblf 221834 893 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LB001 Independence Spacer Spacer with integral plate small (24 X30mm), medium (26 X 34mm), large (29mm X 39mm) 8,15, 20, 25 and 30 deg 11mm – 25mm height LB 19 174 1485 5486 190071 6256 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LB002 Independence Variable Angled Screw Variable Angled Bone Screw 5.5mm x 20mm - 40mm LB 19 165 1464 190071 Changed Benefit 193 0 0 Update 2012-02-01 2019-03-01 Prosthesis LH675 OO136 MUTARS Cancellous Screws MUTARS Cancellous Screws 20-40mm LH 13 123 1231 3369 237075 65 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH676 OO137 IC Muller PE snap lock cup PE acetabulum cup , constrained 44 – 62mm, 28 or 32mm LH 18 163 1425 4008 234880 Changed Benefit 732 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH677 OO138 IC Muller PE Cup PE acetabulum cup with 0 and10 degree lip - cemented 44-62mm, 28-32mm LH 18 163 1425 4006 234879 659 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH678 OO160 MUTARS GenuX MK Augments MUTARS GenuX MK Augments 1-6 Femoral distal, Femoral posterior and 2- 6 Tibial spacers. 5-20mm LH 17 159 1390 221737 284264 284265 284266 1148 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH679 OO161 MUTARS GenuX MK Stems MUTARS GenuX MK Stems 11/12/13/14/15/16/17/18/19/20/22/24/26/28mm dia. 125/150/200/250 length LH 17 159 1399 241989 Changed Benefit 1126 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH680 OO162 MUTARS GenuX MK Offset Adapter MUTARS GenuX MK Offset Adapter Offset adapter 0mm, +2mm, +4mm, +6mm LH 17 159 1396 245856 1208 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IS025 Medicontur BiFlex 677TA Hydrophilic Acrylic Foldable Toric Lens without Blue light Filter Posterior chamber IOL, 360° Special Square Edge, Aspheric – Coma optimized – Toric Optic diameter: 6.0 mm ±0.05 mm, Overall diameter: 13.0 mm ±0.10 mm Powers available: -10.0 - +30.0 D ±0.25 D increment: 0.5 D +31.0 - +35.0 D ±0.5 D increment: 1.0 D Cylinders available: +7.0 D - +9.0 D increment: 0.75 D +9.0 D - +10.0 D increment: 1.0 D IS 1 141 1327 3892 at, t2 221834 858 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IS024 Medicontur BiFlex 677TA Hydrophilic Acrylic Foldable Toric Lens without Blue light Filter Posterior chamber IOL, 360° Special Square Edge, Aspheric – Coma optimized – Toric Optic diameter: 6.0 mm ±0.05 mm, Overall diameter: 13.0 mm ±0.10 mm Powers available: -10.0 - +30.0 D ±0.25 D increment: 0.5 D +31.0 - +35.0 D ±0.5 D increment: 1.0 D Cylinders available: +1.5 D - +7.0 D increment: 0.75 D IS 1 141 1327 3892 at, t1 221834 Changed Benefit 609 0 0 Update 2015-08-01 2019-03-01 Prosthesis EV028 Katana Rod The Katana Rod, part of the Katana Pedicle Screw System is intended to provide immobilization and stabilisation of spinal segments in skeletally mature patients, as an adjunct to fusion in the thoracic, lumbar and sacral spine. These are specialty rods for use in procedures such as the treatment for scoliosis. Titanium or CrCo straight rods. 300 and 500mm EV 19 170 1478 236041 Changed Benefit 426 0 0 Update 2016-08-01 2019-03-01 Prosthesis EV029 Katana Unit Rods Katana Unit Rods 200 - 500mm EV 19 170 1480 4132 236041 1405 0 0 No Change 2017-02-01 2019-03-01 Prosthesis EV030 Evolution Altus ALIF Cage ThoracoLumbar ALIF Cage Small (34x25mm) 8 - 18 degrees, 10 - 18mm Medium (38x30mm) 8 - 18 degrees, 10 - 18mm Medium Long (38x34mm) 8 - 18 degrees, 10 - 18mm Large (42x30mm) 8 - 18 degrees, 10 - 18mm X Large (42x34mm) 8 - 18 degrees, 10 - 22mm XX Large (42x38mm) 13 degrees, 12 - 18mm EV 19 174 1485 5486 236042 6256 0 0 No Change 2017-08-01 2019-03-01 Prosthesis EV031 Evolution Altus Dual Thread Screw Thoraco Lumbar Cage Dual Thread Bone Screw diameter: 5.5 - 6mm Length: 20 - 35mm EV 19 165 1464 Dual Thread 236041 462 0 0 No Change 2017-08-01 2019-03-01 Prosthesis EV032 Katana Connectors In-Line Connectors 5.5mm to 6.35mm 5.5mm to 5.5mm EV 19 167 1472 236041 Changed Benefit 732 0 0 Update 2018-08-01 2019-03-01 Prosthesis MC424 Atlantis Variable Angle Cancellous Screw 10-20mm MC 19 165 1464 169514 Changed Benefit 193 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC436 CD-Horizon C-ring One size only MC 19 173 1484 169514 351 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC437 CD-Horizon Staples 10 - 30mm MC 19 172 1483 169514 395 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC439 CD Horizon Cannulated Pedicle Screw 20mm - 80mm MC 19 165 1463 Cannulated 169514 1338 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC440 CD Horizon Eclipse: 4.5mm Rod 40 - 600mm MC 19 170 1478 169514 Changed Benefit 426 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC447 UCSS Cortical Screws 30 - 50mm MC 19 165 1464 Cannulated 169514 202 0 0 No Change 2006-03-24 2019-03-01 Prosthesis AS207 Kangaroo Skin Level Balloon Gastrostomy Kit Skin level silicone balloon gastrostomy kit, including gastronomy tube accessory bolus and continuous feeding tubes, syringes for inflation and flushing, Patient Handbook 12-24 Fr., 0.8-5 cm, 3-8ml. AS 21 189 1545 4197 185673 288622 195 0 0 No Change 2014-08-01 2019-03-01 Prosthesis EX002 Novation Element HA Novation Press-Fit Element Stems are intended for press-fix fixation and manufactured from Titanium 6A1-4V and have rectangular cross-sectional geometry with transverse proximal grooves and distal parallell grooves. collarless: standard offset, 12/14, sizes 8-18 Extended offset 12/14, sizes 8-18, collarless: standard reduced offset, 12/14, sizes 8-12 Extended reduced offset 12/14, sizes 8-12 collared: standard offset 12/14, sizes 8-18 collared: standard reduced offset 12/14, sizes 8-12 FA 18 161 1407 3949 287412 3779 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX003 L-Series Unipolar Head L-Series unipolar is a modular endoprosthesis consisting of a truncated spherical head and interchangeable neck sleeves. The device is fully machined from cobalt chrome conforming to ASTMF 1537-94 unipolar head: 42mm, 43mm, 44mm, 45mm, 46mm, 47mm, 48mm, 49mm, 50mm, 51mm, 52mm, 53mm, 54mm, 55mm taper sleeve: 12/14-3.5mm, 12/14 +0mm, 12/14 +3.5mm, 12/14 +7mm, 12/14 +10mm FA 18 162 1420 3995 159610 835 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX004 Novation GXL Liner The GXL Liner are indicated for use in skeletally mature individuals undergoing primary surgery for total hip replacement Liner Neutral: Group 1: 28mm ID, Group 2: 28mm IS, 32mm ID, Group 3: 32mm ID, 36mm ID; Group 4: 32mm, 36mm, Group 5: 32mm, 36mm, Liner "Lipped": Group 1: 28mm, Group2: 28mm, 32mm, Group 3: 36mm, Group 4: 32mm, 36mm, Group 5: 36mm, Liner "+5 Lateralised" G FA 18 163 1428 4021 287411 1019 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LH694 OO146 MUTARS LUMiC Cup Modular partial pelvic replacement and acetabular reconstruction device in case of large bone defects 50, 54 and 60mm LH 18 163 1432 4034 Tumour 227162 284582 8744 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH695 OO147 MUTARS LUMiC Stem Stems for use with a modular partial pelvic replacement and acetabula reconstruction device in case of large bone defects 10mm x 65, 75, 85mm, 8mm x 65, 75, 85mm LH 18 164 1820 236007 236018 6108 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH696 OO148 MUTARS LUMiC Screw, M6 M6 Screw used to bolt the LUMiC Cup and LUMiC Stem together 28mm LH 18 164 1434 250195 Changed Benefit 352 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH697 OO149 Implacross PE liner PE Liner for LUMiC acetabula reconstruction system 0,15 and 15 with 4mm offset. 39 - 52 external diameter LH 18 163 1428 4021 277989 1019 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH698 OO155 PE Glenoid PE glenoid Small and Standard LH 13 131 1277 3701 244654 1895 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH699 OO156 MUTARS GenuX MK Coupling MUTARS GenuX MK Coupling 1 LH 17 159 1393 244653 3089 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH700 OO157 MUTARS GenuX MK Tibial Component, cemented MUTARS GenuX MK Tibial Component, cemented 2-6 LH 17 151 1359 Revision, Hinged 238837 3936 0 0 No Change 2018-08-01 2019-03-01 Prosthesis MC338 Medtronic Capsurefix Novus Model 5076 Pacing Lead Silicone; Contents: 1 x lead with anchoring sleeve, stylet & guide, 1 x vein lifter, 2 x fixation tools, extra stylets 45-85cm MC 27 243 1756 134286 236828 898 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC346 Venture Anterior Cervical Plate Single or multi level plate, titanium alloy and Nitinol 20mm - 50mm MC 19 169 1476 4125 169514 Changed Benefit 1348 0 0 Update 2005-10-31 2019-03-01 Prosthesis MC361 2X4 Hinged Surgical Lead model 3999 Materials: silicone rubber, platinum-iridium, polyurethane 30, 45 & 60cm MC 25 222 1679 4486 8 electrodes 119320 Changed Benefit 4018 0 0 Update 2005-10-31 2019-03-01 Prosthesis MC372 CapSure Sense MRI SureScan pacemaker leads Models 4074 & 4574 Bipolar, steroid, passive fixation pacing lead Model 4074: 52 - 58cm; Model 4574: 45 - 53cm MC 27 243 1753 134331 134426 898 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC378 Pyramesh Titanium Surgical Mesh 51 - 500mm MC 19 176 1494 169501 3470 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC379 Pyramesh Titanium Surgical Mesh 5 - 50mm MC 19 176 1494 169501 3470 0 0 No Change 2006-03-24 2019-03-01 Prosthesis EX006 Novation Crown Cup Screws Titanium cortical bone screws Full radius tip: 6.5mm x 15mm, 6.5mm x 20mm, 6.5mm x 25mm, 6.5mm x 30mm, 6.5mm x 35mm, 6.5mm x 40mm, 6.5mm x 45mm, 6.5mm x 50mm, 6.5mm x 55mm, 6.5mm x 60mm, 6.5mm x 70mm; Peripheral Rim screw: 4.5mm x 25mm, 4.5mm x 30mm, 4.5mm x 35mm, 4.5mm x 40mm, 4.5mm x 45mm, 4.5mm x 50mm, 4.5mm x 55mm, 4.5mm x 60mm, 4.5mm x 65mm, 4.5mm x 70mm; Pointed tip: MBA 6.5mm x 15mm, MBA 6.5mm x 20mm, MBA 6.5mm x 25mm, MBA 6.5mm x 30mm, MBA 6.5mm x 35mm, MBA 6.5mm x 40mm, MBA 6.5mm x 45mm, MBA 6.5mm x 50mm, MBA 6.5mm x 55mm, MBA 6.5mm x 60mm FA 18 164 1435 250113 121 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX008 L-Series Bipolar Head The L-Series Bipolar Head is a modular two piece device consisting of a spherical cobalt chrome shell and interchangeable polyethylene liner inserts 28mm 40mm OD, 28mm 41mm OD, 28mm 42mm OD, 28mm 43mm OD, 28mm 44mm OD, 28mm 45mm OD, 28mm 46mm OD, 28mm 47mm OD, 28mm 48mm OD, 28mm 49mm OD, 28mm 50mm OD, 28mm 51mm OD, 28mm 52mm OD, 28mm 53mm OD, 28mm 54mm OD, 28mm 55mm OD, 28mm 57mm OD, 28mm 59 mm OD, 28mm 61mm OD, 22mm 40mm OD, 33mm 41mm OD, 22mm 42mm OD, 22mm 43mm OD, 22mm 44mm OD, 22mm 45mm OD, 22mm 46mm OD, 22mm 47mm OD, 22mm 48mm OD, 22mm 49mm OD, 22mm 50mm OD, 22mm 51mm OD, 22mm 52mm OD, 22mm 53mm OD, 22mm 54mm OD, 22mm 55mm OD, 22mm 56mm OD FA 18 162 1424 4004 159610 753 0 0 No Change 2009-08-01 2019-03-01 Prosthesis AS208 Navien Intracranial Catheter The Navien Intracranial Support Catheter is a single lumen, flexible, variable stiffness composite catheter. The catheter shaft has a hydrophilic coating to reduce friction during use. The Navien Intracranial Support Catheter is visible under fluoroscopy. 105 - 130cm length; 5.0 - 6.3 Fr gauge AS 25 225 1689 4494 218532 665 0 0 No Change 2015-02-01 2019-03-01 Prosthesis AS209 Endo GIA Reinforced Reload with Tri-Staple Technology The Endo GIA Reinforced Reload with Tri-Staple Technology is an endoscopic stapler reload pre-attached with a non-woven absorbable polyglycolic acid staple line reinforcement mesh. This reinforced reload places a triple-staggered row of titanium staples and two layers of absorbable reinforcement material on either side of the cut line. 45mm and 60mm AS 21 194 1582 4319 Integrated 231041 560 0 0 No Change 2015-08-01 2019-03-01 Prosthesis AS210 Kangaroo Single Pass PEG Single Pass PEG 16fg, 20fg AS 21 189 1545 4197 141188 195 0 0 No Change 2015-08-01 2019-03-01 Prosthesis AS211 Parietex Composite Ventral Patch Parietex Composite ventral patch is used for the reinforcement of soft tissues during surgical repair. It is indicated for the treatment of ventral defects (primary and incisional hernias). 4.6cm, 6.6cm, 8.6cm AS 21 194 1783 5438 Coated, Contoured 44756 Changed Benefit 428 0 0 Update 2016-02-01 2019-03-01 Prosthesis EX010 L-Series Taper Sleeve for Unipolar Head The L-series unipolar is a modular endoprosthesis consisting of a truncated spherical head and interchangeable neck sleeves. The device is fully machined from cobalt chrome conforming to ASTM F1537-94. taper sleeve: 12/14 -3.5mm, 12/14 +0mm, 12/14 +3.5mm, 12/14 +7mm, 12/14 +10mm FA 18 164 1451 159610 228 0 0 No Change 2009-08-01 2019-03-01 Prosthesis HW412 Chins Extended chin implants: Round RZ (Models 8313 - 8315) and extended square RZ (Models 8316, 8318). Two piece chin design (Models 8320 - 8322). Single piece chin design, contoured (Models 7520 - 7522). Additional chin shapes (Models 6341 - 6344) Contoured t Extended chin Implants design RZ round small: 45 x 47 x 3mm, medium 45 x 47 x 5mm, large 45 x 47 x 7mm; Extneded Chin Implants square small 45 x 47 x3mm; Medium 45 x 47 x 5mm; Large 45 x 47 x 7mm; Two piece design small 46 x 33 x 5mm; Medium 56 x 36 x 7mm HW 23 200 1592 152165 279 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW413 Genioplasty Wedge Porus Polyethylene. Genioplasty wedges, models 8340 - 8343 Small 60 x 25 x 5mm, medium 60 x 25 x 7.5mm, large 60 x 25 x 10mm HW 23 200 1595 152165 Changed Benefit 322 0 0 Update 2011-02-01 2019-03-01 Prosthesis HW414 Prejowl Shape Porus Polyethylene. Model 8319 45 x 41 x 4mm HW 23 200 1595 152165 Changed Benefit 322 0 0 Update 2011-02-01 2019-03-01 Prosthesis LH701 OO158 MUTARS GenuX MB PE Insert MUTARS GenuX MB PE Insert 2-6 LH 17 153 1371 238794 Changed Benefit 1118 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH702 OO159 MUTARS GenuX MK Femoral Component Cemented MUTARS GenuX MK Femoral Component Cemented Left/Right 2,3,4,5,6 LH 17 149 1348 3908 Hinged 238795 6038 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH703 OO127 MUTARS Humerus cap MUTARS Humerus cap Small, medium and large. +5 and +10mm offset Standard / Inverse LH 13 123 1778 5422 227772 234173 4047 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LI044 Horizon Ceramic Liner Ceramic insert, Biolox Forte 9 sizes for 28, 32 and 36mm heads LI 18 163 1428 4022 210193 Changed Benefit 2250 0 0 Update 2013-08-01 2019-03-01 Prosthesis LI045 Saturne acetabular liner Polyethylene liner for double mobility cup 44/22- 66/22 (12 sizes) 48/28- 66/28 (10 sizes) LI 18 163 1428 4024 217778 1613 0 0 No Change 2013-08-01 2019-03-01 Prosthesis MC310 Centerpiece TiMesh LP Screw MC 19 165 1464 169514 Changed Benefit 193 0 0 Update 2005-10-31 2019-03-01 Prosthesis MC313 Synchro Med II Pump Model No's 8637-20 & 8637-40, Composition - Titanium 20 ml & 40 ml MC 25 223 1681 Variable Flow Rate 97770 Changed Benefit 15438 0 0 Update 2005-10-31 2019-03-01 Prosthesis KT028 Martin Level One Fixation Resorb x & SonicWeld Rx Plate, PDLLA (resorbable) 1.0 to 1.99mm thick, 16 to 32 holes KT 23 199 1589 4296 Resorbable 143326 Changed Benefit 409 0 0 Update 2015-02-01 2019-03-01 Prosthesis IS026 Medicontur BiFlex 677PT Hydrophilic Acrylic Foldable Toric Lens without Blue light Filter, Preloaded Posterior chamber IOL, 360° Special Square Edge, Aspheric – Coma optimized – Toric Optic diameter: 6.0 mm ±0.05 mm, Overall diameter: 13.0 mm ±0.10 mm Powers available: -10.0 - +30.0 D ±0.25 D increment: 0.5 D +31.0 - +35.0 D ±0.5 D increment: 1.0 D Cylinders available: +1.5 D - +7.0 D increment: 0.75 D IS 1 141 1327 3892 at, pl, t1 221834 Changed Benefit 626 0 0 Update 2015-08-01 2019-03-01 Prosthesis KT029 Martin Level One Fixation Plate, titanium 1.0 to 1.99mm thick, 16 to 32 holes KT 23 199 1589 4296 3D 96619 798 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT030 Martin Level One Fixation Plate Titanium 1.0 to 1.99mm thick, 16 to 32 holes KT 23 199 1589 4296 96619 199 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT031 Martin Level One Fixation Mesh, Titanium 0.2 to 0.49mm thick, 1 to 10cm² area KT 23 199 1585 4203 109878 341 0 0 No Change 2015-02-01 2019-03-01 Prosthesis HW415 Nasal Shape or Rhinoplasty Shape Porus Polyethylene. Nasal Arch shapes, nasal arch and nasal sheet (Models 9533 - 9536). Nasal dorsum shapes, design A and design B (Models 7516 - 7518). Nasal valve support, lateral nasal valve support and ext. Nasal arch shapes: small 70 x 13 x 2mm, medium 70 x 15 x 2mm, large 70 x 15 x 2mm, sheet 40 x 9 x 1.1mm. Nasal dorsum shapes: design A small 53 x 5mm, design A large 66 x 8mm, design B 67 x 6.5mm. Nasal valve support: lateral nasal valve 13 x 0.85 x 3.5mm HW 23 200 1597 4361 152165 341 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW416 Micro Thin Sheet Model/s 8438, 83020, 83022, 83029 8438: 30 x 50 x 0.4mm, 83020: 38 x 50 x 0.25mm, 83022: 38 x 50 x 0.35mm, 83029: 38 x 50 x 0.45mm HW 23 199 1588 4254 152165 234 0 0 No Change 2011-02-01 2019-03-01 Prosthesis LH681 OO170 MUTARS RS Cup Acetabulum reconstruction cup, flange multiple screw holes 46, 50, 54, 58, 62mm right & left LH 18 163 1426 4012 238836 Changed Benefit 2196 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH682 OO171 ACCIS Insert (15 degrees) ACCIS liner (15 degrees) for use with MUTARS RS and LUMIC Cup 38/39, 42/44, 46/48, 50/52mm LH 18 163 1428 4023 Revision/Tumour 281539 2241 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH683 OO173 MUTARS Femoral Stem Cemented with TiN and HA Collar MUTARS Femoral Stem Cemented with TiN and HA Collar 11/13/15/17 120/160/200/240mm LH 18 161 1405 3944 244313 3120 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH684 OO174 EPORE Cones/Components Femoral/Tibial metaphyseal Cones and Components, 3D Printed titanium Sizes 2-6 for Femur and Tibia, Left and Right LH 17 159 1400 Metaphyseal 221737 Changed Benefit 2416 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH685 OO177 MUTARS Ulna Anchorage MUTARS Ulna Anchorage Component Left/Right 70-100mm LH 13 131 1275 3676 221739 3398 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH686 OO178 ACS Knee Porous Coated Tibia Component Cementless Tibial base plate porous coated for use with mobile bearing insert - TiN Coated 2-7 LH 17 151 1362 265617 265623 2639 0 0 No Change 2018-08-01 2019-03-01 Prosthesis KT034 Martin Level One Fixation Mesh, Titanium 0.2 to 0.49mm thick, 1 to 10cm² area KT 23 199 1585 4203 Complex 109878 Changed Benefit 707 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT035 Martin Level One Fixation Screw, titanium Diameter 2.25 - 2.74mm KT 23 199 1590 4323 Locking 96619 88 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT032 Martin Level One Fixation Resorb x & SonicWeld Mesh PDLLA (resorbable) 0.20 to 0.49mm thick, 1 to 10 cm2 area KT 23 199 1586 4221 143326 439 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT033 Martin Level One Fixation Resorb x & SonicWeld Reconstruction sheet not mesh PDLLA (resorbable) 25x25mm-0.1mm KT 23 199 1588 4253 143326 336 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT036 Martin Level One Fixation Resorb x & Sonic Weld Plate PDLLA (resorbable) 1.0 to 1.99mm thick, 8 to 15 holes KT 23 199 1589 4293 Resorbable 143326 Changed Benefit 409 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT037 Martin Level One Fixation Plate Titanium 0.5-0.99mm thick, 8-32 holes KT 23 199 1589 4277 96619 199 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT038 Martin Level One Fixation Screw Titanium Diameter 1.25 to 3.24mm KT 23 199 1590 4323 96620 42 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT039 Martin Level One Fixation Mesh Titanium 0.5-0.8mm thick, 1-10cm² KT 23 199 1585 4207 109878 307 0 0 No Change 2015-02-01 2019-03-01 Prosthesis MC315 Low Profile Impedance Extension Kit for SCS Model 7489 Silicone rubber 10, 25, 40, 51, 66cm MC 25 222 1680 96926 Changed Benefit 1434 0 0 Update 2005-10-31 2019-03-01 Prosthesis MC328 Racer Renal Stent System Cobalt Alloy Diameter: 4-7mm; Lengths: 12 &18mm MC 24 206 1622 4439 114003 1710 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC329 Medtronic Driver, Micro Driver Coronary Stent System Cobalt Alloy Driver Stent: diameter (2.25 - 4.5mm), length (8-30mm); Micro-Driver Stent: diameter (2.25 - 2.75mm), length (8 - 24mm) MC 27 247 1767 5348 98309 898 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC336 Medtronic Capsure Z Novus Model 5054 Pacing Lead Silicone; Contents: 1 x lead with anchoring sleeve, stylet & guide, 1 x vein lifter, 2 x fixation tools, extra stylets 45-58cm MC 27 243 1753 142168 898 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC337 Medtronic Capsure Z Novus Model 5554 Pacing Lead Silicone; Contents: 1 x lead with anchoring sleeve, stylet & guide, 1 x vein lifter, 2 x fixation tools, extra stylets 45-58cm MC 27 243 1753 142167 898 0 0 No Change 2005-10-31 2019-03-01 Prosthesis MC387 TiMesh Rigid Fixation Bone Grafting and Plating System Titanium, Square Grid Mesh Large MC 23 199 1585 4206 128523 Changed Benefit 1462 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC389 TiMesh Rigid Fixation Bone Grafting and Plating System Titanium, Square Grid Mesh Small MC 23 199 1585 4207 128523 307 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC393 TiMesh Rigid Fixation Bone Grafting and Plating System Titanium, Z Plate Left and Right 4 hole - 5mm, 9.5mm MC 23 199 1589 4271 128523 166 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC394 CD Horizon Set screw Each in one size MC 19 166 1465 169514 164 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC396 TSRH Spinal Implant System 3D - Rod Length 20-120mm MC 19 170 1478 169514 Changed Benefit 426 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC399 TSRH Spinal Implant System 3D - Nut, Eyebolt locknot, locknut 1/2 inch, locking screws, double hex, flush break, universal breakoff Each in one size MC 19 166 1465 169514 164 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC402 CD Horizon Pedicle Screws Diameter 4.5 - 7.5mm Length 25 - 80mm MC 19 165 1462 169514 895 0 0 No Change 2006-03-24 2019-03-01 Prosthesis KT044 Martin Level One Fixation Mesh PDLLA resorbable >0.8mm thick, 1-10cm² KT 23 199 1586 4230 143326 585 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT045 Martin Level One Fixation Mesh PDLLA resorbable >0.8mm thick, 26-50cm² KT 23 199 1586 4232 143326 Changed Benefit 994 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT046 Martin Level One Fixation Mesh PDLLA resorbable 0.5-0.8mm thick, 26-50cm² KT 23 199 1586 4227 143326 1199 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT040 Martin Level One Fixation Resorb x & Sonic Weld Sonic Pin PDDLA (resorbable) Diameter 1.25 - 3.24mm KT 23 199 1590 4323 Resorbable 143327 137 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT043 Martin Level One Fixation Plate Titanium locking 1.0 to 1.99 mm thick, 4 - 7 holes KT 23 199 1589 4288 Locking 96619 Changed Benefit 458 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT047 Martin Level One Fixation Mesh, Titanium & 3D 0.2-0.49mm thick, 51-200cm² KT 23 199 1585 4205 109878 1365 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT048 Martin Level One Fixation Mesh PDLLA resorbable 0.5-0.8mm thick, 101-200cm² KT 23 199 1586 4229 143326 Changed Benefit 2047 0 0 Update 2015-02-01 2019-03-01 Prosthesis HW417 Sheet Porus Polyethylene. Models 6330, 6331, 8662, 9562. Micro single channel sheet, model 9528. Barrier microplate single channel sheet, model 9527 Medpor Titan Implant Sheets Plain, Barrier & Double Barrier, and Medpor Titan Orbital floor and wall sheets 8102 Sheets 6330: 38 x 50 x 1.5mm, 6331: 50 x 76 x 1.5mm, 8662: 76 x 127 x 1.5mm, 9862: 38 x 50 x 3mm. Microplate single channel Sheet 9528: 38 x 50 x 0.85mm. Barrier microplate single channel Sheet 9527: 38 x 50 x 0.85mm. Titan implant sheets 81020: 76 x 50 x HW 23 199 1588 4254 152165 234 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW418 Barrier Sheet: Barrier Sheet - Orbital Floor Porus Polyethylene. Barrier sheet - Rectangle, models 8312 and 9312. Orbital floor implants, models 8305 and 9305 Barrier sheet - Rectangle: 50 x 76 x 1mm, 50 x 76 x 1.6mm: 50 x 76 x 1mm, 50 x 76 x 1.6mm. Orbital Floor: 38 x 50 x 1mm, 38 x 50 x 1.6mm HW 23 199 1588 4254 152165 234 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW420 Ear Reconstruction Porus Polyethylene. Helical rim, models 8328 and 8329 Helical rim: 37 x 62mm HW 23 200 1594 4349 152165 Changed Benefit 409 0 0 Update 2011-02-01 2019-03-01 Prosthesis MC404 CD HORIZON Spinal System - Rod Rod 20mm - 600mm MC 19 170 1478 169514 Changed Benefit 426 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC406 CD HORIZON Spinal System - Hook Hook - various Extra Small - Large MC 19 168 1475 169514 789 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC407 CD Horizon Domino 3.2mm, 3.5mm, 4.5mm, 5,5mm, 6.35mm MC 19 167 1472 169514 Changed Benefit 732 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC409 CD Horizon Domino & Axial Connector 4.5mm, 5.5mm and 6.35mm MC 19 167 1472 169514 Changed Benefit 732 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC413 Cornerstone Cage Sterile and Non-sterile 4 - 14mm MC 19 174 1486 4134 126313 2409 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC415 BCP Biphasic Calcium Phosphate Reabsorbable Graft Supplement 1-3cc MC 13 123 1241 4092 144137 722 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC418 Atlantis Anterior Cervical Plate Plate 19.0mm - 47.5mm MC 19 169 1476 4125 169514 Changed Benefit 1348 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC419 Atlantis Anterior Cervical Plate Anterior Cervical Plate 50mm - 55mm MC 19 169 1476 4125 169514 Changed Benefit 1348 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC423 Atlantis Fixed Angle Cancellous Screw 10-20mm MC 19 165 1464 169514 Changed Benefit 193 0 0 Update 2006-03-24 2019-03-01 Prosthesis LH688 OO139 Implantcast delta ceramic liner Biolox delta cup liner 32/39, 32/44,36/44, 32/48,36/48,32/52, 36/52, 40/48, 40/52 LH 18 163 1428 4022 233781 Changed Benefit 2250 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH689 OO140 MUTARS intrameduallary connecting module MUTARS intramedullary connecting module 180-440mm Length LH 17 157 1382 244052 244656 3944 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH690 OO141 MUTARS RS Hip System. MUTARS RS coupling device RS coupling device 30mm LH 17 157 1387 3937 237292 284583 1520 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LH687 OO179 ACS Mobile Tibial Component Cemented Tibia Base Plate Cemented for use with a Mobile Bearing insert - TiN Coated 2-7 LH 17 151 1359 265622 265672 Changed Benefit 2147 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH691 OO142 MUTARS RS screw for coupling device RS coupling device screw 60-140mm length M8 LH 18 164 1434 250353 Changed Benefit 352 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH692 OO144 MUTARS - M10 Screw M10 Screw - Tumour System and Arthrodesis Interlocking System 25mm - 245mm Length LH 18 164 1434 250194 Changed Benefit 352 0 0 Update 2018-08-01 2019-03-01 Prosthesis LH693 OO145 MUTARS - KRI Screw M8 KRI Screw M8 - Tumour System and Arthrodesis Interlocking System 25mm - 50mm LH 17 159 1392 250193 273 0 0 No Change 2018-08-01 2019-03-01 Prosthesis KT054 KLS Martin Distractors Zurich II remote release activators 20mm - 50mm KT 23 202 1604 4411 113786 Changed Benefit 487 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT055 KLS Martin Plating System Preshaped reconstruction plates, in left and right options 2.0mm and 2.5mm thickness with 26 holes KT 23 199 1589 4307 Locking 96619 Changed Benefit 1073 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT049 Martin Level One Fixation Mesh PDLLA resorbable >0.8mm thick, 101-200cm2 KT 23 199 1586 4496 143326 Changed Benefit 2047 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT053 KLS Martin Distractor Zurich II distractor bodies 15mm - 30mm distraction length KT 23 202 1604 4402 113786 2145 0 0 No Change 2015-02-01 2019-03-01 Prosthesis KT056 Martin Level One Fixation Plate ,Titanium 1.0 to 1.99mm thick, 8 -15 holes KT 23 199 1589 4293 99619 Changed Benefit 409 0 0 Update 2015-02-01 2019-03-01 Prosthesis KT057 Martin Level One Fixation Plate Titanium 0.5 to 0.99mm thick, 4 - 7 holes KT 23 199 1589 4271 96619 166 0 0 No Change 2015-02-01 2019-03-01 Prosthesis HW422 Mandibular angle Porus Polyethylene. RZ mandibular angles left and right (Models 9955 - 9960); Porus Polyethylene. Contoured mandibular angles left and right (Models 88037 - 88038) RZ mandibular angles: 65 x 35 x 3 x 6.5 x 3 x 3mm, 65 x 35 x 7 x 6.5 x 3 x 3mm, 65 x 35 x 11 x 6.5 x 3 x 3mm. Contoured mandibular angles left and right:59 x 29 x 7 x 11mm. HW 23 200 1596 4355 Polymer 152165 1448 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW423 Nasal Shape. Petite Nasal Dorsum. Porus Polyethylene. Petite Nasal Dorsum ( Models 84000 - 84004). Petite Nasal Dorsum: 4 x 4 x 45mm, 4 x 4 x 55mm, 5 x 5 x 45mm, 5 x 5 x 55mm, 6 x 9 x 55mm. HW 23 200 1597 4360 152165 272 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW421 Complete Orbital Shape Complete left and right. Models 9569, 9570 Complete 61 x 76mm HW 23 200 1598 4366 152165 Changed Benefit 1892 0 0 Update 2011-02-01 2019-03-01 Prosthesis HW424 Nasal Valve Support. Lateral Nasal Valve, Model 7545. External Nasal Valve Batten, Model 7546. External Nasal Valve Batten - Thin, Model 7167 Lateral Nasal Valve:13 x 3.5 x 0.85mm, External Nasal Valve Batten: 25 x 11 x 0.85mm, External Nasal Valve Batten - Thin: 24 x 11.5 x 0.6mm. HW 23 200 1597 4363 152165 221 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW425 Nasal Shell Shapes. Nasal Shell Shapes, Regular and Large with Inserts Small and Large (included). Models 9553 - 9554. Thin Nasal Shell 84006 Regular: 38 x 21 x 17mm, Insert Small 30 x 4 x 9mm, Insert Large 38 x 2.5 x 9mm. Large: 40 x 20 x 18mm, Insert Small 32 x 4 x 9mm, Insert Large 41 x 3 x 9mm. Thin Nasal Dorsal Shell 42.7mm x 16.4mm x 21.8mm HW 23 200 1597 4362 152165 478 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW426 Ultra Thin Sheet Porus Polyethylene. Model 7214 76 x 127 x 0.85mm HW 23 199 1588 4254 152165 234 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW427 Ultra Thin Sheet Porus Polyethylene. Model 7216 127 x 178 x 0.85mm HW 23 199 1588 4254 152165 234 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW428 Sheet - Multi Channel, Barrier Channel. Porus Polyethylene. Miniplate channel sheet, model 9529. Microplate channel sheet, model 9530. Barrier Miniplate and Microplate Channel Sheets, Models 9531 and 9532. Miniplate channel: 40 x 52 x 2.3mm. Mircoplate channel: 40 x 52 x 2.3mm. Barier Miniplate and Microplate Channel Sheets: 40 x 52 x 2.3mm, 40 x 52 x 2.3mm HW 23 199 1588 4254 152165 234 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW433 E-POR Biomaterial/ Orbital Wall and Floor Porous Polyethylene Titanium Mesh Composite (large) Orbital Wall and Floor Porous Polyethylene Titanium Mesh Composite 41 x 42 x 0.6-1.0mm HW 23 200 1598 4367 Coated 152165 960 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW434 E-POR Biomaterial/ Midface Contour Porous Polyethylene Midface Contour Porous Polyethylene One size HW 23 200 1595 4351 144944 1121 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW432 Ear Reconstruction Porus Polyethylene. Ear base left and right, models 7542 and 7525 - 7527. Ear base extended left and right, models 8330 and 8331. Ear base: 29 x 55 x 13mm, 32 x 65 x 16mm. Ear base extended: 30 x 60mm. HW 23 200 1594 4350 152165 585 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW435 E-POR Biomaterial/ Craniotomy Gap Wedge Porous Polyethylene Craniotomy Gap Wedge Porous Polyethylene One Size - V and T shape HW 23 199 1591 4335 144944 375 0 0 No Change 2011-02-01 2019-03-01 Prosthesis IQ024 PreciSAL Mulitfocal PM302AC Pre-loaded acrylic single piece, foldable intraocular lens with anterior and posterior optichaptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology, pupil independent diffractive anterior surface with a near sight correction addition of up to +3.5D, and UV filter. Available in spherical dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; near sight correction addition up to +3.5D on all spherical dioptric powers. IQ 1 141 1327 3893 at, pl 183558 Changed Benefit 694 0 0 Update 2014-08-01 2019-03-01 Prosthesis IQ025 PreciSAL Multifocal PM302A Pre-loaded acrylic single piece, foldable intraocular lens with anterior and posterior optichaptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology, pupil independent diffractive anterior surface with a near sight correction addition of up to +3.5D, and UV and blue filter powers. Available in spherical dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; near sight correction addition up to +3.5D on all spherical dioptric powers. IQ 1 141 1327 3893 at, pl, vblf 183558 728 0 0 No Change 2014-08-01 2019-03-01 Prosthesis AS215 Symbotex Composite Mesh Non-absorbable three-dimensional polyester composite mesh. (On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera) Elliptical 25x15 cm, Elliptical 20x12 cm Rectangular 20x15cm AS 21 194 1783 5439 Coated, Contoured 270735 759 0 0 No Change 2016-08-01 2019-03-01 Prosthesis AS216 Symbotex Composite Mesh Non-absorbable three-dimensional polyester mesh provides long term reinforcement of soft tissues. (On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera.) Rectangular 30x20 cm, Rectangular 25x20 cm AS 21 194 1783 5440 Coated, Contoured 270735 Changed Benefit 1017 0 0 Update 2016-08-01 2019-03-01 Prosthesis AS217 Symbotex Composite Mesh with pre placed suture Non-absorbable three-dimensional polyester composite mesh with pre placed sutures. (Non absorbable pre-placed sutures are tied to the mesh. A died marking is positioned on the center of the textile and helps center and orient the mesh.) Rectangular 15x10 cm Round 15 cm, 12 cm Elliptical 17x10 Round 9cm AS 21 194 1783 5438 Coated, Contoured 270737 Changed Benefit 428 0 0 Update 2016-08-01 2019-03-01 Prosthesis DE278 BD Visitec Lacrimal Intubation Sets Stainless steel probes with solid silicone rods or silicone tubing - packaged sterile 1. Probes 0.90mm x 4.5cm, rod 40cm x 0.80mm. 2. Probes 0.40mm x 11cm, tubing 35cm x 0.64mm. Probes 0.60mm x 11mm, tubing 35cm x 0.30mm. DE 1 146 1337 125073 Changed Benefit 128 0 0 Update 2007-12-01 2019-03-01 Prosthesis DE284 Single Dose Ophthalmic Gases Single dose tamponading gas for retinal surgery 30ml DE 1 148 1345 99568 71 0 0 No Change 2009-02-01 2019-03-01 Prosthesis DE285 Titanium Lapidus Arthrodesis Plate Titanium Lapidus Arthrodesis Plate with locking holes and compresion slot Small, Large DE 13 123 1694 5258 LK 140686 470 0 0 No Change 2009-02-01 2019-03-01 Prosthesis DE289 AnaToemic AnaToemic Phalangial Prosthesis 17mm, 20mm, 21.5mm, 23mm DE 13 124 1461 4048 141580 1145 0 0 No Change 2009-02-01 2019-03-01 Prosthesis BB366 Celsite Safety Venous Access Port Celsite Safety is a venous access port that is implanted and is intended to be used for any condition that requires mid to long-term intermittent or continuous central venous infusions. Standard: 33 x 26mm x 13.7mm: Septum 13.0mm Small: 29 x 22mm x 11.3mm: Septum 10.8mm BB 24 214 1652 pi (power injection) 285508 286710 567 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BB367 Aesculap Spinal System Monoaxial Cannulated Screw All sizes BB 19 165 1462 Cannulated 134538 924 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BB368 Aesculap CranioPlate System/Plate Neuro mesh Cranial fixation system, internal fracture, non biodegradable Plate Neuro, 132 x 158 mm, 0.6mm Mesh BB 23 199 1585 4210 140600 2187 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BB369 Aesculap Spinal System In-Line Connector All Sizes BB 19 167 1472 134538 Changed Benefit 732 0 0 Update 2017-08-01 2019-03-01 Prosthesis BB370 Aesculap Spinal System Offset Connector All Sizes BB 19 167 1473 134538 Changed Benefit 732 0 0 Update 2017-08-01 2019-03-01 Prosthesis BB371 Aesculap Spinal System Pre-bent Rods - Titanium Alloy All Sizes BB 19 170 1478 134538 Changed Benefit 426 0 0 Update 2017-08-01 2019-03-01 Prosthesis DE191 Canaliculus Intubation Sets Silicone, SS & Nylon 17.7 x .064 x 29cm, 15.5 x .051 x 33cm DE 1 146 1337 182623 Changed Benefit 128 0 0 Update 2005-10-31 2019-03-01 Prosthesis DE197 Bio - Fastak with Fibrewire suture 3mm x 11mm DE 13 123 1774 5385 AB 140551 501 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE198 Fastak Suture Anchor (Small Bone) With Fibrewire Suture Dia. 2.4mm x Length 7.5mm DE 13 123 1774 5385 126657 Changed Benefit 442 0 0 Update 2005-10-31 2019-03-01 Prosthesis DE204 Arcaline (Perfluorodecaline) Liquid perfluorocarbon aid for retinal surgery, operative device for retinal surgery, in particular retinal detachment (RD), RD with giant tear etc. 3ml, 5ml, 7ml DE 1 148 1346 140539 228 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS218 PROGRIP™ Laparoscopic Self-Fixating Composite Mesh Laparoscopic self-fixating composite mesh (knitted monofilament polyester with monofilament polylactic acid resorbable grips on one side and a resorbable film made of collagen from porcine origin and glycerol, on the other side) 16 x 14 cm rectangular AS 21 194 1783 5439 Coated 252653 759 0 0 No Change 2016-08-01 2019-03-01 Prosthesis AS219 PROGRIP™ Laparoscopic Self-Fixating Composite Mesh Laparoscopic self-fixating composite right or left or bilateral anatomical mesh (knitted monofilament polyester with monofilament polylactic acid resorbable grips on one side and a resorbable film made of collagen from porcine origin and glycerol, on the other side) 10x15 cm Rectangular Bilateral Anatomical, 10x15 cm Rectangular Right Anatomical, 10x15 cm Left Anatomical, 13x09 cm Right Anatomical, 13x09 cm Left Anatomical AS 21 194 1783 5438 Coated, Contoured 252653 Changed Benefit 428 0 0 Update 2016-08-01 2019-03-01 Prosthesis BB375 Aesculap Patella 3-Pegs All poly patellar, UHMWPE cemented, 3 pegs P1 - P5 BB 17 156 1376 293939 Changed Benefit 537 0 0 Update 2018-02-01 2019-03-01 Prosthesis BB372 Aesculap Spinal System Straight Rods - Titanium Alloy All Sizes BB 19 170 1478 134538 Changed Benefit 426 0 0 Update 2017-08-01 2019-03-01 Prosthesis BB373 Aesculap Spinal System Monoaxial Screw - titanium alloy All Sizes BB 19 165 1462 134538 895 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BB374 Aesculap Cervical Systen Titanium Alloy All Sizes < 55 mm BB 19 169 1477 4127 134538 1251 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BB377 Vitelene PE Cup Insert Highly cross-linked polyethylene liner stabilised with vitamin E 22.2mm - 40mm BB 18 163 1428 4021 297205 1019 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BB378 Plasmafit Acetabular Cup Acetabular Shell with Plasmapore Coating 40mm - 70mm BB 18 163 1426 4013 297206 297207 2022 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BB379 Aesculap AS Tibial and Femoral Stems Tibial and Femoral Stems, cemented or uncemented, CoCr with ZrN coating All Sizes BB 17 159 1399 277356 277357 277359 Changed Benefit 1126 0 0 Update 2018-08-01 2019-03-01 Prosthesis BB380 Aesculap AS Tibial and Femoral Augments Tibial and Femoral Augments/Spacers CoCr with ZrN coating All Sizes BB 17 159 1390 247596 1148 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BB381 Aesculap AS Femoral Stem Locking Nut Femoral Stem Locking Nut, CoCr with ZrN coating One size BB 17 159 1400 277359 698 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BB382 Histoacryl Flexible Topical Skin Adhesive 0.5ml per ampoule BB 21 194 1580 4247 Synthetic 221444 45 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BN027 Omniflow II Vascular Prosthesis Bioengineered Vascular Prosthesis 5-8 mm x 50-65 cm BN 24 208 1636 4457 Biologically engineered 155500 215035 Changed Benefit 2880 0 0 Update 2011-02-01 2019-03-01 Prosthesis BN028 Omniflow II Vascular Prosthesis Biosynthetic vascular prosthesis for peripheral revascularisation and vascular access 9 and 10mm internal diameter; 45 to 85cm length BN 24 208 1636 4456 155500 Changed Benefit 827 0 0 Update 2011-02-01 2019-03-01 Prosthesis BN029 Omniflow II Vascular Prosthesis Bioengineered Vascular Prosthesis 5-8 mm x 30-45 cm BN 24 208 1636 4456 Biologically engineered 155500 215035 2470 0 0 No Change 2011-02-01 2019-03-01 Prosthesis BP002 PEEK Interbody System – Lumbar ALIF Sterile and Non sterile ALIF Implants Width 24-28mm: Length 28-38mm: Height 8-17mm: Lordosis Angle 6 - 8 degrees BP 19 174 1486 4135 273366 273367 273374 3465 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BP003 Ti PEEK Interbody System – Lumbar PLIF/TLIF (Paired) Sterile PLIF Implants TLIF Implants Commercially Pure Titanium and Polyetheretherketone (PEEK-Optima®) Width 8-12mm: Length 22-34mm: Height 7-17mm: Lordosis Angle 0-8 degrees BP 19 174 1486 4135 273366 273367 273374 Changed Product name, Product description, Benefit, Suffix 3465 0 0 Update 2016-08-01 2019-03-01 Prosthesis BP004 PEEK Interbody system – Cervical ACIF Implants; Sterile and Non Sterile Diameter 14mm; 16mm: Height (5mm, - 12mm): Lordosis Angle 0 - 7.5 degrees: Curevd , Straight BP 19 174 1486 4134 273366 273367 273374 2409 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BP001 Ti PEEK Interbody system – Lumbar PLIF/TLIF (single) Sterile PLIF Implants TLIF Implants Commercially Pure Titanium and Polyetheretherketone (PEEK-Optima®) Width 8-12mm: Length 22-34mm: Height 7-17mm: Lordosis Angle 0-8 degrees BP 19 174 1486 4135 273366 273367 273374 Changed Product name 3465 0 0 Update 2016-08-01 2019-03-01 Prosthesis BP005 PEEK Interbody system – Lumbar PLIF/TLIF (single) Sterile and Non sterile PLIF Implants TLIF Implants Width 8-12mm: Length 22-34mm: Height 7-17mm: Lordosis Angle 0-8 degrees BP 19 174 1486 4135 273366 273367 273374 3465 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BP006 TyPEEK Interbody system – Lumbar DLIF Sterile DLIF Implants Commercially Pure Titanium and Polyetheretherketone (PEEK-Optima®) Width 18-22mm: Length 40-60mm: Height 8-17mm: Lordosis Angle 0 - 8 degrees BP 19 174 1486 4135 273366 273367 273374 3465 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BP007 PEEK Interbody System – Lumbar PLIF/TLIF (Paired) Sterile and Non sterile PLIF Implants TLIF Implants Width 8-12mm: Length 22-34mm: Height 7-17mm: Lordosis Angle 0-8 degrees, BP 19 174 1486 4135 Paired 273366 273367 273374 Changed Benefit 2888 0 0 Update 2016-08-01 2019-03-01 Prosthesis BP008 TiPEEK Interbody system – Cervical ACIF Implants; Sterile Commercially Pure Titanium and Polyetheretherketone (PEEK-Optima®) Size: small, standard, large, extra large Width 12.5mm – 19mm Length 11.5mm – 16mm Height 5-12mm: Lordosis Angle 0 - 20°: Curved, Straight, Convex BP 19 174 1486 4134 273366 273367 273374 Changed Product name, Product sizes 2409 0 0 Update 2016-08-01 2019-03-01 Prosthesis BP010 TyPEEK Interbody system – Lumbar ALIF Sterile ALIF Implants Commercially Pure Titanium and Polyetheretherketone (PEEK-Optima®) Width 24-28mm: Length 28-38mm: Height 8-17mm: Lordosis Angle 6-8 degrees, BP 19 174 1486 4135 273366 273367 273374 3465 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BP011 OV006 ANAX 5.5 Spinal System - Set Screws Set screws for locking pedicle screws and connectors. SF1319, SF1320 BP 19 166 1465 292040 164 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BP009 PEEK Interbody System – DLIF Lumbar Sterile and Non sterile DLIF Implants Width 18-22mm: Length 40-60mm: Height 8-17mm: Lordosis Angle 0 - 8 degrees BP 19 174 1486 4135 273366 273367 273374 3465 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BP012 OV004 ANAX 5.5 Spinal System - Monoaxial Screws - Cannulated Monoaxial pedicle screws, cannulated, non-reduction and reduction. Diameter 5 - 8mm Length 30 - 95mm BP 19 165 1462 Cannulated 292040 924 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE215 Titanium Metatarsal Opening Wedge Osteotomy Plate Titanium Metatarsal Opening Wedge Osteotomy Plate with 4 non locking holes and square wedge 2mm - 8mm DE 13 123 1694 5261 Com 140710 1007 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE205 Arcotane (Perfloro-N-Octane) Liquid perfluoro-N-Octane aid for retinal surgery, pre-operative device for retinal surgery, in particular retinal detachment (RD), RD with giant tear, RD with proliferative vitreal retinopathy (PVR) etc. 5ml, 7ml DE 1 148 1346 140539 228 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE216 Titanium Anterior Posterior Sloped Tibial Osteotomy Plate Titanium Anterior Posterior Sloped Tibial Osteotomy Plate with 4 variable angle locking holes and 6 variable angle locking holes 0-17.5mm DE 13 123 1694 5255 Com,VAL 140710 Changed Benefit 1473 0 0 Update 2005-10-31 2019-03-01 Prosthesis DE214 Cortical Screw Screw for Bone fixation 2.01-2.7mm DE 13 123 1231 3371 284416 84 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE217 Titanium Femoral Osteotomy Plate Titanium Femoral Osteotomy Plate with 7 Variable Angle Locking Holes 5mm - 17.5mm DE 13 123 1694 5255 Com,VAL 140710 Changed Benefit 1473 0 0 Update 2005-10-31 2019-03-01 Prosthesis AS220 Parietex Progrip Composite Mesh Pre-Cut, slit mesh with self gripping overlapping flap - right or left knitted (monofilament polyester with polylactic acid monofilament resorbable pins on one of the sides) Elliptic slit 12x8cm left side, elliptic slit 12x8cm right side, elliptic slit 14x9 left side, elliptic slit right side 14x9cm AS 21 194 1783 5438 Coated, Contoured 157201 Changed Benefit 428 0 0 Update 2016-08-01 2019-03-01 Prosthesis AS221 Versatex™ monofilament macroporous polyester mesh Versatex™ Monofilament Mesh is a non-absorbable synthetic surgical mesh made out of a macroporous three-dimensional (3D) monofilament polyester knitted textile and designed to ensure a long term reinforcement of soft tissues. Versatex™ Monofilament Mesh is offered in rectangular and square flat sheet. The mesh is intended for the repair of abdominal wall hernias or other fascial deficiencies that require the addition of a reinforcing material. Largest sizes from 15 cm x 15 cm include a green dyed monofilament polyester (D&C Green No. 6) marking that is positioned in the center of the textile to help center and orient the mesh. Square 30x30 cm, Rectangular 45x30 cm AS 21 194 1782 5437 237409 261 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BP013 OV003 ANAX 5.5 Spinal System - Monoaxial Screws - Non-Cannulated Monoaxial pedicle screws, non-cannulated, non-reduction and reduction. Diameter 4 - 8mm Length 30 - 95mm BP 19 165 1462 292040 895 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BP014 OV002 ANAX 5.5 Spinal System - Polyaxial Screws - Cannulated Polyaxial pedicle screws, cannulated, non-reduction and reduction. Diameter 5 - 8mm Length 30 - 95cm BP 19 165 1463 Cannulated 292040 1338 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BP015 OV001 ANAX 5.5 Spinal System - Polyaxial Screws - Non-Cannulated Polyaxial pedicle screws, non-cannulated, non-reduction and reduction. Diameter 4 - 8mm Length 30 - 95mm BP 19 165 1463 292040 1280 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BP016 OV013 ASPIRON ACP Screws Variable and semi-fixed screws, self-drilling and self-tapping. Diameter: 3.5 – 4.35mm Length: 10 – 20mm BP 19 165 1464 292040 Changed Benefit 193 0 0 Update 2018-08-01 2019-03-01 Prosthesis BP017 OV010 ANAX 5.5 Spinal System - Axial Connector In-line axial connector. Small or large, 2 - 4 holes. BP 19 167 1472 292040 Changed Benefit 732 0 0 Update 2018-08-01 2019-03-01 Prosthesis BP018 OV009 ANAX 5.5 Spinal System - Domino Connector Offset connector, open and closed. 2 and 4 holes. BP 19 167 1473 292040 Changed Benefit 732 0 0 Update 2018-08-01 2019-03-01 Prosthesis BX274 TISSEEL DUPLOTIP 20G x 5.3cm Two component Fibrin Sealant containing human derived fibrinogen and thrombin. A 5.3 cm long dual lumen applicator. BX 21 194 1580 4250 Extender 115590 29 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BP019 OV007 ANAX 5.5 Spinal System - T-Link Collet Adjustable transverse connector. 33 - 90mm BP 19 167 1474 4124 292040 Changed Benefit 1299 0 0 Update 2018-08-01 2019-03-01 Prosthesis BP020 OV008 ANAX 5.5 Spinal System - Lateral Connector Fixed lateral connector, open and closed. 16.5 - 35mm BP 19 167 1474 4123 292040 404 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BP021 OV014 Velofix PEEK Cervical cage Interbody fusion cage. Width: 14 and 16mm Depth: 12 and 14mm Height: 5 - 10mm BP 19 174 1486 4134 292041 2409 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BX275 COSEAL Extended Applicator 22 cm COSEAL, which is listed on the Prostheses List, is a hydrogel that acts as a sealant by adhering to itself and the tissues it contacts. COSEAL is designed to completely seal suture lines along vascular reconstructions to prevent fluids from leaking. A 22 cm long malleable applicator BX 21 194 1580 4250 Extender 114966 29 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BX284 ARTISS Fibrin Sealant 4ml ARTISS is a proprietary fibrin sealant with 4UI/ml human thrombin. It is two-component fibrin sealant made from pooled human plasma, a double virus-inactivated (vapour heated and solvent/detergent treated) and frozen (≤ -20°C) plasma derived biological agent. The two components are formulated as two sterile frozen solutions. Each solution is presented in a separate pre-loaded chamber (2ml) of a double chamber syringe. One chamber contains sealer protein solution with aprotinin while the other chamber contains thrombin solution with calcium chloride, resulting in a 4ml total volume of product for use. BX 21 194 1580 4248 Biological 163515 Changed Benefit 647 0 0 Update 2011-08-01 2019-03-01 Prosthesis BX285 ARTISS Fibrin Sealant 10ml ARTISS is a proprietary fibrin sealant with 4UI/ml human thrombin. It is two-component fibrin sealant made from pooled human plasma, a double virus-inactivated (vapour heated and solvent/detergent treated) and frozen (≤ -20°C) plasma derived biological agent. The two components are formulated as two sterile frozen solutions. Each solution is presented in a separate pre-loaded chamber (5ml) of a double chamber syringe. One chamber contains sealer protein solution with aprotinin while the other chamber contains thrombin solution with calcium chloride, resulting in a 10ml total volume of product for use. BX 21 194 1580 4249 Biological 163515 1295 0 0 No Change 2012-02-01 2019-03-01 Prosthesis AS222 Parietex Progrip Composite Mesh Monofilament polyester with polylactic acid monofilament resorbable pins on one of the sides Rectangular 30x15cm AS 21 194 1783 5440 Coated 157201 Changed Benefit 1017 0 0 Update 2016-08-01 2019-03-01 Prosthesis BB353 EnduRo Rotating Hinge Knee Tibial and Femoral Extension Stems cementless and cemented The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to treat complex revision knee arthoplasty as well as unstable knees Length Tibial: 52,92&172mm Length Femoral: 77,117,157&177mm - Tibial Cemented: x 12,15,18mm - Tibial Cementless: x 11-20cm - Femoral Cemented: x 12,15,18mm - Femoral Cementless: x 13-20mm BB 17 159 1399 96481 Changed Benefit 1126 0 0 Update 2016-02-01 2019-03-01 Prosthesis BB354 EnduRo Rotating Hinge Knee Tibial Component The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to treat complex revision knee arthoplasty as well as unstable knees 1-3 BB 17 151 1359 Revision, Hinged 96481 3936 0 0 No Change 2016-02-01 2019-03-01 Prosthesis BX277 TISSEEL DUPLOSPRAY MIS SNAPLOCK APPLICATOR 30 cm Two component Fibrin Sealant containing human derived fibrinogen and thrombin. A 30 cm long dual lumen metal cannula BX 21 194 1580 4250 Laparoscopic Extender 115590 57 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BX279 Coseal Duplospray Applicator 30cm COSEAL, which is listed on the Prostheses List, is a hydrogel that acts as a sealant by adhering to itself and the tissues it contacts. COSEAL is designed to completely seal suture lines along vascular reconstructions to prevent fluids from leaking. 30cm BX 21 194 1580 4250 Laparoscopic Extender 115590 57 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BX280 Coseal Duplospray Applicator 20cm COSEAL, which is listed on the Prostheses List, is a hydrogel that acts as a sealant by adhering to itself and the tissues it contacts. COSEAL is designed to completely seal suture lines along vascular reconstructions to prevent fluids from leaking. This a 20 cm BX 21 194 1580 4250 Laparoscopic Extender 115590 57 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DE225 Fastak Anchor Titanium with fibrewire suture 2.8mm x 11.7mm DE 13 123 1774 5385 126657 Changed Benefit 442 0 0 Update 2005-10-31 2019-03-01 Prosthesis DE224 Retro Screw Composition PLLA 8-10mm x 20mm DE 13 123 1774 5391 AB 140566 457 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE252 Tightrope Syndesmosis Repair Kit Titanium or stainless steel, with non absorbable Fiberwire suture material One size only DE 13 123 1774 5389 292241 374 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE256 Eclipse Humeral Head Prosthesis Eclipse Humeral Head Prosthesis Trunnion 41 - 53mm DE 13 131 1276 4060 121575 2451 0 0 No Change 2006-03-24 2019-03-01 Prosthesis DE257 Eclipse Humeral Head Prosthesis Eclipse Humeral Head Prosthesis Head 41/16 - 53/20 DE 13 131 1276 4067 121575 1261 0 0 No Change 2006-03-24 2019-03-01 Prosthesis BB355 EnduRo Rotating Hinge Knee Tibial and Femoral Augments/Spacers The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to treat complex revision knee arthoplasty as well as unstable knees Tibial Spacer(augment) to match Tibial component 4, 8, 12 & 16mm Femoral Spacer distal (augment) to match femoral component 4, 8 & 12mm Femoral Spacer posterior/distal (augment) to match femoral component 4x4,4x8,4x12,8x4,8x8,8x12, 12x4, 12x8 and 12x12 BB 17 159 1390 247596 1148 0 0 No Change 2016-02-01 2019-03-01 Prosthesis BB356 Lyoplant Onlay Biological Onlay & Suturable Dura Substitute 2.5 x 2.5cm BB 25 219 1657 Biological 264832 342 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BB357 Lyoplant Onlay Biological Onlay & Suturable Dura Substitute 5 x 5cm and 2.5 x 7.5cm BB 25 219 1658 Biological 264832 518 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BB358 Lyoplant Onlay Biological Onlay & Suturable Dura Substitute 7.5 x 7.5cm BB 25 219 1659 Biological 264832 1064 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BB359 Lyoplant Onlay Biological Onlay & Suturable Dura Substitute 10 x 12.5cm BB 25 219 1660 Biological 264832 Changed Benefit 1796 0 0 Update 2016-08-01 2019-03-01 Prosthesis BX281 Baxter Folfusor Sterile infusor devices, elastomeric driven. Folfusor SV 0.5mL/hr 120mL (Baxter Code 2C4700K), Folfusor SV 2.5mL/hr 120mL (Baxter Code 2C4711K), Folfusor SV 5mL/hr 120mL (Baxter Code 2C4705K). The Baxter Folfusor is a disposable infusion pump used in an ambulatory setting for the continuous infusion of intravenous medications. The codes listed above represent three separate flow rates specific to Chemotherapy protocols. 120mL Maximum Volume BX 21 188 1524 5358 168895 79 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BX282 Floseal Special Applicator Tips Floseal Malleable and Trimmable Applicator with Tips specifically designed for use with Floseal Haemostatic Matrix 14cm BX 21 194 1580 4250 Extender 167776 29 0 0 No Change 2010-08-01 2019-03-01 Prosthesis DE271 RetroButton Femoral Fixation Device 12mm Button with 15-60mm loops, 15mm Button with 15-60mm loops DE 13 123 1774 5389 126657 374 0 0 No Change 2007-12-01 2019-03-01 Prosthesis DE272 Bio-Compression Screw System Fixation Device 16mm, 18mm, 20mm, 22mm, 24mm, 26mm DE 13 123 1231 3370 DT 140794 253 0 0 No Change 2007-12-01 2019-03-01 Prosthesis DE258 Eclipse Humeral Head Prosthesis Eclipse Humeral Head Prosthesis Cage Screw Small - X-Large DE 13 131 1276 4064 121575 2660 0 0 No Change 2006-03-24 2019-03-01 Prosthesis DE273 Trim-IT Spin Pin Trim-IT Pin Fixation 1.5 - 2.0mm x 100mm DE 13 123 1772 5365 AB 140553 Changed Benefit 265 0 0 Update 2007-12-01 2019-03-01 Prosthesis DE275 DC Bead Drug delivery embolisation system 70-150, 100-300, 300-500, 500-700, 700-900 (microns) DE 21 188 1542 4195 131473 Changed Benefit 1853 0 0 Update 2007-12-01 2019-03-01 Prosthesis DE277 Frontalis Suspension Set Stainless steel needles with solid silicone rods and silicone tubing - packaged sterile needles 0.90mm x 6.5cm, rod 40cm - 0.80mm, sleeve 10 x 2mm DE 1 147 1341 125073 299 0 0 No Change 2007-12-01 2019-03-01 Prosthesis BB360 AS Columbus Knee System Femur CR cemented Columbus cemented AS coated CR Fixed bearing femoral component for total knee arthroplasty 1-7 Left and Right BB 17 149 1348 3906 Ceramic Surface 279466 3086 0 0 No Change 2017-02-01 2019-03-01 Prosthesis BB361 activ L Lumbar Disc Prosthesis activ L is the lumbar disc prosthesis for the motion preserving treatment of degenerative disc disease of the lumbar spine. H= 8.5mm/10mm/ 12mm/ 14mm. Small: D= 26mm x W = 31mm Medium: D= 28mm x W = 34.5mm Large: D= 30mm x W = 39mm Extra Large: D= 33mm x W = 40mm BB 19 175 1488 5488 120419 9192 0 0 No Change 2017-02-01 2019-03-01 Prosthesis BB362 Nanogel Synthetic, Biomimetic Bone Substitute Material Syringe 0.5ml, 1.0ml, 2.5ml, 5.0ml BB 13 123 1241 4092 282244 722 0 0 No Change 2017-02-01 2019-03-01 Prosthesis BB363 Neuropatch Dura Substitute Polyurethane Medium BB 25 219 1658 138310 448 0 0 No Change 2017-02-01 2019-03-01 Prosthesis BB364 Aesculap Spinal System Polyaxial Cannulated Screw All Sizes BB 19 165 1463 Cannulated 134538 1338 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BB365 Aesculap Interbody Cage PLIF Interbody Cage All sizes BB 19 174 1486 4135 122641 273761 3465 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BX283 ARTISS Fibrin Sealant 2ml ARTISS is a proprietary fibrin sealant with 4UI/ml human thrombin. It is two-component fibrin sealant made from pooled human plasma, a double virus-inactivated (vapour heated and solvent/detergent treated) and frozen (≤ -20°C) plasma derived biological agent. The two components are formulated as two sterile frozen solutions. Each solution is presented in a separate pre-loaded chamber (1ml) of a double chamber syringe. One chamber contains sealer protein solution with aprotinin while the other chamber contains thrombin solution with calcium chloride, resulting in a 2ml total volume of product for use. BX 21 194 1580 4247 Biological 163515 Changed Benefit 352 0 0 Update 2011-08-01 2019-03-01 Prosthesis BX286 Painfusor Catheter The Painfusor Catheter is an extended fenestration catheter for the administration of analgesic drugs into surgical wounds to manage acute post-operative pain. Pack contains fenestrated catheter, peel away introducer needle accommodating 19Ga (100 mm length), 3M Tegaderm IV Transparent Film Dressing with border 1633, and GripLok catheter securement device Catheters are 35cm + Fenestrated section: (35cm + 2.5cm) - total length 37.5cm, (35cm + 7.5cm) - total length 42.5cm, (35cm + 15cm) - total length 50cm, (35cm + 22.5cm) - total length 57.5cm, (35cm + 30 cm) - total length 65cm BX 21 188 1541 4190 177499 76 0 0 No Change 2012-02-01 2019-03-01 Prosthesis AS213 Veriset Veriset is an absorbable topical hemostatic device intended for use in surgical procedures as an adjunct to hemostasis when conventional methods are ineffective or impractical. Veriset does not consist of any human or animal components. 