Cosmetic Surgery Tips

Tummy Tuck Covered by Medicare

Tummy tuck is a surgical procedure that is used to remove excess fat and skin from the abdominal area. It is performed to improve the appearance of your abdomen and to flatten your stomach.

In Australia, you can get a tummy tuck on Medicare if you have enough health insurance. However, there are some restrictions when it comes to getting this procedure covered by Medicare. In this guide, we discuss the aspects of Tummy tuck covered by Medicare, medicare cover tummy tuck after c section, tummy tuck private health insurance, and What age is best to get a tummy tuck?

You must be at least 65 years old before you can get this service covered by the government-run health care program in Australia. You also need to have lived in Australia for at least 10 years before applying for Medicare benefits.

If you want a tummy tuck in Australia, you should make sure that you meet all of these requirements first before scheduling an appointment with your doctor or surgeon who specializes in this type of surgery.

If you are considering getting a tummy tuck in Australia, you may be wondering if it is covered by Medicare. The answer is yes!

Does Medicare Cover Tummy Tucks

In Australia, the surgical procedure for a tummy tuck (also known as an abdominoplasty) is covered by Medicare. The national health insurance program does not cover liposuction or breast augmentation procedures, though it does cover breast reconstruction after mastectomy.

The cost of a tummy tuck depends on where you get it done. The average cost of a tummy tuck ranges from $6,000 to $12,000 in Australia; however, some surgeons charge as much as $15,000 or more.

Medicare coverage for a tummy tuck in Australia

If you’re wondering whether or not a tummy tuck is covered by your Medicare plan in Australia, the answer is yes! Medicare is a government-funded health insurance program that covers Australians aged over 65 years and people with disability. It also covers some people who are under 65 years but have a permanent disability.

The procedure is only partially funded by Medicare, so it’s important to do some research before you go ahead with it. The amount of money you pay will depend on how much work needs to be done on your body after the surgery. The cost of having this procedure done by an experienced surgeon can range from $5,000 to $10,000. So if you have a high level of pain or discomfort in your stomach area and want to get rid of it once and for all, contact us today!

Medicare is a national program that provides health insurance to people ages 65 and older, as well as younger people with disabilities. It also covers people who have certain medical conditions.

If you are eligible for Medicare, your healthcare costs may be covered by Medicare. This includes the cost of a tummy tuck in Australia.

Tummy tucks are often considered cosmetic procedures, but they can also be used to correct medical issues relating to the abdominal area. For example, if you had a cesarean section and have excess skin or other complications from that surgery, a tummy tuck can help improve your appearance and health by removing excess skin and tightening muscles around your abdomen.

Medicare does not cover all cosmetic surgeries, but it does cover some elective procedures that are medically necessary to improve one’s quality of life or health status. A tummy tuck could fall into this category because it can help treat conditions such as diastasis recti (a condition where the muscles separating the left and right halves of the abdomen tear) or incontinence due to overstretching during pregnancy or obesity-related weight gain.

A tummy tuck, also known as an abdominoplasty, is a cosmetic procedure that reduces excess skin and fat from the abdomen and helps improve the appearance of loose or sagging skin. Medicare does not cover this procedure in Australia.

To get a tummy tuck in Australia, you will need to pay for it out-of-pocket. The average cost of a tummy tuck is $8,500 USD (Australian dollars).

Yes, you can get a tummy tuck on Medicare in Australia if you meet the eligibility requirements. A tummy tuck is cosmetic surgery that removes excess skin and fat from the abdomen and creates a flatter, more toned appearance.

How much is a tummy tuck in Australia?

The average cost of a tummy tuck in Australia is $10,000-$15,000 USD.

Can you get a tummy tuck on Medicare in Australia?

The answer is yes, but only if you meet certain criteria. The first thing to know is that Medicare will only cover cosmetic surgery procedures if you have a medical condition that makes it difficult for you to exercise or perform daily activities.

This means that if you’re simply looking for a tummy tuck because you want to improve your body image, Medicare won’t cover it. However, if you have an underlying medical condition (such as obesity) that makes it difficult for you to maintain good health and physical fitness, then Medicare may cover the cost of a tummy tuck or liposuction.

How much is a tummy tuck in Australia?

