Medicare and Procedure Cover

Many people want to know if Medicare will cover plastic surgery.

Medicare will cover what is deemed essential reconstructive surgery and procedures that have associated Medicare item numbers listed in the Medicare Benefits Schedule (MBS).

Your surgeon will be able to help you understand if your procedure is covered by Medicare, however if you wish to look up a particular type of surgery and their item numbers, refer to the Medicare Benefits Schedule.

Updates and developments in Medicare cover:

ASPS successfully campaigned for the reinstatement of a Medicare item number for reconstructive abdominoplasty addressing post‑pregnancy muscle separation (rectus diastasis).

The Australian Government allocated funding in the 2022‑23 Budget and the item number 30175 came into effect on 1 July 2022.

To qualify under Medicare Item 30175, the following must apply:

  • The abdominal wall defect (rectus diastasis) must be as a consequence of pregnancy.
  • The patient must be at least 12 months post‑partum.
  • The gap between the separated abdominal muscles must be at least 3 cm, measured via diagnostic imaging.
  • Documented symptoms of pain or discomfort at the site of diastasis, and/or low back pain or urinary symptoms likely due to rectus diastasis.
  • The patient must have failed to respond to non‑surgical conservative treatment, such as physiotherapy, lifestyle changes, pain management or braces/exercise.
  • The item is applicable once per lifetime.

What this means for patients?

If you meet the criteria, this procedure is eligible for a Medicare rebate under item 30175.

If you do not meet the eligibility criteria, you may still have the surgery, but it will be classified as cosmetic and must be self‑funded.

Medicare cover means you are accessing a procedure recognised as reconstructive, not purely cosmetic.

To learn more about the procedure, visit Patient Information – Abdominoplasty

Currently there is an MSAC application in progress relating to gender affirming surgeries; titled Access to Surgical Procedures for Gender Affirming Surgeries

This document was last updated in December 2025

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