5cm x 10cm (50cm2) 8 cm x 16 cm (128cm2) AS 21 194 1580 5426 202060 443 0 0 No Change 2016-02-01 2019-03-01 Prosthesis AS214 PROGRIP™ Laparoscopic Self-Fixating Composite Mesh Laparoscopic self-fixating composite mesh (knitted monofilament polyester with monofilament polylactic acid resorbable grips on one side and a resorbable film made of collagen from porcine origin and glycerol, on the other side) 10x15, 16x12 rectangular AS 21 194 1783 5438 Coated 252653 Changed Benefit 371 0 0 Update 2016-08-01 2019-03-01 Prosthesis AS212 Veriset Veriset is an absorbable topical hemostatic device intended for use in surgical procedures as an adjunct to hemostatsis when conventional methods are ineffective or impractical. Veriset does not consist of any human or animal components 2cm x 4cm (8cm2) AS 21 194 1580 5424 202060 73 0 0 No Change 2016-02-01 2019-03-01 Prosthesis BX287 Intermate XLV 250 Sterile infusor devices, elastomeric driven. The Intermate XLV 250 is an ambulatory device utilising elastomeric technology to deliver continuous infusion of parenteral therapy to patients in an ambulatory setting. The device is specifically suitable for patients requiring intravenous immunoglobulin therapy. The nominal flow rate of the Intermate XLV 250 is 250mL/hr, however when used for the administration of IVIG the flow rate is reduced to approximately 120mL/hr. Volume 500mL. Approximate infusion time for IVIG solutions is 4.2 hrs. BX 21 188 1524 5358 168893 79 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BX288 Peri-Strips Dry Model No PSD 4506 One size only BX 21 194 1580 4251 152943 324 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BX289 Peri-Strips Dry Model No PSD 6006 One size only BX 21 194 1580 4251 152943 324 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BX290 Peri-Strips Dry Model No PSD 4506 One size only BX 21 194 1580 4251 152943 324 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BX291 Peri-Strips Dry Model No PSD 8006 One size only BX 21 194 1580 4251 152943 324 0 0 No Change 2013-02-01 2019-03-01 Prosthesis DE290 Titanium Plate with or without Wedge Titanium Plate with or without wedge with 4 and non locking holes. Left and right side specific. Flat Plates - left large, right large, left medium, right medium, left small, right small Wedge Plates - 10mm wedge left, 10mm wedge right, 8mm wedge left, 8mm wedge right, 6mm wedge left, 6mm wedge right DE 13 123 1694 5258 Com, LK 140686 850 0 0 No Change 2009-02-01 2019-03-01 Prosthesis DE292 QuickFix Staple System Compression Staple for Fusion 8mm 10mm DE 13 123 1773 5514 159591 Changed Benefit 127 0 0 Update 2009-08-01 2019-03-01 Prosthesis DP511 Brantigan I/F Cage ALIF C/F Cage Small - Large, 21.5 - 29mm SY 19 174 1486 4135 98094 3465 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP513 Stackable Corpectomy CFRP Cage System Stackable Cage Xsmall-Xlarge SY 19 176 1493 98094 4235 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP514 Brantigan I/F Cage Cervical Brantigan Cage Standard/Large 4-10mm SY 19 174 1486 4134 98094 2409 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP515 I/F Ramp PLIF C/F Ramp 7-15 x 9-17 x 21 - 25 mm SY 19 174 1486 4135 Paired 98094 Changed Benefit 2888 0 0 Update 2005-10-31 2019-03-01 Prosthesis EX025 Optetrak Total Knee System Tibial Augments Tibial Augments for CCK tibial component, half and third blocks, titanium, screw fixation Size 1 - 6 FA 17 159 1390 250092 Changed Product description 1148 0 0 Update 2009-08-01 2019-03-01 Prosthesis EX026 Optetrak Total Knee System Femoral Augments Femoral Augments for CCK femoral component, distal and posterior blocks, titanium, screw fixation Size 1-6 FA 17 159 1390 250092 1148 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX027 Optetrak Total Knee System Femoral and Tibial Stems Femoral and Tibial Stems for Optetrak Knee System, titanium, cemented or uncemented, femoral stem requires stem extension adapter on every occasion, tibial stem requires screw fixation Size 1 - 6 FA 17 159 1399 250112 Changed Benefit 1126 0 0 Update 2009-08-01 2019-03-01 Prosthesis EX024 Exactech M Series body Titanium, complex neck segment 32 - 49mm, -5 - +30mm FA 18 161 1417 Complex (Neck) 247792 1517 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX028 Optetrak Total Knee System Tibial Insert Tibial Insert, UHMWPE, fixed and totally stabilised with peg and reinforced with screw/post fixation (Spine stiffening screw) Size 1 - 5, 1 Delta FA 17 153 1371 277743 Changed Product name, Product sizes, Benefit 1118 0 0 Update 2009-08-01 2019-03-01 Prosthesis EX029 Opetrak Total Knee System Femoral Stem Extension Adpater Femoral Stem Extension Adapter that provides for set changes in angulation of stem needs to be used on every occasion 2 - 7 Degree FA 17 159 1400 250092 698 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX030 Optetrak Total Knee System Tibial Stem Extension Screw Tibial Stem Screw for Tibial stem fixation One size only FA 17 159 1398 252474 126 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX031 Optetrak Total Knee System Femoral Component Femoral Component, cemented, CoCr Size 0 - 6 FA 17 149 1348 3906 277742 2951 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX032 Optetrak Total Knee System, Tibial Baseplate Tibial Baseplate, titanium, fixed insert, cemented Size 0-6 FA 17 151 1357 277744 1923 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX033 Optetrak Total Knee System Femoral Component Femoral Component, cemented, CoCr, posterior stabilised Size 0 - 6 FA 17 149 1348 3907 285676 3041 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX034 Optetrak Hi Flex Femoral Component Femoral Component, Cemented, CoCr, High Flex (Hi Flex), posterior stabilised Size 0 - 5, Left and Right FA 17 149 1348 3907 286117 3041 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX036 Optetrak Total Knee System, Tibial Baseplate Tibial Baseplate, titanium, fixed insert (finned, trapezoid, offset with locking screw), cemented Size 1-6 FA 17 151 1357 Revision 279574 3265 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX038 Optetrak Total Knee System Patellar 26-41mm FA 17 156 1376 279041 Changed Benefit 537 0 0 Update 2009-08-01 2019-03-01 Prosthesis EX039 Optetrak Total Knee System, Tibial Insert Tibial Insert, UHMWPE, Fixed (Cruciate retained) Size 0-6, 1 Delta 9 - 18mm FA 17 153 1369 278343 Changed Product sizes 1019 0 0 Update 2009-08-01 2019-03-01 Prosthesis EX041 Optetrak Total Knee System, Tibial Insert Tibial Insert, UHMWPE, Fixed (Posterior Stabilised) Size 0-6 FA 17 153 1370 285677 Changed Benefit 1073 0 0 Update 2009-08-01 2019-03-01 Prosthesis EX042 Optetrak Total Knee System, Tibial Insert Tibial Insert, UHMWPE, Fixed (Hi Flex) Size 0-6 FA 17 153 1370 286119 Changed Benefit 1073 0 0 Update 2009-08-01 2019-03-01 Prosthesis EX043 Optetrak RBK (Rotating Bearing Knee) Total Knee System Tibial Insert Tibial Insert, UHMWPE, mobile, posterior stabilised Size 1-5, 9mm-15mm FA 17 153 1370 277745 Changed Benefit 1073 0 0 Update 2009-08-01 2019-03-01 Prosthesis EX046 Equinoxe Compression Screw The compression screw compresses the glenoid plate to the bone while providing 30 degrees of angular variability 4.5x18mm white, 4.5x22mm black, 4.5x26mm orange, 4.5x30mm blue, 4.5x34mm red, 4.5x38mm green, 4.5x42mm yellow, 4.5x46mm purple FA 13 123 1231 3369 252473 65 0 0 No Change 2010-02-01 2019-03-01 Prosthesis EX040 Optetrak RBK (Rotating Bearing Knee) Tibial Baseplate Tibial Baseplate, titanium with polished insert surface, cemented, for a mobile insert 1-5 FA 17 151 1359 277746 Changed Benefit 2147 0 0 Update 2009-08-01 2019-03-01 Prosthesis DP523 LCS Complete Knee System patella component Metal backed, CoCr, rotating, cemented Sizes small to large+ SY 17 156 1377 3927 108414 97697 1210 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP524 LCS Complete Knee System patella component All Poly patella, UHMWPE, cemented Sizes small to large+ SY 17 156 1376 108414 97697 Changed Benefit 537 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP546 C- Stem & C- Stem AMT Femoral Stems Stainless steel Ortron 90, highly polished, triple taper Size 1-8 standard, Size 1-8 High Offset, CDH and 0A to 3A sizes SY 18 161 1404 3941 SCP 208307 208843 Changed Benefit 1845 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP550 C- Stem & C- Stem AMT Femoral Stem Stainless steel Ortron 90, highly polished, triple taper, long stem Size 3-8 x 200-240mm length SY 18 161 1405 3944 SCP 208637 Changed Benefit 3120 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP557 Duraloc Acetabular Shell with HA Titanium, beaded, Duofix,HA, with or without holes Inner 36-70 SY 18 163 1427 4016 146751 146752 Changed Benefit 2556 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP575 C-Stem End Cap End Cap Biostop Restrictor (Gelatin, Glycerol, PHBM, water) Size 8- 20 SY 18 164 1437 138222 97695 Changed Benefit 105 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP809 Small / Large Fragment Set S/S K-wire standard 0.2-3.5mm SY 13 123 1772 5365 132151 132155 139419 140187 143217 144676 99178 27 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW453 Fixos Screws Bone Fixation Screws, Double Threaded 2.2mm diameter, 11 to 16mm (each 1mm) HW 13 123 1231 3371 Breakoff 149535 304 0 0 No Change 2012-08-01 2019-03-01 Prosthesis HW454 Fixos Screws, Cannulated, Double Threaded, 2.5mm Done Fixation Screws, Cannulated Threaded, 2.5mm 2.5mm diameter, 10 to 30 (each 2mm) HW 13 123 1231 3371 CN,DT 149535 381 0 0 No Change 2012-08-01 2019-03-01 Prosthesis HW457 Fixos Screws Bone Fixation Screws 2mm diam. X11mm lenth to 2mm x 16mm HW 13 123 1231 3371 Breakoff, CN 149535 430 0 0 No Change 2012-08-01 2019-03-01 Prosthesis HW459 Variax 2 Foot Plates Polyaxial Locking plates with compressions holes Broad Straight – 2-7 Hole Slim Straight – 2-7 Hole Broad Y-Plate – 2-7 Shaft Holes Slim Y-Plate – 2-7 Holes HW 13 123 1694 5298 VAL 1007 0 0 No Change 2012-08-01 2019-03-01 Prosthesis HW460 Memometal Anchorage Bone Screws Anchorage Bone Screws 3.0-3.5mm diameter to 10 - 40mm in length HW 13 123 1231 3370 LK 149535 145 0 0 No Change 2012-08-01 2019-03-01 Prosthesis HW461 Memometal Anchorage Bone Screws Anchorage Locking Bone Screws 3.0 - 3.5mm diameter to 10 - 40mm in length HW 13 123 1231 3370 149535 82 0 0 No Change 2012-08-01 2019-03-01 Prosthesis DP851 Surgical Titanium Mesh System Standard & Trapezoidal 10-16mm x 8-17mm Hgt SY 19 174 1486 4135 Paired 98094 Changed Benefit 2888 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP943 Corail Femoral Stem Titanium, grit blast, full HA coating, Size 6 to 20 or in lengths 110 -190mm SY 18 161 1407 3949 SCP 143073 268793 Changed Benefit 3779 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP944 DePuy Hip Bone Screws Titanium, cancellous screws Size 3.5-6.5 diameter 5-120mm length SY 18 164 1435 150913 171784 98086 99196 121 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP962 Delta Shoulder system DELTA Humeral Head INOX / ST.Steel / Nichtrostender St. 36 - 42 mm in +0-+4 SY 13 131 1276 4067 126913 1261 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP968 SROM Acetabular UHMWPE Liner UHMWPE 22-32mm SY 18 163 1428 4020 98086 720 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP843 Moss Miami (Titanium) Sacral Extender 5.5mm x 5 - 20mm in length SY 19 167 1473 97391 Changed Benefit 732 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP969 SROM Acetabular Constrained UHMWPE Liner UHMWPE Constrained liner includes locking ring 0Deg, 10 Deg, 28mm, 32mm, SY 18 163 1428 4024 98086 1613 0 0 No Change 2005-10-31 2019-03-01 Prosthesis IS029 Medicontur BiFlex 677PTY Hydrophilic Acrylic Foldable Toric Lens with Blue light Filter Posterior chamber IOL, 360° Special Square Edge, Aspheric – Coma optimized – Toric Optic diameter: 6.0 mm ±0.05 mm, Overall diameter: 13.0 mm ±0.10 mm Powers available: -10.0 - +30.0 D ±0.25 D increment: 0.5 D +31.0 - +35.0 D ±0.5 D increment: 1.0 D Cylinders available: +7.0 D - +9.0 D increment: 0.75 D +9.0 D - +10.0 D increment: 1.0 D IS 1 141 1327 3892 at, t2, vblf, pl 221834 901 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IS030 Medicontur BiFlex 677TBY Hydrophilic Acrylic Foldable Toric Lens with Blue light Filter Posterior chamber IOL, 360° Special Square Edge, Aspheric – Coma optimized – Toric Optic diameter: 6.0 mm ±0.10 mm, Overall diameter: 13.0 mm ±0.20 mm Powers available: +5.0 - +9.0 D ±0.25 D increment: 1.0 D +10.0 - +25.0 D ±0.25 D increment: 0.5 D +25.5 - +30.0 D ±0.5 D increment: 0.5 D Cylinders available: +10.0 D - +24.0 D ±0.5 D increment: 1.0 D IS 1 141 1327 3892 at, t2, vblf 221834 893 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER181 Scoliosis & Fracture System - LSZ3-Shear Nut SIGNUS Scoliosis & Fracture System - LSZ3-Shear Nut N/A ER 19 166 1465 216747 164 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER182 Scoliosis & Fracture System - LSZ3-Cross Bar SIGNUS Scoliosis & Fracture System - LSZ3-Cross Bar 4.0x50 mm ER 19 167 1472 216747 Changed Benefit 732 0 0 Update 2014-08-01 2019-03-01 Prosthesis ER184 Signus Poseidon Vertebral Body Replacement System-Vertebral Body SIGNUS Poseidon Vertebral Body Dia 20mm x (Height 35-88mm); ER 19 176 1492 4137 ThoracoLumbar 216750 4139 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER185 Signus Poseidon Vertebral Body Replacement System-End Plate Signus Poseidon End Plate (23-26mm)x(25-43mm); 0-15 degrees ER 19 176 1492 4138 216750 1155 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER186 SIGNUS Contact Thoracolumbar Plating System-Frame Plate Signus Contact Thoracolumbar Plating System-Frame Plate 40-70 mm, in 5 mm increments (straight); 70-120 mm in 5 mm increments (10 deg angled) ER 19 169 1476 4126 216749 Changed Benefit 2118 0 0 Update 2014-08-01 2019-03-01 Prosthesis ER187 SIGNUS Contact Thoracolumbar Plating System-Solid Screw SIGNUS Contact Thoracolumbar Plating System-Solid Screw Dia 6 mm, length 25-45 mm in 5 mm increments ER 19 165 1464 216749 Changed Benefit 193 0 0 Update 2014-08-01 2019-03-01 Prosthesis HW440 E-POR Biomaterial/ Panel - Porous Polyethlene Titanium Mesh Composite Panel - Porous Polyethlene Titanium Mesh Composite >0.8mm thick, 38mm x 50mm HW 23 199 1587 4240 144944 951 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW441 E-POR Biomaterial/ Panel - Porous Polyethylene Titanium Mesh Composite Panel - Porous Polyethylene Titanium Mesh Composite >0.8mm thick, 76mm x 50mm HW 23 199 1587 4241 144944 1121 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW442 E-POR Biomaterial/ Sheet - Porous Polyethylene Sheet - Porous Polyethylene 30mm - 50mm x 0.4mm - 3mm HW 23 199 1588 4254 144944 234 0 0 No Change 2011-08-01 2019-03-01 Prosthesis HW443 E-POR Biomaterial/ Panel - Porous Polyethlene Titanium Mesh Composite Panel - Porous Polyethylene Titanium Mesh Composite 0.5mm - 0.8mm thick, 38mm x 50mm HW 23 199 1587 4239 144994 Changed Benefit 877 0 0 Update 2011-08-01 2019-03-01 Prosthesis HW444 E-POR Biomaterial/ Panel - Porous Polyethlene Titanium Mesh Composite Panel - Porous Polyethylene Titanium Mesh Composite 0.5mm-0.8mm thick, 76mm x 50mm HW 23 199 1587 4240 144994 951 0 0 No Change 2011-08-01 2019-03-01 Prosthesis HW445 Oasys-Occipito Cervico Thoracic System (Saddle) Saddle Connector one size only HW 19 166 1466 139620 Changed Benefit 217 0 0 Update 2012-02-01 2019-03-01 Prosthesis HW466 InZone Detachment System InZone Detachment System is specifically designed for use with the Target Detachable Coils One size HW 25 225 1689 4495 208838 Changed Benefit 333 0 0 Update 2012-08-01 2019-03-01 Prosthesis HW467 Target Detachable Coils Detachable Platinum coils Coil Diameter: 1mm to 24mm Coil Length: 1cm to 50cm HW 25 225 1688 170214 1430 0 0 No Change 2012-08-01 2019-03-01 Prosthesis HW468 Neuro Renegade Hi-Flo Microcatheter Microcatheter for deployment of neuroform stent system 2.5-4.5mm HW 25 225 1689 4494 171934 665 0 0 No Change 2012-08-01 2019-03-01 Prosthesis HW470 Wingspan Stent System Wingspan Self Expanding Nitonol Stent and delivery catheter Stent diameters: 2.5mm to 4.5mm; Stent lengths: 9.0mm to 20.0mm HW 25 225 1687 128926 130061 7125 0 0 No Change 2012-08-01 2019-03-01 Prosthesis HW462 Memometal Memory Staples Memory Metal Implants 10 mm to 25 mm HW 13 123 1773 5514 MM 149534 Changed Benefit 507 0 0 Update 2012-08-01 2019-03-01 Prosthesis DP976 SROM Acetabular Insert Locking Pin Titanium pin provided seperately from insert 3.5mm - 5.0mm SY 18 164 1445 98086 Changed Benefit 159 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP981 SROM ZTHA Femoral Sleeve Titanium, grit blasted with HA, (proximal femoral cone) Small / Large /XX Large size 14B-24F SY 18 161 1411 3967 Cone 98085 Changed Benefit 2574 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP982 SROM ZTT Femoral Sleeve Titanium, beaded without HA, proximal femoral cone 12A-24F SY 18 161 1410 3962 Cone 98085 98086 2742 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DP986 SROM Trochanteric Washer Titanium, fixation with separate screw (DY020) to calcar replacing SROM Femoral Stem 40 x 31, 60 x 45, 70 x 54 SY 18 164 1456 139288 Changed Benefit 507 0 0 Update 2005-10-31 2019-03-01 Prosthesis DP998 DePuy Acetabular Apical Plugs Titanium, apical hole plug for Duraloc, Pinnacle & SROM Acetabular shells One size only SY 18 164 1446 132151 153087 141 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DQ001 BioQ Pharma ReadyfusOR Non-electric pre-filled infusion pain kit 250 ml DQ 21 188 1540 4188 Set 292140 247 0 0 No Change 2017-08-01 2019-03-01 Prosthesis IS034 BiFlex Preloaded 877PAY Hydrophobic Acrylic Foldable Aspheric Monofocal Lens with Blue light Filter Posterior Chamber IOL, special 360° sharp edge, Aspheric - Aberration Balanced Optic diameter: 6.0 mm ±0.10 mm, Overall diameter: 13.0 mm ±0.20 mm Powers available: -0.0 - +9.0 D ±0.25 D increment: 1.0 D +10.0 -+25.0 D ±0.25 D increment: 0.5 D +25.5- +30.0 D ±0.5 D increment: 0.5 D +31.0 - +35.0 D ±0.5 D increment: 1 IS 1 141 1327 3892 at, pl, vblf 221834 333 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IS036 BiFlex 877PA Preloaded Hydrophobic Acrylic Foldable Aspheric Monofocal Lens without Blue Light Filter Posterior Chamber IOL, special 360° sharp edge, Aspheric Aberration Balanced Optic diameter: 6.0 mm ±0.10 mm, Overall diameter: 13.0 mm ±0.20 mm Powers available: -0.0 - +9.0 D ±0.25 D increment: 1.0 D +10.0 - +25.0 D ±0.25 D increment: 0.5 D +25.5 - +30.0 D ±0.5 D increment: 0.5 D +31.0 - +35.0 D ±0.5 D increment: 1.0 D IS 1 141 1327 3892 at, pl 221834 308 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER188 SIGNUS Contact Thoracolumbar Plating System-Expansion Screw SIGNUS Contact Thoracolumbar Plating System-Expansion Screw 6 mm dia, 25-40 mm long in 5 mm increments ER 19 165 1464 Expansion Screw / Expansion Head Screw 216749 289 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER189 SIGNUS Contact Thoracolumbar Plating System-Locking Crown SIGNUS Contact Thoracolumbar Plating System-Locking Crown M12 x 0.75 mm ER 19 166 1465 216749 164 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER190 Signus Mobis II TLIF Implant Signus Mobis II Thoracolumbar Fusion Cage-Peek or Ti Height (6-14 mm)xWidth 9 mm x Length 29 mm ER 19 174 1486 4135 122272 3465 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER197 Anastoclips Vessel Closure System (VCS) (8 and 15 cm shaft) Small, Medium, Large, Extra Large ER 21 194 1771 120976 Changed Benefit 428 0 0 Update 2014-08-01 2019-03-01 Prosthesis ER198 Aeroform Patient Controlled Tissue Expander Aeroform Patient Controlled Tissue Expander; Multichamber, textured, CO2 filled width (12.5, 14, 15.5 cm) x height (11, 12.5, 14 cm) x projection (8, 9.5, 10.5 cm); volume 400, 600 and 800 cc ER 23 203 1606 4414 Textured 216704 1024 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER199 AeroForm Tissue Expander System Dosage Controller AeroForm Tissue Expander System Dosage Controller N/A ER 23 203 1606 5997 Patient Controller 216653 1365 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER200 K2M Spinal Systems – Fixed Cross Connector Fixed Cross Connector 14-60mm ER 19 167 1474 4123 154442 159828 193653 404 0 0 No Change 2015-02-01 2019-03-01 Prosthesis HW446 Hoffmann3 External Fixation system - MRI Curved and straight rod/coupler - carbon fibre MRI curved and straight rod/coupler - carbon fibre Diameter - 11mm, lengths 100-650mm HW 13 123 1237 4509 Standard 112434 147 0 0 No Change 2012-02-01 2019-03-01 Prosthesis HW447 Hoffmann3 External Fixation System - Pin Clamp Pin clamp Assembly 5 hole with/without posts HW 13 123 1237 4511 112434 1023 0 0 No Change 2012-02-01 2019-03-01 Prosthesis HW448 Hoffmann3 External Fixation system - Posts Hoffmann3 posts straight, 30 deg, 90 deg HW 13 123 1237 4508 112434 Changed Benefit 732 0 0 Update 2012-02-01 2019-03-01 Prosthesis HW449 Hoffmann3 External Fixation System Rod & Pin-Rod couplings Coupling, 5/8/11mm rods - 4/5/6mm pins HW 13 123 1237 4508 112434 Changed Benefit 732 0 0 Update 2012-02-01 2019-03-01 Prosthesis HW450 Fixos Screws, Snap-off, 2.7mm Bone Fixation Screws, Snap-off, 2.7mm 2.7mm diameter, 14 to 22mm (each 2mm) HW 13 123 1231 3370 Breakoff 149535 302 0 0 No Change 2012-08-01 2019-03-01 Prosthesis HW451 Fixos Screws, Snap-off,AO fitting 3.0mm Bone Fixation Screws, Snap-off, AO fitting 3.0mm 3.0mm diameter, 10 to 22mm (each 2mm) HW 13 123 1231 3370 CN,DT 149535 379 0 0 No Change 2012-08-01 2019-03-01 Prosthesis HW452 Fixos Screws Bone Fixation Srews, Cannulated, Double Threaded 3.0mm-7.0mm diamter HW 13 123 1231 3370 CN,DT 149535 379 0 0 No Change 2012-08-01 2019-03-01 Prosthesis EX011 Novation Crown Cup Shell - plasma coated Novation Crown Cup and Liners: No-Hole and Cluster Hole design options, shells manufactured from titanium (Ti) alloy with plasma coating, sphere and taper inner diameter geometry. Shell: No-Hole shell size 48-68, 2mm increments; Cluster Hole Size 48-68, 2mm increments; Multi-Hole Size 48-56, Multi-Hole with Rim Fixation, Size 56-68 FA 18 163 1426 4013 287409 2022 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX017 Exactech M series modular Hip System Modular femoral stem, titanium, polished, non HA 11 - 21mm x 135-165mm FA 18 161 1410 3965 Stem 264152 3093 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX018 Exactech M Series Total Hip System Femoral Cone with calcar 21-31mm FA 18 161 1410 3961 Cone 159572 2742 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX022 Exactech Femoral Head Cobalt Chrome Head 28mm - 32mm, -3.5mm to +10mm FA 18 162 1419 3989 293800 703 0 0 No Change 2009-08-01 2019-03-01 Prosthesis EX023 Exactech Femoral Head Ceramic/Femoral Head, Biolox Forte -2 to -5mm, +0 to +10mm FA 18 162 1419 3990 159572 Changed Benefit 1758 0 0 Update 2009-08-01 2019-03-01 Prosthesis IS027 Medicontur BiFlex 677PT Hydrophilic Acrylic Foldable Toric Lens without Blue light Filter, Preloaded Posterior chamber IOL, 360° Special Square Edge, Aspheric – Coma optimized – Toric Optic diameter: 6.0 mm ±0.05 mm, Overall diameter: 13.0 mm ±0.10 mm Powers available: -10.0 - +30.0 D ±0.25 D increment: 0.5 D +31.0 - +35.0 D ±0.5 D increment: 1.0 D Cylinders available: +7.0 D - +9.0 D increment: 0.75 D +9.0 D - +10.0 D increment: 1.0 D IS 1 141 1327 3892 at, t2, pl 221834 867 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IS028 Medicontur BiFlex 677PTY Hydrophilic Acrylic Foldable Toric Lens with Blue light Filter Posterior chamber IOL, 360° Special Square Edge, Aspheric – Coma optimized – Toric Optic diameter: 6.0 mm ±0.05 mm, Overall diameter: 13.0 mm ±0.10 mm Powers available: -10.0 - +30.0 D ±0.25 D increment: 0.5 D +31.0 - +35.0 D ±0.5 D increment: 1.0 D Cylinders available: +1.5 D - +7.0 D increment: 0.75 D IS 1 141 1327 3892 at, pl, t1, vblf 221834 659 0 0 No Change 2015-08-01 2019-03-01 Prosthesis 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 ER 24 208 1636 4457 R (ringed) 216528 Changed Benefit 1548 0 0 Update 2014-08-01 2019-03-01 Prosthesis 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; ER 24 208 1639 216528 831 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER173 LifeSpan ePTFE vascular grafts-supported, tapered or end modified 50-80 cm 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 ER 24 208 1639 R (ringed) 216528 831 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER174 Nile Alternative Fixation System - Tether, Connector, Set Screws Woven Braid, polyester; Clamp, Titanium; Set Screw, Titanium (2.8-3.8)mm width, 60cm strap length, (50-110)mm leader (4.5-5.5)mm rod or rail Size 20 Hexalobe ER 19 166 1816 Complex 193653 953 0 0 No Change 2014-08-01 2019-03-01 Prosthesis EX047 Equinoxe Glenosphere Locking Screw The Locking Screw locks compression screws to the glenoid plate at a variable angle one size FA 13 123 1231 3369 LK 159797 128 0 0 No Change 2010-02-01 2019-03-01 Prosthesis HW436 E-POR Biomaterial/ Transsphenoidal Sellar Contourable Porous Polyethylene Transphenoidal Sellar Contourable Porous Polyethylene 2.5mm x 20mm - 40mm HW 23 200 1595 4352 144944 Changed Benefit 487 0 0 Update 2011-02-01 2019-03-01 Prosthesis HW437 E-POR Biomaterial/ Mastoid, Pterional, Contourable Porous Polyethylene Mastoid, Pterional, Contourable Porous Polyethylene Left, Right, 43mm - 57mm x 0.6mm, 1.5mm HW 23 200 1593 4346 144944 Changed Benefit 1267 0 0 Update 2011-02-01 2019-03-01 Prosthesis HW438 E-POR Biomaterial/ Temporal Fossa Implant Porous Polyethylene Temporal Fossa Implant Porous Polyethylene 61mm - 105mm x 18mm - 20mm HW 23 200 1595 4351 144944 1121 0 0 No Change 2011-02-01 2019-03-01 Prosthesis HW439 E-POR Biomaterial/ Burr Hole Cover, Porous Polyethylene Burr Hole Cover, Porous Polyethylene 15mm x 3mm x 5mm; 29mm x 7mm x 14mm HW 23 199 1591 4335 144944 375 0 0 No Change 2011-02-01 2019-03-01 Prosthesis DR001 Freedom Lumbar Disc Lumbar Disc Replacement Prosthesis 26mmx36mm, 28mmx38mm, 30mmx40mm, 12-16mm, 4-12 degrees. DR 19 175 1488 5488 279935 9192 0 0 No Change 2017-08-01 2019-03-01 Prosthesis DR002 BioSphere Putty Bone Graft Substitue - Bioactive Glass Putty 1cc, 2.5cc, 5cc DR 13 123 1241 4092 AUG 297474 1026 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DR003 BioSphere Putty Bone Graft Substrate - Bioactive Glass 10cc DR 13 123 1241 4093 AUG 297474 2185 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DR004 Freedom Cervical Disc Cervical disc replacement prosthesis. Footprints: 13x16mm, 15x18mm, 17x20mm Heights: 5, 6mm DR 19 175 1488 5487 280296 6256 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DU001 Perla Posterior Cervico-Thoracic Fixation System - Polyaxial Screw Polyaxial lateral mass screws: polyaxial screws, smooth shank screws, preferred angle screws Diameter: 3.5mm, 4.0mm Length (polyaxial and preferred angle): 8mm, 10mm, 12mm, 14mm, 16mm, 18mm, 20mm, 24mm, 28mm, 32mm, 36mm, 40mm, 44mm, 48mm, 52mm Length (smooth shank): 18mm, 20mm, 22mm, 24mm, 26mm, 28mm, 30mm, 32mm, 34mm, 36mm DU 19 165 1463 198720 1280 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DU002 Perla Posterior Cervico-Thoracic Fixation System - Set Screw Set screws for Perla spinal fixation system: set screws, extended set screws, hexagonal set screws One size only DU 19 166 1465 198720 164 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER175 Santorini Stackable Corpectomy Cage-Small Corpectomy Cage, Peek (12x17)mm footprint x (2-62)mm height ER 19 176 1493 198786 4235 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER176 Santorini Stackable Corpectomy Cage-Medium/Large Corpectomy Cage, Peek (16x20) or (21x25)mm footprint x (2-98)mm height ER 19 176 1493 198786 4235 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER177 Scoliosis & Fracture System -LSZ3-Rod Signus Scoliosis & Fracture System -LSZ3Scoliosis & Fracture System-LSZ3-Rod 5.5 x 500mm 5.5x500 mm ER 19 170 1478 216747 Changed Benefit 426 0 0 Update 2014-08-01 2019-03-01 Prosthesis ER178 Scoliosis & Fracture System - LSZ3-Lamina Screw Signus Scoliosis & Fracture System - LSZ3-Lamina Screw 5.0;7.5;10.0 mm ER 19 165 1464 216747 Changed Benefit 193 0 0 Update 2014-08-01 2019-03-01 Prosthesis ER179 Scoliosis & Fracture System - LSZ3-Lamina Hook SIGNUS Scoliosis & Fracture System - LSZ3-Lamina Hook 5.0;7.5;10.0 mm ER 19 168 1475 216747 789 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER180 Scoliosis & Fracture System - LSZ3-Clip Signus Scoliosis & Fracture System - LSZ3-Clip N/A ER 19 166 1471 216747 385 0 0 No Change 2014-08-01 2019-03-01 Prosthesis DU003 Perla Posterior Cervico-Thoracic Fixation System - Parallel Connector Parallel rod connectors Diameter: 3.5/3.5mm; 3.5/5.4mm DU 19 167 1472 198720 Changed Benefit 732 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER168 LifeSpan ePTFE vascular grafts-straight, regular or thin wall-10cm LifeSpan ePTFE vascular grafts-straight, regular or thin wall-5-8 mm dia x length 10cm 5-8 mm dia x 10 cm long ER 24 208 1636 4454 216528 233 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER169 LifeSpan ePTFE vascular grafts-straight-regular or thin wall-20cm LifeSpan ePTFE vascular grafts-straight-regular or thin wall; 5-8mm dia x 20 cm long 5-8 mm dia x 20 cm long ER 24 208 1636 4455 216528 760 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER170 LifeSpan ePTFE vascular grafts-straight-regular or thin wall, 50-100 cm LifeSpan ePTFE vascular grafts-straight-regular or thin wall, 5-10 mm dia x length 50-100 cm 5-10 mm dia x length 50-100 cm ER 24 208 1636 4457 216528 Changed Benefit 922 0 0 Update 2014-08-01 2019-03-01 Prosthesis IT005 Hawk 4.0mm Cannulated Screw system - Guide Pin Threaded, Stainless steel 1.5mm in diameter and length of 200mm IT 13 123 1772 5365 230955 27 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IT006 Hawk 3.0mm Cannulated Screw System - guide pin Threaded, stainless steel 1.0mm in diameter with a length of 200mm IT 13 123 1772 5365 230955 27 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IT007 Hawk Anterior Ankle Fusion Set 4.5mm screw set with lengths ranging from 35mm to 110mm. 4.5mm x length (35mm to 110mm) IT 13 123 1231 3369 191738 65 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IT008 Hawk Anterior Ankle Fusion Set 3.5mm diameter screw set lengths 35mm to 110mm 3.5mm x length 35mm to 110mm IT 13 123 1231 3370 191738 82 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IT009 Hawk Anterior Ankle Fusion Set 6.5mm screw set with lengths ranging from 35mm to 110 mm. 6.5mm length 35mm to 110mm IT 13 123 1231 3369 191738 65 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IT010 Hawk 6.5mm Cannulated Screw System 6.5mm Cannulated Screw 6.5mm in diameter 45 to 115mm in length IT 13 123 1231 3369 CN 230954 191 0 0 No Change 2015-08-01 2019-03-01 Prosthesis MC543 Vertex Spinal System Plate/rod 80 - 240mm MC 19 171 1481 169514 Changed Benefit 2907 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC539 Pyramesh End ring/cap 10 - 25mm MC 19 176 1495 169501 1275 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC545 Vertex Spinal System Screws Diameter 3.5 - 4.5mm Length 6 - 52mm MC 19 165 1463 169514 1280 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC542 Vertex Spinal System Connector Length 10 - 13mm; diameter 3.2 - 6.35mm MC 19 167 1472 169514 Changed Benefit 732 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC546 Vertex Spinal System Set screw One size only MC 19 166 1465 169514 164 0 0 No Change 2006-03-24 2019-03-01 Prosthesis AS223 Symbotex Skirted Composite Mesh Non-absorbable three-dimensional polyester skirted composite mesh. On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera. A flap attached to the reinforcement helps place and fix the mesh. 30x20 cm Rectangle 25x20 cm Rectangle AS 21 194 1783 5440 Coated, Contoured 270736 Changed Benefit 1017 0 0 Update 2016-08-01 2019-03-01 Prosthesis BD024 HiRes Ultra Cochlear Implant with the HiFocus Mid-Scala Electrode The HiRes Ultra Cochlear Implant with HiFocus Mid-Scala Electrode is the implanted component of the HiResolution Bionic Ear System. It receives information through an RF transmission coil, processes the information and then sends the resulting signal to an electrode array implanted in the cochlear. It consists of receiving/transmitting coil, Stimulator electrodes and HiFocus Mid-Scala Electrode array 56.2 x 28.5 x 4.5 BD 22 196 1526 295250 Changed Benefit 12892 0 0 Update 2018-02-01 2019-03-01 Prosthesis BD025 Naida CI Q90 Sound Processor (Replacement Order) The Naida CI Q90 sound processor is one part of a cochlear implant system that enables hearing. The other necessary parts of the system are the Implantable Cochlear Stimulator (ICS), headpiece and headpiece cable. The sound processor consists of two parts: the sound processor and battery power source. There are five battery options, including three sizes of Lithium Ion rechargeable PowerCel™ batteries and a Zn-Air Battery Pak One size BD 22 196 1528 4147 Generation 4 282255 Changed Benefit 7648 0 0 Update 2018-02-01 2019-03-01 Prosthesis AS224 PROGRIP™ Laparoscopic Self-Fixating Composite Mesh Laparoscopic self-fixating composite right or left anatomical mesh (knitted monofilament polyester with monofilament polylactic acid resorbable grips on one side and a resorbable film made of collagen from porcine origin and glycerol, on the other side) 16 x 12 cm right anatomical, 16 x 12 cm left anatomical AS 21 194 1783 5438 Coated, Contoured 252653 Changed Benefit 428 0 0 Update 2016-08-01 2019-03-01 Prosthesis AS225 Parietex Progrip Composite Mesh Monofilament polyester with polylactic acid monofilament resorbable pins on one of the sides Rectangular 15x15cm, 20x15cm AS 21 194 1783 5439 Coated 157201 759 0 0 No Change 2016-08-01 2019-03-01 Prosthesis AS226 Symbotex Composite Mesh with pre placed suture Non-absorbable three-dimensional polyester composite mesh with pre placed sutures. (Non absorbable pre-placed sutures are tied to the mesh. A died marking is positioned on the center of the textile and helps center and orient the mesh.) Rectangular 42x32 cm, Rectangular 37x28 cm AS 21 194 1783 5505 Coated 270737 3040 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BD026 HiRes Ultra Cochlear Implant with HiFocus Slim-J Electrode The HiRes Ultra Cochlear Implant with HiFocus Slim-J Electrode is the implanted component of the HiResolution Bionic Ear System. It receives information through an RF transmission coil, processes the information and then sends the resulting signal to an electrode array implanted in the cochlear. It consists of receiving/transmitting coil, Stimulator electrodes and HiFocus Slim-J Electrode array 56.2 x 28.5 x 4.5 BD 22 196 1526 301320 Changed Benefit 12892 0 0 Update 2018-08-01 2019-03-01 Prosthesis BE002 ER375 CRE8 Coronary Stent Coronary Artery Drug Eluting Stent The stent is available in 7 diameters: 2.25mm; 2.5mm; 2.75mm; 3.0mm; 3.5mm; 4.0mm; 4.5mm and 8 lengths: 8mm; 12mm; 16mm; 20mm; 25mm; 31mm; 38 mm and 46 mm. BE 27 247 1766 5346 230863 230864 230865 2484 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BF001 Vigor/X'Plo PEEK Interbody Fusion Cage Rotatable posterior lumbar interbody fusion cage Heights: 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 14mm, 16mm and Lengths: 24mm, 26mm, 32mm BF 19 174 1486 4135 Paired 211536 Changed Benefit 2888 0 0 Update 2013-08-01 2019-03-01 Prosthesis BF002 A-Mesh Spinal Titanium Mesh Spacer A-Mesh® Spinal Titanium Mesh is designed to restore biomechanical integrity throughout the thoracic and lumbar spine following vertebrectomy or corpectomy for patients with spine tumors or fractures. Diameter: 10mm, Length: 20mm, 50mm 70mm Diameter: 12mm, Length: 20mm, 50mm, 70mm Diameter: 14mm, Length: 20mm, 50mm, 70mm Diameter: 16mm, Length: 20mm, 50mm, 70mm, 90mm Diameter: 20mm, Length: 20mm, 50mm, 70mm, 90mm Diameter: 25mm, Length: 20mm, 50mm, 70mm, 90mm Diameter: 30mm, Length: 20mm, 50mm, 70mm, 90mm Diameter: 35mm, Length: 20mm, 50mm, 70mm, 90mm BF 19 176 1494 187179 3470 0 0 No Change 2013-08-01 2019-03-01 Prosthesis BF005 Smartloc Spinal Fixation System / Fixation Rod Fixation Rod for Smartloc Spinal Fixation System 40mm - 80mm BF 19 170 1478 150778 Changed Benefit 426 0 0 Update 2013-08-01 2019-03-01 Prosthesis BF006 Smartloc Spinal Fixation System/ Polyaxial Pedicle Screw & Reduction Screw Polyaxial Pedicle Screw and Reduction Screw Length 30mm – 55mm; Diameter 4.5mm, 5.5mm, 6.0mm, 6.5mm, 7.0mm, 7.5mm, 8.0mm BF 19 165 1463 150778 1280 0 0 No Change 2013-08-01 2019-03-01 Prosthesis IT011 Hawk 4.0mm Cannulated Screw System 4.0mm Cannulated screw 4.0mm in diameter with lengths of 26mm to 70mm IT 13 123 1231 3370 CN 230954 208 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IT012 Hawk 3.0mm Cannulated Screw system 3.0mm cannulated screw 3.0mm in diameter with lengths of 14mm to 50mm IT 13 123 1231 3370 CN,DT 230954 379 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LB003 Independence Fixed Angled Screw Fixed Angled Bone Screw 5.5mm x 20mm - 40mm LB 19 165 1464 190071 Changed Benefit 193 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB004 TransContinental Spacer PEEK Interbody cages X-small, small, medium, large, x-large 0 deg, 6 deg and 10 degree 7 - 17mm Height LB 19 174 1486 4135 191535 3465 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LB005 TransContinental M Spacer PEEK Interbody cages 0 degree, 6 degree, 20 degree and 25 degree, Height: 8mm - 21mm . Length: 35mm-60mm, Width: 20mm LB 19 174 1486 4135 191535 3465 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LB006 Signature Spacer PEEK Interbody spacer small, medium, large. 7mm - 17mm Height LB 19 174 1486 4135 190020 3465 0 0 No Change 2012-02-01 2019-03-01 Prosthesis AS227 ReliaTack Articulating Reloadable Fixation Device Articulating, reloadable, sterile, single use fixation device prepackaged with 30 standard single use, absorbable reloads 5.1mm, 30 tacks AS 21 194 1582 4331 Absorbable, Articulating/Roticulating 275114 712 0 0 No Change 2016-08-01 2019-03-01 Prosthesis AS228 ReliaTack Articulating Reloadable Fixation Device (Reloads x 5) 5 x absorbable reloads to be used with ReliaTack articulating tacking device 5.1mm, 5 tacks AS 21 194 1582 6003 5 Tacks, Absorbable 275114 174 0 0 No Change 2016-08-01 2019-03-01 Prosthesis AS229 ReliaTack Articulating Reloadable Fixation Device (Reloads x 10) 10 x absorbable reloads to be used with ReliaTack atriculating tacking device 5.1mm, 10 tacks AS 21 194 1582 6003 10 Tacks, Absorbable 275114 Changed Benefit 347 0 0 Update 2016-08-01 2019-03-01 Prosthesis AS230 Symbotex Composite Mesh Non-absorbable three-dimensional polyester composite mesh. (On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera.) Elliptical 40x24cm, 34x20cm AS 21 194 1783 5503 Coated 270735 1066 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LB007 Continental Spacer PEEK Interbody spacer x-small, small, medium, large. 0deg, 8deg, 15deg. 9mm - 21mm Height LB 19 174 1486 4135 190020 3465 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LB008 TRUSS® Thoracolumbar Plate with slider Thoracolumbar plate 45mm-99.5mm LB 19 169 1476 4126 190063 Changed Benefit 2118 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB009 TRUSS® Thoracolumbar Plate Thoracolumbar plate 22mm - 55mm LB 19 169 1476 4126 190063 Changed Benefit 2118 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB010 TRUSS® Thoracolumbar Variable Angle Screws Variable Angle screw 5.5m and 6.5mm diameter x 22mm - 57mm length LB 19 165 1464 190063 Changed Benefit 193 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB011 TRUSS® Thoracolumbar Fixed Angle Screws Fixed Angle screw 5.5m and 6.5mm diameter x 22mm - 57mm length LB 19 165 1464 190063 Changed Benefit 193 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB012 CITADEL® Anterior Lumbar Plate Anterior Lumbar plate 20mm - 99mm length LB 19 169 1476 4126 190969 Changed Benefit 2118 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB013 CITADEL® Anterior Variable Angled Bone Screws Variable Angle screw 22m - 57mm length LB 19 165 1464 190969 Changed Benefit 193 0 0 Update 2012-02-01 2019-03-01 Prosthesis BP023 OV012 ASPIRON Anterior Cervical Plate >55mm Anterior cervical plate >55mm 57 - 111mm BP 19 169 1476 4125 >55mm 292040 1636 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BP024 OV011 ASPIRON Anterior Cervical Plate ≤55mm Anterior cervical plate ≤55mm 19 - 54mm BP 19 169 1476 4125 292040 Changed Benefit 1348 0 0 Update 2018-08-01 2019-03-01 Prosthesis BP025 OV005 ANAX 5.5 Spinal System - Rods Rod for spinal internal fixation system - Straight and curved, titanium and cobalt-chromium, sanded and non-sanded finish, anodizing and non-anodizing. Diameter 5.5mm Length 35 - 600mm BP 19 170 1478 292040 Changed Benefit 426 0 0 Update 2018-08-01 2019-03-01 Prosthesis BQ001 Vocal Chord Medialisation Implant Montgomery Laryngeal Keel 12, 14, 16 - Clear and Radiopaque BQ 22 198 1570 119029 261 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LB014 CITADEL® Anterior Fixed Angles Bone Screws Fixed Angle screw 22mm - 57mm length LB 19 165 1464 190969 Changed Benefit 193 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB015 VIP Anterior Cervical Plate Anterior Cervical Plate 13mm - 46mm LB 19 169 1476 4125 190972 Changed Benefit 1348 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB016 VIP Anterior Cervical Fixed Angle Screws Anterior Cervical Fixed Angle Bone Screws 4.6mm - 5.1mm Diameter, 12mm - 20mm length LB 19 165 1464 190972 Changed Benefit 193 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB017 VIP Anterior Cervical Variable Angle Screws Anterior Cervical Variable Bone Screws 4.6mm - 5.1mm Diameter, 12mm - 20mm length LB 19 165 1464 190972 Changed Benefit 193 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB018 REVOLVE Stabilization System Poliaxial Screw Polyaxial, cannulated pedicale screw 5.5mm - 8.5mm diameter 30mm - 90mm length LB 19 165 1463 Cannulated 190043 1338 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LB019 REVOLVE Stabilization Locking Cap Locking Cap One Size LB 19 166 1468 190043 Changed Benefit, Group 582 0 0 Update 2012-02-01 2019-03-01 Prosthesis AS231 Symbotex Composite Mesh Non-absorbable three-dimensional polyester composite mesh. On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera. Rectangular 42x32cm, Rectangular 37x28cm AS 21 194 1783 5505 Coated 270735 3040 0 0 No Change 2016-08-01 2019-03-01 Prosthesis AS232 Versatex™ monofilament macroporous polyester mesh Versatex™ Monofilament Mesh is a non-absorbable synthetic surgical mesh made out of a macroporous three-dimensional (3D) monofilament polyester knitted textile offered in rectangular and square flat sheet. The mesh is intended for the repair of abdominal wall hernias or other fascial deficiencies that require the addition of a reinforcing material. Rectangular 11 x 6 cm, Rectangular 15 x 10 cm AS 21 194 1782 5434 237409 76 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LB020 REVOLVE Stabilization System Rods Rod 5.5mm diameter 40mm - 300mm length LB 19 170 1478 190043 Changed Benefit 426 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB023 REVERE Locking Cap Locking Cap 4.5, 5.5 and 6.35mm LB 19 166 1465 190039 164 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LB025 REVERE Hooks Hook - various small, medium, large LB 19 168 1475 190039 789 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LB026 REVERE Cross Connectors Cross Connectors 4.5mm 20mm-78mm 5.5mm 29mm-91mm 6.35mm 29-90mm LB 19 167 1474 4124 190039 Changed Benefit 1299 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB027 REVERE ADDITION Offset Connectors Connector, offset 4.5, 5.5 and 6.35mm Diameter, 15-150mm Length LB 19 167 1473 190039 Changed Benefit 732 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB028 REVERE ADDITION In-line Connectors Connector, in-line 4.5mm, 5.5mm and 6.35mm LB 19 167 1472 190039 Changed Benefit 732 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB029 REVERE ADDITION Offset Rod Connectors with Integral Rod Offset Connector with integral rod 5.5mm - 6.5 mm, 20mm - 200mm length LB 19 167 1473 190039 Changed Benefit 732 0 0 Update 2012-02-01 2019-03-01 Prosthesis AS233 Symbotex Composite Mesh with pre placed suture Non-absorbable three-dimensional polyester composite mesh with pre placed sutures. (Non absorbable pre-placed sutures are tied to the mesh. A died marking is positioned on the center of the textile and helps center and orient the mesh.) Rectangular 30x20 cm, Rectangular 25x20 cm AS 21 194 1783 5440 Coated, Contoured 270737 Changed Benefit 1017 0 0 Update 2016-08-01 2019-03-01 Prosthesis AS234 Versatex™ monofilament macroporous polyester mesh Versatex™ Monofilament Mesh is a non-absorbable synthetic surgical mesh made out of a macroporous three-dimensional (3D) monofilament polyester knitted textile offered in rectangular and square flat sheet. The mesh is intended for the repair of abdominal wall hernias or other fascial deficiencies that require the addition of a reinforcing material. Largest sizes from 15 cm x 15 cm include a green dyed monofilament polyester (D&C Green No. 6) marking that is positioned in the center of the textile to help center and orient the mesh. Square 15x15 cm, Square 20x20 cm AS 21 194 1782 5435 237409 81 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BF007 Smartloc Spinal Fixation System/Transverse Link Cross link for Smartloc Spinal Fixation System Telescopes to 70mm BF 19 167 1474 4124 150778 Changed Benefit 1299 0 0 Update 2013-08-01 2019-03-01 Prosthesis BF008 Smartloc Spinal Fixation System / Set Screw Set screw for poyaxial pedicle screw 8mm diameter, 5mm height BF 19 166 1465 150778 164 0 0 No Change 2013-08-01 2019-03-01 Prosthesis BP022 OV015 Velofix PEEK Lumbar Cage The Velofix PEEK Lumbar Cage is intended to facilitate spinal interbody arthrodesis. It is implanted via the posterior approach, and allows restoration of spinal disc height and natural curvature. Nerve root decompression is also achieved by opening the neural foramen. The cages are available in several sizes with implant selection based on each individual clinical case. The device is manufactured from PEEK (ASTM F2026) and includes three radiopaque markers made of tantalum. It is indicated for use with autogenous bone graft in patients with degenerative disc disease (DDD) at one or two levels for L2 to S1, and is intended to be used with supplemental fixation. Design: Convex, bullet design Length: 22, 26, 30mm Height: 7 - 16mm Angle: 0, 4, 8° BP 19 174 1486 4135 292041 3465 0 0 No Change 2018-08-01 2019-03-01 Prosthesis MC457 LordoTec Cage (LT-Cage) Titanium, PEEK 18-28mm MC 19 174 1486 4135 Paired 99682 Changed Benefit 2888 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC458 TSRH 3D Screw 4.5 -8.5mm diameter MC 19 165 1463 Shank 169514 640 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC451 Pyramesh Ovoid 8 - 130mm MC 19 176 1494 169501 3470 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC456 Interfix Titanium Cage 12 x 20mm - 24 x 50mm MC 19 174 1486 4135 Paired 126313 Changed Benefit 2888 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC459 TSRH 3D Extended Post Screw 30 - 60mm MC 19 165 1463 Shank 169514 640 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC462 Zephir Cancellous Screw 13-17mm MC 19 165 1464 Closed 169514 202 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC482 Axis Cervical Plating System Screw: Cancellous 6 - 24mm MC 19 165 1464 169514 Changed Benefit 193 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC496 Tenor Transverse Links - Titanium 40-100mm MC 19 167 1474 4124 169514 Changed Benefit 1299 0 0 Update 2006-03-24 2019-03-01 Prosthesis AS235 Symbotex Composite Mesh Non-absorbable three-dimensional polyester composite mesh. On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera. Round 15 cm, 12 cm, 9 cm Elliptical 17x10 cm Rectangular 15x10 cm AS 21 194 1783 5438 Coated, Contoured 270735 Changed Benefit 428 0 0 Update 2016-08-01 2019-03-01 Prosthesis AS236 Parietex Progrip Composite Mesh Monofilament polyester with polylactic acid monofilament resorbable pins on one of the sides 15x9 rectangular AS 21 194 1783 5438 Coated 157201 Changed Benefit 371 0 0 Update 2016-08-01 2019-03-01 Prosthesis AS237 Symbotex Composite Mesh with pre placed suture Non-absorbable three-dimensional polyester composite mesh with pre placed sutures. (Non absorbable pre-placed sutures are tied to the mesh. A died marking is positioned on the center of the textile and helps center and orient the mesh.) Elliptical 40x24cm, Elliptical 34x20 cm AS 21 194 1783 5503 Coated 270737 1066 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BQ005 Thyroplasty Montgomery Thyroplasty Implant System male - 8,9,10,11,12,13 female - 6,7,8,9,10 BQ 22 198 1573 117683 1113 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BQ006 Extra-tracheal Cannula a) Montgomery Short-Term Cannula b) Montgomery Long-Term Cannula a) 4, 6, 8, 10 b) 4, 6, 8, 10 for Stoma Sizes 17-25, 25-33, 33-41, 41-49, 49-57, 57-65mm BQ 22 198 1574 Extra-tracheal 119737 283 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BQ007 ProTrach DualCare Set ProTrach DualCare is attached to a tracheostomy tube and is designed to eliminate the necessity of finger occlusion, enabling the tracheostomised patient to speak easily and more clearly. It combines a speaking valve with an HME, and this way both enabling hands-free speech and helping to keep the lungs healthy by providing the important humidification of the inhaled air. The Set includes: 180pc HME Regular, 1pc Speaking Valve, 1pc ProTrach HME DigiTop, 1 Removal Aid and 1 connection strap. 15mm 22mm BQ 22 198 1569 275618 661 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LB030 REVERE H-LINK Transverse Connector with integral Rods 5.5mm - 6.35mm Rod with 38mm - 71mm transverse connector and 40 - 45mm rod LB 19 167 1474 4124 190039 Changed Benefit 1299 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB031 REVERE Integrated Staple Head Plate Integrated Staple Head Plate small, medium, large, x-large LB 19 172 1483 190039 395 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LB032 REVERE Blocking Plate, Anterior Screw Blocking Plate One Size LB 19 172 1482 190039 226 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LB033 REVERE Bone Screw, Anterior Plate Bone Screw 5.5mm - 7.5mm Diameter x 25mm - 50mm Length LB 19 165 1464 190039 Changed Benefit 193 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB034 Colonial Spacers Anterior Cervical Interbody Cage 12 x 11 mm, 14 x 12mm, 16 x 14mm, 18 x 15mm and 0, 7, 12, 15 and 20 degree lordosis LB 19 174 1486 4134 191532 Changed Product sizes 2409 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB036 Coalition Variable Angled Screw Bone screw Variable angle 3.6mm and 4.2mm diameter, 12mm - 20mm length LB 19 165 1464 190040 Changed Benefit 193 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB037 Coalition Fixed Angled Screw Bone screw, Fixed Angle 3.6mm and 4.2mm diameter, 12mm - 20 mm length LB 19 165 1464 190040 Changed Benefit 193 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB038 XTEND Anterior Cervical Plate Anterior Cervical Plate 10mm - 54mm LB 19 169 1476 4125 190070 Changed Benefit 1348 0 0 Update 2012-02-01 2019-03-01 Prosthesis BQ003 Intra-tracheal Cannula Montgomery Safe-T-Tubes Clear and Radiopaque except c) a) Paediatric b) Standard c) Hebeler d) Thoracic e) Extra-Long f) Tapered g) Montgomery Salivary Bypass Tube h) Har-el Pharyngeal Tube i) Montgomery Esophageal Tube j) Trachael Fenestrator k) Moore Trache a) 6, 7, 8, 9 b) 10, 11, 12, 13, 14. 15, 16 c) 12, 15, 18 d) 10, 11, 12, 13, 14, 15, 16 e) 10, 11, 12, 13, 14, 15, 16 f) 8/10, 10/13 g) 8, 10, 12, 14, 16, 18, 20 h) one size only i) one size only j) size 6, 8 and 10 k) size 6 and 8 BQ 22 198 1574 Intra-tracheal 119736 119737 447 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BQ004 Ventilation Tubes / Grommet a) Tubingen Gold Type b) Tubingen Titanium Type c) T Tube d) Reuter Bobbin Type e) Paparella Type f) Collar Button Type g) Star Tube h) Bevel Buttton Tube i) Straight Tube j) Armstrong Type k) Shepard Type l) Donaldson Type m) Angular Type n) Myringotomy Tube with Trocar o) Ventilation Tubes with Eyelets p) Minimal Type a) I.D. 1.25mm w/w, I.D.1.25mm wo/w, I.D. 1.5mm wo/w b) one size only c) L- 6, 7.5, 12 d) I.F.O.D 2.5mm, 2.7mm e) one size only f) one side only g) one size only h) one size only i) i.d.-0.9mm,1.1mm,1.15mm j) L-3.8mm, 3.7mm, 10mm k) L- 2.2mm w/t, 2.2mm wo/t,2.4mm w/t l) S- one size only, F one size only m) one size only n) Silver or Titanium o) one or two p) one size only BQ 22 196 1566 120972 19 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LB039 XTEND Anterior Cervical Plate >55mm Anterior Cervical Plate >55mm 57mm - 104mm LB 19 169 1476 4125 >55mm 190070 1636 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LI046 Saturne reconstruction cup Dual coated, mobile, cementless reconstruction cup Sizes: 50 - 66mm LI 18 163 1432 4034 216970 2783 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI047 Femoral Shaft Locking Screw Titanium femoral locking screw 6.2 diameter, 13 lengths 20-80 in 5mm increments LI 18 164 1435 135326 121 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI048 Horizon Acetabular Fixation Screw Titanium countersunk cancellous screw Diam 6.5mm, lenghts 16 - 55 mm LI 18 164 1435 135326 121 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI049 Extreme Hip System Femoral Stem Stem component of modular femoral stem, titanium, HA, with distal screw holes 4 lengths - 250 to 400mm, 6 diameters LI 18 161 1413 3976 Stem 210347 4412 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI050 Extreme Revision Hip Monobloc Epiphysis Metaphyseal Section Combined metaphyseal and epiphyseal sections, adjustable rotation, anodized titanium with HA coating 4 sizes LI 18 161 1413 3979 Body 217486 3972 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI051 Optimal Revision Stem Cementless, modular revision / reconstruction stem Sizes 1-5 LI 18 161 1413 3979 Stem 135326 5202 0 0 No Change 2013-08-01 2019-03-01 Prosthesis AS238 Symbotex Skirted Composite Mesh Non-absorbable three-dimensional polyester skirted, coated, contoured composite mesh. On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera. A flap attached to the reinforcement helps place and fix the mesh. 20 x15 cm Rectangle AS 21 194 1783 5439 Coated, Contoured 270736 759 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BB383 Histoacryl Topical and Surgical Adhesive 0.5ml per ampoule BB 21 194 1580 4247 Synthetic 206441 45 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BB384 BB072 BB073 BB168 CranioFix Titanium Skull Fixation Clamp 11mm - 20mm BB 23 199 1591 4337 138311 93 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BB385 BB082 BB084 Celsite Access Port Single Access Port Standard, Small, Baby BB 21 188 1522 4164 133738 137735 461 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BD015 Neptune Sound Processor replacement part is the external part of the cochlear implant system. Also includes Neptune Connect The Neptune Processor is an external component of the HiRes Bionic Ear System. The processor is intended to deliver HiResolution sound to a cochlear implant. Also includes Neptune Connect. One size. Processor: H x W X D: 26 x 18 x 60mm Neptune Connect Size: H x W x D: 17 x 18 x 58mm BD 22 196 1528 4147 Generation 4 198825 Changed Benefit 7648 0 0 Update 2012-08-01 2019-03-01 Prosthesis LI054 Acor Anatomic Femoral Stem for Modular Neck Anodised titanium, fully HA Coated, curved stem and used with separate neck 7 Sizes LI 18 161 1407 3949 Removable Neck 210109 3779 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI055 Alumina Head Ceramic femoral head, biolox forte >32mm LI 18 162 1420 3996 210133 1806 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI056 Integrale Femoral Stem Anodised titanium, fully HA Coated,straight stem and used with separate neck 7 Sizes LI 18 161 1407 3949 Removable Neck 210194 210195 3779 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI058 metallic femoral head M30NW femoral head with 10/12 taper 22.2mm - 32mm short, medium, long LI 18 162 1419 3988 210159 703 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI059 Saturne Cemented Tripolar Cup Stainless steel cemented acetabular cup with an anatomical anti-disloction profile Sizes 44 - 60 in 2mm increments LI 18 163 1425 4009 210137 Changed Benefit 1582 0 0 Update 2013-08-01 2019-03-01 Prosthesis LI052 Modular Neck for Acor & Integrale Femoral Stems Titanium neck, with varying alignments & tapers 4 sizes LI 18 161 1417 210537 Changed Benefit 1078 0 0 Update 2013-08-01 2019-03-01 Prosthesis LI060 Horizon Acetabular Shell Anodised titanium, HA encoated with screw holes for ceramic inserts 42 - 70 mm LI 18 163 1427 4015 210192 2373 0 0 No Change 2013-08-01 2019-03-01 Prosthesis MC503 CD Horizon Fixed Angle Screw 25 - 90mm MC 19 165 1462 169514 895 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC504 CD Horizon Breakoff Set Screw 25 - 55mm MC 19 166 1465 169514 164 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC506 Orfil Double Pearl-Tipped Wires 1 - 350mm MC 13 123 1772 5364 169514 11 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC507 LIFT/VERTE-SPAN Vertebral Body Cages Short - Extra Long MC 19 176 1492 4137 ThoracoLumbar 169501 4139 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC509 CD Occipital-Cervical Loop CD Occipital-Cervical Loop One size only MC 19 171 1481 169514 Changed Benefit 2907 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC512 TiMesh Maxillary Prosthesis One size only MC 23 200 1596 4358 Maxilla 128523 2071 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC501 CD Horizon Multi-Axial screw (Stainless Steel) 25 - 80mm MC 19 165 1463 169514 1280 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC513 TiMesh Full Mandible One size only MC 23 200 1596 4353 128523 1482 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC515 TiMesh Hemimandible, Left/Right One size only MC 23 200 1596 4358 Hemimandible 128523 629 0 0 No Change 2006-03-24 2019-03-01 Prosthesis BD020 HiRes90K Advantage Cochlear Implant with HiFocus 1j Electrode The HiRes90K Advantage Cochlear Implant with HiFocus 1j Electrode is the implanted component of the HiResolution Bionic Ear System. It receives information through an RF transmission coil, processes the information and then sends the resulting signal to an electrode array implanted in the cochlear. It consists of receiving/transmitting coil, Stimulator electrodes and HiFocus 1j Electrode array Implant Size: 56mm (L) x 28mm (w x5.7mm (thickness). Electrode size: Active length 17mm, Tip diameter 0.4mm, Basal diameter 0.8mm. Total length of electrode array 25mm BD 22 196 1526 220306 Changed Benefit 12892 0 0 Update 2014-08-01 2019-03-01 Prosthesis LI061 Saturne Press Fit Dual Mobility Acetabular Cup A cementless, stippled and peripherally expanded, acetabular cup. Flattened pole and an elevated rim to help prevent dislocation. Sizes: 44 - 64 in 2mm increments LI 18 163 1427 4018 216969 2373 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI062 Score Knee System Femoral Component Femoral component, Cemented, CoCr, with extended patellar groove 7 sizes LI 17 149 1348 3906 210577 2951 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI063 Score Knee System Femoral Component Femoral Component, CoCr, cemented, Posterior Stabilised 4 sizes in left and right LI 17 149 1348 3907 Revision 210579 5501 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI064 Score Knee System Femoral Component Femoral Component, CoCr, uncemented, stippled surface, titanium plasma spray with HA, pegged 7 Sizes LI 17 149 1352 3917 210576 3667 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI065 Score Knee System Tibial and Femoral Augments Tibial and Femoral half blocks, CoCr, screw fixation used for femoral blocks, tibial blocks cemented 31 sizes LI 17 159 1390 135327 1148 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI066 Score Knee System Femoral and Tibial Stems Femoral and Tibial Stems, Titanium, cemented 7 diameters (10-22), 4 lengths (75-200mm) LI 17 159 1399 210605 Changed Benefit 1126 0 0 Update 2013-08-01 2019-03-01 Prosthesis MC517 TiMesh Mandibular "J" Plate One size only MC 23 199 1589 4288 128523 161 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC519 TiMesh Squareplate 4 holes x 1mm - 4 holes x 2.2mm MC 23 199 1589 4271 128523 166 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC520 TiMesh X Plate 4 holes x 1mm - 4 holes x 2.2mm MC 23 199 1589 4271 128523 166 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC521 TiMesh Naso-Orbital-Ethmoid 1mm - 2.2mm; Complex 1, Complex 2, Complex 3 MC 23 200 1597 4364 Complex 128523 527 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC522 TiMesh Curved Plate: Standard, Rigid, Left, Right 1mm x 12 holes MC 23 199 1589 4293 128523 Changed Benefit 409 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC516 TiMesh Mandibular Symphysis One size only MC 23 200 1596 4358 Symphsis 128523 1262 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC524 TiMesh Isogrid Panel One size only MC 23 199 1585 4205 128523 1365 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC525 TiMesh Sugar Mesh Panel / Grid 11 x 7.5cm MC 23 199 1585 4205 128523 1365 0 0 No Change 2006-03-24 2019-03-01 Prosthesis LI067 Score Knee System Offset Connector Connector for stems to alter stem offset morse taper but also including screw for additional fixation, titanium 2mm, 4mm, 6mm LI 17 159 1396 135327 1208 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI068 Score Knee System Tibial Baseplate Tibial Baseplate, Cemented, CoCr, polished insert surface for mobile insert 7 Sizes LI 17 151 1359 Revision 210578 3489 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI069 Score Knee System Tibial Baseplate Tibial baseplate, CoCr, uncemented, stippled surface, titanium plasma spray with HA 7 Sizes LI 17 151 1362 3924 Revision 135327 4338 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI070 Score Knee System Tibial Insert Tibial Insert, mobile bearing, UHMWPE 7 sizes, 5 thicknesses LI 17 153 1369 135327 1019 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LI071 Score Knee System Tibial Insert Tibial Insert, mobile bearing, posterior stabilised with reinforcement post 20 sizes LI 17 153 1370 210526 Changed Benefit 1073 0 0 Update 2013-08-01 2019-03-01 Prosthesis LI072 Score Knee System Patellar Component All poly patella UHMWPE, cemented 6 Diameters LI 17 156 1376 210604 210794 216375 Changed Benefit 537 0 0 Update 2013-08-01 2019-03-01 Prosthesis LI074 Delta Ceramic Head Biolox Delta Head 28 and 32mm heads 10/12 and 12/14 LI 18 162 1419 3992 281064 Changed Product sizes 1845 0 0 Update 2014-08-01 2019-03-01 Prosthesis LI075 Large Delta Ceramic Head Biolox Delta Head 36mm heads 10/12 and 12/14 LI 18 162 1420 3998 281064 Changed Product sizes 2022 0 0 Update 2014-08-01 2019-03-01 Prosthesis LI076 Horizon II Delta Ceramic Insert Ceramic Insert, Biolox Delta 9 sizes for 28, 32 and 36mm heads LI 18 163 1428 4022 223258 Changed Benefit 2250 0 0 Update 2014-08-01 2019-03-01 Prosthesis LI092 E2 PMMA Centraliser PMMA distal Centraliser 20mm LI 18 164 1438 260435 139 0 0 No Change 2016-02-01 2019-03-01 Prosthesis MC448 UCSS Cortical Lag Screws 36 - 50mm MC 19 165 1464 Cannulated 169514 202 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC449 Pyramesh Angled 25 - 150mm MC 19 176 1494 169501 3470 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC450 Pyramesh Curved / Round 20 - 150mm MC 19 176 1494 169501 3470 0 0 No Change 2006-03-24 2019-03-01 Prosthesis BD022 HiRes90K Advantage Cochlear Implant with the HiFocus Mid-Scala Electrode The HiRES90K Advantage Cochlear Implant with HiFocus Mid-Scala electrode is the implanted component of the HiResolution Bionic Ear System. It receives information through an RF transmission coil, processes the information and then sends the resulting signal to an electrode array implanted in the cochlea. It consists of receiving/transmitting coil, Stimulator electrodes and HiFocus Mid-Scala Electrode array Implant Size: 56mm (L) x 28mm (w) x 5.7mm (thickness. Electrode size: Active length 15mm, Tip diameter 0.5mm, Basal diameter 0.7mm. Total length of electrode array 23.7mm BD 22 196 1526 220306 Changed Benefit 12892 0 0 Update 2014-08-01 2019-03-01 Prosthesis BD023 Naida CI Q90 Sound Processor (Initial Order) Sound Processor One size BD 22 196 1528 4145 282255 10925 0 0 No Change 2017-02-01 2019-03-01 Prosthesis IS037 677MTY BiFlex Single-Piece Aspheric Hydrophilic Progressive Diffractive Toric IOL with Blue filter and 360' Special Square Edge for implantation into capsular bag Optic diameter: 6.0 mm ±0.05 mm, Overall diameter: 13.0 mm ±0.10 mm Powers available: -10.0 - +30.0 D ±0.25 D increment: 0.5 D Cylinders available: +1.0 D - +4.5 D increment: 0.5 D +5.25D - +6.0 D increment: 0.75 D IS 1 141 1327 3893 at, t1, vblf 221834 1021 0 0 No Change 2017-02-01 2019-03-01 Prosthesis IT001 Hawk Anterior Ankle Fusion Set Anatomically contoured 6 hole plate and screw set for anterior fixation of the ankle joint. 77mm in length 22mm in width 23mm depth IT 13 123 1694 5255 Com 177278 Changed Benefit 922 0 0 Update 2015-08-01 2019-03-01 Prosthesis IT002 Hawk 6.5mm Cannulated Screw System - Washer Titanium Washer Internal diameter 6.6mm and external diameter 14mm IT 13 123 1231 3374 232499 93 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IT003 Hawk 4.0mm Cannulated Screw System - Washer Titanium washer internal diameter of 4.13mm and external diameter of 10mm IT 13 123 1231 3374 232499 93 0 0 No Change 2015-08-01 2019-03-01 Prosthesis IT004 Hawk 6.5mm Cannulated Screw System - Guide Pin Threaded, Stainless steel 2.5mm in diameter and 200 in length IT 13 123 1772 5365 230955 27 0 0 No Change 2015-08-01 2019-03-01 Prosthesis MC529 Hydrocephalus Shunt Lumbar peritoneal 84cm MC 25 220 1667 130410 140357 140358 140359 140360 Changed Benefit 428 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC530 Hydrocephalus Shunt Ventricular/Atrial, CSF Flow Control Shunts, Cont Small Valve 38cm-90cm MC 25 220 1666 4469 Reservoir/Priming function 129681 1387 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC531 Hydrocephalus Shunt Ventricular/Peritoneal. CSF Flow Control Valves, BioGlide Contoured, Ventriculostomy Kit-E, Neonatal Delta Snap Shunt 12mm-90cm MC 25 220 1666 4469 Distal catheter, Reservoir/Priming function 129681 1563 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC532 Hydrocephalus Shunt With Hydrostatic Valve, Delta Valves/Shunts/BioGlide, Vent Catheters 12mm-90cm MC 25 220 1666 4469 Antisyphon function, Reservoir/Priming function 129681 Changed Benefit 1473 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC534 Pressure valve (anti-siphon device or flushing valve or flush pump) Neonatal Reservior, CSF Lumbo Peritoneal 2 - 90cm MC 25 220 1670 129650 356 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC537 Danek Unit Rod System Scoliosis Rods 5.5mm to 6.35mm MC 19 170 1480 4132 169514 1405 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC528 TiMesh Cranial Custom Mesh 121mm x 72mm - 152 x 152mm MC 23 200 1593 4343 Biomodelled 128523 Changed Benefit 9682 0 0 Update 2006-03-24 2019-03-01 Prosthesis HW473 Restoration Acetabular Wedge Augment System The Restoration Acetabular Wedge Augment System is designed for hip surgeries requiring additional acetabular component support in cases where host bone is insuficient. The Wedge Augments provide the intraoperative flexibility to optimize screw placement. Outer Diameter 46mm, Inner Diameter 48, Thickness 15mm Screw Holes 3 Outer Diameter 46mm, Inner Diameter 48, Thickness 20mm Screw Holes 4 Outer Diameter 46mm, Inner Diameter 48, Thickness 25mm Screw Holes 4 Outer Diameter 50mm, Inner Diameter 52, Thickness 15mm Screw Holes 3 Outer Diameter 50mm, Inner Diameter 52, Thickness 20mm Screw Holes 4 Outer Diameter 50mm, Inner Diameter 52, Thickness 25mm Screw Holes 4 Outer Diameter 54mm, Inner Diameter 56, Thickness 15mm Screw Holes 4 Outer Diameter 54mm, Inner Diameter 56, Thickness 20mm Screw Holes 6 Outer Diameter 54mm, Inner Diameter 56, Thickness 25mm Screw Holes 6 Outer Diameter 58mm, Inner Diameter 60, Thickness 15mm Screw Holes 6 Outer Diameter 58mm, Inner Diameter 60, Thickness 20mm Screw Holes 6 Outer Diameter 58mm, Inner Diameter 60, Thickness 25mm Screw Holes 6 Outer Diameter 62mm, Inner Diameter 64, Thickness 15mm Screw Holes 6 Outer Diameter 62mm, Inner Diameter 64, Thickness 20mm Screw Holes 8 Outer Diameter 62mm, Inner Diameter 64, Thickness 25mm Screw Holes 8 Outer Diameter 66mm, Inner Diameter 68, Thickness 15mm Screw Holes 6 Outer Diameter 66mm, Inner Diameter 68, Thickness 20mm Screw Holes 8 HW 18 164 1433 Bone Reconstruction 192159 2899 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW474 HOFFMANN LRF Coupling SHORT , LONG HW 13 123 1237 3757 197935 342 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW475 HOFFMAN LRF FOOT RING PLATE/ARCH DIAMETER - 100-210MM HW 13 123 1237 4506 197935 2850 0 0 No Change 2013-02-01 2019-03-01 Prosthesis DU016 Juliet LL Lateral Lumbar Cage Lateral lumbar - PEEK or titanium PEEK- Width: 21mm Length: 40mm, 45mm, 50mm, 55mm, 60mm Height: 8mm, 10mm, 12mm, 14mm, 16mm Lordotic angle: 6º Titanium- Width: 17mm, 21mm, 25mm Length: 25mm, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm Height: 6mm, 8mm, 10mm, 12mm, 14mm, 16mm Lordotic angle: 0º, 6º DU 19 174 1486 4135 166194 3465 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DU017 Romeo 2 Posterior Thoraco-lumbar Fixation System - Monoxial Screw Monomial pedicle screw Diameter: 4mm, 5mm, 6mm, 7mm, 8mm Length: 25m, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm, 70mm, 80mm DU 19 165 1462 166153 895 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DU018 Romeo 2 Posterior Thoraco-lumbar Fixation System - Polyaxial Screw, Reduction Screw, 25D Screw Polyaxial screw, polyaxial reduction screw Diameter: 4mm, 5mm, 6mm, 7mm, 8mm Length: 25mm, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm, 70mm, 80mm, 90mm DU 19 165 1463 166153 1280 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DU019 Romeo 2/Romeo 2 MIS Posterior Thoraco-lumbar Fixation System - Set Screw Set screw One size only DU 19 166 1465 166153 164 0 0 No Change 2017-02-01 2019-03-01 Prosthesis HW476 HOFFMANN LRF - FULL CIRCULAR RING FULL CURCULAR RING DIAMETER - 80 - 270MM HW 13 123 1237 3405 197935 685 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW477 HOFFMANNLRF - NUTS, WASHERS , SPACERS NUTS, WASHERS , SPACERS SHORT, LONG, M6,M8,1-7MM HW 13 123 1237 4507 197935 45 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW478 HOFFMANN LRF - PARTIAL CIRCULAR RING PARTIAL CIRCULAR RING DIAMETER - 100-240MM HW 13 123 1237 3406 197935 1050 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW479 HOFFMANN LRF - POSTS POSTS LENGTHS - 44-88MM HW 13 123 1237 4512 197935 Changed Benefit 105 0 0 Update 2013-02-01 2019-03-01 Prosthesis HW480 HOFFMANN LRF - STATIC STRUT STATIC STRUT LENGTHS - 20 -60MM HW 13 123 1237 4505 197935 950 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW481 HOFFMANN LRF - THREADED TELESCOPIC ROD THREADED TELESCOPIC ROD DIAMETER - 6MM LENGTHS - 30-400MM HW 13 123 1237 4505 197935 950 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW482 HOFFMANN LRF - WIRE BOLT COUPLINGS WIRE BOLT COUPLING SHORT, MEDIUM, LONG HW 13 123 1237 3757 197935 342 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW483 ES2 Spinal System, Rod Hex end rods 5.5mm x 20 - 600mm HW 19 170 1478 179471 Changed Benefit 426 0 0 Update 2013-02-01 2019-03-01 Prosthesis BR005 OPRA System Abutment - titanium Length 20mm - 78mm BR 13 123 1778 5408 145495 Changed Product sizes, Benefit 18288 0 0 Update 2005-10-31 2019-03-01 Prosthesis BR006 OPRA System Abutment screw - titanium Length 23mm BR 13 123 1778 5409 145495 Changed Product sizes 5486 0 0 Update 2005-10-31 2019-03-01 Prosthesis BR007 OPRA System - Graft Screw Graft Screw One size only BR 13 123 1229 5363 145488 96 0 0 No Change 2013-08-01 2019-03-01 Prosthesis BS021 Interlock Detachable Coils Platinum-tungsten, Fibered Occlusion System Coil diameters up to 30mm and lengths up to 100cm. Delivery system lengths up 200cm BS 24 213 1646 5472 P, ids (Platinum, integral delivery system) 293646 1125 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BX292 Supple Peri-Guard (4 x 4cm) Model No PC0404SN - 4 x 4cm Bovine pericardium patch 4 x 4cm BX 20 182 1507 5452 152945 Changed Benefit 333 0 0 Update 2013-02-01 2019-03-01 Prosthesis BX293 Supple Peri-Guard (6 x 8cm) Model No PC0608SN -6 x 8cm Bovine pericardium patch 6 x 8cm BX 20 182 1507 5453 152945 Changed Benefit 523 0 0 Update 2013-02-01 2019-03-01 Prosthesis BX294 Supple Peri-Guard (10 x 16cm) Model No PC1016SN - 10 x 16 Bovine pericardium patch 10 x 16cm BX 20 182 1507 5454 152945 722 0 0 No Change 2013-02-01 2019-03-01 Prosthesis DE346 Engipore Pre-formed Bone Substitute 0-5cc Pre-formed Bone Substitute 0-5cc Catalogue number: PFS015005-30-00 Size: 4.7cc Catalogue number: PFS015006-19-00 Size: 2.6cc Catalogue number: PFS015006-20-00 Size: 3.6cc Catalogue number: PFS015006-25-00 Size: 2.2cc Catalogue number: PFS015005-21-00 Size: 1.2cc Catalogue number: PFS015005-22-00 Size: 2.4cc Catalogue number: PFS015008-01-00 Size: 4.2cc DE 13 123 1241 4092 183652 722 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DE347 Engipore Pre-formed Bone Substitute 5-10cc Pre-formed Bone Substitute 5-10cc Catalogue No: PFS015005-31-00 Size: 6.4cc Catalogue No: PFS015005-32-00 Size: 8.2cc Catalogue No: PFS015005-23-00 Size: 7.2cc Catalogue No: PFS015005-24-00 Size: 9.6cc Catalogue No: PFS015008-02-00 Size: 6.8cc Catalogue No: PFS015008-03-00 Size: 9.9cc Catalogue No: PFS015009-01-00 Size: 5cc Catalogue No: PFS015009-02-00 Size: 15cc Catalogue No: PFS015009-03-00 Size: 5cc Catalogue No: PFS015009-04-00 Size: 15cc Catalogue No: PFS015009-01-00 Size: 5cc Catalogue No: PFS015009-02-00 Size: 15cc Catalogue No: PFS015009-03-00 Size: 5cc Catalogue No: PFS015009-04-00 Size: 15cc DE 13 123 1241 4093 183652 296946 1140 0 0 No Change 2012-02-01 2019-03-01 Prosthesis HW484 ES2 Spinal System, Screw Polyaxial cannulated screw with integrated blades Diam 4.5mm to 8.5mm, Length 25mm to 90mm HW 19 165 1463 Cannulated 179471 1338 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW485 MDM CoCr Liner Modular Dual Mobility (MDM) CoCr Liner The MDM CoCr Liner comes in a range of inner diameters of 36mm - 58mm HW 18 163 1428 4023 217674 1845 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW486 Stryker Leibinger Hybrid MMF Plate SMARTLOCK Hybrid MMF Plate, Locking System - Universal SMARTLOCK Hybrid MMF Component - MMF Plate One size - 9 Hole Straight Plate, for maxilla and Mandible HW 23 199 1589 4277 Locking 124329 304 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW487 Stryker Leibinger Hybrid MMF Screws SMARTLock Hybrid MMF Screws, Locking System - Universal SMARTLock Hybrid MMF Component - MMF Screws Two Sizes - 2.0mm Diameter, 6mm Length 2.0mm Diameter, 8mm Length HW 23 199 1590 4323 Locking 124318 88 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW488 Excelsior SL-10 & Excelsior 1018 Excelsior SL-10 & the Excelsior 1018 Microcatheter is indicated to assist in the delivery of diagnostic agents, such as contrast media, and therapeutic agents, such as occlusion coils, into the peripheral, coronary and neurovasculature. Length: 150cm Outer Diameter: 2.4F - 2.6F Inner Diameter: 0.165" - 0.019" HW 25 225 1689 4494 149440 174576 177031 665 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW489 HOFFMANN3 external fixation system Sterile field kit Standard kit A HW 13 123 1237 5508 112434 Changed Benefit 6048 0 0 Update 2013-02-01 2019-03-01 Prosthesis HW490 HOFFMANN3 external fixation system Sterile field kit Standard kit B HW 13 123 1237 5509 112434 5397 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW491 Stryker Leibinger Plating System Craniofacial Fixation Screws 1.5 - 2.7mm diameter, 3 - 20mm length HW 23 199 1590 4323 124318 64730 42 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BX295 Supple Peri-Guard (8 x 14cm) Nodel No PC0814SN - 8 x 14 Bovine pericardium patch 8 x 14cm BX 20 182 1507 5454 152945 722 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BX308 Actifuse ABX MIS Actifuse ABX MIS, Refill Cartridge, 7.5ml 7.5ml BX 13 123 1241 4093 AUG 193684 2185 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BX309 Actifuse ABX MIS Actifuse ABX MIS, Applicator and Cartridge, 7.5ml 7.5ml BX 13 123 1241 4093 AUG 193684 2185 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BX310 Actifuse ABX Easyfill Actifuse ABX Easyfill - A silicate substituted synthetic bone graft 1.5mL to 4mL BX 13 123 1241 4092 AUG 188736 1026 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BX311 ACTIFUSE ABX Putty Actifuse AVX Putty - A silicated substituted synthetic bone graft. 