The cost of a tummy tuck in Australia depends on several factors: where you live and where the procedure is performed; whether or not there are complications during surgery; and whether or not any additional surgeries are required after the initial procedure. In general, expect to pay between $5,000 and $10,000 for this type of procedure at an accredited facility—more if there are complications or additional surgeries required afterward!

Medicare will cover a tummy tuck in Australia, but only if you have the surgery done on your neck or back (which is why we do it).

If you’re interested in getting a tummy tuck, get in touch with us and we’ll let you know if it’s covered by Medicare or not.

We can also help you figure out what the cost of surgery will be and answer any other questions you have about tummy tucks!

Medicare covers a tummy tuck in Australia.

In order to get a tummy tuck on Medicare, you must have been diagnosed with diastasis recti, which is the separation of the abdominal muscles. A surgeon will then perform an incision at the pubic hairline and remove excess skin, fat, and tissue from the abdominal area, as well as tighten your abdominal muscles. The cost of a tummy tuck on Medicare can vary depending on where you live, but it’s typically around $8,000 USD.

A tummy tuck is a procedure that removes excess skin and fat from the abdomen and improves the contour of the abdominal muscles. The surgery removes loose skin, reduces the size of the abdominal muscles, and tightens the abdominal wall to give you a flatter, smoother stomach.

Tummy tuck costs vary based on where you live, the type of tummy tuck you have, and whether or not you get additional procedures done at the same time. You can expect to pay up to $8,000 for a tummy tuck performed by an experienced surgeon in Australia.

Medicare Cover Tummy Tuck After C-Section

URGENT UPDATE – Australian Government has reinstated a Medicare Item Number for a Tummy Tuck for some post-pregnancy patients with Diastasis Recti (Split Tummy Muscles) if you are eligible and meet the new criteria. This new Medicare item number -30175 started 1st July 2022. Read the MBS Item Number 30175 factsheet

PLEASE NOTE – Dr Turner does not offer FREE Tummy Tuck surgery. Medicare and/or your Private Health Insurer may offer a PARTIAL SUBSIDY for a procedure to be done in a private plastic surgery practice like Dr Turner’s. There will still be a SIGNIFICANT GAP PAYMENT for your surgery that you have to pay for. FREE plastic surgery MAY be available in some public hospitals for some procedures but there is a significant waiting period – sometimes many years spent waiting for elective surgery. If you want your surgery sooner than that and can’t afford it – please consider other funding options.

PLEASE NOTE – Dr Turner does not offer FREE Tummy Tuck surgery. Medicare and/or your Private Health Insurer may offer a PARTIAL SUBSIDY for a procedure to be done in a private plastic surgery practice like Dr Turner’s. There will still be a SIGNIFICANT GAP PAYMENT for your surgery that you have to pay for.

FREE plastic surgery MAY be available in some public hospitals for some procedures but there is a significant waiting period – sometimes many years spent waiting for elective surgery. If you want your surgery sooner than that and can’t afford it – please consider other funding options.

Can you get Medicare to cover Abdominoplasty?

Many patients get coverage for an Abdominoplasty through Australian Medicare using the popular Medicare item number 30177. In order for Medicare to cover the surgery, the procedure must be seen as a medical necessity by your surgeon and GP. This means that you are getting the surgery due to an underlying medical condition. If you are getting a tummy tuck for purely cosmetic reasons or just to enhance your looks, it is very unlikely Medicare will pay for it. 

You may be eligible for a Medicare item number related to skin removal after massive weight loss (30177) or post pregnancy issues like diastasis recti (30175).

Dr Scott Turner is an experienced Sydney Plastic Surgeon and Tummy Tuck Expert – find out more about his Abdominoplasty Surgery and look at his Tummy Tuck before and after pictures to see the results. 

What is a Full Tummy Tuck Surgery?

A tummy tuck or abdominoplasty is a surgical procedure that involves the removal of excess fat and skin. The full tummy tuck procedure can also restore weakened muscles to create a smoother, firmer abdominal profile. Many people get it done for aesthetic reasons only. However, sometimes it is medically necessary if the excess skin is interfering with your quality of life and creating plenty of skin problems. 

Why Should I Consider a Tummy Tuck?

A tummy tuck or abdominoplasty is a life-altering surgical procedure. The surgery prevents and treats a variety of skin-related problems that come as a result of having excess skin and can improve the quality of life. 

