Is Skin Removal Surgery Covered by Medicare? Body Lift Eligibility, Item Numbers and Costs in Australia

Dr Chaithan Reddy, Specialist Plastic Surgeon, FRACS (Plast), AHPRA MED0001617343 | Last updated 1 November 2026

If you’ve lost a lot of weight and loose skin is now causing medical problems, Medicare may pay part of the cost of removing it. The rules are strict, and surgery done only to change how you look isn’t covered. Even with a rebate, most people are still left with some out-of-pocket costs, so get a written quote before you book.

Cost is one of the first things people ask about once they decide to look into skin removal. It’s also one of the most confusing. Medicare, private health insurance and surgical fees all interact, and the rules are not always explained clearly.

This article sets out the actual Medicare criteria in plain English, explains how private health cover works and lists what goes into the cost of body lift surgery in Sydney. The aim is to help you understand where you stand before your consultation.

Does Medicare cover skin removal surgery after weight loss?

Sometimes. Medicare can help with skin removal surgery when excess skin after significant weight loss is causing a medical problem. It does not cover surgery performed for cosmetic reasons.

The difference comes down to function. If loose skin causes recurring rashes, skin breakdown or difficulty with everyday activities, surgery to remove it may be considered medically necessary. If the main goal is a better shape or contour, it is classed as cosmetic. The Medicare Benefits Schedule (MBS) also states that these procedures are not a treatment for obesity itself.

The MBS criteria in plain English

To qualify for a Medicare rebate, your situation needs to match the description of a specific MBS item. The main criteria for skin removal after weight loss are:

1. Significant weight loss. For these items, Medicare defines this as weight loss equal to at least 5 BMI (body mass index) points. For someone 170 cm tall, that is roughly 14.5 kg.
2. A stable weight. Your weight must have been stable for at least six months after the weight loss, before surgery.
3. A skin condition that hasn’t responded to treatment. For the tummy tuck and belt lipectomy items, there must be intertrigo (inflammation in moist skin folds) or another skin condition that puts the skin at risk. It must have failed at least three months of non-surgical treatment.
4. An impact on daily life. For those same items, the excess skin and fat must interfere with your activities of daily living, such as walking, exercising, dressing or keeping skin clean.

The exact requirements differ between items, so not every criterion applies to every operation. Dr Reddy will assess which item, if any, fits your situation. He will base this on your examination, history and medical records.

Which MBS item numbers relate to body lift surgery?

Four MBS items relate to skin removal after significant weight loss. The table below summarises each one, based on the descriptions on MBS Online at the time of writing.

MBS descriptions and fees are reviewed regularly. You can check the current wording of any item on MBS Online. There are also separate items for abdominal wall problems after pregnancy, which are not covered in this article.

What Medicare doesn’t cover

Medicare doesn’t cover cosmetic surgery, and it rarely covers the full cost of surgery even when an item applies. Things that are generally not covered include:

• Skin removal or contouring done for appearance only.
• Liposuction performed purely to improve shape.
• Surgery where the MBS criteria are not met, such as when weight has not been stable for six months.
• The difference between the MBS fee and what your surgeon, anaesthetist and assistant charge.
• Private hospital and theatre fees, which are paid by your health fund (if covered) or by you.
• Compression garments and other items you may need during recovery.

When more than one MBS item is used in the same operation, the Multiple Operation Rule also applies. Under this rule, the Medicare benefit for each additional item is reduced.

Private health insurance and body lift surgery

If your surgery has an MBS item number and your policy includes the right category, your health fund may help pay hospital and theatre costs. Funds won’t put anything towards purely cosmetic surgery, though.

There is an important detail that many people miss. On the Australian Government’s private health website, the skin removal items above are listed under the “Weight loss surgery” clinical category, not “Plastic and reconstructive surgery”. Weight loss surgery is a minimum requirement only for Gold hospital cover, although some insurers include it in lower tiers.

Other things to know:

• Waiting periods. The maximum waiting period for a pre-existing condition is 12 months. Your insurer decides whether your condition counts as pre-existing.
• How fees are split. For in-hospital treatment as a private patient, Medicare pays 75% of the MBS fee. Your insurer usually pays the remaining 25%, if your policy covers that item.
• Gaps and excesses. Any amount charged above the MBS fee is a gap, unless covered by a gap scheme. Your policy may also have an excess for the hospital admission.

The simplest way to find out where you stand is to call your fund with the item numbers from your quote. Ask whether they are covered, whether waiting periods apply and what you are likely to pay.

If you don’t have private cover, some public hospitals offer skin removal after weight loss to people who meet their clinical criteria. Places are scarce and the wait can be long. Your GP will know what’s available in your area.

What affects the cost of a body lift in Sydney?

The cost of a body lift in Sydney depends on how extensive the surgery is and how long it takes. Because every plan is different, a fixed price is not possible before you have been assessed.