20ml BX 13 123 1241 4094 AUG 188736 4370 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BX312 Actifuse ABX Easyfill Putty Actifuse ABX Easyfill Putty - A silicate substituted synthetic bone graft 10ml BX 13 123 1241 4093 AUG 188736 2185 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BX313 Actifuse ABX Easyfill Putty Actifuse ABX Easyfill Putty - A silicate substituted synthetic bone graft 5ml BX 13 123 1241 4092 AUG 188736 1026 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BX314 ACTIFUSE SHAPE 1.6mL–BONE MATRIX IMPLANT ARTIFICIAL A silicate substituted synthetic bone graft 1.6mL BX 13 123 1241 4092 AUG 203922 1026 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX315 ACTIFUSE SHAPE 2.6mL–BONE MATRIX IMPLANT ARTIFICIAL A silicate substituted synthetic bone graft 2.6mL BX 13 123 1241 4092 AUG 203922 1026 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX316 ACTIFUSE GRANULES –BONE MATRIX IMPLANT ARTIFICIAL A silicate substituted synthetic bone graft 20mL BX 13 123 1241 4094 AUG 209519 4370 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX317 ACTIFUSE SHAPE 8.0mL –BONE MATRIX IMPLANT ARTIFICIAL A silicate substituted synthetic bone graft 8.0mL BX 13 123 1241 4093 AUG 203922 2185 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX318 ACTIFUSE SHAPE15.8mL –BONE MATRIX IMPLANT ARTIFICIAL A silicate substituted synthetic bone graft 15.8mL BX 13 123 1241 4094 AUG 203922 4370 0 0 No Change 2014-08-01 2019-03-01 Prosthesis DU020 Romeo 2 Posterior Thoraco-lumbar Fixation System - Hook Laminar hook, pedicular hook, offset (left/right), angled (left/right) Small, large, extended DU 19 168 1475 166153 789 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DU021 Romeo 2/Romeo 2 MIS Posterior Thoraco-lumbar Fixation System - Rod, Percutaneous Rod Rod, percutaneous rod Rod - Diameter 5.4mm Length: pre-bent: 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm, 70mm, 80mm, 90mm; straight: 100mm, 120mm, 140mm, 160mm, 180mm, 200mm, 220mm, 240mm, 350mm, 500mm, 550mm Percutaneous Rod - Diameter: 5.4mm Length: pre-bent - 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm, 65mm, 70mm, 75mm, 80mm, 85mm, 90mm; straight - 100mm, 110mm, 120mm, 130mm, 140mm, 150mm, 160mm, 170mm, 180mm, 190mm, 200mm, 210mm, 220mm, 230mm, 240mm, 250mm DU 19 170 1478 166153 Changed Benefit 426 0 0 Update 2017-02-01 2019-03-01 Prosthesis DU022 Romeo 2 Posterior Thoraco-lumbar Fixation System - Parallel Rod Connector, Axial Rod Connector Parallel rod connector, axial rod connector one size only DU 19 167 1472 166153 Changed Benefit 732 0 0 Update 2017-02-01 2019-03-01 Prosthesis DU023 Romeo 2 Posterior Thoraco-lumbar Fixation System - Multiaxial Cross Connector Multiaxial cross connector, Multiaxial pre-bent cross connector Length: 33 - 36mm, 36-43mm, 43-55mm, 55-80mm DU 19 167 1474 4124 166153 Changed Benefit 1299 0 0 Update 2017-02-01 2019-03-01 Prosthesis DU024 Romeo 2 Posterior Thoraco-lumbar Fixation System - Straight Cross Connector Straight cross connector Length: 18mm, 21mm, 24mm, 27mm, 30mm DU 19 167 1474 4123 166153 404 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DU025 Romeo 2 Posterior Thoraco-lumbar Fixation System - Transverse Hook Cross Connector Transverse hook cross connector One size only DU 19 166 1471 166153 385 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER201 K2M Spinal Systems-Transitional Rod Transitional Rod 3.5-(4.5 /5.5)mm x (300-600)mm length or 5.5/5.5mm x 495 rod/rail ER 19 170 1478 Dual Diameter 154442 159828 Changed Benefit 529 0 0 Update 2015-02-01 2019-03-01 Prosthesis ER202 Mesa Monoaxial Screw Monoaxial screw, rotating head Diameter: 4.5mm - 8.5mm, Length: 25mm - 55mm ER 19 165 1462 Integrated Locking Mechanism 154442 1059 0 0 No Change 2015-02-01 2019-03-01 Prosthesis ER206 Signus TLIF Implant Signus TLIF Implant (Peek or Titanium) Height (6-18 mm) x Width 11 mm x Length (28-40) mm x 0 or 6 degree angle ER 19 174 1486 4135 129772 3465 0 0 No Change 2015-02-01 2019-03-01 Prosthesis ER207 SIGNUS Cervical Plating Implant System-Plate SIGNUS Cervical Plating Implant System-Plate 22-54 mm, in 2 mm increments ER 19 169 1476 4125 216749 Changed Benefit 1348 0 0 Update 2015-02-01 2019-03-01 Prosthesis ER208 SIGNUS Cervical Plating Implant System-Plate (>55 mm) SIGNUS Cervical Plating Implant System-Plate (>55 mm) 56-100 mm, in 3-5 mm increments ER 19 169 1476 4125 >55mm 216749 1636 0 0 No Change 2015-02-01 2019-03-01 Prosthesis ER209 SIGNUS Cervical Plating Implant System-Bone Screw SIGNUS Cervical Plating Implant System-Cervical Bone Screw, fixed or variable angle; self drilling or self tapping dia (2.7-4.3 mm)x length (12-22 mm) ER 19 165 1464 216749 Changed Benefit 193 0 0 Update 2015-02-01 2019-03-01 Prosthesis ER210 Capri Vertebral Body Replacement System-Cage Cage, Internal or External Component 23 - 122mm height, multiple footprints ER 19 176 1492 4137 ThoracoLumbar 204117 4139 0 0 No Change 2015-02-01 2019-03-01 Prosthesis ER211 Mesa Hooks Thoracic and Lumbar hooks Various blade and throat sizes ER 19 168 1475 Integrated Locking Mechanism 154442 953 0 0 No Change 2015-02-01 2019-03-01 Prosthesis ER212 Mesa Polyaxial Cannulated Screw Cannulated Pedicle Screw, polyaxial Diameter: 5.5-6.5mm Length: 30-45mm ER 19 165 1463 Integrated Locking Mechanism, Cannulated 154442 Changed Benefit 1502 0 0 Update 2015-02-01 2019-03-01 Prosthesis ER213 K2M Spinal Systems Set Screws Set Screw Diameter: 5-9mm ER 19 166 1465 154442 159828 193653 164 0 0 No Change 2015-02-01 2019-03-01 Prosthesis ER214 Everest Spinal System -Cannulated Screw Polyaxial Screw, Cannulated (4.5 -10.5)mm diam x (20-110)mm ER 19 165 1463 Cannulated 193653 1338 0 0 No Change 2015-02-01 2019-03-01 Prosthesis ER215 Everest Spinal System-Fenestrated Screw Polyaxial Screw, Fenestrated (4.5 -9.5)mm diam x (20-110)mm ER 19 165 1463 Cannulated 193653 1338 0 0 No Change 2015-02-01 2019-03-01 Prosthesis ER216 Lap-Band Adjustable Gastric Banding (LAGB) System - AP-small and AP-large ER 21 190 1548 226688 3135 0 0 No Change 2015-02-01 2019-03-01 Prosthesis ER217 Lap-Band Access Port For use with the Lap-Band Adjustable Gastric Banding System Standard, low profile ER 21 190 1779 226686 589 0 0 No Change 2015-02-01 2019-03-01 Prosthesis ER219 Lap-Band AP with RapidPort EZ LAP-BAND AP RapidPort EZ System 11.6mm x 30.5mm x 14mm 11.6mm x 30.5mm x 16.5mm ER 21 190 1548 226688 3135 0 0 No Change 2015-02-01 2019-03-01 Prosthesis ER220 RapidPort EZ Access Port Kit (replacement port) Access Port Kit for LAP-BAND RapidPort EZ system 11.6mm x 30.5mm x 14mm 11.6mm x 30.5mm x 16.5mm ER 21 190 1779 226686 589 0 0 No Change 2015-02-01 2019-03-01 Prosthesis ER221 SIGNUS Diplomat Pedicle Screw System-Polyaxial Screw-Shank SIGNUS Diplomat Pedicle Screw System-Polyaxial Screw-Shank dia (5.5-9.5 mm) xlength (30-100 mm) ER 19 165 1463 Shank 216751 640 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER222 SIGNUS Diplomat Pedicle Screw System - Monoaxial Screw SIGNUS Diplomat Pedicle Screw System - Monoaxial Screw dia (5.5-9.5 mm) xlength (30-70 mm) ER 19 165 1462 216751 895 0 0 No Change 2015-08-01 2019-03-01 Prosthesis BX319 ACTIFUSE GRANULES 10mL–BONE MATRIX IMPLANT ARTIFICIAL A silicate substituted synthetic bone graft 10mL BX 13 123 1241 4093 AUG 209519 2185 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX320 ACTIFUSE GRANULES –BONE MATRIX IMPLANT ARTIFICIAL A silicate substituted synthetic bone graft 5mL BX 13 123 1241 4092 AUG 209519 1026 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX321 ACTIFUSE GRANULES 40mL–BONE MATRIX IMPLANT ARTIFICIAL A silicate substituted synthetic bone graft 40mL BX 13 123 1241 4095 AUG 209519 5700 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX322 ACTIFUSE EASY PREP –BONE MATRIX IMPLANT ARTIFICIAL A silicate substituted synthetic bone graft 10ml BX 13 123 1241 4093 AUG 209521 2185 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX323 ACTIFUSE MICROGRANULES2.5mL–BONE MATRIX IMPLANT ARTIFICIAL A silicate substituted synthetic bone graft 2.5mL BX 13 123 1241 4092 AUG 209520 1026 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX324 ACTIFUSE MICROGRANULES 5mL–BONE MATRIX IMPLANT ARTIFICIAL A silicate substituted synthetic bone graft 5mL BX 13 123 1241 4092 AUG 209520 1026 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER223 SIGNUS Diplomat Pedicle Screw System - Screw Head (Tulip) SIGNUS Diplomat Pedicle Screw System - Screw Head (Tulip) dia 12.5 mm x height 14.9-150 mm ER 19 166 1469 216751 Changed Benefit 732 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER224 SIGNUS Diplomat Pedicle Screw System - Set Screw SIGNUS Diplomat Pedicle Screw System - Set Screw dia 9.7mm x height 4.2mm or N/A ER 19 166 1465 216751 164 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER225 SIGNUS Diplomat Pedicle Screw System - Rod-Straight or Curved SIGNUS Diplomat Pedicle Screw System - Rod-Straight or Curved dia 5.5 mm x length (30-150 mm) ER 19 170 1478 216751 Changed Benefit 426 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER226 SIGNUS Diplomat Pedicle Screw System - Offset Connector SIGNUS Diplomat Pedicle Screw System - Offset Connector dia 5.5 mm x length (15-30 mm) ER 19 167 1473 216751 Changed Benefit 732 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER227 SIGNUS Diplomat Pedicle Screw System - Parallel Connector SIGNUS Diplomat Pedicle Screw System - Parallel Connector 5.5 mm x (4.5-6.0 mm) ER 19 167 1472 216751 Changed Benefit 732 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER228 SIGNUS Diplomat Pedicle Screw System - Sleeve SIGNUS Diplomat Pedicle Screw System - Sleeve Diameter 5.5 mm ER 19 167 1472 216751 Changed Benefit 732 0 0 Update 2015-08-01 2019-03-01 Prosthesis BX326 Infusor Sterile Infusor Devices, Spring Powered SV Half, 5ml/hr, nominal 60ml vol, max 65ml. SV Single day, 2ml/hr, nominal 48ml vol, max 65ml BX 21 188 1540 4188 168893 81 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX327 Infusor Sterile Infusor Devices, Elastomeric Driven LV 10, 10ml/hr, 240ml vol LV 5, 5ml/hr, 240ml vol BX 21 188 1524 5358 168893 79 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX328 Infusor Sterile Infusor Devices, Elastomeric Driven LV 2, 2ml/hr, 275 ml vol; LV 1.5, 1.5ml/hr, 275 ml vol. BX 21 188 1524 5358 168893 79 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX325 ACTIFUSE MICROGRANULES –BONE MATRIX IMPLANT ARTIFICIAL A silicate substituted synthetic bone graft 10mL BX 13 123 1241 4093 AUG 209520 2185 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX329 Infusor Sterile Infusor Devices, Spring Powered SV Multi day, 0.5ml/hr, nominal 60ml vol, max vol 65ml SV Seven day, 0.5ml/hr, nominal 84ml vol max 95ml Vol BX 21 188 1540 4188 168893 81 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER229 SIGNUS Noval Interbody Fusion Cage SIGNUS Noval Interbody Fusion Cage height (8-18 mm) x width (40-48 mm)x lordosis (5-15 degrees) ER 19 174 1486 4135 129772 3465 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER231 Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Monoaxial Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Monoaxial dia (4-7 mm) x length (25-55 mm) ER 19 165 1462 235417 235418 895 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER232 Spineway Mont Blanc Pedicle Screw System-Locking Screw Spineway Mont Blanc Pedicle Screw System-Locking Screw Height 3.7 mm ER 19 166 1465 235417 235418 164 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER233 Spineway Mont Blanc Pedicle Screw System-Rod Spineway Mont Blanc Pedicle Screw System-Rod dia (4.0-5.5 mm) x length (40-500 mm) ER 19 170 1478 235417 235418 Changed Benefit 426 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER234 Spineway Mont Blanc Pedicle Screw System-Hook Spineway Mont Blanc Pedicle Screw System-Hook dia (14-22 mm)x length (10.2-27.15 mm)x (height (14.4 to 29.7mm) ER 19 168 1475 235417 235418 789 0 0 No Change 2015-08-01 2019-03-01 Prosthesis HW492 Stryker Leibinger Plating System Mandible Fixation plates 1.0 - 1.99mm thick, 4 - 7 holes HW 23 199 1589 4288 11565 124319 161 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW493 Stryker Leibinger Plating System Mandible Locking Fixation Plates 1.0 -1.9mm thick, 4 - 7 holes HW 23 199 1589 4288 Locking 295882 Changed Benefit 458 0 0 Update 2013-02-01 2019-03-01 Prosthesis HW494 Stryker Leibinger Plating System Mandible Fixation Plates 1.0 - 1.99mm thick, 8 -15 holes HW 23 199 1589 4293 Locking 124319 64730 629 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW495 Stryker Leibinger Plating System Mandible Fixation Plates 1.0 - 1.9mm thick, 16- 32 holes HW 23 199 1589 4296 11565 124319 199 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW496 Stryker Leibinger Plating System Mandible Fixation Plates 1.0 -1.9mm thick, 16 - 32 holes HW 23 199 1589 4296 Locking 122928 124319 64730 798 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW497 Stryker Leibinger Plating System Fracture or reconstruction plates 0.5 - 0.99mm thick, <4 holes HW 23 199 1589 4267 122928 124319 93 0 0 No Change 2013-02-01 2019-03-01 Prosthesis IT013 Hawk 2.0mm Twist off Screw 2.0mm Twist off Screw 2.0mm in diameter with lengths of 11mm to 20mm IT 13 123 1231 3372 Breakoff 230954 281 0 0 No Change 2015-08-01 2019-03-01 Prosthesis BX330 Basal Bolus Infusor Sterile Infusor Devices, Balloon based Basal/Bolus 60, Basal 0.5ml/hr, Bolus 0.5 x 65ml Basal/Bolus 15, Basal 0.5ml/hr, Bolus 2ml/hr x 65ml Basal/Bolus infusor, Basal 2ml/hr, Bolus 2ml/hr x 65ml BX 21 188 1524 5359 Bolus 168893 416 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX331 Multi Infusors Sterile Infusor Devices, Elastomeric Driven Multirate 5, 7 or 12ml/hr x 300ml Multirate 2, 4 or 6 ml/hr x 300ml Multirate 2, 3, 5ml Multirate 1, 2, 3ml BX 21 188 1524 5359 Set 168893 Changed Benefit 347 0 0 Update 2014-08-01 2019-03-01 Prosthesis BX332 Veritas Collagen Matrix - Small Bovine pericardium biologic mesh for the repair of soft tissue for size < 200cm² RM-0208 2cm x 8cm; RM-0304 3cm x 4cm; RM-0407 4cm x 7cm; RM-0416 4cm X 16cm; RM-0608 6cm x 8cm; RM-0618 6cm x 18cm; RM-0816 8cm x 16cm; RM-0818 8cm x 18cm; RM1016 10cm x 16cm; RM-1212 12cm x 12cm BX 21 194 1798 5491 Coated 219240 747 0 0 No Change 2014-08-01 2019-03-01 Prosthesis DE293 Prostop Arthroereisis Subtalar implant 7x12mm 8x12mm 9x14mm 10x14mm 11x16mm 12x16mm DE 13 124 1219 3261 98527 Changed Benefit 1321 0 0 Update 2009-08-01 2019-03-01 Prosthesis DE294 Bead Block Polyvinyl Alcohol hydrogel microspheres in pre-loaded syringe 2ml- (100 - 300, 300 - 500, 500 - 700, 700 - 900, 900 - 1200 microns DE 24 213 1645 158665 184 0 0 No Change 2009-08-01 2019-03-01 Prosthesis DE295 Compression Staple Compression staple for fusion 10x10mm 10x15mm 15x10mm 15x15mm 20x20mm DE 13 123 1773 5514 COMP 159591 396 0 0 No Change 2009-08-01 2019-03-01 Prosthesis DE296 Pull PEG System Initial placement percutaneous endoscopic gastrostomy kit 20Fr; 60cm DE 21 189 1545 4197 97184 195 0 0 No Change 2009-08-01 2019-03-01 Prosthesis DE297 BioComposite Interference Screw Soft Tissue Fixation Device 7mm - 35mm DE 13 123 1774 5391 AB, HA 164043 457 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DE298 Tightrope Syndesmosis Buttress Plate For Syndesmosis and Fracture Repair Universal one size only DE 13 123 1774 5387 126657 Changed Benefit 442 0 0 Update 2010-02-01 2019-03-01 Prosthesis DE299 SpeedCinch Meniscal Repair Device Curved needle and reverse curved needle DE 13 123 1774 5389 126657 374 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DE301 Suture Button Multiple hole button for fixation of bone to bone or soft tissue to bone, and are intended as fixation posts, a distribution bridge, or for distributing suture tension over areas of ligament or tendon repair 2.6mm - 7.5mm DE 13 123 1774 5390 126657 374 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DU004 Perla Posterior Cervico-Thoracic Fixation System - Axial Connector, Lateral Connector Axial connectors, lateral connectors Axial - Diameter: 3.5/3.5mm Lateral - small, large DU 19 167 1473 198720 Changed Benefit 732 0 0 Update 2017-02-01 2019-03-01 Prosthesis DU005 Perla Posterior Cervico-Thoracic Fixation System - Cross Connector Adjustable rod-to-rod cross connectors, head-to-head cross connectors RTR - Length: 21-23mm, 23-26mm, 26-32mm, 32-44mm, 44-45mm HTH - Length: 20-25mm, 25-30mm, 30-35mm, 35-40mm, 40-45mm, 45-50mm DU 19 167 1474 4124 198720 Changed Benefit 1299 0 0 Update 2017-02-01 2019-03-01 Prosthesis DE348 Calcaneal Step Plate Calcaneal Step Plate 5mm, 7.5mm, 10mm DE 13 123 1694 5255 Com, LK 140710 1178 0 0 No Change 2012-02-01 2019-03-01 Prosthesis EX048 Equinoxe Humeral Liner The Equinoxe Reverse Shoulder System includes a reverse semi-constrained prosthesis for use in total-shoulder joint replacement procedures in cases with an irreparable or nonfunctional rotator cuff. Liner: 36mm+0, 36mm+2.5, 38mm+0, 38mm+2.5, 42mm+0, 42mm+2.5, 46mm+0, 46mm+2.5 Constrained Humeral Liner: 36mm+0, 36mm+2.5, 38mm+0, 38mm+2.5, 42mm+0, 42mm+2.5, 46mm+0, 46mm+2.5 FA 13 131 1276 4069 264172 279721 774 0 0 No Change 2010-02-01 2019-03-01 Prosthesis EX049 Equinoxe Glenoid Plate The glenoid plate provides multiple options for screw insertion 0 degree, 8 degree, 10 degree FA 13 131 1277 4078 262854 284693 284694 284695 1991 0 0 No Change 2010-02-01 2019-03-01 Prosthesis EX050 Equinoxe Glenosphere The glenosphere aids in glenosphere insertion and protects any remaining intact soft tissues. 36mm, 38mm, 42mm & 46mm FA 13 131 1277 4079 279903 266161 Changed Benefit 2176 0 0 Update 2010-02-01 2019-03-01 Prosthesis EX051 Equinoxe Humeral Long Stem The long/revision stem is intended for cemented fixation only. The long/revision stem is advised when the distal bone quality is insufficient to adequately anchor the primary stems (typically as a result of mid-humeral fractures) 8x175mm, 8x215mm, 10x200mm, 12x200mm FA 13 131 1276 4063 264382 3800 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DE302 BioComposite Corkscrew Suture Anchor Suture Anchor >4mm-6.5mm DE 13 123 1774 5387 AB 164048 Changed Product description, Product sizes 501 0 0 Update 2010-02-01 2019-03-01 Prosthesis DE304 BioComposite SutureTak Suture Anchor 2.4-3mm DE 13 123 1774 5385 AB 164047 501 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DE306 BioComposite SwiveLock The SwiveLock is a 4.75 or 5.5mm twist-in knotless anchor. This anchor functions very similar to the PushLock but with a twist-in design. This anchor is available with a b-TCP and PLLA anchor body and PEEK eyelet. 4.75mm - 5.5mm DE 13 123 1774 5387 AB 164046 501 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DE309 ENGlpore Granules (size 1,0-2,5 mm) 15 cc Granules (size 2,5-4,0 mm) 15 cc Granules (size 1,0-2,5 mm) 15 cc Granules (size 2,5-4,0 mm) 15 cc DE 13 123 1241 4094 152231 1425 0 0 No Change 2011-08-01 2019-03-01 Prosthesis DE310 SINTlife Nanostructured Paste/putty in syringe 0-5 cc DE 13 123 1241 4092 296945 185277 722 0 0 No Change 2011-08-01 2019-03-01 Prosthesis DU007 Perla Posterior Cervico-Thoracic Fixation System - Rod Straight rods, pre-bent rods - Titanium or cobalt chromium Diameter: 3.5mm Length: 20mm, 25mm, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm, 65mm, 70mm, 75mm, 80mm, 85mm, 90mm, 100mm, 110mm, 120mm, 240mm, 350mm DU 19 170 1478 198720 Changed Benefit 426 0 0 Update 2017-02-01 2019-03-01 Prosthesis DU008 Perla Posterior Cervico-Thoracic Fixation System - Transition Rod Transition rods - Titanium or cobalt chromium Diameter: from 5.4 to 3.5mm Length: 300mm, 600mm DU 19 170 1478 Dual Diameter 198720 Changed Benefit 529 0 0 Update 2017-02-01 2019-03-01 Prosthesis DU009 Juliet Ti TL, Juliet Ti OL Titanium lumbar cage TL - Length: 30mm or 34mm Height: 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm or 16mm Width: 10.5mm Lordosis: 6º OL - Length: 28mm, 32mm or 36mm Height: 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm or 16 mm Width: 8mm, 8.5mm, 9mm or 10.5mm Lordosis: 6º or 12º DU 19 174 1486 4135 166194 3465 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DU006 Perla Posterior Cervico-Thoracic Fixation System - Hook Straight hooks, offset hooks (left/right) One size only DU 19 168 1475 198720 789 0 0 No Change 2017-02-01 2019-03-01 Prosthesis EX052 All Polyethylene cemented acetabular component The All Polyethylene cemented acetabular components are indicated for use in skeletally mature individuals undergoing primary surgery for total hip replacement due to osteoarthritis, rheumatoid arthritis, osteonecrosis, ankylosing spondylitis, congential hip dysplasia, post-traumatic degenerative problems of the hip, and for treatment of proximal femoral fractures where prosthetic replacement is determined by the surgeon as the preferred treatment. 22mm ID: 44mm OD, 46mm OD, 48mm OD, 50mm OD, 52mm OD, 54mm OD 28mmID: 48mmOD, 50mmOD, 52mmOD, 54mm OD, 56mm OD, 58mm OD, 60mm OD 32mm ID: 52mm OD, 54mmOD, 56mm OD, 58mm OD, 60mm OD FA 18 163 1425 4006 159572 659 0 0 No Change 2010-02-01 2019-03-01 Prosthesis EX055 Equinoxe Humeral Stem, Fracture The fracture stem is intended for cemented fixation only and is advised for 3 & 4 part fractures of the proximal humerus Fracture: left: 6.5mm - 12.5mm, right 6.5mm- 12.5mm Long stem fracture: left 6.5mmx200mm right 6.5mmx200mm FA 13 131 1276 4057 293561 293562 Changed Benefit 3771 0 0 Update 2010-02-01 2019-03-01 Prosthesis EX058 Equinoxe Humeral Head The humeral head is used in hemi-shoulder and total-shoulder joint replacement procedures and for use in fractures of the proximal humerus and for use in total-shoulder joint replacement procedures in conjunction with an irreparable or nonfunctional rotator cuff. Multiple head heights for each diameter provides surgeon flexibility in patients with soft tissue challenges 38mm - 53mm FA 13 131 1276 4067 265513 1261 0 0 No Change 2010-02-01 2019-03-01 Prosthesis EX060 Equinoxe Glenoid, keeled UHMWPE component used to replace the Glenoid during total shoulder arthroplasty. This component is to be used with the Equinoxe total shoulder replacement small, medium, large FA 13 131 1277 3701 159609 1895 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DE311 SINTlife Nanostructured Paste/putty in syringe - 10 cc 10 cc DE 13 123 1241 4093 152261 1140 0 0 No Change 2011-08-01 2019-03-01 Prosthesis DE312 ENGlpore Granules (size 1,0-2, 5 mm) 5 cc Granules (size 2, 5-4, 0 mm) 5 cc Granules (size 1,0-2, 5 mm) 5 cc Granules (size 2, 5-4, 0 mm) 5 cc DE 13 123 1241 4092 152261 722 0 0 No Change 2011-08-01 2019-03-01 Prosthesis DE342 PEEKPower HTO Plate Medial High Tibial Osteotomy Implant Device System One Universal Size DE 13 123 1694 5256 140710 Changed Benefit 674 0 0 Update 2012-02-01 2019-03-01 Prosthesis DE343 PEEKPower HTO Plate Medial High Tibial Osteotomy Implant Device System 5.0mm DE 13 123 1231 3369 LK 140710 128 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DE344 iBalance HTO System PEEK Screws for iBalance HTO Implant 4.5mm Cortical and 6.5mm Cancellous DE 13 123 1231 3369 LK 140686 128 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DE345 iBalance HTO System Medial High Tibial Osteotomy Implant Device System Small (6mm, 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm) Medium (5mm, 6mm, 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm) Large (5mm, 6mm, 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm) DE 13 123 1772 5457 140686 1513 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DU011 Scarlet AC-T Cervical Cage Cervical cage - anatomical, lordotic Height: 5mm, 6mm, 7mm, 8mm, 9mm, 10mm Footprint: 12 x 15mm (Small); 14 x 17mm (Large) DU 19 174 1485 5485 166194 Changed Benefit 4379 0 0 Update 2017-02-01 2019-03-01 Prosthesis DU012 Scarlet AC-T Screw, Reduction Screw Screw, reduction screw Diameter: 3mm, 3.5mm Length: 12mm, 14mm, 16mm, 18mm DU 19 165 1464 166154 Changed Benefit 193 0 0 Update 2017-02-01 2019-03-01 Prosthesis DU013 Tryptik 2 Anterior Cervical Plate Anterior cervical plate Length: 20mm, 22mm, 24mm, 26mm, 28mm, 30mm, 32mm, 34mm, 36mm, 38mm, 40mm, 43mm, 46mm, 49mm, 52mm DU 19 169 1476 4125 166151 Changed Benefit 1348 0 0 Update 2017-02-01 2019-03-01 Prosthesis DU010 Juliet Ti PO Titanium lumbar cage Length: 24mm Height: 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm or 16mm Width: 8mm, 8.5mm, 9mm or 10.5mm Lordosis: 6º or 12º DU 19 174 1486 4135 Paired 166194 Changed Benefit 2888 0 0 Update 2017-02-01 2019-03-01 Prosthesis DU014 Tryptik 2 Anterior Cervical Plate Anterior cervical plate Length: 55mm, 58mm, 61mm, 64mm, 68mm, 72mm, 76mm, 80mm, 84mm, 88mm, 92mm DU 19 169 1476 4125 >55mm 166151 1636 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DU015 Tryptik 2 Screw Self-tapping screws, self-drilling screws - variable and fixed angle Diameter: 4.0mm, 4.5mm Length: 12mm, 14mm, 16mm, 18mm DU 19 165 1464 166154 Changed Benefit 193 0 0 Update 2017-02-01 2019-03-01 Prosthesis EX062 Equinoxe Reverse Torque Definition Screw Kit Reverse Torque Definition Screw with Drive One size only FA 13 131 1278 5428 252473 1159 0 0 No Change 2010-08-01 2019-03-01 Prosthesis EX064 Equinoxe Reverse Shoulder, Fracture Humeral Adapter Tray. Reverse, fracture humeral adapter tray. +0mm, +5mm, +10mm, +15mm FA 13 131 1278 4086 244994 829 0 0 No Change 2010-08-01 2019-03-01 Prosthesis EX065 Equinoxe Torque Definition Screw Kit. Torque Definition Screw with Drive. One size only. FA 13 131 1278 5428 252473 1159 0 0 No Change 2010-08-01 2019-03-01 Prosthesis EX066 Optetrak Total Knee System CCK (Constrained Condylar Knee) Femoral Component Femoral Component, cemented, CoCr, totally stabilised Size 1 - 6 FA 17 149 1348 3908 Revision 277741 Changed Product name 5590 0 0 Update 2015-02-01 2019-03-01 Prosthesis EY001 Reform Polyaxial Screw Polyaxial Screw Diameter 4.5mm to 10.5mm Length 25mm to 120mm EY 19 165 1463 287905 1280 0 0 No Change 2017-08-01 2019-03-01 Prosthesis EY002 Reform Tulip Head Tulip Head 12.5mm/17mm EY 19 166 1469 287905 Changed Benefit 732 0 0 Update 2017-08-01 2019-03-01 Prosthesis EY003 Reform Locking Cap Locking Cap 3.5mm to 5.5mm EY 19 166 1465 287905 164 0 0 No Change 2017-08-01 2019-03-01 Prosthesis EX061 Equinoxe Glenoid, pegged UHMWPE component used to replace the Glenoid during total shoulder arthroplasty. This component is to be used with the Equinoxe total shoulder replacement small, medium, large, X-Large FA 13 131 1277 3701 264381 270232 278648 293762 1895 0 0 No Change 2010-02-01 2019-03-01 Prosthesis EY006 Reform Hooks Hooks and Reduction Hooks Various EY 19 168 1475 287905 789 0 0 No Change 2017-08-01 2019-03-01 Prosthesis EY007 Reform Crosslinks Crosslinks Adjustable Length 20mm to 100mm EY 19 167 1474 4124 287905 Changed Benefit 1299 0 0 Update 2017-08-01 2019-03-01 Prosthesis EY004 Reform Rods Straight and Lordotic Curved Rods Length 20mm to 600mm EY 19 170 1478 287905 Changed Benefit 426 0 0 Update 2017-08-01 2019-03-01 Prosthesis EY005 Reform Dominoes Dominoes - Axial and Parallel Diameter 3.5mm to 6.0mm EY 19 167 1472 287905 Changed Benefit 732 0 0 Update 2017-08-01 2019-03-01 Prosthesis EY008 Reform Modular Polyaxial Screws Module Polyaxial Screws Diameter 4.5mm to 10.5mm Length 25mm to 120mm EY 19 165 1463 Shank 287905 640 0 0 No Change 2017-08-01 2019-03-01 Prosthesis EY009 Reform POCT Polyaxial Screw Polyaxial Screw Length 8mm to 50mm EY 19 165 1463 287906 1280 0 0 No Change 2017-08-01 2019-03-01 Prosthesis EY010 Reform POCT Rod Rod - Straight and Curved Length 20mm to 350mm EY 19 170 1478 287906 Changed Benefit 426 0 0 Update 2017-08-01 2019-03-01 Prosthesis EY012 Reform POCT Cap Screw Cap Screw One size only EY 19 166 1465 287906 164 0 0 No Change 2017-08-01 2019-03-01 Prosthesis EY011 Reform POCT Cross Connector Cross Connector Diameter 3.5mm EY 19 167 1474 4124 287906 Changed Benefit 1299 0 0 Update 2017-08-01 2019-03-01 Prosthesis BQ008 ProTrach DualCare Speaking Valve ProTrach DualCare System is attached to a tracheostomy tube and is designed to eliminate the necessity of finger occlusion, enabling the tracheostomised patient to speak easily and more clearly. It combines a speaking valve with a HME and in this way enabling speaking and supporing your lungs with important heating and moisturising. The Set includes: 1pc Speaking Valve, 1pc ProTrach HME DigiTop, 1 Removal Aid and 1 connection strap.ProTrach DualCare Speaking Valve, 1 HME DigiTop, 1 removal aid and 1pc Connection Strap 15mm 22mm BQ 22 198 1569 275618 97 0 0 No Change 2017-02-01 2019-03-01 Prosthesis BQ010 Tracheal Speaking Valve Provox a) Two b) Vega c) Vega Puncture Set a) 4.5, 6, 8, 10, 12.5, 15mm b) 17, 20, 22.5fr in 4, 6, 8, 10, 12.5, 15mm c) 17, 20, 22.5fr in 4, 6, 8, 10, 12.5, 15mm BQ 22 198 1569 120197 236026 97 0 0 No Change 2018-02-01 2019-03-01 Prosthesis BR001 OPRA System Central screw - titanium One size only BR 13 123 1778 5404 145488 1767 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BR002 OPRA System Healing cylinder - titanium One size only BR 13 123 1778 5405 145488 Changed Benefit 2993 0 0 Update 2005-10-31 2019-03-01 Prosthesis BR003 OPRA System Healing screw - titanium One size only BR 13 123 1778 5406 145488 2337 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BR004 OPRA System Fixture Biohelix 15 - 80mm BR 13 123 1778 5407 145488 35055 0 0 No Change 2005-10-31 2019-03-01 Prosthesis IT024 Frame It Partial Ring Partial circular ring 2/3 rings and half rings Diameter 80mm-220mm IT 13 123 1237 3406 282764 1050 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IT025 Frame It Coupling Coupling devices; Posts, Basic Struts, Plates, Hinges and Extenders Ranging from 1-12 holes IT 13 123 1237 3757 282764 342 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IT026 Frame It Struts Complex 3D Strut Standard IT 13 123 1237 4505 3D 282764 1235 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IT027 Frame It Foot Plate Foot plate Diameter 80mm-220mm IT 13 123 1237 4506 282764 2850 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IT028 Frame It Nuts & Bolts Nuts, Bolts and spacers standard IT 13 123 1237 4507 282764 45 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IT029 Frame It Rods Threaded Rods 6mm Diameter Lengths from 80mm-200mm IT 13 123 1237 4509 Standard 282764 147 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IT030 Frame It Wires - Olives Wires with stopper Diameter 1mm-3mm Length 120mm-250mm IT 13 123 1772 5365 OL 282764 Changed Benefit 121 0 0 Update 2018-08-01 2019-03-01 Prosthesis IT031 Integrant 6.5mm Screws 6.5mm diameter screws with variable pitch/dynamic thread 6.5mm diameter, 45mm-120mm length IT 13 123 1231 3369 CN,DT 230954 362 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IT032 Integrant 4.0mm Cannulated Screws Cannulated screws with variable pitch/dynamic thread screw heads 4.0mm Diameter with lenghts from 26mm-70mm IT 13 123 1231 3370 CN,DT 230954 379 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IT033 IT016 Anchor It 5mm Fully threaded suture anchor with fibrewire suture 5mm IT 13 123 1774 5387 271554 Changed Benefit 442 0 0 Update 2018-08-01 2019-03-01 Prosthesis IT034 IT016 Anchor It Fully threaded Titanium suture anchor with fibrewire suture 2.5mm - 3.5mm IT 13 123 1774 5385 271554 Changed Benefit 442 0 0 Update 2018-08-01 2019-03-01 Prosthesis 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 IZ 24 211 1642 184695 184696 184697 184698 184699 184700 185255 2231 0 0 No Change 2013-08-01 2019-03-01 Prosthesis IZ002 EOS Endoluminal Occlusion System EOS is made of self-expandable Nitinol flat wire, serving as a supportive scaffold with significant radial strength, covered by impermeable ePTFE membrane for achievement of immediate occlusion of a peripheral vessel. This implant is pre-loaded on a delivery catheter with 2 deployment handles. This System will be inserted through a standard guide catheter (not included) up to the targeted segment. 3 to 5 mm of vessel diameter (6.1 mm diameter unconstrained) 4.5 to 8 mm of vessel diameter (9.1 mm diameter unconstrained) 7.5 to 11 mm of vessel diameter (12.2 mm diameter unconstrained) IZ 24 213 1648 229075 1805 0 0 No Change 2017-08-01 2019-03-01 Prosthesis JA002 uDesis™ Gel 10cc uDesis™ is a synthetic, highly crystalline beta-tricalcium phosphate bone substitute. 10cc JA 13 123 1241 4093 283845 1140 0 0 No Change 2018-02-01 2019-03-01 Prosthesis JA003 uDesis Gel 1cc-5cc uDesis™ is a synthetic, highly crystalline beta-tricalcium phosphate bone substitute. 1cc, 2.5cc, 5cc JA 13 123 1241 4092 283845 722 0 0 No Change 2018-02-01 2019-03-01 Prosthesis JA004 OH543 C7 Cervical Cage Cervical Cage H 3-16mm L 12-16mm W 12-16mm JA 19 174 1486 4134 289247 2409 0 0 No Change 2018-08-01 2019-03-01 Prosthesis JA005 OH536 Dynamic Cage PLIF/TLIF Spinal Cage Angle 0° - 12° Height 7-16mm Length 22-32mm Width 8-11mm JA 19 174 1486 4135 Paired 289247 Changed Benefit 2888 0 0 Update 2018-08-01 2019-03-01 Prosthesis MC595 Mastergraft Calcium Phosphate Ceramic Granules 10cc Vial MC 13 123 1241 4093 96971 1140 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC596 Mastergraft Calcium Phosphate Ceramic Granules 15cc Vial MC 13 123 1241 4094 96971 1425 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC597 Mastergraft Calcium Phosphate Ceramic Granules 30cc Vial MC 13 123 1241 4095 96971 1482 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC602 Union Verte-Stack 8 - 20mm MC 19 174 1486 4135 169501 3465 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC603 Union Verte-Stack 8 - 20mm MC 19 176 1493 169501 4235 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC606 Union Verte-Stack Centre Piece 5-40mm MC 19 176 1493 169501 4235 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC608 TSRH Connector Small, Medium, Large MC 19 166 1469 169514 Changed Benefit 732 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC609 CD Horizon Spinal System Percutaneous Set Screw 4.5 to 6.35mm dia MC 19 166 1465 169514 164 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC610 Vantage Vantage plates and Screws; Thoracic Plate 3.5 - 8cm MC 19 169 1476 4126 169514 Changed Benefit 2118 0 0 Update 2006-03-24 2019-03-01 Prosthesis LB060 REVLOK Fenestrated Screw System Screw Fenestrated Screw 5.5mm -10.5mm x 30mm -120mm LB 19 165 1463 Cannulated 196054 1338 0 0 No Change 2013-02-01 2019-03-01 Prosthesis LB061 REVLOK Fenestrated Screw System Locking Cap Locking Cap One Size LB 19 166 1468 196054 Changed Benefit, Group 582 0 0 Update 2013-02-01 2019-03-01 Prosthesis LB062 SI-LOK Stabilization System Fusion Screw 8.0-12.0mm diameter x 25-60mm length LB 19 261 1821 no suffix 199414 1925 0 0 No Change 2013-02-01 2019-03-01 Prosthesis LB065 COALITION Spacer ACDF Spacer 12mm x 14mm, 14mm x 16mm and 15mm x 18mm ,5mm - 12mm height LB 19 174 1485 5485 190040 Changed Benefit 4379 0 0 Update 2013-08-01 2019-03-01 Prosthesis LB066 XP and R Corpectomy Spacer System Expandable Corpectomy spacer Small, Medium,15-88mm in varying lordotic/kyphotic angles LB 19 176 1492 4137 Cervical 190055 2984 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LB067 BEACON™ Stabilization System Clamp Clamp 5.5mm and 6.35mm small, medium, large LB 19 166 1469 219169 Changed Benefit 732 0 0 Update 2014-02-01 2019-03-01 Prosthesis LB068 BEACON™ Stabilizer System Connector Connector 5.5mm and 6.35mm small, medium, large, offset LB 19 166 1469 219169 Changed Benefit 732 0 0 Update 2014-02-01 2019-03-01 Prosthesis LI108 HACTIV Uncemented Stem Titanium, gritblast, HA coated, collared, collarless and high offset Sizes 7 to 20 LI 18 161 1407 3949 232289 3779 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LI109 Eclipse BCP Screw Absorbable, osteoconducting interference screw Diameter 7mm to 10mm Length 20mm to 30mm LI 13 123 1774 5391 AB 284239 457 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LI110 Comete Anchor ACL Femoral Cortical Fixation Length 15mm to 40mm LI 13 123 1774 5389 285471 374 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LI111 Anatomic Cemented Femur Cemented Posterior Stabilised Femoral Component 1 to 7 LI 17 149 1348 3907 222529 3041 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LI112 Anatomic Cemented Tibial Baseplate Cemented fixed bearing tibial baseplate Size 1 to 7 LI 17 151 1357 222531 1923 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LI113 Anatomic Fixed Bearing Insert Posterior stabilised, fixed bearing polyethylene insert Size 1 to 7 Heights 10 to 20 LI 17 153 1370 222532 Changed Benefit 1073 0 0 Update 2018-08-01 2019-03-01 Prosthesis LB040 XTEND Anterior Cervical Extender Plate Anterior Cervical Extender Plate 10mm - 46mm LB 19 169 1476 4125 190070 Changed Benefit 1348 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB041 XTEND Variable Angled Screws Variable Angled Bone Screws 4.2, 4.6 and 5.1mm diameter x 10mm - 20mm length LB 19 165 1464 190070 Changed Benefit 193 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB042 XTEND Fixed Angled Screws Fixed Angled Bone Screws 4.2, 4.6 and 5.1mm diameter x 10mm - 20mm length LB 19 165 1464 190070 Changed Benefit 193 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB043 ELLIPSE Stabilization System, Polyaxial Screw Polyaxial Bone Screw 3.5mm - 4.5mm diameter 8mm x 50mm length LB 19 165 1463 190061 1280 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LB045 ELLIPSE Stabilization System, Tapered Rod Dual Diameter Rod 3.5mm ti 4.0mm - 6.5mm x 350mm - 500mm length LB 19 170 1478 Dual Diameter 190061 Changed Benefit 529 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB046 ELLIPSE Stabilization System, Rod Rod 3.5mm Diameter x 40mm - 240mm LB 19 170 1478 190061 Changed Benefit 426 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB069 BEACON™ Stabilization System Posted Screw Posted Screw and Reduction Screw 4.5mm - 9.5mm diameter 25mm - 90mm length LB 19 165 1463 Shank 219169 640 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LB070 SUSTAIN spacer PLIF cage 8mm-17mm height, 8mm-12mm width, 22mm length LB 19 174 1486 4135 Paired 191531 Changed Benefit 2888 0 0 Update 2014-02-01 2019-03-01 Prosthesis LB071 SUSTAIN Spacer TLIF Cage 8mm-17mm height, 8mm-12mm width, 26-30mm length LB 19 174 1486 4135 191534 3465 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LB072 ELLIPSE Stabilization System Parallel Connector Connector 3.5mm to 4.0 - 6.5mm Rod LB 19 167 1473 190061 Changed Benefit 732 0 0 Update 2014-02-01 2019-03-01 Prosthesis LB073 ELLIPSE Stabilization System In-line Connector Connector 3.5mm - 6.35mm LB 19 167 1472 190061 Changed Benefit 732 0 0 Update 2014-02-01 2019-03-01 Prosthesis LB074 ELLIPSE® Stabilization System Lateral Connector Connector Std, Short, medium, long LB 19 167 1473 190061 Changed Benefit 732 0 0 Update 2014-02-01 2019-03-01 Prosthesis LB075 ELLIPSE® Stabilization System Lateral Connector Connector 3.5mm to 10.0mm - 3.5mm - 6.5mm Rod LB 19 167 1472 190061 Changed Benefit 732 0 0 Update 2014-02-01 2019-03-01 Prosthesis LB076 REVERE Rods Rod, precurved and straight 30mm-600mm in 4.5mm 5.5mm and 6.35mm diameter LB 19 170 1478 190039 Changed Benefit 426 0 0 Update 2014-02-01 2019-03-01 Prosthesis LI093 C2 Cancellous Screws titanium, Cancellous Screws 15mm - 50mm LI 18 164 1435 260435 121 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LI094 F2 Femoral Head Femoral Heads, CoCr Diameter 32mm, -4, 0, +4, +8 LI 18 162 1419 3989 226929 703 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LI095 CL2 Cementless Femoral Stem Titanium, grit plast full HA coating 8 - 18 LI 18 161 1407 3949 228604 3779 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LI096 F2 Large Femoral Head Femoral heads, CoCr Diameter 36mm, -4, 0, +4, +8 LI 18 162 1420 3995 226929 835 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LI097 C2 XL2 Polyethylene Liner XL2 Polyethylene Liner 32-48mm, 32-50mm, 32-52mm, 32-54mm, 32-56mm, 32-58mm, 32-60mm, 32-62mm, 32-64mm, 32-66mm, 36-68mm, 36-52mm, 36-54mm, 36-56mm, 36-58mm, 36-60mm, 36-62mm, 36-64mm, 36-66mm, 36-68mm. LI 18 163 1428 4021 229459 1019 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LI098 DC2 Femoral Head Delta Ceramic Femroal Heads Diameter 28mm, 32mm, S, M, L, XL LI 18 162 1419 3992 227160 1845 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM001 TriMed Wrist Fixation System Washer One size LM 13 123 1772 5369 182677 111 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LM005 TriMed Fixation Systems Multiple stainless steel wire forms various sizes LM 13 123 1772 5370 182677 447 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LM014 Trimed Marked K-Wire Stainless Steel Diameter 0.9 - 1.1mm LM 13 123 1772 5365 182677 27 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LM030 Synovis Coupler High Density polyethylene (ring); Stainless Steel (pins) Diameter 1-4mm LM 23 203 1608 95596 609 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LM033 Trimed Wrist Fixation System, Volar Peg Plate Stainless Steel Volar Peg Plate 3-hole, Right & Left, 4 and 5 Peg; Volar Peg Plate 5-hole, Right & Left, 4 and 5 Peg LM 13 123 1694 5276 182677 869 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LM041 Trimed Bearing Plate, Fixation Pegs Bearing plate fixation pegs 2.3mm LM 13 123 1231 4521 182677 126 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LM042 Microclip Malleable titanium clip 1.5-2.5mm x 2-3.5mm LM 21 194 1581 4256 279904 11 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LM052 Ascension Compression Screw Titanium Compression Screw 2-5mm diameter ; 12 - 40mm length LM 13 123 1231 3370 CN,DT 118626 379 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LM053 Osteotec Silicone PIP Joint Replacement 2 component hinged joint replacement for the proximal interphalangeal joint 5 - 50 LM 13 131 1274 6146 Total 118424 1330 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LM057 Ascension Radial Head Locking Plate and Screws Titanium pre-formed anatomical radial head plate small and large LM 13 123 1694 5277 VAL 118638 1439 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LM061 Xpode Screws Xpode screws 2.4mm LM 13 123 1231 3371 LK 182677 147 0 0 No Change 2006-03-24 2019-03-01 Prosthesis LM066 TriMed Olecranon Sled Washer one size LM 13 123 1694 5255 182677 Changed Benefit 542 0 0 Update 2006-11-30 2019-03-01 Prosthesis LM070 Ligament Augmentation Reconstruction System Woven Polyester Prosthetic Ligament Various LM 13 123 1776 5398 135600 4217 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MC547 Macropore Z Plates 10 hole MC 23 199 1589 4277 Resorbable 153968 153969 153970 210 0 0 No Change 2006-03-24 2019-03-01 Prosthesis LI099 C2 Acetabular Shell titanium Cup with sintered titanium coating 48 - 68mm LI 18 163 1426 4014 227893 2944 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LI100 E2 Cemented Stem Cemented Femoral Stems size 0 - 4 LI 18 161 1404 3941 228276 1845 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LI101 DC2 Large Femoral Head Delta Ceramic Femoral Heads Diameter 36mm, 40mm, 44mm, S, M, L, XL LI 18 162 1420 3998 227160 2022 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LI102 C2 Hole Eliminator Titanium Screw Hole Plug 6.3 x 3.2mm, 11.3 x 4.2mm LI 18 164 1441 260435 141 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LI103 P2 Cemented Cup Cemented Acetabular Cup Size 49 - 61 LI 18 163 1425 4007 227894 Changed Benefit 823 0 0 Update 2016-02-01 2019-03-01 Prosthesis LI104 Austofix Ceramic System Biolox ceramic femoral head 36mm LI 18 162 1420 3996 158179 1806 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LI105 U2 Taper Sleeve Taper Sleeve, Unipolar -4, 0, +4, +8 LI 18 164 1442 158179 457 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LI106 Hyperion Cobalt Chrome Femoral Head Cobalt Chrome, 12/14 Taper Sizes 22, 28 and 32 mm LI 18 162 1419 3989 158179 703 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LI107 Austofix Ceramic System Biolox Ceramic Femoral Head 28 and 32 mm LI 18 162 1419 3990 158179 Changed Benefit 1758 0 0 Update 2016-08-01 2019-03-01 Prosthesis MC548 Macropore Cranial Recon 29 - 165mm MC 23 200 1593 153968 153969 153970 469 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC550 Macropore Rectangle Plates 4-8 hole MC 23 199 1589 4271 Resorbable 153968 153969 153970 195 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC551 Macropore Protective Disc 25mm MC 23 199 1586 4219 153968 153969 153970 161 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC553 Macropore Oblong Plates 6 - 8 hole MC 23 199 1589 4271 Resorbable 153968 153969 153970 195 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC554 Macropore CraniDisk 23 - 28mm MC 23 199 1586 4219 153968 153969 153970 161 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC559 Macropore L Plates 8 hole, Left & Right MC 23 199 1589 4277 Resorbable 153968 153969 153970 210 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC560 Macropore Protective Sheets 60 x 80 x 0.5mm - 60 x 80 x 0.8mm MC 23 199 1586 4227 153968 153969 153970 1199 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC562 Macropore Y Plates 7 hole MC 23 199 1589 4271 Resorbable 153968 153969 153970 195 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC563 Macropore Straight Plates 4 hole MC 23 199 1589 4271 Resorbable 153968 153969 153970 195 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC566 Macropore C Plates 8 hole MC 23 199 1589 4293 Resorbable 153968 153969 153970 Changed Benefit 409 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC567 Macropore Clover Leaf Plates 4 hole MC 23 199 1589 4288 Resorbable 153968 153969 153970 Changed Benefit 253 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC568 Macropore Bur Hole Cover 25mm MC 23 199 1586 4219 153968 153969 153970 161 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC570 Macropore Tacks 1.5 x 4mm - 2.0 x 6mm MC 23 199 1591 4333 155385 51 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC571 Timesh 12 Point Screws 3 - 20mm MC 23 199 1590 4323 128524 42 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC574 Timesh X-Drive Screws 2 - 15mm MC 23 199 1590 4321 128524 Changed Benefit 68 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC576 Timesh Double Y Plates 3 Hole - 2.5mm - 7mm MC 23 199 1589 4271 128523 166 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC577 R90 Spacer Spinal Implant (Peek) Height 7 - 16mm Lordosis 6 - 18 degrees MC 19 174 1486 4135 Paired 126313 Changed Benefit 2888 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC580 Macropore Locks 2 - 20mm MC 23 199 1591 4339 155385 Changed Benefit 683 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC584 CSF - Distal Catheters Non metallic and latex free, Models 43418,43103,43111,43209,43522,43551,27211 Distal cardiac/peritoneal catheters ID 1.3mm OD 2.5mm Length 90cm, 96cm, 110cm, 120cm, ID 1.2mm, OD 2.1mm, Length 90cm, 75cm, 58cm MC 25 220 1668 Distal 140357 176 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC585 Maverick Artificial Disc Cobalt Chrome 8mm - 14mm MC 19 175 1488 5488 126312 9192 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC586 CD Horizon Sextant Percutaneous Cannulated Multi Axial Screw Cannulated titanium percutaneous multi axial screw Dia 3.5 to 9.5mm, Length 15 to 65mm MC 19 165 1463 Cannulated 169514 1338 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC587 CD Horizon Spinal System Percutaneous Rod 20mm to 600mm MC 19 170 1478 169514 Changed Benefit 426 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC589 Affinity Anterior cervical cage System The Affinity Cage is constructed of titanium alloy - kit includes trials, reamers and inserters. 6mm to 14mm MC 19 174 1486 4134 99682 2409 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC590 Vertex Reconstruction System Crosslink/Bar Extra small to large MC 19 167 1474 4124 169514 Changed Benefit 1299 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC591 Vertex Reconstructive System Laminar Hook Composition - titanium alloy 4.5 - 6.0mm MC 19 168 1475 169514 789 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC592 CD Horizon System SMA Staple Length 4-10mm MC 19 172 1483 Complex 108421 Changed Benefit 1193 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC593 CD Horizon System SMA Staple Length 12-18mm MC 19 172 1483 Complex 108421 Changed Benefit 1193 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC594 Mastergraft Calcium Phosphate Ceramic Granules 5cc Vial MC 13 123 1241 4092 96971 722 0 0 No Change 2006-03-24 2019-03-01 Prosthesis LB048 ELLIPSE Stabilization System, Locking Cap Locking Cap One Size LB 19 166 1468 190061 Changed Benefit, Group 582 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB049 ELLIPSE® Stabilization System Hooks Hooks 5 - 7mm LB 19 168 1475 190061 789 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LB050 ELLIPSE® Stabilization System Occipital Plate Occipital Plate Small to Large LB 19 169 1477 4129 190061 Changed Benefit 2166 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB051 ELLIPSE Occipito Cervico Thoracic Stabilization System T-Connector and Locking Nut 21mm - 63mm LB 19 167 1474 4123 190061 404 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LB052 ELLIPSE® Stabilization System Occipital Screw Bone Screw 4.0mm to 4.5mm Diameter x 6mm - 16mm Length LB 19 165 1464 190061 Changed Benefit 193 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB053 CORRIDOR Fixation System Screw Cannulated Screws Bone Screws 3.5mm - 4.5 diameter. 3 0mm - 60mm length LB 19 165 1464 Cannulated 190041 202 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LB054 CORRIDOR Fixation System Screw Non Cannulated Screws Bone Screws 3.5mm - 4.5mm diameter, 30mm - 60mm Length LB 19 165 1464 190041 Changed Benefit 193 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB055 Xpand Corpectomy Spacer System Expandable corpectomy spacer small, Medium, Large. 15-120mm in varying lordotic/kyphotic angles LB 19 176 1492 4137 ThoracoLumbar 190055 4139 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LB056 REVERE ADDITION In-line Rod Connectors with Integral Rod IN-line Connector with integral rod 5.5mm-6.5mm 160-200mm length LB 19 167 1472 190039 Changed Benefit 732 0 0 Update 2012-02-01 2019-03-01 Prosthesis LB057 ELLIPSE Stabilization System, Top Loading T-Connector T-Connector 21mm - 56mm LB 19 167 1474 4124 190061 Changed Benefit 1299 0 0 Update 2012-08-01 2019-03-01 Prosthesis LB058 ZYFUSE Facet Fixation System Screw with washer Facet Screw 5.0 - 6.0mm diameter x 30 - 60mm length LB 19 165 1464 Cannulated 196053 202 0 0 No Change 2013-02-01 2019-03-01 Prosthesis LB059 ZYFUSE Facet Fixation System Screw Facet Screw 5.0 - 6.0mm diameter x 30 - 60mm length LB 19 165 1464 Cannulated 196053 202 0 0 No Change 2013-02-01 2019-03-01 Prosthesis IT014 Superior Fusion Plate System - Plate Anatomically contoured 6 hole plate and screw set with locking screw hole option, for anterior fixation of ankle joint. Used for Primary, Revision and Pantalar fusions. The fixation plate is 77mm in length, 22mm in width and 23mm in depth. 6 hole plate IT 13 123 1694 5255 Com, LK 177278 1178 0 0 No Change 2016-02-01 2019-03-01 Prosthesis IT015 Superior Fusion Plate System - Locking screws 4.5mm locking screw set with lengths ranging from 35mm to 110mm.Locking screws to hold and aid an anatomical contoured locking plate used for primary, revision and pantalar anterior ankle fusions. 4.5mm in diameter with lengths of 35mm,37mm, 39mm, 41mm, 43mm, 45mm, 47mm, 49mm, 50mm, 55mm, 60mm, 65mm, 70mm, 75mm, 80mm, 85mm, 90mm, 95mm, 100mm, 105mm, 110mm each IT 13 123 1231 3369 LK 191738 128 0 0 No Change 2016-02-01 2019-03-01 Prosthesis IT017 Arch It Subtalar Arthroereisis Implant 8mm, 9mm, 10mm, 11mm & 12mm IT 13 124 1219 3261 266192 Changed Benefit 1321 0 0 Update 2016-02-01 2019-03-01 Prosthesis IT018 Fuse It Titanium alloy fusion cage - to use in situations such as anterior cervical fusion surgery 6mm x 1cm, 8mm x 1cm, 10mm x 1cm, 12mm x 1cm, 6mm x 1cm, 8mm x 2cm, 10mm x 2cm, 12mm x 2cm IT 19 174 1486 4134 235024 2409 0 0 No Change 2016-02-01 2019-03-01 Prosthesis IT019 Frame IT - Pre-assembled Frame Pre assembled Frame - used for the correction of deformities 120mm-180mm IT 13 123 1237 3401 282764 6175 0 0 No Change 2017-08-01 2019-03-01 Prosthesis IT020 Frame IT - Pins Fixation Pins used in conjunction with the external fixation frame to adjust the placement of frame to best suit individual patient 6mm IT 13 123 1237 4510 282833 142 0 0 No Change 2017-08-01 2019-03-01 Prosthesis IT021 Integrant Bone Graft Granules Osteo Conductive Bone Substitute, that promotes bone growth 0.5cc - 5.0cc IT 13 123 1241 4092 282832 722 0 0 No Change 2017-08-01 2019-03-01 Prosthesis IT022 Loop It Titanium or stainless steel fixation device with non-absorbable fibrewire suture material One Size Only IT 13 123 1774 5387 AB 297561 501 0 0 No Change 2018-08-01 2019-03-01 Prosthesis IT023 Frame It Full Ring Full Circular Ring Diameter 80mm-220mm IT 13 123 1237 3405 282764 685 0 0 No Change 2018-08-01 2019-03-01 Prosthesis BF021 SealFoam, High Density SealFoam is an absorbable Polysaccharide Haemostat 60mm x 40mm x 2mm 60mm x 40mm x 4mm 120mm x 25mm x 4mm (2/pack) BF 21 191 1797 194564 Changed Benefit 143 0 0 Update 2015-02-01 2019-03-01 Prosthesis BF022 Redmond Cervical Cage Stand-alone cervical interbody fusion cage with locking cap 14mm L x 15mm W; 5mm - 12mm H 15mm L x 15mm W; 5mm - 12mm H 15mm L x 17mm W; 5mm - 12mm H BF 19 174 1485 5485 211536 Changed Benefit 4379 0 0 Update 2016-08-01 2019-03-01 Prosthesis BF023 Redmond Screw Variable or constrained self-drilling/self-tapping/oversized screw Length: 12mm, 13mm, 14mm, 15mm, 16mm, 17mm, 18mm, 20mm Diameter: 4.0m (self-drilling and self-tapping); 4.5mm (oversized) BF 19 165 1464 211536 Changed Benefit 193 0 0 Update 2016-08-01 2019-03-01 Prosthesis BF024 NexStat The Topical Hemostatic powder consists of purified potato starch polysaccharide. These products are sterile packed and intended for single use. 3grams BF 21 191 1552 280607 143 0 0 No Change 2017-02-01 2019-03-01 Prosthesis BG001 BloodStop iX BloodStop iX is a new generation haemostat made from water soluble, oxidised-etherified regenerated cellulose 10x20cm, 5x35cm BG 21 191 1554 6010 Antimicrobial, Low Antigenicity 240712 36 0 0 No Change 2016-02-01 2019-03-01 Prosthesis DE365 QuickFix Screw, Small Titanium Snapp-off Small Bone Screw, small 3.0mm Diameter x 13-19mm Lengths DE 13 123 1231 3370 Breakoff 140686 302 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DE366 Low Profile Cancellous Bone Screws Low Profile Cancellous Bone Screws 4mm DE 13 123 1231 3370 LK 140686 145 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DE364 QuickFix Screw Micro Titanium Snap-off Small Bone Screw 2.0mm Diameter x 10-14mm lengths DE 13 123 1231 3372 Breakoff 140686 281 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DE367 Cancellous Bone Screws Cancellous Bone Screws 25-50mm x 6.5mm DE 13 123 1231 3369 98527 65 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DE368 Locking Cortical land Cancellous Screws, Small Locking Cortical and Cancellous Screws, Small 3-3.5mm DE 13 123 1231 3370 LK 284416 145 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MC611 Vantage Vantage Plates and Screws; Thoracic Screw 5.5-10.5 x 15-100mm MC 19 165 1464 169514 Changed Benefit 193 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC612 Vantage Vantage Plates and Screws; ATL Plate 4 - 10cm MC 19 169 1476 4126 169514 Changed Benefit 2118 0 0 Update 2006-03-24 2019-03-01 Prosthesis AS239 Symbotex Composite Mesh with pre placed suture Non-absorbable three-dimensional polyester composite mesh with pre placed sutures. (Non absorbable pre-placed sutures are tied to the mesh. A died marking is positioned on the center of the textile and helps center and orient the mesh.) Rectangular 20x15 cm Elliptical 25x15 cm, Elliptical 20x12 cm AS 21 194 1783 5439 Coated, Contoured 270737 759 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BG002 BloodStop iX BloodStop iX is a new generation haemostat made from water soluble, oxidised-etherified regenerated cellulose 1.3x5cm, 5x5cm, 5x10cm BG 21 191 1554 6008 Antimicrobial, Low Antigenicity 240712 Changed Benefit 20 0 0 Update 2016-02-01 2019-03-01 Prosthesis BH001 Lactosorb Resorbable Craniomaxillofacial Fixation System Lactosorb Plates, 1.5mm & 2mm System, All shapes PGA/PLA 4 - 7 hole BH 23 199 1589 4271 Resorbable 143958 195 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BH016 TMJ System Screw, Cross Drive, Fossa. Titanium 2.0mm dia x (5 - 13)mm BH 23 199 1590 4323 145265 42 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BH017 TMJ System Screw, Cross Drive, Fossa. Titanium 2.3mm Dia x (5 - 13)mm BH 23 199 1590 4323 145265 42 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BH018 W Lorenz Osteosynthesis System Sheet 1.5mm System. Titanium (203-206)mm x (123-127)mm x (0.2-0.3)mm BH 23 199 1585 4206 143959 Changed Benefit 1462 0 0 Update 2009-08-01 2019-03-01 Prosthesis BH019 W Lorenz Osteosynthesis System Sheet 1.5mm System. Titanium 206 x 123 x 0.6mm BH 23 199 1585 4210 143959 2187 0 0 No Change 2009-08-01 2019-03-01 Prosthesis DE369 Titanium Locking Cortical and Cancellous Screws, Large Titanium Locking Cortical and Cancellous Screws, Large 4.5-6.5mm DE 13 123 1231 3369 LK 140686 128 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DE370 Cannulated Low Profile Screws, Small Cannulated Low Profile Screws, Small 3-4mm DE 13 123 1231 3370 CN 140686 208 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DE371 Cannulated Titanium Low Profile Screws, Large Cannulated titanium Low Profile Screws, Large 4.5-6.7mm DE 13 123 1231 3369 CN 140686 191 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DE372 Low Profile MTP Plate Athrodesis Plate - 6 hole plates Contoured small left,contoured small right, contoured standard right,contoured standard left DE 13 123 1694 5258 LK 140686 470 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DE373 Low Profile MTP Plate Arthodesis Plate - 8 Hole plate 8 Hole plate DE 13 123 1694 5262 LK 140686 638 0 0 No Change 2012-02-01 2019-03-01 Prosthesis DE374 GraftBolt Interference Screw and Sheath 7mm, 8mm, 9mm and 10mm DE 13 123 1774 5391 98527 Changed Benefit 181 0 0 Update 2012-08-01 2019-03-01 Prosthesis BH021 W Lorenz Osteosynthesis System Bone Screw, Cross Drive or Centre Drive. Titanium 1.8mm dia x (3.5 - 17)mm BH 23 199 1590 4323 128459 42 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BH023 W Lorenz Osteosynthesis System Panel, Regular or Small Grid. Titanium (42-85) x (40-53)mm x 0.6mm BH 23 199 1585 4208 119508 497 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BH024 W Lorenz Osteosynthesis System Pre-contoured Neuro Mesh, titanium 163 x 115 x 0.3mm BH 23 199 1585 4205 Complex 119508 1443 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BS026 VortX and Pushable Coils Pushable coils Diameters up to 30mm and lengths up to 60mm BS 24 213 1646 5472 P (Platinum) 293646 129 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS028 GDC and PVA Delivery Catheters Microcatheter Delivery Systems Delivery system lengths up to 175cm BS 24 213 1693 5506 275748 630 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS034 Contour PVA Polyvinyl Alcohol (PVA) embolization particles spherical-shaped PVA Up to 1200 micron, volume up to 2ml. BS 24 213 1645 289243 184 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BH020 W Lorenz Osteosynthesis System Bone Screw, Cross Drive or Centre Drive. Titanium 1.5mm dia x (3.5 - 17)mm BH 23 199 1590 4323 143957 42 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BS035 WALLSTENT Endoprosthesis Biomedical superalloy, self expanding stent Stent Diameters up to 30mm and lengths up to 100mm BS 24 206 1622 4440 159294 1710 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DU026 Romeo 2 MIS Posterior Thoraco-lumbar Fixation System - Cannulated Polyaxial Screw Cannulated polyaxial pedicle screw, perforated cannulated polyaxial pedicle screw Cannulated Screw - Diameter: 5mm, 6mm, 7mm Length: 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm Perforated Cannulated Screw - Diameter: 5mm, 5.5mm, 6mm, 7mm, 8mm Length: 35mm, 40mm, 45mm, 50mm, 55mm, 60mm DU 19 165 1463 Cannulated 166153 1338 0 0 No Change 2017-02-01 2019-03-01 Prosthesis BS046 Ultraflex Oesophageal Stent; Ultraflex Oesophageal NG Stent Nitinol, self expanding stent Diameters up to 30mm & lengths up to 150mm BS 21 192 1558 4237 120176 2375 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS047 Ultraflex Tracheobronchial Stent Nitinol, self expanding stent Diameters up to 25mm & lengths up to 80mm BS 21 192 1563 149594 2850 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS051 Wallstent Biliary Stent Monofilament wire, self-expanding stent Diameters up to 10mm & lengths up to 100mm BS 21 192 1556 4234 136261 2114 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS052 Wallstent Biliary Stent Monofilament wire, self-expanding stent Diameters up to 10mm & lengths up to 100mm BS 21 192 1556 4235 136261 2874 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS053 Wallstent Enteral Stent Monofilament wire, self-expanding stent Diameters up to 30mm & lengths up to 150mm BS 21 192 1562 119517 3325 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS054 Flexima Biliary Stent Polyurethane Biliary Stent Diameters up to 12Fr & lengths up to 15cm BS 21 192 1556 4218 Delivery System 127387 190 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS055 RX Biliary Stent Polyurethane Biliary Stent Diameters up to 12Fr & lengths up to 15cm BS 21 192 1556 4218 Delivery System 127387 190 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AS240 Versatex™ monofilament macroporous polyester mesh Versatex™ Monofilament Mesh is a non-absorbable synthetic surgical mesh made out of a macroporous three-dimensional (3D) monofilament polyester knitted textile offered in rectangular and square flat sheet. The mesh is intended for the repair of abdominal wall hernias or other fascial deficiencies that require the addition of a reinforcing material. Largest sizes from 15 cm x 15 cm include a green dyed monofilament polyester (D&C Green No. 6) marking that is positioned in the center of the textile to help center and orient the mesh. Square 50x50 cm AS 21 194 1782 5947 237409 613 0 0 No Change 2016-08-01 2019-03-01 Prosthesis AS241 Symbotex Skirted Composite Mesh Non-absorbable three-dimensional polyester skirted composite mesh. On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera. A flap attached to the reinforcement helps place and fix the mesh. 8 cm Round, 15x10 cm Rectangle AS 21 194 1783 5438 Coated, Contoured 270736 Changed Benefit 428 0 0 Update 2016-08-01 2019-03-01 Prosthesis BS056 Carotid WALLSTENT Elgiloy self expanding stent Stent diameters up to 10mm and lengths up to 40mm BS 24 206 1622 4440 166856 1710 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS059 Express Vascular LD Stent; Express Vascular SD Stent Stainless Steel, Balloon Expanding Stent Stent Diameters up to 10mm and lengths up to 60mm BS 24 206 1622 4439 153169 1710 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS066 Biliary Drainage Stent, Amsterdam Biliary Stent C-Flex or Polyurethane Biliary Stent Diameters up to 12Fr & lengths up to 15cm BS 21 192 1556 4218 127387 78 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS069 Liberte Coronary Stent System Consists of a balloon expandable stent, pre-mounted on a Maverick 2 Monorail delivery catheter. Stent lengths: 8,12,16,20,24,28 & 32 mm Stent diameters: 2.25, 2.5, 2.75, 3.0, 3.5, 4.0, 4.5 & 5.0 mm BS 27 247 1767 5348 126580 898 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS070 Wallstent RX Biliary Stent Monofilament wire, self-expanding stent Diameters up to 10mm & lengths up to 100mm BS 21 192 1556 4235 136261 2874 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS071 Ultraflex Precision Colonic Stent Nitinol, self expanding stent Diameters up to 30mm & lengths up to 150mm BS 21 192 1557 Self Expanding 119517 2907 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DU031 Juliet Anterior Lumbar Cage PEEK cage with built in anatomical shape. The cage has built in stabilising Titanium spike to stabilise the implant in the disc space. All 26 mm length. 10, 12, 14 and 16mm height. 5 or 10 degree slope. DU 19 174 1486 4135 166194 3465 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DU032 Romeo 2 PAD System Interspinous fusion device 8mm to 18mm DU 19 177 1496 198720 Changed Benefit 1372 0 0 Update 2017-02-01 2019-03-01 Prosthesis DU033 Tryptik Anterior Cervical Plate (>55mm) Tryptik Anterior Cervical Plate is designed to have a low profile with screw holes that allow for up to 20 degree angulations. The plate is made of Titanium The product is available in 5 lenghts, 60, 65, 70, 80 and 90mm DU 19 169 1477 4127 >55mm 166153 1636 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DU034 Juliet TLIF Cage PEEK cage with built in anatomical angulations 4 thicknesses - 8, 10, 12 and 14mm DU 19 174 1486 4135 166194 3465 0 0 No Change 2017-02-01 2019-03-01 Prosthesis BS078 Advantage, Advantage Blue Transvaginal Mid-Urethral Sling System One size only AM 26 226 1698 5315 104326 Changed Product name, Product description, Benefit 822 0 0 Update 2005-10-31 2019-03-01 Prosthesis BS082 Resolution Clip Device Pre-loaded endoscopically applied clip, radiopaque stainless steel & cobalt chrome. 7Fr, 11mm jaw opening BS 21 194 1581 4258 Endoscopic 116734 134 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS085 Filterwire EZ Embolic Protection Device Vessel compatibility 3.5mm - 5.5mm and delivery system lengths up to 300cm. BS 24 211 1643 167933 1995 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS086 Polaris Ultra Ureteral Stent Dual durometer ureteral stent with attached suture Diameters up to 14Fr & lengths up to 40cm BS 26 227 1701 5322 Therm 104324 129379 203 0 0 No Change 2006-03-24 2019-03-01 Prosthesis BS089 WallFlex Oesophageal Stent, WallFlex RMV Oesophageal Stent Nitinol, self expanding stent Diameters up to 30mm & lengths up to 155mm BS 21 192 1558 4238 120176 3325 0 0 No Change 2006-03-24 2019-03-01 Prosthesis BS090 WallFlex Enteral Stent (Duodenal/Colonic) Nitinol, self expanding stent Diameters up to 30mm & lengths up to 150mm BS 21 192 1562 119517 3325 0 0 No Change 2006-03-24 2019-03-01 Prosthesis DU038 Scarlet AL-T Bone Screw Bone Screw Diameter 5.0-5.5mm Length 25-40mm DU 19 165 1464 166154 Changed Benefit 193 0 0 Update 2018-08-01 2019-03-01 Prosthesis DV009 Morcher Capsular Tension Ring PMMA Implant sizes 8 -12mm DV 1 143 1331 132347 151 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DV010 Morcher Complex Capsular Tension Ring PMMA Implant 9.5mm, 10mm, 11mm, 12.5mm, 13mm DV 1 143 1332 132347 Changed Benefit 317 0 0 Update 2005-10-31 2019-03-01 Prosthesis DV020 Molteno Implant Double plate - dual chamber One size only DV 1 144 1333 128911 404 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DV022 Eyetec DCR Tubes Stainless steel, silicone tubing, Bodkin lacrimal intubation set 30cm DV 1 146 1337 117458 Changed Benefit 128 0 0 Update 2005-10-31 2019-03-01 Prosthesis DV029 Eyejet CTR Capsular tension ring made of PMMA per-load on disposable injector 10mm, 11mm, 12mm DV 1 143 1331 pl 132347 231 0 0 No Change 2007-06-01 2019-03-01 Prosthesis DV230 Molteno 3 Drainage implant for glaucoma, made of silicon Small & Large size DV 1 144 1333 v 128911 594 0 0 No Change 2007-06-01 2019-03-01 Prosthesis DV231 Vision Blue Trypan blue dye for ophthalmic applications 0.5ml syringe DV 1 142 1330 147581 46 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BF010 WinLoc Cervical Plate System - plate Titanium anterior cervical plate 3-Level: 58mm, 62mm, 66mm, 70mm, 74mm, 78mm, 82mm 4-Level: 86mm, 90mm BF 19 169 1477 4127 >55mm 218438 1636 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BF011 WinLoc Cervical Plate System - screw Variable self drilling screw/self tapping screw/oversized screw, expandable screw Length: 12mm, 14mm, 16mm, 18mm Diameter: 4.0mm, 4.5mm BF 19 165 1464 218438 Changed Benefit 193 0 0 Update 2014-08-01 2019-03-01 Prosthesis BF012 Vigor PEEK Cervical Disc Spacer PEEK cervical spine disc spacer Height: 5mm, 6mm, 7mm, 8mm, 9mm, 10mm Width: 12mm, 13mm, 14mm, 15mm, 16mm, 17mm Length: 12mm, 14mm, 16mm Angulation: 0°, 5° BF 19 174 1486 4134 211536 2409 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BF013 Redmond Lumbar Cage System - Fusion Cage PEEK titanium ALIF Height: 12, 14, 16, 18, 20mm Width: 28, 34, 36, 39, 43mm Length: 24, 27, 30, 32mm Angle: 6º, 12º, 18º BF 19 174 1485 5486 211536 6256 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BF014 Redmond Lumbar Cage System - Locking screw, closed Titanium screw Diameter: 5.5mm; Length: 15, 20, 25, 30, 35mm BF 19 165 1464 Closed 211536 202 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BF015 Redmond Lumbar Cage System - Locking screw, cannulated Cannulated titanium screw Diameter: 5.5mm; Length: 15, 20, 25, 30, 35mm BF 19 165 1464 Cannulated 211536 202 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BS091 Percuflex; Percuflex Plus; Percuflex Plus SureDrive Ureteral stent with attached suture Diameters up to 14Fr & lengths up to 40cm BS 26 227 1701 5322 Therm 104324 132306 203 0 0 No Change 2006-11-30 2019-03-01 Prosthesis BS092 Contour Ureteral Stent, Contour SureDrive Ureteral Stent Ureteral stent with attached suture Diameters up to 14Fr & lengths up to 40cm BS 26 227 1701 5322 Therm 104324 203 0 0 No Change 2006-11-30 2019-03-01 Prosthesis BS093 Retromax Plus Ureteral Stent Ureteral stent Diameters up to 14Fr & lengths up to 40cm BS 26 227 1701 5322 Therm 104324 129379 203 0 0 No Change 2006-11-30 2019-03-01 Prosthesis BS094 Contour VL; Stretch VL Flexima; Ureteral Stents Ureteral stent with attached suture Diameters up to 14Fr & lengths up to 40cm BS 26 227 1702 5325 Therm 129376 Changed Benefit 201 0 0 Update 2006-11-30 2019-03-01 Prosthesis BS095 Urinary Diversion Stents Percuflex urinary diversion stent Diameters up to 14Fr & lengths up to 95cm BS 26 227 1703 104324 129379 Changed Benefit 125 0 0 Update 2006-11-30 2019-03-01 Prosthesis BS096 Lynx, Lynx Blue Suprapubic Mid-Urethral Sling System One size only AM 26 226 1698 5315 104326 Changed Product name, Product description, Benefit 822 0 0 Update 2006-11-30 2019-03-01 Prosthesis BS097 Obtryx Transoburator Mid-Urethral Sling System Polypropylene mesh sling One size only BS 26 226 1698 5315 104326 Changed Benefit 822 0 0 Update 2006-11-30 2019-03-01 Prosthesis DU027 Romeo 2 Posterior Thoraco-lumbar Fixation System - Iliac Connector Iliac connector Length: 15mm, 20mm, 30mm, 40mm, 50mm, 60mm DU 19 167 1473 166153 Changed Benefit 732 0 0 Update 2017-02-01 2019-03-01 Prosthesis DU028 Romeo 2 Posterior Thoraco-lumbar Fixation System - Transverse Rod Transverse rod Length: 20mm, 30mm, 40mm, 50mm, 60mm, 70mm, 80mm DU 19 166 1470 166153 385 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DU029 Tryptik Anterior Cervical Plate bone screw Tryptik Anterior Cervical Plate bone screws are designed to have a low profile and lock into the plate on insertion to prevent back out. The screw is made o Titanium The produc is available in 2 diameters, namely 3.8 and 4.5mm. The 3.8mm screw is available in 4 lenghts: 12, 14, 16 and 18mm while the 4.5mm screw is available in 3 lenghts, 14, 16 and 18mm DU 19 165 1464 166154 Changed Benefit 193 0 0 Update 2017-02-01 2019-03-01 Prosthesis DU030 Juliet Posterior Lumbar Interbody Cage PEEK cage built in anatomical slope. All 22mm length. 