Medical Practitioners 2008
SERVICES BY MEDICAL PRACTITIONERS
This schedule is only applicable to road accident trauma emergency care where the RAF is liable for compensation in terms of the Road Accident Fund Act (Act Nr 56 of 1996) as amended.
Emergency care means the immediate, appropriate and justifiable medical assessment, treatment and care required to prevent or limit future impairment to bodily functions and/or to preserve the person's life.
In calculating the prices in this schedule, the following rounding method is used: Values R10 and below rounded to the nearest cent, R10+ rounded to the nearest 10 cent. Modifier values are rounded to the nearest
cent. When new item prices are calculated, e.g. when applying a modifier, the same rounding scheme should be followed.
VAT EXCLUSIVE PRICES APPEAR IN BRACKETS.
RULES GOVERNING THE TARIFF
A.
Consultations: Definitions: (a) New and established patients: A consultation/visit refers to a clinical situation where a medical practitioner personally obtains a patient’s medical history, performs an
06.52
appropriate clinical examination and, if indicated, administers treatment, prescribes or assists with advice. These services must be face-to-face with the patient and excludes the time spent doing
special investigations which receive additional remuneration. (b) Subsequent visits: Refers to a voluntarily scheduled visit performed within four (4) months after the first visit. It may imply taking down
a medical history and/or a clinical examination and/or prescribing or administering of treatment and/or counselling. (c) Hospital visits: Where a procedure or operation was done, hospital visits are
regarded as part of the normal after-care and no fees may be levied (unless otherwise indicated). Where no procedure or operation was carried out, fees may be charged for hospital visits according
to the appropriate hospital or inpatient follow-up visit code.
B.
Normal hours and after hours: After-hours services are paid at the same rate as benefits for normal hours services. Bona fide emergency medical services rendered to a patient, at any time, may
06.52
attract a fee as specified in modifier 0011 and items 0146 or 0147 (which should be added to the appropriate consultative services code selected from items 0190-0192, 0173-0175, 0161-0164, 01660169)
C.
Comparable services: A service may be rendered that is not listed in this edition of the coding structure. The fee that may be charged in respect of the rendering of a service not listed in this coding
06.52
structure shall be based on the fee in respect of a comparable service. For these procedure(s)/service(s), item 6999: Unlisted procedure or service code, should be used. Please contact the SA
Medical Association (SAMA) Private Practice Unit via e-mail on coding@samedical.org to obtain a comparable code for the unlisted procedure/service which will be based on the fee for a comparable
service in the coding structure. When item 6999 is used to indicate that an unlisted service was rendered, the use of the item must be supported by a special report. This report must include: (1) An
adequate definition or description of the nature, extent and need for the procedure/service or “medical necessity”; (2) In which respect is this service unusual or different in technique, compared to
available procedures/services listed in the coding structure? Information regarding the nature and extent of the procedure/service, time and effort, special/dedicated equipment needed to provide this
service, must be included in the report; (3) Is this procedure/service medically appropriate under the circumstances? Explain why another procedure/service listed in the coding structure will not be
appropriate in this case; (4) A description of the complexity of the symptoms and concurrent problems must be supplied; (5) Final diagnosis supported by the appropriate ICD-10 code(s); (6) Pertinent
physical findings (size, location and number of lesions if applicable); (7) Mention any other diagnostic or therapeutic procedure(s)/service(s) provided at the same session; (8) Any further diagnostic or
therapeutic procedure(s)/service(s) to be provided in the follow-up period; and (9) Description of the follow-up care needed. Please note: This comparable service code may not be used for a period
longer than six months for a particular procedure /service after which time an application has to be made to the Fund for the addition of a specific code or for an extension of time.
D.
Cancellation of appointments: Unless timely steps are taken to cancel an appointment for a consultation, the relevant consultation fee may be charged. In the case of a general practitioner "timely"
06.52
shall mean two hours and in the case of a specialist 24 hours prior to the appointment. Each case shall, however, be considered on merit and, if circumstances warrant, no fee shall be charged. If a
patient has not turned up for a procedure, each member of the surgical team is entitled to charge for a visit at or away from doctor's rooms as the case may be
E.
Pre-operative visits: The appropriate fee may be charged for all pre-operative visits with the exception of a routine pre-operative visit at the hospital
06.52
F.
Administering of injections and/or infusions: Where applicable, fees for administering injections and/or infusions may only be charged when done by the practitioner himself
06.52
G.
Post-operative care: (a) Unless otherwise stated, the fee in respect of an operation or procedure shall include normal after-care for a period not exceeding ONE month (after-care is excluded from
06.52
pure diagnostic procedures during which no therapeutic procedures were performed). (b) If the normal after-care is delegated to any other registered health professional and not completed by the
surgeon, it shall be his/her own responsibility to arrange for this to be done without extra charge. (c) When post-operative care/treatment of a prolonged or specialised nature is required, such fee as
may be agreed upon between the surgeon and the Fund or the patient (in case of a private account) may be charged. (d) Normal after-care refers to an uncomplicated post-operative period not
requiring any further incisions
H.
