A breast reduction is not one fee. It is five: the surgeon, the anaesthetist, the surgical assis tant, the hospital, and your garments and aftercare. Medicare rebates part of the first two when item 45523 applies, and your health fund covers part of the hospital. What is left is your out-of-pocket cost.
Dr Kumar does not publish a package price, because the five parts move independently and a single figure would be wrong for most people. What you get instead is an itemised quote at your consultation, after the hospital has checked your fund.
The five parts
| Part | Who bills it | What offsets it |
|---|---|---|
| Surgeon’s fee | Dr Kumar | under item 45523, if criteria are met |
| Anaesthetist’s fee | The anaesthetist directly | A separate, smaller Medicare rebate |
| Surgical assistant | The assistant directly | A Medicare rebate where an assistant is required |
| Hospital and theatre | Westmead Private Hospital | Private health cover, if you hold the right category |
| Garments, dressings, aftercare | Included in Dr Kumar’s nursing fee | Not rebatable |
What moves the number
- Whether item 45523 applies. Macromastia with neck or shoulder pain, and no implant. Without it there is no Medicare benefit on the surgeon’s fee at all.
- Your health fund and your waiting periods. Cover for this category, fully served, is the single biggest factor in the hospital cost.
- How long the operation takes. Anaesthetic time is billed in units.
- Whether anything is done at the same time. Combining procedures often reduces the total against doing them separately, because you pay for one anaesthetic and one hospital stay.
- Whether an assistant is required.
What you will actually receive
Your quote is itemised. It lists each of the five parts, the Medicare benefit against each where one applies, and your fund’s contribution where the hospital has confirmed it. Nothing is bundled into a single figure, so you can see exactly what you are paying and to whom. More about costs and payment.
The consultation itself is $400, with a Medicare rebate of approximately $88.
Paying for it
Dr Kumar’s practice offers an in-house instalment plan — no finance company is involved. The deposit is paid when surgery is booked, which can only happen after the seven-day cooling-off period has ended, and the balance is due one month before the operation.
On superannuation: early release is decided by the ATO. Dr Kumar’s team can discuss whether a procedure may genuinely meet the requirements, but it is ultimately a decision between you, your financial planner and the ATO.
Common questions
Is it cheaper in the public system? Breast reduction is performed publicly for symptomatic macromastia, through a public outpatient referral, at no cost to you. Waiting times vary by area and are often measured in years.
Can I claim the gap on my health fund? No. Health funds contribute to hospital costs, not to the gap on medical fees. Some funds participate in gap schemes that reduce, but rarely remove, that gap.
Why can’t you tell me a price on the phone? Because the two figures that matter most — whether the Medicare item applies to you, and what your fund covers — can only be established after an examination and a fund check.
Is a cheaper quote elsewhere comparable? Ask what it includes. A quote that omits the assistant, the garments or the twelve months of follow-up is not the same quote.
Next step
Bring a GP referral to a consultation and you will leave with an itemised quote once your fund has been checked. Call 1300 267 726 or request a call from Dr Kumar’s nursing team.
All surgery carries risks, and individual results will vary. Read more about the risks of surgery here. A GP referral is required to see Dr Kumar.
Dr Rohit Kumar (MED0001630444) Registered medical practitioner, specialist plastic surgeon (specialist registration in surgery – plastic surgery).