8, 10, 12 and 14mm heights. 0 or 5 degrees anatomical slope. DU 19 174 1486 4135 Paired 166194 Changed Benefit 2888 0 0 Update 2017-02-01 2019-03-01 Prosthesis AS243 Parietex Multifilament Polyester Mesh Parietex Multifilament Polyester Mesh 12 x 8 cm; 13 x 9 cm; 14 x 9 cm; 14 x 10 cm; 15 x 10 cm; 16 x 12 cm AS 21 194 1782 5434 Contoured 125428 195 0 0 No Change 2016-08-01 2019-03-01 Prosthesis AS244 Parietex Composite Dual sided polyester meshes with a resorbable adhesion-prevention hydrophilic film 25 cm, 30 cm AS 21 194 1783 5440 Coated 214997 214998 Changed Benefit 1017 0 0 Update 2016-08-01 2019-03-01 Prosthesis AS245 Parietex Composite Dual sided polyester meshes with a resorbable adhesion-prevention hydrophilic film 20 cm AS 21 194 1783 5439 Coated 214997 214998 759 0 0 No Change 2016-08-01 2019-03-01 Prosthesis AS246 ABSORBATACK Absorbable Fixation Device 5mm AS 21 194 1582 4331 Absorbable 181415 509 0 0 No Change 2016-08-01 2019-03-01 Prosthesis AT074 Anatomics Cranial Patient Specific Implant - One Piece Cranial patient specific implant constructed of Titanium, Acrylic or Porous Polyethylene Custom AT 23 200 1593 4343 Biomodelled 288564 Changed Benefit 9682 0 0 Update 2017-08-01 2019-03-01 Prosthesis AS242 Parietex Composite Dual sided polyester meshes with a resorbable adhesion-prevention hydrophilic film 8 cm, 9 cm, 12 cm, 15 cm AS 21 194 1783 5438 Coated, Contoured 214997 214998 Changed Benefit 428 0 0 Update 2016-08-01 2019-03-01 Prosthesis BF016 Redmond Cage System - Locking screw, expandable Expandable titanium screw Diameter: 4.0mm; Length: 12, 14, 16, 18mm Diameter: 5.5mm; Length: 15, 20, 25, 30, 35mm BF 19 165 1464 Expansion Screw / Expansion Head Screw 211536 289 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BF017 Redmond Lumbar Cage System - Locking Cap Titanium locking cap Diameter: 3mm; Length: 4mm or 6mm BF 19 166 1465 211536 164 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BF018 Combo Cervical Cage Combination titanium PEEK cervical cage Height: 5, 6, 7, 8, 9, 10mm Width: 12, 13, 14, 15, 16, 17mm Length: 12, 14mm BF 19 174 1486 4134 211536 2409 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BF019 Latero Lumbar Cage PEEK lumbar cage Height: 10, 11, 12, 13, 14, 15, 16 or 18mm Width: 16, 18, 20 or 22mm Length: 30, 35, 40, 45, 50 or 55mm Angle: 9* BF 19 174 1486 4135 211536 3465 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BF020 A-Mesh Spinal Titanium Mesh Plate and Set Screw A-Mesh Spinal Titanium Mesh is designed to restore biomechanical integrity throughout the thoracic and lumbar spine following vertebrectomy or corpectomy for patients with spine tumors or fractures Diameter 10m 12, 14, 16, 20, 15, 30 or 35mm BF 19 176 1495 187179 1275 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BX333 Veritas Collagen Matrix- Large Bovine pericardium biologic mesh repair of soft tissue > 200cm² 12cm x 25cm BX 21 194 1798 5492 Coated 219240 1412 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX334 Peri-strips dry with Veritas Collagen Matrix Circular Staple Line Reinforcement Peri-Strips Dry with Veritas is a remodelable material designed to increase staple line strength for surgical repair of soft tissue deficiencies One circular stapler firing: 20-400mm diameter BX 21 194 1580 4251 219234 219235 324 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX335 Peri-Strips dry with Veritas Collagen Matrix Linear Single Firing Peri-Strips Dry with Veritas is a remodeable material designed to increase staple line strength for surgical repair of soft tissue deficiencies 30-130mm BX 21 194 1580 4251 219227 324 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BX336 OSTENE Bone Haemostasis material 2.5g OSTENE is a water soluble polymer which provides immediate bone haemostasis, ie a bone haemostasis material, in surgical procedures 2.5g per stick BX 21 191 1552 229426 119 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BX337 Ostene 3.5g Bone Haemostasis material OSTENE is a water soluble polymer which provides immediate bone haemostasis, ie a bone haemostasis material, in surgical procedures 3.5g BX 21 191 1552 229426 166 0 0 No Change 2015-08-01 2019-03-01 Prosthesis AT075 Anatomics Cranial Patient Specific Implant - Two Piece Patient Specific Cranial Implant constructed of Titanium, Acrylic or Porous Polyethylene Custom AT 23 200 1593 4343 Biomodelled Two Piece 288564 10169 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AT076 Anatomics Biomodel A patient-specific, 3D printed biomodel intended to assist the surgeon during pre- and intraoperative procedural planning. The device is custom made so the size will vary. AT 23 200 1807 288564 1950 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AT077 Anatomics Bone Screws Titanium bone screws for patient specific implants Diameter - 1.6-2.0 mm Length - 5mm AT 23 199 1590 4323 288564 42 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AT078 Anatomics Fixation Straight Plates Titanium fixation straight plates 2 Holes Thickness - 0.6mm Length - 15mm AT 23 199 1589 4267 288564 93 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AT079 Anatomics Fixation Double-Y Plates Titanium craniofacial fixation plates 6 Holes Thickness - 0.6mm Length - 17mm AT 23 199 1589 4271 288564 166 0 0 No Change 2017-08-01 2019-03-01 Prosthesis 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 11.5fr and 13fr guage. Available in 150mm, 175mm, 200mm and 250mm length and straight and curved configuration. BX 24 214 1651 120507 114 0 0 No Change 2016-08-01 2019-03-01 Prosthesis 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. BX 24 214 1651 A (Anti-infective Agent Coating) 120507 142 0 0 No Change 2016-08-01 2019-03-01 Prosthesis AT080 Anatomics Burr Hole Plates Titanium burr hole plate Thickness - 0.6mm Diameter - 18-22mm AT 23 199 1589 4271 Burr 288564 166 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AT081 Anatomics Surgical Guide Biomodelled surgical guides to support surgical decision making both pre and intra-operatively The device is custom made so the size will vary AT 23 200 1593 5496 Biomodelled 288564 2584 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AT082 Anatomics Patient Specific Orbital Rim Custom, 3D-printed orbital rim constructed of porous polyethylene. The device is custom made so the size will vary. AT 23 200 1598 4370 Biomodelled 288564 4095 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AT083 Anatomics Patient Specific Malar Implant A customised patient specific implant constucted of porous polyethelene The device is customised so sizes will vary AT 23 200 1595 4352 Biomodelled 288564 4095 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AT084 Anatomics Patient Specific Mandible Custom mandible implant constructed of porous polyethylene The device is custom made so the size will vary. AT 23 200 1596 6741 Biomodelled 288564 5655 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AT085 Anatomics Patient Specifc Surgical Guide Patient specific surgical guide created from patient CT scan data, used to assist surgeons to implant the device by assisting in clinical decision making both pre- and intraoperatively The device is custom made so the size will vary. AT 23 200 1596 5498 Biomodelled 288564 2584 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AT086 NEUROVENT-P catheter RAUMEDIC NEUROVENT-P catheter for the continuous measurement of ICP (intracranial pressure) within the parenchyma. 5F AT 25 253 1794 Catheter 282695 1235 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AT087 Anatomics Patient Specific Orbital Floor Implant A custom, patient specific implant intended for the reconstruction of the patient's orbital floor manufactured with titanium or porous polyethylene. The device is custom made so the size will vary. AT 23 200 1598 4367 Biomodelled 288564 4095 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AT088 Anatomics Patient Specific Surgical Guide The Surgical Guide component of the system is created from the patient's CT scan data to assist the surgeon with pre- and intraoperative planning. The device is custom made so the size will vary. AT 23 200 1598 6023 Biomodelled 288564 2584 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BF009 WinLoc Cervical Plate System - plate Titanium anterior cervical plate 1-Level: 25mm, 27mm, 30mm, 33mm, 36mm 2-Level: 39mm, 42mm, 45mm, 48mm, 51mm, 54mm BF 19 169 1477 4127 218438 1251 0 0 No Change 2014-08-01 2019-03-01 Prosthesis DU035 Tryptik Anterior Cervical Plate Tryptik Anterior Cervical Plate is designed to have low profile with screw holes that allow for up to 20 degree angulations. The plate is made of Titanium The product is available in 8 lengths, 20, 25, 30, 35, 40, 45, 50, 55mm DU 19 169 1477 4127 166153 1251 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DU036 Tryptik Anterior Cervical Cage Tryptik Anterior Cervical Cages are manufactured from PEEK and are anatomically shaped to fit between vertebral bodies. The cages have large graft windows for graft to increase the rate of fusion. The cage also features 4 stabilising spikes that provide s The product is available in 2 sizes, the 12mm cage is available in 3 thicknesses, while the 14mm cage is available in 4 thicknesses 5, 6, 7, and 8mm DU 19 174 1486 4134 166194 2409 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DU037 Scarlet AL-T Secured Lumbar Cage Secured Lumbar Cage Small, Medium and Large Footprint Height 10-18mm DU 19 174 1485 5486 166194 6256 0 0 No Change 2018-08-01 2019-03-01 Prosthesis FA008 Optetrak Logic Total Knee System, Femoral Component, CR, Cemented Femoral Component, cemented, CoCr Size 0 - 6, Left and Right FA 17 149 1348 3906 285439 2951 0 0 No Change 2018-08-01 2019-03-01 Prosthesis FA009 Optetrak Logic Total Knee System, Femoral Component, CR, Porous Femoral Component, CR, Porous Coated Size 0 - 6, Left and Right FA 17 149 1351 3914 285901 3309 0 0 No Change 2018-08-01 2019-03-01 Prosthesis FA010 Optetrak Logic Total Knee System, Tibial Insert, CR Tibial Insert, UHMWPE, Fixed (Cruciate retained), Neutral, Slope +, Slope ++ Size 0 - 6, 9 - 15mm FA 17 153 1369 285442 284907 1019 0 0 No Change 2018-08-01 2019-03-01 Prosthesis FA011 Optetrak Logic Total Knee System, Femoral Component, PS, Cemented Femoral Component, PS, Cemented Size 0 - 6, Left and Right FA 17 149 1348 3907 285440 3041 0 0 No Change 2018-08-01 2019-03-01 Prosthesis FA012 Optetrak Logic Total Knee System, Tibial Insert, PS Tibial Insert, UHMWPE, Fixed (Posterior Stabilised) Size 0 - 6, 9-15mm FA 17 153 1370 285502 285503 Changed Benefit 1073 0 0 Update 2018-08-01 2019-03-01 Prosthesis FA013 Optetrak Logic Total Knee System, Tibial Baseplate Tibial Baseplate, titanium, fixed insert, cemented Size 0 - 6 FA 17 151 1357 285441 1923 0 0 No Change 2018-08-01 2019-03-01 Prosthesis ER251 Amendia Savannah-T Pedicle Screw System-Rods Pedicle Screw System-Rods, Straight and curved dia 5.5 mm x length (30-500 mm) ER 19 170 1478 234195 Changed Benefit 426 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER252 Amendia Savannah T Pedicle Screw System-Set Screws Pedicle Screw System-Set Screws one size ER 19 166 1465 234195 164 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER253 Amendia Savannah-T Pedicle Screw System-Connector (offset) Savannah-T Pedicle Screw System-Connector (offset) 44 x 6 x 16.7mm ER 19 167 1473 234195 Changed Benefit 732 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER254 Amendia Savannah-T Pedicle Screw System-Connector Transverse (rod to rod), adjustable Pedicle Screw System-Connector Transverse (rod to rod) 65-70 mm;70-75 mm; 75-80 mm ER 19 167 1474 4124 234195 Changed Benefit 1299 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER255 Amendia Zeus Fusion Cages-TLIF Zeus Fusion Cages-TLIF, PEEK (straight-versatile/curved/bullet nosed) width (9-13 mm) x length (20-36 mm) x height (7-16 mm) ER 19 174 1486 4135 233730 3465 0 0 No Change 2015-08-01 2019-03-01 Prosthesis FB001 K-Wire K-Wire, stainless steel, sterile 0.6mm – 2.8mm x 75mm – 230mm FB 13 123 1772 5365 226653 27 0 0 No Change 2018-02-01 2019-03-01 Prosthesis FB002 K-Wire K-Wire, threaded, stainless steel, sterile 1.2mm – 2.8mm x 100mm – 230mm FB 13 123 1772 5365 226653 27 0 0 No Change 2018-02-01 2019-03-01 Prosthesis FC008 GL-DTRAX Expandable Cage System Expandable titanium cage One Size FC 19 174 1487 290977 1444 0 0 No Change 2018-02-01 2019-03-01 Prosthesis FC009 GL -DTRAX Cervical Cage- B Cervical Cage with integral fixation. One Size FC 19 174 1487 293579 1444 0 0 No Change 2018-02-01 2019-03-01 Prosthesis FC010 GL-DTRAX Cervical Cage- T Titanium Cervical Cage One Size FC 19 174 1487 293579 1444 0 0 No Change 2018-02-01 2019-03-01 Prosthesis FC011 Ally Bone Screw For use with DTRAX Cages One size FC 19 165 1464 290978 Changed Benefit 193 0 0 Update 2018-02-01 2019-03-01 Prosthesis FC012 GL-DTRAX Bone Screw Cortical screw One Size FC 19 165 1464 290978 Changed Benefit 193 0 0 Update 2018-02-01 2019-03-01 Prosthesis FE001 Filshie Clip Titanium One size only FE 26 233 1716 5344 153023 147 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JD003 CarboFix Piccolo Plate Systems – Non-Locking Screws: Small Titanium alloy screws (non-locking) for fixation of CarboFix plate shaft and head. Non-Locking Distal Screw 3.5mm x 10mm, 12mm, 14mm, 16mm, 18mm, 22.5mm, 25.0mm, 27.5mm, 30.0mm, 32.5mm, 35.0mm, 40.0mm, 45.0mm Non-Locking Screw 3.5mm x 10mm, 12mm, 14mm, 16mm, 18mm, 20mm, 22mm, 24mm, 26mm, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm JD 13 123 1231 3370 222648 82 0 0 No Change 2017-08-01 2019-03-01 Prosthesis JD004 CarboFix Piccolo Distal Fibula Plate System – Plate component CFR-PEEK distal fibula plate Left 72mm, 83mm, 96mm, 112mm, 153mm, 182mm Right 72mm, 83mm, 96mm, 112mm, 153mm, 182mm JD 13 123 1694 5290 VAL 222648 Changed Benefit 1643 0 0 Update 2017-08-01 2019-03-01 Prosthesis JD005 CarboFix Piccolo Distal Radius Plate System – Plate component CFR-PEEK distal volar radius plate Right 52mm, 60mm, 90mm Left 52mm, 60mm, 90mm Narrow Right 50mm, 58mm Narrow Left 50mm, 58mm JD 13 123 1694 5277 VAL 222648 1439 0 0 No Change 2017-08-01 2019-03-01 Prosthesis JD006 CarboFix Piccolo Proximal Humerus Plate Systems – Plate component CFR-PEEK proximal humerus plate 100mm, 120mm, 154mm, 190mm, 262mm JD 13 123 1694 5274 VAL 222648 Changed Benefit 1643 0 0 Update 2017-08-01 2019-03-01 Prosthesis LM078 Ascension HRA - Humeral Resurfacing Arthroplasty A anatomic semi constrained, monobody device intended for resurfacing of the humeral head. 40mm x 16mm to 56mm x21mm LM 13 131 1276 4068 149178 3040 0 0 No Change 2008-07-01 2019-03-01 Prosthesis LM080 Neurolac A bioresorbable tension-less Nerve repair guide 1.5mm x 3cm to 10.0mm x 3cm LM 21 192 1564 139653 1425 0 0 No Change 2008-07-01 2019-03-01 Prosthesis LM081 Surgicraft Washers Fixation Washers All Sizes LM 13 123 1231 3374 149434 93 0 0 No Change 2008-07-01 2019-03-01 Prosthesis LM084 Polyganics Vivosorb A bioresorbable co polyester sheet 2cm x 3cm to 13cm x 20cm LM 21 194 1579 5432 Complex, Bioresorbable 148712 1235 0 0 No Change 2008-07-01 2019-03-01 Prosthesis LM091 FixEx Bone Cement Calcium Phosphate Bone Cement 5cc LM 13 123 1241 4092 CDS 115698 Changed Benefit 1188 0 0 Update 2009-02-01 2019-03-01 Prosthesis LM100 Hyprocure Sinus Tarsi Implant 5-9mm LM 13 124 1219 3261 291288 Changed Benefit 1321 0 0 Update 2010-08-01 2019-03-01 Prosthesis LM102 Ascension Silicone Finger joint replacement MCP moulded silicone finger joint Various LM 13 131 1274 6146 Total 92524 1330 0 0 No Change 2011-08-01 2019-03-01 Prosthesis LM103 Ascension Silicone Finger joint replacement PIP moulded silicone finger joint 00-05 LM 13 131 1274 6146 Total 92524 1330 0 0 No Change 2011-08-01 2019-03-01 Prosthesis FE003 Filshie Clips - Sterishot With Disposable Applicator One Size FE 26 233 1716 5344 With applicator 157661 Changed Benefit 389 0 0 Update 2005-10-31 2019-03-01 Prosthesis FJ001 LH534 Oxiplex/AP Absorbable Adhesion Barrier Gel Combination of Polyethylene Oxide (PEO) and Sodium Carboxylmethylcellulose stabilised with Calcium and made isotonic with Sodium Chloride. Kit contains 2 x 20ml Sterile syringes , 1 x Applicator 2 x 20ml Sterile Syringes, 1 x Applicator FJ 21 194 1579 5433 Complex 152224 1235 0 0 No Change 2018-08-01 2019-03-01 Prosthesis HW498 Stryker Leibinger Plating System Craniofacial Fixation Plates 0.5 - 0.99mm thick, 4 -7 holes HW 23 199 1589 4271 11565 124319 16221 64730 166 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW499 Delta Resorbable Fixation System Craniofacial Resorbable Fixation Plates 0.5 -0.99mm thick, 4 - 7 holes HW 23 199 1589 4271 Resorbable 151009 72659 195 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW500 Stryker Leibinger Plating System Craniofacial Fixation Plates ,Locking 0.5 - 0.9mm thick, 4 -7 holes HW 23 199 1589 4271 Locking 124319 64730 190 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW501 Stryker Leibinger Plating System Craniofacial Fixation Plates, Compression 0.5 - 0.9mm thick, 4 -7 holes HW 23 199 1589 4271 Compression 124319 64730 166 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW503 Delta Resorbable fixation System Craniofacial Resorbable Fixation Plates 0.5 - 0.99mm thick, 8 -32 holes HW 23 199 1589 4277 Resorbable 151009 72659 210 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW504 Stryker Leibinger Plating System Craniofacial Locking Fixation Plates 0.5 - 0.99mm thick, 8 -32 holes HW 23 199 1589 4277 Locking 124319 64730 304 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW505 Stryker Leibinger Plating System Mandible Fixation Plates 1.0 - 1.99mm thick, <4 holes HW 23 199 1589 4286 11565 124319 112 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW506 Stryker MEDPOR Implant Porous Polyethylene Mesh Block HW 23 199 1588 4255 152165 804 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW502 Stryker Leibinger Plating System Craniofacial Fixation Plates 0.5 - 0.99mm thick, 8 -32 holes HW 23 199 1589 4277 124319 151009 16221 64730 72659 199 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW507 Stryker Leibinger Plating System Craniofacial Titanium Mesh System 0.5 - 0.8mm thick, 11 - 50cm² HW 23 199 1585 4208 124319 64730 497 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW508 Stryker Leibinger Plating System Mandible Locking Fixation Plates 1.0 - 1.99mm thick, 8 - 15 holes HW 23 199 1589 4293 11565 124319 Changed Benefit 409 0 0 Update 2013-02-01 2019-03-01 Prosthesis HW509 Stryker Leibinger Plating System Universal Mandibular Locking Screws 2.0 - 2.7mm diameter, 3 - 24mm length HW 23 199 1590 4323 Locking 124318 64730 88 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW510 Delta Resorbable Fixation System Resorbable Screws 1.7mm diameter, 3 -6mm length HW 23 199 1590 4323 Resorbable 151008 72659 137 0 0 No Change 2013-02-01 2019-03-01 Prosthesis HW511 Stryker Leibinger Plating System Micro Screws 1.0 - 1.2mm diameter, 3 - 15mm length HW 23 199 1590 4321 124318 16221 64730 Changed Benefit 68 0 0 Update 2013-02-01 2019-03-01 Prosthesis HW512 Anchor-L Lumbar Cage System, Anterior Lumbar Interbody Cage Anterior Lumbar Interbody Cage Footprints; 22x30mm, 25x35mm, 28x40mm Heights 10-20mm (2mm incr.) Lordosis 4°,8°,12°,16° HW 19 174 1485 5486 205486 6256 0 0 No Change 2013-08-01 2019-03-01 Prosthesis HW513 Anchor-L Lumbar cage System, Bone Screw Bone Screw Dia 5mm- 6mm, Length 20mm- 30mm HW 19 165 1464 205486 Changed Benefit 193 0 0 Update 2013-08-01 2019-03-01 Prosthesis HW514 Anchor-L Lumbar Cage System, Locking Plate Final Locking plate One Size HW 19 166 1467 205486 408 0 0 No Change 2013-08-01 2019-03-01 Prosthesis LB090 CREO Stabilization System Preassembled Polyaxial Screw The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation. 4.0mm diameter to 10.5mm diameter 20mm to 120mm length LB 19 165 1463 190039 1280 0 0 No Change 2014-08-01 2019-03-01 Prosthesis LB091 CREO Stabilization Tapered Rod The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation. 4.75 and 5.5 600mm LB 19 170 1478 Dual Diameter 190039 Changed Benefit 529 0 0 Update 2014-08-01 2019-03-01 Prosthesis LB092 CANOPY Laminoplasty System Plate Laminoplasty Plate 5 - 13mm LB 19 169 1477 4131 219536 722 0 0 No Change 2014-08-01 2019-03-01 Prosthesis LB093 FORTIFY Ti Corpectomy Spacer Core Expandable corpectomy spacer 12mm and 20mm x 15mm-120mm LB 19 176 1492 4137 ThoracoLumbar 190055 4139 0 0 No Change 2014-08-01 2019-03-01 Prosthesis LB094 PLYMOUTH Thoracolumbar Plate System Screw Bone Screw 5.5mm - 6.5mm 22mm - 57mm LB 19 165 1464 190063 Changed Benefit 193 0 0 Update 2014-08-01 2019-03-01 Prosthesis HW516 HOFFMANN3 EXTERNAL FIXATION SYSTEM ROD COUPLER 0-120 DEGREES HW 13 123 1237 4508 112434 Changed Benefit 732 0 0 Update 2013-08-01 2019-03-01 Prosthesis HW517 HOFFMANN3 EXTERNAL FIXATION SYSTEM MULTIPLANAR CLAMP PIN/ROD-ROD STANDARD HW 13 123 1237 3402 3D 112434 1579 0 0 No Change 2013-08-01 2019-03-01 Prosthesis HW518 AVS Anchor C Cervical Cage System Standalone Cervical Cage 12 x 14mm, 14 x 16mm, height range ; 6mm-12 mm.) 0, 4 and 8 degree angulation HW 19 174 1485 5485 189613 Changed Benefit 4379 0 0 Update 2013-08-01 2019-03-01 Prosthesis HW519 AVS Anchor C Cervical Cage System Screw for use with Anchor C Cervical Cage Diameter 3.5-4mm Length 8-14mm HW 19 165 1464 189613 Changed Benefit 193 0 0 Update 2013-08-01 2019-03-01 Prosthesis HW520 AVS Navigator Steerable TLIF Cage L 26-31mm, H6-15mm, 0 and 4 degree anglulation HW 19 174 1486 4135 205486 3465 0 0 No Change 2013-08-01 2019-03-01 Prosthesis HW521 Mantis Augmentable Screw Augmentable Pedicle Screw 5.5-8.5mm diameter, 40-65mm Length HW 19 165 1463 Cannulated 179471 1338 0 0 No Change 2013-08-01 2019-03-01 Prosthesis HW522 Stryker Leibinger 3D Orbital Floor Plate Stryker Leibinger 3D Orbital Floor Plate Small, Right Small, Left Large, Right Large, Left HW 23 200 1598 4367 868 0 0 No Change 2013-08-01 2019-03-01 Prosthesis HW523 Restoration Modular Body Milled, Broached, Cone and Calcar body options Milled: Dia 19-25mm with 2 mill Depths; 27-29mm with Mill Depths Broach: 1-8 Cone: Diam 19-31mm, Heights +0, +10, +20, +30 Calcar: Diameter 19-29mm, 3 Heights each HW 18 161 1413 3979 Body 145601 3972 0 0 No Change 2013-08-01 2019-03-01 Prosthesis HW524 Dall Miles Cable Grip System Cable and sleeve 1.6mm and 2.0mm HW 13 123 1772 5367 141273 16234 485 0 0 No Change 2013-08-01 2019-03-01 Prosthesis HW525 Exeter Hip X-Change Revision System X-Change Stainless steel Revision Mesh - Medial Wall,Rim, Femoral. Flat Small, medium and large HW 13 123 1777 5399 205495 902 0 0 No Change 2013-08-01 2019-03-01 Prosthesis HW526 Memometal Anchor Fixation System Anchors 1-2mm HW 13 123 1774 5384 149537 Changed Benefit 294 0 0 Update 2013-08-01 2019-03-01 Prosthesis HW527 Memometal Anchor Fixation System Anchors 3.6mm HW 13 123 1774 5385 149537 Changed Benefit 442 0 0 Update 2013-08-01 2019-03-01 Prosthesis HW528 Stryker Neuro Mesh Plates Titanium malleable mesh plates for cranial reconstruction 0.2-0.49mm HW 23 199 1585 4204 Complex 203105 214470 214471 214472 829 0 0 No Change 2014-02-01 2019-03-01 Prosthesis ER257 Amendia Zeus Fusion Cages-PLIF Amendia Zeus Fusion Cages-PLIF (paired), PEEK width (9-13 mm) x length (22-30 mm) x height (7-18 mm) x lordosis (0-8 degrees) ER 19 174 1486 4135 Paired 233730 Changed Benefit 2888 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER258 Amendia Zeus Fusion Cages-Lateral (LLIF) Zeus Fusion Cages-Lateral (LLIF)-straight/lordotic/oblique width (9-25 mm) x length (24-60 mm) x height (8-18 mm) x lordosis (0-28 degrees) ER 19 174 1486 4135 233730 3465 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER259 Amendia Zeus Fusion Cages-Cervical Zeus Fusion Cages-Cervical width 14 mm x height (5-12 mmm) X lordosis (0-5 degrees) ER 19 174 1486 4134 233730 2409 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER260 Amendia Phenix Fusion Cages-Cervical Amendia Phenix Fusion Cages-Cervical (straight and lordotic), PEEK width (12-17 mm) x length (12-14 mm) x height (5-36 mm) x lordosis (0-10 degrees) ER 19 174 1486 4134 233730 2409 0 0 No Change 2015-08-01 2019-03-01 Prosthesis EY013 E4 TLIF Cage Interbody Cage 6mm height to 16mm height EY 19 174 1486 4135 181030 3465 0 0 No Change 2018-08-01 2019-03-01 Prosthesis ER256 Amendia Zeus Fusion Cages-ALIF Amendia Zeus Fusion Cages-ALIF, PEEK width (34-42 mm) x length (24-27 mm) x height (8-22 mm) x lordosis (0-13 degrees) ER 19 174 1486 4135 233730 3465 0 0 No Change 2015-08-01 2019-03-01 Prosthesis JD007 CarboFix Piccolo Plate Systems – Locking Screws: Mini Titanium alloy screws (locking) for fixation of CarboFix plate shaft and head. Locking Proximal Screw 2.5mm x 14mm, 16mm, 18mm, 20mm, 22mm, 24mm, 26mm Locking Screw 2.7mm x 10mm, 12mm, 14mm, 16mm, 18mm, 20mm, 22mm, 24mm JD 13 123 1231 3371 LK 222648 147 0 0 No Change 2017-08-01 2019-03-01 Prosthesis JD008 Distal Femur Plate Distal Femoral Locking Plates ≥7 to ≤15 holes JD 13 123 1694 5287 VAL 222648 1710 0 0 No Change 2018-02-01 2019-03-01 Prosthesis JD009 Distal Femur Plate Distal Femoral Locking Plates ≥16 Holes JD 13 123 1694 5288 VAL 222648 2331 0 0 No Change 2018-02-01 2019-03-01 Prosthesis JD010 Ankle Arthrodesis Nail Arthrodesis Nail 10 & 12mm diameter JD 13 123 1228 3332 222647 Changed Benefit 4493 0 0 Update 2018-02-01 2019-03-01 Prosthesis JD011 Screws - Reconstruction Screws 3.5 - 5 mm diameter JD 13 123 1229 3713 222647 Changed Benefit 143 0 0 Update 2018-02-01 2019-03-01 Prosthesis JD012 Nail Caps Nail Cap 0, 5, 10 & 11mm diameter JD 13 123 1229 5363 222647 96 0 0 No Change 2018-02-01 2019-03-01 Prosthesis JD013 Screws - Non Locking ≥4.5mm) ≥4.5mm JD 13 123 1231 3369 222648 65 0 0 No Change 2018-02-01 2019-03-01 Prosthesis JA006 OH542 LP Cage LP - PLIF Peek Cage 0°-8°, H 8-15mm L 22-27mm W 9-11mm JA 19 174 1486 4135 Paired 289247 Changed Benefit 2888 0 0 Update 2018-08-01 2019-03-01 Prosthesis JA007 OH537 Medussa-PL Cage ThoracoLumbar/Lumbar Interbody Fusion Cage - PLIF, TLIF 0°-8°, H 6-16mm L 25-38mm W 9-11mm JA 19 174 1486 4135 Paired 289247 Changed Benefit 2888 0 0 Update 2018-08-01 2019-03-01 Prosthesis JA008 OH355 Medyssey Spinal Fixation System Cannulated Monoaxial Screw 4.0-8.5 JA 19 165 1462 Cannulated 148858 924 0 0 No Change 2018-08-01 2019-03-01 Prosthesis JA009 OH356 Medyssey Spinal Fixation System Cannulated Polyaxial Screw 4.0-8.5 JA 19 165 1463 Cannulated 148858 1338 0 0 No Change 2018-08-01 2019-03-01 Prosthesis JA010 OH350 Medyssey Spinal Fixation System Crosslink 41 - 66mm JA 19 167 1473 148858 Changed Benefit 732 0 0 Update 2018-08-01 2019-03-01 Prosthesis JA011 OH357 Medyssey Spinal Fixation System Monoaxial Screw 4.0-8.5 JA 19 165 1462 148858 895 0 0 No Change 2018-08-01 2019-03-01 Prosthesis JA012 OH358 Medyssey Spinal Fixation System Polyaxial Screw 4.0-8.5 JA 19 165 1463 148858 1280 0 0 No Change 2018-08-01 2019-03-01 Prosthesis JA013 OH354 Novel/Zenius Reduction Mono screw Monoaxial Reduction pedicle screw 5.5-8.5 JA 19 165 1462 With cap/cover plate 148858 953 0 0 No Change 2018-08-01 2019-03-01 Prosthesis JA014 OH353 Novel/Zenius Reduction Poly Screw Polyaxial Reduction pedicle screw 5.5-8.5 JA 19 165 1463 148858 1280 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LB077 REVERE Rods Preshaped Pre-shaped Rods 4.5, 5.5 - 6.35mm LB 19 170 1478 Shaped 190039 Changed Benefit 577 0 0 Update 2014-02-01 2019-03-01 Prosthesis LB078 REVERE Rods, Dual Unit Scoliosis Rods 5.5mm - 6.35mm 450mm - 500mm LB 19 170 1480 4132 190039 1405 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LB079 REVERE Polyaxial Screw Polyaxial screw 5.5 Titanium, Alloy and Stainless Steel- 4.0-8.5mm x 20mm to 90mm in 5mm increments 5.5 Reduction screws - 5.5mm-7.5mm x 30mm-90mm in 5mm increments 6.35 Titanium Alloy and Stainless Steel - 5.5mm - 90mm x 25mm to 120mm in 5mm increments 5.5 Dual Diameter Screw Titanium Alloy and Stainless Steel - 5.5mm, 6.0mm 7.0mm, 7.5mm x 30mm to 100mm in 5mm increments 6.35 Dual Diameter Screws Titanium Alloy and Stainless Steel - 5.5mm, 6.0mm, 7.0mm, 7.5mm x 30mm to 65mm in 5mm increments 4.0-8.0mm diameter 20-90mm length 4.5 - 6.5mm diameter uniplanar fracture reduction screws, 25-55mm in 5mm increments LB 19 165 1463 190039 1280 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LB080 REVERE TRANSITION HA coated Pedicle Screw Polyaxial Screw HA Coated, Dual Outer Diameter, Prefered Angle 5.5mm-8.5mm x 35mm - 100mm LB 19 165 1463 196585 1280 0 0 No Change 2014-02-01 2019-03-01 Prosthesis JA016 OH351 Medyssey set screw Set screw 9.5 - 10mm JA 19 166 1465 148858 164 0 0 No Change 2018-08-01 2019-03-01 Prosthesis JA017 OH540 Spinal Plate - Cervical Anterior Cervical Plate 20mm - 53mm JA 19 169 1476 4125 289731 Changed Benefit 1348 0 0 Update 2018-08-01 2019-03-01 Prosthesis JA018 OH541 Spinal Plate - Cervical 55mm+ Anterior Cervical Plate 55mm+ 56 - 92mm JA 19 169 1476 4125 >55mm 289731 1636 0 0 No Change 2018-08-01 2019-03-01 Prosthesis JA019 OH539 Spinal Plate Screws Self-Drilling and Self-Tapping Plate Screws Diam - 4.0 - 4.5mm Length - 10 - 16mm JA 19 165 1464 289731 Changed Benefit 193 0 0 Update 2018-08-01 2019-03-01 Prosthesis JA020 OH538 Taurus-P Taurus-P Fusion Cage 0-8°, H7-16mm, L25-40mm, W9-12mm JA 19 174 1486 4135 289247 3465 0 0 No Change 2018-08-01 2019-03-01 Prosthesis JC001 K-Wires K-Wires - stainless steel Diameter 0.8mm to 4mm Length 100mm to 350mm JC 13 123 1772 5365 286985 27 0 0 No Change 2017-08-01 2019-03-01 Prosthesis JA015 OH352 Novel/Zenius Rods Rod 5.5, 6.0, 6.5 JA 19 170 1478 148858 Changed Benefit 426 0 0 Update 2018-08-01 2019-03-01 Prosthesis LB096 FORTIFY Ti Corpectomy Spacer Endplate Expandable corpectomy spacer endplate 12 and 20mm x 12-50mm 0-12deg LB 19 176 1492 4138 190055 1155 0 0 No Change 2014-08-01 2019-03-01 Prosthesis LB095 PLYMOUTH Thoracolumbar Plate System Plate Thoracolumbar Plate 15 - 24mm LB 19 169 1476 4126 190063 Changed Benefit 2118 0 0 Update 2014-08-01 2019-03-01 Prosthesis LB097 FORTIFY R Corpectomy Spacer Core Expandable corpectomy spacer 14mm 15mm-88mm LB 19 176 1492 4137 ThoracoLumbar 190055 4139 0 0 No Change 2014-08-01 2019-03-01 Prosthesis LB098 FORTIFY R Corpectomy Spacer Endplate Expandable corpectomy spacer endplate 14-30mm X 14-25mm LB 19 176 1492 4138 190055 1155 0 0 No Change 2014-08-01 2019-03-01 Prosthesis LB099 CANOPY Laminoplasty System Screw Bone and graft screw for Laminoplasty Plate 2.2mm - 3.0mm 4mm - 12mm LB 19 165 1464 219536 Changed Benefit 193 0 0 Update 2014-08-01 2019-03-01 Prosthesis LB100 CREO AMP™ Modular Screw Shaft Modular screw shaft 4.0mm - 10.5mm x 20mm - 120mm LB 19 165 1463 Shank 190039 640 0 0 No Change 2014-08-01 2019-03-01 Prosthesis JD001 CarboFix Piccolo Plate Systems – Locking Screws: Small Titanium alloy screws (locking) for fixation of CarboFix plate shaft and head. Locking Proximal Screw 4.0mm x 25.0mm, 30.0mm, 32.5mm, 35.0mm, 37.5mm, 40.0mm, 42.5mm, 45.0mm, 47.5mm, 50.0mm, 55.0mm, 60.0mm Locking Distal Screw 3.5mm x 10mm, 12mm, 14mm, 16mm, 18mm, 22.5mm, 25.0mm, 27.5mm, 30.0mm, 32.5mm, 35.0mm, 40.0mm, 45.0mm Locking Screw 3.5mm x 12mm, 14mm, 16mm, 18mm, 20mm, 22mm, 24mm, 26mm JD 13 123 1231 3370 LK 222648 145 0 0 No Change 2017-08-01 2019-03-01 Prosthesis JD002 CarboFix Piccolo Plate Systems – Non-Locking Screws: Mini Titanium alloy screws (non-locking) for fixation of CarboFix plate shaft and head. Non-Locking Proximal Screw 2.5mm x 14mm, 16mm, 18mm, 20mm, 22mm, 24mm, 26mm Non-Locking Screw 2.7mm x 12mm, 14mm, 16mm, 18mm, 20mm, 22mm, 24mm JD 13 123 1231 3371 222648 84 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LB081 REVERE Cannulated Polyaxial Screw Cannulated Polyaxial Screw 5.5mm x 25 - 8.5 x 65mm LB 19 165 1463 Cannulated 190039 1338 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LB082 REVERE TRANSITION HA Coated Cannulated Polyaxial Screw Polyaxial Screw HA Coated, Cannulated 6.5mm - 8.5mm x 35mm - 6mm LB 19 165 1463 Cannulated 196585 1338 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LB083 REVERE Monoaxial Screw Monoaxial Screw 4.0mm x 20-35mm in 5mm increments 4.5mm x 20-45mm in 5mm increments 5.0mm x 25-55mm in 5mm increments 5.5mm x 20 -50mm in 5mm increments 5.5 x 27mm in 5mm increments and 25mm-6mm increments in 5mm increments 6.5mm x 25-65mm in 5mm increments 6.5mm x 27mm -55mm in 5mm increments and 25mm - 65mm in 5mm increments 8.5mm x 25mm-65mm in 5mm increments 9.0mm x 25- 25mm-120mm in 5mm increments 10.0mm x 25mm-120mm in 5mm increments LB 19 165 1462 190039 895 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LB084 REVERE TRANSITION HA Coated Monoaxial Screw Monoaxial Screw HA Coated 6.5mm - 8.5mm x 35mm - 65mm LB 19 165 1462 190039 895 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LB085 CREO Stabilization System Hook The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation. 4.75 and 5.5; small, medium and large LB 19 168 1475 190039 789 0 0 No Change 2014-08-01 2019-03-01 Prosthesis DV241 Eyetec DCR Tubes Crawford and Cannaliculus Intubation Sets N/A DV 1 146 1337 117458 Changed Benefit 128 0 0 Update 2009-08-01 2019-03-01 Prosthesis DV242 Molteno Implant Glaucoma Drainage Device - Single Plate/Single Plate-Dual Chamber/Double Plate N/A DV 1 144 1333 128911 404 0 0 No Change 2009-08-01 2019-03-01 Prosthesis DV243 D.O.R.C. Silicon Oil D.O.R.C. Silicon Oil 1000/2000/5000CS 10ml DV 1 148 1347 193027 185 0 0 No Change 2009-08-01 2019-03-01 Prosthesis DV244 D.O.R.C. Eftiar Eftiar Decaline and Octane 5ml 5ml, 7ml DV 1 148 1346 148699 228 0 0 No Change 2009-08-01 2019-03-01 Prosthesis DV246 Rayner Sulcoflex Ashperic (Premium) I.O.L. Pseudophakic Supplementary I.O.L.O.L. -10.0D to -5.50D in 0.5D increments. +5.50D to 10.00D in 0.5D increments DV 1 141 1328 3895 100926 276 0 0 No Change 2010-02-01 2019-03-01 Prosthesis DV248 HOYA PY-60MV Preloaded in cartridge, Multifocal, Aspheric, Blue-blocker, Single Piece, Hydrophobic +14.0D to 27.0D (0.5 steps) DV 1 141 1327 3893 at, vblf 112674 117417 712 0 0 No Change 2010-02-01 2019-03-01 Prosthesis LB086 CREO Stabilization System Cross Connector The CREO Stabilization System implants are non-cervical spinal fixation intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation. 4.75 and 5.5, 30-91mm LB 19 167 1474 4124 190039 Changed Benefit 1299 0 0 Update 2014-08-01 2019-03-01 Prosthesis LB087 CREO Stabilization System Rod The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation. 4.75 and 5.5 diameter 15mm - 600mm length LB 19 170 1478 190039 Changed Benefit 426 0 0 Update 2014-08-01 2019-03-01 Prosthesis LB088 CREO Stabilization System Locking Cap The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation. 4.75 and 5.5 LB 19 166 1468 190039 Changed Benefit, Group 582 0 0 Update 2014-08-01 2019-03-01 Prosthesis LB089 CREO Stabilization System Preassembled Monoaxial Screw The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation. 4.75 and 5.5 4.0mm diameter to 8.5mm diameter 20mm to 90mm length LB 19 165 1462 190039 895 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER235 Spineway Mont Blanc Pedicle Screw System-Connector (in line) Spineway Mont Blanc Pedicle Screw System-Connector (in line; domino or axial) 15mm x(15-16 mm); dia (7.5-8.5mm) x length (30-80 mm) ER 19 167 1472 235417 235418 Changed Benefit 732 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER236 Spineway Mont Blanc Pedicle Screw System-Connector (transverse rod to rod, adjustable) Spineway Mont Blanc Pedicle Screw System-Connector (transverse rod to rod, adjustable) 15-20mm; 20-25mm; 20-30mm;25-30mm; 30-40 mm; 40-50mm; 40-55 mm; 55-70 mm; 70-85 mm; ER 19 167 1474 4124 235417 235418 Changed Benefit 1299 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER237 Spineway Mont Blanc Pedicle Screw System-Connector lateral (offset) Spineway Mont Blanc Pedicle Screw System-Connector lateral (offset) dia 5.5 mm x length (30-80) mm ER 19 167 1473 235417 235418 Changed Benefit 732 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER238 Spineway Mont Blanc Pedicle Screw System-Rod (tapered) Spineway Mont Blanc Pedicle Screw System-Rod (tapered) dia 5.5 mm x length (50-550 mm) ER 19 170 1478 235417 235418 Changed Benefit 426 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER239 Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Monoaxial (closed) Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Monoaxial (closed) dia (3.5-4.0 mm) x length (20-35 mm) ER 19 165 1462 Closed 235417 235418 895 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER240 Pyrenees Cervical Plate System-MonoPlate, Long Pyrenees Cervical Plate System-MonoPlate, Long Length 56-78 mm ER 19 169 1476 4125 >55mm 154444 1636 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER241 Pyrenees Cervical Plate System-Monoplate, Short Pyrenees MonoPlate, Short 18-55mm length ER 19 169 1476 4125 154444 Changed Benefit 1348 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER242 Cascadia Interbody Spacer Cascadia interbody spacer, porous Ti 8.5 -14mm wide ER 19 174 1486 4135 193652 3465 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER243 MESA Rail CoCr and Ti shaped beam rail rods Diameter: 4.5-5.5mm Length: 375-500mm ER 19 170 1478 Shaped 154442 Changed Benefit 577 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER244 Spineway Twin Peaks TLIF Fusion Cage Twin Peaks TLIF Fusion Cage height (7-15 mm) x length (25-35 mm) x lordosis (4-9 degrees) ER 19 174 1486 4135 235415 3465 0 0 No Change 2015-08-01 2019-03-01 Prosthesis FA001 Equinoxe Replicator Plate The Equinoxe Replicator Plate is intended to connect the humeral head to the stem and to position the replacement humeral head in a variety of positions to match patient’s anatomy. 0mm – 4.5mm Offset FA 13 131 1278 4084 266159 278519 1159 0 0 No Change 2018-02-01 2019-03-01 Prosthesis FA002 Ceramic modular head Biolox Delta Ceramic heads 32mm or less 28 and 32mm FA 18 162 1419 3992 285507 1845 0 0 No Change 2018-02-01 2019-03-01 Prosthesis FA003 BSC Acetabular Shell Titanium, plasma spray, HA with 3 holes 46-66mm FA 18 163 1427 4018 285479 2373 0 0 No Change 2018-02-01 2019-03-01 Prosthesis FA004 Ceramic Modular head Biolox Delta Ceramic heads > 32mm 36, 40 and 44mm FA 18 162 1420 3998 285507 2022 0 0 No Change 2018-02-01 2019-03-01 Prosthesis FA005 Biolox Delta Acetabular Liner Biolox Delta ceramic acetabular liner 28mm, 32mm, 36mm, 40mm FA 18 163 1428 4025 285506 2303 0 0 No Change 2018-02-01 2019-03-01 Prosthesis FA006 Xonit X-PE Acetabular Liner Highly Cross-Linked Acetabular Insert Standard/Dysplasia: 39-52mm/28mm 39-52mm/32mm 44-52mm/36mm 48-52mm/40mm FA 18 163 1428 4021 285483 285959 1019 0 0 No Change 2018-02-01 2019-03-01 Prosthesis FA007 Equinoxe Humeral Stem, Primary, Press-Fit Press-Fit Humeral Stem 7 – 19mm FA 13 131 1276 4058 244995 3325 0 0 No Change 2018-08-01 2019-03-01 Prosthesis FA015 Optetrak Logic Total Knee System, RBK Tibial Baseplate Tibial Baseplate, titanium with polished insert surface, cemented, for a mobile insert Size 1F/1T - 5F/5T FA 17 151 1359 285906 Changed Benefit 2147 0 0 Update 2018-08-01 2019-03-01 Prosthesis FA016 EX014 EX015 EX016 Exactech M series modular Hip System Modular Titanium Revision Hip - Metaphyseal Segment 21 - 31mm, XSmall - Large FA 18 161 1410 3964 Cone 262532 2742 0 0 No Change 2018-08-01 2019-03-01 Prosthesis FA017 EX019 EX020 EX021 Exactech Total Hip System Modular stem Titanium polished, non HA Diameter: 11mm-21mm, Length: 200mm - 300mm FA 18 161 1412 3975 Stem 264152 4851 0 0 No Change 2018-08-01 2019-03-01 Prosthesis FA018 EX005 Novation Crown Cup Constrained Liner Sphere and taper liner diameter geometry for compatibility with the Novation Crown Cup Constrained Liner: Group 1: 48/50mm, shells, 28mm ID; Group 2: 52/54mm, shells, 32mm ID; Group 3: 56/58mm shells, 36mm ID; Group 4: 60/62mm shells, 36mm ID; Group 5: 64/66/68mm shells, 36mm ID FA 18 163 1428 4024 287410 1613 0 0 No Change 2018-08-01 2019-03-01 Prosthesis FA014 Optetrak Logic Total Knee System, RBK Tibial Insert Tibial Insert, UHMWPE, mobile, posterior stabilised Size 1 - 5, 9 - 15mm FA 17 153 1370 285911 Changed Benefit 1073 0 0 Update 2018-08-01 2019-03-01 Prosthesis FA019 EX005 Novation Crown Cup Constraining Ring Acetabular liner locking ring Size 1 - 5 FA 18 164 1449 287413 150 0 0 No Change 2018-08-01 2019-03-01 Prosthesis ER245 Spineway Twin Peaks PLIF Fusion Cage Twin Peaks PLIF Fusion Cage-oblique height (7-14 mm) x length (28-32 mm) ER 19 174 1486 4135 235415 3465 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER246 Spineway Twin Peaks PLIF Fusion Cage-Paired Twin Peaks PLIF Fusion Cage-Paired, (standard or bullet shaped) height (7-14 mm) x length (20-25 mm) x lordosis (0-8 degrees) ER 19 174 1486 4135 Paired 235415 Changed Benefit 2888 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER247 Amendia Savannah-T Pedicle Screw System-Pedicle Screw, Monoaxial, Cannulated Savannah-T Pedicle Screw System-Pedicle Screw, Monoaxial, Cannulated dia (6.5-8.5mm) x length (30-65mm) ER 19 165 1462 Cannulated 234195 924 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER248 Amendia Savannah-T Pedicle Screw System-Polyaxial Pedicle Screw Savannah-T Pedicle Screw System-Polyaxial Pedicle Screw-Low, Medium, Hip Top with standard and Grip Quick Threads dia (5.5-7.5 mm) x length (30-65 mm) ER 19 165 1463 234195 1280 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER249 Amendia Savannah-T Pedicle Screw System-Polyaxial Pedicle Screw-Cannulated Pedicle Screw System-Polyaxial Pedicle Screw-Cannulated, Low, Mid, High Top standard and Grip Quick Threads dia (5.5-7.5 mm) x length (30-65 mm) ER 19 165 1463 Cannulated 234195 1338 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER250 Amendia Savannah T Pedicle Screw System-Pedicle Screw, Monoaxial Pedicle Screw System-Pedicle Screw, Monoaxial dia (5.5-7.5 mm) x length (40-65 mm) ER 19 165 1462 234195 895 0 0 No Change 2015-08-01 2019-03-01 Prosthesis AW018 SERI Surgical Scaffold Silk-derived biological surgical scaffold 10cm x 25cm AW 21 194 1798 5492 206374 1259 0 0 No Change 2015-02-01 2019-03-01 Prosthesis AW019 BRST Round MICROCELL™ Micotextured cohesive gel filled mammary implant Round-shaped implants with MICROCELL™ microtextured surface, silicone elastomer barrier layer and cohesive silicone gel. Available in three profiles: moderate, high and extra high. 175 - 700 g AW 23 204 1610 4429 Textured 220900 741 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AW020 Strattice Reconstructive Tissue matrix Strattice Reconstructive Tissue matrix is a biologic, surgical implant made from porcine dermis. It is intended for use as a soft tissue patch to reinforce soft tissue where weakness exists and for the surgical repair of damaged ot ruptured soft tissue membranes. Indications for use include breast reconstruction and repair of hernias. 0 - 50cm2 AW 21 194 1798 5491 Coated 199300 747 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AW021 Strattice Reconstructive Tissue matrix Strattice reconstructive Tissue Matrix is a biologic, surgical implant made from porcine dermis. It is intended for use as a soft tissue patch to reinforce soft tissue where weakness exists and for the surgical repair of of damaged or ruptured soft tissue membranes. Indications for use include breast reconstruction and repair of hernias. 51 - 150cm2 AW 21 194 1798 5491 Coated 199300 747 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AW022 Strattice Reconstructive Tissue Matrix Strattice reconstructive Tissue Matrix is a biologic, surgical implant made from porcine dermis. It is intended for use as a soft tissue patch to reinforce soft tissue where weakness exists and for the surgical repair of of damaged or ruptured soft tissue membranes. Indications for use include breast reconstruction and repair of hernias. 151 - 250cm2 AW 21 194 1798 5492 Coated 199300 1412 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AW023 Strattice Reconstructive Tissue matrix Strattice reconstructive Tissue Matrix is a biologic, surgical implant made from porcine dermis. It is intended for use as a soft tissue patch to reinforce soft tissue where weakness exists and for the surgical repair of of damaged or ruptured soft tissue membranes. Indications for use include breast reconstruction and repair of hernias. 251 - 400cm2 AW 21 194 1798 5492 Coated 199300 1412 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AW024 Strattice Reconstructive Tissue Matrix Strattice reconstructive Tissue Matrix is a biologic, surgical implant made from porcine dermis. It is intended for use as a soft tissue patch to reinforce soft tissue where weakness exists and for the surgical repair of of damaged or ruptured soft tissue membranes. Indications for use include breast reconstruction and repair of hernias. 401 - 600cm2 AW 21 194 1798 5493 Coated 199300 Changed Benefit 3278 0 0 Update 2017-08-01 2019-03-01 Prosthesis BH050 Comprehensive Shoulder - Glenoid Stem Glenoid Post, Ti Regenerx or Polyethylene 1 size BH 13 131 1277 3701 144584 1895 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BH051 Comprehensive Shoulder - Reverse Glenosphere Reverse glenosphere (31mm to 41)mm x (standard, +3, +6) BH 13 131 1277 4079 144584 Changed Benefit 2176 0 0 Update 2010-02-01 2019-03-01 Prosthesis BH052 Comprehensive Shoulder - Reverse Glenoid Baseplate Reverse glenoid baseplate, Ti, Porous coating 28mm, 25mm BH 13 131 1277 4078 144584 1991 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BH054 Comprehensive Shoulder - reverse humeral tray Modular Reverse Humeral tray, to mount onto Comprehensive stem Std, +5, +10 BH 13 131 1278 4086 104347 829 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BH055 Comprehensive shoulder - reverse humeral cup Reverse shoulder humeral bearing, highly cross linked UHMWPE (Standard or Retentive) x (std, +3) x (31 to 41)mm BH 13 131 1276 4069 104347 774 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BH058 Explor Radial Head Head (10-20)mm x (20-24)mm BH 13 131 1275 3675 127000 Changed Benefit 1267 0 0 Update 2010-02-01 2019-03-01 Prosthesis BH059 Explor Radial Head Stem (5-10)mm x (22-32)mm BH 13 131 1275 3674 127000 1259 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BH060 Discovery Elbow System Humeral Component, Hydroxy Apatite + porous coated or cemented (3-6)mm diam x (75-150)mm length BH 13 131 1275 3673 126999 4387 0 0 No Change 2010-02-01 2019-03-01 Prosthesis MC645 Strata Valve Unitised NSC (non siphon control) PSM range Adjustable CSF valve with five symmetric performance level steps. Includes a strata valve, pre-attached ventricular catheter, and a pre-attached peritoneal catheter. Right Angle Clip. Disposable Quick Release Ventricular Catheter Introducer. 8-120cm MC 25 220 1666 4468 Distal catheter, Proximal catheter, Reservoir/Priming function 145337 2565 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC646 Strata Valve Assembly NSC (non siphon control) PSM range Adjustable CSF valve with five symmetrical performance level steps. Includes a strata valve, an integral distal peritoneal catheter and catheter passer, and a female leur adaptor and prefill tubing. One size MC 25 220 1666 4468 Distal catheter, Reservoir/Priming function 134740 2427 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC647 Delta Valve with Bioglide PSM range CSF Flow Valve. Polypropylene and acetal plastic base. Silicone elastomer dome. Surface of valve bonded with hydrogel (Bioglide surface modification). 36-40mm x 9-20mm (0.5-2.0) MC 25 220 1666 4469 Antisyphon function, Coating, Reservoir/Priming function 129681 1577 0 0 No Change 2006-03-24 2019-03-01 Prosthesis BH074 Synergy/Polaris Spinal System Fixed Transverse Connectors 10 - 31.5mm BH 19 167 1474 4123 146992 404 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BH075 Synergy/Polaris Spinal System Lateral Connectors 25-75mm BH 19 167 1473 168658 281236 Changed Benefit 732 0 0 Update 2010-08-01 2019-03-01 Prosthesis BH076 Synergy Spinal System Point/Double Hex Set Screw 4.75 - 6.35mm BH 19 166 1465 146992 164 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BH079 Synergy/Polaris Spinal System Variable Locking Screws 4.75-8.5mm BH 19 165 1463 Shank 146992 640 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BH108 Anterior Cervical Plate System Titanium Cancellous Bone Screw 4 - 20mm BH 19 165 1464 168658 Changed Benefit 193 0 0 Update 2010-08-01 2019-03-01 Prosthesis BH073 Synergy/Polaris Spinal System Adjustable Transverse Connector XXS-Medium BH 19 167 1474 4124 146992 Changed Benefit 1299 0 0 Update 2010-08-01 2019-03-01 Prosthesis BH110 C-Thru Anterior Spine System Cervical Cage - PEEK Lordotic 5-12mm, Parallel 5-12mm, Convex 5-12mm BH 19 174 1486 4134 169025 2409 0 0 No Change 2011-02-01 2019-03-01 Prosthesis BS101 Polyflex Airway Stent Polyester braided material encapsulated with silicone, self expanding stent Diameters up to 25mm & lengths up to 80mm BS 21 192 1563 126797 2850 0 0 No Change 2006-11-30 2019-03-01 Prosthesis LM133 TriMed Compression Screws 'Compression Screws 3.0-4.5mm LM 13 123 1231 3370 CN,DT,LK 229704 442 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM134 TriMed Compression Screws Compression Screws 4.5-7.5mm LM 13 123 1231 3369 CN,DT,LK 229704 425 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM135 TriMed Hook Plate Hook Plate ≤ 6 holes LM 13 123 1694 5289 LK 182677 1330 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM136 TriMed Hook Plate Hook Plate ≥ 7 to ≤ 15 holes LM 13 123 1694 5290 LK 182677 1330 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM140 TriMed Wrist Fixation System TriMed Volar Bearing Plate 3 and 5 hole LM 13 123 1694 5276 VAL 182677 1439 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM141 TriMed Wrist Fixation System TriMed Volar Bearing Plate 7,9 and 11 Hole LM 13 123 1694 5277 VAL 182677 1439 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM142 Extremity Medical Compression Screw System Compression Screws ≥ 4.5mm LM 13 123 1231 3369 CN,DT 164980 362 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM143 Extremity Medical Compression Screw System Compression Screws 3.0-4.5mm LM 13 123 1231 3370 CN,DT 164980 379 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MC648 Delta Valve Unitised with Bioglide PSM range CSF Flow Valves. Polypropylene and acetal plastic base. Silicone elastomer dome. Unitised system includes the valve, integral ventricular and peritoneal catheter (all components connected). Surface of valve bonded with hydrogel (Bioglide surface modificat 8-13.5cm x 90-120cm (0.5-2.0) MC 25 220 1666 4469 Antisyphon function, Coating, Distal catheter, Proximal catheter, Reservoir/Priming function 129681 Changed Benefit 1891 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC649 Delta Shunt Unitised Delta valve is a fixed pressure CSF valve, available in four performance levels. Delta Unitised shunt includes a delta valve, pre-attached ventricular catheter, and a pre-attached peritoneal catheter. Right Angle Clip. Disposable Quick Release Ventricular Delta Unitised Shunt small (Distal 65cm-90cm, ventricular 11cm) - 0.5, 1.0, 1.5 and 2.0. Delta Unitised Shunt regular (Distal 90cm, ventricular catheter 13cm) - 0.5, 1.0, 1.5 and 2.0 MC 25 220 1666 4469 Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function 139696 1786 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC650 Delta Shunt Assembly Delta valve is a fixed CSF pressure valve, available in four performance levels. Includes an Integral (distal) Peritoneal Catheter, Disposable Peritoneal Catheter Passer, Female Luer Adapter and Prefill Tubing. 90-120cm (0.5 - 2.0) MC 25 220 1666 4469 Antisyphon function, Distal catheter, Reservoir/Priming function 134740 Changed Benefit 1648 0 0 Update 2006-03-24 2019-03-01 Prosthesis AU007 Aus Systems Titanium Miniplates (Bone Plates) Plate Titanium 0.7mm profile 4-7 holes AU 23 199 1589 4271 109176 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AW025 Strattice Reconstructive Tissue Matrix Strattice reconstructive Tissue Matrix is a biologic, surgical implant made from porcine dermis. It is intended for use as a soft tissue patch to reinforce soft tissue where weakness exists and for the surgical repair of of damaged or ruptured soft tissue membranes. Indications for use include breast reconstruction and repair of hernias. 601 - 800 cm2 AW 21 194 1798 5494 Coated 199300 4275 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BH036 Biolox Delta Option Ceramic Femoral Heads ceramic modular head, biolox delta 36mm to 60mm BH 18 162 1420 3998 117715 2022 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BH037 Biolox Delta Option Taper Taper Sleeve, Titanium -6mm, -3mm, Std, +3mm and +6mm BH 18 164 1442 117715 457 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BH039 Avantage Reload Dual Mobility Cementless Acetabular Cup Revision Acetabular Cup polished inner surface, with flanges, Porous HA Coating, Stainless Steel 44mm - 64mm BH 18 163 1427 4018 119236 2373 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BH040 Avantage Dual Mobility Cemented Acetabular Cup Acetabular shell, polished inner surface, Stainless Steel 44mm - 60mm BH 18 163 1425 4009 223850 Changed Benefit 1582 0 0 Update 2010-02-01 2019-03-01 Prosthesis LM105 Ascension Radial head Proximal Radial Head 20/22/24mm LM 13 131 1275 3675 112685 Changed Benefit 1267 0 0 Update 2011-08-01 2019-03-01 Prosthesis LM111 Ascension Radial Head Plate Screws Ascension radial Head Plate Non-Locking Screws 2.7mm x 10-26mm LM 13 123 1231 3371 118625 84 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM112 Ascension Radial Head Plate Screws Ascension Radial Head Plate Locking Screws 2.7mm x 10mm - 40mm LM 13 123 1231 3371 LK 118625 147 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM117 TriMed Radial Column Plates Radial Column Plate 3 & 5 hole LM 13 123 1694 5276 182677 869 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM118 TriMed Radial Column Plates Radial Column Plate 7 hole LM 13 123 1694 5277 182677 869 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM104 Ascension Radial Head Proximal Radial Stem 01/02/03/04, standard & long LM 13 131 1275 3674 112685 1259 0 0 No Change 2011-08-01 2019-03-01 Prosthesis LM119 TriMed Ulna Column Plates Ulna Column Plate 3 & 5 hole LM 13 123 1694 5276 182677 869 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM120 TriMed Ulna Column Plates Ulna Column Plate 7 hole LM 13 123 1694 5277 182677 869 0 0 No Change 2012-02-01 2019-03-01 Prosthesis AU014 Aus Systems Titanium Miniplates (Bone Plates) Low profile burr hole cover 10mm, 14mm, 18mm, 22mm AU 23 199 1589 4271 Burr 109176 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AU019 Aus Systems Titanium Miniplates (Bone Plates) Plate Titanium 1mm & 1.2mm profile 16 & 19 hole AU 23 199 1589 4296 109176 199 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AU059 Aus systems titanium bone screws titanium bone screws 1.5mm diameter - 2.3mm diameter, 3mm length to 15mm length AU 23 199 1590 4323 114616 42 0 0 No Change 2012-02-01 2019-03-01 Prosthesis AU060 Aus systems titanium Miniplates (Bone plates) titanium miniplates 8,19 hole AU 23 199 1589 4277 109176 199 0 0 No Change 2012-02-01 2019-03-01 Prosthesis AU061 Aus Systems Titanium Miniplates (bone Plates) Titanium Miniplates 1.0-1.99mm thick, 4-7 holes AU 23 199 1589 4288 109176 161 0 0 No Change 2012-02-01 2019-03-01 Prosthesis AW004 Natrelle® 510 TruForm™ Dual Gel Breast Prosthesis Anatomical textured implant with dual gel for projection of nipple/areola complex, concave base and tapered edges for minimisation of edge/thoracic wall palpability. LX sizes from 130-575 grams, MX sizes from 145-600 grams, FX sizes from 165-630 grams AW 23 204 1610 4432 Pre-shaped 171387 1170 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BH061 Discovery Elbow System Ulnar Component; Hydroxy apatite + porous coated or cemented (3-5)mm dia x (75-115)mm length BH 13 131 1275 3676 126999 3398 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BH062 Discovery Elbow System 2 x Condyle Bearings, 2 x screws, Poly articulation bearings Std, Revision BH 13 131 1275 4052 126999 1368 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BH063 Regenerex Sleeve Augment Augment, cone or finned sleeve, SSK/OSS Systems, Ti (25mm to 40mm, Type A or B) x Extra small/Large BH 17 159 1400 Metaphyseal 98451 Changed Benefit 2416 0 0 Update 2010-08-01 2019-03-01 Prosthesis BH064 Sternalock plates, various shapes 7-15 holes BH 13 123 1694 5262 Com, LK 128458 1018 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BH065 Sternalock Plate, locking, >6 hole, Various shapes 8-12 hole BH 13 123 1694 5256 LK 119508 931 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BH066 Synergy/Polaris Spinal System Rods 4.75-6.35 diameter BH 19 170 1478 146992 Changed Benefit 426 0 0 Update 2010-08-01 2019-03-01 Prosthesis BH067 Synergy/Polaris Spinal System Rods 30 - 60cm BH 19 170 1478 146992 Changed Benefit 426 0 0 Update 2010-08-01 2019-03-01 Prosthesis BH070 Synergy/Polaris Spinal System Open/Closed Screws 4.0 to 8.0mm dia. BH 19 165 1462 146992 895 0 0 No Change 2010-08-01 2019-03-01 Prosthesis AW005 Natrelle® INSPIRA® TruForm Textured Mammary Implant Round implants with textured surface. Available in four projections: low, moderate, full and extra-full; and two cohesive gel types: TruForm™ 1 Responsive Gel and TruForm™ 2 Soft-Touch™ Gel. 110 - 800 grams AW 23 204 1610 4429 Textured 175422 175425 741 0 0 No Change 2010-08-01 2019-03-01 Prosthesis AW007 Natrelle® 410 BioDIMENSIONAL™ TruForm™ 2 Soft-Touch™ Gel and TruForm™ 3 Cohesive Gel Textured Mammary Implants. Full, moderate or low height; Extra full,full, moderate or low projection 125 - 775 grams AW 23 204 1610 4432 Pre-shaped 171475 171512 1170 0 0 No Change 2010-08-01 2019-03-01 Prosthesis AW008 Natrelle® INSPIRA® TruForm™ Smooth Mammary Implant Round implants with smooth surface. Available in four projections: low, moderate, full and extra-full; and two cohesive gel types: TruForm™ 1 Responsive Gel and TruForm™ 2 Soft-Touch™ Gel. 110 - 800 grams AW 23 204 1610 4429 175421 175426 595 0 0 No Change 2010-08-01 2019-03-01 Prosthesis AW012 Natrelle® 150, 1-Stage BioDimensional™ Tissue Expander Full height, Short Height, textured 9.6 -16cm width x 8 - 17cm height x 4.2 - 7.1cm projection AW 23 203 1606 4414 Expander Implant 169956 1989 0 0 No Change 2010-08-01 2019-03-01 Prosthesis AW013 Natrelle® 133, 2-Stage BioDimensional™ Tissue Expander Silicone Elastomer. Saline filled. 150-950 cm3 AW 23 203 1606 4414 Textured 175797 1024 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BS103 Dynamic (Y) Stent Bifurcated Tracheobronchial stent. Bronchial Limbs made of silicone and tracheal stem made of silicone with embedded stainless steel c-shape rings. Diameters up to 25mm & lengths up to 120mm BS 21 192 1563 126797 2850 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BS104 Precision Plus IPG; Precision Plus IPG with Multiwave Technology Rechargeable Neurostimulation System Implantable Pulse Generator. One Size Only BS 25 222 1677 4481 Unlimited Deep Discharge Battery 129091 231187 20900 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BS106 Precision Plus Remote Patient Programmer; Precision Plus with MultiwaveTechnology Remote Patient Programmer Hand held remote control External Patient Programmer One Size Only BS 25 222 1678 4483 128681 166929 231196 1425 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BS102 Polyflex Oesophageal Stent Polyester braided material encapsulated with silicone, self expanding stent Diameters up to 30mm & lengths up to 150mm BS 21 192 1558 4238 126757 126797 3325 0 0 No Change 2006-11-30 2019-03-01 Prosthesis BS109 Precision SCS Eight Contact Leads Eight contact percutaneous leads. 30cm to 70cm BS 25 222 1679 4486 8 electrodes 128775 Changed Benefit 4018 0 0 Update 2007-06-01 2019-03-01 Prosthesis BS111 Precision SCS Lead Extensions Lead Extensions 25cm to 55cm BS 25 222 1680 128679 Changed Benefit 1434 0 0 Update 2007-06-01 2019-03-01 Prosthesis LM145 TriMed Bone Screw Locking Cortical Bone Screw 3.2mm x 10-40mm LM 13 123 1231 3370 LK 182677 145 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM146 TriMed Bone Screws Non-Locking Cortical Bone Screw 3.2/3.8/4.0 x 10-60mm LM 13 123 1231 3370 182677 82 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM144 TriMed Bone Screw Non-Locking Cortical Bone Screws 2.3mm x 7mm - 32mm 2.7mm x 8mm - 28mm LM 13 123 1231 3371 182677 84 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM147 TriMed Bone Screw Locking Compression Bone Screw 4mm x 35-60mm LM 13 123 1231 3370 LK 182677 145 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MC613 Vantage Vantage Plates and Screws; ATL Screw 6.5 x 30-55mm MC 19 165 1464 169514 Changed Benefit 193 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC614 Vantage Vantage Plates and Screws; Staple (rostral/caudal) One Size Only MC 19 172 1483 169514 395 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC615 Vantage Vantage Plates and Screws; Lock Nut One Size Only MC 19 166 1465 169514 164 0 0 No Change 2006-03-24 2019-03-01 Prosthesis BH041 Avantage Dual Mobility Acetabular Cup Inlay UHMWPE Dual Mobility Liner 44-66mm diameter shells BH 18 163 1428 4024 119236 1613 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BH044 Biomet Phoenix Nail Arthrodesis Nailing System - Nail Ankle Arthrodesis Locking Nail, Titanium Alloy 9 - 12mm diameter x 150 - 420mm length BH 13 123 1228 3332 114474 Changed Benefit 4493 0 0 Update 2010-02-01 2019-03-01 Prosthesis BH045 Biomet Phoenix Arthrodesis Nailing System - End Cap Offset end cap, Titanium 0mm - 20mm BH 13 123 1229 5363 114474 96 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BH046 Biomet Phoenix Ankle Nailing System - 5mm Double-lead thread screw Double lead screw - Ti-6Al-4V Standard or osseotite finish 5mm Dia x (20 to 110)mm length BH 13 123 1229 3713 114474 Changed Benefit 143 0 0 Update 2010-02-01 2019-03-01 Prosthesis BH047 Comprehensive Shoulder System Humeral Stems, standard, mini, micro and revision, porous coated, Ti 4mm to 20mm Diameter BH 13 131 1276 4058 104347 3325 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BH049 Comprehensive shoulder - glenoid Modular hybrid glenoid base UHMWPE; Titanium small, medium, large BH 13 131 1277 3702 144584 2109 0 0 No Change 2010-02-01 2019-03-01 Prosthesis MC618 Medishield Anti-Adhesion Gel MediShield Anti-Adhesion Gel is an adhesion barrier gel for prevention of complications after spinal surgery. MediShield is a co-polymer gel composed of carboxymethylcellulose and polyethylene oxide. 3cc Syringe MC 21 194 1579 5433 Complex 137951 1235 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC625 Modified Dual TiMesh TiMesh Surgical Mesh Modified, includes two cranial plates. Composition: Titanium 121mm x 77mm - 152mm x 152mm. MC 23 200 1593 4343 Biomodelled, Dual Mesh 128523 Changed Benefit 10237 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC626 Macropore FRP (fast resorbing polymer) Polylactide and Polyglycolide polymer 1.8mm x 3-8mm MC 23 199 1590 4323 Resorbable 153968 137 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC627 Macropore FRP (fast resorbing polymer) Polylactide and Polyglycolide polymer 100mm x 100mm x 0.75mm MC 23 199 1586 4228 153968 Changed Benefit 1892 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC628 Macropore FRP (fast resorbing polymer) Polylactide and Polyglycolide polymer 60mm x 80mm x 0.75mm MC 23 199 1586 4227 153968 1199 0 0 No Change 2006-03-24 2019-03-01 Prosthesis LM122 TriMed Periarticular Plate Periarticular Plates ≤ 6 holes LM 13 123 1694 5258 LK 182677 470 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM123 TriMed Periarticular Plate Periarticular Plates ≥ 7 to ≤ 15 holes LM 13 123 1694 5259 LK 182677 Changed Benefit 536 0 0 Update 2012-02-01 2019-03-01 Prosthesis LM124 TriMed Periarticular Plate Periarticular Plates ≥ 16 holes LM 13 123 1694 5260 LK 182677 Changed Benefit 1017 0 0 Update 2012-02-01 2019-03-01 Prosthesis LM121 'TriMed Wire Plates Wire Fixation plate 3 & 5 hole LM 13 123 1694 5258 182677 214 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM125 TriMed Sidewinder Ankle Fixation Plate ≤ 6 holes LM 13 123 1694 5258 Com, LK 182677 850 0 0 No Change 2012-02-01 2019-03-01 Prosthesis LM126 TriMed Sidewinder Ankle Fixation Plate 7 hole sidewinder plate LM 13 123 1694 5259 Com, LK 182677 Changed Benefit 916 0 0 Update 2012-02-01 2019-03-01 Prosthesis LM131 TriMed Compression Screws Compression screws 1.7mm LM 13 123 1231 3372 CN,DT,LK 229704 Changed Benefit 420 0 0 Update 2012-02-01 2019-03-01 Prosthesis LM132 TriMed Compression Screws Compression Screws 2.0mm – 2.5mm LM 13 123 1231 3371 CN,DT,LK 229704 444 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MC629 Macropore FRP (fast resorbing polymer) Polylactide and Polyglycolide polymer 50mm x 50mm 0.75mm MC 23 199 1586 4226 153968 921 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC630 Macropore FRP (fast resorbing polymer) Polylactide and Polyglycolide polymer 25mm x 25mm x 0.75mm MC 23 199 1586 4225 153968 585 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC632 Verte-Stack XS Centre Piece. Stackable Corpectomy Device. Height 5-50mm MC 19 176 1493 169501 4235 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC635 CD Horizon Legacy In-Line Connector Length 40-110mm MC 19 167 1472 169514 Changed Benefit 732 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC636 CD Horizon Eclipse Dual Head Screws 20-60mm MC 19 165 1462 Complex 169514 998 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC637 CD Horizon Spire Plate 35-41mm MC 19 177 1496 169514 Changed Benefit 1372 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC638 Peritoneal Catheter PSM range with Bioglide Translucent silicone elastomer with Barium impregnated stripe. Catheter surface bonded with Hydrogel. 60-90cm MC 25 220 1668 Distal, Coating 130410 242 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC640 Strata Shunt, Unitised Adjustable CSF valve with five symmetric performance level steps. Includes strata valve, pre-attached ventricular catheter, and a pre-attached peritoneal catheter. Right Angle Clip. Disposable Quick Release Ventricular Catheter Introducer. Disposable Sub 8-13.5cm x 9-120cm MC 25 220 1666 4468 Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function 129681 145335 3040 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC641 Strata Valve Unitised with Bioglide PSM range CSF Flow Valve. Polypropylene and acetal plastic base. Silicone elastomer dome. One size only MC 25 220 1666 4468 Antisyphon function, Coating, Distal catheter, Proximal catheter, Reservoir/Priming function 145337 Changed Benefit 3144 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC642 Strata Valve Assembly with Bioglide PSM range CSF Flow Valves. Polypropylene and acetal plastic base. Silicone elastomer dome. One size MC 25 220 1666 4468 Antisyphon function, Coating, Distal catheter, Reservoir/Priming function 169061 Changed Benefit 3007 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC639 Ventricular Catheter PSM range with Bioglide Translucent silicone elastomer with Barium impregnated stripe. Catheter surface bonded with Hydrogel. 