Removal of lesions: Items involving removal of lesions include follow-up treatment for 10 days
06.52
K.
Practice of specialists: In terms of the conditions in respect of the practice of specialists as published in Government Gazette No. 12958 of 11 January 1991, a specialist may treat any person who
06.52
comes to him direct for consultation. A specialist who is consulted by a patient or who treats a patient, shall take all reasonable steps to ensure the collaboration of the patient's general practitioner.
L.
Procedures performed at time of visits: If a procedure is performed at the time of a consultation/visit, the fee for the visit PLUS the fee for the procedure is charged
06.52
M.
Procedure planned to be performed later: In cases where, during a consultation/visit, a procedure is planned to be performed at a later occasion, a visit may not be charged for again, at such a later
06.52
occasion
N.
“Per consultation”: No additional fee may be charged for a service for which the fee is indicated as “per consultation”. Such services are regarded as part of the consultation/visit performed at the time 06.52
the condition is brought to the doctor's attention
O.
Costly or prolonged medical services or procedures: In the case of costly or prolonged medical services or procedures, the medical practitioner shall first ascertain from the Fund for what amount the 06.52
will accept responsibility in respect of such treatment, should the practitioner wish any direct payment from the Fund
13 Mar 2008
Page 1 of 151
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
P.
Q.
R.
S.
T.
U.
V.
Y.
Z.
AA.
EE.
FF.
GG.
RR.
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
Travelling fees: (a) Where, in cases of emergency, a practitioner was called out from his residence or rooms to a patient's home or the hospital, travelling fees can be charged according to the section
on travelling expenses (section IV) if he had to travel more than 16 kilometres in total. (b) If more than one patient would be attended to during the course of a trip, the full travelling expenses must be
divided between the relevant patients. (c) A practitioner is not entitled to charge for any travelling expenses or travelling time to his rooms. (d) Where a practitioner's residence would be more than 8
kilometres away from a hospital, no travelling fees may be charged for services rendered at such hospitals, except in cases of emergency (services not voluntarily scheduled). (e) Where a practitioner
conducts an itinerant practice, he is not entitled to charge fees for travelling expenses except in cases of emergency (services not voluntarily scheduled). (f) For voluntarily scheduled services, fees
for travelling expenses may only be charged where the patient and the practitioner have entered into an agreement to this effect. The Fund benefits will not be applicable in such instances.
Intensive care/High Care: Units in respect of items 1204 to 1210 (Categories 1 to 3) EXCLUDE the following: (a) Anaesthetic and/or surgical fees for any condition or procedure, as well as a first
consultation/visit, which is, regarded as the assessment of the patient, while the daily intensive care/high care fee covers the daily care in the intensive/high care unit. (b) Cost of any drugs and/or
materials. (c) Any other cost which may be incurred before, during or after the consultation/visit and/or the therapy. (d) Blood gases and chemistry tests, including the arterial puncture to obtain the
specimen. (e) Procedural items 1202 and 1212 to 1221. but INCLUDE the following: (f) Performing and interpretation of a resting ECG. (g) Interpretation of chemistry tests and x-rays. (h) Intravenous
treatment (items 0206 and 0207), except intravenous infusion in patients under the age of three years (item 0205) that does not form a part of the daily ICU/High Care fee and may be charged for
separately on a daily basis (fee includes the introduction of the cannula as well as the daily management)
Multiple organ failure: Units for items 1208, 1209 and 1210 (Category 3: Cases with multiple organ failure) include resuscitation (i.e. item 1211: Cardio-respiratory resuscitation)
Ventilation: Units for items 1212, 1213 and 1214 (ventilation) include the following: (a) Measurement of minute volume, vital capacity, time- and vital capacity studies. (b) Testing and connecting the
machine. (c) Putting patient on machine: setting machine, synchronising patient with machine. (d) Instruction to nursing staff. (e) All subsequent visits for 24 hours.
Ventilation (items 1212 to 1214) does not form a part of normal post-operative care, but may not be added to item 1204: Catogory 1: Cases requiring intensive monitoring
Obstetric procedures: (a) When a general practitioner treats a patient in the ante-natal period and, after starting the confinement, requests an obstetrician to take over the case, the general
practitioner shall be entitled to charge for all the ante-natal consultations he/she has performed. (i) If the patient has been in labour for less than 6 hours, the general practitioner shall charge 50,00
clinical procedure units according to item 2614: Global obstetric care. (ii) If the patient has been in labour for more than 6 hours, the general practitioner shall charge 80,00 clinical procedure units
according to item 2614: Global obstetric care. (b) When a general practitioner calls an obstetrician to help with a confinement, take over the management of a confinement, and treats the patient
until after the post-partum visit, the obstetrician shall charge according to item 2614: Global obstetric care. (c) When a general practitioner calls an obstetrician (specialist or general practitioner) to
help with a confinement, or take over the management of a confinement, but the general practitioner treats the patient until after the post-partum visit, the obstetrician shall charge according to item
2616: Intrapartum obstetric care by obstetrician in consultation, and the general practitioner according to item 2614: Global obstetric care.