Most patients feel extremely happy and confident post-surgery as they are able to engage in a wider range of activities without worrying about their excess skin getting in the way. 

The surgery dramatically improves how you look and feel about yourself. You will be able to show off your toned mid-section and wear your favourite clothes without feeling self-conscious. Increased confidence is a huge benefit that positively impacts every aspect of life. 

Believe it or not, the surgery can dramatically improve your posture and also relieves back pain and incontinence in certain patients. All in all, it will dramatically improve your self-image. 

What are the Criteria to get Medicare Item 30177 for Abdominoplasty?

There are many health concerns that make tummy tuck a medical necessity and help you qualify for Medicare Rebate including:

Quick Facts about Medicare Cover for Tummy Tuck

You’ll need a Medical Referral with your Documented concerns

In order to claim your surgery on Medicare, you will need a Medical Referral from your General Practitioner. You can get it prior to booking an initial consultation with a cosmetic surgeon or after the first appointment. 

It is important to demonstrate medical necessity, including skin problems. While consulting with your GP, it is worth discussing your symptoms to ensure the clinical need is documented in your referral.

The GP referral will last for 12 months.

So will my Abdominoplasty be covered by Medicare? 

The answer to this is ‘MAYBE’ – Medicare offers rebates on abdominoplasty if you meet the special criteria and conditions as listed below.

How Do You Qualify for Medicare Rebate for Tummy Tuck Surgery? – MBS Codes

These MBS Codes are relevant for Tummy Tuck Surgery:

Lipectomy, excision of skin and subcutaneous tissue associated with redundant abdominal skin and fat that is a direct consequence of significant weight loss, in conjunction with a radical abdominoplasty (Pitanguy type or similar), with or without repair of musculoaponeurotic layer and transposition of the umbilicus, not being a service associated with a service to which item 30165, 30168, 30171, 30172, 30176, 30179, 45530, 45564 or 45565 applies, if:

Radical abdominoplasty, with repair of rectus diastasis, excision of skin and subcutaneous tissue, and transposition of umbilicus, not being a laparoscopic procedure, where the patient has an abdominal wall defect as a consequence of pregnancy, if:

(i) has a diastasis of at least 3cm measured by diagnostic imaging prior to this service; and

(ii) has symptoms of at least moderate severity of pain or discomfort at the site of the diastasis in the abdominal wall during functional use and/or low back pain or urinary symptoms likely due to rectus diastasis that have been documented in the patient’s records by the practitioner providing this service; and

(iii) has failed to respond to non-surgical conservative treatment including physiotherapy; and

(iv) has not been pregnant in the last 12 months

the service is not a service associated with a service to which item 30165, 30651, 30655, 30168, 30171, 30172, 30176, 30177, 30179, 45530, 45564 or 45565 applies

Applicable once per lifetime

What is the Medicare Tummy Tuck Criteria in Australia?

People who meet the conditions associated with this item number qualify for Medicare rebate in Australia: 30177 or 30175

How Do I Qualify for Medicare Coverage for Tummy Tuck?

You can qualify for tummy tuck coverage if you meet Medicare’s criteria.

If you’re having abdominoplasty due to skin problems or post pregnancy concerns, you’ll be required to meet multiple conditions. In this case, your doctor needs to verify that:

Will health insurance help cover the cost of the Tummy Tuck surgery?

First things first, you need to meet the strict criteria set by Medicare. If that’s the case, your insurance is more likely to pay for the procedure. It is important to be fully aware of the Medicare codes and rebate eligibility criteria as these two factors can change and affect your claim. 

If you qualify for Medicare you may also be eligible for rebates on the tummy tuck surgery from your Private Health Insurance Provider. This only applies if your condition meets the criteria for Medicare Item Number.

You will need to have the right level of cover and have served the waiting period. It is always a good idea to check in directly with your own Private Health Fund, regarding your policy as they can differ drastically. 

Private Health Funds only cover a procedure if;

Why is Medicare for Abdominoplasty Rebate So Confusing?

The confusion primarily stems from the variables of the situation. Each patient is different and has different reasons for getting the abdominoplasty done. In certain cases, Medicare offers a minor rebate on certain procedures and complete rebate on others. 