15-23cm MC 25 220 1668 Proximal, Coating 141102 237 0 0 No Change 2006-03-24 2019-03-01 Prosthesis DE398 Oculentis LENTIS L-302-1 Foldable one-piece monofocal C loop acrylic IOL. Optic Size 6.0mm, Overall Length 12.00mm. +-0.0D to +35.0D (1.0D steps) and +15.5D to +26.5D (0.5D steps). DE 1 141 1327 3892 192478 265 0 0 No Change 2012-08-01 2019-03-01 Prosthesis DE407 Non-Locking Cortical and Cancellous Screws, Small Non-Locking Cortical and Cancellous Screws, Small 3-3.5mm DE 13 123 1231 3370 284416 82 0 0 No Change 2012-08-01 2019-03-01 Prosthesis BS140 Advantage Fit, Advantage Fit Blue Transvaginal Mid-Urethral Sling System One size only AM 26 226 1698 5315 104326 Changed Product name, Product description, Benefit 822 0 0 Update 2009-08-01 2019-03-01 Prosthesis BS141 EndoVive Initial Feeding Tube Silicone enteral feeding tube Up to 24 Fr BS 21 189 1545 4197 159455 195 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BS142 EndoVive Replacement Feeding Tube Silicone enteral feeding tube Up to 28 Fr BS 21 189 1545 4198 159455 160876 Changed Benefit 86 0 0 Update 2009-08-01 2019-03-01 Prosthesis BS143 Precision SCS External Patient Recharger System External Patient Recharging System: Base Station, Charger, Cradle power supply, charger base station. One size only BS 25 222 1678 4497 149462 155857 155859 155924 1279 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BS153 Myopore Bipolar sutureless myocardial pacing lead 25-54cm BS 27 243 1746 161123 1235 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BS158 Precision Connector M1 Lead extension for Precision SCS System 35. 55. 70 cm length BS 25 222 1680 162422 Changed Benefit 1434 0 0 Update 2010-02-01 2019-03-01 Prosthesis BS167 Placehit Wallstent Biomedical cobalt-based alloy, self expanding stent Stent diameters up to 19mm and lengths up to 100mm BS 24 206 1622 4440 136261 1710 0 0 No Change 2010-02-01 2019-03-01 Prosthesis 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 BS 24 206 1622 4440 159294 1710 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BS169 Precision SCS Splitter Lead extension for connection of multiple leads Multiple Configurations BS 25 222 1680 167101 167102 197908 Changed Benefit 1434 0 0 Update 2010-08-01 2019-03-01 Prosthesis BS170 Endotak Reliance S 4-SITE Passive fixation single coil defibrillation leads & 4-SITE connector. 50-70cm BS 27 242 1741 e 165638 6480 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BS173 Advanix Plastic Stent with Naviflex Delivery System Plastic stent manufactured pre loaded on a delivery catheter 5-18cm length, 7-10 FR diameter BS 21 192 1556 4218 Delivery System 127387 190 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BS174 Endotak Reliance SG 4-SITE Active fixation single coil defibrillation leads with ePTFE covered coil & 4-SITE connector. 50-70cm BS 27 242 1743 e 165645 6480 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BS178 Endotak Reliance 4-SITE Active fixation dual coil defibrillation leads with 4-SITE connector 50-70cm BS 27 242 1743 e 165639 6480 0 0 No Change 2010-08-01 2019-03-01 Prosthesis DV265 RayOne Ashperic preloaded Preloaded aspheric intraocular lens, hydrophilic acrylic, UV absorbing, 360 square edge, anti-vaulting haptics 6mm optic, range sphere -10 to +34 DV 1 141 1327 3892 at, pl 220612 308 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DV266 RayOne Toric Aspheric preloaded Single piece preloaded aspheric toric acrylic IOL, UV absorbing, 360 square edge, anti-vaulting haptics 6mm optic, +8 to +30 sphere, +1 to +6 cylinder in 0.5 steps DV 1 141 1327 3892 at, pl, t1 220612 Changed Benefit 626 0 0 Update 2017-02-01 2019-03-01 Prosthesis DV267 Hoya Vivinex XY1AT Toric Preloaded injector system, toric / corrects corneal astigmatism, micro-incision, aspheric, blue blocker, single piece hydrophobic IOL Power: + 10.0 to 30.0 (0.5 steps), IOL Cylinder power: 1.0D (XY1AT2), 1.50D (XY1AT3), 2.25D (XY1AT4), 3.00D (XY1AT5), 3.75D (XY1AT6), 4.50D (XY1AT7), 5.25D (XY1AT8), 6.00D (XY1AT9) DV 1 141 1327 3892 at, pl, t1, vblf 117417 659 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DV268 Hoya Vivinex iSert preloaded IOL (Model XC1) Preloaded injector system, micro incision, aspheric, UV filtering, single piece, hydrophobic acrylic +6.0 to 30.0 D (in 0.5D steps) DV 1 141 1327 3892 at, pl 117417 308 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BS179 Endotak Reliance S 4-SITE Active fixation single coil defibrillation leads & 4-SITE connector 50-70mm BS 27 242 1743 e 165640 6480 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BS180 Endotak Reliance G 4-SITE Passive fixation dual coil defibrillation leads with ePTFE covered coils & 4-SITE connector 50-70cm BS 27 242 1741 e 165641 6480 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BS181 Endotak Reliance SG 4-SITE Passive fixation single coil defibrillation leads with ePTFE covered coil & 4-SITE connector 50-70 BS 27 242 1741 e 165642 6480 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BS182 Endotak Reliance G 4-SITE Active fixation dual coil defibrillation leads with ePTFE covered coils & 4-SITE connector. 50-70cm BS 27 242 1743 e 165644 6480 0 0 No Change 2010-08-01 2019-03-01 Prosthesis DE412 Low Profile Locking Screws Locking screws for Arthrex Fracture Plate Fixation 2.01mm to 2.7mm DE 13 123 1231 3371 LK 284416 147 0 0 No Change 2013-02-01 2019-03-01 Prosthesis DE413 Locking Reconstruction Plate Reconstruction Plate for communited Fibula Shaft Fractures 4-6 Holes DE 13 123 1694 5258 LK 140686 470 0 0 No Change 2013-02-01 2019-03-01 Prosthesis DE414 Locking Reconstruction Plates Reconstruction Plate for communited Fibula Shaft Fractures 7-12 holes DE 13 123 1694 5259 LK 140686 Changed Benefit 536 0 0 Update 2013-02-01 2019-03-01 Prosthesis DE415 Locking Third Tubular Plates Plate for fracture of the Fibula 7-12 Holes DE 13 123 1694 5259 LK 140686 Changed Benefit 536 0 0 Update 2013-02-01 2019-03-01 Prosthesis BY011 Motiva, Matrix Silk Surface PLUS Sterile Silicone Breast Implants, Motiva Matrix SilkSurface PLUS - Prosthesis, internal, mammary, gel filled 105cc to 500cc BY 23 204 1610 4429 Textured 282778 741 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BY012 Motiva Ergonomix Implant Matrix, SilkSurface with Qid Sterile Silicone Breast Implants Motiva Implant Matrix Ergonomix, SilkSurface with Qid - Prosthesis, internal, mammary, gel filled 105cc to 500cc BY 23 204 1610 4429 Textured, Pre-shaped 282777 975 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BY013 Motiva, Matrix Silk Surface PLUS Sterile Silicone Breast Implants, Motiva Matrix, SilkSurface PLUS - prostheses, Internal, Mammary, gel filled 500cc to 1050cc BY 23 204 1610 4432 Textured 282778 741 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BY014 Motiva, Matrix Silk Surface PLUS with QID Sterile Silicone Breast Implants, Motiva Matrix, SilkSurface PLUS with QID - prostheses, Internal, Mammary, gel filled 500cc TO 1050cc BY 23 204 1610 4432 Textured, Pre-shaped 282776 1170 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BY015 Motiva Ergonomix Implant Matrix, SilkSurface with QID Sterile Silicone Breast Implants, Motiva Ergonomix Matrix, SilkSurface PLUS with QID - prostheses, Internal, Mammary, gel filled 500cc TO 775cc BY 23 204 1610 4432 Textured, Pre-shaped 282777 1170 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BY016 Motiva, Matrix Silk Surface PLUS with QID Sterile Silicone Breast Implants Motiva Implant Matrix SilkSurface PLUS with Qid - Prosthesis, internal, mammary,gel filled 105cc to 500cc BY 23 204 1610 4429 Textured, Pre-shaped 282776 975 0 0 No Change 2017-08-01 2019-03-01 Prosthesis CB010 Hydrocoils Framing and filling coils with Hydrogel. Diam: 1-24mm Length: 1-50cm CB 25 225 1688 137933 1430 0 0 No Change 2012-08-01 2019-03-01 Prosthesis CB011 Microplex Coils Framing and filling coils Diam: 1-24mm Length: 1-68cm CB 25 225 1688 137934 1430 0 0 No Change 2012-08-01 2019-03-01 Prosthesis ER264 Amendia Diamond Anterior Cervical Plate System- Plate (large, greater than 55mm) Diamond Anterior Cervical Plate System- Plate (large, greater than 55mm) 56-92 mm ER 19 169 1476 4125 >55mm 233539 1636 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER265 Amendia Diamond Anterior Cervical Plate System- Screws Diamond Anterior Cervical Plate System- Screws (hex drive fixed or variable with Grip QuickTM Threads dia 4.0/4.3 mm x length (12-20 mm) ER 19 165 1464 233539 Changed Benefit 193 0 0 Update 2015-08-01 2019-03-01 Prosthesis ER266 Veniti VICI Venous Stent System VICI and VICI VERTO Venous Stent System dia (12-16 mm) x length (60-120 mm) ER 24 206 1622 4440 235679 1710 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER273 Spineway Ayers Rock Cervical Cage Spineway Ayers Rock cervical fusion cage Height (5-9mm) x Length (13-19mm) x Width (12-15mm) ER 19 174 1486 4134 235415 2409 0 0 No Change 2016-02-01 2019-03-01 Prosthesis ER274 Spineway Blue Mountain Cervical Plate System-Plate Spineway Blue Mountain cervical plate Length (24-54mm) x Width (17.5mm) ER 19 169 1477 4127 235416 1251 0 0 No Change 2016-02-01 2019-03-01 Prosthesis DY036 Duraloc Marathon Acetabular UHMWPE Cross Linked Liner UHMWPE, highly cross linked, Sizes 36-76mm SY 18 163 1428 4021 98086 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY064 Protrusio Acetabular Reconstruction Cage Titanium, grit blast, proximal distal flange, left & right sided 49-69ID SY 18 163 1432 4035 138292 1253 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ER261 Amendia Spartan Transfacet Pedicle Screw System-Monoaxial Screw, Cannulated Amendia Spartan Transfacet Pedicle Screw System-Monoaxial Screw, Cannulated dia 4.3mm x length (20-35mm); dia 5.0 mm x length (20-55mm) ER 19 165 1464 Cannulated 233732 202 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER262 Amendia Samson Corpectomy Vertebral Body Replacement System Amendia Samson Corpectomy Vertebral Body Replacement System dia 13.5x height (14-48 mm) ER 19 176 1814 233540 3470 0 0 No Change 2015-08-01 2019-03-01 Prosthesis ER263 Amendia Diamond Anterior Cervical Plate System- Plate Amendia Diamond Anterior Cervical Plate System- Plate 22-54 mm ER 19 169 1476 4125 233539 Changed Benefit 1348 0 0 Update 2015-08-01 2019-03-01 Prosthesis CB012 LVIS Intraluminal Support Device Self-expanding intracranial vascular stent Diameters: 2.5, 3.5, 4.5, 5.5mm Lengths: 9-30mm CB 25 225 1687 194409 7125 0 0 No Change 2013-02-01 2019-03-01 Prosthesis CB013 Scepter Occlusion Balloon Catheter Intravascular occlusion balloon catheter Balloon diameter: 4mm Balloon lengths: 10 - 20mm CB 25 225 1689 6022 194400 1641 0 0 No Change 2013-02-01 2019-03-01 Prosthesis CB014 Headway Microcatheter Single lumen microcatheter Internal diameter: 0.42mm - 0.69mm Outside diameter - distal: 1.6 - 2.6 Fr Outside diameter - proximal 2.1 -3.1 Fr Length: 150cm to 167cm CB 25 225 1689 4494 162633 665 0 0 No Change 2013-02-01 2019-03-01 Prosthesis CB015 V-Grip Detachment Controller A battery powered device used to control detachment of an implantable embolisation coil from a delivery pusher. One size only CB 25 225 1689 4495 148674 Changed Benefit 333 0 0 Update 2013-08-01 2019-03-01 Prosthesis CB016 Skater All-Purpose Drainage Catheter All-purpose drainage catheters for abscesses and fluid collections Single Step Drainage Catheter w/Locking Pigtail 6Fx20cm, 6Fx25cm, 7Fx20cm, 7Fx25cm, 8Fx20cm, 8Fx25cm, 8Fx30cm, 10Fx20cm, 10Fx25cm, 10Fx30cm, 12Fx20cm, 12Fx25cm, 14Fx20cm, 14Fx25cm, 16Fx25cm Single Step Drainage Catheter w/Non-Locking Pigtail 6Fx20cm, 6Fx25cm, 7Fx20cm, 7Fx25cm, 8Fx20cm, 8Fx25cm, 8Fx30cm, 10Fx20cm, 10Fx25cm, 10Fx30cm, 12Fx20cm, 12Fx25cm, 14Fx20cm, 14Fx25cm, 16Fx25cm Drainage Catheter w/Locking Pigtail 6Fx25cm, 6Fx35cm, 7Fx25cm, 7Fx35cm, 8Fx25cm, 8Fx35cm, 10Fx25cm, 10Fx35cm, 12Fx25cm, 12Fx35cm, 14Fx25cm, 14Fx35cm, 16Fx25cm Drainage Catheter w/Non-Locking Pigtail 6Fx25cm, 6Fx35cm, 7Fx25cm, 7Fx35cm, 8Fx25cm, 8Fx35cm, 10Fx25cm, 10Fx35cm, 12Fx25cm, 12Fx35cm, 14Fx25cm, 16Fx25cm CB 21 193 1577 4243 223261 404 0 0 No Change 2015-08-01 2019-03-01 Prosthesis CB017 Skater Biliary Drainage Catheter Used for biliary drainage applications Biliary Drainage Catheter w/Locking Pigtail 8Fx40cm, 10Fx40cm, 12Fx40cm Biliary Drainage Catheter w/Non-Locking Pigtail 8Fx40cm, 10Fx40cm, 12Fx40cm CB 21 193 1577 5489 223261 114 0 0 No Change 2015-08-01 2019-03-01 Prosthesis CB018 Skater Nephrostomy Drainage Catheter A drainage catheter intended for use for Nephrostomy applications either by direct stick or modified seldinger technique. 6 - 14 Fr CB 26 234 1718 223260 114 0 0 No Change 2015-08-01 2019-03-01 Prosthesis CK001 Microline Pentax Disposable 10ml Titanium K2 Clip Cartridge Disposable cartridge containing 19 surgical grade titanium clips delivered using a re-usable hand piece applier medium/large clip CK 21 194 1581 4259 129715 60 0 0 No Change 2007-12-01 2019-03-01 Prosthesis CB019 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. Suitable for vessels up to 32mm CB 24 211 1642 283794 284696 2231 0 0 No Change 2016-02-01 2019-03-01 Prosthesis CB020 CASPER Carotid Artery Stent System Self-expanding nickel titanium (nitinol) stent implant Outer Diameter 5-10mm Overall Length 25 - 47mm Layer Length 25 - 47mm CB 24 206 1622 4440 285016 1710 0 0 No Change 2017-08-01 2019-03-01 Prosthesis CB021 Headway Duo Single Lumen Microcatheter Proximal ID = .0165in min. (0.42 mm) OD = .027in (0.70 mm) Distal ID = .0165in min. (0.42 mm) OD = .023in (0.58 mm) Length: 156cm and 167cm CB 25 225 1689 4494 296334 665 0 0 No Change 2018-08-01 2019-03-01 Prosthesis CB022 Chaperon Guiding Catheter System Guiding Catheter Guiding Catheter: 5Fr - 0.059”/1.5mm ID & 6Fr - 0.071"/1.8mm ID Inner Catheter: 4Fr - 0.041”/1.05mm ID & 5Fr - 0.048"/1.22mm ID CB 25 225 1689 4494 162770 665 0 0 No Change 2018-08-01 2019-03-01 Prosthesis DE416 Locking Third Tubular Plate Plate for fracture fixation of the Fibula 4-6 holes DE 13 123 1694 5258 LK 140686 470 0 0 No Change 2013-02-01 2019-03-01 Prosthesis DV250 Hoya-PS AF-1 (UY) PY-60AD Preloaded in cartridge, Aspheric, Blue blocker, Foldable, Single-Piece, Hydrophobic Acrylic +6.0D to +30.0D (0.5D steps) DV 1 141 1327 3892 at, pl, vblf 117417 333 0 0 No Change 2010-08-01 2019-03-01 Prosthesis DV252 HOYA iSert® 251 Preloaded injector system, Micro-incision, Aspheric, Blue-Blocker, Single Piece, Hydrophobic +6.0D to 30.0D (5 steps) DV 1 141 1327 3892 at, pl, vblf 112674 117417 333 0 0 No Change 2011-02-01 2019-03-01 Prosthesis DV253 HOYA AF-1 351 Toric T3/T4/T5/T6/T7/T8/T9 Preloaded injector system, correct corneal astigmatism micro-incision, ashperic, blue-blocker, single piece hydophobic. IOL Power: + 10.0 to 30.0 (0.5 steps), IOL Cylinder power: 1.50D (351T3), 2.25D (351T4), 3.00D (351T5), 3.75D (351T6), 4.50D (351T7), 5.25D (351T8), 6.00D (351T9) DV 1 141 1327 3892 at, pl, t1, vblf 112674 117417 659 0 0 No Change 2011-08-01 2019-03-01 Prosthesis DV270 OcuGas 6 Tamponade gas for retinal surgery A sterile DV 1 148 1345 292815 71 0 0 No Change 2018-02-01 2019-03-01 Prosthesis DV271 RayOne Trifocal Diffractive step trifocal with smooth transition and reduced light loss 0.0 D to +30.0D (increments 0.5D) DV 1 141 1327 3893 at, pl 220612 Changed Benefit 694 0 0 Update 2018-02-01 2019-03-01 Prosthesis DY020 SROM Trochanteric Washer Screw Titanium, attaches washer to calcar replacement stem 42mm, 52mm, 62mm SY 18 164 1450 99193 99196 176 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY031 Duraloc Option Acetabular Shell Titanium, beaded with HA (duofix) 46-66 mm SY 18 163 1427 4016 146753 97696 Changed Benefit 2556 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY034 Duraloc Option Acetabular Shell Ceramic Insert Ceramic, Biolox Forte 46-66 mm SY 18 163 1428 4022 97696 98086 Changed Benefit 2250 0 0 Update 2005-10-31 2019-03-01 Prosthesis DV269 HOYA iSert® 250 Preloaded injector system, Micro-Incision, Aspheric, UV filtering, Single Piece, Hydrophobic +6.0D to +30.0D (in 0.5D steps) DV 1 141 1327 3892 at, pl 112674 117417 308 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BS116 Polaris Loop Ureteral Stent Dual durometer ureteral stent with attached suture Diameters up to 14Fr & lengths up to 40cm BS 26 227 1701 5322 Therm 104324 129376 203 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BS121 Precision SCS IPG Port IPG Port Plug One Size Only BS 25 222 1690 4500 156761 Changed Benefit 160 0 0 Update 2007-06-01 2019-03-01 Prosthesis BS118 Precision SCS Lead Blanks Lead Blank One Size Only BS 25 222 1679 4487 156757 461 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BS133 Acuity Spiral Unipolar passive fixation 80, 90 & 100cm BS 27 243 1751 155274 Changed Benefit 2246 0 0 Update 2009-02-01 2019-03-01 Prosthesis BS119 Precision SCS Trial Leads Trial Leads 30cm - 70cm BS 25 222 1679 4487 128775 197912 461 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BS120 Clik Anchor Kit Clik, Clik X, Clik X MRI Anchors Two anchors BS 25 222 1690 4501 156760 319 0 0 No Change 2007-06-01 2019-03-01 Prosthesis BS137 EPIC Nitinol Stent Nitinol self expanding stent Stent diameters up to 14mm and lengths up to 120mm BS 24 206 1622 4440 104281 1710 0 0 No Change 2009-02-01 2019-03-01 Prosthesis DV254 Rayner Premium Sulcoflex Multifocal Toric Supplementary IOL 653Z-Premium Multifocal Toric Supplementary IOL -7D to +7D (Spherical Equivalent) Cylinder 1D, 4D, 5D, 6D Addition 3.5D DV 1 141 1328 3896 at, t1 100926 1024 0 0 No Change 2012-08-01 2019-03-01 Prosthesis DV255 Rayner Standard Sulcoflex Multifocal Toric Supplementary IOL 653Z-Standard Multifocal Toric Supplementary IOL -3D to +3D (Spherical Equivalent) Cylinders 2D and 3D Addition 3.5D DV 1 141 1328 3896 at, t1 10026 1024 0 0 No Change 2012-08-01 2019-03-01 Prosthesis DV256 LIS 052 "StenTube" Large Diameter Lachrymal Intubation Set 1.32mm Tube diameter DV 1 146 1337 117460 Changed Benefit 128 0 0 Update 2013-02-01 2019-03-01 Prosthesis DV257 Lacricath Lachrymal Duct Balloon Catheter Bilateral Lachrymal Duct Balloon Catheter System including inflation device. 2mm, 3mm, 5mm and 9mm DV 1 146 1803 bilateral 117460 835 0 0 No Change 2013-02-01 2019-03-01 Prosthesis DV258 Lacricath Unilateral Lachrymal Duct Balloon Catheter Unilateral Lachrymal Duct Balloon Catheter system including inflation device 2mm, 3mm, 5mm and 9mm DV 1 146 1803 117460 461 0 0 No Change 2013-02-01 2019-03-01 Prosthesis DV259 Meddev Eyelid Weight, Implantable Contour eyelid implants for patients with facial palsy. Contour Gold 1.8, 2.0, 2.2, 2.4, 2.6, 2.8g DV 1 145 1336 3901 205794 760 0 0 No Change 2013-08-01 2019-03-01 Prosthesis DV260 Meddev Eyelid Weight, Implantable Thin Profile eyelid implants for patients with facial palsy Gold Thin 0.6, 0.8, 1.0, 1.2, 1.4, 1.6g DV 1 145 1336 3900 205794 404 0 0 No Change 2013-08-01 2019-03-01 Prosthesis DV261 Meddev Eyelid Weight, Implantable Platinum Platinum Contour and Thin Profile eyelid implants for patients with facial palsy Platinum Thin 0.6, 0.8, 1.0, 1.2, 1.4, 1.6, 1.8g Contour Platinum 1.8, 2.0, 2.2, 2.4, 2.6, 2.8g DV 1 145 1336 3902 205794 1235 0 0 No Change 2013-08-01 2019-03-01 Prosthesis DV262 Hoya 751 Intra Ocular Lens Intra Ocular Lens Power +10 dioptres - +26 dioptres DV 1 141 1327 3892 at, pl, vblf 117417 333 0 0 No Change 2015-02-01 2019-03-01 Prosthesis DV263 Rayner C-flex Advance Aspheric IOL Mini incision pre-loaded aspheric IOL Power range +8.0 - +34.0 dioptres in 0.5 increments DV 1 141 1327 3890 at, pl 100926 308 0 0 No Change 2015-02-01 2019-03-01 Prosthesis DV264 Hoya Vivinex iSert Preloaded IOL (Model XY1) Intra Ocular Lens Power +6 dioptres - +30 dioptres DV 1 141 1327 3892 at, pl, vblf 117417 333 0 0 No Change 2015-08-01 2019-03-01 Prosthesis MC676 SiLo Lateral Connector 10-40mm MC 19 167 1473 169514 Changed Benefit 732 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC678 TiMesh Rigid Fixation Bone Grafting and Plating System Titanium, Universal Plate 12h MC 23 199 1589 4277 128523 199 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC683 Infuse Bone Graft Recombinant human Bone Morphogenetic Protein rhBMP-2 Medium 8.4mg MC 13 123 1241 4120 121164 5700 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC684 Infuse Bone Graft Recombinant human Bone Morphogenetic Protein rhBMP-2 Large 12mg MC 13 123 1241 4121 121164 6080 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC674 CD HORIZON Spinal System - Set Screw Set Screw 3.5mm - 6.35mm MC 19 166 1465 169514 164 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC675 CD Horizon Legacy Screw Diameter 3.5 - 10.5mm MC 19 165 1463 169514 1280 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC685 Verte-Stack Crescent PEEK Height 6 - 18mm MC 19 174 1486 4135 126313 172926 3465 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC687 Neurostimulation System - Accessory Kits Lead Accessory Plug and Closed Boot Kit Model 3550-29 . MC 25 222 1690 4500 121280 Changed Benefit 160 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC688 Neurostimulation System - Extensions 1 x 8 Synergy Extension Kit Model 7472; 1 x 8 Extension Kit Model 37081 20, 40 & 60cm MC 25 222 1680 123244 Changed Benefit 1434 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC689 Lead Revision Kits Sterile Revision Kit for Octad leads 45cm (3550-26), Sterile Revision Kit for Octad leads 60-75cm (3550-27) 30 & 45cm; 60 & 75cm MC 25 222 1690 4499 240576 518 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC690 Neurostimulation System - Octad Leads Octad Standard Lead Kit without Percutaneous Extension Model 3777, 45, 60 & 75cm MC 25 222 1679 4486 8 electrodes 123243 Changed Benefit 4018 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC692 Restore Rechargeable Neurostimulation System External Patient Recharger System Model 37752 one size only MC 25 222 1678 4497 121279 1279 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC694 Restore Rechargeable Neurostimulation System External Patient Programmer Antenna Model 37092 One size only MC 25 222 1678 4484 121279 169 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC699 Attain OTW Model 4194 Lead Model 4194 78cm, 88cm MC 27 243 1759 120254 Changed Benefit 4493 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC701 Mosaic Cinch, Aortic, Mitral Models 305cxx, 310cxx 19mm - 35mm MC 20 179 1499 145761 145762 4750 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC706 Venture Anterior Cervical Plate Single or multi level plate, titanium alloy and Nitinol 52.5mm - 55mm MC 19 169 1476 4125 169514 Changed Benefit 1348 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC707 Danek Unit Rod System Scoliosis S-Rods Widths 5.5 - 6.35mm; left and right MC 19 170 1480 4132 169514 1405 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC710 Neurostimulation System - Octad Leads Octad Standard Lead Kit with Percutaneous extension model 3877 45, 60 & 75cm MC 25 222 1679 4486 8 electrodes 123243 Changed Benefit 4018 0 0 Update 2006-11-30 2019-03-01 Prosthesis MC711 Neurostimulation System - Octad Leads Octad Compact Lead Kit without Percutaneous Extension Model 3778 45, 60 & 75cm MC 25 222 1679 4486 8 electrodes 123243 Changed Benefit 4018 0 0 Update 2006-11-30 2019-03-01 Prosthesis MC712 Neurostimulation System - Octad Leads Octad Compact Lead Kit with Percutaneous Extension Model 3878 45, 60 & 75cm MC 25 222 1679 4486 8 electrodes 123243 Changed Benefit 4018 0 0 Update 2006-11-30 2019-03-01 Prosthesis MC713 Adapta Pacemaker VDDR Pacemaker Models ADVDD01 11.1cc 23.6g MC 27 240 1732 125080 Changed Benefit 4867 0 0 Update 2006-11-30 2019-03-01 Prosthesis MC719 InterStim Neurostimulator Model 3023 Titanium 42g MC 26 232 1712 125909 Changed Benefit 9073 0 0 Update 2006-11-30 2019-03-01 Prosthesis MC726 Adapta Pacemaker DR Pacemaker Models ADDR01, ADDRS1, ADDRL1, ADDR06, ADDR03 11.1-14.2cc 23.6g-31.3g MC 27 240 1734 125076 125077 125084 125085 8237 0 0 No Change 2006-11-30 2019-03-01 Prosthesis ER275 Spineway Blue Mountain Cervical Plate System-Plate, >55 mm Spineway Blue Mountain cervical plate, >55mm Length (56-93mm) x Width (17.5mm) ER 19 169 1477 4127 >55mm 235416 1636 0 0 No Change 2016-02-01 2019-03-01 Prosthesis ER276 Spineway Blue Mountain Cervical Plate System-Screw Spineway Blue Mountain Cervical Plating System-Screw Diameter (3, 4, 4.5mm) x Length (7.2, 12-20mm) ER 19 165 1464 235416 Changed Benefit 193 0 0 Update 2016-02-01 2019-03-01 Prosthesis ER277 Spineway Kili Lumbar Fusion Cage System-Cage Spineway Kili lumbar fusion cage Height (7-15mm) x Width (26-36mm) x Depth (21-29mm) x Angle (2-12 degrees) ER 19 174 1485 5486 235415 6256 0 0 No Change 2016-02-01 2019-03-01 Prosthesis ER278 Spineway Kili Lumbar Fusion Cage System-Screw Spineway Kili fusion cage system screw Diameter 4.5 mm, Length 20, 23mm ER 19 165 1464 235415 Changed Benefit 193 0 0 Update 2016-02-01 2019-03-01 Prosthesis ER279 OverStitchTM Endoscopic Suturing System Needle Driver, Anchor Exchange and Tissue Helix Device 1 size only ER 21 194 1581 5769 Endoscopic System 237773 237774 Changed Benefit 1993 0 0 Update 2016-02-01 2019-03-01 Prosthesis ER280 OverStitchTM Endoscopic Suturing System - 2.0 Suture Endoscopic Polyproprylene Suture with Cinch 2-0 suture ER 21 194 1581 6101 Endoscopic System 236906 245894 285 0 0 No Change 2016-02-01 2019-03-01 Prosthesis AW026 Strattice Reconstructive Tissue Matrix Strattice reconstructive Tissue Matrix is a biologic, surgical implant made from porcine dermis. It is intended for use as a soft tissue patch to reinforce soft tissue where weakness exists and for the surgical repair of of damaged or ruptured soft tissue membranes. Indications for use include breast reconstruction and repair of hernias. + 800cm2 AW 21 194 1798 5495 Coated 199300 5225 0 0 No Change 2017-08-01 2019-03-01 Prosthesis AW027 XEN Glaucoma Treatment System The XEN Glaucoma Treatment System consists of an injector device that is preloaded with a XEN Gel Implant. The XEN Gel Implant creates a new subconjunctival outflow pathway to reduce intraocular pressure in patients with mild to advanced primary open-angle glaucoma where previous treatments have failed. XEN Gel Implant is 6mm long, 150µm outside diameter and 45µm inside diameter. AW 1 144 1802 6442 297899 1330 0 0 No Change 2018-02-01 2019-03-01 Prosthesis AX020 S2 Nail System Cannulated supracondylar nail, stainless steel 11/13mm x 160-380mm AX 13 123 1228 3328 119002 1065 0 0 No Change 2006-03-24 2019-03-01 Prosthesis AX021 S2 Nail System 6.2mm condylar screws 6.5mm x 60-85mm AX 13 123 1229 3712 119002 Changed Benefit 222 0 0 Update 2006-03-24 2019-03-01 Prosthesis HW542 ICONiX Anchor ICONiX Anchor soft-tissue fixation 1.4mm, 2.3mm HW 13 123 1774 5384 229717 Changed Benefit 294 0 0 Update 2015-02-01 2019-03-01 Prosthesis HW544 Stryker Anatomical Biomodel for Mandible Patient Specific Craniofacial Anatomical Biomodel Custom HW 23 200 1807 218563 1950 0 0 No Change 2015-02-01 2019-03-01 Prosthesis HW545 Stryker Biomodelled Patient Specific Mandible Reconstruction Plate Biomodelled Patient Specific Mandible Complex Locking Reconstruction Plate Custom HW 23 200 1596 4358 Biomodelled 218563 4095 0 0 No Change 2015-02-01 2019-03-01 Prosthesis HW546 Stryker Anatomical Biomodel for PEEK Patient Specific Craniofacial Anatomical Biomodel Custom HW 23 200 1807 225792 1950 0 0 No Change 2015-02-01 2019-03-01 Prosthesis HW547 Stryker Biomodelled Patient Specific PEEK Implant Biomodelled Patient Specific Craniofacial Implant PEEK Custom HW 23 200 1593 4343 Biomodelled 257032 Changed Benefit 9682 0 0 Update 2015-02-01 2019-03-01 Prosthesis HW548 Knotilus Anchor Knotilus Anchor Soft Tissue Fixation Knotilus Anchor, 3.5mm HW 13 123 1774 5385 229722 Changed Benefit 442 0 0 Update 2015-02-01 2019-03-01 Prosthesis AY017 Starclose 6 Fr Exchange Sheath, Dilator, Guidewire, implantable nitinol clip pre-mounted on a Clip Applier 6 Fr AY 24 212 1644 100993 369 0 0 No Change 2005-10-31 2019-03-01 Prosthesis 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 AY 24 211 1643 142453 168012 1995 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AY022 Cobalt Chromium Balloon Expandable Peripheral Stent Cobalt Chromium Diameter 4-10mm, Length 12-58mm AY 24 206 1622 4439 119499 1710 0 0 No Change 2007-06-01 2019-03-01 Prosthesis AY023 Xience Everolimus Eluting Stent System Everolimus Eluting Stent System 2.25mm to 4.0mm widths, 8mm to 28mm lengths AY 27 247 1766 5346 135963 2484 0 0 No Change 2007-12-01 2019-03-01 Prosthesis AY024 Omnilink Stainless Steel Balloon Deployable Peripheral Stent Stainless Steel Balloon Expandable Peripheral Stent on 018/035 system 018 & 035 system: 5-10mm diameter by 12, 16, 18, 28, 38, 58mm length AY 24 206 1622 4439 146848 1710 0 0 No Change 2007-12-01 2019-03-01 Prosthesis AY028 Multilink Coronary Stent System - Vision Cobalt chrome stent 2.25mm to 4.0mm widths, 8mm to 38mm lengths AY 27 247 1767 5348 126481 126482 898 0 0 No Change 2007-12-01 2019-03-01 Prosthesis ER281 IC-8, Hydrophobic Small Aperture Intraocular Lens A hydrophobic posterior chamber intraocular lens (IOL), embedded with a central circular mask, which operates under the principle of small aperture optics to reduce near vision blur and provide seamless extended range vision from distance to near. The overall diameter is 12.5 millimetres with a 6 millimetre diameter aspheric optic. ER 1 141 1327 3893 at 236210 677 0 0 No Change 2016-02-01 2019-03-01 Prosthesis ER282 Cascadia Lateral Interbody spacer, Porous Ti 8-20mm high ER 19 174 1486 4135 193652 3465 0 0 No Change 2016-08-01 2019-03-01 Prosthesis ER283 AnastoClip GC AnastoClip GC Medium Large Extra Large Medium, with long applier Large, with long applier Extra Large, with long applier ER 21 194 1771 278601 Changed Benefit 428 0 0 Update 2016-08-01 2019-03-01 Prosthesis ER284 Premia Spine Versalink Fixation System-Rods (straight or bent) Premia Spine Versalink Rods (straight or bent) dia 6 mm, length (40-180) mm ER 19 170 1478 267145 Changed Benefit 426 0 0 Update 2016-08-01 2019-03-01 Prosthesis HW549 Bioabsorbable (PLLA) Wedge Interference Screws Bioabsorbable (PLLA) ACL Wedge Interference Screw 9, 10, 11, 12 x35mm; 7, 8, 9, 10 x 28mm; 7,8,9 x 23mm HW 13 123 1774 5391 AB 143167 457 0 0 No Change 2015-08-01 2019-03-01 Prosthesis HW550 Biosteon (HA/PLLA) Cross-Pin Biosteon ACL Cross Pin Bioabsorbable (HA/PLLA) Titanium - 8 x40mm; 8x50mm; 8x60mm PLLA - 6x40mm; 6x50mm HW 13 123 1774 5394 AB 143030 462 0 0 No Change 2015-08-01 2019-03-01 Prosthesis HW551 VariAx Elbow Plating System Periarticular anatomic humerus ≤ 6 holes HW 13 123 1694 5273 VAL 237797 Changed Benefit 1643 0 0 Update 2015-08-01 2019-03-01 Prosthesis HW552 PEEK Intraline Suture Anchor PEEK Intraline Suture Anchor 5.5mm, 6.5mm HW 13 123 1774 5387 229717 Changed Benefit 442 0 0 Update 2015-08-01 2019-03-01 Prosthesis HW553 PEEK Zip Anchor PEEK Zip Anchor 5.5mm, 6.5mm HW 13 123 1774 5387 229717 Changed Benefit 442 0 0 Update 2015-08-01 2019-03-01 Prosthesis HW554 ReelX STT Anchor ReelX STT Knotless Anchor (PEEK) 5.5mm, 4.5mm HW 13 123 1774 5387 22667 Changed Benefit 442 0 0 Update 2015-08-01 2019-03-01 Prosthesis HW555 TwinLoop FLEX Anchor TwinLoop FLEX Anchor 3.5mm HW 13 123 1774 5385 229717 Changed Benefit 442 0 0 Update 2015-08-01 2019-03-01 Prosthesis 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 AY 24 211 1643 141869 1995 0 0 No Change 2008-07-01 2019-03-01 Prosthesis 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 AY 24 206 1622 4440 146848 1710 0 0 No Change 2008-07-01 2019-03-01 Prosthesis AY032 ACCULINK Peripheral Stent System Nickel-Titanium Intra-vascular stent 4-10mm diameter, 13-56mm length AY 24 206 1622 4440 150102 1710 0 0 No Change 2009-08-01 2019-03-01 Prosthesis AY033 Proglide Suture Mediated Closure Device 5 - 8 French AY 24 212 1644 300736 369 0 0 No Change 2009-08-01 2019-03-01 Prosthesis AY034 Prostar Suture Mediated Closure Device - Closure of Large holes Up to 24 French AY 24 212 1644 L (Large) 300736 675 0 0 No Change 2009-08-01 2019-03-01 Prosthesis AY036 Absolute Pro (Long Length) Laser cut nitinol self expanding stent ≥150 Diameter 5mm to 10mm; length 150mm, 170mm, 200mm AY 24 206 1622 4441 146848 Changed Benefit 2822 0 0 Update 2010-02-01 2019-03-01 Prosthesis LB113 SP-Fix™ Spinous Process Fixation Posterior non-pedicle supplemental fixation device 35-55mm LB 19 177 1496 237299 Changed Benefit 1372 0 0 Update 2015-08-01 2019-03-01 Prosthesis LB114 Unify Dynamic Anterior Cervical Plate System – Plate Titanium Alloy Dynamic Anterior Cervical Plate Depth - 2.8mm Width – 16.6mm Length – 10- 55 mm LB 19 169 1476 4125 190070 Changed Benefit 1348 0 0 Update 2015-08-01 2019-03-01 Prosthesis LB115 Unify Dynamic Anterior Cervical Plate System – Plate Titanium Alloy Dynamic Anterior Cervical Plate Depth - 2.8mm Width – 16.6mm Length – 58 -70 mm LB 19 169 1476 4125 >55mm 190070 1636 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LB116 Unify Dynamic Anterior Cervical Plate System – Screws Variable and fixed angle expanding titanium alloy screws Diameter – 4.2mm and 4.6mm Length – 10mm – 20mm LB 19 165 1464 Expansion Screw / Expansion Head Screw 190070 289 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LB117 Colonial - TPS ACDF System ACDF spacer with Titanium Plasma Spray Height : 5-12mm, Width 12-18mm, Length: 11-15mm LB 19 174 1486 4134 191532 2409 0 0 No Change 2016-02-01 2019-03-01 Prosthesis ER285 Premia Spine Versalink Fixation System-Rods (shaped) Premia Spine Versalink Fixation System-Rods (shaped) offset and angle (0-30 degrees), length (40-90) mm ER 19 170 1478 Shaped 267145 Changed Benefit 577 0 0 Update 2016-08-01 2019-03-01 Prosthesis ER286 Premia Spine Versalink Fixation System-Cross Bar Premia Spine Versalink Fixation System-Cross Bar one size ER 19 170 1478 267145 Changed Benefit 426 0 0 Update 2016-08-01 2019-03-01 Prosthesis ER287 Premia Spine Versalink Fixation System-Ring Nut/set screws Premia Spine Versalink Fixation System-Nut/set screws N/A ER 19 166 1465 267145 164 0 0 No Change 2016-08-01 2019-03-01 Prosthesis ER288 Premia Spine Versalink Fixation System-Polyaxial Pedicle Screw Premia Spine Versalink Fixation System-Cannulated Polyaxial Pedicle Screw dia (5.5-8.5)mm x length (25-60)mm ER 19 165 1463 Cannulated 267145 1338 0 0 No Change 2016-08-01 2019-03-01 Prosthesis ER289 Pyrenees Segmental Plate Single level fusion plate with shelf. 5-10mm shelf ER 19 169 1476 4125 154444 Changed Benefit 1348 0 0 Update 2016-08-01 2019-03-01 Prosthesis LB118 Continental TPS Spacer ALIF PEEK spacer with Titanium Plasma Spray Width 25-39mm, Length 20-28mm, Height 9-21mm LB 19 174 1486 4135 191535 3465 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LB119 Assure-X Anterior Cervical Plate System - Plates Titanium Alloy Anterior Cervical Plate 1.8 mm profile, 16mm width, 10-54mm in length LB 19 169 1477 4127 190070 1251 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LB120 Assure-X Anterior Cervical Plate System - Plates > 55mm Titanium Alloy Anterior Cervical Plate 1.8mm profile, 16mm width, 57-100 mm in length LB 19 169 1477 4127 >55mm 190070 1636 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LB121 Assure-X Anterior Cervical Plate System - Screws Variable Angle and Fixed Angle Self-drilling and Self-tapping Expansion Bone Screws Diameter 4.2-4.6 mm, Length 10-20mm LB 19 165 1464 Expansion Screw / Expansion Head Screw 190070 289 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LB122 CREO MIS Posterior Stabilization System - Bone Screws Cannulated self-tapping polyaxial screws - Shank Diameter 4.5-10.5mm, Length 25-120mm LB 19 165 1463 Shank 190039 640 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LB123 CREO MIS Posterior Stabilization System - Locking Cap Threaded Locking Cap 9mm diameter LB 19 166 1465 190039 164 0 0 No Change 2016-02-01 2019-03-01 Prosthesis ER292 Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Polyaxial, MIS, Cannulated Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Polyaxial, MIS, Cannulated dia (4.5-8.0 mm) x length (25-60 mm) ER 19 165 1463 Cannulated 235417 235418 1338 0 0 No Change 2016-08-01 2019-03-01 Prosthesis ER293 Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Polyaxial Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Polyaxial dia (4-8 mm) x length (25-110 mm) ER 19 165 1463 235417 235418 1280 0 0 No Change 2016-08-01 2019-03-01 Prosthesis FJ002 LH001 Oxiplex Absorbable Adhesion Barrier Gel Oxiplex Absorbable Adhesion Barrier gel (Oxiplex is a co-polymer gel composed of carboxymethylcellulose and polyethylene.) 3ml in sterile 3ml syringe FJ 21 194 1579 5433 Complex 149294 1235 0 0 No Change 2018-08-01 2019-03-01 Prosthesis FJ003 LM196 Dynavisc Absorbable adhesion barrier gel 1 ml FJ 21 194 1579 5433 Complex 208839 433 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LB124 CREO MIS Posterior Stabilization System - Screw Head Modular Polyaxial Screw Head 10mm and 30mm LB 19 166 1469 196054 Changed Benefit 732 0 0 Update 2016-02-01 2019-03-01 Prosthesis LB125 CREO MIS Posterior Stabilization System Titanium alloy and cobalt chrome straight and curved rods 30-500mm LB 19 170 1478 190039 Changed Benefit 426 0 0 Update 2016-02-01 2019-03-01 Prosthesis LB126 Sustain - O TPS TPS coated PEEK radiolucent lumbar interbody fusion device Height-8mm-18mm, Width 8mm - 12mm, Length - 26mm-30mm LB 19 174 1486 4135 191535 3465 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LB127 Sustain - O TPS TPS coated PEEK radiolucent lumbar interbody fusion device Height 8-18mm, Width 8-12mm, Length 22mm LB 19 174 1486 4135 Paired 191535 Changed Benefit 2888 0 0 Update 2016-02-01 2019-03-01 Prosthesis LB128 Signature-R, Signature-R TPS & Signature-Ti TLIF System PEEK or TPS Coated PEEK or Titanium lumbar interbody fusion device Small - 10 x 28mm with heights from 7-17mm Large - 11 x 33mm with heights from 7-17mm PEEK TPS - 10-11mm x 32-37mm with heights from 7-17mm LB 19 174 1486 4135 191535 3465 0 0 No Change 2016-02-01 2019-03-01 Prosthesis 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 FK 24 214 1652 pi (power injection) 222676 222677 567 0 0 No Change 2015-02-01 2019-03-01 Prosthesis GE006 Seprafilm Adhesion Barrier Sodium hyaluronate carbomethylcellulose membrane 13cm x 15cm GE 21 194 1579 5432 133341 328 0 0 No Change 2006-03-24 2019-03-01 Prosthesis GG001 Fin II Acetabular Shell titanium, Plasma sprayed, HA, with variable screw options 44 to 72mm GG 18 163 1427 4018 279500 2373 0 0 No Change 2018-02-01 2019-03-01 Prosthesis GG002 Contile Fin II Bone Screw 20 to 50mm GG 13 123 1231 3369 246519 65 0 0 No Change 2018-02-01 2019-03-01 Prosthesis GG003 Contile Fin II Acetabular, Mueller Cup 28mm and 32mm Mueller Cup 28mm Neutral and 10 Degree, 32mm Neutral and 10 Degree GG 18 163 1425 4006 284657 285462 659 0 0 No Change 2018-02-01 2019-03-01 Prosthesis HW556 Titanium Intraline Anchor Titanium Intraline Anchor 5.5mm, 6.5mm HW 13 123 1774 5387 229717 Changed Benefit 442 0 0 Update 2015-08-01 2019-03-01 Prosthesis HW557 Stryker Memometal Varisation Staple Varisation Staple Stainless Steel 26-90Deg x 8-10mm HW 13 123 1773 5514 149534 Changed Benefit 127 0 0 Update 2015-08-01 2019-03-01 Prosthesis JD014 Screws - Locking Locking ≥4.5mm JD 13 123 1231 3369 LK 222648 128 0 0 No Change 2018-02-01 2019-03-01 Prosthesis JD015 Proximal Femur Nails Nails Diameter 11mm Proximal Diameter 17mm <220mm length JD 13 123 1228 3326 222647 Changed Benefit 1010 0 0 Update 2018-02-01 2019-03-01 Prosthesis JD016 Proximal Femur Nail Femoral Nail Diameter 11mm Proximal Diameter 17mm Length ≥220mm JD 13 123 1228 3327 222647 1370 0 0 No Change 2018-02-01 2019-03-01 Prosthesis JD017 Proximal Femur Lag Screws Lag Screws 80-110mm Length JD 13 123 1229 3341 222647 199 0 0 No Change 2018-02-01 2019-03-01 Prosthesis JD018 Nail Set Screw Nail Set Screw Static & Dynamic JD 13 123 1229 3713 222647 Changed Benefit 143 0 0 Update 2018-02-01 2019-03-01 Prosthesis GG004 Contile Fin II Acetabular Biolox Delta Ceramic Liners Contile Fin II Acetabular Biolox Delta Ceramic Liner inserts 28mm,32mm, 36mm & 46mm Inserts 28mm 44mm to 46mm, Inserts 32mm 48mm to 66mm, Inserts 36mm 52mm to 66mm, Inserts 40mm 56mm to 66mm GG 18 163 1428 4025 281318 2303 0 0 No Change 2018-02-01 2019-03-01 Prosthesis GG005 SMR Femoral Head CoCr 22 to 40mm GG 18 162 1419 3989 280608 703 0 0 No Change 2018-02-01 2019-03-01 Prosthesis GG006 Biolox Delta Ceramic Femoral Heads Biolox Delta Ceramic Femoral Heads 28mm 32mm Biolox Delta Femoral Head 28mm - -3.5mm to +3.5mm and Biolox Delta Femoral Head 32mm - 3.5mm to +7mm GG 18 162 1419 3992 279805 1845 0 0 No Change 2018-02-01 2019-03-01 Prosthesis GG007 Biolox Delta Ceramic Femoral Head 36mm A sterile implantable component of a hip prostheses system intended to replace the femoral head in total hip arthroplasty procedures. Diameter: 36mm Taper: 12/14 Neck: S, M, L, XL Centre of rotation: -3.5, 0, +3.5, +7.0mm GG 18 162 1420 3998 279805 2022 0 0 No Change 2018-08-01 2019-03-01 Prosthesis GI003 Bio-Oss Bone Natural Bone Mineral Derived from bovine bone Granule size 0.25 - 1mm, 1.0gm (2cc) Granule size 1 - 2mm, 1.0gm (3cc) Granule size 0.25 - 1mm, 2.0gm (4cc) GI 13 123 1241 4111 229987 503 0 0 No Change 2015-02-01 2019-03-01 Prosthesis JD019 Femoral Nail Femoral Nail Diameter 10 - 12mm JD 13 123 1228 3328 222647 1065 0 0 No Change 2018-02-01 2019-03-01 Prosthesis JD020 Tibial Nail Tibial Nail 10 - 11mm diameter JD 13 123 1228 3329 222647 Changed Benefit 1268 0 0 Update 2018-02-01 2019-03-01 Prosthesis JD021 1/3 Tubular Plate 1/3 Tubular Plates ≤ 6 holes JD 13 123 1694 5258 VAL 222648 784 0 0 No Change 2018-02-01 2019-03-01 Prosthesis JD022 MTP Plate Fusion Plates Left and Right JD 13 123 1694 5258 VAL 222648 784 0 0 No Change 2018-02-01 2019-03-01 Prosthesis JD023 1/3 Tubular Plate 1/3 Tubular Plate ≥ 7 to ≤ 15 holes JD 13 123 1694 5259 VAL 222648 849 0 0 No Change 2018-02-01 2019-03-01 Prosthesis JJ003 Spongostan Absorbable Haemostat Standard (Box of 20) 70 x 50 x 10mm JJ 21 191 1553 4199 144852 9 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ004 Spongostan Absorbable Haemostat Film (Box of 20) 200 x 70 x 0.5mm JJ 21 191 1553 4200 144852 28 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ005 Spongostan Absorbable Haemostat Special (Box of 20) 70 x 50 x 1mm JJ 21 191 1553 4199 144852 9 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LB129 CREO MCS - Screw Post Double threaded, dual outer diameter screw post Diameter 5.0-7.5mm, Length 20-45mm LB 19 165 1463 Shank 190039 640 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LB130 CREO MCS - Polyaxial Screw Pre-assembled dual outer diameter polyaxial screw Diameter: 5.0- 6.5 mm, Length 20-45mm LB 19 165 1463 190039 1280 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM148 Ascension DRUJ Ulna Head, Implant System Cobalt chromium stem with PyroCarbon or Cobalt Chromium Articular Surface 0, 1, 2, 3, 4 LM 13 131 1273 3667 118638 1064 0 0 No Change 2012-08-01 2019-03-01 Prosthesis LM149 Ascension DRUJ Ulna Head, Implant System Cobalt chromium stem with PyroCarbon or Cobalt Chromium Articular Surface 0, 1, 2, 3, 4 LM 13 131 1273 3668 118638 1064 0 0 No Change 2012-08-01 2019-03-01 Prosthesis LM184 Trimed Clavicle Fixation Plates Plates for fixation of fractures of the clavicle 7-15 holes LM 13 123 1694 5271 LK 182677 Changed Benefit 1682 0 0 Update 2013-08-01 2019-03-01 Prosthesis LM185 Trimed Locking Cortical Screws Locking cortical screw 2.01 to 2.7mm diameter LM 13 123 1231 3371 LK 182677 Changed Product sizes 147 0 0 Update 2013-08-01 2019-03-01 Prosthesis GI004 Bio-Oss This bone block consists of anorganic bovine bone matrix sterilised by gamma-irradiation. Bio-Oss is a natural bone mineral for filling of bone defects in maxillofacial surgery, implantology, and periodontology. approx 1.4-1.6g, 2cc GI 13 123 1241 4111 229987 503 0 0 No Change 2015-02-01 2019-03-01 Prosthesis GI005 Bio-Oss Natural bone mineral derived from bovine bone 1 to 2mm; 2.0g (6cc) GI 13 123 1241 4112 229987 1330 0 0 No Change 2015-02-01 2019-03-01 Prosthesis GI006 Bio-Oss Natural bone mineral derived from bovine bone 1 to 2mm: 0.5g (1.5cc) GI 23 201 1602 4395 229987 Changed Benefit 293 0 0 Update 2015-02-01 2019-03-01 Prosthesis GI007 Bio-Oss Pen Pen applicator with natural bone mineral derived from bovine bone 0.25 to 1mm; 0.25g (0.5125cc) GI 23 201 1602 4394 229990 Changed Benefit 293 0 0 Update 2015-02-01 2019-03-01 Prosthesis GI008 Bio-Oss Pen Pen applicator with natural bone mineral derived from bovine bone 0.25 to 1mm; 0.5g (1.025cc) GI 23 201 1602 4395 229990 Changed Benefit 293 0 0 Update 2015-02-01 2019-03-01 Prosthesis GI009 Bio-Oss Pen Pen applicator with natural bone mineral derived from bovine bone 1 to 2mm; 0.5g (1.5cc) GI 23 201 1602 4395 229990 Changed Benefit 293 0 0 Update 2015-02-01 2019-03-01 Prosthesis GI014 Geistlich Mucograft Collagen Matrix 15mm x 20mm, 20mm x 30mm, diameter 8mm GI 23 199 1588 4253 229991 229995 336 0 0 No Change 2015-02-01 2019-03-01 Prosthesis JJ006 Spongostan Absorbable Haemostat Anal 20s (Box of 20) 80 x 30mm JJ 21 191 1553 4199 Anatomically Conforming 144852 16 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ007 Spongostan Absorbable Haemostat Anal 5s (Box of 5) 80 x 30mm JJ 21 191 1553 4199 Anatomically Conforming 144852 16 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ008 Surgicel Nu-Knit Absorbable Haemostat High density, oxidised regenerated cellulose, the material is biocompatible and also bactericidal 7.5 x 10cm JJ 21 191 1554 6009 Antimicrobial, Low Antigenicity, Woven 177701 70 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ009 Surgicel Fibrillar Absorbable Haemostat Fibrous fleece, oxidised regenerated cellulose, the material is biocompatible and also bactericidal 2.5 x 5.1cm JJ 21 191 1554 6008 Antimicrobial, Low Antigenicity, Micro-fibrous 166221 37 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ010 Interceed Absorbable Adhesion Barrier Oxidized Regenerated Cellulose 7.6cm x 10.2cm JJ 21 194 1579 5431 137081 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LM196 Dynavisc Absorbable adhesion barrier gel 1 ml LM 21 194 1579 5433 Complex 208839 433 0 0 No Change 2014-08-01 2019-03-01 Prosthesis LM197 MiniFlo Fixator Finger mini fixator system Radius: 25 and 30mm LM 13 123 1237 3401 Mini 222613 1952 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM198 MiniFlo pins Bone pins(screws)for finger mini fixator system Thread diameter: 1.6,&2.0, 2.5mm LM 13 123 1237 4510 222614 142 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM199 MiniFlo Extension Posts Extension posts for finger mini fixator system T extension, Straight extension LM 13 123 1237 4512 222584 Changed Benefit 105 0 0 Update 2015-02-01 2019-03-01 Prosthesis LM207 BonAlive Putty Bone Graft Substitute - Bioactive Glass Putty 1cc, 2.5cc, 5cc LM 13 123 1241 4092 AUG 231484 1026 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM208 BonAlive Putty Bone Graft Substitute - Bioactive Glass Putty 10cc LM 13 123 1241 4093 AUG 231484 2185 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM209 Jones Fracture Plate Fracture Fixation Systems ≤ 6 holes LM 13 123 1694 5261 Com 182677 1007 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM210 Jones Fracture Plate Fracture Fixation Systems ≥ 7 to ≤ 15 holes LM 13 123 1694 5262 Com 182677 762 0 0 No Change 2015-02-01 2019-03-01 Prosthesis GI015 Bio-Oss Collagen The product consists of Bio-Oss granules, embedded in 10% porcine collagen. The collagen component is resorbed within a few weeks. The properties of the Bio-Oss granules remain unchanged. Facilitates handling. 1 preformed block of cancellous-bone granulate and collagen, block sizes 500mg GI 13 123 1241 4114 229994 Changed Benefit 808 0 0 Update 2015-02-01 2019-03-01 Prosthesis GI016 Bio-Oss Collagen The product consists of Bio-Oss granules, embedded in 10% porcine collagen. The collagen component is resorbed within a few weeks. The properties of the Bio-Oss granules remain unchanged. Facilitates handling. 1 preformed block of cancellous-bone granulate and collagen, block size 250mg GI 13 123 1241 4114 229994 Changed Benefit 808 0 0 Update 2015-02-01 2019-03-01 Prosthesis GI017 Bio-Oss Collagen The product consists of Bio-Oss granules, embedded in 10% porcine collagen. The collagen component is resorbed within a few weeks. The properties of the Bio-Oss granules remain unchanged. Facilitates handling. 1 preformed block of cancellous-bone granulate and collagen, block size 100mg GI 13 123 1241 4114 229994 Changed Benefit 808 0 0 Update 2015-02-01 2019-03-01 Prosthesis JJ013 Surgicel ORIGINAL Absorbable Haemostat Oxidised regenerated cellulose gauze, the material is biocompatible and also bactericidal 5 x 7.5cm JJ 21 191 1554 6008 Antimicrobial, Low Antigenicity 171589 177702 Changed Benefit 20 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ014 Surgicel ORIGINAL Absorbable Haemostat Oxidised regenerated cellulose gauze, the material is biocompatible and also bactericidal 1.25 x 5cm JJ 21 191 1554 6008 Antimicrobial, Low Antigenicity 171589 177702 Changed Benefit 20 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ015 Spongostan Absorbable Haemostat Dental (Box of 24) 10 x 10 x 10mm JJ 21 191 1553 4199 144852 9 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ020 Vicryl Mesh 1 sheet/box Large - 30cm x 30cm JJ 21 194 1783 5503 143774 285 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ023 Surgicel Nu-Knit Absorbable Haemostat High density, oxidised regenerated cellulose, the material is biocompatible and also bactericidal 2.5 x 2.5cm JJ 21 191 1554 6008 Antimicrobial, Low Antigenicity, Woven 177701 35 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ012 Surgicel ORIGINAL Absorbable Haemostat Oxidised regenerated cellulose gauze, the material is biocompatible and also bactericidal 5-10.2 x 20-35cm JJ 21 191 1554 6010 Antimicrobial, Low Antigenicity 171589 177702 37 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LM211 Trimed Volar & Dorsal Hook Plate Wrist Fixation System - Volar & Dorsal Hook Plates ≤ 6 holes LM 13 123 1694 5276 LK 182677 1126 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM212 Trimed Volar & Dorsal Hook Plate Wrist Fixation System - Volar & Dorsal Hook Plate ≥ 7 to ≤ 15 holes LM 13 123 1694 5277 LK 182677 1126 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM213 Fusion Cup PEEK curved and round plate 7, 9, 10, 11 & 12 hole LM 13 123 1694 5259 Com, VAL 229707 1229 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM214 Highly Elastic Staples Nitinol Staples 8-25mm LM 13 123 1773 5514 MM 229705 Changed Benefit 507 0 0 Update 2015-02-01 2019-03-01 Prosthesis LM215 BonAlive Granules Bone Graft Substitute - Bioactive Glass Granules Range (1-5cc) 0.5-08mm (small) 1cc 0.5-08mm (small) 2.5cc 0.5-0.8mm (small) 5cc 1.0-2.0mm (medium) 5cc 2.0-3.15mm (large) 5cc LM 13 123 1241 4092 AUG 176953 1026 0 0 No Change 2015-02-01 2019-03-01 Prosthesis AX103 U2 Femoral Head Unipolar Femoral heads, CoCr Size 42 - 56mm AX 18 162 1420 3995 172424 835 0 0 No Change 2014-02-01 2019-03-01 Prosthesis AY002 Flexiflo inverta PEG kit Basic, Flexiflo inverta PEG kit with snare Composition - biocompatible silicone tube. Items included in kit/product - Sliding retention disc, Insertion wire, Gastrostomy tube with attached Dilator Catheter, seldinger needle 14g, magna port connector, scalpel, Snare (in kit with snare) 20F AY 21 189 1545 4197 39940 195 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AY005 Flexiflo balloon gastrostomy tube Composition - biocompatible silicone. Items included in kit/product - sliding retention disc and opened edged feeding port 16 french, 18 french, 20 french AY 21 189 1545 4198 29742 Changed Benefit 86 0 0 Update 2005-10-31 2019-03-01 Prosthesis AY012 GRAFTMASTER RX Coronary Stent Graft Stainless Steel/PTFE 16-26 mm x 2.8 - 4.8 mm AY 27 247 1767 5349 l, m 214226 2320 0 0 No Change 2005-10-31 2019-03-01 Prosthesis 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 AY 24 206 1622 4440 97959 1710 0 0 No Change 2005-10-31 2019-03-01 Prosthesis GI018 Master Pin Pins used in dental surgery for the fixation of membranes (absorbable, non-absorbable and titanium membranes) in order to avoid micro-mobility of the graft. With sharp tips and the stable construction, the pins can be precisely inserted into cortical bones. The pins have an additional minithread and are a hybrid composed of a screw and pin. The thread makes easy and safe removal possible after a healing period has taken place. This thread enlarges the surface of the shaft at the same time and therefore offers more stability. 3.5mm GI 23 201 1602 4389 280879 76 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW529 Accolade II Femoral Hip System Femoral Hip Stem (127 & 132 neck angle) Size 0 - 11 HW 18 161 1407 3952 198383 4394 0 0 No Change 2014-02-01 2019-03-01 Prosthesis HW530 Excelsior XT27 Stryker Neurovascular Excelsior XT-27 Microcatheter is intended to assist in the delivery of diagnostic agents, such as contrast media, therapeutic agents and interventional devices, into the neurovasculature Length: 150cm / 135cm Distal Lengths: 6cm / 18cm Outer Diameter: 2.7F - 2.9F Inner Diameter: 0.027" HW 25 225 1689 4494 202911 665 0 0 No Change 2014-02-01 2019-03-01 Prosthesis HW531 Stryker Plating System Locking Screw 5.0mm HW 13 123 1231 3369 LK 119660 128 0 0 No Change 2014-02-01 2019-03-01 Prosthesis HW532 Pelvis II Plating System Quadrilateral Surface Plates Small/Large HW 13 123 1694 5285 119660 760 0 0 No Change 2014-08-01 2019-03-01 Prosthesis JJ029 Surgicel Fibrillar Absorbable Haemostat Fibrous fleece, oxidised regenerated cellulose, the material is biocompatible and also bactericidal 10.2 x 10.2cm JJ 21 191 1554 6010 Antimicrobial, Low Antigenicity, Micro-fibrous 166221 105 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ030 Surgicel Fibrillar Absorbable Haemostat Fibrous fleece, oxidised regenerated cellulose, the material is biocompatible and also bactericidal 5.1 x 10.2cm JJ 21 191 1554 6009 Antimicrobial, Low Antigenicity, Micro-fibrous 166221 74 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ033 Ligaclip* Ligating Clips - titanium Titanium clips contained in a plastic cartridge 3-5mm; 6 clips per cartridge JJ 21 194 1581 4256 122810 11 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ034 Ligaclip* Ligating Clips - titanium Titanium clips contained in a plastic cartridge 9-12 mm; 6 clips per cartage JJ 21 194 1581 4256 122810 11 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ035 Ligaclip* Ligating Clips - titanium Titanium clips contained in a plastic cartridge 3-5 mm; 20 clips per cartridge JJ 21 194 1581 4256 122810 37 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ036 Absolok* Extra Absorbable Ligating Clips Polydioxanone clips contained in a plastic cartridge Small to Extralarge JJ 21 194 1581 4256 Resorbable 121372 87 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LM216 BonAlive Granules Bone Graft Substitute - Bioactive Glass Granules (5.1-10cc) 13140 - 0.5-0.8mm small granules, 10cc syringe 13340 - 1.0-2.0mm medium granules, 10cc syringe 13440 - 2.0-3.15mm large granules, 10cc syringe LM 13 123 1241 4093 AUG 176953 2185 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM217 Bioplate Biomesh System Titanium cranial biomesh 0.3 to 0.45mm thickness, 32-60mm x 43-60mm LM 23 199 1585 4204 123206 Changed Benefit 683 0 0 Update 2015-02-01 2019-03-01 Prosthesis LM218 Bioplate Biomesh System Titanium cranial biomesh 0.45mm thickness, 85-132mm x 90-134mm LM 23 199 1585 4205 123206 1365 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM219 Bioplate Biomesh System Titanium cranial biomesh 0.6mm thickness, 36-65 x 52-65mm LM 23 199 1585 4208 123206 497 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM220 BIOPLATE Biomesh Titanium cranial biomesh 0.6mm thickness, 90-127 x 92-131mm LM 23 199 1585 4209 123206 1146 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM221 BIOPLATE Biomesh Titanium cranial biomesh 3ME, packaged non-sterile 20 x 20cm LM 23 199 1585 4210 123206 2187 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM222 BIOPLATE Low Profile Low Profile 2-hole Straight Plate 11mm - 14mm length LM 23 199 1589 4261 123205 Changed Benefit 63 0 0 Update 2015-02-01 2019-03-01 Prosthesis HW533 VariAx Compression Plating System Periarticular variable angle locking plate ≥ 7 to ≤ 15 HW 13 123 1694 5259 VAL 269713 237797 849 0 0 No Change 2014-08-01 2019-03-01 Prosthesis HW534 VariaAx Compression Plating System Periarticular variable angle locking plate ≥ 16 holes HW 13 123 1694 5260 VAL 269713 237797 1331 0 0 No Change 2014-08-01 2019-03-01 Prosthesis HW535 VariAx Compression Plating System VAL 1/3 Tubular Plate >/=6 holes HW 13 123 1694 5258 VAL 139635 784 0 0 No Change 2014-08-01 2019-03-01 Prosthesis HW536 Stryker Intermedullary Nailing System Femoral Nails 7-15mm Diameter , 140 to 480 lengths HW 13 123 1228 3329 95185 Changed Benefit 1268 0 0 Update 2014-08-01 2019-03-01 Prosthesis HW537 Stryker Intramedullary Nailing System Tibial nails 8-15mm Diameter, 240- 420mm lengths HW 13 123 1228 3329 139722 Changed Benefit 1268 0 0 Update 2014-08-01 2019-03-01 Prosthesis JJ037 Ligaclip* Multiple Clip Applier Metal/plastic applier preloaded with titanium clips 3-12 mm; 20 clips per applier JJ 21 194 1581 4258 Open 122810 231 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ038 Ligaclip* Multiple Clip Applier Metal/plastic applier preloaded with titanium clips 3-12 mm; 30 clips per applier JJ 21 194 1581 4258 Open 122810 231 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ039 Ligaclip* Multiple Clip Applier Metal/plastic applier preloaded with titanium clips; reloadable 5-6mm; 20 clips per applier JJ 21 194 1581 4258 Open 122810 231 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LB101 CREO AMP™ Tulip Tulip Head 4.75mm and 5.5mm LB 19 166 1469 190039 Changed Benefit 732 0 0 Update 2014-08-01 2019-03-01 Prosthesis LB102 CREO AMP™ Sacral Plate Sacral Plate One size LB 19 167 1472 190039 Changed Benefit 732 0 0 Update 2014-08-01 2019-03-01 Prosthesis LB103 CREO AMP™ Lamina Clamp Lamina clamp Small, medium, large LB 19 168 1475 190039 789 0 0 No Change 2014-08-01 2019-03-01 Prosthesis LM223 Bioplate Plating System Plates of various shape 4 to 7 holes LM 23 199 1589 4263 123205 Changed Benefit 137 0 0 Update 2015-02-01 2019-03-01 Prosthesis LM224 BIOPLATE Low Profile Low Profile Flex Contoured Burr Hole Cover Low profile 0.3mm, 1.5mm diam hole, 12 - 18mm diam plate LM 23 199 1589 4263 Burr 123205 185 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM225 BIOPLATE Low Profile Low Profile 8-hole Boxcar Plate 10 x 24mm LM 23 199 1589 4265 123205 274 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM231 BIOPLATE Biomesh Titanium, lattice, 48 hole, packaged non-sterile 32 x 44mm LM 23 199 1589 4284 123205 Changed Benefit 293 0 0 Update 2015-02-01 2019-03-01 Prosthesis LM232 Bioplate Plating System Titanium Screws 1.25 to 3.24mm Diameter LM 23 199 1590 4323 123204 42 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LM235 HA/TCP Granules HA/TCP Bone graft substitute Granules 2.5cc, 5cc LM 13 123 1241 4092 232997 722 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM236 HA/TCP Granules HA/TCP Bone graft substitute Granules 10cc LM 13 123 1241 4093 232997 1140 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM237 HA/TCP Granules HA/TCP Bone graft substitute Granules 15cc, 20cc LM 13 123 1241 4094 232997 1425 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM238 HA/TCP Granules HA/TCP Bone graft substitute Granules 25cc, 30cc LM 13 123 1241 4095 232997 1482 0 0 No Change 2015-08-01 2019-03-01 Prosthesis MC651 Delta Valve Assembly with Bioglide PSM range CSF Flow Valves. Polypropylene and acetal plastic base. Silicone elastomer dome. Assembly system includes the valve, integral peritoneal catheter, female luer adapter and prefill tubing. Surface of the valve bonded with hydrogel (Bioglide surface modifica 90-120cm (0.5, 1.0, 1.5, 2.0) MC 25 220 1666 4469 Antisyphon function, Coating, Distal catheter, Reservoir/Priming function 134740 1753 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC656 Pyramid Pyramid Bone Screws 6.5mm Diameter, 20 -60mm length in 5mm increments MC 19 165 1464 169514 Changed Benefit 193 0 0 Update 2006-03-24 2019-03-01 Prosthesis HW538 Simplex HV Simplex HV is a fast-setting acrylic resin for use in bone surgery. Mixing the two separate sterile components produces a ductile bone cement which, after hardening, fixes the implant and transfers stresses produced during movement evenly to the bone. Simplex HV cement powder also contains insoluble zirconium dioxide as an X-ray contrast medium. Simplex HV does not emit a signal and does not pose a safety risk in a magnetic resonance environment. There is only one size. Powder Component 40g, Liquid Component 20ml HW 13 123 1279 4087 220884 157 0 0 No Change 2015-02-01 2019-03-01 Prosthesis HW539 VersiTomic G-Lok VersiTomic G-Lok suspension fixation device - No Loop No Loop HW 13 123 1774 5390 229719 374 0 0 No Change 2015-02-01 2019-03-01 Prosthesis HW540 VersiTomic G-Lok VersiTomic G-Lok suspension fixation device 15mm, 20mm, 25mm, 30mm, 35mm, 40mm, 45mm, 50mm HW 13 123 1774 5389 229719 374 0 0 No Change 2015-02-01 2019-03-01 Prosthesis HW541 Biosteon (HA/PLLA) Screws Biosteon HA/PLLA reabsorbable bone screw 6, 7, 8, 9, 10 x 23mm; 6, 7, 8, 9, 10, 11, 12 x 28mm; 9, 10, 11, 12 x 35mm HW 13 123 1774 5391 AB, HA 143167 457 0 0 No Change 2015-02-01 2019-03-01 Prosthesis LB104 SECURE Cervical Artificial Disc Cervical Disc Replacement System 5mm - 9mm, 11x12 - 15x18mm LB 19 175 1488 5487 191978 6256 0 0 No Change 2014-08-01 2019-03-01 Prosthesis LB106 InterContinental Plate Lateral Plate 20mm x 8mm - 21mm. LB 19 169 1476 4126 190063 Changed Benefit 2118 0 0 Update 2015-02-01 2019-03-01 Prosthesis LB107 InterContinental HA Screws HA Coated Bone Screws 5.5mm x 30mm - 60mm LB 19 165 1464 190063 Changed Benefit 193 0 0 Update 2015-02-01 2019-03-01 Prosthesis LB108 SILC™ Clamp Inline connector 4.5 -6.35mm LB 19 167 1472 190039 Changed Benefit 732 0 0 Update 2015-08-01 2019-03-01 Prosthesis LB109 SILC™ PET Band PET Band 4 -6mm LB 19 166 1816 190039 789 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LB110 ASSURE® Anterior Cervical Plate System – Plate Titanium Alloy Anterior Cervical Plate 1.8 mm depth, 16mm width, 14- 54mm length LB 19 169 1476 4125 190070 Changed Benefit 1348 0 0 Update 2015-08-01 2019-03-01 Prosthesis LB111 ASSURE® Anterior Plate System – Plate Titanium Alloy Anterior Cervical Plate 1.8 mm depth, 16mm width, 57-100mm length LB 19 169 1476 4125 >55mm 190070 1636 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LB112 ASSURE® Anterior Plate System – Screws Standard - Self-drilling or Self Tapping Rigid – Self Drilling or Self Tapping Diameter - 4.0 -4.5mm Length – 10-20mm LB 19 165 1464 190070 Changed Benefit 193 0 0 Update 2015-08-01 2019-03-01 Prosthesis MC660 Mastergraft Matrix 5cc MC 13 123 1241 4114 96971 Changed Benefit 808 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC662 Mastergraft Matrix 20cc MC 13 123 1241 4116 96971 2143 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC663 Mastergraft Matrix 10cc MC 13 123 1241 4115 96971 Changed Benefit 1889 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC667 SiLo Set Screw One Size only MC 19 166 1465 169514 164 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC668 CD HORIZON Spinal System - Lateral Connector Lateral Connector 10mm - 100mm MC 19 167 1473 169514 Changed Benefit 732 0 0 Update 2006-03-24 2019-03-01 Prosthesis MC669 BCP Biphasic Calcium Phosphate Reabsorbable Graft Supplement 5cc MC 13 123 1241 4092 144137 722 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC670 BCP Biphasic Calcium Phosphate Reabsorbable Graft Supplement 10cc MC 13 123 1241 4093 144137 1140 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC671 BCP Biphasic Calcium Phosphate Reabsorbable Graft Supplement 20cc MC 13 123 1241 4094 144137 1425 0 0 No Change 2006-03-24 2019-03-01 Prosthesis MC673 Verte-Stack Perimeter Cage Extra Small, Small, Medium, Large, Extra Large MC 19 174 1486 4135 126313 3465 0 0 No Change 2006-03-24 2019-03-01 Prosthesis AY037 Xience PRIME LL Everolimus Eluting Coronary Stent; Xience PRIME Everolimus Eluting Coronary Stent; Xience PRIME SV Everolimus Eluting Coronary Stent Coronary Artery Stent, Drug Eluting XIENCE PRIME LL 2.50; 2.75; 3.00; 3.50; 4.0 x 33MM; XIENCE PRIME LL 2.50; 2.75; 3.00; 3.50; 4.0 x 38MM; XIENCE PRIME SV 2.25 x 08; 12; 15; 18; 23; 28MM; XIENCE PRIME 2.50 x 08; 12; 15; 18; 23; 28MM; XIENCE PRIME 2.75 x 08; 12; 15; 18; 23; 28MM; XIENCE PRIME 3.00 x 08; 12; 15; 18; 23; 28MM; XIENCE PRIME 3.50 x 08; 12; 15; 18; 23; 28MM; XIENCE PRIME 4.00 x 08; 12; 15; 18; 23; 28MM AY 27 247 1766 5346 167859 167878 167879 2484 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BH111 Ziptight Fixation System Ankle Syndesmosis device, stainless steel or titanium, PE suture with or without disposable instruments. One Size BH 13 123 1774 5389 116765 208040 374 0 0 No Change 2011-02-01 2019-03-01 Prosthesis BH116 Polaris Spine System Polaris, Polyaxial screw, Titanium 4.0-8.5mm dia BH 19 165 1463 168658 1280 0 0 No Change 2011-02-01 2019-03-01 Prosthesis BH117 Allthread Knotless Suture Anchor Knotless peek suture anchor, polymer 4.5, 5.5 & 6.8mm BH 13 123 1774 5387 117747 Changed Benefit 442 0 0 Update 2011-02-01 2019-03-01 Prosthesis CO036 Standard Abutments Abutment Complete - Titanium 3.0mm - 90780, 4.0mm - 90778, 5.5mm - 90776, 7.0mm - 90774 CO 23 200 1599 4374 123984 402 0 0 No Change 2006-03-24 2019-03-01 Prosthesis CO037 Face to Face Console Abutment Unigrip - Titanium 30, 60, 90, 110 Degrees CO 23 200 1599 4374 Angled/Offset 123984 873 0 0 No Change 2006-03-24 2019-03-01 Prosthesis CO038 Face to Face Healing Abutment Unigrip - Titanium 7mm CO 23 200 1599 4376 123984 278 0 0 No Change 2006-03-24 2019-03-01 Prosthesis CO042 Vistafix™ Fixture ST Titanium self-tapping fixtures for the retention of midface and orbital prostheses. 3mm and 4mm CO 23 200 1599 4373 123984 619 0 0 No Change 2007-12-01 2019-03-01 Prosthesis CO046 Cochlear™ Nucleus® CI512 Cochlear Implants with Contour Advance Electrode Model CI512, 5th generation cochlear implant with perimodiloar electrode array. Titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable silicone seal. One Size CO 22 196 1526 165361 Changed Benefit 12892 0 0 Update 2010-02-01 2019-03-01 Prosthesis DE417 Locking Medial Hook Plate Locking Medial Hook Plate for Fixation of medial malleolus fractures 3-5 holes DE 13 123 1694 5258 Com, LK 140686 850 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH118 Allthread Titanium Suture Anchor Suture anchor, titanium with Maxbraid suture with and without needles. 