(a) Electro-convulsive treatment: Visits at hospital or nursing home during a course of electro-convulsive treatment are justified and may be charged for in addition to the fees for the procedure. (b)
Except where otherwise indicated, the duration of a medical psychotherapeutic session is set at 20 minutes or part thereof, provided that such a part comprises 50% or more of the time of a session.
This set duration is also applicable for psychiatric examination methods
Except where otherwise indicated, radiologists are entitled to charge for contrast material used
No fee is subject to more than one reduction
Procedures to exclude cost of isotope
Ultrasound examinations: The international norm approved for use in South Africa for NORMAL PREGNANCY is two ultrasound exams: (a) The first scan should preferably include a nuchal thickness
estimation and be performed between 10 and 14 weeks gestation. The second scan should be performed between 20 and 24 weeks and should include a full anatomical report. All subsequent
ultrasound scans are excluded from the benefits unless accompanied by proper motivation. An ultrasound scan to assess an abnormal early pregnancy may be formed before 10 weeks but this scan
may not be used to diagnose a normal uncomplicated pregnancy. Item 3618 is a gynaecological scan and its use is not approved for use in pregnancy. (b) In cases where the scan is performed by
the attending practitioner, a clear indication for such a scan must be entered on the account rendered, or a letter of motivation must be attached to the account (the practitioner must elect one of the
two options). (c) In case of a referral, the referring doctor must submit a letter of motivation to the radiologist or other practitioner doing the scan. A copy of the letter of motivation must be attached to
the first account rendered to the patient (by the radiologist or the other practitioner doing the scan) and must be attached to the first account submitted to the Fund by the patient or the doctor, as the
case may be. (d) In case of a referral to a radiologist, no motivation should be required from the radiologist
(a) When a cystoscopy precedes a related operation, Modifier 0013: Endoscopic examination done at an operation, applies, e.g. cystoscopy followed by transurethral (TUR) prostatectomy. (b) When
a cystoscopy precedes an unrelated operation, Modifier 0005: Multiple procedures/operations under the same anaesthetic, applies, e.g. cystoscopy for urinary tract infection followed by inguinal
hernia repair. (c) No modifier applies to item 1949: Cystoscopy, when performed together with any of items 1951 to 1973.
Capturing and recording of examinations: Images from all radiological, ultrasound and magnetic resonance imaging procedures must be captured during every examination and a permanent record
generated by means of film, paper, or magnetic media. A report of the examination, including the findings and diagnostic comment, must be written and stored for five years
The radiology section in this price list is not for use by registered specialist radiology practices (Pr No "038") or nuclear medicine practices (Pr No "025"), but only for use by other specialist practices
or general practitioners.
A separate radiology schedule is for the exclusive use of registered specialist radiology practices (Pr No "038") and nuclear medicine practices (Pr No "025").
13 Mar 2008
Page 2 of 151
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
XX.
Diagnostic services rendered to hospital inpatients: Quote Modifier 0091 on all accounts for diagnostic services (e.g. MRI, X-rays, pathology tests) performed on patients officially admitted to hospital
or day clinic
YY.
Diagnostic services rendered to outpatients: Quote Modifier 0092 on all accounts for diagnostic services (e.g. MRI, X-rays, pathology tests) performed on patients NOT officially admitted to hospital or
day clinic (could be within the confines of a hospital)
MODIFIERS GOVERNING THE STRUCTURE
0002
Written report on X-rays: The lowest level code for a new patient office (consulting rooms) visit is applicable only where a radiologist is requested to give a written report on X-rays taken elsewhere
and submitted to him. The above mentioned item and the lowest level initial hospital visit code, as appropriate are not to be used for routine reporting of X-rays taken elsewhere
0004
Procedures performed in own procedure rooms: Procedures performed in doctors' own procedure rooms instead of in a hospital theatre or unattached theatre unit: as per fee for procedure + 100%
(the value of modifier 0004 equals 100% of the value of the procedure performed). See Section V (Section G in SAMA's DBT) for a list of procedures, which are often done in rooms to which Modifier
0004 should not be applied. Please note: Only the medical practitioner who owns the facility and the equipment may charge modifier 0004. Only one person may claim this modifier for procedures
performed in doctors' own procedure rooms
0005
Multiple therapeutic procedures/operations under the same anaesthetic:
06.52
06.52
06.52
06.52
06.52
a) Unless otherwise identified in the tariff when multiple therapeutic procedures/operations add significant time and/or complexity, and when each procedure/operation is clearly identified and defined,
the following values shall prevail: 100% (full value) for the first or major procedure/operation, 75% for the second procedure/operation, 50% for the third procedure/operation, 25% for the fourth and
subsequent procedures/operations. This modifier does not apply to purely diagnostic procedures.
b) In the case of multiple fractures and/or dislocations the above values shall prevail.