Your total cost is made up of several parts:

• the surgeon’s fee
• the anaesthetist’s fee
• the surgical assistant’s fee, where needed
• hospital accommodation and theatre fees
• compression garments

The factors that change the total most are:

• The type of body lift. A lower body lift, an upper body lift and a staged full body lift are very different in scale.
• Combined procedures. Adding an arm lift, thigh lift or breast surgery increases operating time and cost.
• Operating time and hospital stay. Body lift patients usually stay in hospital for several days, which adds to hospital fees.
• Whether surgery is staged. Two or more separate operations each carry their own hospital and anaesthetic fees.

After your consultation, you will receive a written quote that lists each fee and the relevant item numbers. Take the time to review it, ask questions and check it with your fund before you decide.

How to check whether you might qualify

You can start preparing well before your consultation. These steps make the assessment clearer and help avoid surprises later:

1. Get a GP referral. You need a referral to see a specialist plastic surgeon. A valid referral is also needed to claim a Medicare rebate for the consultation. See our GP referral page for details.
2. Gather your weight history. Records from your GP, bariatric team or weight management program help show how much you lost and how long it has been stable.
3. Document skin problems and treatments. Ask your GP to note any rashes, infections or skin breakdown, and the creams or medicines tried. Dated photos can also help.
4. Attend your consultation. Dr Reddy will examine you, review your records and discuss which procedures, if any, meet MBS criteria.
5. Review your written quote. It should list each fee, the item numbers that may apply and any parts considered cosmetic.
6. Call your health fund. Give them the item numbers and ask about cover, waiting periods, excess and gap arrangements.

Is it worth paying for the cosmetic parts?

That is a personal decision, and there is no right answer. Some people only want the functional problem fixed. Others decide to pay for extra contouring at the same time, such as treating areas that don’t meet Medicare criteria.

It helps to think about what is bothering you most. If rashes and hygiene are the main issue, a Medicare-eligible procedure may be enough. If shape and clothing fit matter too, it may be worth discussing a broader plan, keeping in mind that each extra procedure adds cost, time in surgery and recovery.

If your plan includes both, your quote should show clearly which parts relate to Medicare items and which are cosmetic. Dr Reddy can talk you through the options so you can make an informed choice without pressure. Our body contouring and skin removal surgery page explains how different procedures can be combined.

Risks to consider

Whether or not Medicare contributes, a body lift is major surgery with real risks. These include scarring, bleeding, infection, seroma (fluid under the skin), wound healing problems and blood clots. Some patients need further surgery. Please read our surgery risks and complications page and discuss your own risks with Dr Reddy.

Why choose Dr Reddy for body lift surgery in Sydney, North Shore and Central Coast

Skin removal after weight loss sits right where cosmetic and reconstructive surgery meet. Some concerns are functional, some are cosmetic, and many patients have both. Understanding the difference matters for your treatment plan and for your costs.

Dr Chaithan Reddy is a Specialist Plastic Surgeon trained in both cosmetic surgery and plastic and reconstructive surgery. That training means he can assess the functional and cosmetic sides of your concerns, and explain clearly which parts of a plan may meet Medicare criteria.

Dr Reddy is a Fellow of the Royal Australasian College of Surgeons (FRACS). He takes time to explain your options, recovery, risks and costs, so your decision is a well-informed one.

Credentials

• Specialist Plastic Surgeon, AHPRA registration MED0001617343
• MBBS (Hons), BDS (Hons), MS, FRACS (Plast)
• Fellow of the Royal Australasian College of Surgeons
• Trained in cosmetic and plastic and reconstructive surgery

Professional listings

• Australian Society of Plastic Surgeons (ASPS)
• Australasian Society of Aesthetic Plastic Surgeons (ASAPS)
• Australian and New Zealand Board for Plastic and Cosmetic Surgery (ANZBPCS)
• Westmead Private Hospital

Consulting locations

• St Leonards (North Shore Practice): Fl 4/205 Pacific Hwy, St Leonards NSW 2065
• Bella Vista (Norwest Practice): Norwest Private Hospital, Bella Vista NSW 2153
• Westmead (Westmead Practice): Westmead Specialist Centre, 16-18 Mons Rd, Westmead NSW 2145
• North Gosford (Central Coast Practice): 12 Jarrett St, North Gosford NSW 2250

Learn more about Dr Chaithan Reddy, or view our before and after gallery. Every patient is different and individual results vary.

Book a consultation with Dr Reddy by calling 1300 073 339, (02) 8459 7111 or (02) 8459 7112, or email info@theplasticsurgeryclinic.com.au. A GP referral is required for a specialist consultation. You can find out more on our GP referral page.

Every patient is unique and results may vary. All surgery carries risks; please read our surgery risks page and discuss them with Dr Reddy during your consultation.

Further reading

• Body Lift
• Body Contouring and Skin Removal Surgery
• Tummy Tuck Surgery (Abdominoplasty)
• Body Lift Procedure and Recovery

Medical references

• Australian Government Department of Health, Disability and Ageing. MBS Online: Item 30179.
• Australian Government, privatehealth.gov.au. Weight loss surgery: MBS items.
• Australian Government, privatehealth.gov.au. Clinical categories.
• Australian Government, privatehealth.gov.au. Waiting periods.
• Australian Government, privatehealth.gov.au. Out of pocket costs.
• Healthdirect Australia. Guide to cosmetic surgery.