5.0 & 6.5mm BH 13 123 1774 5387 117747 Changed Benefit 442 0 0 Update 2011-02-01 2019-03-01 Prosthesis BH119 Allthread Peek Suture Anchor Suture anchor, peek polymer, with maxbraid suture and without needles 5.5 &6.8mm BH 13 123 1774 5387 117747 Changed Benefit 442 0 0 Update 2011-02-01 2019-03-01 Prosthesis BH120 RHK Knee - Femoral Component Rotating hinge, cemented, CoCr with hinge assembly. Small right, Standard right, Small left, Standard left. BH 17 149 1348 3908 Revision, Hinged 109969 6038 0 0 No Change 2011-02-01 2019-03-01 Prosthesis BH122 RHK Knee - Stemmed Tibial Tray Tibial Component, stemmed tray 63-71mm BH 17 151 1359 Revision, Hinged 109969 3936 0 0 No Change 2011-02-01 2019-03-01 Prosthesis BH123 RHK Knee - Modular Tibial Tray Tibial Component, modular tray 63 to 71mm BH 17 151 1359 Revision, Hinged 109969 3936 0 0 No Change 2011-02-01 2019-03-01 Prosthesis BH124 RHK Knee - Tibial Bearing Tibial Insert, ArCom Bi-Helical Rotating Bearing (63-71)mm x (12-20)mm BH 17 153 1369 109969 1019 0 0 No Change 2011-02-01 2019-03-01 Prosthesis BS228 Flexima Nephrostomy Catheter Urinary drainage catheters for internal and external drainage of the urinary tract. Length up to 25cm BS 26 234 1718 132027 114 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS229 Flexima vanSonnenburg Sump Catheter Dual lumen catheters that drain cavity contents by application of suction Length up to 35cm BS 21 193 1577 4243 132027 404 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS234 INGENIO MRI EL DR Dual Chamber Pacemaker, Extended Life, MRI Compatible 14cc BS 27 240 1733 i 202981 8237 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS235 INGENIO MRI DR Dual Chamber Pacemaker, MRI Compatible 12cc BS 27 240 1733 i 202980 8237 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS236 INGENIO MRI SR Single Chamber Pacemaker, MRI Compatible 11.5cc BS 27 239 1730 i 202982 4268 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS237 Vercise IPG Kit Dual Channel, 16 Contact, Zero Volt Rechargeable Deep Brain Stimulation IPG One size only BS 25 221 1672 4473 Unlimited Deep Discharge Battery 201944 20900 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS238 Boston Scientific DBS Lead Kit Deep brain stimulation lead with 8 in-line contact electrodes. Independent 19-filar platinum-core. 30cm - 45cm BS 25 221 1674 4476 202017 Changed Benefit 3943 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH125 RHK Knee - Augments Augment, Femoral or Coned Tibial Augments (63-79)mm x 20mm, small or std x (10-30)mm BH 17 159 1390 109969 1148 0 0 No Change 2011-02-01 2019-03-01 Prosthesis BH126 Versadial Humeral Head Humeral Head (38 -58)mm x (19 -37)mm x (39-61)mm BH 13 131 1276 4067 104347 1261 0 0 No Change 2011-08-01 2019-03-01 Prosthesis BH127 Versadial Humeral Head Eccentric adaptor, taper insert Std, reverse BH 13 131 1278 4084 104347 1159 0 0 No Change 2011-08-01 2019-03-01 Prosthesis BH131 ARCOS Revision Hip System Cone Proximal Body Cone Proximal Body Porous plasma sprayed coated 60-80mm body BH 18 161 1412 3974 Body 98097 3972 0 0 No Change 2011-08-01 2019-03-01 Prosthesis BH132 ARCOS Modular Revision Hip System Short Distal Stems Distal Stem bullet or slottedtip, porous plasma spray <200mm BH 18 161 1410 3964 Stem 274396 274398 3093 0 0 No Change 2011-08-01 2019-03-01 Prosthesis BH133 ARCOS Modular Revision Hip System Distal Stems Distal Stems Stems ≥200mm BH 18 161 1412 3974 Stem 274396 274397 274398 274605 274608 4851 0 0 No Change 2011-08-01 2019-03-01 Prosthesis BH134 Orthopaedic Salvage System Tibial Component, Resurfacing or Segmental, Non-Modular tray, CoCr, Ti 63-83mm BH 17 157 1381 3932 98451 Changed Benefit 7247 0 0 Update 2011-08-01 2019-03-01 Prosthesis BH135 Orthopaedic Salvage System Tibial Component, Resurfacing or Segmental, Non-Modular tray, CoCr, Ti 63-83mm BH 17 157 1381 3932 98451 Changed Benefit 7247 0 0 Update 2011-08-01 2019-03-01 Prosthesis BS239 Boston Scientific DBS Extension Kit Deep brain stimulation extension kit 55cm BS 25 221 1674 4477 202034 1995 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS240 Vercise Physician's Spare Kit Boots accessory kit for DBS N/A BS 25 221 1676 4498 203998 166 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS241 Boston Scientific DBS Tunneling Tool Tunneling tool for DBS - straw, long N/A BS 25 221 1676 4498 156757 166 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS242 Boston Scientific DBS OR Cable & Extension OR cable and extension for DBS One size only BS 25 221 1676 4479 157994 190 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS243 Vercise Remote Control, Vercise Remote Control 2 Remote patient control for DBS One size only BS 25 221 1673 4474 202019 279188 1330 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS244 SureTek Burr Hole Cover Burr hole cover 14mm compatability BS 25 221 1676 4478 203999 Changed Benefit 523 0 0 Update 2013-02-01 2019-03-01 Prosthesis BS245 Vercise Charging System Recharging system for DBS N/A BS 25 221 1673 4475 202018 203085 1876 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS246 Introducer Kit Introducer intended for the percutaneous introduction and placement of leads. Length: 13cm; 23cm. BS 25 222 1690 4501 166195 Changed Benefit 160 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH136 Orthopaedic Salvage System Femoral/Tibial Interlocking devices:locking pin, femoral and tibial bushings, tibial bearing. Axle, reinforced Yoke, locking screws CoCr, Ti One size only except srew - small or large, Tibial bearing 12-22mm BH 17 159 1393 35667 3089 0 0 No Change 2011-08-01 2019-03-01 Prosthesis BH137 Orthopaedic Salvage System Tibial bearing Insert UHMWPE 12-22mm Thick BH 17 157 1384 35667 2058 0 0 No Change 2011-08-01 2019-03-01 Prosthesis BH138 Peanut Growth Control Plating System - Plates Guided growth control plate, titanium alloy, stepped and arched 12 and 16mm, 2 holes BH 13 123 1694 5255 188744 Changed Benefit 542 0 0 Update 2012-02-01 2019-03-01 Prosthesis BH139 Peanut Growth Control Plating System - Screws Cannulated growth contol screws, titanium alloy 4.5mm Diameter, Length 16, 24, 30 and 40mm BH 13 123 1231 3369 CN 188744 191 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BH143 Zyston Curved Interbody Spacer Transformaminal Lumbar Interbody Spacer, PEEK (7 to 18)mm height to (27x32)mm length, Parallel, Lordotic BH 19 174 1486 4135 169024 3465 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BS247 Stylet Kit Stylet Kit with steering cap and stiffer stylet Stiffer stylet length: Up to 70cm BS 25 222 1690 4501 156759 Changed Benefit 160 0 0 Update 2013-02-01 2019-03-01 Prosthesis CK002 Microline Pentax Disposable 10ml Titanium K2 clip Cartridge Disposable cartridge containing 10 surgical grade titanium clips delivered using a reusable hand piece applier. Medium/Large Clip CK 21 194 1581 4259 129715 60 0 0 No Change 2007-12-01 2019-03-01 Prosthesis CK003 Endox Visu-Loc Clip Applier Single-use laparoscopic clip applier Medium, Large CK 21 194 1581 4258 Laparoscopic 137044 381 0 0 No Change 2007-12-01 2019-03-01 Prosthesis CK005 Exmoor Plastics Ear Vent Drains - Reuter Bobbin Without hole, teflon 1.14 mm lumen dia x 2.54 mm inner flange dia x 2.54 mm outer flange dia x 0.76 inter flange. 1.52mm total length CK 22 196 1566 133977 19 0 0 No Change 2017-08-01 2019-03-01 Prosthesis CK006 Exmoor Plastics Ear Vent Drains - Collar Button Teflon 1.14 mm lumen dia x 2.24 mm inner flange dia x 2.24 mm outer flange dia x 1.27 inter flange. 1.78 mm total length CK 22 196 1566 133977 19 0 0 No Change 2017-08-01 2019-03-01 Prosthesis CK007 Exmoor Plastics Ear Vent Drains - Collar Button Teflon 1.14 mm lumen dia x 3.0 mm inner flange dia x 3.0 mm outer flange dia x 1.27 inter flange. 1.78 mm total length CK 22 196 1566 133977 19 0 0 No Change 2017-08-01 2019-03-01 Prosthesis DE418 Locking Medial Hook Plate Locking Medial Hook Plate for fixation of Medial malleolus fractures 7 Holes DE 13 123 1694 5259 Com, LK 140686 Changed Benefit 916 0 0 Update 2013-02-01 2019-03-01 Prosthesis DE419 Locking Lateral Hook Plate Locking Lateral Hook Plate for Fracture Fixation of the Lateral Malleolus 3-5 Holes DE 13 123 1694 5258 Com, LK 140686 850 0 0 No Change 2013-02-01 2019-03-01 Prosthesis DE420 Locking Lateral Hook Plate Locking Lateral Hook Plate for Fixation of Lateral Malleolus 7 Holes DE 13 123 1694 5259 Com, LK 140686 Changed Benefit 916 0 0 Update 2013-02-01 2019-03-01 Prosthesis DE421 Locking distal Fibula plate Locking Distal Fibula Plate For Fracture Fixation 4-6 Holes ( Left and Right Specific) DE 13 123 1694 5290 LK 140686 1330 0 0 No Change 2013-02-01 2019-03-01 Prosthesis DE422 Locking Distal Fibula Plate Locking Distal Fibula Plate for Fracture Fixation 8 Hole ( Left and Right Specific) DE 13 123 1694 5290 LK 140686 1330 0 0 No Change 2013-02-01 2019-03-01 Prosthesis DE423 PEEKPower HTO Plate Medial High Tibial Osteotomy Implant Device System 4.5mm Titanium compression Screws DE 13 123 1231 3369 227070 65 0 0 No Change 2013-02-01 2019-03-01 Prosthesis DE427 Headless Compression Screw Headless Compression Screw for bone fixation 3mm x 10-32mm DE 13 123 1231 3370 CN,DT 203466 379 0 0 No Change 2013-08-01 2019-03-01 Prosthesis DE438 PEEK Distal Radius Plate Peek Plate for Fracture Fixation 7 Hole Plate (left & right side specific) DE 13 123 1694 5277 140710 869 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE439 Peek Delta Screws Interference screw for soft tissue Fixation 6-12mm Diameter x (23mm-35m) Length DE 13 123 1774 5391 98527 Changed Benefit 181 0 0 Update 2014-02-01 2019-03-01 Prosthesis DE440 Interference Screws Interference screw for Soft Tissue Fixation 7-10mm x (15-35mm) DE 13 123 1774 5391 98527 Changed Benefit 181 0 0 Update 2014-02-01 2019-03-01 Prosthesis DE437 PEEK Distal Radius Plate Peek Plate for Fracture Fixation 3-5 Hole Plate (Left & right side specific) DE 13 123 1694 5276 140710 869 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE441 Medial Column Plate Plate for fusion Small, Medium, Large (Left and Right) DE 13 123 1694 5259 LK 140686 Changed Benefit 536 0 0 Update 2014-02-01 2019-03-01 Prosthesis DE442 X Plate Plate for fusion Small DE 13 123 1694 5261 Com, LK 140686 Changed Benefit 1263 0 0 Update 2014-02-01 2019-03-01 Prosthesis DE443 Low Profile T-Plate Plate for fusion 3-6 Holes DE 13 123 1694 5261 LK 140686 Changed Benefit 883 0 0 Update 2014-02-01 2019-03-01 Prosthesis CK008 Exmoor Plastics Ear Vent Drains - Collar Button Teflon 1.4 mm lumen dia x 2.55 mm inner flange dia x 2.55 mm outer flange dia x 0.85 inter flange. 1.35 mm total length CK 22 196 1566 133977 19 0 0 No Change 2017-08-01 2019-03-01 Prosthesis CK009 Exmoor Plastics Ear Vent Drains - Collar Button Teflon 1.75 mm lumen dia x 2.85 mm inner flange dia x 2.85 mm outer flange dia x 0.95 inter flange. 1.46 mm total length CK 22 196 1566 133977 19 0 0 No Change 2017-08-01 2019-03-01 Prosthesis CK010 Exmoor Plastics Ear Vent Drains - Shepards Drain Teflon Shephards Drain 1.14 mm lumen dia x 2.36 mm inner flange dia x 2.36 mm outer flange dia x 1.42 inter flange. 2.41 mm total length CK 22 196 1566 133977 19 0 0 No Change 2017-08-01 2019-03-01 Prosthesis CK011 Exmoor Plastics Ear Vent Drains - Teflon Shephards Drain with wire grasping feature Teflon Shephards Drain with wire 0.97 mm lumen dia x 2.08 mm inner flange dia x 2.08 mm outer flange dia x 1.42 inter flange. 2.41 mm total length CK 22 196 1566 133977 19 0 0 No Change 2017-08-01 2019-03-01 Prosthesis DE444 Low Profile Straight Plate Plate for Fusion 4-6 Holes DE 13 123 1694 5261 LK 140686 Changed Benefit 883 0 0 Update 2014-02-01 2019-03-01 Prosthesis DE445 Vesocclude Ligating Clips Titanium Ligating Clips Small, Narrow (6 per cartridge), Small, wide (6 per cartridge) DE 21 194 1581 4256 202037 11 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE446 Vesocclude Ligating Clips Titanium ligating Clips Small, Narrow (24 per cartridge), Small, Wide (24 per Cartridge) DE 21 194 1581 4256 202037 44 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE447 Vesocclude Ligating Clips Titanium ligating Clips Medium (6 per cartridge) DE 21 194 1581 4256 202037 11 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE448 Vesocclude Ligating Clips Titanium Ligating Clips Medium (24 per cartridge) DE 21 194 1581 4256 202037 2 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE449 Vesocclude Ligating Clips Titanium Ligating Clips Medium Large (6 per cartridge) DE 21 194 1581 4256 202037 11 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BH144 Polaris Domino Parallel and axial, rod to rod connectors, titanium alloy (3.5 - 6.35mm) x (3.5 - 6.35mm) BH 19 167 1472 168658 Changed Benefit 732 0 0 Update 2012-02-01 2019-03-01 Prosthesis BH145 TunneLoc Tibial Fixation Device with Tensioner, PEEK 7 to 10mm diameter BH 13 123 1774 5391 116765 Changed Benefit 181 0 0 Update 2012-02-01 2019-03-01 Prosthesis BH147 EBI XFIX Dynafix System MAC Rings or Arcs, Rotational or fixed 100-220mm BH 13 123 1237 3406 145253 1050 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BH148 EBI XFIX Dynafix System MAC system couplig devices, Ring, Angulating coupler, rotational adapter Male Female BH 13 123 1237 4508 145253 Changed Benefit 732 0 0 Update 2012-02-01 2019-03-01 Prosthesis BH150 EBI XFIX Dynafix System Standard Straight Fixator Complete Stndard 5 or 8 cm arms BH 13 123 1237 3401 145253 6175 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BH151 EBI XFIX Dynafix System Clamp: Straight body, tee or ankle 5-8cm BH 13 123 1237 3402 145253 1579 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BH152 EBI XFIX Dynafix System Compression / Distraction / dynamisation modules 5-8cm BH 13 123 1237 3402 145253 1579 0 0 No Change 2012-02-01 2019-03-01 Prosthesis CK012 Exmoor Plastics Ear Vent Drains - Donaldson Grommet With tab, silicone rubber 1.1 mm lumen dia x 2.25 mm inner flange dia x 2.25 mm outer flange dia x 0.76 inter flange. 2.25 mm total length CK 22 196 1566 133977 19 0 0 No Change 2017-08-01 2019-03-01 Prosthesis CL001 Advantage I-125 Pre-load Advantage I-125 Pre-load consists of stranded Advantage I-125 seeds pre-loaded on prescription into brachytherapy needles specifically for treatment of an individual patient. They arrive sterile and pre-packaged ready for use in theatre Stranded seeds are pre-loaded in brachytherapy needles in a prescribed configuration; up to 120 seeds CL 21 187 1521 4162 175081 6175 0 0 No Change 2009-08-01 2019-03-01 Prosthesis CL002 Advantage I-125 Seed Advantage I-125 seeds are sealed radioactive sources containing Iodine-125 for interstitial brachytherapy 3mm x 0.5mm silver rod within 4.5 x 0.8mm sealed titanium capsule, up to 120 seeds CL 21 187 1521 4162 154457 6175 0 0 No Change 2010-02-01 2019-03-01 Prosthesis CL003 Advantage I-125 Seed The Advantage I-125 seed is a sealed radioactive source containing Iodine-125 for interstitial brachytherapy 3mm x 0.5mm silver rod within 4.5 x 0.8mm sealed titanium capsule CL 21 187 1521 4163 154457 78 0 0 No Change 2010-02-01 2019-03-01 Prosthesis BH153 EBI XFIX Dynafix System Body component Std BH 13 123 1237 3756 145253 1900 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BH154 EBI XFIX Dynafix System Fixator Complete, small Small, Extra small BH 13 123 1237 3401 Small 145253 Changed Benefit 2043 0 0 Update 2012-02-01 2019-03-01 Prosthesis BH155 EBI XFIX Dynafix System Clamp straight body, Tee, or ankle Small or extra small BH 13 123 1237 3402 Small 145253 4560 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BS183 Endotak Reliance 4-SITE Passive fixation dual coil defibrillation leads with 4-SITE connector 50-70cm BS 27 242 1741 e 165643 6480 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BS184 Advanix Plastic Stent Plastic stent manufactured individually 5-18cm length, 7-10 FR diameter BS 21 192 1556 4218 127387 78 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BS185 Xenform Soft Tissue Repair Matrix 2x7cm Graft derived from fetal dermal bovine tissues 2x7cm BS 26 229 1707 5328 174878 747 0 0 No Change 2011-02-01 2019-03-01 Prosthesis CO021 Nucleus Freedom Implant with Contour Advance Electrode Model C124RE (CA), Generation 4 Cochlear implant with perimodiolar electrode array. Titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable silicone seal one size only CO 22 196 1526 117025 Changed Benefit 12892 0 0 Update 2005-10-31 2019-03-01 Prosthesis CO024 Nucleus Freedom Implant with Straight Electrode Model CI24RE (ST), Generation 4 Cochlear Implant with straight array electrode One size only CO 22 196 1526 117025 Changed Benefit 12892 0 0 Update 2005-10-31 2019-03-01 Prosthesis CO028 BAHA - Cover screw unigrip Titanium cover screws, individually packaged and delivered sterile. The cover screws are used to prevent bone overgrowth of the implant. One size only CO 22 196 1560 4152 123984 135 0 0 No Change 2006-03-24 2019-03-01 Prosthesis CO032 Flange fixture - self tapping fixture with pre-mounted abutment Self tapping titanium flange fixture with abutment in two sizes: 3mm and 4mm Self Tapping 4mm and 3mm with BAHA Abutment CO 22 196 1560 4151 Abutment & Fixture 123984 Changed Benefit 1833 0 0 Update 2006-03-24 2019-03-01 Prosthesis CO035 Face to Face Cover Screw with Internal Hexagon One Size Only CO 23 200 1599 4377 123984 138 0 0 No Change 2006-03-24 2019-03-01 Prosthesis BS186 Xenform Soft Tissue Repair Matrix 4x7cm Graft derived from fetal dermal bovine tissues 4x7cm BS 26 229 1707 5328 174878 747 0 0 No Change 2011-02-01 2019-03-01 Prosthesis BS187 Xenform Soft Tissue Repair Matrix 6x10cm Graft derived from fetal dermal bovine tissues 6x10cm BS 26 229 1707 5328 174878 747 0 0 No Change 2011-02-01 2019-03-01 Prosthesis BS188 Xenform Soft Tissue Repair Matrix 8x12cm Graft derived from fetal dermal bovine tissues 8x12cm BS 26 229 1707 5329 174878 1140 0 0 No Change 2011-02-01 2019-03-01 Prosthesis BS192 Percuflex® Helical Ureteral Stent with Hydro Plus™ Coating 6fr to 8fr and 10cm to 30cm BS 26 227 1701 5322 Therm 129376 203 0 0 No Change 2011-08-01 2019-03-01 Prosthesis BS196 Innova Self-Expanding Stent Nitinol, self expanding stent Diameters up to 8mm, lengths less than 150mm BS 24 206 1622 4440 104281 1710 0 0 No Change 2011-08-01 2019-03-01 Prosthesis BS197 Innova Self-Expanding Stent Nitinol, self expanding stent Diameters up to 8mm, Lengths greater than 150mm BS 24 206 1622 4441 104281 Changed Benefit 2822 0 0 Update 2011-08-01 2019-03-01 Prosthesis BS211 OMEGA Bare Metal Stent Platinum Chromium Bare Metal Stent 2.25mm to 4.50mm Diameter. 8mm to 38mm Length. BS 27 247 1767 5348 187434 898 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BS212 Pacemaker/Defibrillator port safety plug Pacemaker/Defibrillator Plug that seals unused IS-1/DF-1 or IS-4/DF-4 port 3.2mm x 38mm BS 27 246 1765 190242 Changed Benefit 58 0 0 Update 2012-02-01 2019-03-01 Prosthesis BS213 Lead Cap Kit Caps used to protect lead terminal connector pin 4.75mm and 3.2mm BS 27 246 1765 133935 Changed Benefit 58 0 0 Update 2012-02-01 2019-03-01 Prosthesis BS214 WallFlex Biliary Stent Stent with permalume covering 6 - 10 x 40 - 120mm BS 21 192 1556 4235 136261 177661 2874 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BS215 WallFlex Biliary Stent Bare Metal Stent 6 - 10 x 40 - 120mm BS 21 192 1556 4234 136261 177661 2114 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BS225 Speedband Superview Super 7 Multiple Band Ligator 7 bands per unit, compatible with scopes with outer diameter of 8.6mm - 11.5mm BS 21 194 1581 5490 133438 254 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS226 Obtryx II Transobturator Mid-Urethral Sling System Polypropylene mesh sling One size only BS 26 226 1698 5315 104326 Changed Benefit 822 0 0 Update 2013-02-01 2019-03-01 Prosthesis BS227 Flexima All-Purpose Drainage Catheter All-purpose drainage catheters for abscesses and fluid collections. Length up to 25cm BS 21 193 1577 4243 132027 120 0 0 No Change 2013-02-01 2019-03-01 Prosthesis DE428 Corkscrew Suture Anchor Titanium alloy with Fibrewire suture 3.5mm DE 13 123 1774 5385 126657 Changed Benefit 442 0 0 Update 2013-08-01 2019-03-01 Prosthesis DE429 Corkscrew Suture Anchor Non Absorbable Suture Anchor >4mm DE 13 123 1774 5387 126657 Changed Benefit 442 0 0 Update 2013-08-01 2019-03-01 Prosthesis DE430 Corkscrew Suture Anchor Titanium alloy with Fibrewire suture 2.2mm DE 13 123 1774 5384 126657 Changed Benefit 294 0 0 Update 2013-08-01 2019-03-01 Prosthesis DE431 Corkscrew FT Suture Anchor with Fiberwire 2.4mm - 3.9mm DE 13 123 1774 5385 AB 126657 501 0 0 No Change 2013-08-01 2019-03-01 Prosthesis DE432 Corkscrew FT Suture Anchor with Fiberwire 4mm - 6.5mm DE 13 123 1774 5387 AB 126657 501 0 0 No Change 2013-08-01 2019-03-01 Prosthesis DE433 Pushlock Suture Anchor Knotless Suture Anchor 2.5 - 3.5mm DE 13 123 1774 5385 126657 Changed Benefit 442 0 0 Update 2013-08-01 2019-03-01 Prosthesis DE434 Pushlock Suture Anchor Knotless Suture Anchor 4.5mm DE 13 123 1774 5387 126657 Changed Benefit 442 0 0 Update 2013-08-01 2019-03-01 Prosthesis DE435 BioComposite PushLock BioComposite Pushlock Knotless Suture Anchor 2.4 - 3.5 mm DE 13 123 1774 5385 AB 164045 501 0 0 No Change 2013-08-01 2019-03-01 Prosthesis DE436 BioComposite PushLock Knotless Suture Anchor 4.5mm DE 13 123 1774 5387 AB 164045 501 0 0 No Change 2013-08-01 2019-03-01 Prosthesis GM124 Global Acetabular System- Highly cross-linked and Annealed constrained liner highly cross linked and annealed constrained liner 28mm, 32mm 36mm Diameter Neutral, 10 degree and 20 degree size range 44mm to 72mm GM 18 163 1428 4024 120787 1613 0 0 No Change 2008-07-01 2019-03-01 Prosthesis GN001 Opsys Injectable SUI Opsys is a manually injectable, non-absorbable, permanent, synthetic tissue bulking agent used in the endoscopic treatment of female Stress Urinary Incontinence. Opsys Kit contains 5 x 1ml syringes. GN 26 226 1699 5316 169958 Changed Benefit 504 0 0 Update 2012-02-01 2019-03-01 Prosthesis GN002 Opsys Injectable SUI Opsys is a manually injectable, non-absorbable, permanent, synthetic tissue bulking agent used in the endoscopic treatment of female Stress Urinary Incontinence. 1 x 1ml syringe. GN 26 226 1699 5316 169958 Changed Benefit 504 0 0 Update 2012-02-01 2019-03-01 Prosthesis GN003 Vantris Bulking agent for the treatment of Vesicoureteric Reflux 1ml Syringe GN 26 235 1719 169958 950 0 0 No Change 2012-02-01 2019-03-01 Prosthesis GO001 RBK Total Knee System Patella component Patella component All poly, UHMWPE, cemented, 3 pegs 24mm - 40mm GO 17 156 1376 279233 Changed Benefit 537 0 0 Update 2005-10-31 2019-03-01 Prosthesis GO002 RBK Total Knee System Tibial Insert Tibial Insert, UHMWPE, mobile bearing 1-5, 10-20mm GO 17 153 1369 279249 279791 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ172 Mersilene Mesh Non-absorbable polyester mesh 30cm x 30cm JJ 21 194 1782 5437 120154 261 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ173 VICRYL Mesh Polyglactin 910 - synthetic absorbable mesh. 15cm x 15cm JJ 21 194 1783 5439 143774 144 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ174 Prolene Mesh Small polypropylene monofilament non absorbable mesh 2.5cm x 10cm JJ 21 194 1782 5434 126920 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ175 Prolene Mesh Medium polypropylene monofilament non absorbable mesh 7.6cm x 15cm JJ 21 194 1782 5434 126920 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ176 Prolene Mesh Large polypropylene monofilament non absorbable mesh 30cm x 30cm JJ 21 194 1782 5437 126920 261 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ177 Prolene Mesh Small keyhole polypropylene monofilament non absorbable mesh 4.6cm x 10.2cm JJ 21 194 1782 5434 120154 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ178 Prolene Mesh Large keyhole polypropylene monofilament non absorbable mesh 6cm x 13.7cm JJ 21 194 1782 5434 120154 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis GO004 RBK Total Knee System Tibial Baseplate Tibial baseplate, CoCr, beaded, uncemented, for mobile bearing insert 1-5 GO 17 151 1362 143923 75734 2639 0 0 No Change 2005-10-31 2019-03-01 Prosthesis GO005 RBK Total Knee System Tibial Baseplate Tibial baseplate, CoCr, uncemented, beaded, with Titanium plasma spray and HA for mobile bearing insert 1-5 GO 17 151 1362 3924 278988 Changed Benefit 2997 0 0 Update 2005-10-31 2019-03-01 Prosthesis GO006 RBK Total Knee System Femoral Component Femoral Component, CoCr, cemented 0 - 5 GO 17 149 1348 3906 278987 2951 0 0 No Change 2005-10-31 2019-03-01 Prosthesis GO007 RBK Total Knee System Femoral Component Femoral Component, uncemented, CoCr, Porous coated 1-5 Left and Right GO 17 149 1351 3914 278986 3309 0 0 No Change 2005-10-31 2019-03-01 Prosthesis GO003 RBK Total Knee System Tibial Baseplate Tibial baseplate, grit blast, CoCr, cemented, for mobile bearing insert 0 - 5 GO 17 151 1359 279029 Changed Benefit 2147 0 0 Update 2005-10-31 2019-03-01 Prosthesis GO008 RBK Total Knee System Patella component Patella component, metal back, CoCr, mobile, titanium plasma sprayed with HA, uncemented sizes 1 - 5 GO 17 156 1378 3928 279029 1210 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW574 Triathlon Tritanium Femoral Cone Augments 3D printed Tritanium Cone Augments intended for filling bone voids in metaphyseal region of bone. CPTi porous foam for biological fixation or cement interdigitation, for use with Triathlon TS cemented or uncemented stems Femoral Cone Augments, 6 sizes, L & R (Size 1-2, Size 3, 4, 5, 6 and Size 7-8) HW 17 159 1400 Metaphyseal 262263 Changed Benefit 2416 0 0 Update 2016-08-01 2019-03-01 Prosthesis HW575 Triathlon Tritanium Symmetric Tibial Cone Augments 3D printed Tritanium Cone Augments intended for filling bone voids in metaphyseal region of bone. CPTi porous foam for biological fixation or cement interdigitation, for use with Triathlon TS cemented or uncemented stems Symmetric Tibial Cone Augments, 5 sizes (A – E) HW 17 159 1400 Metaphyseal 262263 Changed Benefit 2416 0 0 Update 2016-08-01 2019-03-01 Prosthesis JJ180 Prolene Hernia System BI-LAYER POLYPROPYLENE NON ABSORBABLE MEDIUM TO EXTENDED JJ 21 194 1782 5434 Contoured 126920 195 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ184 Endopath Multi Stapler Endoscopic titanium stapler with staples 11mm shaft diameter JJ 21 194 1582 4320 Endoscopic 124512 509 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ186 Ligaclip Endoscopic Multiclip Applier Metal/plastic stapler with titanium clips 10-12 mm shaft diameter, medium to large clip JJ 21 194 1581 4258 Laparoscopic 122810 381 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ222 Prolene Mesh - medium Constructed of knitted filaments of extruded polypropylene identical to that used in Prolene suture. Material is approx. 0.027mm thick. Non-absorbable mesh for tension free-inguinal hernia techniques. Medium - 6" x 6" JJ 21 194 1782 5435 126920 81 0 0 No Change 2005-10-31 2019-03-01 Prosthesis 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 JJ 24 213 1646 5472 P (Platinum) 137980 129 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE450 Vesocclude Ligating Clips Titanium Ligating Clips Medium large (24 per cartridge) DE 21 194 1581 4256 202037 44 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE451 Vesocclude Ligating Clips Titanium Ligating Clips Large (6 per cartridge) DE 21 194 1581 4256 202037 11 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE452 Vesocclude Ligating Clips Titanium Ligating Clips Large (24 per cartridge) DE 21 194 1581 4256 202037 44 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE453 X Plate Plate for fusion Medium, Large DE 13 123 1694 5258 LK 140686 470 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE454 Low Profile T-Plate Plate for fusion 7-9 Holes DE 13 123 1694 5262 LK 140686 638 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DY077 Apex Hole eliminator Hole eliminator screw Titanium One size only SY 18 164 1441 153087 141 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY087 Surgical Titanium Mesh System End Plate or Screws or End Cap (Round / Oblong / Trapezoidal) 10-33mm SY 19 176 1495 128257 97391 98094 1275 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY088 Surgical Titanium Mesh System Rings (Standard and Angled) 17-26mm x 22-33mm SY 19 176 1495 98094 1275 0 0 No Change 2005-10-31 2019-03-01 Prosthesis GO031 Global re-surfacing uni-compartmental (GRU) knee tibial component GRU Tibia. All poly, uni compartment, tibial component, UHMWPE -2-5, 6.5-9.5mm regular GO 17 152 1363 272792 Changed Benefit 1118 0 0 Update 2005-10-31 2019-03-01 Prosthesis GO032 Global re-surfacing uni-compartmental knee femoral component Uni Femoral component, CoCr, cemented Size 1-5 Right medial/left lateral; Size 1-5 Left medial/right lateral GO 17 150 1353 272791 2058 0 0 No Change 2005-10-31 2019-03-01 Prosthesis GO035 RBK Total Knee System Patello Femoral (trochlear component) Trochlear Component, cemented, CoCr Size 00 to 5 GO 17 155 1374 278985 2460 0 0 No Change 2005-10-31 2019-03-01 Prosthesis GO114 RBK Total Knee System Stems Tibial and Femoral Stems, cemented, Titanium including locking bolt 10mm to 24mm thick x 80mm to 170mm long GO 17 159 1399 278990 Changed Benefit 1126 0 0 Update 2006-03-24 2019-03-01 Prosthesis GO115 RBK Total Knee System Tibial Baseplate Tibial Baseplate, for mobile insert, CrCo, cemented Size 00 to 5 GO 17 151 1359 Revision 278989 3489 0 0 No Change 2006-03-24 2019-03-01 Prosthesis GO116 RBK Total Knee System Tibial Augments Tibial hemi blocks and wedges, CoCr, Titanium 5mm and 10mm thick GO 17 159 1390 246978 1148 0 0 No Change 2006-03-24 2019-03-01 Prosthesis DY097 Vetebrplastic Cement Vetebrplastic cement One size only SY 13 123 1279 4087 96550 157 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY107 Carbon Fibre Cages Stackable Cage Titanium Interface Screw Nuts One size only SY 19 166 1465 128255 128257 98094 164 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY109 Carbon Fibre Cages Stackable Cage Titanium Protective Sleeve 5-15mm SY 19 166 1466 135462 Changed Benefit 217 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY110 Carbon Fibre Cages Stackable Cage Titanium Interface Screws M4 / M5 SY 19 165 1464 128255 128257 98094 Changed Benefit 193 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY134 Summit Femoral Stem Titanium, beaded proximally with HA, duofix distal grit blast Size 1-10 SY 18 161 1407 3950 SCP 215936 Changed Benefit 4262 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY136 Restore Orthobiologic Soft Tissue Implant Restore Patch One size only SY 13 123 1776 5397 149583 6022 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY148 LCS Complete Knee System femoral component Femoral component, cemented, CoCr, totally constrained Sizes small to large+ SY 17 149 1348 3908 Revision 131657 138036 5590 0 0 No Change 2005-10-31 2019-03-01 Prosthesis GO119 RBK Total Knee System Rotating hinge bushing mechanism Rotating Hinge Bushing Mechansim Complete mechanism GO 17 159 1393 143926 3089 0 0 No Change 2006-03-24 2019-03-01 Prosthesis GO120 RBK Total Knee System Screw, Ti 5mm to 5.7mm x 5mm to 17.5mm long GO 17 159 1398 246508 246509 246510 126 0 0 No Change 2006-03-24 2019-03-01 Prosthesis DY151 MBT Knee System Revision Tibial base Plate Tibial baseplate, cemented, CoCr, for rotating platform, also usable with specific hinged insert Sizes 1-7 SY 17 151 1359 Revision, Hinged 98092 3936 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY153 LCS Complete Knee System Augments Femoral distal and posterior augments, CoCr, with screws Sizes small to large+. 5-15mm SY 17 159 1390 131657 1148 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY156 LCS, PFC and SROM Knee Systems, femoral metaphyseal sleeve Universal femoral metaphyseal sleeve, Porocoat, smaller size cemented, larger sizes uncemented, titanium 20 - 46mm SY 17 159 1400 Metaphyseal 131657 Changed Benefit 2416 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY157 MBT Knee Systems tibial metaphyseal sleeve Universal tibial metaphyseal sleeve, Porocoat, smaller size cemented or uncemented, larger sizes uncemented, titanium 29 - 61mm SY 17 159 1400 Metaphyseal 98092 Changed Benefit 2416 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY159 MBT Knee System tibial augments Tibial blocks, with screws, CoCr Sizes 1-7. 5-15mm SY 17 159 1390 98092 1148 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY182 Monarch Spinal System Rods 6.35 & 5.5mm x 35-600mm SY 19 170 1478 145010 97391 Changed Benefit 426 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY184 Monarch Spinal System Dual Rod Connectors End to End or Side by Side 4.75 to 6.35mm SY 19 167 1472 145010 97391 Changed Benefit 732 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY187 Limb Preservation System Beaded, 'Porocoat' Standard & Trochanter Replacement Neutral, 15deg Left & Right in both styles SY 18 161 1410 3962 Body, Tumor 131657 Changed Benefit 6143 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY188 Limb Preservation System Distal Femoral Replacement Component Left/Right XX Small and X Small SY 17 157 1380 3931 131657 Changed Benefit 7163 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY189 Limb Preservation System LPS Diaphyseal Stem, Cemented, Bowed, with 2cm Beaded Collar 11mm - 17mm diameter x 150 - 200mm length SY 17 157 1382 3934 131657 4093 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY190 Limb Preservation System LPS Diaphyseal Stem Fully Beaded, Bowed, with 2cm Beaded Collar Porocoat 12.5mm - 18.5mm diameter x 150mm - 200mm length SY 17 157 1386 131657 2716 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY191 Limb Preservation System Total Femoral Segment Component (Male/Male) 55 mm Length SY 17 157 1387 3938 131657 3936 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY193 Limb Preservation System LPS Diaphyseal Stem, Cemented, Straight, with 2cm Beaded Collar 9mm - 17mm diameter, 100 - 125mm length SY 17 157 1382 3934 131657 4093 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY194 Limb Preservation System LPS Diaphyseal Stem Fully Beaded, Straight, with 2cm Beaded Collar Porocoat 10.5mm - 18.5mm diameter x 100mm - 125mm length SY 17 157 1386 131657 2716 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY195 Limb Preservation System Tibial Replacement Component XX Small - Med SY 17 157 1381 3933 98092 7186 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY196 Limb Preservation System Tibial Hinge Insert XX Small - Large, 12 - 31mm SY 17 159 1393 98092 3089 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY192 Limb Preservation System Segmental Component (Male/Male) 25 to 125mm Length SY 17 157 1387 3938 131657 3936 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY210 Pinnacle Acetabular Cross Linked UHMWPE Insert UHMWPE, highly cross linked insert 22-48mm ID SY 18 163 1428 4021 98086 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY217 Limb Preservation System Intercalary Segment Component (Male/Female) 55mm SY 17 157 1387 3937 Complex 131657 Changed Benefit 6519 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW558 TransForm Occlusion Balloon Catheters The TransForm Occlusion Balloon Catheter consists of a single lumen catheter shaft with a balloon attached at the distal end. The balloon is available in a compliant version and a super compliant version. Radiopaque markers are located at the proximal and distal ends of the balloon to facilitate fluoroscopic visualization. The balloon catheter is recommended for use with a Stryker Neurovascular 0.014 in (0.36 mm) guidewire to seal the distal segment of the catheter lumen allowing inflation of the balloon. The guidewire can be moved distally or proximally once beyond the distal tip (seal portion) of the catheter and still maintain a positive seal for inflating the balloon. The distal outer segment of the catheter shaft is coated with a hydrophilic material that reduces friction during manipulation in the vessel. A luer fitting hub at the proximal end of the catheter is used for the attachment of accessories. Effective Length: 150 cm Balloon Outer Diameter: 3 mm - 7 mm Balloon Nominal Length: 5 mm - 30 mm Maximum Catheter Shaft Outer Diameter: 2.8 F HW 25 225 1689 4494 223661 665 0 0 No Change 2015-08-01 2019-03-01 Prosthesis HW559 ICONiX TT Anchor ICONiX TT Anchor soft-tissue fixation 1.4mm, 2.3mm HW 13 123 1774 5385 229717 Changed Benefit 442 0 0 Update 2016-02-01 2019-03-01 Prosthesis HW560 Tritanium PL Posterior Lumbar Cage Porous Titanium Alloy Interbody Cage 6-16mm height, 23-32mm length, 9-11mm width, 0, 6 and 12 degrees HW 19 174 1486 4135 265560 3465 0 0 No Change 2016-02-01 2019-03-01 Prosthesis HW561 Stryker Fixos Screws Stryker Fixos Screws >4.5mm 5mm & 7mm diameter HW 13 123 1231 3369 CN,DT 227536 362 0 0 No Change 2016-02-01 2019-03-01 Prosthesis HW562 Uni-Elbow (Radio-Capitellar Replacement) Uni-Compartmental Arthroplasty of the lateral radial humeral joint: Radio Capitellum Implant Radio Capitellum Implant: Size S & L for Left; and S & L for Right HW 13 131 1275 3673 240014 4387 0 0 No Change 2016-02-01 2019-03-01 Prosthesis HW563 Leibinger Titanium Implant System Profyle hand and small fragment plate system 2.3mm system HW 13 123 1694 5261 VAL 124318 1197 0 0 No Change 2016-02-01 2019-03-01 Prosthesis HW564 Leibinger Titanium Implant System Profyle hand and small fragment plate system 2.3mm system HW 13 123 1694 5262 VAL 124318 952 0 0 No Change 2016-02-01 2019-03-01 Prosthesis HW565 SR Hand Implant System SR Hand MCP Proximal, CoCr - Titanium Alloy, UHMWPE XS/S/M/L/XL HW 13 131 1274 6044 167056 665 0 0 No Change 2016-02-01 2019-03-01 Prosthesis DY294 Bremer Halo Crown System Aluminium Crown & Vest Standard & 3D SY 13 123 1237 3755 138862 138863 138874 Changed Benefit 2883 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY295 Bremer Halo Crown System Titanium Skull Pins Standard & Hi-Fix SY 13 123 1237 4513 139287 428 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY293 Crossover System (Titanium) Crossover Nut or Ball Screw One size only SY 19 166 1465 128257 164 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY322 Carbon Fibre Interbody Fusion Device Stackable C/F Cage System Wedges 11 Degree Small-Large SY 19 176 1493 98094 4235 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW566 SR Hand Implant System SR Hand MCP Distal CoCr - Titanium Alloy, UHMWPE XS/S/M/L/XL HW 13 131 1274 6143 167056 665 0 0 No Change 2016-02-01 2019-03-01 Prosthesis HW567 Neuroform ATLAS Stent System The Neuroform Atlas (Atlas) Stent System is intended to be used for stent assisted embolization for intracranial aneurysm therapy. The purpose of the stent is to retain the occlusive devices within the aneurysm. Occlusive devices can be delivered prior to stent placement or after stent placement. The Atlas Stent System consists of a self-expanding, sterile, nitinol stent preloaded over a delivery wire inside an introducer sheath. The sheath and delivery wire are used to transfer the stent into a 0.0165 to 0.017 inch internal diameter microcatheter. After transferring the stent, the sheath is removed from the proximal end of the delivery wire. The delivery wire is then used to advance the stent to the distal end of the microcatheter. The microcatheter and stent system are repositioned as a unit to ensure the stent is located across the aneurysm. The stent is deployed by stabilizing the delivery wire and withdrawing the microcatheter. The Neuroform Atlas stent cannot be repositioned or captured once deployed. Stent Diameter (mm): 3.0, 4.0, 4.5 Stent Length (mm): 15, 21, 24, 30 HW 25 225 1687 278675 7125 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LB134 Calber Expandable Lumbar Fusion Device Expandable titanium alloy and PEEK lumbar interbody fusion device Un-expanded Height -7-12mm, Expanded Height 11-17mm, Width 10-12mm, Length 26-30mm LB 19 174 1486 4135 190042 3465 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LB135 Caliber Expandable Lumbar Fusion Device - Paired Expandable titanium alloy and PEEK lumbar inter-body fusion device Unexpanded Height 7-12mm, Expanded Height 11-17mm, Width 10-12mm, Length 22mm LB 19 174 1486 4135 Paired 190042 Changed Benefit 2888 0 0 Update 2016-08-01 2019-03-01 Prosthesis LB136 TransContinental TPS Lateral Lumbar Interbody Fusion (LLIF) Device Length - 40-60mm in 5mm increments Height - 7-17mm Width - 18mm & 22mm LB 19 174 1486 4135 191535 3465 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LB137 Fortify® I Integrated Corpectomy Spacer System - Core PEEK and Titanium Cores with option of fixed lower endplate 12mm, 14mm and 20mm diameter Height 24-90mm to 32-120mm (expanded) LB 19 176 1492 4136 190055 2214 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LB138 Fortify I Integrated Corpectomy Spacer System - Endplates PEEK and Titanium endplates Lateral – 22mm X 40-50mm, 14mm X 14-16mm, 12-14mmX 14-16mm, 21x23mm and 25 X 30mm LB 19 176 1492 4138 190055 1155 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LB139 Fortify® I-R Corpectomy Spacer System - Screws Bone Screws, fixed or variable angles, self-tapping or self-drilling 4.2, 3.6, and 5.5mm diameter, 12-60mm length LB 19 165 1464 190055 Changed Benefit 193 0 0 Update 2016-08-01 2019-03-01 Prosthesis HW568 Stryker DirectInject DirectInject bone cement 3cc 5cc HW 13 123 1241 4092 CDS 278932 Changed Benefit 1188 0 0 Update 2016-08-01 2019-03-01 Prosthesis HW569 Simplex HV with Gentamicin High viscosity bone cement with antibiotic (Gentamicin) One unit contains: Powder Component 40.8g, Liquid Component 20ml HW 13 123 1279 4088 276417 Changed Benefit 166 0 0 Update 2016-08-01 2019-03-01 Prosthesis HW570 CinchLock SS Flex Knotless Anchor CinchLock SS Flex Knotless Anchor for soft tissue fixation 3mm HW 13 123 1774 5385 229717 Changed Benefit 442 0 0 Update 2016-08-01 2019-03-01 Prosthesis HW571 LITe Plate System - Screw Bone Screw Dia 5mm-5.5mm, Length 22mm-60mm HW 19 165 1464 277947 Changed Benefit 193 0 0 Update 2016-08-01 2019-03-01 Prosthesis HW572 LITe Plate System - Plate Anterior and Lateral Lumbar Locking Plates Buttress1Size, Universal and Sacral Length 21mm-37mm, Lateral Length 16mm- 28mm HW 19 169 1476 4126 277947 Changed Benefit 2118 0 0 Update 2016-08-01 2019-03-01 Prosthesis HW573 Stryker DirectInject DirectInject bone cement 10cc HW 13 123 1241 4093 CDS 278932 1449 0 0 No Change 2016-08-01 2019-03-01 Prosthesis HW576 Triathlon Tritanium Asymmetric Tibial Cone Augments 3D printed Tritanium Cone Augments intended for filling bone voids in metaphyseal region of bone. CPTi porous foam for biological fixation or cement interdigitation, for use with Triathlon TS cemented or uncemented stems. Asymmetric Tibial Cone Augments, 4 sizes, LM/RL & RM/LL, (B-E). HW 17 159 1400 Metaphyseal 262263 Changed Benefit 2416 0 0 Update 2016-08-01 2019-03-01 Prosthesis HW580 ES2 Augmentable Polyaxial Screw Fenestrated Cannulated Polyaxial Screw Dia 5.5mm to 8.5mm, length 30mm to 90mm HW 19 165 1463 Cannulated 279143 1338 0 0 No Change 2017-02-01 2019-03-01 Prosthesis JJ040 Ligaclip* 20/20 Reload Unit Metal reload cartridge containing titanium clips 5 mm; 20 clips JJ 21 194 1581 4259 122810 60 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ050 Proximate* Linear Stapler Metal/Plastic linear stapler preloaded with titanium staples, manual closure 55 - 60mm JJ 21 194 1582 4320 132167 342 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ056 Proximate Articulating Linear Stapler Articulating linear stapler preloaded with titanium staples 55mm JJ 21 194 1582 4320 Articulating/Roticulating 132167 712 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LB146 CAPITOL Polyaxial Screw Self-tapping polyaxial screw 3.5 - 4.0mm diameter, 8-26mm length LB 19 165 1463 190061 1280 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LB147 CAPITOL Locking Cap Non-threading locking cap One size only LB 19 166 1465 190061 164 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LB148 CAPITOL Curved Rod Pre-lordosed Rods 3.5mm diameter 25-120mm length LB 19 170 1478 190061 Changed Benefit 426 0 0 Update 2017-02-01 2019-03-01 Prosthesis LB149 Canopy Radiolucent Spacer Slide-on PEEK spacer with graft packing chamber 5-13mm in 2mm increments LB 19 169 1477 4131 219536 722 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LB150 Caliber -L Expandable Lateral Lumbar Interbody Fusion Device Width -16mm, Length 25-40mm in 5mm increments Width -18mm, Length 40-60mm in 5mm increments Width -22mm, 40 - 60mm in 5mm increments Heights - 7-10mm, 8-11mm, 9-13mm, 10-13mm, 10mm-14mm, 11-15mm, 11-16mm, 12-16mm, 12-17mm LB 19 174 1486 4135 190042 3465 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LB151 QUARTEX Rods Ttianium alloy and cobalt chrome alloy curved and straight rods 3.5 and 4.0mm diameter, 25-500mm LB 19 170 1478 190061 Changed Benefit 426 0 0 Update 2017-08-01 2019-03-01 Prosthesis JJ070 TVT (Tension-Free Vaginal Tape) Single use device Undyed Prolene (polypropylene) nonabsorbable tape 11 x 450mm JJ 26 226 1698 5315 99193 Changed Benefit 822 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ076 Mitek Ethibond Knotless Suture Anchor Titanium anchor 2.7 x 10.8 mm SY 13 123 1774 5385 133430 Changed Benefit 442 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ078 Rigidfix ACL Cross Pin Polylactic acid pin 2.7 & 3.3mm x 42mm SY 13 123 1774 5394 AB 140561 462 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ083 Mitek GII Anchor Threader Tab Titanium Suture Anchor 2.4 x 8.8mm SY 13 123 1774 5385 133430 136374 Changed Benefit 442 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ087 Mitek Tacit Quick Anchor Titanium Suture Anchor 2.0 x 3.6mm SY 13 123 1774 5384 136374 Changed Benefit 294 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ089 Mitek GII QuickAnchor Plus Titanium Anchor, with various sutures 2.4 x 8.8mm SY 13 123 1774 5385 133430 140532 Changed Benefit 442 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ091 Mini Quick Anchor with Suture Anchor with Suture Anchor with Suture and Multiple size needles SY 13 123 1774 5384 136374 154626 154627 Changed Benefit 294 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ093 Mitek Rotator Cuff Quick Anchor Plus Titanium Anchor, with various sutures 2.8 x 11mm SY 13 123 1774 5385 133430 140533 140797 Changed Benefit 442 0 0 Update 2005-10-31 2019-03-01 Prosthesis LB140 Fortify® I-R Static Corpectomy Spacer System -Spacer PEEK spacer with integrated titanium plates Footprint - 12 X14mm Heights 15-33mm (2mm increments) LB 19 176 1814 190055 3470 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LB141 RISE Expandable Lumbar Fusion Device Width:10mm, Length: 26mm, 30mm Width:12mm, Length: 26mm and 30mm Heights 7-17mm LB 19 174 1486 4135 214537 3465 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LB142 RISE - paired Expandable Lumbar Fusion Device Width: 8mm, 10mm and 12mm Length: 22mm Height 7-17mm LB 19 174 1486 4135 Paired 214537 Changed Benefit 2888 0 0 Update 2017-02-01 2019-03-01 Prosthesis LB143 Rise IntraLIF Intradiscal Lumbar Interbody Fusion Device Width 8mm, Length 26mm, 30mm and 34mm Height 7-14mm LB 19 174 1486 4135 214537 3465 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LB144 RISE IntraLIF - paired Intradiscal Lumbar Interbody Fusion Device 8mm Width, 22mm Length 7-14mm Height LB 19 174 1486 4135 Paired 214537 Changed Benefit 2888 0 0 Update 2017-02-01 2019-03-01 Prosthesis LB145 Coalition Anchor Titanium Anchor for Coalition Spacer 12mm, 14mm and 15mm LB 19 165 1464 190040 Changed Benefit 193 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER305 Barricaid Annular replacement prosthesis Height: 14mm; Width 8mm, 10mm, 12mm ER 19 263 1823 273822 5679 0 0 No Change 2016-08-01 2019-03-01 Prosthesis ER306 Amendia Pathway TLIF Fusion Cage Pathway TLIF 28mm x 10 mm x (7-14) mm ER 19 174 1486 4135 233730 3465 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER307 Amendia Pathway PLIF Fusion Cage Amendia Pathway PLIF Fusion Cage (paired) 23mm x 10mm x (7-14) mm, 0-6° ER 19 174 1486 4135 Paired 233730 Changed Benefit 2888 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER308 Amendia Pathway ACIF Fusion Cage Amendia Pathway ACIF Fusion Cage (5-12) mm, 0-7° ER 19 174 1486 4134 233730 2409 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER309 Ulrich Anterior Distraction Device Ulrich Anterior Distraction Device (ADD)-telescoping cage, thoracolumbar dia (12-16 mm) x height collapsed (10-39 mm) x height extended (13-65 mm) x angle (0-6°) ER 19 176 1492 4137 ThoracoLumbar 279702 4139 0 0 No Change 2017-02-01 2019-03-01 Prosthesis JJ095 Mitek Super Quick Anchor Plus Titanium Anchor, with various sutures 2.8 x 11.4mm SY 13 123 1774 5385 133430 140548 140796 Changed Benefit 442 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ096 Mitek Fastin Anchor Titanium Suture Anchor 3 x 8.4mm, 4 x 9.7mm, 5.2 x 11.5mm SY 13 123 1774 5387 133430 Changed Benefit 442 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ097 Fastin Anchor System Suture Anchor 4 - 6.5mm SY 13 123 1774 5387 133430 140534 140798 152661 152662 Changed Benefit 442 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ099 Panalok Anchor System Polylactic acid absorbable anchor with absorbable and non-absorbable suture 4.1 x 6.0mm SY 13 123 1774 5387 AB 143370 143372 143378 501 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ100 Micro Quick Anchor Titanium Suture Anchor 1.3 x 3.7mm SY 13 123 1774 5384 136374 161092 Changed Benefit 294 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ127 Absolute Absorbable Interference Screw Polylactic acid screw 7 to11mm x (23 to 30mm) SY 13 123 1774 5391 AB 140560 457 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ156 Hakim Precision Valve System Precision valve standard with reservoir Very low to very high including micro SY 25 220 1666 4469 Reservoir/Priming function 140904 149290 1387 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ240 VYPRO II Mesh Composition - equal part Vicryl polyglactin yarn - non-absorbable Prolene polypropylene yarn. Partly absorbable lightweight mesh for tension free-inguinal hernia techniques Small 6 x 11cm JJ 21 194 1783 5438 128896 90 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ241 VYPRO II Mesh Composition - equal part Vicryl polyglactin yarn - non-absorbable Prolene polypropylene yarn. Partly absorbable lightweight mesh for tension free-inguinal hernia techniques Medium 12 x 10cm JJ 21 194 1783 5438 128896 90 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LB131 Niko Corpectomy Spacer PEEK Thoracolumbar pre-assembled corpectomy cage Width 12 and 14mm, Length 14mm and 16mm, Height 15-33mm in 2mm increments LB 19 176 1814 190055 3470 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LB132 Sustain-IR and Sustain-IR Narrow PEEK radiolucent interbody lumbar fusion device Height 7-17mm, Length 26-30mm LB 19 174 1486 4135 191535 3465 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LB133 Sustain-IR and Sustain-IR Narrow - Paired PEEK radiolucent interbody lumbar fusion device Height 7-17mm, Length 18-22mm LB 19 174 1486 4135 Paired 191535 Changed Benefit 2888 0 0 Update 2016-02-01 2019-03-01 Prosthesis ER310 Ulrich posterior OCT System (neon3)-Pedicle Screws Ulrich posterior OCT System (neon3)-Pedicle Screws, non-cannulated, lateral mass screws dia (3.5-4 mm) x length (10-28 mm) ER 19 165 1463 279706 1280 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER311 Ulrich posterior OCT System (neon3)-Pedicle Screws, cannulated Ulrich posterior OCT System (neon3)-Pedicle Screws, cannulated dia (4-5.5 mm) x length (20-55 mm) ER 19 165 1463 Cannulated 279706 1338 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER312 Ulrich posterior OCT System (neon3)-Occipital Screws Ulrich posterior OCT System (neon3)-Occipital screws, self tapping dia 5 mm x length (6-16 mm) ER 19 165 1464 279706 Changed Benefit 193 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER313 Ulrich posterior OCT System (neon3)-Locking Screw Ulrich posterior OCT System (neon3)-Locking Screw, nut N/A ER 19 166 1465 279706 164 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER314 Ulrich posterior OCT System (neon3)-Connector, axial/parallel Ulrich posterior OCT System (neon3)-Connector, axial/parallel one size ER 19 167 1472 279706 Changed Benefit 732 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER315 Ulrich posterior OCT System (neon3)-Connector, offset Ulrich posterior OCT System (neon3)-Connector, offset, square or parallel, left or right length (7-20 mm) ER 19 167 1473 279706 Changed Benefit 732 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER316 Ulrich posterior OCT System (neon3)-Connector, transverse Ulrich posterior OCT System (neon3)- Crosslink, adjustable, screw to screw and rod to rod length adjustable within range of 34-50 mm ER 19 167 1474 4124 279706 Changed Benefit 1299 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER317 Ulrich posterior OCT System (neon3)-Hooks Ulrich posterior OCT System (neon3)-Hooks, counter hooks, right/left, short/long short to long ER 19 168 1475 279706 789 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER318 Ulrich posterior OCT System (neon3)-Rods, occipital Ulrich posterior OCT System (neon3)-Rods, occipital, various shapes dia 4 mm x length (240-300 mm) ER 19 170 1480 4133 279706 Changed Benefit 2166 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER319 Ulrich posterior OCT System (neon3)-Rods Ulrich posterior OCT System (neon3)-Rods, Titanium or Co-CR, straight or curved dia 4 mm x length (20-400 mm) ER 19 170 1478 279706 Changed Benefit 426 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER320 Ulrich posterior OCT System (neon3)-Plate-rod Ulrich posterior OCT System (neon3)-Occipital plate, lateral, with rod One size ER 19 171 1481 279706 Changed Benefit 2907 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER321 Ulrich posterior OCT System (neon3)-Toggle Ulrich posterior OCT System (neon3)-Toggle, incl. nut and washer N/A ER 19 165 1464 Complex 279706 250 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER322 Ulrich posterior OCT System (neon3)-Plate Ulrich posterior OCT System (neon3)-Plate, occipital, midline for occipital and standard rod (4 mm). 47,57 mm ER 19 169 1477 4129 279706 Changed Benefit 2166 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER323 Ulrich Anterior Cervical Plating System-Plate Ulrich Mambo modular anterior cervical plating system 2-6 holes; length to 55 mm ER 19 169 1476 4125 279704 Changed Benefit 1348 0 0 Update 2017-02-01 2019-03-01 Prosthesis GI019 Geistlich Bio-Gide Perio / Geistlich Bio-Gide Compressed Geistlich Bio-Gide Perio and Geistlich Bio-Gide Compressed are collagen membranes containing porcine collagen in a bilayer structure. Geistlich Bio-Gide Perio is used for guided bone regeneration and is especially indicated for periodontal bone defects in oral and maxillofacial surgery. Geistlich Bio-Gide Compressed is intended to be used as a barrier membrane in the regeneration of bone defects. 16 x 22 mm, 13 x 25 mm, 20 x 30 mm GI 23 199 1588 4253 230085 294333 336 0 0 No Change 2017-08-01 2019-03-01 Prosthesis GI020 Geistlich Bio-Gide Shape Geistlich Bio-Gide Shape is intended to be used as a barrier membrane in the regeneration of bone defects and used after bone grafting procedures in extraction sockets. Because of its elasticity, Geistlich Bio-Gide Shape should be used in combination with void-filling bone graft materials such as autologous bone or bone substitutes (e.g. Geistlich Bio-Oss / Geistlich Bio-Oss Collagen) whenever possible. The porous surface, facing the bone, allows the ingrowth of bone-forming cells. The dense surface, facing the soft tissue, prevents the ingrowth of fibrous tissue into the bone defect. 14 x 24 mm GI 23 199 1588 4253 287902 336 0 0 No Change 2017-08-01 2019-03-01 Prosthesis GI021 Geistlich Bio-Gide Geistlich Bio-Gide is a collagen membrane containing porcine collagen in a bilayer structure. It is used for guided bone regeneration and peridontal tissue regeneration in oral and maxillofacial surgery. 13 x 25 mm, 25 x 25 mm, 30 x 40 mm GI 23 199 1588 4253 230084 336 0 0 No Change 2018-02-01 2019-03-01 Prosthesis GM119 Global Metal Acetabular Inserts CoCr, metal on metal, varying diameter Multiple sizes GM 18 163 1428 4023 120787 1845 0 0 No Change 2007-12-01 2019-03-01 Prosthesis LM240 Exabone Paste Preloaded Paste in Syringe 0.5cc, 1cc, 2cc, 2.5cc, 5cc LM 13 123 1241 4092 232998 722 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM241 Exabone Paste Preloaded Paste in Syringe 10cc LM 13 123 1241 4093 232998 1140 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM239 Exabone HA/TCP Wedges, Blocks, Discs HA/TCP Bone Substitute Wedges: 15-35mm width x 20-15mm length x 6-14mm height 1 X 4-10mm height 2 Blocks: 4-20mm length x 10-30mm width x 10-45mm height Discs: 5-20mm diameter x 5-20mm height LM 13 123 1241 4092 232997 722 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM242 Exabone Paste Preloaded Paste in Syringe 15cc LM 13 123 1241 4094 232998 1425 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM243 HK2 Finger Mini Fixator System 1.2mm, 1.5mm, 1.8mm LM 13 123 1772 5371 235591 Changed Benefit 104 0 0 Update 2015-08-01 2019-03-01 Prosthesis LM244 Ligamentotaxor Finger Mini Fixator System 1 size only LM 13 123 1237 3401 Mini 235592 1952 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM245 Universal Tendon Spacer Tendon Spacer 1 size only LM 13 131 1273 4050 235820 Changed Benefit 294 0 0 Update 2015-08-01 2019-03-01 Prosthesis LM246 Duafit Interphalangeal implant 11 - 20 mm implant length, zero, 10.0 or 17.0 degrees of plantarflexion LM 13 123 1228 5474 236773 548 0 0 No Change 2015-08-01 2019-03-01 Prosthesis BA084 Bard Mesh Kugel Patch Large Oval 14 x 18cm BA 21 194 1782 5435 Coated 24168 527 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA125 Groshong Central Venous Catheter Closed-Ended CVC, Single Lumen 5.5Fr - 9.5Fr BA 24 214 1649 cu (cuffed) 42589 162 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA126 Groshong Central Venous Catheter Closed-Ended CVC, Multiple Lumen 5.5Fr - 9.5 Fr BA 24 214 1650 cu (cuffed) 42589 325 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BH157 EBI XFIX Dynafix System CD Mechanism Small, Extra Small fixator BH 13 123 1237 3756 Small, CDD 145253 2361 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BH158 EBI XFIX Dynafix System Distal Radius Fixator, Wristfix, Stainless Steel, Aluminium One Size Only BH 13 123 1237 6401 217978 3420 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BH159 EBI XFIX Dynafix System Clamp: straight body, Tee or ankle 5 - 8 cm BH 13 123 1237 3402 145253 1579 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BH161 EBI XFIX Dynafix System Body Component Std BH 13 123 1237 3756 145253 1900 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BH163 EBI XFIX Dynafix System Clamp: straight body, Tee or ankle Small, Extra Small BH 13 123 1237 3402 Small 145253 4560 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BH166 Comprehensive Shoulder Screws Screw, Locking, Ti 4.75 dia x (15-45)mm BH 13 123 1231 3369 LK 144584 210290 128 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BH167 Comprehensive Shoulder Screws Screw, Non-Locking (4.75 or 6.5)mm x 15-50mm BH 13 123 1231 3369 153087 65 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BH168 Washerloc Tibial Fixation Device Screw - Ti 24 - 60mm x 5.8mm diameter BH 13 123 1774 5391 116765 Changed Benefit 181 0 0 Update 2012-02-01 2019-03-01 Prosthesis BH169 Washerloc Tibial Fixation Device Interference Anchor Plate (4.75 or 6.5)mm dia x 15-50mm BH 13 123 1231 3374 116765 93 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BH170 Zyston Straight Interbody Spacer Posterior Lumbar Interbody Spacer, PEEK (7mm x 20mm) to (18mm x 30mm), Convex, Lordotic BH 19 174 1486 4135 Paired 169024 Changed Benefit 2888 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH179 Nancy Nail System Pediatric Flexible Nail 2.5 or 3.0 mm x 190 -290mm BH 13 123 1228 5360 138850 Changed Benefit 223 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH180 Nancy Nail System Pediatric Flexible Nail 3.5 mm x 270-350mm BH 13 123 1228 5360 138550 Changed Benefit 223 0 0 Update 2013-02-01 2019-03-01 Prosthesis LM247 Compression Staples Compression Staples Multiple sizes LM 13 123 1773 5514 COMP 236772 Changed Product sizes 396 0 0 Update 2015-08-01 2019-03-01 Prosthesis LM248 OS2®-V Varisation Staple Varisation Staple 8 & 10mm, 26 degrees & 90 degrees LM 13 123 1773 5514 236772 Changed Benefit 127 0 0 Update 2015-08-01 2019-03-01 Prosthesis LM252 OsteoMed FPS Bone screws 3.5/4mm x 10-70mm LM 13 123 1231 3370 LK 202319 145 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM253 OsteoMed FPS Titanium locking footplates 2mm and 2.7mm LM 13 123 1694 5262 VAL 202319 952 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM254 OsteoMed FPS Titanium locking footplates 2mm and 2.7mm LM 13 123 1694 5261 VAL 202319 1197 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM255 OsteoMed FPS Screw Washers 2/2.7/3.5/4.0mm LM 13 123 1231 3374 202319 93 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM256 Osteomed Screws Bone Screws - threaded/lag 1.2/1.6/2.0mm x 4-36mm LM 13 123 1231 3372 202319 Changed Benefit 60 0 0 Update 2015-08-01 2019-03-01 Prosthesis LM257 OsteoMed HPS Bone screws - angled locking 1.6/2mm x 6-36mm LM 13 123 1231 3372 LK 202230 123 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM258 Bone Screws - cannulated Screws - cannulated 2.0mm x 6.0-36.0mm LM 13 123 1231 3372 CN,DT 202320 357 0 0 No Change 2015-08-01 2019-03-01 Prosthesis BS254 Precision Spectra IPG 32-output, multi-channel, zero-volt rechargeable neurostimulation system IPG with 3D alogrythmic programming One Size Only BS 25 222 1677 4481 Adaptive Stimulation, Unlimited Deep Discharge Battery, 32 Electrode IPG 205793 24700 0 0 No Change 2013-08-01 2019-03-01 Prosthesis BS255 CoverEdge 32 Contact Surgical Leads CoverEdge 32 has 4x8 tightly-spaced electrodes and CoverEdge 32 X has 4x8 widely-spaced electrodes. Up to 70cm in length BS 25 222 1679 4486 ≥32 electrodes 218230 11590 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BS256 Tunnelling Tools Aid in placement of leads. Various BS 25 222 1690 4501 156757 Changed Benefit 160 0 0 Update 2014-02-01 2019-03-01 Prosthesis BS257 Wrenches Used to secure leads and anchors. One size only BS 25 222 1690 4501 157487 Changed Benefit 160 0 0 Update 2014-02-01 2019-03-01 Prosthesis BS258 Insertion Needles Aid in placement of leads. Various BS 25 222 1690 4501 156758 254954 Changed Benefit 160 0 0 Update 2014-02-01 2019-03-01 Prosthesis BS259 Passing Elevators and Paddle Blanks Aid in placement of leads, helps verify that the epidural space is cleared. Various BS 25 222 1690 4501 156762 218730 Changed Benefit 160 0 0 Update 2014-02-01 2019-03-01 Prosthesis LM262 Osteomed Plates Low Profile plates 1.2/1.6/2.0/2.4mm 4-12 hole; straight, L, T LM 13 123 1694 5262 VAL 202319 952 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM263 OsteoMed HPS Low Profile hand plates 1.2/1.6/2.0/2.4mm 4-12 hole; Complex LM 13 123 1694 5262 Com, VAL 202319 1332 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM264 Hemi-Great Toe Implant Great Toe implant, Cobalt Chromium XS, S, M, L LM 13 124 1461 4048 202433 1145 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM265 Reflexion 1st MPJ Implant System Reflexion metatarsal stems, 3 part 1st MPJ reconstruction system, 2 part composition - titanium/cobalt chrome, 1 part composition - titanium/UHMWPE, Small, medium, large LM 13 124 1461 4044 202432 760 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM266 Reflexion 1st MPJ Implant System Reflexion metatarsal heads, 3 part 1st MPJ reconstruction system, 2 part composition - titanium/cobalt chrome, 1 part composition - titanium/UHMWPE, Standard, long, extra-long LM 13 124 1461 4046 202432 Changed Benefit 503 0 0 Update 2015-08-01 2019-03-01 Prosthesis MC732 Endeavour Drug Eluting Coronary Stent System Cobalt Alloy, ABT - 578 Diameter: 2.25mm-4.5mm; Length: 8.00mm-38.0mm MC 27 247 1766 5346 131573 2484 0 0 No Change 2007-06-01 2019-03-01 Prosthesis MC733 Quadripolar Stretch-Coil Extensions Model 37083 Single, Silver and Silicone Rubber 20cm - 60cm MC 25 222 1680 132587 Changed Benefit 1434 0 0 Update 2007-06-01 2019-03-01 Prosthesis MC734 Quadripolar Stretch-Coil Extensions Model 37082 Bifurcated, Silver and Silicone Rubber 20cm - 60cm MC 25 222 1680 132588 Changed Benefit 1434 0 0 Update 2007-06-01 2019-03-01 Prosthesis MC735 Rivulet Ventricular Catheter 4cm - 23cm MC 25 220 1668 Proximal 164728 176 0 0 No Change 2007-06-01 2019-03-01 Prosthesis MC736 Vertex Max Cannulated Screw Posterior cannulated cervical screw Diameter 3.5 - 4.5mm Length 20 - 60mm MC 19 165 1463 Cannulated 169514 1338 0 0 No Change 2007-06-01 2019-03-01 Prosthesis MC740 SCS Sub Compact Lead Octad Sub Compact Lead Kit without Percutaneous Extension Model 3776 45, 60 and 75cm MC 25 222 1679 4486 8 electrodes 137079 Changed Benefit 4018 0 0 Update 2007-12-01 2019-03-01 Prosthesis MC741 Indura Intrathecal Catheter Sutureless pump connector, Silicone, Titanium and Nylon One size only MC 25 223 1683 4492 137796 1045 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MC742 Prime Advanced Implantable Neurostimulator Dimensions: 65 x 49 x 15mm MC 25 222 1677 4480 141860 Changed Benefit 18193 0 0 Update 2007-12-01 2019-03-01 Prosthesis MC743 Complete SE Stent Nitinol 20mm - 80mm MC 24 206 1622 4440 142353 1710 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MC744 Complete SE Stent Nitinol 100mm - 120mm MC 24 206 1622 4440 142353 1710 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MC745 CG Future Composite Ring Semi-rigid mitral annuloplasty ring, with anterior flexibility 24, 26, 28, 30, 32, 34, 36 & 38mm MC 20 181 1842 136236 2280 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MC746 Restore Advanced INS Implantable Neurostimulator Dimensions: 65 x 49 x 15mm MC 25 222 1677 4481 141861 Changed Benefit 18193 0 0 Update 2007-12-01 2019-03-01 Prosthesis MC747 Valiant Endovascular Stent Graft Nitinol and polyester system 22-46mm diameter, 110mm length MC 24 207 1625 4442 141302 10476 0 0 No Change 2007-12-01 2019-03-01 Prosthesis BS260 RELIANCE 4-FRONT Active, Single/Dual coil, defibrillation lead Length: 59cm -70cm AM 27 242 1743 e 303416 217430 217431 217432 6480 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BS261 RELIANCE 4-FRONT Passive, single/dual coil, defibrillation lead Length: 59cm - 70cm AM 27 242 1741 e 303417 217433 217434 217435 6480 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BS262 INLIVEN IS-1 Cardiac Resynchronization therapy pacemaker 15cc BS 27 241 1736 i 213931 9734 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BS268 FORMIO MRI DR Dual Chamber Pacemaker, MRI Compatible 12cc BS 27 240 1734 i 213929 8237 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BS269 VITALIO MRI EL DR Dual Chamber Pacemaker, extended life MRI Compatible 14cc BS 27 240 1734 i 213927 8237 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BS271 VITALIO MRI SR Single Chamber Pacemaker, MRI Compatible 11.5cc BS 27 239 1730 i 213925 4268 0 0 No Change 2014-02-01 2019-03-01 Prosthesis BS272 SYNERGY Everolimus-Eluting Platinum Chromium Coronary Stent System with Bioabsorbable Polymer 8mm to 48mm in length, diameter of 2.25 mm - 4.0 mm BS 27 247 1766 5346 220361 2484 0 0 No Change 2014-08-01 2019-03-01 Prosthesis MC748 Valiant Endovasculat Stent Graft Nitinol and polyester system 22-46mm diameter, 150mm length MC 24 207 1625 4442 141302 10476 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MC749 Legacy HA Coated Screw Hydroxyapatite coated pedicle screw 4.5mm - 8.5mm MC 19 165 1463 169514 1280 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MC750 Durepair Dura Substitute, Collagen 1" x 1" MC 25 219 1657 Biological 134482 342 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MC753 Durepair Dura Substitute, Collagen 3" x 3" MC 25 219 1659 Biological 134482 1064 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MC754 Durepair Dura Substitute, Collagen 4" x 5" MC 25 219 1660 Biological 134482 Changed Benefit 1796 0 0 Update 2007-12-01 2019-03-01 Prosthesis MC755 InterStim II Neurostimulator Titanium Weight 22g MC 26 232 1712 136721 Changed Benefit 9073 0 0 Update 2007-12-01 2019-03-01 Prosthesis MC756 InterStim iCON Patient Programmer Hand held device Model 3037 to be used with implantable neurostimulation devices One size only MC 26 232 1713 5337 137808 1330 0 0 No Change 2007-12-01 2019-03-01 Prosthesis MC759 SCS Sub Compact Lead Ocatd Sub Compact Lead Kit with Percutaneous Extension Model 3876 45, 60 and 75cm MC 25 222 1679 4486 8 electrodes 137080 Changed Benefit 4018 0 0 Update 2007-12-01 2019-03-01 Prosthesis MC760 Complete SE Stent Nitinol 150mm MC 24 206 1622 4441 142353 Changed Benefit 2822 0 0 Update 2007-12-01 2019-03-01 Prosthesis MC763 Reveal XT Reveal XT Insertable Cardiac Monitor 61 x 19 x 8 mm with a volume of 9cc MC 27 249 1770 149903 3120 0 0 No Change 2008-07-01 2019-03-01 Prosthesis MC764 Microelectrode Cable Cable used for intracranial recording of neural activity prior to DBS One size MC 25 221 1676 4479 138186 190 0 0 No Change 2008-07-01 2019-03-01 Prosthesis MC767 Stimloc Burr Hole Cover 14mm MC 25 221 1676 4478 151095 Changed Benefit 523 0 0 Update 2008-07-01 2019-03-01 Prosthesis MC769 Endeavor Sprint Drug Eluting Stent System Cobals Alloym ABT - 578 Diameter: 2.25mm-4.0mm; Length: 8.0mm-30.0mm MC 27 247 1766 5346 149954 2484 0 0 No Change 2008-07-01 2019-03-01 Prosthesis MC770 Snap Lid Connector Connector for implanted lead to external Implantable Pulse Generator 2.5" x 5.0" MC 25 221 1676 4479 119991 190 0 0 No Change 2008-07-01 2019-03-01 Prosthesis MC773 Assurant Cobalt Stent Iliac balloon expandable stent system Diameter: 6 - 10mm , Length: 20 - 80mm MC 24 206 1622 4439 149584 1710 0 0 No Change 2008-07-01 2019-03-01 Prosthesis MC774 8578 Sutureless Pump Connector Sutureless Pump Connector: Material radiopaque silicon titanium, nylon One size only MC 25 223 1684 4503 113523 570 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BH181 Nancy Nail System Pediatric Flexible Nail 4.0 mm x 330-450mm BH 13 123 1228 5360 138850 Changed Benefit 223 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH183 Nancy Nail System Pediatric Flexible Nail 2.0 - 4.0 mm x 130 - 450mm BH 13 123 1228 5360 138850 Changed Benefit 223 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH184 Small / Large Fragment Set Cannulated Bone Screw Titanium 4.5 - 8mm BH 13 123 1231 3369 CN 153087 191 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH185 Small / Large Fragment Set Bone Screw, Titanium 3.5 - 4.0mm diameter BH 13 123 1231 3370 153087 82 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH186 Small / Large Fragment Set Cannulated Titanium Bone Screw 3.0mm - 4.0mm BH 13 123 1231 3370 CN 153087 208 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH187 Small / Large Fragment Set 3.5mm Titanium plate 7-14 holes BH 13 123 1694 5259 97981 279 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH188 Small / Large Fragment Set 3.5mm Titanium plates 2 to 6 holes BH 13 123 1694 5255 153056 Changed Benefit 542 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH189 Small / Large Fragment Set S/S Washer Spiked, Standard, Cancellous, Cortical & Fastening Wire One size only BH 13 123 1231 3374 200720 93 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS274 DYNAGEN CRT-D DF-4 ICD with cardiac resynchronization therapy. 32.5cc, 9.9mm BS 27 238 1726 a,d,e 221619 221622 34985 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BS275 DYNAGEN CRT-D DF-1 High energy CRT-D with DF-1 RV connector & lS-1 (G156) or LV-1 (G151) LV connector. 