0006
0007
0008
0009
0010
0011
0013
0014
c) “+” Means that this item is used in addition to another definitive procedure and is therefore not subject to reduction according to Modifier 0005 (see also Modifier 0082)
Visiting specialists performing procedures: Where specialists visit smaller centres to perform procedures, fees for these particular procedures are exclusive of after-care. The referring practitioner will
then be entitled to subsequent hospital visits for after-care. If the referring practitioner is not available, the specialist shall, on consultation with the patient, choose an appropriate locum tenens. Both
the surgeon and the practitioner who handled the after-care, must in such instances quote Modifier 0006 with the particular items which they use
a) Use of own monitoring equipment in the rooms: Remuneration for the use of any type of own monitoring equipment in 06.52
15.000
105.42 15.000
105.42
the rooms for procedures performed under intravenous sedation - 15, 00 clinical procedure units irrespective of the
(92.47)
(92.47)
number of items of equipment provided.
b) Use of own equipment in hospital theatre or unattached theatre unit: Remuneration for the use of any type of own
equipment for procedures performed in a hospital theatre or unattached theatre unit when appropriate equipment is not
provided by the hospital - 15,00 clinical procedure units irrespective of the number of items of equipment provided.
Specialist surgeon assistant: Where a procedure requires a registered specialist surgeon assistant, the fee is 33,33% (1/3) of the fee for the specialist surgeon
Assistant: The fee for an assistant is 20% of the fee for the specialist surgeon, with a minimum of 36,00 clinical procedure units. The minimum fee payable may not be less than 36,00 clinical
procedures units
Local anaesthesic: (a) A fee for a local anaesthetic administered by the operator may only be charged for (1) an operation or procedure having a value greater than 30, 00 clinical procedure units (i.e.
31, 00 or more clinical procedure units allocated to a single item) or (2) where more than one operation or procedure is done at the same time with a combined value greater than 50, 00 clinical
procedure units. (b) The fee shall be calculated according to the basic anaesthetic units for the specific operation. Anaesthetic time may not be charged for, but the minimum fee as per Modifier 0036:
Anaesthetic administered by a general practitioner, shall be applicable in such a case. (c) Not applicable to radiological procedures (such as angiography and myelography. (d) No fee may be levied
for topical application of local anaesthetic. (e) Please note: Modifier 0010: Local anaesthetic administered by the operator, may not be added on the surgeon’s account for procedures that were
performed under general anaesthetic.
Emergency procedures: Any bona fide, justifiable emergency procedure (all hours) undertaken in an operating theatre and/or in another setting in lieu of an operating theatre, will attract an additional
12,00 clinical procedure units per half-hour or part thereof of the operating time for all members of the surgical team. Modifier 0011 does not apply in respect of patients on scheduled lists. (A medical
emergency is any condition where death or irreparable harm to the patient will result if there are undue delays in receiving appropriate medical treatment)
Endoscopic examinations done at operations: Where a related endoscopic examination is done at an operation by the operating surgeon or the attending anaesthesiologist, only 50% of the fee for the
endoscopic examination may be charged
Operations previously performed by other surgeons: Where an operation is performed which has been previously performed by another surgeon, e.g. a revision or repeat operation, the fee shall be
calculated according to the tariff for the full operation
13 Mar 2008
Page 3 of 151
06.52
06.52
06.52
06.52
06.52
06.52
06.52
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
0015
0017
0018
0019
0046
0047
0048
0049
0050
0051
0053
0055
0057
0058
0061
0063
0064
0065
0066
0067
0069
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
Intravenous infusions: Where intravenous infusions (including blood and blood cellular products) are administered as part of the after-treatment after the operation or confinement, no extra fees shall
be charged as this is included in the global operative or maternity fees. Should the practitioner doing the operation or attending to the maternity case prefer to ask another practitioner to perform postoperative or post-confinement intravenous infusions, then the practitioner himself (and not the patient) shall be responsible for remunerating such practitioner for the infusions
Injections administered by practitioners: When desensitisation, intravenous, intramuscular or subcutaneous injections are 06.52
7.500 85.12 (74.67)
7.500 85.12 (74.67)
administered by the practitioner him-/herself to patients who attend the consulting rooms, a first injection forms part of the
consultation/visit and only all subsequent injections for the same condition should be charged at 7.50 consultative
services units using modifier 0017 to reflect the amount (not chargeable together with a consultation item)
Surgical modifier for persons with a BMI of 35> (calculated according to kg/m2): Fee for procedure +50% for surgeons and a 50% increase in anaesthetic time units for anaesthesiologists