Please note that rebates are generally available for reconstructive procedures only or if the surgery is deemed as a ‘medical necessity’. For a lot of patients, Abdominoplasty falls under this category. 

NOTE – Medicare Rebates are subject to change and review

Please note that MBS Item codes are reviewed regularly and can be changed/eliminated from the Medicare rebate schedule at any time. If you are currently eligible for a Medicare rebate for tummy tuck surgery, it is best to get the procedure sooner rather than later.

tummy tuck private health insurance

Nose job

If you were to ask certain celebrities, they may admit to a nose job—but would say theirs were medically necessary. The truth is a bit more complicated. Rhinoplasty (a “nose job”) can be performed to correct impaired breathing caused by structural defects of the nose (such as a deviated septum, one source of chronic congestion), but it also—and often—includes aesthetic tweaks to enhance facial harmony and the proportions of the nose. Insurance covers the portion of the surgery that’s medically necessary. However, “once we’ve finished the structural work, we mark the time on the operative record,” and after that, it’s on the patient’s tab, says Deborah J. Johnson, MD, a plastic surgeon in Sacramento, CA and past president of the American Society of Plastic Surgeons (ASPS). Surgery or no surgery, these 13 health insurance tricks can save you thousands.

Otoplasty (Ear surgery)

Ear surgery, also known as otoplasty, can improve the shape, position, or proportion of the ear, according to the Mayo Clinic. It can also correct a defect from a birth defect or injury, they say. Both adults and children can benefit from otoplasty, but if you make it to adulthood without it, then any changes you might want to make “will probably be on your dime,” Dr. Johnson says. Otoplasty in adults is covered by insurance, however, when it interferes with hearing. When it isn’t covered, the average cost of otoplasty was $2,909, per 2017 statistics from the ASPS. This type of surgery isn’t as popular as the most in-demand cosmetic treatments around the country.

Eyelid Lift

When eyelids appear droopy, you might look permanently tired—but this sagging can also impair vision, according to the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). Surgery, called blepharoplasty (eyelid lift) can correct these problems. Without insurance, the average cost is $3,026, according to the ASPS. Dr. Johnson says it actually will in two situations. The first is when extra skin weighs down the eyelid, obstructing the patient’s vision. The second is when the muscles of the upper lid become stretched out over time, leaving the patient with a sleep-eyed look that also impairs vision. This is how dermatologists and plastic surgeons look younger without an eyelid lift.

“Beauty” marks

It’s called a beauty mark, but you don’t think it’s so beautiful. If you decide to have that mole removed, will insurance cover it? According to Dr. Johnson, “even if the mole turns out to be benign, insurance will usually cover its removal if it strikes a doctor as suspicious.” Suspicious moles may include those that follow the ABCDEs the Skin Cancer Foundation lists: those that are asymmetrical, have uneven borders, are not uniform in color, moles with a diameter larger than a pencil eraser and moles that are changing, bleeding, or itching. If it does turn out to be cancerous, Dr. Johnson adds, “your insurance plan should also cover surgery to reconstruct your appearance.” Some people might confuse moles or lesions for beauty marks which is why you should check your body for these 7 skin cancer symptoms now.

Boob jobs

Breast augmentation—aka a boob job—may be covered by insurance in certain circumstances. Dr. Johnson explains that when you talk about plastic surgery covered by insurance, the question always comes down to what is “cosmetic” versus “reconstructive.” “It’s cosmetic if it’s simply the altering of the normal to make it look better but still normal. Aging is normal, so if someone comes in for work on their breasts due to the normal aging process, we consider that cosmetic,” Dr. Johnson explains. “If it’s addressing functional disabilities and deformities, it’s reconstructive.” But the notion of what is “normal” and what is a “deformity” is constantly evolving, as Johnson points out.

Since 1998, insurance companies have been required by law to cover not only breast reconstruction following mastectomy but also reconstruction of the other breast to make breasts look symmetrical and balanced after mastectomy and any physical complications at all stages of mastectomy.

This includes revising previous reconstructions, points out Maria LoTempio, MD, a New York City-based plastic surgeon specializing in reconstructive and cosmetic surgery exclusively for women. That means that following an initial reconstruction, a woman can opt for a different reconstructive approach for the purpose of enhancing the aesthetic result. Dr. LoTempio notes that the likelihood of insurance covers diminishes as time passes following the initial reconstruction, although in one case, a patient received full coverage for significant revision nearly eight years following her initial surgery. Dr. Johnson suggests that patients read their plans carefully and work closely with customer service representatives at the insurance company to determine whether the desired surgery will be covered.