32.0cc, 9.9mm BS 27 238 1726 a,d 221620 221621 34445 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BS276 AUTOGEN ICD VR DF-4 Single Chamber implantable cardioverter defibrillation, 4IJ, DF-4 RV connector 26.5cc - 29.5cc, 60.0g - 68.9g, 9.9mm BS 27 236 1723 a, d, e 221627 221629 Changed Benefit 32162 0 0 Update 2014-08-01 2019-03-01 Prosthesis BS277 AUTOGEN ICD DR DF-4 Dual Chamber implantable cardioverter defibrillation, 4IJ, DF-4 RV connector 28.0cc - 31.0cc, 62.5g - 71.4g, 9.9mm BS 27 237 1725 a,d,e 221640 221642 Changed Benefit 34474 0 0 Update 2014-08-01 2019-03-01 Prosthesis BS278 AUTOGEN ICD VR DF-1 Single Chamber implantable cardioverter defibrillation, 4IJ, DF-1 RV connector 28.5cc -31.5cc, 61.9g - 70.7g, 9.9mm BS 27 236 1723 a, d 221628 221630 Changed Benefit 31622 0 0 Update 2014-08-01 2019-03-01 Prosthesis BS273 PROMUS PREMIER Platinum chromium alloy stent coated with a blended polymer mixed with everolimus. 8mm to 38mm in length, diameter of 2.25 mm - 4.0 mm BS 27 247 1766 5346 220360 2484 0 0 No Change 2014-08-01 2019-03-01 Prosthesis MC775 Interstim Lead Introducer Kit Lead Introducer Kit for Sacral Nerve Stimulation One size only MC 26 232 1715 5342 133763 514 0 0 No Change 2008-07-01 2019-03-01 Prosthesis MC776 Specify 5-6-5 Surgical Lead Triple Array 16 Electrode Surgical Lead with Duraloc Technology 30, 65cm MC 25 222 1679 4486 greater than 8 and less than 32 electrodes 148397 7258 0 0 No Change 2008-07-01 2019-03-01 Prosthesis MC777 Interstim Extension Lead Quadripolar Extension Kit 10, 25, 51cm MC 26 232 1714 5341 150165 Changed Benefit 1434 0 0 Update 2008-07-01 2019-03-01 Prosthesis AY039 MULTI-LINK 8 Coronary Stent System, MULTI-LINK 8 SV Coronary Stent System and MULTI-LINK 8 LL Coronary Stent System The MULTI-LINK 8, MULTI-LINK 8 SV, MULTI-LINK 8 LL Coronary Stent System (CSS) is comprised of two main components: the cobalt chromium (CoCr) stent and the balloon expandable delivery system. MULTI-LINK 8: Diam: 2.5, 2.75, 3.0, 3.5, 4.0mm, Stent Length: 8, 12, 15, 18, 23, 28mm; MULTI-LINK 8 SV CSS: Diam: 2.25mm, Stent Length: 8, 12, 15, 18, 23, 28mm; MULTI-LINK 8 LL CSS: Diam: 2.5, 2.75, 3.0, 3.5, 4.0mm, Stent Length: 33 and 38mm AY 27 247 1767 5348 174511 174519 176896 898 0 0 No Change 2011-02-01 2019-03-01 Prosthesis AY040 XIENCE Xpedition Everolimus Eluting Coronary Stent System Coronary Artery Stent, Drug Eluting Xience Xpedition DES - 2.25 x (8,12,15,18,23,28) RX CE, 2.50 x (8,12,15,18,23,28,33,38,48) RX CE; 2.75 x (8,12,15,18,23,28,33,38,48) RX CE; 3.00 x (8,12,15,18,23,28,33,38,48) RX CE; 3.25 x (8,12,15,18,23,28,33,38) RX CE; 3.50 x (8,12,15,18,23,28,33,38,48) RX CE; 4.00 x (8,12,15,18,23,28,33,38) RX CE; AY 27 247 1766 5346 215602 215603 215604 264373 2484 0 0 No Change 2014-02-01 2019-03-01 Prosthesis AY041 Absolute Self Expanding Peripheral stent Laser cut nitinol self expanding stent, 20mm - 120mm lengths Size ranges from: 5.0X20MM, 80CM - 8.0x120MM, 135CM AY 24 206 1622 4440 146848 1710 0 0 No Change 2014-02-01 2019-03-01 Prosthesis AY042 Supera Peripheral Stent System Interwooven Self-Expanding Nitinol Stent Stent inner diameter: 4.0 mm - 6.0 mm Stent outer diameter: 4.5 mm - 6.5 mm Stent length: 150 mm - 200mm AY 24 206 1622 4441 227976 Changed Benefit 2822 0 0 Update 2014-02-01 2019-03-01 Prosthesis AY043 Supera Peripheral Stent System Interwoven Self-Expanding Nitnol Stent Stent inner diameter: 4.0 mm - 8.0 mm Stent outer diameter: 4.5 mm - 7.5 mm Stent length: 20 mm - 120 mm AY 24 206 1622 4440 227976 1710 0 0 No Change 2014-02-01 2019-03-01 Prosthesis LM267 Reflexion 1st MPJ Implant System ReflexionPhalangeal Bases, 3 part 1st MPJ reconstruction system, 2 part composition - titanium/cobalt chrome, 1 part composition - titanium/UHMWPE, Small, medium, large LM 13 124 1461 4045 202432 Changed Benefit 751 0 0 Update 2015-08-01 2019-03-01 Prosthesis LM268 ExtremiFix Screws Headless Cannulated Compression Screw Diameter 3.0mm, 4.0mm. Length 10mm to 52mm; Diameter 2.71mm - 4.49mm. LM 13 123 1231 3370 CN,DT 202435 379 0 0 No Change 2015-08-01 2019-03-01 Prosthesis LM274 FlowCOUPLER High Density polyethylene (ring); Stainless Steel (pins) with preattached probe 2.0mm, 2.5mm, 3.0mm, 3.5mm, 4.0mm LM 23 203 1608 with Doppler probe 243832 990 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM275 PANTERA Proximal Humerus Fracture Fixation Plate System - Plates Proximal Humerus Plate ≥ 7 to ≤ 15 holes LM 13 123 1694 5274 VAL 182168 Changed Benefit 1643 0 0 Update 2016-02-01 2019-03-01 Prosthesis LM276 PANTERA Proximal Humerus Fracture Fixation Plate System - Plate ≥ 16 holes Proximal Humerus Plate ≥ 16 holes LM 13 123 1694 5275 VAL 182168 Changed Benefit 1643 0 0 Update 2016-02-01 2019-03-01 Prosthesis LM277 PANTERA Proximal Humerus Fracture Fixation Plate System - Post with Cross Element Threaded Locking Screw 5.2mm LM 13 123 1231 3369 CN,LK 182168 Changed Benefit 254 0 0 Update 2016-02-01 2019-03-01 Prosthesis AY044 XIENCE Alpine Everolimus Eluting Coronary Stent System Drug eluting coronary artery stent 2.00 mm x (08, 12, 15, 18, 23, 28) mm 2.25 mm x (08, 12, 15, 18, 23, 28) mm 2.50 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm 2.75 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm 3.00 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm 3.25 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm 3.50 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm 4.00 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm AY 27 247 1766 5346 266175 2484 0 0 No Change 2016-02-01 2019-03-01 Prosthesis AY046 Omnilink Elite Vascular Balloon-Expandable Stent System Omnilink Elite Vascular Balloon-Expandable Stent System is a balloon- expandable stent system indicated for the treatment of atherosclerotic iliac artery lesions with reference vessel diameters of ≥ 5.0 mm and ≤ 11.0 mm, and lesion lengths up to 50 mm. 6.0mm x (12,16,19,29,39,59)mm x 80cm 7.0mm x (12,16,19,29,39,59)mm x 80cm 8.0mm x (19,29,39,59)mm x 80cm 9.0mm x (19,29,39,59)mm x 80cm 10.0mm x (19,29,39,59)mm x 80cm 6.0mm x (12, 16,19,29,39,59)mm x 135cm 7.0mm x (12, 16,19,29,39,59)mm x 135cm 8.0mm x (19,29,39,59)mm x 135cm 9.0mm x (19,29,39,59)mm x 135cm 10.0mm x (19,29,39,59)mm x 135cm AY 24 206 1622 4439 269609 1710 0 0 No Change 2017-08-01 2019-03-01 Prosthesis BA010 Bard Inferior Vena Cava Filter Nitinol self expanding vena cava filter For IVC with a diameter less than or equal to 28mm diameter BA 24 211 1642 150739 150742 198865 198866 2231 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BH190 Headless Compression Screws Headless Compression Screws 3mm-4mm BH 13 123 1231 3370 CN,DT 210290 379 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH191 Barouk System Staples Varisation Staple Stainless Steel 26-90Deg x 8-10mm BH 13 123 1773 5514 127053 Changed Benefit 127 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH192 Barouk System Staples Memory Staple - Titanium Alloy 12-20mm Long BH 13 123 1773 5514 MM 127053 97988 Changed Benefit 507 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH193 Twistoff Screw TwistOff Screw Titanium 8-15mm Long BH 13 123 1231 3372 Breakoff 210290 281 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH194 Periarticular Plating System Plate Calcaneal - Titanium Small - Large BH 13 123 1694 5296 97981 892 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH195 Periarticular Plating System Fibula Composite Plate - Titanium 5 Hole BH 13 123 1694 5255 153056 Changed Benefit 542 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH197 Periarticular Plating System Meta Plate - Titanium Sm - Lge 3 to 6 Holes BH 13 123 1694 5292 153056 1158 0 0 No Change 2013-02-01 2019-03-01 Prosthesis LB152 QUARTEX Tapered Rods Tapered rods which transition in diameter. Diameter 3.5mm & 4.0mm transitioning up to 6.5mm Length 350mm -500mm LB 19 170 1478 Dual Diameter 190061 Changed Benefit 529 0 0 Update 2017-08-01 2019-03-01 Prosthesis LB153 QUARTEX Polyaxial Screws Polyaxial screws 3.5-5.5mm diameter 8-50mm length LB 19 165 1463 190061 1280 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LB154 QUARTEX Locking Cap Threaded locking cap One size only LB 19 166 1465 190061 164 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LB155 QUARTEX Hooks Left and Right Inline Hooks One size only LB 19 168 1475 190061 789 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LB156 QUARTEX Parallel Connectors Parallel Connector 4.0mm Rod to 4.0-6.5mm Rod LB 19 167 1473 190061 Changed Benefit 732 0 0 Update 2017-08-01 2019-03-01 Prosthesis LB157 QUARTEX Lateral Connectors Lateral Connectors standard, short, long, extra long for 3.5mm and 4.0mm rods LB 19 167 1473 190061 Changed Benefit 732 0 0 Update 2017-08-01 2019-03-01 Prosthesis LB158 QUARTEX Inline Connectors In-line connectors 4.0mm-4.0mm and 4.0mm-6.5mm LB 19 167 1472 190061 Changed Benefit 732 0 0 Update 2017-08-01 2019-03-01 Prosthesis LB159 QUARTEX T-Connectors Rod to Rod and Head to Head T-Connectors 21mm to 57mm - 27mm to 63mm LB 19 167 1474 4124 190061 Changed Benefit 1299 0 0 Update 2017-08-01 2019-03-01 Prosthesis BA019 Impra PTFE Vascular Grafts ePTFE graft - radially supported, thin wall, 10 - 50cm long 4mm - 8mm diameter BA 24 208 1636 4455 R (ringed) 23171 1444 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA020 Impra PTFE Vascular Grafts ePTFE graft - thin wall, 10 - 50cm long 3mm - 10mm diameter BA 24 208 1636 4455 23171 760 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA022 Impra PTFE Vascular Grafts ePTFE graft - radially supported, regular wall, 10-50cm long 4 - 19mm diameter BA 24 208 1636 4455 R (ringed) 23171 1444 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA025 Impra PTFE Vascular Grafts ePTFE graft - regular wall, 10-50cm long 3 - 19mm diameter BA 24 208 1636 4455 23171 760 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA039 Grafts Vascular Polyester pledgets Rectangle, Oval, Circle, Square 2.9mm-8mm x 6mm - 9.5mm BA 24 209 1640 4461 24168 78 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA044 Ureteral Stent Hydrophilic coated ureteral stent Fr 4.7 – 8.0, Length 22-32cm BA 26 227 1702 5324 235658 189 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BH198 Periarticular Plating System Fibula Composite Plate - Titanium 9 Hole BH 13 123 1694 5256 153056 97981 Changed Benefit 674 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH199 Periarticular Plating System Tibial Plate - Titanium 7 - 15 Holes BH 13 123 1694 5256 Com 153056 Changed Benefit 1054 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH202 Ace External Fixator Wire bayonet point - stainless steel 1.8mm BH 13 123 1772 5365 162938 200704 27 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH240 Hoffman Wrist Kit Hoffman Sterile Wrist Kit One size only BH 13 123 1237 3401 Mini 202247 1952 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH241 Headless Compression Screws Headless Compression Screws 2.0 - 3mm BH 13 123 1231 3371 CN,DT 209305 210296 381 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH242 ALPS Foot System Complex periarticular foot plates small to large BH 13 123 1694 5258 Com, VAL 153056 1164 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH243 ALPS Foot System Calcaneal foot plate small to large BH 13 123 1694 5296 VAL 153056 1462 0 0 No Change 2013-02-01 2019-03-01 Prosthesis LM278 PANTERA Proximal Humerus Fracture Fixation Plate System - Locking Cortical Screw Locking Cortical Screw 3.5mm LM 13 123 1231 3370 LK 182168 145 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM279 PANTERA Proximal Humerus Fracture Fixation Plate System - Cortical Screw Cortical Screw 3.5mm LM 13 123 1231 3370 182168 82 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM280 PANTERA Proximal Humerus Fracture Fixation Plate System - Post Cap Screw Post Cap Screw 2.7 mm LM 13 123 1231 3370 LK 182168 145 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM281 PANTERA Proximal Humerus Fracture Fixation Plate System - Cross Element Screw Cross Element Screw 1.9 mm LM 13 123 1231 3372 CN 182168 186 0 0 No Change 2016-02-01 2019-03-01 Prosthesis MC728 Adapta Pacemaker SR Pacemaker Models ADSR01, ADSR06, ADSR03 9.7 - 11.0cc 21.5 - 22.5g MC 27 239 1730 125081 125082 125083 4268 0 0 No Change 2006-11-30 2019-03-01 Prosthesis MC730 Attain StarFix LV Lead Over the wire left Ventricular Lead 78, 88, 103cm MC 27 243 1762 131306 3600 0 0 No Change 2007-06-01 2019-03-01 Prosthesis MC731 Titan Anchor Silicone with titanium insert One size only MC 25 222 1690 4501 133358 Changed Benefit 160 0 0 Update 2007-06-01 2019-03-01 Prosthesis BA047 Gastrostomy Tube Silicone Tubes and Replacement Tubes 12Fr - 28Fr BA 21 189 1545 4197 141582 141583 195 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA049 Hickman/Broviac Catheters Open-Ended CVC, Single Lumen 2.7Fr - 9.6Fr BA 24 214 1649 cu (cuffed) 145466 145469 162 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA051 Hickman/Leonard Catheters Open-Ended CVC, Multiple Lumen 7Fr - 12.5Fr BA 24 214 1650 cu (cuffed) 145468 145469 325 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA057 Groshong Subcutaneous Ports Titanium or MRI Implatable Port, Closed-Ended Catheter, Single Chamber 7Fr - 8 Fr BA 24 214 1652 156248 157391 157393 157396 157399 450 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA059 Dual Lumen Subcutaneous Ports Silicone, Polyurethane or ChronoFlex Open-ended Catheter 7 - 10 French Catheter BA 24 214 1653 156247 157389 157390 707 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA061 Bard Mesh PerFix Plug Small, Medium, Large BA 21 194 1691 24168 Changed Benefit 250 0 0 Update 2005-10-31 2019-03-01 Prosthesis BA070 Bard Mesh Flat mesh 2.5x10cm, 4.5x10cm, 5x10cm, 6x13.7cm, 7.5x15cm, 10x15cm, 5x30.5cm BA 21 194 1782 5434 122873 76 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BH244 ALPS foot system periarticular foot, metatarsal and tarsal plates small to large BH 13 123 1694 5259 Com, VAL 153056 1229 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH245 Rockwood Clavicle Pin Clavicle Pin with dual thread 2.5mm BH 13 123 1231 3371 DT 140023 Changed Benefit 255 0 0 Update 2013-02-01 2019-03-01 Prosthesis BS248 OR Cable OR Cable Lengths up to 65cm BS 25 222 1690 5484 157994 190 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS249 Medical Adhesive Medical adhesive is used to assist in fixing the lead to the suture sleeve. One size BS 25 222 1690 4501 156755 Changed Benefit 160 0 0 Update 2013-02-01 2019-03-01 Prosthesis BS250 Flexima Biliary Drainage Catheter Biliary drainage catheters for drainage of the biliary tree Length up to 35cm BS 21 193 1577 5489 132027 114 0 0 No Change 2013-08-01 2019-03-01 Prosthesis BS252 Upsylon Y-Mesh Kit Y-Mesh with single use instrument for mesh placement Graft Dimensions: 24 x 4 cm BS 26 229 1706 5326 ap 150342 643 0 0 No Change 2013-08-01 2019-03-01 Prosthesis BS253 Precision Spectra Patient Remote Programmer Hand held remote control External Patient Programmer One size only BS 25 222 1678 4483 206305 206306 1425 0 0 No Change 2013-08-01 2019-03-01 Prosthesis CO069 Cochlear ™ Nucleus® CP910 Sound Processor (Initial) The Cochlear Nucleus CP910 Sound Processor is a behind-the-ear sound processor two built-in directional microphones There is only one size of the processing unit and coil. There are two sizes for battery holder and cover. CO 22 196 1528 4145 216062 10925 0 0 No Change 2014-02-01 2019-03-01 Prosthesis CO070 Cochlear ™ Nucleus® CP910 Sound Processor (Replacement) The Cochlear Nucleus CP910 Sound Processor is a behind-the-ear sound processor with two built-in directional microphones CO049 CO 22 196 1528 4147 Generation 4 216062 Changed Benefit 7648 0 0 Update 2014-02-01 2019-03-01 Prosthesis DE455 Low Profile T-Plate Plate for fusion 2-4 Holes DE 13 123 1694 5258 LK 284416 470 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE456 Low Profile Straight Plate Plate for fusion 7-8 Holes DE 13 123 1694 5262 LK 140686 638 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE457 Low Profile Straight Plate Plate for fusion 2-5 Holes DE 13 123 1694 5258 LK 140686 470 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE458 Swivelock Twist-in knotless suture anchor ≥4mm DE 13 123 1774 5387 126657 Changed Benefit 442 0 0 Update 2014-02-01 2019-03-01 Prosthesis DE459 Bio Swivelock Twist-in knotless suture anchor ≥4mm DE 13 123 1774 5387 AB 140565 501 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE460 Bio Suturetak Suture Anchor Absorbable Suture Anchor with Fiberwire 2.4mm - 3mm DE 13 123 1774 5385 AB 126657 501 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DE461 SutureTak Suture Anchor 2.4mm - 3.9mm DE 13 123 1774 5385 126657 Changed Benefit 442 0 0 Update 2014-02-01 2019-03-01 Prosthesis CO052 Baha BA300 abutment. Titanium abutment of the Baha BI300 implant system. 6 mm and 9 mm CO 22 196 1560 4151 Abutment & Concave 123984 Changed Benefit 889 0 0 Update 2010-08-01 2019-03-01 Prosthesis CO053 Baha BIA300 implants with abutments Self tapping titanium implant with pre-mounted abutment of the Baha 3 system, for the Baha FAST surgery. 3mm implant with 6mm abutment, 4mm implant with 6mm abutment, 4mm implant with 9mm abutment. CO 22 196 1560 4151 Abutment, Fixture & Concave 123984 1916 0 0 No Change 2010-08-01 2019-03-01 Prosthesis CO054 Baha Cover Screw conical Titanium cover screw of the Baha BI300 implant system used in the two-stage surgery. One size CO 22 196 1560 4152 123984 135 0 0 No Change 2010-08-01 2019-03-01 Prosthesis CO057 Cochlear™ Nucleus® CI422 cochlear implant with Straight Electrode Model CI422, 4th generation cochlear implant with straight array. Titanium casing, removable magnet. 22 half banded platinum intracochlear electrodes moulded with a silicone elastomer carrier and spaced over a 20mm active array. The electrode diameter is 0.6mm at the badal end, tapering to 0.3mm at the apical electrode band. One size CO 22 196 1526 192676 Changed Benefit 12892 0 0 Update 2012-02-01 2019-03-01 Prosthesis DE463 SwiveLock Suture Anchor Suture Anchor 3.5mm DE 13 123 1774 5385 126657 Changed Benefit 442 0 0 Update 2014-08-01 2019-03-01 Prosthesis DE464 Calcaneal Fracture Plate Calcaneal Fracture Plate for fixation of Calcaneal fractures X-small, small, Medium, Large - LEFT and RIGHT side specific plates DE 13 123 1694 5296 VAL 140686 1462 0 0 No Change 2015-02-01 2019-03-01 Prosthesis DE465 Compression FT Headless Compression Screw for bone fixation 2.5mm x 8-30mm DE 13 123 1231 3371 CN,DT 227070 381 0 0 No Change 2015-02-01 2019-03-01 Prosthesis DE466 Compression FT Headless Compression Screw for bone fixation 3.5mm/4.0mm x 12-50mm DE 13 123 1231 3370 CN,DT 227070 379 0 0 No Change 2015-02-01 2019-03-01 Prosthesis DE462 SutureTak Suture Anchor Suture Anchor 2mm DE 13 123 1774 5384 164047 Changed Benefit 294 0 0 Update 2014-08-01 2019-03-01 Prosthesis DE469 Ankle Fusion Plating System Fusion Plate for Ankle Joint Arthritis Anterior, Posterior, Lateral DE 13 123 1694 5256 LK 140686 931 0 0 No Change 2015-08-01 2019-03-01 Prosthesis DE471 Titanium Volar Radius Plating System Fixation Plate for Distal Radius Fractures 7- 15 holes DE 13 123 1694 5277 VAL 140686 1439 0 0 No Change 2016-02-01 2019-03-01 Prosthesis DE472 Endowrist Stapler 45 Endowrist Stapler 45 White Reload, 45 Blue Reload, 45 Green Reload Length of reload: 45mm Staple height: 2.5mm, 3.5mm, 4.3mm DE 21 194 1582 4317 Endoscopic, Articulating/Roticulating 239813 Changed Benefit 347 0 0 Update 2016-02-01 2019-03-01 Prosthesis DE474 Achilles Speedbridge Convenience Pack Disposable convenience pack for Achilles Insertional Tendonopathy one size DE 13 123 1774 5387 126657 Changed Benefit 442 0 0 Update 2016-08-01 2019-03-01 Prosthesis DE475 Biocomposite Swivelock Anchor Knotless Suture Anchor 3.5mm DE 13 123 1774 5385 164046 Changed Benefit 442 0 0 Update 2016-08-01 2019-03-01 Prosthesis DE470 Titanium Volar Distal Radius Plating System Fixation Plate for Distal Radius Fractures 6 holes or less DE 13 123 1694 5276 VAL 140686 1439 0 0 No Change 2016-02-01 2019-03-01 Prosthesis DE476 Quickset Injectable Macroporous Calcium Phospahte 5cc DE 13 123 1241 4092 267632 722 0 0 No Change 2016-08-01 2019-03-01 Prosthesis DE477 Quickset Injectable Macropourous Calcium Phosphate 8cc DE 13 123 1241 4093 267632 1140 0 0 No Change 2016-08-01 2019-03-01 Prosthesis DE478 Quickset Injectable Macroporous Calcium Phosphate 16cc DE 13 123 1241 4094 267632 1425 0 0 No Change 2016-08-01 2019-03-01 Prosthesis DY335 Summit Cervical Rod System Dual Diameter Rod 3.0/4.75-5.5mm x 150-600mm SY 19 170 1478 Dual Diameter 92307 Changed Benefit 529 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY336 Summit Cervical Rod System Cross Connector One size only SY 19 167 1474 4123 92307 404 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY337 Summit Cervical Rod System Open Cable Connector One size only SY 19 166 1469 92307 Changed Benefit 732 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY338 Summit Cervical Rod System Cortical, Cancellous and Rescue Screws 3.5-4.5mm x 12-48mm SY 19 165 1464 92307 Changed Benefit 193 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY342 Summit Cervical Rod System Connectors Left or Right or Neutral One size only SY 19 167 1473 92307 Changed Benefit 732 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY343 Summit Cervical Rod System Rod 3mm x 70-200mm SY 19 170 1478 92307 Changed Benefit 426 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY344 Summit Cervical Rod System Transverse Connector Hook One size only SY 19 168 1475 92307 789 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY353 Conduit TCP Bone matrix implant 10cc SY 13 123 1241 4093 136840 1140 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY354 Conduit TCP Bone matrix implant 15cc SY 13 123 1241 4094 136840 1425 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY355 Conduit TCP Bone matrix implant 30cc SY 13 123 1241 4095 136840 1482 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY361 Conduit Conduit Blocks 10 x 10 x 10mm to 25 x 25 x 30mm SY 13 123 1241 4095 136839 1482 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY362 Conduit Conduit Cylinder H8 - 20 x D10 - 20mm SY 13 123 1241 4092 136839 722 0 0 No Change 2005-10-31 2019-03-01 Prosthesis CO058 Cochlear Vistafix 3 VXI300 Implants Titanium implant with TiOblast™ for Vistafix one-stage or two-stage surgery 3 mm and 4 mm CO 23 200 1599 4373 Concave 123984 1055 0 0 No Change 2012-08-01 2019-03-01 Prosthesis CO059 Cochlear Vistafix 3 VXA300 Healing Abutment Titanium healing abutment can be used during healing to avoid having to select the abutment length during surgery. The markings can be used to indicate thickness of the soft tissue. The healing abutment is mounted on the implant and is only compatible with theVXI300 implants 9 mm CO 23 200 1599 4376 123984 278 0 0 No Change 2012-08-01 2019-03-01 Prosthesis CO060 Cochlear Vistafix 3 Cover screw conical Cover screw conical for Vistafix VXI300 implant. The Cover screw is only compatible with VXI300 implants One size CO 23 200 1599 4377 123984 138 0 0 No Change 2012-08-01 2019-03-01 Prosthesis CO061 Cochlear Vistafix 3 VXA300 Abutments Titanium abutment for Vistafix one-stage and two-stage surgery. VXA Abutments are only compatible with VXI300 Implants 3.5 mm, 4.5 mm, 6 mm, 7.5 mm CO 23 200 1599 4374 Concave 123984 Changed Benefit 913 0 0 Update 2013-02-01 2019-03-01 Prosthesis DE479 Headless Compression Screw System Headless Compression Screw for bone fixation 2.5mm Diameter x (8-34mm Length) DE 13 123 1231 3371 CN,DT 227070 381 0 0 No Change 2016-08-01 2019-03-01 Prosthesis DE480 Headless Compression Screw System Headless Compression Screw for bone fixation 3mm Diameter ( 10-36mm Lengths) 4.3mm Diameter (14-80mm Lengths) DE 13 123 1231 3370 CN,DT 227070 379 0 0 No Change 2016-08-01 2019-03-01 Prosthesis DE481 Headless Compression Screw System Headless Compression Screw for bone fixation 6.5mm Diameter (30-120mm Diameter) DE 13 123 1231 3369 CN,DT 227070 362 0 0 No Change 2016-08-01 2019-03-01 Prosthesis DE483 FiberTak Suture Anchor Suture anchor with 2 x #2 FibreWire CL or 1.3mm SutureTape 1.3mm DE 13 123 1774 5384 126657 Changed Benefit 294 0 0 Update 2016-08-01 2019-03-01 Prosthesis DE484 Oculentis LENTIS L-402 Foldable three piece monofocal acrylic IOL Optic Size 6.0mm, Overall Length 13.00mm. +-0.0D to +35.0D (1.0D) + 15.5D to +26.5D (0.5D). Minus range on demand. DE 1 141 1327 3892 at 198807 300 0 0 No Change 2016-09-01 2019-03-01 Prosthesis DE485 Oculentis LENTIS L-402 Pre-loaded Pre-loaded foldable three piece monofocal acrylic IOL. Optic Size 6.0mm, Overall Length 13.00mm. +-0.0D to +35.0D (1.0D) +15.5D to +26.5D (0.5D). Minus range on demand. DE 1 141 1327 3892 at, pl 198807 308 0 0 No Change 2016-09-01 2019-03-01 Prosthesis CO062 Cochlear™ Baha® BA400 DermaLock™ Abutment Titanium abutment with hydroxyapatite (HA) coating 6mm, 8mm, 10mm, 12mm, 14mm CO 22 196 1560 4151 HA 123984 1059 0 0 No Change 2013-02-01 2019-03-01 Prosthesis CO063 Cochlear ™ Baha® BIA400 Implant with Abutment Pre-mounted self-tapping titanium implant with TiOblast™ surface and coated Abutment with hydroxyapatite (HA) coating for Baha FAST surgery 4mm implant with pre-mounted 6mm, 8mm, 10mm, or 12mm , or 14mm abutment CO 22 196 1560 4151 Abutment & Fixture, HA 123984 2087 0 0 No Change 2013-02-01 2019-03-01 Prosthesis CO064 Cochlear ™ Nucleus® CP910 Sound Processor Hybrid™ Mode (Initial) The Cochlear Nucleus CP910 Sound processor in "Hybrid Mode" facilitates electroacoustic stimulation of the cochlea There is only one size of the processing unit and coil. There are two sizes for the battery holder and cover. CO 22 196 1528 4145 Electroacoustic 216062 Changed Benefit 12303 0 0 Update 2014-02-01 2019-03-01 Prosthesis DE486 Oculentis LENTIS LS-312Y Foldable one-piece monofocal C Loop Acrylic IOL. Violet Light Filter. Optic Size 6.0mm, Overall Length 12.0mm. Available Diopters: +-0.0D to 35.0D (1.0D steps) +15.5D to 26.5D (0.5D steps). DE 1 141 1327 3892 at, vblf 198807 Changed Benefit 317 0 0 Update 2016-09-01 2019-03-01 Prosthesis DE487 Oculentis LENTIS LS-312Y Pre-loaded Pre-loaded Foldable one-piece monofocal C Loop Acrylic IOL. Violet Light filter. Optic Size 6.0mm. Overall Length 12.0mm. Available Diopters +-0.0D to 35.0D (1.0D steps) +15.5D to 26.5D (0.5D steps). DE 1 141 1327 3892 at, pl, vblf 198807 333 0 0 No Change 2016-09-01 2019-03-01 Prosthesis DY332 Summit Cervical Rod System Occipital Plates "Y" or "T" or transoral 31-45mm, small - large SY 19 169 1477 4129 92307 Changed Benefit 2166 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY333 Summit Cervical Rod System Occipital Bone Screw 4.5 - 5.25 Dia x 6 -16mm length SY 19 165 1464 92307 Changed Benefit 193 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY334 Summit Cervical Rod System Transition Rod 3.0/4.0/3.0mm SY 19 170 1478 Dual Diameter 92307 Changed Benefit 529 0 0 Update 2005-10-31 2019-03-01 Prosthesis CO065 Cochlear™ Nucleus CP910 Sound Processor Hybrid™ Mode (Replacement) The Cochlear Nucleus CP910 Sound Processor in "Hybrid Mode" facilitates electroacoustic stimulation to the cochlea There is only one size of the processing unit and coil. There are two sizes for the battery holder. CO 22 196 1528 4147 Generation 4 Electroacoustic 216062 Changed Benefit 8612 0 0 Update 2014-02-01 2019-03-01 Prosthesis CO066 Cochlear™ Nucleus® CP920 Sound Processor - Hybrid™ Mode (Initial) The Cochlear Nucleus CP920 Sound Processor in "Hybrid Mode" facilitates electroacoustic stimulation of the cochlea There is only one size of the processing unit and coil. There are two sizes for battery holder and cover. CO 22 196 1528 4145 Electroacoustic 216063 Changed Benefit 12303 0 0 Update 2014-02-01 2019-03-01 Prosthesis CO067 Cochlear™ Nucleus® CP920 sound Processor - Hybrid™ Mode (Replacement) The Cochlear Nucleus CP920 Sound Processor in "Hybrid Mode" facilatates electroacoustic stimulation of the cochlea. There is only one size of the processing unit and coil. There are two sizes for battery holder and cover. CO 22 196 1528 4147 Generation 4 Electroacoustic 216063 Changed Benefit 8612 0 0 Update 2014-02-01 2019-03-01 Prosthesis CO068 Cochlear™ Baha® BIM400 Implant Magnet The Cochlear Baha BIM400 is an implantable magnet that lies completely under the skin One size CO 22 196 1560 4151 Magnetic Coupling 123984 1059 0 0 No Change 2014-02-01 2019-03-01 Prosthesis DY363 Conduit Conduit Wedge H6-18 x D15 x L15 SY 13 123 1241 4092 136839 722 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY367 PFC Sigma TC3 Knee System Tibial Insert Tibial Insert, totally constrained, mobile bearing, UHMWPE, with post Size 1.5 to 5 thickness of 10mm to 30mm SY 17 153 1371 138289 Changed Benefit 1118 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY368 LCS Complete Knee System femoral component Femoral component, cemented, CoCr Sizes small to large+ SY 17 149 1348 3906 Revision 131657 5411 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY372 LCS Complete Knee System rotating platform tibial insert Tibial insert, rotating platform with post, UHMWPE Sizes small to large+. 10-30mm SY 17 153 1370 138289 Changed Benefit 1073 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY373 LCS Complete Knee System femoral component Femoral component, uncemented, Porocoat, beaded Titanium with TiN surface treatment Sizes small to large+ SY 17 149 1351 3914 Ceramic Surface, SCP 97699 Changed Benefit 3443 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY374 LCS Complete Knee System femoral component Femoral component, cemented, Titanium with TiN surface treatment Sizes small to large+ SY 17 149 1348 3906 Ceramic Surface 131657 3086 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BS279 AUTOGEN ICD DR DF-1 Dual Chamber implantable cardioverter defibrillation, 4IJ, DF-1 RV connector 28.5cc - 31.5cc, 62.3g - 71g, 9.9mm BS 27 237 1725 a,d 221641 221643 Changed Benefit 33934 0 0 Update 2014-08-01 2019-03-01 Prosthesis BS280 DYNAGEN ICD VR DF-4 Single Chamber implantable cardioverter defibrillation, 4IJ, DF-4 RV connector 26.5cc - 29.5cc, 60g - 68.9g, 9.9mm BS 27 236 1722 a,d,e 221631 221634 31241 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BS281 DYNAGEN ICD DR DF-4 Dual Chamber implantable cardioverter defibrillation, 4IJ, DF-4 RV connector 28.0cc - 31.0cc, 62.5g - 71.4g, 9.9mm BS 27 237 1724 a,d,e 221644 221646 Changed Benefit 33487 0 0 Update 2014-08-01 2019-03-01 Prosthesis BS282 DYNAGEN ICD VR DF-1 Single Chamber implantable cardioverter defibrillation, 4IJ, DF-1 RV connector 28.5cc - 31.5cc, 61.9g - 70.7g, 9.9mm BS 27 236 1722 a,d 221632 221635 30701 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BS283 DYNAGEN ICD DR DF-1 Dual Chamber implantable cardioverter defibrillation, 4IJ, DF-1 RV connector 28.5cc - 31.5cc, 62.3g - 71g, 9.9mm BS 27 237 1724 a,d 221645 221647 Changed Benefit 32947 0 0 Update 2014-08-01 2019-03-01 Prosthesis BS284 AUTOGEN CRT-D DF-4 ICD with cardiac resynchronization therapy. PaceSafe RV, RA, and LV auto threshold. 32.5cc, 73.6g, 9.9mm BS 27 238 1727 a,d,e 221615 37980 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BS285 AUTOGEN X4 CRT-D DF-4 ICD with cardiac resynchronization therapy. 32.5cc, 73.8g, 9.9mm BS 27 238 1727 a,d,e 221633 37980 0 0 No Change 2014-08-01 2019-03-01 Prosthesis CO048 Cochlear™ Nucleus® CP810 Sound Processor - INITIAL The ear level sound processor of the Nucleus 5 cochlear implant system with multiple wearing options and a remote control. One size CO 22 196 1528 4145 165764 10925 0 0 No Change 2010-02-01 2019-03-01 Prosthesis CO049 Cochlear™ Nucleus® CP810 Sound Processor - REPLACEMENT The ear level sound processor of the Nucleus 5 cochlear implant system with multiple wearing options and a remote control. One size CO 22 196 1528 4147 Generation 4 165764 Changed Benefit 7648 0 0 Update 2010-02-01 2019-03-01 Prosthesis CO050 Baha BA210 Abutment Titanium abutments compatible with hexagonal coupling Baha implants 5.5mm and 8.5mm CO 22 196 1560 4151 Abutment 123984 850 0 0 No Change 2010-08-01 2019-03-01 Prosthesis CO051 Baha® BI300 Implant Titanium self-tapping implant with TiOblast surface of the Baha 3 system 3mm and 4 mm CO 22 196 1560 4151 Fixture & Concave 123984 1028 0 0 No Change 2010-08-01 2019-03-01 Prosthesis GO193 Apex Knee, Tibial Base Plate - Porous Tibial Baseplate, Cementless Size 1 Left & Right, Size 2 Left & Right, Size 3 Left & Right, Size 4 Left & Right, Size 5 Left & Right, Size 6 Left & Right GO 17 151 1360 3923 287595 Changed Benefit 2416 0 0 Update 2009-08-01 2019-03-01 Prosthesis GO194 Apex Knee, Tibial Base Plate - Cemented Tibial Baseplate, Cemented, Non-Porous, Size 1 - 7 Left & Right Size 1 Left & Right, size 2 Left & Right, size 3 Left & Right, size 4 Left & Right, size 5 Left & Right, size 6 Left & Right, size 7 Left & Right. GO 17 151 1357 278528 1923 0 0 No Change 2009-08-01 2019-03-01 Prosthesis GO195 Apex Knee, Femoral Component Porous Coated Femoral Component Porous Coated Size 1 to 6 left & Right. Sizes 1-6, 1+, 2+, 3+, 4+, 5+, 6+ in Left & Right GO 17 149 1351 3914 286880 3309 0 0 No Change 2009-08-01 2019-03-01 Prosthesis GO196 Apex Knee - Cemented Femoral Component CR Cemented Femoral Component, Non-Porous, Size 1 to 6 Size 1-6, 1+, 2+, 3+, 4+, 5+, 6+ in Left & Right GO 17 149 1348 3906 273814 2951 0 0 No Change 2009-08-01 2019-03-01 Prosthesis DY457 PFC Sigma Knee System tibial insert Tibial insert, posterior stabilised, rotating platform UHMWPE Sizes 1 - 6. 8-30mm SY 17 153 1370 138289 Changed Benefit 1073 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY464 DePuy Delta Ceramic Femoral Head Ceramic delta >32mm >32mm SY 18 162 1420 3998 138290 2022 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ER324 Ulrich Anterior Cervical Plating System-Plate (>55 mm) Ulrich Mambo Anterior Cervical Plating System-Plate (>55 mm) 8-10 holes, length 56-92 mm ER 19 169 1476 4125 >55mm 279704 1636 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER325 Ulrich Anterior Cervical Plating System-Screws Ulrich Mambo Anterior Cervical Plating System-Screws, self drilling dia (3.5-4.0 mm) x length (13-19 mm) ER 19 165 1464 Dual Thread 279704 462 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER326 Ulrich Anterior Cervical Plating System-set and locking screw Ulrich Mambo Anterior Cervical Plating System-settling and clamping screws N/A ER 19 166 1465 279704 164 0 0 No Change 2017-02-01 2019-03-01 Prosthesis GO233 Novae Dual Mobility Cup A cementless metal acetabular dual mobility cup designed to be used with a polyethylene liner. 41mm to 73mm diameter in 2mm increments GO 18 163 1427 4018 296615 296620 296616 2373 0 0 No Change 2012-02-01 2019-03-01 Prosthesis GO234 Novae Double Mobility Cup Insert A cementless metal acetabular dual mobility cup designed to be used with a polyethylene liner. 22mm x 43 - 69mm diameter in 2mm increments 28mm x 47 - 69mm diameter in 2mm increments GO 18 163 1428 4023 282775 1845 0 0 No Change 2012-02-01 2019-03-01 Prosthesis GO256 Apex Revision Knee System A modular tibial baseplate sizes 1-6 GO 17 151 1357 Revision 196653 3265 0 0 No Change 2013-02-01 2019-03-01 Prosthesis GO257 Apex Revision Knee Tibial Insert Apex Revision Knee Tibial Insert size 1 to 6mm x 10 to 28mm GO 17 153 1370 196653 282757 282762 Changed Benefit 1073 0 0 Update 2013-02-01 2019-03-01 Prosthesis GO259 Apex Revision Knee - Femoral and Tibial Augment Locking Screw/Bolt Femoral and Tibial Locking Screw/Bolt Femoral Augment Locking Screw/Bolt - one size only Tibial Augment Locking Screw/Bolt - 4mm, 8mm, 12mm GO 17 159 1398 252312 126 0 0 No Change 2013-02-01 2019-03-01 Prosthesis ER327 Ulrich Anterior Cervical Cage Ulrich cerv-X Anterior Cervical Cage-PEEK, convex and lordotic height (4-10mm) x width (12-16mm) x length (12-14mm) x angle (0-5°) ER 19 174 1486 4134 279703 2409 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER328 SIGNUS Diplomat Pedicle Screw System – Transverse Connector, adjustable SIGNUS Diplomat Pedicle Screw System – Cross Connector, adjustable small 35-45mm medium 41-58mm large 54-82mm ER 19 167 1474 4124 129774 Changed Benefit 1299 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER330 Ulrich Pedicle Screw System-Pedicle Screw, monoaxial, cannulated Ulrich Pedicle Screw System (cosmicMIA, uCentum)-Pedicle Screw, monoaxial, cannulated, with or without HA coating or fenestrations dia (4.5-10 mm) x length (25-60 mm) ER 19 165 1462 Cannulated 279706 289054 924 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER331 Ulrich Pedicle Screw System-Pedicle Screw, monoaxial Ulrich Pedicle Screw System (uCentum,flamenco)-Pedicle Screw, monoaxial, standard or long arm dia (4.5-10 mm) x length (25-60 mm) ER 19 165 1462 279706 895 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER332 Ulrich Pedicle Screw System-Pedicle Screw, polyaxial, cannulated Ulrich Pedicle Screw System (uCentum)-Pedicle Screw, polyaxial, cannulated, with or without fenestrations dia (4.5-10 mm) x length (25-60 mm) ER 19 165 1463 Cannulated 279706 1338 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LB169 RISE-L Lateral Lumbar Interbody Fusion Device Expandable titanium lumbar interbody fusion device Width 18-22mm, Length 40-60mm, Height 7-10mm (unexpanded) - 14-17mm (expanded) LB 19 174 1486 4135 214537 3465 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LB170 REVERE Anterior Staple System - Cross Connector Top Tightening Cross Connector 13mm -20mm LB 19 167 1474 4123 190039 404 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LB171 ELSA Expandable Lateral Interbody Fusion Spacer Expandable lateral interbody fusion spacer with integrated fixation Height (unexpanded): 7-11mm Height (expanded): 14-20mm Length: 40-65mm Width: 20mm LB 19 174 1485 5486 191535 6256 0 0 No Change 2018-02-01 2019-03-01 Prosthesis LB172 Altera Articulating Expandable TLIF Articulating Expandable Titanium TLIF Spacer Length: 26-36mm Height (non-expanded):8-12mm Height (expanded): 12-16mm LB 19 174 1486 4135 214537 3465 0 0 No Change 2018-02-01 2019-03-01 Prosthesis LB173 ELSA Bone Screw Variable Angle Bone Screw Diameter: 5.5mm Length: 30-60mm LB 19 165 1464 191535 Changed Benefit 193 0 0 Update 2018-08-01 2019-03-01 Prosthesis LB174 Haven Dual Plates Dual Laminoplasty plates 32mm - 39mm LB 19 169 1477 4131 Bilateral laminoplasty plate 219536 910 0 0 No Change 2018-08-01 2019-03-01 Prosthesis JJ416 Prolene *3D Patch Polypropylene Mesh Sterile Three-dimensional device consisting of a flat mesh onlay patch secured to a formed expandable diamond-shaped mesh patch component. 5.49cm x 12.50cm 3D Patch large with extended overlay JJ 21 194 1782 5434 Contoured 126920 195 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ421 MicroFix Anchor with Suture Anchor with suture Anchor with Suture and Multiple size needles SY 13 123 1774 5384 AB 140549 161091 503 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ432 SURGICEL Nu knit Absorbable Haemostat High density , oxidised regenerated cellulose, the material is biocompatible and also bactericidal. 2.5 x 8.75cm JJ 21 191 1554 6008 Antimicrobial, Low Antigenicity, Woven 177701 35 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ433 SURGICEL Nu knit Absorbable Haemostat High density , oxidised regenerated cellulose, the material is biocompatible and also bactericidal. 15.2 x 22.9cm JJ 21 191 1554 6010 Antimicrobial, Low Antigenicity, Woven 177701 98 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ441 Titanium Mesh Titanium Mesh Sterile 0.2mm thickness, 15cm x 15cm SY 23 199 1585 4206 143829 Changed Benefit 1462 0 0 Update 2005-10-31 2019-03-01 Prosthesis LB175 ELSA ATP Anterior-to-Psoas Expandable Lumbar Spacer Width: 20mm Length - 40mm-65mm Unexpanded Height - 7-10mm Expanded Height - 14mm-17mm LB 19 174 1485 5486 191535 6256 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LB176 CREO Offset Connectors Threaded Head Offset Connectors 15mm-150mm LB 19 167 1473 190039 Changed Benefit 732 0 0 Update 2018-08-01 2019-03-01 Prosthesis LC005 Friendly Femoral Stem Femoral Stem Cemented Tapered Polished FeCrNiMnMoNbN 0, 1, 2, 3 LC 18 161 1404 3941 210666 1845 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC009 Modulus Femoral Body Femoral Body 12/14 Taper CCD 125* to 130* - Ti6AI4V A & B x Small to Large LC 18 161 1410 3961 Body 210669 2514 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC010 Modulus Modular Femoral Stem Modulus Modular Femoral Stem Size A & B x 13 to 26mm diameter LC 18 161 1410 3961 Stem 210668 2742 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC011 C2 Femoral Stem C2 Femoral Stem Standard / Lateralised / Revision 12/14 Taper Ti6AI4V 02 to 12 LC 18 161 1406 3945 210716 210720 3401 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC012 Lima Cup Metal Liner 28mm, 32mm and 36mm LC 18 163 1428 4023 216035 1845 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC013 FIT Femoral Stem FIT Femoral Stem 12/14 Taper Ti6AI4V HA Coated Size 1-7, Left & Right LC 18 161 1407 3949 210717 3779 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC015 Sam-Fit modular stem Modular stem 1 - 7 LC 18 161 1407 3952 210760 4394 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC020 Lima Cemented Cup UHMWPE Cemented Cup Unmodified 28-36mm OD x 44-58mm OD 20* LC 18 163 1425 4006 213029 659 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC021 Acetabular Plate Acetabular Reconstruction Plate Ti 50 - 66mm x Standard or Long LC 18 163 1432 4035 210762 1253 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC022 Delta Revision TT Acetabular Cup Delta Revision TT Acetabular Cup Ti 50 - 66mm LC 18 163 1432 4034 210779 2783 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC023 DELTA Coupling / Spacer / Liner DELTA Coupling / Spacer / Adaptor / Liner CoCrMo Size Small to Extra Large Angle (In degrees) 0 to 20 Offset +5 LC 18 164 1806 210771 1371 0 0 No Change 2009-08-01 2019-03-01 Prosthesis ER333 Ulrich Pedicle Screw System-Pedicle Screw, Polyaxial Ulrich Pedicle Screw System (uCentum, flamenco)-Pedicle Screw, Polyaxial, standard or long arm dia (4.5-10 mm) x length (25-60 mm) ER 19 165 1463 279706 1280 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER334 Ulrich Pedicle Screw System-Rods Ulrich Pedicle Screw System (cosmicMIA, uCentum,flamenco)-Rods, straight, curved and scoliosis, open or percutaneous. dia (5.5-6.0 mm) x length (30-500 mm) ER 19 170 1478 279706 Changed Benefit 426 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER335 Ulrich Pedicle Screw System-Locking screws Ulrich Pedicle Screw System (cosmicMIA, uCentum, flamenco)-Locking screws various ER 19 166 1465 279706 164 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER336 Ulrich Pedicle Screw System-Hooks Ulrich Pedicle Screw System (uCentum, flamenco)-Hooks, pedicle,lamina, offset (left or right) width (5-9 mm) x length (5-11 mm) ER 19 168 1475 279706 789 0 0 No Change 2017-02-01 2019-03-01 Prosthesis GO260 Apex Revision Knee Apex Revision Knee Femoral and Tibial Augments Femoral, Size 0-6+, 5mm/10mm/15mm Tibial, Size 0-6, 4mm GO 17 159 1390 252312 1148 0 0 No Change 2013-02-01 2019-03-01 Prosthesis GO261 Novae Double Cup Cortical Bone Screw Cortical Bone Screw 5mm diameter, 30 to 65mm length in 5mm increments GO 18 164 1435 246511 121 0 0 No Change 2013-02-01 2019-03-01 Prosthesis GO262 Apex Revision Knee - Tibial Insert Locking Peg/Bolt Tibial Insert Locking Peg/Bolt 10; 11; 12; 14; 16; 18; 20; 24 and 28mm GO 17 159 1397 276775 126 0 0 No Change 2013-02-01 2019-03-01 Prosthesis GO275 OSIQ Nano HA Bone Paste - Bone matrix implant artificial OSIQ is a ready to use Nano Bone Graft Substitiute injectable bone matrix paste. Pre loaded syringes 0.5cc,1.0cc,2.0cc,3.0cc & 5.0cc GO 13 123 1241 4092 203115 722 0 0 No Change 2015-02-01 2019-03-01 Prosthesis GO276 ELIZ Bone Graft Substitute Synthetic HA / TCP Bone Graft Substitute Granules (1.0 - 4.0mm) (0.8 - 1.5mm) (0.5 - 1.0mm) Volume / Vial (0.25cc to 5.0cc) GO 13 123 1241 4092 204043 722 0 0 No Change 2015-02-01 2019-03-01 Prosthesis HW581 ES2 Augmentable Monoaxial Screw Fenestrated Cannulated Monoaxial Screw Dia 5.5mm to 7.5mm, length 30mm to 90mm HW 19 165 1462 Cannulated 279143 924 0 0 No Change 2017-02-01 2019-03-01 Prosthesis HW612 METS Stem Titanium, curved and straight 6 diameters, 10-15mm HW 17 157 1386 279902 2716 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW613 METS Tibial Stem Titanium 5 diameters 9-13mm HW 17 157 1386 276635 2716 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW614 METS Tibial Collar Coated Titanium collar with HA coating 5 diameters 20-32mm HW 17 157 1387 3936 278021 Changed Benefit 4024 0 0 Update 2017-08-01 2019-03-01 Prosthesis JJ242 VYPRO II Mesh Composition - equal part Vicryl polyglactin yarn - non-absorbable Prolene polypropylene yarn. Partly absorbable lightweight mesh for tension free-inguinal hernia techniques Large 15 x 10cm JJ 21 194 1783 5438 128896 90 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ243 VYPRO II Mesh Composition - equal part Vicryl polyglactin yarn - non-absorbable Prolene polypropylene yarn. Partly absorbable lightweight mesh for tension free-inguinal hernia techniques Extra large 15 x 15cm JJ 21 194 1783 5439 128896 144 0 0 No Change 2005-10-31 2019-03-01 Prosthesis ER337 Ulrich Pedicle Screw System-Transverse connectors, adjustable Ulrich Pedicle Screw System (uCentum,flamenco)-crosslink connectors, adjustable, with or without hook closed (35-92) mm x open (43-107 mm) ER 19 167 1474 4124 279706 Changed Benefit 1299 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER338 Ulrich Pedicle Screw System-inline connector Ulrich Pedicle Screw System (flamenco)-inline connectors, axial or parallel dia 5.5 mm to (5.5-6.0 mm) ER 19 167 1472 279706 Changed Benefit 732 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER339 Ulrich Pedicle Screw System-Offset connector Ulrich Pedicle Screw System (uCentum, flamenco)-Offset connector for dia 6mm x length (15-60 mm) ER 19 167 1473 279706 Changed Benefit 732 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER340 Ulrich Pedicle Screw System-Locking cap Ulrich Pedicle Screw System (uCentum/uBase)-Locking cap assembly (dual innie screw, nut, washer) one size ER 19 166 1468 279706 582 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER341 Ulrich Pedicle Screw System-Rod, dual diameter Ulrich Pedicle Screw System (flamenco)-Rod, hybrid dia 5.5 mm /4.5 mm, length 400 mm dia 5.5 mm /6.0 mm, length 400 mm dia 5.5 mm /6.25 mm, length 400 mm dia 5.5 mm /6.25 mm, (threaded), length 400 mm ER 19 170 1478 Dual Diameter 279706 Changed Benefit 529 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER342 Ulrich anterior lateral thoracolumbar plating system-Plate Ulrich Golden Gate anterior lateral thoracolumbar plating system-C Plate, A/B orientations 45-130 mm ER 19 169 1477 4128 279704 Changed Benefit 2118 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER343 Ulrich anterior lateral thoracolumbar plate-Screws Ulrich anterior lateral thoracolumbar plate-Screws, mono and polyaxial, cannulated, dual thread, self tapping. dia 7 mm; length 20-55 mm; polyaxiality 7° ER 19 165 1464 Dual Thread 279704 462 0 0 No Change 2017-02-01 2019-03-01 Prosthesis HW582 NasoPore / OtoPore NasoPore / OtoPore is a bioresorbable foam packing for the nasal or ear cavity. 4cm and 8cm HW 21 191 1797 273654 Changed Benefit 143 0 0 Update 2017-02-01 2019-03-01 Prosthesis HW583 ICONiX w/ Needles ICONiX w/ Needles Anchor for soft tissue fixation 1.4mm, 2.3mm HW 13 123 1774 5384 229717 Changed Benefit 294 0 0 Update 2017-02-01 2019-03-01 Prosthesis HW584 ProCinch ProCinch Adjustable Loop Fixation Device Universal Sizing: Button 13mmx4mm 2 Construct Options: ProCinch RT (reverse tension)- tension device through AM Portal ProCinch ST (standard tension)- tension device through lateral femoral condyle HW 13 123 1774 5389 229717 374 0 0 No Change 2017-02-01 2019-03-01 Prosthesis HW585 Excelsior XT-17 Microcatheter Excelsior XT-17 Microcatheter - single lumen devices Outer Diameter: 2.4F (Proximal) & 1.7F (Distal) Inner Diameter: 0.017 inches Length: 150cm Shapes: Straight 45, 90 & J HW 25 225 1689 4494 285509 665 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW586 METS Coned Hemi-Pelvis Shell METS Coned Hemi-Pelvis Shell Diameters: 9,10,12,16 HW 18 163 1432 4034 Tumour 277434 8744 0 0 No Change 2017-08-01 2019-03-01 Prosthesis JJ442 Gynecare TVT-O Items included are: Gynecare TVT Obturator device, Two Gynecare TVT Helical Passers and a Gynecare TVT Atraumatic Winged Guide. The device component of the system consists of undyed or blue Prolene Polypropylene Mesh 1.1x45 cm JJ 26 226 1698 5315 99193 Changed Benefit 822 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ443 Proximate Intraluminal Stapler PPH Proximate Hemorrhoidal Circular Stapler PPH One Size Only JJ 21 194 1582 4320 Circular 99218 Changed Benefit 697 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ444 Ethicon Endo-Surgery Gastric band sutureless port and applier Implantable infusion port & locking connector for adjustable gastric band. Replacement port & locking connector for use with adjustable gastric band. One size only JJ 21 190 1779 94734 589 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ446 PROCEED Surgical Mesh PROCEED Surgical Mesh B1 2x4 (inches) JJ 21 194 1783 5438 Coated 117402 Changed Benefit 371 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ447 PROCEED Surgical Mesh PROCEED Surgical Mesh R1 3x6 inches JJ 21 194 1783 5438 Coated 117402 Changed Benefit 371 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ448 PROCEED Surgical Mesh PROCEED Surgical Mesh N1 4x6 inches oval JJ 21 194 1783 5438 Coated 117402 Changed Benefit 371 0 0 Update 2005-10-31 2019-03-01 Prosthesis HW587 Bone Screws Titanium Bone Screws Ø4.5mm 50mm & 80mm HW 18 164 1450 246513 176 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW588 Steinmann Pins Titanium Steinmann Pins Ø5mm x 300mm HW 18 164 1445 246513 Changed Benefit 159 0 0 Update 2017-08-01 2019-03-01 Prosthesis HW589 VertePlex PMMA Cement 20 gram HW 13 123 1279 4087 289085 157 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW590 VertePlex HV High Viscosity PMMA Cement 20 gram HW 13 123 1279 4087 289085 157 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW591 PCD Precision Cement Delivery System with VertePlex HV High Viscosity PMMA Cement with Mixer and Delivery System 20 gram HW 13 123 1279 4089 288933 450 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW593 Xia 4.5 CT Polyaxial Screw Cortical Thread Polyaxial Screw Dia 4mm to 6.5mm, length 20mm to 45mm HW 19 165 1463 279160 1280 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW594 Xia 4.5 CT Cannulated Polyaxial Screw Cannulated Cortical Thread Polyaxial Screw Dia 4.5mm to 6.5mm, length 20mm to 45mm HW 19 165 1463 Cannulated 279160 1338 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW595 Stryker Locked Plating System Periarticular variable angle locking plate - clavicle 1-6 holes HW 13 123 1694 5270 VAL 196764 Changed Benefit 1663 0 0 Update 2017-08-01 2019-03-01 Prosthesis HW596 Stryker Locked Plating System Periarticular variable angle locking plate - clavicle 7-15 holes HW 13 123 1694 5258 Com, VAL 237797 1164 0 0 No Change 2017-08-01 2019-03-01 Prosthesis JJ449 PROCEED Surgical Mesh PROCEED Surgical Mesh D1 4x8 inches JJ 21 194 1783 5438 Coated 117402 Changed Benefit 371 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ450 PROCEED Surgical Mesh PROCEED Surgical Mesh M1 6x6 inches JJ 21 194 1783 5439 Coated 117402 759 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ451 PROCEED Surgical Mesh PROCEED Surgical Mesh G1 6x8 inches oval JJ 21 194 1783 5439 Coated 117402 759 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ452 PROCEED Surgical Mesh PROCEED Surgical Mesh H1 8x10 inches oval JJ 21 194 1783 5440 Coated 117402 Changed Benefit 1017 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ453 PROCEED Surgical Mesh PROCEED Surgical Mesh J1 8x12 inches JJ 21 194 1783 5440 Coated 117402 Changed Benefit 1017 0 0 Update 2005-10-31 2019-03-01 Prosthesis JJ454 PROCEED Surgical Mesh PROCEED Surgical Mesh T1 10x13 inches oval JJ 21 194 1783 5503 Coated 117402 1066 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ455 PROCEED Surgical Mesh PROCEED Surgical Mesh W1 10x14 inches JJ 21 194 1783 5503 Coated 117402 1066 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ456 PROCEED Surgical Mesh PROCEED Surgical Mesh L1 12x12 inches JJ 21 194 1783 5503 Coated 117402 1066 0 0 No Change 2005-10-31 2019-03-01 Prosthesis HW597 Stryker Locked Plate System Periarticular variable angle locking plate - clavicle 7-15 holes HW 13 123 1694 5271 VAL 196764 1995 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW598 Stryker Locked Plate System Periarticular variable angle locking plate - clavicle 7-15 holes HW 13 123 1694 5259 Com, VAL 196764 1229 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW599 METS Femoral Knee CoCR-molybdenum hinged femoral component includes axle, bushes and circlip Small left; small right; standard left; standard right HW 17 157 1380 3931 Hinge included 269992 Changed Benefit 7814 0 0 Update 2017-08-01 2019-03-01 Prosthesis HW600 METS Smooth Trochanter Titanium, uncoated small and standard HW 18 161 1410 3965 Body, Tumour 276356 Changed Benefit 4526 0 0 Update 2017-08-01 2019-03-01 Prosthesis HW601 METS Spiked Trochanter Titanium, HA coated Small and Standard HW 18 161 1411 3970 Body, Tumour 276557 3972 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW602 METS Trochanter plate Titanium with plasma spray of titanium and HA One size HW 18 164 1454 246512 405 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW603 METS Trochanter Screw Titanium Short, Medium, Long HW 18 164 1435 246513 121 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW604 METS Total Femoral Link Component Curved titanium link shaft 165mm, 225mm HW 18 161 1410 3965 Stem, Tumour 259943 3760 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ER344 Ulrich anterior lateral thoracolumbar plating system-Nut Ulrich Golden Gate anterior lateral thoracolumbar plating system-hex nut one size ER 19 166 1465 279704 164 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER345 Signus Diana SI Joint Fusion Device The DIANA® sacroiliac fusion device is a titanium alloy, tapered hollow cylindrical implant with radial fenestrations to encourage bony in-growth and a threaded outer surface for fixation and stabilisation of the sacroiliac joint. Tapered design: dia at wide point (13-21 mm) x dia at narrow point (12-20mm) x length 30mm ER 19 261 1821 no suffix 216752 1925 0 0 No Change 2017-02-01 2019-03-01 Prosthesis HW606 METS Tibial Fixed Hinge CoCr-Molybdenum Stem lengths 140mm and 180mm HW 17 157 1381 3933 278135 7186 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW607 METS Tibial Plateau Plate CoCr Small and standard in 4 thicknesses HW 17 157 1385 246518 1912 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW608 METS Proximal Tibia Fixed Hinge CoCr-Molybdenum proximal tibial component including bumper Small and standard HW 17 157 1381 3933 278015 7186 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW609 METS Proximal Tibia Fixed Hinge Coated CoCr-Molybdenum with HA coated patella tendon reattachment mechanism and bumper Small and standard HW 17 157 1381 3933 278016 7186 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW605 METS Principal Shaft Titanium shaft 45mm-150mm HW 18 161 1410 3965 Spacer, Tumour 246516 3760 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW610 METS stippled Integral Shaft and Stem Titanium, HA coated, shaft and stem with round or oval collar L=15,30mm; D=27,30mm (round); D=30x38,36x44mm (oval) HW 18 161 1411 3970 Stem, Tumour 278138 4323 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW611 METS Stippled Collar Titanium, HA coated, round or oval 4 sizes round, 4 sizes oval HW 17 157 1387 3936 246514 246515 Changed Benefit 4024 0 0 Update 2017-08-01 2019-03-01 Prosthesis JJ413 Prolene *3D Patch Polypropylene Mesh Sterile Three-dimensional device consisting of a flat mesh onlay patch secured to a formed expandable diamond-shaped mesh patch component. 5.49cm x 12.50cm 3DPatch large with preshaped overlay JJ 21 194 1782 5434 Contoured 126920 195 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ414 Prolene *3D Patch Polypropylene Mesh Sterile Three-dimensional device consisting of a flat mesh onlay patch secured to a formed expandable diamond-shaped mesh patch component. 5.49cm x 12.50cm 3D Patch with medium preshaped overlay JJ 21 194 1782 5434 Contoured 126920 195 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ415 Prolene *3D Patch Polypropylene Mesh Sterile Three-dimensional device consisting of a flat mesh onlay patch secured to a formed expandable diamond-shaped mesh patch component. 5.49cm x 12.50cm 3D Patch medium with extended overlay JJ 21 194 1782 5434 Contoured 126920 195 0 0 No Change 2005-10-31 2019-03-01 Prosthesis GO157 RBK Universal Knee System Tibial Baseplate Tibial Baseplate, short keel, uncemented, CoCr, beaded, with titanium plasma spray and HA, for mobile insert 1 -5 GO 17 151 1362 3924 143926 Changed Benefit 2997 0 0 Update 2007-12-01 2019-03-01 Prosthesis GO158 RBK Universal Knee System Insert Bolt Insert bolt for RBK universal pegged and non pegged inserts 10mm - 20mm GO 17 159 1392 143926 273 0 0 No Change 2007-12-01 2019-03-01 Prosthesis GO159 RBK Universal Tibial Insert Tibial Insert, UHMWPE, fixed, requiring fixation with separate bolt Size 1- 5, 10mm - 20mm GO 17 153 1369 143926 1019 0 0 No Change 2007-12-01 2019-03-01 Prosthesis GO160 RBK Universal Tibial Insert Tibial Insert, UHMWPE, mobile bearing, requiring fixation with separate bolt 1-5, 10mm - 20mm GO 17 153 1369 143926 1019 0 0 No Change 2007-12-01 2019-03-01 Prosthesis GO164 Absolut Cemented Femoral Stem CoCr, Polished, Double Taper, Sizes 000 - 4, with various offsets GO 18 161 1404 3941 248972 1845 0 0 No Change 2007-12-01 2019-03-01 Prosthesis GO156 RBK Universal Knee System Tibial Baseplate Tibial Baseplate, short keel, uncemented, CoCr, beaded, for mobile insert 1 - 5 GO 17 151 1362 143926 2639 0 0 No Change 2007-12-01 2019-03-01 Prosthesis GO165 Global Centraliser Femoral Centraliser Various GO 18 164 1438 247614 139 0 0 No Change 2007-12-01 2019-03-01 Prosthesis JJ464 Divide Absorbable Adhesion Barrier Oxidised regenerated cellulose 3.8 x 5.1cmm JJ 21 194 1579 5431 137984 166 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ465 ULTRAPRO Mesh ULTRAPRO Mesh S3 6 x 11cm JJ 21 194 1783 5438 120154 90 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ466 ULTRAPRO Mesh ULTRAPRO Mesh P3 10 x 12cm JJ 21 194 1783 5438 120154 90 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ467 ULTRAPRO Mesh ULTRAPRO Mesh N3 10 x 15cm JJ 21 194 1783 5438 120154 90 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ468 ULTRAPRO Mesh ULTRAPRO Mesh M3 15 x 15cm JJ 21 194 1783 5439 120154 144 0 0 No Change 2005-10-31 2019-03-01 Prosthesis JJ469 ULTRAPRO Mesh ULTRAPRO Mesh T1 15x30cm JJ 21 194 1783 5440 120154 209 0 0 No Change 2005-10-31 2019-03-01 Prosthesis LB160 QUARTEX Occiptal Screws Occipital Screws Diameter 4.2mm-4.6mm and Length 6mm-16mm LB 19 165 1464 190061 Changed Benefit 193 0 0 Update 2017-08-01 2019-03-01 Prosthesis LB161 QUARTEX Occipital Plate Occipital Plate Small to Large LB 19 169 1477 4129 190061 Changed Benefit 2166 0 0 Update 2017-08-01 2019-03-01 Prosthesis DY377 MBT knee system tibial baseplate Tibial baseplate, uncemented, Titanium, TiN, beaded (Porocoat) for rotating platform, (non keeled only) Sizes 1 - 7 SY 17 151 1362 97700 2639 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY402 Cathcart Unipolar Head CoCr Unipolar Femoral head. Needs to be used with DY403 Head Taper insert 41 to 60mm SY 18 162 1420 3995 97395 835 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY403 Cathcart Taper Insert CoCr head taper insert for use with Unipolar Head (DY402) -3 to +10mm SY 18 164 1442 255314 457 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY404 PFC Sigma Knee System RPF/PS150 femoral component Femoral component, cemented, CoCr, high flex, posterior stabilised Size 1-6 including narrow sizes SY 17 149 1348 3907 191588 97698 3041 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY405 PFC Sigma Knee System RPF tibial insert Tibial insert, UHMWPE, rotating platform for high flex with post Size 1 - 6. 10-30mm SY 17 153 1370 97698 Changed Benefit 1073 0 0 Update 2005-10-31 2019-03-01 Prosthesis LB162 QUARTEX Occipital Clamp Occipital Clamps 3.5mm to 4.0mm, short and long LB 19 166 1471 190061 385 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LB163 QUARTEX Occipital Jointed Rod Occipital Jointed Rods Left and Right, 4mm -Left and Right LB 19 170 1480 4133 190061 Changed Benefit 2166 0 0 Update 2017-08-01 2019-03-01 Prosthesis LB164 AFFIRM Vertebral Compression Fracture System - Access Pack Bone Cement and Delivery System 20g LB 13 123 1279 4087 192479 274306 157 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LB165 Fortress and Fortress-Plus Bone Cement Bone Cement 20g LB 13 123 1279 4087 274306 157 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LB166 REVERE Anterior Dual Staple Dual Anterior Staple constructed of Titanium Alloy small, medium, large, x-large LB 19 172 1483 190039 395 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LB167 REVERE Anterior Single Staple Single anterior staple constructed of Titanium Alloy small, medium, large LB 19 172 1483 190039 395 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LB168 REVERE Anterior Staple System - Washer Washers and Stackable Washers 5.5mm - 8.5mm LB 19 172 1482 190039 226 0 0 No Change 2017-08-01 2019-03-01 Prosthesis DY406 Leopard 5 Lodotic Carbon Fibre Body Fusion Device Carbon Fibre cage 7 - 18mm SY 19 174 1486 4135 98094 3465 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY407 Leopard Parallel Carbon Fibre Body Fusion Device Carbon Fibre Cage 7 - 18mm SY 19 174 1486 4135 98094 3465 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY408 Mobility Ankle Mobile Bearing 1-6 from 3-11mm SY 13 124 1269 3646 98045 591 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY418 Mobile Ankle Uncemented Porocoat Tibial component Size 1-6 SY 13 124 1460 4041 98045 1900 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY419 Mobile Ankle Uncemented Porocoat Talar component Size 1-6 SY 13 124 1460 4040 98045 2185 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY427 Conduit TCP Bone matrix implant 5cc SY 13 123 1241 4092 136840 722 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY438 Expedium Spine System Hooks, Right, Left, Angled, Offset, Extended, Reduced Bladed 4.25 - 12mm including narrow - wide SY 19 168 1475 97391 789 0 0 No Change 2005-10-31 2019-03-01 Prosthesis GO169 RBK Total Knee System Femoral Component Femoral Component, cemented, CoCr, totally constrained Size 0 to 5 GO 17 149 1348 3908 Revision, Hinged 143926 6038 0 0 No Change 2007-12-01 2019-03-01 Prosthesis GO189 Apex Knee, All-Poly Patella All-Poly Dome 3 Peg Patella 26mm x 10mm & 8mm, 29mm x 10mm & 8mm, 32mm x 10mm & 8mm, 35mm x 10mm & 8mm, 38mm x 10mm & 8mm, 41mm x 10mm GO 17 156 1376 278529 Changed Benefit 537 0 0 Update 2009-08-01 2019-03-01 Prosthesis GO190 Apex Knee, Locking Bolt Tibial Insert Locking Bolt One size GO 17 159 1392 158606 273 0 0 No Change 2009-08-01 2019-03-01 Prosthesis GO191 Apex Knee, Tibial Insert Tibial Insert, Standard, Ultra & Congruent, Size 1-7, 10mm to 20mm. Size 1, 10mm to 20mm, size 2, 10mm to 20mm, size 3, 10mm to 20mm, size 4, 10mm to 20mm, size 5, 10mm to 20mm, size 6, 10mm to 20mm, size 7, 10mm to 20mm. GO 17 153 1369 271614 278615 1019 0 0 No Change 2009-08-01 2019-03-01 Prosthesis GO166 Absolut Bone Plugs Medullary bone plugs Small, Medium, Large, Extra Large GO 18 164 1437 257494 Changed Benefit 105 0 0 Update 2007-12-01 2019-03-01 Prosthesis GO192 Apex Knee, Bone Screw 6.5mm Bone Screw 20mm, 25mm, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm, 65mm & 70mm. GO 17 159 1398 242554 126 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BA225 Bard Mesh Crurasoft Patch 7x6cm, 11x8cm BA 21 194 1785 5446 122873 Changed Benefit 333 0 0 Update 2013-08-01 2019-03-01 Prosthesis BH246 Rockwood Clavical Pin Clavical Pin with dual thread 4.5mm BH 13 123 1231 3369 DT 140023 236 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH247 Rockwood Clavical Pin Clavical Pin with dual thread 3.0-3.8mm BH 13 123 1231 3370 DT 140023 253 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH251 Small/Large Fragment Set Humeral Titanium Plate 7 to 15 holes BH 13 123 1694 5274 97981 Changed Benefit 1073 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH252 Small/Large Fragment Set Radial Titanium Plate 7 to 15 holes BH 13 123 1694 5277 97981 869 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH253 Distal Radius Plating System DVR titanium radius plates 7 to 15 holes BH 13 123 1694 5277 VAL 209306 1439 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH254 Distal Radius Fracture Repair System DVR-A, distal volar radius locking plate, titanium 16 to 20 holes BH 13 123 1694 5278 VAL 153056 1691 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH256 Distal Radius Fracture Repair System Fragment locking plate, titanium Right, left, straight, Y BH 13 123 1694 5277 VAL 97981 1439 0 0 No Change 2013-02-01 2019-03-01 Prosthesis MC838 Medtronic ACTIVA PC Neurostimulator for Deep Brain Stimulation ACTIVA PC Dual channel primary cell neuro stimulator for Deep Brain Stimulation (37601) One size only MC 25 221 1672 4472 Dual Channel 160118 14307 0 0 No Change 2009-08-01 2019-03-01 Prosthesis MC839 Medtronic MiniMed Insulin Infusion Pump Paradigm Veo Model MMT-554. 'Smart' Insulin Pump with REAL-Time continuous glucose monitoring capability, incorporating a low glucose suspend and with remote control. 5.1 x 7.6 x 2.0cm MC 21 188 1525 4187 DE, SS 95763 9025 0 0 No Change 2009-08-01 2019-03-01 Prosthesis MC840 Medtronic MiniMed Insulin Infusion Pump Paradigm Veo Model MMT-754. 'Smart' Insulin Pump with REAL-Time continuous glucose monitoring capability, incorporating a low glucose suspend and with remote control. 5.1 x 9.4 x 2.0cm MC 21 188 1525 4187 DE, SS 95763 9025 0 0 No Change 2009-08-01 2019-03-01 Prosthesis MC842 Medtronic Screening Cable (Twist Lock) Screening Cable with Twist Lock for Intraoperative testing One size only MC 25 221 1676 4479 119991 190 0 0 No Change 2009-08-01 2019-03-01 Prosthesis MC843 Medtronic Screening Cable (Alligator Clip) Screening Cable with Alligator Clip for Intraoperative testing One size only MC 25 221 1676 4479 119991 190 0 0 No Change 2009-08-01 2019-03-01 Prosthesis MC844 Profile 3D Annuloplasty Ring 3D, rigid annuloplasty ring with physiologic mitral valve shape Diameter (mm) 24 - 40mm MC 20 181 1842 158457 2280 0 0 No Change 2009-08-01 2019-03-01 Prosthesis AA008 Bioring Gastric Band Replacement Port Bioring gastric band access port with catheter and connector Diameter 34mm; height 10.4mm AA 21 190 1779 163167 589 0 0 No Change 2010-02-01 2019-03-01 Prosthesis AA009 Bioring Gastric Band Adjustable gastric banding kit Small, Large and Extra Large AA 21 190 1548 160524 3135 0 0 No Change 2010-02-01 2019-03-01 Prosthesis AA010 Adhesix Bioring Gastric Band Adjustable gastric band system with mesh fixation of port Small, Large and Extra Large AA 21 190 1548 181215 3135 0 0 No Change 2012-02-01 2019-03-01 Prosthesis AA015 CABS Air Composit Umbilical hernia, Parietal Prosthesis with inflatable expansion Balloon 5cm, 7cm, 9cm (all sizes in diameter) AA 21 194 1783 5438 Coated, Contoured 203355 Changed Benefit 428 0 0 Update 2014-08-01 2019-03-01 Prosthesis AA016 4D - DOME SEMI ABSORBABLE HERNIA MESH 4D DOME semi absorbable bio mesh for abdominal reinforcement inguinal, femoral and incisional hernias 2.4, 9 x 5 cm 3.0, 9 x 5 cm 3.8, 9 x 5 cm AA 21 194 1782 5434 Coated, Contoured 222740 Changed Benefit 333 0 0 Update 2014-08-01 2019-03-01 Prosthesis AA017 4D - SEMI ABSORBABLE HERNIA MESH 4DMESH semi absorbable bio mesh for abdominal reinforcement inguinal, femoral and incisional hernias 6 x 13.5 cm 10.5 x 14 cm 12 x 15 cm AA 21 194 1782 5434 Coated 283655 Changed Benefit 333 0 0 Update 2017-02-01 2019-03-01 Prosthesis AA018 4D - Semi Absorbable Hernia Mesh 4DMESH semi absorbable bio mesh for abdominal reinforcement inguinal, femoral and incisional hernias. 