Surgery on neonates (up to and including 28 days after birth) and low birth weight infants (less than 2500g) under general anaesthesia (excluding circumcision): per fee for procedure + 50% for
surgeons and a 50% increase in anaesthetic time units for anaesthesiologists
Where in the treatment of a specific fracture or dislocation (compound or closed) an initial procedure is followed within one month by an open reduction, internal fixation, external skeletal fixation or
bone grafting on the same bone, the fee for the initial treatment of that fracture or dislocation shall be reduced by 50%. Please note: This reduction does not include the assistant’s fee where
applicable. After one month, a full fee as for the initial treatment, is applicable
A fracture NOT requiring reduction shall be charged on a fee per service basis
Where in the treatment of a fracture or dislocation, an initial closed reduction is followed within one month by further
06.52
27.000
189.76 27.000
189.76
closed reductions under general anaesthesia, the fee for such subsequent reductions will be 27,00 clinical procedure
(166.46)
(166.46)
units (not including after-care)
Except where otherwise specified, in cases of compound fractures, 77,00 clinical procedure units (specialists) and 77,00 06.52
77.000
541.16 77.000
541.16
clinical procedure units (general practitioners) are to be added to the units for the fractures including debridement
(474.70)
(474.70)
In cases of a compound fracture where a debridement is followed by internal fixation (excluding fixation with Kirschner
06.52
115.500
811.73 115.500
811.73
wires, as well as fractures of hands and feet), the full amount according to either Modifier 0049: Cases of compound
(712.04)
(712.04)
fractures, or Modifier 0051: Fractures requiring open reduction, internal fixation, external skeletal fixation and/or bone
grafting, may be added to the fee for the procedure involved, plus half of the amount according to the second modifier
(either Modifier 0049: Cases of compound fractures or Modifier 0051: Fractures requiring open reduction, internal fixation,
external skeletal fixation and/or bone grafting, as applicable)
Fractures requiring open reduction, internal fixation, external skeletal fixation and/or bone grafting: Specialists add 77,00 06.52
77.000
541.16 77.000
541.16
clinical procedure units. General practitioners add 77,00 clinical procedure units
(474.70)
(474.70)
Fracture requiring percutaneous internal fixation [insertion and removal of fixatives (wires) in respect of fingers and toes
06.52
32.000
224.90 32.000
224.90
included]: Specialists and general practitioners add 32,00 clinical procedure units
(197.28)
(197.28)
Dislocation requiring open reduction: Units for the specific joint plus 77,00 clinical procedure units for specialists. General 06.52
77.000
541.16 77.000
541.16
practitioners add 77,00 clinical procedure units
(474.70)
(474.70)
Multiple procedures on feet: In multiple procedures on feet, fees for the first foot are calculated according to Modifier 0005: Multiple procedures/operations under the same anaesthetic. Calculate fees
for the second foot in the same way, reduce the total to 75% and add to the total for the first foot
Revision operation for total joint replacement and immediate re-substitution (infected or non-infected): per fee for total joint replacement + 100%
Combined procedures on the spine: In cases of combined procedures on the spine, both the orthopaedic surgeon and the neurosurgeon are entitled to the full fee for the relevant part of the operation
performed
Where two specialists work together on a replantation procedure, each shall be entitled to two-thirds of the fee for the procedure
Where the replantation is unsuccessful, no further surgical fee is payable for amputation of the non-viable parts
Additional operative procedures by same surgeon, under section 3.8.6: Spinal deformities, within a period of 12 months: 75% of scheduled fee for the lesser procedure, except where otherwise
specified elsewhere
Microsurgery of the fallopian-tubes and ovaries: Where micro-surgical techniques are used, with the aid of a microscope, 25% may be added to the fee
Microsurgery of the larynx: Add 25% to the fee of the operation performed (For other operations requiring the use of an operation microscope, the fee include the use of the microscope, except where
otherwise specified elsewhere in the Tariff)
When endoscopic instruments are used during intranasal surgery: Add 10% of the fee of the procedure performed. Only applicable to items 1025, 1027, 1030, 1033, 1035, 1036, 1039, 1047, 1054
and 1083
13 Mar 2008
Page 4 of 151
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
0070
0072
0074
0075
0077
0079
0080
0081
0082
0083
0084
0085
0086
0090
0091
0092
0095
0097
0160
0165
5104
6100
6101
6102
6103
6104
6105
Add 45,00 clinical procedure units to procedure(s) performed through a thorascope
Anaesthesiology
RVU
Fee
316.26 45.000
316.26
(277.42)
(277.42)
Non invasive peripheral vascular tests: The number of tests in a single case is restricted to two (2) per diagnosis. Tests are not justified in cases of uncomplicated varicose veins
Endoscopic procedures performed with own equipment: The basic procedure fee plus 33.33% (1/3) of that fee ("+" codes excluded) will apply where endoscopic procedures are performed with own
equipment.
