Schedule 5 - Appendix A - Surgically Implanted Prostheses

CARDIO-THORACIC
Billing Code Product Further Size Notations
MC020 Gem II VR Model 7229Cx Implantable Titanium 39cc, 49cc, 40cc
Cardioverter Defibrillator; Medtronic
Gem Model 7227Cx; Gem Model
7227 Implantable Cardioverter
MC022 Medtronic Micro Jewel II Model Titanium 54cc
MC023 Medtronic Micro Jewel Model 7221Cx Titanium 72cc
ICD
MC024 Medtronic Micro Jewel Model 7221D Titanium 72cc
MC201 Medtronic A/Asia Gem III VR Model Titanium One size only, 39.2cc
7231CX
MC202 Medtronic Gem III DR Model 7275 Titanium One size only, 39.5cc
Implantable Cardioverter Defibrillator
MC227 Medtronic Gem III AT Model 7276 Titanium 39.5cc
Implantable Cardioverter Defibrillator
MC237 Gem Model 7227B Titanium, "B" Style Connector 56cc
MC238 Gem Model 7227D Titanium, "D" style connector 53cc
MC239 Gem Model 7227E Titanium, "E" style connector 55cc
MC245 Marquis DR Model 7274 Titanium 36cc
Leads, Implantable Defibrillator
MC002 Medtronic Sprint Quattro Lead Model Silicone and polyurethane 65-100cm
6944RV/SVC 65cm; Model
6944RV/SVC 75cm; or Model
6944RV/SVC 100cm; Medtronic
Sprint Quattro Lead Model
MC026 Medtronic Transvene SVC Lead Model Model 6937-35, Model 6937-52, 35 - 110cm x 660mm
6937; Model 6939 Transvene Model 6937-58, Model 6937-110;
Unipolar Subcutaneous Patch Lead Silicone; Model 6939-50; Silicone
MC027 Model 6721 Unipolar Epicardial Model 6721S-50, Model 6721M-50, 370, 660, 840mm
Patch Leads S/M/L Model 6721L-50; Silicone
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