12 x 17 cm 17 x 17 cm AA 21 194 1782 5435 Coated 283655 527 0 0 No Change 2017-02-01 2019-03-01 Prosthesis AB003 BioGlue Surgical Adhesive - 5ml Syringe System Model No BG3515-5-A (BioGlue Surgical Adhesive) One size only AB 21 194 1580 4248 Biological 137751 Changed Benefit 647 0 0 Update 2005-10-31 2019-03-01 Prosthesis AB004 BioGlue Surgical Adhesive - 10ml Syringe System Model No BG3510-5-A (BioGlue Surgical Adhesive) One size only AB 21 194 1580 4249 Biological 137751 1295 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AB008 BioGlue Surgical Adhesive - Syringe Standard Applicator Tip Model No BGAT-SY (BioGlue Surgical Adhesive) Standard Applicator Tip AB 21 194 1580 4250 Applicator Tip 137420 24 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AB009 BioGlue Surgical Adhesive - Syringe 10cm Extender Model No BGAT-10-SY (BioGlue Surgical Adhesive) 10cm Extender AB 21 194 1580 4250 Extender 137420 29 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AB010 BioGlue Surgical Adhesive - Syringe 27CM Extender Model No BGAT-27-SY (BioGlue Surgical Adhesive) 27cm Extender AB 21 194 1580 4250 Extender 137420 29 0 0 No Change 2005-10-31 2019-03-01 Prosthesis AB065 BioGlue Delivery Tip Extension (various sizes) Rigid Extender Tip (BGDTE range) 10cm, 27cm, 35cm AB 21 194 1580 4250 Laparoscopic Extender 137420 57 0 0 No Change 2007-12-01 2019-03-01 Prosthesis AB074 FLEXIGRIP (Various Sizes) Nitinol Sternal Closure Clips - various sizes 20mm - 40mm AB 20 252 1791 167412 133 0 0 No Change 2010-08-01 2019-03-01 Prosthesis AB075 BioGlue Surgical Adhesive - 2ml Syringe System Model No BG3502-5-A (BioGlue Surgical Adhesive) 2ml AB 21 194 1580 4247 Biological 137751 Changed Benefit 352 0 0 Update 2013-02-01 2019-03-01 Prosthesis BA129 Groshong Peripherally Inserted Central Catheter Closed-Ended PICC, Single Lumen 3Fr - 5Fr BA 24 214 1649 cu (cuffed) 42589 162 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA130 Groshong Peripherally Inserted Central Catheter Closed-Ended PICC, Multiple Lumen 3Fr - 5Fr BA 24 214 1650 42589 107 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA140 Haemodialysis Catheters Dialysis Catheter, Multiple Lumen 12.5Fr - 16FR BA 24 214 1651 cu (cuffed) 107195 117986 145482 156250 170529 277925 297 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA157 Bard Mesh Flat Mesh 15X15cm BA 21 194 1782 5435 122873 81 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA158 Bard Mesh Flat Mesh 25x35.5cm BA 21 194 1782 5437 122873 261 0 0 No Change 2005-10-31 2019-03-01 Prosthesis BA178 Peripheral Vascular Bare Metal Stent Nitonol self expanding stent 4mm - 14mm diameters, 2cm - 12cm lengths BA 24 206 1622 4440 52136 1710 0 0 No Change 2006-11-30 2019-03-01 Prosthesis BH297 ALPS Hand Fracture System - Locking Plate 1.0 - 2.5mm titanium hand plates 7 to 25 holes BH 13 123 1694 5262 VAL 153056 952 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BS286 AUTOGEN CRT-D DF-1 High energy CRT-D with DF-1 RV connector & lS-1 (G173) or LV-1 (G175) LV connector. PaceSafe RV, RA, and LV auto threshold. 32.0cc, 72.8g, 9.9mm BS 27 238 1727 a,d 221617 37440 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BS287 AUTOGEN X4 CRT-D DF-1 High energy CRT-D with DF-1 RV connector & lS4 LV connector 32.0cc, 73.4g, 9.9mm BS 27 238 1727 a,d 221618 37440 0 0 No Change 2014-08-01 2019-03-01 Prosthesis BS289 Advanix Plastic Stent Plastic stent manufactured individually, indicated for the treatment of pancreatic strictures. 2 - 18cm length / 3 - 10 FR diameter BS 21 192 1561 226891 81 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BS290 Advanix Plastic Stent and Pusher Kit Plastic stent manufactured, indicated for the treatment of pancreatic strictures. Delivery System in form of a pusher (short wire or long wire system specific). 2 - 18cm length / 3 - 10 FR diameter BS 21 192 1561 Pusher 226891 138 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BH259 HI S3 Shoulder Fixation System S3 Shoulder Plate 16-20 Hole, Left & Right BH 13 123 1694 5275 VAL 97981 Changed Benefit 1643 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH261 HI S3 Shoulder Fixation System Locking Peg 4mm diameter BH 13 123 1231 3370 LK 153087 145 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH264 Small Bone Fixation System - Small Bone Flexible Nail Intramedullary Nail 1.6mm and 1.1mm BH 13 123 1772 5364 137673 11 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH265 Small Bone Fixation System - Small Bone Fixation System Kit Intramedullary Nail Fixation System Kit 1.6mm and 1.1mm BH 13 123 1228 5360 137673 Changed Benefit 223 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH266 VersaNail IM Nailing Platform Troch Entry and Universal Femoral Nails, Titanium, Locking, cannulated. 9-13mm x 28-48CM BH 13 123 1228 3327 97378 1370 0 0 No Change 2013-02-01 2019-03-01 Prosthesis LC024 Lima Bone Screw Titanium Bone Screw Dia. 4.5mm to 6.5mm Length 15mm - 90mm LC 18 164 1435 168711 121 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC025 Delta Hemispheric Acetabular Cup Delta Hemispheric Acetabular Cup Ti6AI4V 50 - 62mm & Eccentricity 12-18mm LC 18 164 1433 210763 1230 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC026 Lima Accent Hip System Femoral Stem Cemented, tapered, polished 1 -6 LC 18 161 1404 3941 168581 1845 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC027 Revision Modular Femoral Body Revision Modular Femoral Body 12/14 Taper with Locking Screw Ti6AI4V Std & Lat x 50-70mm - Body Height LC 18 161 1410 3961 Body 210642 2514 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC029 Modular Neck Modular Neck Segment - CoCrMo Size 1-6, Sm & Lg in STD, LAT, AVR/RVL, AVL/RVR LC 18 161 1417 210671 Changed Benefit 1078 0 0 Update 2009-08-01 2019-03-01 Prosthesis LM282 IBS Screw Compression Screw 2mm diameter LM 13 123 1231 3372 CN,DT 266217 357 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM283 IBS Screw Compression Screw 2.5mm diameter LM 13 123 1231 3371 CN,DT 266216 381 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM284 Bone Screw Bone Screw 2.01-2.7mm diameter LM 13 123 1231 3371 CN 266217 Changed Benefit 210 0 0 Update 2016-02-01 2019-03-01 Prosthesis BA181 PowerPort Titanium or MRI implantable port, Open-ended Catheter, Single Chamber 6Fr - 8Fr BA 24 214 1652 pi (power injection) 149028 170347 567 0 0 No Change 2008-07-01 2019-03-01 Prosthesis BA183 Peripherally Inserted Central Catheter Power Injectable PICC, Multiple Lumen 4Fr - 6Fr BA 24 214 1650 pi (power injection) 155226 286034 286035 286036 286037 286038 286039 Changed Benefit 203 0 0 Update 2009-02-01 2019-03-01 Prosthesis BA184 Peripherally Inserted Central Catheter Power Injectable PICC, Single Lumen 3Fr - 6Fr BA 24 214 1649 pi (power injection) 155226 286034 286035 286036 Changed Benefit 148 0 0 Update 2009-02-01 2019-03-01 Prosthesis BA186 Bard Sepramesh IP Bioresorbable Coating/Permanent Mesh 7.6cm x 15.2cm BA 21 194 1783 5438 Coated 184209 Changed Benefit 371 0 0 Update 2009-08-01 2019-03-01 Prosthesis BA187 SEPRAMesh IP Bioresorbable Coating/Permanent Mesh Polypropylene & polyglycolic acid polymer mesh coated with a biopolymer: a bioresorbable coating of modified sodium hyaluronate, carboxymethylcellulose & polyethylene glycol based hydrogel. 4 x 8 inch BA 21 194 1783 5438 Coated 184209 Changed Benefit 371 0 0 Update 2009-08-01 2019-03-01 Prosthesis BA188 Bard Sepramesh IP Bioresorbable Coating/Permanent Mesh 10.2cm x 20.3cm; 15.2cm x 20.3cm BA 21 194 1783 5439 Coated 184209 759 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BA203 Fixation Anchor Set Open or Laparoscopic Permanent Fixation System. 15 Fasteners; 30 Fasteners BA 21 194 1582 4331 Endoscopic 137898 402 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BA204 SorbaFix Open of Laparoscopic Absorbable Fixation System. 15 Fasteners; 30 Fasteners BA 21 194 1582 4331 Absorbable 170112 509 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BA205 Ventrio Hernia Patch Three layer, mesh/ePTFE with absorbable polydioxanone monofilament. 22x27cm, 27x35cm. BA 21 194 1783 5503 Coated 169933 1066 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BA206 Ventrio Hernia Patch. Three layer, mesh/ePTFE with absorbable polydioxanone monofilament. 16x31cm, 20x25cm. BA 21 194 1783 5440 Coated 169933 Changed Benefit 1017 0 0 Update 2010-08-01 2019-03-01 Prosthesis BA207 Ventrio Hernia Patch Three layer, mesh/ePTFE with absorbable polydioxanone monofilament. 14x18cm BA 21 194 1783 5439 Coated 169933 759 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BA208 PowerPort with Groshong Catheter Titanium or MRI implantable Port, Closed-Ended Catheter, Single Chamber 8Fr BA 24 214 1652 pi (power injection) 170345 170346 567 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BA209 HemoStar Long Term Haemodialysis Catheter Dialysis Catheter, Multiple Lumen 14.5Fr - 16Fr BA 24 214 1650 cu (cuffed) 170529 325 0 0 No Change 2010-08-01 2019-03-01 Prosthesis BH268 Polyax Plating System Titanium Locking Screw 4.5-5.5mm BH 13 123 1231 3369 LK 153087 128 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH269 Polyax Plating system Cannulated Locking Screw, Titanium 4.5 to 8.0mm diameter BH 13 123 1231 3369 CN,LK 153087 Changed Benefit 254 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH271 Polyax Plating System Non-Locking Screw, Titanium 40-100mm BH 13 123 1231 3369 153087 65 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH272 Polyax Plating System Locking Bone screws 4.0mm diameter BH 13 123 1231 3370 LK 153087 145 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH273 ALPS - Anatomic Locked Plating System 3.5mm titanium plate 2-6 holes BH 13 123 1694 5258 VAL 153056 784 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH274 ALPS - Anatomic Locked Plating System 3.5mm Titanium plates 7 to 15 holes BH 13 123 1694 5259 VAL 153056 849 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH277 ALPS Plating System & Biodrive Screws Cannulated Bone Screws 3.0 to 4.0mm diameter BH 13 123 1231 3370 CN 210296 208 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH279 ALPS - Anatomic Locked Plating System 3.5mm titanium locking spider plates Small - large and offset BH 13 123 1694 5258 Com, VAL 137673 1164 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH281 ALPS LFS 4.5mm titanium plates 1-6 holes BH 13 123 1694 5255 VAL 153056 Changed Benefit 1112 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH282 ALPS LFS 4.5mm titanium plates, 7-15 holes BH 13 123 1694 5256 VAL 153056 Changed Benefit 1244 0 0 Update 2013-02-01 2019-03-01 Prosthesis LM286 Bone Screw Bone Screw 2.71 to 4.49mm diameter LM 13 123 1231 3370 CN 266217 208 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM287 IBS Screw Compression Screw 4.5, 6.5 & 8.0mm diameter LM 13 123 1231 3369 CN,DT 266217 362 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM288 Bone Screw Bone Screw 4.5mm diameter and larger LM 13 123 1231 3369 CN 266217 191 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM290 NEOFIT - Screws NEOFIT screws 2.7 & 3.0mm LM 13 123 1231 3370 LK 266216 145 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM291 Forearm Locking Plate Forearm plates ≤ 6 holes LM 13 123 1694 5258 Com, LK 182677 850 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM293 Ascension MCP Finger Joint Replacement PyroCarbon MCP Distal Component 05D, 10D, 20D, 30D, 40D, 50D LM 13 131 1274 6143 94980 665 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM294 Ascension MCP Finger Joint Replacement PyroCarbon MCP Proximal Component 05P, 10P, 20P, 30P, 40P, 50P LM 13 131 1274 6044 94980 665 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM285 IBS Screw Compression Screw 3.00 & 3.5mm diameter LM 13 123 1231 3370 CN,DT 266217 379 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM295 Ascension PIP Finger Joint Replacement PyroCarbon PIP Distal Component 10D, 20D, 30D, 40D LM 13 131 1274 6145 94980 760 0 0 No Change 2016-02-01 2019-03-01 Prosthesis BH283 ALPS Plating System Non-locking bone screws 4.5 - 6.5mm diameter BH 13 123 1231 3369 153087 65 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH284 ALPS Plating System Locking screws 4.5 to 6.5mm diameter BH 13 123 1231 3369 LK 153087 128 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH285 ALPS LFS 4.5mm Titanium Spider plates Single hole plate with hooks BH 13 123 1694 5255 Com,VAL 153056 Changed Benefit 1473 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH287 ALPS Anatomic Locked plating system Distal and Proximal Tibial Plates, Titanium 7 to 15 holes BH 13 123 1694 5293 VAL 153056 97981 1495 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH288 ALPS-Anatomic Locked Plating system Distal and Proximal Tibial Plates, Titanium 16 - 25 holes BH 13 123 1694 5294 VAL 153056 97981 1728 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH290 ALPS Elbow System Humeral Titanium Plates Small - Large, 7 to 15 holes BH 13 123 1694 5274 VAL 153056 Changed Benefit 1643 0 0 Update 2013-02-01 2019-03-01 Prosthesis BH291 Distal Radius Plating System Radial and Ulna Plates ≤6 holes BH 13 123 1694 5276 VAL 209306 1439 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH292 ALPS Elbow System Ulna Titanium Plates Small – Large, 3 to 6 holes BH 13 123 1694 5279 VAL 153056 1439 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BH293 ALPS Elbow System Ulna Titanium Plates Small – Large, 7 to 15 holes BH 13 123 1694 5280 VAL 153056 1439 0 0 No Change 2013-02-01 2019-03-01 Prosthesis LM296 Ascension PIP Finger Joint Replacement PyroCarbon PIP Proximal Component. 10P, 20P, 30P, 40P LM 13 131 1274 6144 94980 760 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM297 Pyrocarbon Lunate Pyrocarbon Lunate replacement Mulitple LM 13 131 1273 3666 Changed Benefit 2043 0 0 Update 2016-02-01 2019-03-01 Prosthesis LM298 Pyrocarbon carpal implants Pyrocarbon carpal replacement implants Multiple sizes LM 13 131 1274 6146 665 0 0 No Change 2016-02-01 2019-03-01 Prosthesis LM300 Intramedullary Arthrodesis Implant Implant for small joint Arthrodesis Small, Medium, Large LM 13 123 1228 5474 164980 548 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LM304 OsteoMed FPS Titanium locking footplates 3.5mm and 4mm LM 13 123 1694 5258 Com, VAL 202319 1164 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LM305 Extremilock FPS Ankle Plating System 3.5mm and 4mm LM 13 123 1694 5292 VAL 202319 1728 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LM306 Osteomed FPS Calcaneal Plates 7 to 15 holes LM 13 123 1694 5296 VAL 202319 1462 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LM307 Osteomed FPS Anterior Lateral Plates 7 to 15 holes LM 13 123 1694 5293 VAL 202319 1495 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LM308 Osteomed FPS Fibular Fracture Plates 7 to 15 holes LM 13 123 1694 5290 VAL 202319 Changed Benefit 1643 0 0 Update 2016-08-01 2019-03-01 Prosthesis LM309 Osteomed FPS Tubular Plates 7 to 15 holes LM 13 123 1694 5259 VAL 202319 849 0 0 No Change 2016-08-01 2019-03-01 Prosthesis LM310 Skeletal Dynamics Bone Screw Locking Bone Screw Locking 3.0m and 3.5mm LM 13 123 1231 3370 LK 278692 145 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM311 Skeletal Dynamics Pegs Smooth Pegs:Locking, Threaded Pegs: Locking & Non Locking 2mm, 2.3mm & 2.7mm LM 13 123 1231 4521 278692 126 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM312 Skeletal Dynamics Peg High Compression Locking High Compression Locking Peg 2.7mm LM 13 123 1231 3371 CN,DT,LK 278692 444 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM313 Volar Bearing Plate Screws Volar Bearing Plate Screws 2.5mm x 10mm-30mm LM 13 123 1231 3371 LK 278692 147 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM314 Headless Compression Screws Compression Screws 2.5mm LM 13 123 1231 3371 CN,DT 279795 381 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM315 Headless Compression Screws Compression Screws 3.5mm LM 13 123 1231 3370 CN,DT 279795 379 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM316 Skeletal Dynamics Washer Washer One size LM 13 123 1231 3374 278692 93 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM317 Skeletal Dynamics Bone Screw Non-Locking Non-Locking Cortical Bone Screws 3.0mm, 3.5mm LM 13 123 1231 3370 278692 82 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM318 PROTEAN Plate Plate One size LM 13 123 1694 5277 LK 278692 1126 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM319 Screws Non Locking 2.01 - 2.7mm diameter all lengths LM 13 123 1231 3371 278692 84 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM320 Screws Screws, Locking 2.01 to 2.7mm diameter LM 13 123 1231 3371 LK 278692 147 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM321 GEMINUS Volar Distal Radius Plates Fixation Plate for Distal Radius Fractures 3 and 4 hole LM 13 123 1694 5276 VAL 278692 1439 0 0 No Change 2017-02-01 2019-03-01 Prosthesis MC778 Oscor Adaptor Adaptor for LV-1 lead to unipolar and bipolar IS-1 10cm, 17cm and 40cm MC 27 244 1763 137315 360 0 0 No Change 2008-07-01 2019-03-01 Prosthesis MC806 Infuse Bone Graft Recombinant human bone morphogenetic protein rhBMP-2 Extra Small 2.1mg MC 13 123 1241 4118 121164 1425 0 0 No Change 2008-07-01 2019-03-01 Prosthesis MC807 Infuse Bone Graft Recombinant human bone morphogenetic protein rhBMP-2 Mini 1.05mg MC 13 123 1241 4118 121164 1425 0 0 No Change 2008-07-01 2019-03-01 Prosthesis MC808 Infuse Bone Graft Recombinant human bone morphogenetic protein rhBMP-2 Small 4.2mg MC 13 123 1241 4119 121164 3040 0 0 No Change 2008-07-01 2019-03-01 Prosthesis MC809 Valiant Endovascular Stent Graft Nitinol and polyester system 24 - 46 diameter, up to 179mm MC 24 207 1625 4442 141302 10476 0 0 No Change 2008-07-01 2019-03-01 Prosthesis MC810 Valliant Endovascular Stent Graft Nitinol and polyester system 24 - 46 diameter, 180 - 227mm length MC 24 207 1625 4443 141302 13775 0 0 No Change 2008-07-01 2019-03-01 Prosthesis MC811 Attain Ability 4196 LV Lead/ Attain Ability SureScan 4196 MRI LV Lead Over the wire dual electrode left ventricular lead 78, 88, and 103 cm MC 27 243 1759 284518 Changed Benefit 4493 0 0 Update 2009-02-01 2019-03-01 Prosthesis MC816 Endeavor Resolute Drug Eluting Coronary Stent System Cobalt Alloy, ABT - 578, BioLinx Polymer Diameter:2.25mm-4.0mm; Length: 8.00mm-30.0mm MC 27 247 1766 5346 153680 2484 0 0 No Change 2009-02-01 2019-03-01 Prosthesis MC817 Medtronic Intrathecal Catheter Revision Kit (Proximal) Revision kit to repair proximal end of intrathecal catheter (8596SC) 66cm MC 25 223 1684 4503 153487 570 0 0 No Change 2009-02-01 2019-03-01 Prosthesis BA211 Haemodialysis Catheters Haemodialysis Catheters, multiple lumen 11Fr - 13.5Fr BA 24 214 1651 141187 114 0 0 No Change 2011-02-01 2019-03-01 Prosthesis BA212 Peripherally Inserted Central Catheter Valved, Power Injectable PICC, Single Lumen 4Fr - 6Fr BA 24 214 1649 pi (power injection) 191603 Changed Benefit 148 0 0 Update 2012-02-01 2019-03-01 Prosthesis BA213 Peripherally Inserted Central Catheter Valved, Power Injectable PICC, Multiple Lumen 4Fr-6Fr BA 24 214 1650 pi (power injection) 191603 Changed Benefit 203 0 0 Update 2012-02-01 2019-03-01 Prosthesis BA215 Haemodialysis Catheter Power Injectable, Triple Lumen Haemodialysis Catheter 13Fr BA 24 214 1651 pi (power injection) 141187 332 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BA216 Lifestent Lifestent cut nitinol self expanding stent 6-10mm diameter 20mm-120mm length BA 24 206 1622 4440 160453 1710 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BA217 Lifestent Laser cut nitinol self expanding stent Diameter 5mm to 10mm; length 150mm - 200mm BA 24 206 1622 4441 160453 Changed Benefit 2822 0 0 Update 2012-02-01 2019-03-01 Prosthesis BA218 Lifestent Valeo Stainless Steel Balloon Expandable Peripheral Stent 6-10mm diameter 17-56mm length BA 24 206 1622 4439 161500 1710 0 0 No Change 2012-02-01 2019-03-01 Prosthesis MC818 Medtronic Intrathecal Catheter Revision Kit (Distal) Revision kit to repair distal end of intrathecal catheter (8598A) 38.1cm MC 25 223 1684 4503 153486 570 0 0 No Change 2009-02-01 2019-03-01 Prosthesis MC819 Pyramid +4 Anterior Plate Height: 33mm - 45mm MC 19 169 1476 4126 169514 Changed Benefit 2118 0 0 Update 2009-02-01 2019-03-01 Prosthesis MC820 T2 Expandable vertebral body replacement cage Diameters: 13 - 31mm MC 19 176 1492 4137 ThoracoLumbar 169501 4139 0 0 No Change 2009-02-01 2019-03-01 Prosthesis MC821 T2 End Cap 13-31 mm, 0, 4, 8, 15 degree lordosis MC 19 176 1495 169501 1275 0 0 No Change 2009-02-01 2019-03-01 Prosthesis MC822 CD Horizon Legacy Multiaxial Iliac Screw Dia 5.5 to 10.5mm MC 19 165 1463 169514 1280 0 0 No Change 2009-02-01 2019-03-01 Prosthesis MC823 CD Horizon Legacy Fixed Iliac Screw 5.5mm to 8.5mm Diameter MC 19 165 1462 Closed 169514 895 0 0 No Change 2009-02-01 2019-03-01 Prosthesis MC825 Medtronic Percutaneous Quad extension Percutaneous extension (in line connector for quadripolar leads only) One size only MC 25 222 1690 4500 138711 Changed Benefit 160 0 0 Update 2009-02-01 2019-03-01 Prosthesis MC826 Medtronic Accessory Kit for Deep Brain Stimulation Boots accessory kit for DBS (3550-25) N/A MC 25 221 1676 4498 240576 166 0 0 No Change 2009-02-01 2019-03-01 Prosthesis BA219 Encapsulated Carbon Lined Stent Graft PTFE covered nitinol self-expanding stent 4mm - 13.5mm diameter, 2cm - 12cm length BA 24 207 1635 4451 143665 3225 0 0 No Change 2012-02-01 2019-03-01 Prosthesis BA220 Groshong Peripherally Inserted Central Catheter Closed-Ended, Power Injectable PICC, Single Lumen 5Fr BA 24 214 1649 pi (power injection) 198806 Changed Benefit 148 0 0 Update 2012-08-01 2019-03-01 Prosthesis BA221 Implanted infusion Port Titanium or MRI Implanted Port, Open-Ended Catheter, Single Chamber 6Fr - 9.6Fr BA 24 214 1652 156249 157392 157394 157395 157397 157398 157400 157401 157402 157403 450 0 0 No Change 2013-02-01 2019-03-01 Prosthesis BA222 Bard 3D Max Mesh 3D Mesh Medium left, Medium Right, large Left, Large Right BA 21 194 1782 5434 Contoured, Without Fixation 122873 Changed Benefit 250 0 0 Update 2013-08-01 2019-03-01 Prosthesis BA223 Bard 3D Max Mesh 3D Mesh Extra Large Left, Extra Large Right BA 21 194 1782 5435 Contoured, Without Fixation 122873 285 0 0 No Change 2013-08-01 2019-03-01 Prosthesis BA224 Bard Mesh Kugel Patch 8x12cm oval; 9.5x13cm oval; 11x14oval; 8cm circle; 10.2cm circle; 12cm circle; BA 21 194 1782 5434 Coated 122873 Changed Benefit 333 0 0 Update 2013-08-01 2019-03-01 Prosthesis MC827 Medtronic Pisces Quad Leads Pisces Quad Lead (3487A), Pisces Quad Compact Lead (3887), Pisces Quad Plus Lead (3888) Various MC 25 222 1679 4486 4 electrodes 137348 143034 143035 3230 0 0 No Change 2009-02-01 2019-03-01 Prosthesis MC828 Medtronic Resume Surgical Leads Surgical Leads - Resume II (3587A), Resume TL (3986A) 25cm MC 25 222 1679 4486 4 electrodes 141857 141858 3230 0 0 No Change 2009-02-01 2019-03-01 Prosthesis MC829 Medtronic On Point Lead On point peripheral nerve lead kit (3987A) 25cm MC 25 222 1679 4486 4 electrodes 141859 3230 0 0 No Change 2009-02-01 2019-03-01 Prosthesis MC831 Medtronic Lead Extender Kits 6984M: IS-1 BI Lead to IS-1 BI IPG; 6981M: IS-1 UNI Lead to IS-1 UNI IPG; 6986M: 3.2mm BI Lead to IS-1 BI IPG; 6985M: IS-1 UNI Lead to EPG; OSCOR Lead Extender BIS-BIS-40 37 - 50cm MC 27 245 1764 137315 382 0 0 No Change 2009-02-01 2019-03-01 Prosthesis MC833 CapSureFix Novus Model 4076 Pacing Lead (MRI SureScan) Active fixation pacemaker lead, including MRI compatible models 35 - 85cm MC 27 243 1756 286952 898 0 0 No Change 2009-08-01 2019-03-01 Prosthesis MC834 Sprint Quattro Secure S (MRI SureScan) Model 6935, Active Fixation Single Coil Defibrillation Lead, including MRI models 52 - 100cm MC 27 242 1743 286979 6480 0 0 No Change 2009-08-01 2019-03-01 Prosthesis MC837 Medtronic Activa Patient Programmer Medtronic Activa Patient Programmer (Model 37642) One size only MC 25 221 1673 4474 160115 1330 0 0 No Change 2009-08-01 2019-03-01 Prosthesis BS291 REBEL REBEL is a balloon expandable platinum chromium (PtCr) alloy stent pre-mounted on a monorail catheter. 8mm to 32mm in length, diameter of 2.25mm to 4.50mm BS 27 247 1767 5348 230025 898 0 0 No Change 2015-02-01 2019-03-01 Prosthesis BS292 ACUITY X4 Left ventricular family of quad leads with four pacing and sensing electrodes. Three lead configurations offered to assist in LV lead placement and avoid phrenic nerve stimulation and high thresholds. 86cm, 95cm BS 27 243 1759 j 235035 235036 235037 Changed Benefit 4493 0 0 Update 2015-08-01 2019-03-01 Prosthesis BS293 B26 Pocket Adaptor Pocket Adaptor for Deep Brain Stimulation IPG 15cm BS 25 221 1674 4477 231754 1995 0 0 No Change 2015-08-01 2019-03-01 Prosthesis BS294 Latitude Communicator Remote patient management system for implanted cardiac devices One size only BS 27 266 1832 201875 230414 1568 0 0 No Change 2015-08-01 2019-03-01 Prosthesis BS295 Ingevity Passive MR conditional pacing lead 45cm to 59cm BS 27 243 1753 263512 263513 898 0 0 No Change 2016-02-01 2019-03-01 Prosthesis BS296 Ingevity Active MR conditional pacing lead 45cm to 59cm BS 27 243 1756 263514 898 0 0 No Change 2016-02-01 2019-03-01 Prosthesis BS297 EMBLEM S-ICD Pulse Generator Subcutaneous Implantable Cardioverter Defibrillator 59.5cc: (W) 83.1mm x (H) 69.1mm x (D)12.7mm BS 27 236 1812 260382 30701 0 0 No Change 2016-02-01 2019-03-01 Prosthesis CO072 Cochlear ™ Nucleus® CP920 Sound Processor (Replacement) The Cochlear Nucleus CP920 Sound Processor is a behind-the-ear sound processor with two built-in directional microphones. It has no accessory port for cables. There is only one size of the processing unit and coil. There are two sizes for battery holder and cover. CO 22 196 1528 4147 Generation 4 216063 Changed Benefit 7648 0 0 Update 2014-02-01 2019-03-01 Prosthesis CO073 Cochlear™ Baha® 4 Sound Processor The Cochlear Baha 4 Sound Processor is a wireless-enabled, fully programmable head-worn digital sound processor for the Baha Implantable Bone Conduction Hearing System. One size. CO 22 196 1560 4150 Programmable, Wireless-enabled 123987 6484 0 0 No Change 2014-02-01 2019-03-01 Prosthesis CO074 Cochlear Nucleus CI522 Cochlear Implant with Slim Straight Electrode Model CI522, 5th generation cochlear implant with straight electrode array. Titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable tapered silicone seal. One size CO 22 196 1526 232917 Changed Benefit 12892 0 0 Update 2015-02-01 2019-03-01 Prosthesis CO075 Cochlear Baha 5 Sound Processor The Cochlear Baha 5 Sound Processor (26,mm x 19mm x12mm) is a wireless-enabled smartphone compatible fully programmable head-word digital sound processor for the Baha Implantable Bone Conduction Hearing System One size (26mm x 19 mm x 12 mm) CO 22 196 1560 4150 Programmable, Wireless-enabled 123987 6484 0 0 No Change 2015-08-01 2019-03-01 Prosthesis CO076 Cochlear Baha 5 SuperPower Sound Processor The Cochlear Baha 5 SuperPower sound processor is a powerful (up to 65dB HL) wireless-enabled, smartphone compatible, fully programmable, digital sound processor for the Baha Implantable Bone Conduction Hearing System. It is intended to be fitted as a head worn split system - it comprises a behind-the-ear (BTE) Sound Processing Unit, an Actuator unit, and a Cable between the BTE and the Actuator unit. One size CO 22 196 1560 4150 Programmable, Wireless-enabled 123987 6484 0 0 No Change 2016-02-01 2019-03-01 Prosthesis CO077 Cochlear Baha 5 Power Sound Processor The Cochlear Baha 5 Power sound processor is a powerful (up to 55dB HL), wireless-enabled, smartphone compatible, fully programmable, digital sound processor for the Cochlear Baha 'Connect' and 'Attract' Implantable Bone Conduction Hearing Systems. One size CO 22 196 1560 4150 Programmable, Wireless-enabled 123987 6484 0 0 No Change 2016-08-01 2019-03-01 Prosthesis CO078 Cochlear™ Nucleus® CI532 Cochlear Implant with Slim Modiolar Electrode Model CI532, 5th generation cochlear implant with slim modiolar electrode array. Titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable tapered silicone seal. One size CO 22 196 1526 286928 Changed Benefit 12892 0 0 Update 2017-08-01 2019-03-01 Prosthesis BS298 Ultraflex Oesophageal NG Covered Stent Translucent polyurethane covered nitinol, self expanding stent Diameters up to 30mm & lengths up to 150mm BS 21 192 1558 4238 120176 3325 0 0 No Change 2016-02-01 2019-03-01 Prosthesis BS299 Resolution 360 Clip Device Radiopaque, single-use clip pre-loaded on a flexible, rotatable delivery system 7Fr, 11mm jaw opening BS 21 194 1581 4258 Endoscopic 116734 134 0 0 No Change 2016-02-01 2019-03-01 Prosthesis BS300 HANAROSTENT HANAROSTENT Intestine Asymmetric, HANAROSTENT Colon/Rectum TTS, HANAROSTENT Colon/Rectum, HANAROSTENT Colon/Rectum Asymmetric, HANAROSTENT Colon/Rectum Lasso. Self-expanding nitinol colon/rectum stent, Diameter 20-24mm, Length 60-180mm BS 21 192 1557 Self Expanding 272681 2907 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BS301 TwynLay TwynLay Colon/Rectum. Self-expanding nitinol colon/rectum stent Diameter 22-24mm, Length 60-170mm BS 21 192 1557 Self Expanding 272681 2907 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BS302 CHOOSTENT CHOOSTENT Esophagus, Esophagus Valve, Esophagus Asymmetric, Esophagus Upper. Covered esophageal stent, self-expanding nitinol Diameter 18-24mm, Length 50-220mm BS 21 192 1558 4238 272685 3325 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BS303 HANAROSTENT HANAROSTENT Esophagus, Esophagus Valve, Esophagus Benign BS, Bariatric Surgery, Esophagus TTS, Esophagus Skidproof, Esophagus Asymmetric, Esophagus Bone Shape Partial Covered, Esophagus Valve Partial covered. Covered esophagus stent, self-expanding nitinol Diameter 18-30mm, Length 50-240mm BS 21 192 1558 4238 272685 3325 0 0 No Change 2016-08-01 2019-03-01 Prosthesis CO079 Kanso®, Cochlear ™ Nucleus® CP950 Sound Processor (Replacement) An off-the-ear sound processor with two built-in directional microphones, wireless connectivity, and equivalent functionality to the Cochlear N6 behind-the-ear sound processor in a fully integrated single unit, enclosing radiofrequency (RF) coil, supplying power, and signals to internal implant. One size (40.9 mm x 35.2 mm x 11.4 mm) CO 22 196 1528 4147 Generation 4 282194 Changed Benefit 7648 0 0 Update 2017-08-01 2019-03-01 Prosthesis CO080 Kanso®, Cochlear™ Nucleus® CP950 Sound Processor (Initial) An off-the-ear sound processor with two built-in directional microphones, wireless connectivity, and equivalent functionality to the Cochlear N6 behind-the-ear sound processor in a fully integrated single unit, enclosing radiofrequency (RF) coil, supplying power, and signals to internal implant. One size (40.9 mm x 35.2 mm x 11.4 mm) CO 22 196 1528 4145 282194 10925 0 0 No Change 2017-08-01 2019-03-01 Prosthesis CO081 Cochlear™ Nucleus® CP1000 Sound Processor - Hybrid™ Mode (initial) The CP1000 (Nucleus 7, N7) - Hybrid Mode is a behind-the-ear (BTE) sound processor that is designed to function in a similar manner to the CP900 series (CP910/920) (Nucleus 6, N6) sound processor but with new architectural design, which provides improved battery life and MFi wireless connectivity directly with iOS devices via Smart App. The CP1000 in hybrid mode facilitates acoustic stimulation in the cochlea. There is one size of the sound processor unit with 3 battery options and 7 different magnet strengths. CO 22 196 1528 4145 Electroacoustic 292000 Changed Benefit 12303 0 0 Update 2018-02-01 2019-03-01 Prosthesis BS304 HANAROSTENT HANAROSTENT Duodenum/Pylorus Kim’s Flare, HANAROSTENT Duodenum/Pylorus Lasso, HANAROSTENT Duodenum/Pylorus Lasso. Self-expanding nitinol duodenum/pylorus stent Diameter 18-24mm, Length 60-180mm BS 21 192 1562 272682 3325 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BS305 TwynLay TwynLay Duodenum/Pylorus. Self-expanding nitinol duodenum/pylorus stent Diameter 20mm, Length 60-150mm BS 21 192 1562 272682 3325 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BS306 HANAROSTENT HANAROSTENT Biliary, HANAROSTENT Biliary Flap, HANAROSTENT Biliary Flap Lasso, HANAROSTENT Biliary Lasso (SHCL Models). Self-expanding nitinol biliary stent Diameter 6-10mm, Length 20-150mm BS 21 192 1556 4235 272683 272684 2874 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BS307 HANAROSTENT HANAROSTENT Biliary(NNN), HANAROSTENT Biliary Hilar. Un-covered self-expanding nitinol biliary stent Diameter 6-10mm, Length 40-120mm BS 21 192 1556 4234 272683 272684 2114 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BS308 TwynLay TwynLay Biliary. Self-expanding nitinol biliary stent Diameter 8-10mm, Length 40-120mm BS 21 192 1556 4235 272683 272684 2874 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BS309 Benefit Stent Benefit Biliary Stent. Un-covered self-expanding nitinol biliary stent Diameter 6-8mm, Length 40-120mm BS 21 192 1556 4234 272683 272684 2114 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BS310 HANAROSTENT Pseudocyst HANAROSTENT Biliary (Flange) Lasso (BCF Models). Self-expanding, nitinol Diameter 8-16mm, Length 20-150mm BS 21 192 1561 6011 272683 272684 3800 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BS311 HANAROSTENT HANAROSTENT Trachea/Bronchial. Covered trachea/bronchium stent, self-expanding nitinol Length 30-80mm, Diameter 12-20mm BS 21 192 1563 272686 2850 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BS312 Infinion CX Lead 1 x 16 lead with two 8 contact tails 50 - 70cm BS 25 222 1679 4486 greater than 8 and less than 32 electrodes, Bifurcated proximal tail 275241 8550 0 0 No Change 2016-08-01 2019-03-01 Prosthesis BS313 AXIOS Stent and Delivery System for use in pseudocyst drainage. Self-expanding nitinol stent Length 10mm, Lumen Diameter 10-15mm BS 21 192 1561 6011 271558 3800 0 0 No Change 2016-08-01 2019-03-01 Prosthesis CO071 Cochlear ™ Nucleus® CP920 Sound Processor (Initial) The Cochlear Nucleus CP920 Sound Processor is a behind-the-ear sound processor with two built-in directional micophones. There is only one size of the processing unit and coil. There are two sizes for battery holder and cover. CO 22 196 1528 4145 216063 10925 0 0 No Change 2014-02-01 2019-03-01 Prosthesis CO082 Cochlear™ Nucleus® CP1000 Sound Processor - Hybrid™ Mode (replacement) The CP1000 (Nucleus 7, N7) - Hybrid Model is a behind-the-ear (BTE) sound processor that is designed to function in a similar manner to the CP900 series (CP910/920) (Nucleus 6, N6) sound processor but with new architectural design, which provides improved battery life and MFi wireless connectivity directly with iOS devices via Smart App. The CP1000 in hybrid mode facilitates acoustic stimulation in the cochlea. There is one size of the sound processor unit with 3 battery options and 7 different magnet strengths. CO 22 196 1528 4147 Generation 4 Electroacoustic 292000 Changed Benefit 8612 0 0 Update 2018-02-01 2019-03-01 Prosthesis 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. n/a CQ 20 259 1819 181875 95000 0 0 No Change 2014-08-01 2019-03-01 Prosthesis ER353 Ulrich Anterior Distraction Device System (ADDplus)-Locking Screw Ulrich Anterior Distraction Device System (ADDplus)-Locking Screw one size ER 19 166 1465 279702 164 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER354 Ulrich thoracolumbar body replacement system (ObeliscPro)-Telescoping cage Ulrich thoracolumbar body replacement system (ObeliscPro)-Telescoping cage, thoracolumbar dia 20 mm x collapsed height (17-76 mm) x expanded height (23-132 mm) ER 19 176 1492 4137 ThoracoLumbar 279702 4139 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER355 Ulrich thoracolumbar body replacement system (ObeliscPRO)-End plates Ulrich thoracolumbar body replacement system (ObeliscPRO)-End plates, various shapes dia (20-32 mm) x angle (0-15°); oval (32x26 mm) x angle (0-15°); lateral length (35-55 mm) x angle (0-15°) ER 19 176 1492 4138 279702 1155 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER356 Ulrich Fusion Cages-ALIF Ulrich Fusion Cages pezo/tezo-ALIF (various shapes), PEEK or Titanium height (8-26mm) x width (22-28mm) x length (28-34mm) x angle (0-12°) ER 19 174 1486 4135 279703 279705 3465 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DE498 Oculentis LENTIS LS-313Y Foldable one-piece monofocal acrylic plate haptic IOL. Violet Light Filter. Optic Size 6.0mm, Overall Length 11.00mm. Available Diopters: +-0.0D to 35.0D (1.0D steps). +15.5D to 26.5D (0.5 steps). DE 1 141 1327 3892 at, vblf 198807 Changed Benefit 317 0 0 Update 2016-09-01 2019-03-01 Prosthesis DE499 Oculentis LENTIS LS-313Y Pre-loaded Pre-loaded foldable one-piece monofocal acrylic plate haptic IOL. Violet Light Filter. Optic Size 6.0mm, Overall Length 11.00mm. Available Diopters: +-0.0D to 35.0D (1.0D steps). +15.5D to 26.5D (0.5 steps). DE 1 141 1327 3892 at, pl, vblf 198807 333 0 0 No Change 2016-09-01 2019-03-01 Prosthesis DE500 TightRope Button Titanium or stainless steel button 5mm-20mm DE 13 123 1774 5390 126657 374 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DE501 MTP Plate, Straight Metatarso-Phalangeal Fusion plate for 1st MTP Small and Standard, ≤ 6 holes DE 13 123 1694 5258 VAL 140686 784 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DE502 Arthrex Clavicle Plating System Locking clavicle plate and screw system for fixation of clavicle fractures. 7-10 holes DE 13 123 1694 5256 140686 Changed Benefit 674 0 0 Update 2017-02-01 2019-03-01 Prosthesis DY517 Solution Implantable Hip System Revision Standard & MMA 8 straight or bowed porous coated collarless, coxa vara or high offset uncemented stem 8 inch (200mm) size 10.5 - 22.5 SY 18 161 1408 3954 98085 5053 0 0 No Change 2009-02-01 2019-03-01 Prosthesis DY520 Pinnacle Acetabular Shell Titanium. Beaded with HA (Duofix) acetabular cup 38 - 80mm SY 18 163 1427 4016 98086 Changed Benefit 2556 0 0 Update 2009-02-01 2019-03-01 Prosthesis DY521 Pinnacle Acetabular Shell Titanium, beaded (Porocoat), not HA, acetabular cups 38 - 80mm SY 18 163 1426 4011 SCP 221600 221679 223026 Changed Benefit 2204 0 0 Update 2009-02-01 2019-03-01 Prosthesis DY524 Uniplate Spinal System Titanium Anterior Cervical Plate 13-55mm SY 19 169 1476 4125 148371 Changed Benefit 1348 0 0 Update 2009-08-01 2019-03-01 Prosthesis DY527 Expedium Spinal System - Cobalt Chrome Double Wire CoCr wire double with/without button 1.0mm SY 13 123 1772 5365 OL 169174 Changed Benefit 121 0 0 Update 2010-08-01 2019-03-01 Prosthesis DY528 Expedium Spinal System - Cobalt Chrome Single Wire CoCr wire single with/without button 1.0mm SY 13 123 1772 5364 OL 169174 Changed Benefit 149 0 0 Update 2010-08-01 2019-03-01 Prosthesis CR007 Rotaglide + Total Knee System, Tibial Insert Tibial Insert, Mobile bearing, UHMWPE 7mm - 17mm CR 17 153 1369 106748 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis CR008 Rotaglide + Total Knee System, Tibial Insert Tibial Insert, fixed, UHMWPE 9.5mm - 17mm CR 17 153 1369 106748 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis CR020 Metalok Femoral Head Metal on metal, CoCr Head 28mm (short/med/long neck) CR 18 162 1421 106747 2109 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DE488 Oculentis LENTIS LU-313 TY Patient Specific: Foldable one-piece monofocal toric acrylic IOL. Violet Light Filter Optic size: 6.0mm, Overall Length 11.00mm. Sph +/_ 0.0D to +35.0D In 0.01D increments) Cyl +0.25D to +6.99D cyl (in 0.01D increments). DE 1 141 1327 3892 at, t1, vblf 198807 642 0 0 No Change 2016-09-01 2019-03-01 Prosthesis DE489 Oculentis LENTIS LU-313-TY Pre-loaded Patient Specific: Pre-loaded foldable one-piece monofocal toric acrylic IOL. Violet Light Filter Optic Size: 6.0mm, Overall Length 11.00mm. Sph -10.0D to +35.0D (in 0.01D incrments). Cyl +0.25D to +6.99D cyl (in 0.01D increments) DE 1 141 1327 3892 at, pl, t1, vblf 198807 659 0 0 No Change 2016-09-01 2019-03-01 Prosthesis DY530 Pinnacle Femoral Head CoCr metal on metal 33-48mm SY 18 162 1421 133401 2109 0 0 No Change 2010-08-01 2019-03-01 Prosthesis DY531 Pinnacle Femoral Head CoCr metal on metal 28-32mm SY 18 162 1421 133401 2109 0 0 No Change 2010-08-01 2019-03-01 Prosthesis DY545 Monarch Spinal System Threaded Connector One size only SY 19 167 1474 4123 97391 404 0 0 No Change 2011-02-01 2019-03-01 Prosthesis DY547 Delta motion acetabular cup Titanium, plasma with HA cup with preassembled delta ceramic liner 42 - 68mm OD SY 18 163 1429 4030 115426 4587 0 0 No Change 2011-02-01 2019-03-01 Prosthesis DY551 Delta modular head Delta ceramic modular head 32mm SY 18 162 1419 3992 115687 1845 0 0 No Change 2011-02-01 2019-03-01 Prosthesis DY552 Delta modular head Delta ceramic modular head 36-58mm SY 18 162 1420 3998 115687 2022 0 0 No Change 2011-02-01 2019-03-01 Prosthesis DY553 Delta Modular Head - sleeve sleeve for use with Delta Modular Head S - XL, -3.5 to +7 SY 18 164 1451 115687 228 0 0 No Change 2011-02-01 2019-03-01 Prosthesis DE490 Oculentis LENTIS L-312 Foldable one-piece monofocal acrylic C Loop IOL Opric size 6.0mm. Overall Length 12.00mm. Central Thickness 1.02mm (+22.0D). Available Diopters: -10.0D to 35.0D (1.0D steps). +10.5D to 29.5D (0.5D steps). DE 1 141 1327 3892 at 198807 300 0 0 No Change 2016-09-01 2019-03-01 Prosthesis DE491 Oculentis LENTIS L-312 Pre-loaded Pre-loaded foldable one-piece monofocal acrylic C Loop IOL Optic size 6.0mm. Overall length 12.00mm. Central thickness 1.02mm (+22.0D). Available Diopters: -10.0D to 35.0D (1.0D steps). +10.5D to 29.5D ( 0.5D steps). DE 1 141 1327 3892 at, pl 198807 308 0 0 No Change 2016-09-01 2019-03-01 Prosthesis DE492 Oculentis LENTIS L-313 Foldable one-piece monofocal acrylic plate haptic IOL Optic Size 6.0mm, Overall length 11.0mm. Available Diopters: +-10.0D to 36.0D (1.0D steps) +10.5D to 29.5D (0.5D steps) DE 1 141 1327 3892 at 198807 300 0 0 No Change 2016-09-01 2019-03-01 Prosthesis DE493 Oculentis LENTIS L-313 Pre-loaded Pre-loaded foldable one-piece monofocal acrylic plate haptic IOL Optic Size 6.0mm, Overall Length 11.00mm. Available Diopters: +-10.0D to 35.0D (1.0D steps). +10.5D to 29.5 D (0.5D steps). DE 1 141 1327 3892 at, pl 198807 308 0 0 No Change 2016-09-01 2019-03-01 Prosthesis DY556 Expedium Spine System Polyaxial Screws 4.35 - 12mm diameter SY 19 165 1463 Cannulated 145290 1338 0 0 No Change 2011-08-01 2019-03-01 Prosthesis DY574 Summit Sl System Connectors Various SY 19 167 1473 92307 Changed Benefit 732 0 0 Update 2013-02-01 2019-03-01 Prosthesis DY575 Summit Sl System Connectors - wedding bands and axial Various SY 19 167 1472 92307 Changed Benefit 732 0 0 Update 2013-02-01 2019-03-01 Prosthesis DY576 Healix Anchor System Titanium anchor with suture 2.9 - 3.9mm SY 13 123 1774 5385 133430 Changed Benefit 442 0 0 Update 2013-08-01 2019-03-01 Prosthesis DY555 Expedium Spine System Contoured Scoliosis Rod 4.5 - 7.5 Diameter x - 320 - 455mm SY 19 170 1478 Shaped 97391 Changed Benefit 577 0 0 Update 2011-08-01 2019-03-01 Prosthesis DY577 Healix Anchor System Titanium anchor with suture 4.5 - 6.5mm SY 13 123 1774 5387 133430 Changed Benefit 442 0 0 Update 2013-08-01 2019-03-01 Prosthesis DY578 Expedium Spine System Rods 4.5 to 7.5 Diameter SY 19 170 1478 97391 Changed Benefit 426 0 0 Update 2014-08-01 2019-03-01 Prosthesis DZ001 Valens Shoulder and Elbow - Elbow Distal Humerus, Lateral, Medial, Olecranon, Locking Plates 1-6 Holes DZ 13 123 1694 5273 LK 276915 1330 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DZ002 Valens Shoulder and Elbow - Elbow Distal Humerus, Lateral, Medial, Olecranon, Locking Plates 7-15 Holes DZ 13 123 1694 5274 VAL 276915 Changed Benefit 1643 0 0 Update 2017-02-01 2019-03-01 Prosthesis DZ003 Valens Shoulder and Elbow - Elbow Locking Compression Plate Proximal Radius 1-6 Holes DZ 13 123 1694 5276 VAL 276915 1439 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER350 Ulrich Anterior Distraction Device System (ADDplus)-Telescopic cage Ulrich Anterior Distraction System (ADDplus) telescopic cage, integral end plate, cervical. dia 12 mm x collapsed height (13-40 mm) x expanded height (18-65 mm) x angle (0-18°) ER 19 176 1492 4137 ThoracoLumbar 279702 4139 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER351 Ulrich Anterior Distraction Device (ADDplus)-Screws, Osmium, cancellous Ulrich Anterior Distraction Device (ADDplus)-Screws, Osmium,cancellous dia (4-4.5mm) x length (12-26mm) ER 19 165 1464 279702 Changed Benefit 193 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER352 Ulrich Anterior Distraction Device (ADDplus)-Screws, Osmium, expansion Ulrich Anterior Distraction Device (ADDplus)-Screws, Osmium, expansion, include bolt. dia (4-5 mm) x length (12-18 mm) ER 19 165 1464 Expansion Screw / Expansion Head Screw 279702 289 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DE494 Oculentis LENTIS Mplus Toric LU-313MFT Patient specific one-piece multifocal-toric plate haptic acrylic IOL Overall Length 11.0mm and Optic Size 6.0 + 0.0D to +36.0D inclusive in 0.01D increments. Cyl +0.25 to +6.99D inclusive in 0.01D increments DE 1 141 1327 3893 at, t1 198807 Changed Benefit 986 0 0 Update 2016-09-01 2019-03-01 Prosthesis DE495 Oculentis LENTIS Mplus Toric LU-313MFT Pre-loaded Patient specific one-piece multifocal-toric plate haptic acrylic IOL Overall Length 11.0mm and Optic Size 6.0 + 0.0D to +36.0D inclusive in 0.01D increments. Cyl +0.25 to +6.99D inclusive in 0.01D increments DE 1 141 1327 3893 at, pl, t1 198807 Changed Benefit 1003 0 0 Update 2016-09-01 2019-03-01 Prosthesis DE496 Oculentis LENTIS Mplus LS-313 MF Foldable one-piece multifocal plate haptic acrylic IOL Overall Length 11.0mm and Optic Size 6.0mm. Available diopters +-10.0D to +36.0D (0.05D steps) DE 1 141 1327 3893 at 198807 677 0 0 No Change 2016-09-01 2019-03-01 Prosthesis DE497 Oculents LENTIS Mplus LS-313MF Preloaded Pre-loaded Foldable one-piece multifocal plate haptic acrylic IOL. Overall Length 11.0mm and Optic Size 6.0mm. Available diopters +-10.0D to +36.0D (0.05D steps) DE 1 141 1327 3893 at, pl 198807 Changed Benefit 694 0 0 Update 2016-09-01 2019-03-01 Prosthesis DE503 Dx Swivelock A knotless screw in anchor used for soft tissue fixation to bone 2.4 - 3.9mm DE 13 123 1774 5385 126657 Changed Product sizes, Benefit 442 0 0 Update 2017-02-01 2019-03-01 Prosthesis DE504 Double Compression Plate System Fixation plates for surgical compression across fusion sites. Double Compression Plate, 2 Hole, 20 mm Double Compression Plate, 2 Hole, 25 mm Double Compression Plate, 2 Hole, 30 mm Double Compression Plate, 3 Hole, 20 mm Double Compression Plate, 3 Hole, 25 mm Double Compression Plate, 3 Hole, 30 mm Double Compression Plate, 4 Hole, Straight, 20 mm Double Compression Plate, 4 Hole, Straight, 25 mm Double Compression Plate, 4 Hole, Straight, 30 mm Double Compression Plate, 4 Hole, Square, 20 mm Double Compression Plate, 4 Hole, Square, 25 mm Double Compression Plate, 4 Hole, Square, 30 mm DE 13 123 1694 5258 LK 140686 470 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DE505 MTP Plate, Straight , Long 1st MTP Arthrodesis Plate , Straight, Long - 8 Holes 8 Holes DE 13 123 1694 5259 VAL 140686 849 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DE506 Oculentis LENTIS Comfort Toric LS313MF15T0-T6 Pre-loaded foldable one piece multifocal toric plate haptic acrylic IOL Overall Length 11.0mm and Optic Size 6.0mm, SE: +10.0D to +30.0D (0.5D steps), Cyl: +0.75D to +5.25D (0.75D steps). DE 1 141 1327 3893 at, pl, t1 198807 Changed Benefit 1003 0 0 Update 2017-02-01 2019-03-01 Prosthesis DE507 Mini Tightrope CMC CMC fixation device One size only DE 13 123 1774 5389 151509 374 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DE508 MTP Plate 1st MTP Arthrodesis Plate ≤ 6 holes DE 13 123 1694 5258 LK 140686 470 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DE509 Mini Tightrope CMC Fixation Device One Size fits all DE 13 123 1774 5389 151509 374 0 0 No Change 2017-02-01 2019-03-01 Prosthesis DY467 PFC Sigma Knee System tibial baseplate Tibial baseplate, cemented, keeled, Titanium, standard and offset keels with capacity for augment and stem attachment Size 1-6 SY 17 151 1357 Revision 98092 3265 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY471 PFC Sigma Knee System femoral component Femoral component, cemented, CoCr Size 1-6 including narrow sizes SY 17 149 1348 3906 131657 97699 2951 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY478 Uniplate ACP System Rescue Screw 12-18mm SY 19 165 1464 128257 Changed Benefit 193 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY479 Uniplate ACP System Primary Screw 12-18mm SY 19 165 1464 128257 Changed Benefit 193 0 0 Update 2005-10-31 2019-03-01 Prosthesis DY481 PFC Sigma Knee System tibial insert Tibial insert, UHMWPE, standard and posterior lipped Sizes 1 - 6. 8-30mm SY 17 153 1369 137608 138289 97698 98088 1019 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY510 SROM Femoral Calcar Replacement Stem, long Titanium, fluted, distal polished femoral long stem & neck, bowed and straight with Calcar Replacement 9 -21mm diameter, greater than 200mm length SY 18 161 1412 3975 Stem, SCP 98085 Changed Benefit 4851 0 0 Update 2009-02-01 2019-03-01 Prosthesis DY502 LCS Complete Knee System patella component Metal backed, CoCr, rotating, uncemented Sizes small to large+ SY 17 156 1378 3928 108414 138093 97697 1210 0 0 No Change 2005-10-31 2019-03-01 Prosthesis DY511 SROM Femoral Stem Long Titanium, fluted, distal polished femoral long stem & neck, bowed and straight 9 -21mm diameter, greater than 200mm length SY 18 161 1412 3975 Stem, SCP 98085 Changed Benefit 4851 0 0 Update 2009-02-01 2019-03-01 Prosthesis DY512 Pinnacle Acetabular Cup System Pinnacle ceramic liner 44 - 66mm SY 18 163 1428 4025 98086 2303 0 0 No Change 2009-02-01 2019-03-01 Prosthesis DY514 Kar (Corail Revision) Femoral Stem Titanium, grit blast, full HA coating, fluted distally Size ≤13, (length less than 200mm) SY 18 161 1407 3949 143074 3779 0 0 No Change 2009-02-01 2019-03-01 Prosthesis DY515 Kar (Corail Revision) Femoral Stem Titanium, grit blast, full HA coating, fluted distally Sizes 14 - 20, (length 200mm & greater) SY 18 161 1409 3957 143074 173831 5053 0 0 No Change 2009-02-01 2019-03-01 Prosthesis LM324 Osteomed Screws Bone Screws 2- 2.7m x 6-38mm LM 13 123 1231 3371 LK 202319 147 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM325 Osteomed Screws Bone Screw standard and threaded/lag. 2.01-2.7mm x 4-50mm. LM 13 123 1231 3371 202319 84 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM326 Extremilock Screws Screws 2.7mm - 4.49mm x 8-70mm LM 13 123 1231 3370 149435 202319 82 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM327 Osteomed Screws Cannulated Compression Screws Diameter 2.0mm, 2.4mm and 2.7mm. Length 6mm to 52mm LM 13 123 1231 3371 CN,DT 202319 381 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM328 Total Ossicle Replacement a) TTP Tuebingen Type Aerial Type b) TTB-Vario Aerial c) TTP Variac System Total d) Malleus Notch Prosthesis e) Regensburg Type Total Prosthesis f) Malleus Replacement g) Duesseldorf Type Total h) Omega Connector a) Length - 3 to to 7mm b) one size only c) one size only d) Length - 3 to 7mm e) Length - 4 to 5mm f) one size only g) lengths - 3 to 7mm h) length - 0.5mm LM 22 196 1565 4157 119747 384 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM323 GEMINUS Hook Plate GEMINUS Hook Plate One size LM 13 123 1772 5369 278692 111 0 0 No Change 2017-02-01 2019-03-01 Prosthesis GO299 Global Acetabular Ceramic Insert Ceramic, Biolox Delta 44-72mm GO 18 163 1428 4022 218811 Changed Benefit 2250 0 0 Update 2018-02-01 2019-03-01 Prosthesis GO300 Global Acetabular Cancellous Screw Titanium 6.5mm cancellous bone screw 15mm to 50mm GO 18 164 1435 257913 121 0 0 No Change 2018-02-01 2019-03-01 Prosthesis GO301 Global Acetabular System HCLA (highly Cross-Linked and Annealed) Acetabular Liner Highly Cross-Linked and Annealed polyethylene Insert 44-72mm Cup OD 22-40mm Head ID Neutral and Lipped GO 18 163 1428 4021 218814 1019 0 0 No Change 2018-02-01 2019-03-01 Prosthesis GO302 Biolox Delta Ceramic Femoral Heads Biolox Delta Ceramic Femoral Heads 28mm 32mm Biolox Delta Femoral Head 28mm - -3.5mm to +3.5mm and Biolox Delta Femoral Head 32mm - 3.5mm to +7mm GO 18 162 1419 3992 218812 1845 0 0 No Change 2018-02-01 2019-03-01 Prosthesis GO303 Biolox Delta Ceramic Femoral Heads Biolox Delta Femoral Head 36mm Biolox Delta Femoral Head 36mm -4.0mm to +8.0mm, 40mm -4.0mm to +8.0mm GO 18 162 1420 3998 218812 2022 0 0 No Change 2018-02-01 2019-03-01 Prosthesis GO304 BioBall Femoral Head Femoral Head Vivium > 32mm 36mm to 58mm GO 18 162 1420 3994 266539 Changed Benefit 713 0 0 Update 2018-02-01 2019-03-01 Prosthesis GO305 BioBall Femoral Head Femoral Head Vivium < 32mm 28mm, 32mm GO 18 162 1419 3989 266538 703 0 0 No Change 2018-02-01 2019-03-01 Prosthesis LM329 Partial Ossicle Replacement a) TTP Tuebingen Type bell b) CliP Dresden Type c) Malleus d) Angular Plester e) Angular CliP f) TTP - Vario Bell TTP - Variac System, Partial g) CliP Partial FlexBAL h) Duesseldorf Type Partial a) length 1.75 to 3.5mm b) length 1.75 to 3.5mm c) length 1.75 to 3.5mm d) length 2.25 or 3.25mm e) length 2.25 or 3.25mm f) one size g) length 1.75 to 3.5mm h) length 1.75 to 4.5mm LM 22 196 1565 4156 119746 342 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM332 Stapes a) NiTiBOND b) Soft CliP c) K-Piston d) Angular Piston e) CliP Piston aWengen f) CliP Piston MVP g) Lenticle Cup a) Diameter - 0.4 or 0.6mm in lengths - 3.5 to 5.5mm b) Diameter - 0.4 or 0.6mm in lengths 3.5 to 5.5mm c) Diameter - 0.4 or 0.6mm in lengths 3.5 to 10mm d) Diameter 0.4 or 0.6mm in lengths 4.25, 4.5, 4.75mm e) Diameter - 0.4mm or 0.6mm in lengths 3.5 to 5.5mm f) Diameter 0.4 or 0.6mm in lengths - 5 to 6.25mm g) lengths - 3 to 4.5mm LM 22 196 1565 4154 119746 99 0 0 No Change 2017-02-01 2019-03-01 Prosthesis LM333 Internal joint articulating fixator Elbow Internal joint articulating fixator Elbow One size - adjustable LM 13 123 2945 7348 278692 Changed Product name, Product description, Product sizes, Benefit, Group, Subgroup, Suffix 2460 0 0 Update 2017-08-01 2019-03-01 Prosthesis LM334 Axis Pin Axis Pin 2.5mm x 30mm-70mm LM 13 123 1237 4510 278692 142 0 0 No Change 2017-08-01 2019-03-01 Prosthesis ER362 Amendia ISSYS LP Spinal Fixation System-Connector (axial) Amendia ISSYS LP Spinal Fixation System-Connector (axial) accommodates dia (5.5-6.35 mm) x length 35 mm ER 19 167 1472 281992 Changed Benefit 732 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER363 Amendia ISSYS LP Spinal Fixation System-Connector (offset) Amendia ISSYS LP Spinal Fixation System-Connector, offset (short, long, "S" rod compatible) accommodates dia (6; 6.35 mm) x length (20 mm; 35 mm) ER 19 167 1473 281992 Changed Benefit 732 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER364 Amendia ISSYS LP Spinal Fixation System-Connector (transverse; rod to rod) Amendia ISSYS LP Spinal Fixation System-Cross Connector (mono and polyaxial) 17-26 mm (mono) 6mm;6.35 x (45-85 mm) (poly) ER 19 167 1474 4123 281992 404 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER365 Amendia ISSYS LP Spinal Fixation System-Washer Amendia ISSYS LP Spinal Fixation System-Washer one size ER 19 172 1482 281992 226 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER366 Amendia ISSYS LP Spinal Fixation System-Staple Amendia ISSYS LP Spinal Fixation System-Staple (rostral or caudal) Small;medium;large ER 19 172 1483 281992 395 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER367 Amendia ISSYS LP Spinal Fixation System-Locking Screw Amendia ISSYS LP Spinal Fixation System-Locking Screw (Blocker) N/A ER 19 166 1465 281992 164 0 0 No Change 2017-02-01 2019-03-01 Prosthesis JJ569 Cougar Spine System Anterior/lateral Lumbar Interbody Fusion Cage, Carbon Fibre Reinforced Polymer (CFRP) Small - Large, 7 - 65mm SY 19 174 1486 4135 98094 3465 0 0 No Change 2006-11-30 2019-03-01 Prosthesis JJ573 Summit Cemented Femoral Stem CoCr, tapered, unpolished Sizes 0-10, with various offsets SY 18 161 1404 3939 98085 Changed Benefit 1625 0 0 Update 2007-06-01 2019-03-01 Prosthesis JJ582 SmartMix Bone Cement with Vacuum Mixing System 40 to 100g SY 13 123 1279 4089 141068 450 0 0 No Change 2007-06-01 2019-03-01 Prosthesis JJ583 SmartMix Antibiotic Bone Cement with Vacuum Mixing System 40 to 100g SY 13 123 1279 4090 150881 150882 150883 151144 450 0 0 No Change 2007-06-01 2019-03-01 Prosthesis JJ584 Femoral Prep Kit Femoral Preparation Kit One size only SY 18 164 1438 132111 139 0 0 No Change 2007-06-01 2019-03-01 Prosthesis JJ585 Ultrapro Hernia System Ultrapro Hernia System. Mesh Made From Composite of Monocryl & Prolene Small to Large Oval JJ 21 194 1783 5438 Contoured 132509 285 0 0 No Change 2007-06-01 2019-03-01 Prosthesis JJ588 Femoral Intrafix System Screw and Sheath Fixation System for the Femur in ACL repairs 7 to 10mm SY 13 123 1774 5391 133430 Changed Benefit 181 0 0 Update 2007-12-01 2019-03-01 Prosthesis ER368 Amendia Securis Screw System-Pedicle Screw Amendia Securis Screw System-Pedicle Screw (Polyaxial, cannulated) dia (5.5-8.5 mm) x length (30-80 mm) ER 19 165 1463 Cannulated 281992 1338 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER369 Amendia Securis Screw System-Rods Amendia Securis Screw System-Rods (CoCr, straight or pre-bent) dia 5.0 mm x length (35-240 mm) ER 19 170 1478 281992 Changed Benefit 426 0 0 Update 2017-02-01 2019-03-01 Prosthesis ER370 Amendia Securis Screw System-Set Screw Amendia Securis Screw System-Set Screw (Blocker) One size ER 19 166 1465 281992 164 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER371 Amendia Regent Anterior Cervical Plate System-Plate Amendia Regent Anterior Cervical Plate System-Plate 12-55 mm; thickness 1.95 mm ER 19 169 1477 4127 233539 1251 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER372 Amendia Regent Anterior Cervical Plate System-Plate (> 55 mm) Amendia Regent Anterior Cervical Plate System-Plate (> 55 mm) 58-84 mm, thickness 1.95 mm ER 19 169 1477 4127 >55mm 233359 1636 0 0 No Change 2017-02-01 2019-03-01 Prosthesis ER373 Amendia Regent Anterior Cervical Plate System-Screw Amendia Regent Anterior Cervical Plate System-Screw (self tapping; fixed or variable) dia (4-4.5 mm) x length (10-20 mm) ER 19 165 1464 233539 Changed Benefit 193 0 0 Update 2017-02-01 2019-03-01 Prosthesis JJ589 PFC Sigma Knee System tibial baseplate All poly UHMWPE, Cemented, pegged Sizes 1 - 6. 8-30mm SY 17 151 1356 97700 Changed Benefit 1118 0 0 Update 2007-12-01 2019-03-01 Prosthesis JJ590 PFC Sigma Knee System Tibial Baseplate All poly UHMWPE, cemented, non pegged Sizes 1 - 6. 8-30mm SY 17 151 1356 138289 Changed Benefit 1118 0 0 Update 2007-12-01 2019-03-01 Prosthesis JJ593 Mountaineer OCT Spinal System CT Minipolyaxial Screw - Favoured Angle and Medial/Lateral 3.5-4.35mm x 10 - 50mm SY 19 165 1463 128257 1280 0 0 No Change 2007-12-01 2019-03-01 Prosthesis JJ595 Mountaineer OCT Spinal System CT Hook 3.5mm - Small, Medium, Large SY 19 168 1475 97391 789 0 0 No Change 2007-12-01 2019-03-01 Prosthesis JJ596 Mountaineer Spinal System CT Dual Diameter Rod 3.5 - 6.35mm x 420 - 600mm SY 19 170 1478 Dual Diameter 97391 Changed Benefit 529 0 0 Update 2007-12-01 2019-03-01 Prosthesis JJ597 Mountaineer Spinal System CT Rod 3.5mm x 60 - 400mm SY 19 170 1478 97391 Changed Benefit 426 0 0 Update 2007-12-01 2019-03-01 Prosthesis JJ599 Mountaineer OCT Spinal System Transverse Connector Plate 21 - 56mm SY 19 167 1474 4123 145364 404 0 0 No Change 2007-12-01 2019-03-01 Prosthesis GO306 Osteobridge Modular diaphyseal endoprosthesis Arthrodese Nail 10/30mm x 110mm to 16/30mm x 150mm. Osteobridge nail 7mm to 16mm to 60mm to 200mm. Osteobridge spacer 40mm x 20mm to 30mm to 70mm Osteobridge diaphsis reducing bushing 8mm to 20mm Osteobridge spacer connector 25 to 30mm Osteobridge reducing sleeve 8mm to 30mm GO 13 123 1228 3331 131659 279141 4464 0 0 No Change 2018-02-01 2019-03-01 Prosthesis GO307 BioBall Delta Femoral Head, >32mm Femoral Head Biolox Delta Ceramic, >32mm 36mm, 40mm, 44mm, 48mm GO 18 162 1420 3998 276307 2022 0 0 No Change 2018-02-01 2019-03-01 Prosthesis GO308 BioBall Delta Femoral Head, 32mm or less Femoral Head Biolox Delta Ceramic, 28mm and 32mm 28mm, 32mm GO 18 162 1419 3992 276307 1845 0 0 No Change 2018-02-01 2019-03-01 Prosthesis GO309 Global Acetabular System Apical Plugs Titanium Apical Dome Hole plug One size only GO 18 164 1446 300153 141 0 0 No Change 2018-08-01 2019-03-01 Prosthesis GO310 GO296 Global Femoral Heads CoCr Femoral Heads 32mm or less 22.2mm, 28mm, 32mm GO 18 162 1419 3989 305165 703 0 0 No Change 2018-08-01 2019-03-01 Prosthesis LC030 Revision Modular Femoral Stem Revision Modular Femoral Stem Ti6A4I 14-26mm Diameter x 140mm Length LC 18 161 1410 3961 Stem 210670 2742 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC032 Modular Head Modular Head CoCrMo 28-32mm Diameter Small to XXXLarge LC 18 162 1419 3989 210718 703 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC036 SMR Shoulder - Modular Augment Modular Augment Ti6AI4V 20 - 50mm LC 13 131 1278 4081 225458 950 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC037 SMR Adaptor Adaptor Eccentric / Neutral / CTA Standard & long 0 to +8mm LC 13 131 1278 4084 221473 221712 1159 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC038 SMR Shoulder System Metal Back Glenoid Small, Small R, Standard, Large LC 13 131 1277 3702 218703 2109 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC042 SMR Shoulder System Short and Revision Cemented Stem Dia 12-20mm x length 80-210mm LC 13 131 1276 4063 218715 218783 3800 0 0 No Change 2009-08-01 2019-03-01 Prosthesis LC044 SMR Large Resection Stem Resection Stem Large Ti6AI4V 7-10mm Dia x 50-80 Height LC 13 131 1276 4057 211984 Changed Benefit 3771 0 0 Update 2009-08-01 2019-03-01 Prosthesis LC062 HVS BONE SCREW Self drilling, self threading double threaded cannulated screw Length 10-34mm LC 13 123 1231 3371 CN,DT 173930 381 0 0 No Change 2011-08-01 2019-03-01 Prosthesis GO277 ELIZ Bonr graft Substitute Synthetic HA /TCP Bone Graft Substitute Granules (1.0 - 4.0mm) (0.8 - 1.5mm) (0.5 - 1.0mm) Volume / Vial 10.0cc GO 13 123 1241 4093 204043 1140 0 0 No Change 2015-02-01 2019-03-01 Prosthesis GO282 Novae STICK Dual Mobility Cup A cemented metal acetabular dual mobility cup designed to be used with a polyethylene liner 43-69mm diameter in 2mm increments GO 18 163 1425 4009 298114 Changed Benefit 1582 0 0 Update 2015-08-01 2019-03-01 Prosthesis GO283 Apex Revision Knee Stems Apex Revision Knee Femoral and Tibial Stems Modular Stem - 9-25mm x 75-150mm Offset - 9-25mm x 75-15mm x 2-4mm Angled Stem - 9-25mm x 75x150mm Modular Tibial Keels 1-16 GO 17 159 1399 276775 Changed Benefit 1126 0 0 Update 2015-08-01 2019-03-01 Prosthesis GO284 Apex Revision Knee Modular Tibia Cup Modular Tibia Cup Only One size GO 17 159 1395 276775 649 0 0 No Change 2015-08-01 2019-03-01 Prosthesis GO285 Paragon Hip Stem PCHA Paragon Femoral Stem, Porous and HA coated 1-12, STD, High Offset, Coxa Vara, Collared GO 18 161 1407 3952 296134 296139 4394 0 0 No Change 2016-02-01 2019-03-01 Prosthesis GO286 Apex PS Cemented Revision Femoral Component The femoral component of a total knee revision system that incorporates a proportionally sized box. Sizes 1-6, plus Sizes 1+ to 5+ Left and Right GO 17 149 1348 3907 Revision 196653 5501 0 0 No Change 2016-08-01 2019-03-01 Prosthesis GO287 Apex PS Cemented Femoral Component The femoral component of a total knee system that incorporates a proportionally sized box. Sizes 1-6, plus Sizes 1+ to 6+ Left and Right GO 17 149 1348 3907 278616 3041 0 0 No Change 2016-08-01 2019-03-01 Prosthesis GO288 NanoBone - Granules Nanocrystalline HA in a porous silica matrix, synthetic bone graft substitute granules 0.6ml, 1.2ml, 2.4ml, 5ml GO 13 123 1241 4092 AUG 281303 1026 0 0 No Change 2017-02-01 2019-03-01 Prosthesis GO289 NanoBone - Granules Nanocrystalline HA in a porous silica matrix, synthetic bone graft substitute block 0. 75ml (5x10x15 mm3) GO 13 123 1241 4092 AUG 281303 1026 0 0 No Change 2017-02-01 2019-03-01 Prosthesis GO290 NanoBone - Putty Nanocrystalline HA in a porous silica matrix, synthetic bone graft substitute putty 0.5ml, 1.0ml, 2.5ml, 5ml GO 13 123 1241 4092 AUG 292263 1026 0 0 No Change 2017-08-01 2019-03-01 Prosthesis GO291 NanoBone - Putty Nanocrystalline HA in a porous silica matrix, synthetic bone graft substitute putty 10ml GO 13 123 1241 4093 AUG 292263 2185 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW615 METS Tibial Shaft Titanium shaft 45-115mm HW 17 157 1382 246516 3944 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW616 METS Proximal Tibia Rotating Hinge Titanium with UHMWPE bearing Small and standard HW 17 157 1381 3933 278017 7186 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW617 METS Tibial Component Rotating Hinge CoCr-Molybdenum with UHMWPE bumper pad Small and standard HW 17 157 1381 3932 278019 Changed Benefit 7247 0 0 Update 2017-08-01 2019-03-01 Prosthesis HW618 METS Femoral Plateau Plate Titanium Small & Standard, 4 thicknesses HW 17 157 1385 246518 1912 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW619 METS Humeral Component for use with Hemi Head Titanium humeral component Small and standard HW 13 123 1778 5459 276014 6690 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW620 METS Humeral Head Fixation Screw Titanium screw which fixes the humeral component and the humeral head together Small and standard HW 13 123 1778 5460 246503 Changed Benefit 537 0 0 Update 2017-08-01 2019-03-01 Prosthesis HW621 METS Humeral Component with Liner and re-attachment Titanium component with HA coated rails for tissue reattachment, HYMWPE liner with encased metal ring for use with contrained glenoid Mono-size, left and right HW 13 123 1778 5461 277425 Changed Benefit 8541 0 0 Update 2017-08-01 2019-03-01 Prosthesis HW622 METS Humeral Collar Round Coated Titanium colar with HAP coated stipples 20mm, 22mm, 24mm HW 13 123 1778 5462 246505 3916 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW623 METS Humeal Stem Straight titanium stems, 7-11mm diameters Diameters 7-11mm, Lengths 70-90mm HW 13 123 1778 5463 276068 2587 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW624 METS Humeral Shaft Titanium shafts in 15mm increments, reconstructs the humeral shaft where there is diseased or deficient bone Lengths 38-143mm HW 13 123 1778 5464 246504 3081 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW625 METS Humeral Integral Shaft & Stem Coated Titanium, combined shaft, stem & collar with HA coated stipples 20mm shaft plateau with 8mm diameter stem, 24mm shaft plateau with 10mm diameter stem 7945 HW 13 123 1778 5465 276913 7548 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW626 METS Humeral Component with Liner Titanium component, UHMWPE liner with encased metal ring for use with constrained glenoid Mono-size, left and right HW 13 123 1778 5467 277395 6729 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LM335 Nerve Capping Device A peripheral bioresorbable nerve capping device 30mm LM 21 192 1564 285368 1425 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LM336 Osteo-x External Mini Fixator The Osteo-x® external fixator is a device used for the fixation and distraction of small bones, primarily in the hand. It incorporates four K-wires which are driven into the bone and placed to provide three-dimensional stability. One Size Only LM 13 123 1237 3401 Small, CDD 278692 2755 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LM337 Trimed Plates Elbow, Forearm, clavicle and Wrist Plates ≥ 7 to ≤ 15 holes LM 13 123 1694 5259 Com, LK 182677 Changed Benefit 916 0 0 Update 2017-08-01 2019-03-01 Prosthesis LM338 Stapes Stapes Prosthesis Ø 0.4mm, Ø 0.5mm & Ø 0.6mm Lengths 3.50mm - 5.50mm LM 22 196 1565 4156 119746 342 0 0 No Change 2017-08-01 2019-03-01 Prosthesis LM339 Orthopaedic Fixation Plate Orthopaedic Fixation Plates 2 - 8 holes and/or Small, Medium, Large LM 13 123 1694 5298 VAL 266216 1007 0 0 No Change 2018-02-01 2019-03-01 Prosthesis HW627 METS Humeral Component with Reattachment for use with Hemi Head Titanium humeral component with HA coated rails for tissue reattachment Small and standard HW 13 123 1778 5468 276015 8875 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW628 METS Bayley Walker Glenoid Component Titanium HAP coated tapered screw with 22.2mm CoCr-Molybdenum head, for Glenoid fixation Extra small, small and standard HW 13 123 1778 5469 276250 7111 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW629 METS Tibial Rotating Hinge Polyethylene UHMWPE tibial bearing component N/A HW 17 157 1384 278136 2058 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW630 METS Proximal Tibia Rotating Hinge Coated Titanium with UHMWPE bearing and HA coated patella tendon reattachment mechanism Small and Std HW 17 157 1381 3933 278018 7186 0 0 No Change 2017-08-01 2019-03-01 Prosthesis HW631 Xia Serrato Polyaxial Screw Polyaxial Screw, Reduction Polyaxial Screw, Medial Biased Angle Screw Dia 4mm-10.5mm, Length 20mm-130mm HW 19 165 1463 279159 1280 0 0 No Change 2018-02-01 2019-03-01 Prosthesis HW632 Xia Serrato Cannulated Polyaxial Screw Cannulated Polyaxial Screw Dia 4.5mm-7.5mm; Length 20mm-60mm HW 19 165 1463 Cannulated 279159 1338 0 0 No Change 2018-02-01 2019-03-01 Prosthesis HW633 Hoffmann LRF System Hexapod Strut XS, S, M, L HW 13 123 1237 4505 3D 197935 1235 0