Endoscopic procedures performed in own procedure room: The fee plus 21,00 clinical procedure units will apply where
06.52
21.000
147.59 21.000
147.59
endoscopic procedures are performed in rooms with own equipment. This fee is chargeable by medical practitioners who
(129.46)
(129.46)
own or rent the facility. Please note: Modifier 0075 is not applicable to any of the items for diagnostic procedures in the
otorhinolaryngology sections of the tariff.
Physical treatment: When two separate areas are treated simultaneously for totally different conditions, such treatment shall be regarded as two treatments for which separate fees may be charged.
(Only applicable if services are provided by a specialist in physical medicine)
When a first consultation/visit proceeds into, or is immediately followed by a medical psychotherapeutic procedure, fees for the procedure are calculated according to the appropriate individual
psychotherapy code (items 2957, 2974 or 2975)
Multiple examinations: Full Fee
Repeat examinations: No reduction
“+” Means that this item is complementary to a preceding item and is therefore not subject to reduction
A reduction of 33,33% (1/3) in the fee will apply to radiological examinations as indicated in section 19: Radiology where hospital equipment is used
Film costs: In the case of radiological items where films are used, practitioners should adjust the fee upwards or downwards in accordance with changes in the price of films in comparison with
November 1979; the calculation must be done on the basis that film costs comprise 10% of the monetary value of the unit (This information is obtainable from the Radiological Society of SA)
'Left Side' modifier to be added to when items 6500 to 6519 are used when the left side is examined. Please note that the absence of this modifier indicates that the right side was examined
Vascular groups: “Film series” and “Introduction of Contrast Media” are complementary and together constitute a single examination: neither fee is therefore subject to increase in terms of Modifier
0080: Multiple examinations
Radiologist’s fee for participation in a team: 30, 00 radiology units per ½ hour or part thereof for all interventional radiological procedures, excluding any pre- or post-operative angiography,
catheterisation, CT-scanning, ultrasound-scanning or x-ray procedures. (Only to be charged if radiologist is hands-on, and not for interpretation of images only)
Diagnostic services rendered to hospital inpatients: Quote Modifier 0091 on all accounts for diagnostic services (e.g. MRI, X-rays, pathology tests) performed on patients officially admitted to hospital
or day clinic (refer to Rule XX)
Diagnostic services rendered to outpatients: Quote Modifier 0092 on all accounts for diagnostic services (e.g. MRI, X-rays, pathology tests) performed on patients NOT officially admitted to hospital or
day clinic (could be within the confines of a hospital) (refer to Rule YY)
Radiation materials: Exclusively for use where radiation materials supplied by the practice are used by clinical and radiation oncologists, modifier 0095 should be used to identify these materials. This
modifier is only chargeable by the practice responsible for the cost of this material and where the hospital did not charge therefore. Please note that item 0201 should not be used for these materials
Pathology tests performed by non-pathologists: Where items under Clinical Pathology (section 21) and Anatomical Pathology (section 22) fall within the province of other specialists or general
practitioners, the fee is to be charged at two-thirds of the pathologists fee
Aspiration of biopsy procedure performed under direct ultrasound control by an ultrasound aspiration biopsy transducer (Static Realtime): Fee for part examined plus 30% of the units
Use of contrast during ultrasound study: add 6.00 ultrasound units
06.52
6.000 40.19 (35.25)
6.000 40.19 (35.25)
Ultrasound in pregnancy, multiple gestation, after twenty weeks: plus 30%
In order to charge the full fee (600,00 magnetic resonance units) for an examination of a specific single anatomical region, it should be performed with the applicable radio frequency coil including T1
and T2 weighted images on at least two planes
Where a limited series of a specific anatomical region is performed (except bone tumour), e.g a T2 weighted image of a bone for an occult stress fracture, not more than two-thirds (2/3) of the fee may
be charged. Also applicable to all radiotherapy planning studies, per region
All post-contrast studies (except bone tumour), including perfusion studies, to be charges at 50% of the fee
Post-contrast study: Bone tumour: 100% of the fee
Limited examination of the hypophysis e.g. where a coronal T1 and sagittal T1 series are performed, two-thirds (2/3) of the fee is applicable
Where, in a limited hypophysis examination, Gadolinium is administered and coronal T1 and sagittal T1 series are repeated, a single full fee for the entire examination is applicable + cost of
Gadolinium + disposable items
13 Mar 2008
06.52
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Page 5 of 151
45.000
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
6106
6107
6108
6109
6110
6300
6301
6302
6303
6305
I.