Apart from breast reconstruction, breast implant revision surgery may also be covered by insurance, says the ASPS. Dr. Johnson points out that women who have already undergone a “boob job” may be able to have the removal of their implants paid for by insurance if the implants are found by a doctor to be faulty. Here’s everything you always wanted to know about breast implants.

Breast reduction

On the flipside is breast reduction surgery, a procedure where the surgeon removes fatty tissue, glandular tissue, and excess skin, says the ASPS. Beyond aesthetics, women may choose breast reduction to address physical discomfort. The ASPS says that many insurance companies cover this surgery. One downside, says Dr. Johnson, is that insurance companies tend to use cup size as a guideline (often denying coverage if you’re not a “DD or larger,” she says).

Dr. Johnson recommends documenting the symptoms and their duration. She also recommends documenting all non-surgical measures taken by the woman that have failed (such as diet, exercise, supportive bras, chiropractic, and massage). It’s also a good idea to document the woman’s willingness to endure scarring in the interest of relieving her symptoms, Dr. Johnson adds, because this shows that her desire for the surgery isn’t frivolous. (If you’re considering breast reduction surgery, here are 8 things you should know before going under the knife for breast reduction surgery, including costs, risks, and benefits.)

Male breast reduction

The American Board of Cosmetic Surgery estimates that up to 50 percent of men in the United States will experience enlarged breasts during their lifetime. For some men, the answer is gynecomastia surgery, which removes excess fat and glandular tissue for a flatter, firmer, and more masculine chest contour.

According to Dr. Johnson, insurance companies are more willing to pay for the surgery in teens and young adults than they are for older adults. There’s a common belief, she notes, that “if this guy made it through his teens and early twenties without the surgery, he’s fine,” she says. Plastic surgery before and after photos might be alluring, but before considering going under the knife read these 13 things plastic surgeons won’t tell you.


Following major weight loss, some people may be left with excess skin. Patients may choose to undergo panniculectomy, a surgical procedure to remove excess skin and fat that hangs from the belly. In terms of insurance coverage, the law is still evolving in this area, according to Dr. Johnson. “There was a time a few years back when insurers covered panniculectomy. Then they decided it was a problem of one’s own making and began to deny coverage,” she recalls. “Then the American Medical Association classified obesity as a disease, and states began requiring insurance companies to once again cover the surgery,” Dr. Johnson adds. If you’ve never heard of a panniculectomy, chances are that these unusual cosmetic surgeries will be news to you as well.

Tummy tuck

Whereas a panniculectomy removes only excess skin, a tummy tuck (also known as abdominoplasty) involves the removal of excess skin and fat from the abdomen and a tightening of the fascia that lies on the abdominal muscles, Mayo Clinic explains. A tummy tuck will be covered by insurance, however, when it is done as part of a breast reconstruction. For example, in what is known as a DIEP Flap procedure, Dr. LoTempio uses skin and fatty tissue from the abdomen to replace the skin and tissue removed from the breast during mastectomy, resulting in a soft, natural, reconstructed breast. In SIEA Flap surgery, the blood vessels in the lower abdomen, just beneath the skin, are used. Surgery isn’t necessary if you try these 23 ways to flatten your belly without surgery.

Butt lifts

The average surgeon charges $4,884 for butt implants, so wouldn’t it be nice if insurance would cover it? Spoiler: it won’t. However, if you must undergo a mastectomy for medical reasons, there are surgeons who are able to create new breasts out of skin, fat, and blood vessels removed from the gluteal area, says Dr. LoTempio. This surgery results in a newly contoured and lifted backside and is now routinely covered by insurance, she says. In fact, there are several other flap surgeries that can be performed using thigh tissue which result in a what Dr. LoTempio calls a “mini thigh lift.” Perhaps you don’t need a butt lift and the right underwear to flatter your butt shape will do.