I.a
I.b
I.b.1
Code
0161
0162
0163
0164
0166
0167
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
Where a magnetic resonance angiography (MRA) of large vessels is performed as primary examination, 100% of the fee is applicable. This modifier is only applicable if the series is performed by use 06.52
of a recognised angiographic software package with reconstruction capability
Where a magnetic resonance angiography (MRA) of the vessels is performed additional to an examination of a particular region, 50% of the fee is applicable for the angiography. This modifier is only 06.52
applicable if the series is performed by use of a recognised angiographic software package with reconstruction capability
Where only a gradient echo series is performed with a machine without a recognised angiographic software package with reconstruction ability, 20% of the full fee is applicable specifying that it is a
06.52
“flow sensitive series”
Very limited studies to be charged at 33,33% of the full fee e.g. MR urography for renal colic, diffusion studies of the brain additional to routine brain
06.52
MRI spectroscopy: 50% of fee
06.52
If a procedure lasts less than 30 minutes, only 50% of the machine fees for items 3536-3550 will be allowed (specify time of procedure on account)
06.52
If a procedure is performed by a radiologist in a facility not owned by himself, the fee will be reduced by 40% (i.e. 60% of the fee will be charged)
06.52
When the procedure is performed by a non-radiologist, the fee will be reduced by 40% (i.e. 60% of the fee will be charged)
06.52
When a procedure is performed entirely by a non-radiologist in a facility owned by a radiologist, the radiologist owning the facility may charge 55% of the procedure units used. Modifier 6302 applies 06.52
to the non radiologist performing the procedure
When multiple catheterisation procedures are used (items 3557, 3559, 3560, 3562) and an angiogram investigation is performed at each level, the unit value of each such multiple procedure will be
06.52
reduced by 20,00 radiological units for each procedure after the initial catheterisation. The first catheterisation is charged at 100% of the unit value
Consultative Services
General Practitioner visits
Specialists tiered consultation structure
New and established patients: Consultations/visits by psychiatrists (22) only
Description
Ver Add
Specialists
General Practitioners Anaesthesiology
/ non-designated
Specialists
RVU
Fee
RVU
Fee
RVU
Fee
Psychiatry ('22'): New and established patients: Consultation/visit of new or established patient with problem focused
history, clinical examination and straightforward decision making for minor problem. Typically occupies the doctor
personally with the patient between 10 and 20 minutes (for hospital consultation/visit by psychiatrist - refer to items 01660169)
Psychiatry ('22'): New and established patients: Consultation/visit of new or established patient with detailed history,
clinical examination and straightforward decision making and counselling. Typically occupies the doctor personally with
the patient between 21 and 35 minutes (for hospital consultation/visit by psychiatrist - refer to items 0166-0169)
Psychiatry ('22'): New and established patients: Consultation/visit of new or established patient with detailed history,
complete clinical examination and moderately complex decision making and counselling. Typically occupies the doctor
personally with the patient between 36 and 45 minutes (for hospital consultation/visit by psychiatrist - refer to items 01660169)
Psychiatry ('22'): New and established patients: Consultation/visit of new or established patient with comprehensive
history and clinical examination for complex problem requiring complex decision making and counselling. Typically
occupies a doctor personally with the patient between 46 and 60 minutes (for hospital consultation/visit by psychiatrist refer to items 0166-0169)
Psychiatry (22): First hospital consultation/visit with problem focused history, clinical examination and straightforward
decision making for minor problem. Typically occupies the doctor personally with the patient for between 10 and 20
minutes
Psychiatry (22): First hospital consultation/visit with detailed history, clinical examination and straightforward decision
making and counselling. Typically occupies the doctor personally with the patient for between 21 and 35 minutes
13 Mar 2008
Page 6 of 151
06.52
15.000
203.00
(178.10)
06.52
27.500
372.20
(326.50)
06.52
40.000
541.40
(474.90)
06.52
52.500
710.60
(623.30)
06.52
15.000
203.00
(178.10)
06.52
27.500
372.20
(326.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
0168
Psychiatry (22): First hospital consultation/visit with detailed history, complete clinical examination and moderately
06.52
40.000
541.40
complex decision making and counselling. Typically occupies the doctor personally with the patient for between 36 and
(474.90)
45 minutes
0169
Psychiatry (22): First hospital consultation/visit with comprehensive history and clinical examination for complex problem 06.52
52.500
710.60
requiring complex decision making and counselling. Typically occupies a doctor personally with the patient for between
(623.30)
46 and 60 minutes
I.c
General practitioner and specialist services
0190
New and established patient: Consultation/visit of new or established patient of an average duration and/or complexity. Includes counselling with the patient and/or family and co-ordination with
other health care providers or liaison with third parties on behalf of the patient (for hospital consultation/visit - refer to item 0173-0175 or item 0109) - not appropriate for pre-anaesthetic
assessment followed by the appropriate anaesthetics - refer to new anaesthetic structure