You love those high-heeled shoes, but your feet don’t. Now you have a bunion—a painful bony bump on the joint at the inside of your toe. This is a foot deformity. According to Josef J. Geldwort, MD, DPM, a sports medicine doctor and podiatrist in New York City, “more health insurance companies will cover a bunion procedure than you may think. It all depends on the circumstances,” he says. Namely, if your bunion is causing pain and impacting your functioning. While you’re waiting for surgery, try these ways to deal with your bunion pain.

Varicose veins

“I’ve had many patients tell me that they were reluctant to see a doctor for their varicose veins because they thought varicose veins were a cosmetic problem, so their health insurance plan wouldn’t pay for treatment,” says Steven D. Cox, MD, a surgeon at Fairfield Medical Center in Lancaster, OH. It is true that most health plans will authorize treatment of varicose veins if we can demonstrate medical necessity. “If you have large, bulging veins on your legs or thighs, you probably have a problem called venous insufficiency, which meets the criteria for medical necessity for insurance plans,” he says. According to Dr. Johnson, the rule is that “generally, if your varicose veins present with painful symptoms and you’ve tried and failed with non-invasive therapies such as support stockings and sclerotherapy, then insurance will cover the surgery.” It probably won’t alleviate the need for surgery, but here’s why horse chestnuts may provide some relief for the discomfort of varicose veins.

What age is best to get a tummy tuck

Are you considering a tummy tuck in Pasadena, CA? Are you curious if there is an age limit with this body contouring procedure? A tummy tuck, or abdominoplasty, has no age limit if the patient is in good health. Many men and women, regardless of age, want to improve the way they look. When exercise and diet have taken your body as far as they can go, a tummy tuck can take it to another level, even in your 60s. Pregnancy, significant weight loss, and aging are common reasons women and men struggle with excess fat and loose skin in the abdominal region. To give you an idea of how this skin tightening surgery works for any age group, read on to learn more from board-certified plastic and reconstructive surgical specialist Dr. Omar Ahmed and the professional team at Omar Ahmed, M.D. in Pasadena, CA.

What does a tummy tuck do?

A tummy tuck is an excellent way to put an end to stubborn fat and loose skin. It is a popular cosmetic procedure that reduces excess fat and skin while repairing lax stomach muscles in the abdomen area. Dr. Ahmed offers this body contouring option so Pasadena, CA men and women can have a flatter, smoother, more toned-looking stomach. Natural processes, such as childbirth, pregnancy, age, and weight loss, may prevent individuals from having the contoured stomach they want. During your consultation, Dr. Ahmed will provide a full assessment to ensure you are a good candidate and physically healthy before considering abdominoplasty. Contrary to popular belief, there is no wrong or right age to get a tummy tuck.

At what age can you get a tummy tuck?

While there is no age limit to a tummy tuck, individuals considering this skin tightening and fat removal surgery must be healthy and in good physical condition. A tummy tuck is generally performed on patients from age 18 – 65 years old or even older. However, the question does come up with any plastic surgery if there is an age limit? Generally speaking, age is not as important as a patient’s emotional and physical health, skin tone or laxity, and the tissues’ condition being operated on. Patients in their 60s who have lost a significant amount of weight or lost the abdomen’s toned appearance due to aging can live a healthier, better life and be more satisfied with their body after a tummy tuck procedure.

Who is an ideal candidate for a tummy tuck in Pasadena, CA?

In Pasadena, CA, women and men can achieve dramatic results with this fat reduction and skin tightening surgery. During a thorough consultation, Dr. Ahmed will discuss your cosmetic goals, assess your overall health, and perform a physical examination to ensure you are suitable for surgery. Women in their 20s, 30s, or 40s may consider tummy tuck surgery as part of their mommy makeover after having children. In some situations, older patients in their 50s or 60s may need this body contouring treatment due to weight loss and the natural aging process. Regardless of age, good candidates for a tummy tuck are:

Regardless of your age, when you choose to have tummy tuck surgery, having all the information is essential to make the best decision for you. Abdominoplasty is a surgical procedure performed by a highly qualified, experienced expert, like board-certified plastic and reconstructive surgical specialist Dr. Omar Ahmed. During a one-on-one consultation, Dr. Ahmed can determine if you are the right candidate for a tummy tuck procedure. He will consider important factors, like your overall health, lifestyle habits, and excess stomach skin removal needs. If you live in Pasadena, CA, and are interested in tummy tuck surgery offered at Omar Ahmed, M.D., contact our office to schedule a private consultation today.

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