0191
New and established patient: Consultation/visit of new or established patient of a moderately above average duration and/or complexity. Includes counselling with the patient and/or family and
co-ordination with other health care providers or liaison with third parties on behalf of the patient (for hospital consultation/visit - refer to item 0173-0175 or item 0109) - not appropriate for preanaesthetic assessment followed by the appropriate anaesthetics - refer to new anaesthetic structure
0192
New and established patient: Consultation/visit of new or established patient of long duration and/or high complexity. Includes counselling with the patient and/or family and co-ordination with
other health care providers or liaison with third parties on behalf of the patient (for hospital consultation/visit - refer to item 0173-0175 or item 0109) - not appropriate for pre-anaesthetic
assessment followed by the appropriate anaesthetics - refer to new anaesthetic structure
0173
First hospital consultation/visit of an average duration and/or complexity. Includes counselling with the patient and/or family and co-ordination with other health care providers or liaison with third
parties on behalf of the patient (not appropriate for pre-anaesthetic assessment followed by the appropriate anaesthetics - refer to new anaesthetic structure)
0174
First hospital consultation/visit of a moderately above average duration and/or complexity. Includes counselling with the patient and/or family and co-ordination with other health care providers
or liaison with third parties on behalf of the patient (not appropriate for pre-anaesthetic assessment followed by the appropriate anaesthetics - refer to new anaesthetic structure)
0175
First hospital consultation/visit of long duration and/or high complexity. Includes counselling with the patient and/or family and co-ordination with other health care providers or liaison with third
parties on behalf of the patient (not appropriate for pre-anaesthetic assessment followed by the appropriate anaesthetics - refer to new anaesthetic structure)
0109
Hospital follow-up visit to patient in ward or nursing facility - Refer to general rule G(a) for post-operative care) (may only be charged once per day) (not to be used with items 0111, 0145, 0146,
0147 or ICU items 1204-1214)
0111
Paediatric hospital follow-up visits (excluding neonates) by paediatricians or paediatric cardiologists (may only be charged once per day) (not to be used with items 0109 or ICU items 12041214). For a healthy neonate please use item 0109 for a hospital follow-up visit
0129
Prolonged face-to-face attendance to a patient: ADD to either item 0192, item 0175, item 0164 or item 0169 as appropriate, for each 15-minute period only if service extends 10 minutes or
more into the next 15-minute period following on the first 60 minutes
0145
For consultation/visit away from the doctor's home or rooms (non-emergency): ADD only to the consultation/visit items 0190-0192, items 0173-0175, items 0161-0164 or items 0166-0169, as
appropriate. Note: Only one of items 0145, 0146 or 0147 may be charged and not combinations thereof
0146
For an unscheduled emergency consultation/visit at the doctors' home or rooms, all hours: ADD only to the consultation/visit items 0190-0192, items 0161-0164 or items 0151-0153, as
appropriate (refer to general rule B). Note: Only one of items 0145, 0146 or 0147 may be charged and not combinations thereof
0147
For an unscheduled emergency consultation/visit away from the doctor's home or rooms, all hours: ADD only to the consultation/visit items 0190-0192, items 0173-0175, items 0161-0164, items
0166-0169 or items 0151-0153, as appropriate. Note: Only one of items 0145, 0146 or 0147 may be charged and not combinations thereof
0148
For elective after-hours services on request of the patient or family (non emergency) (refer to general rule B): ADD 50% of the fee for the appropriate consultation/visit item (only to be used with
items 0190-0192, items 0173-0175, items 0161-0164, items 0166-0169 or items 0151-0153) and reflect this as a separate item 0148. Usage: This item is used when, for example, a patient or
the family request the doctor for a non-emergency consultation/visit outside of the normal hours period as reflected in general rule B.
0149
After-hours bona fide emergency consultation/visit (21:00-6:00 daily): ADD 25% of the fee for the appropriate consultation/visit item (only to be used with items 0190-0192, items 0173-0175,
items 0161-0164, items 0166-0169 or items 0151-0153) and reflect this as a separate item 0149. Note: The after-hour period applicable to this item is from Monday to Sunday 21:00-6:00
Practice Type
0190
0191
0192
0173
0174
0175
0109
0111
0129
0145
0146
0147
0148
Anaesthesiology
192.90
192.90
192.90
192.90
192.90
192.90
(169.20)
(169.20)
(169.20)
(169.20)
(169.20)
(169.20)
Cardiology
295.10
295.10
295.10
295.10
295.10
295.10
(258.90)
(258.90)
(258.90)
(258.90)
(258.90)
(258.90)
13 Mar 2008
Page 7 of 151
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52 +
06.52 +
06.52 +
06.52 +
06.52 +
06.52
0149
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Cardiothoracic Surgery
Dermatology
Gastroenterology
General Medical Practice
Medical Oncology
Medicine (Specialist Physician)
Neurology
Neurosurgery
Nuclear Medicine
Obstetrics and Gynaecology
Opthalmology
Orthopaedics
Otorhinolaryngology
Paediatric Cardiology
Paediatrics
Pathology (Anatomical)
Pathology (Clinical)
Physical Medicine
Plastic and Reconstructive Surgery
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
190.80
(167.40)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
204.30
(179.20)
192.90
(169.20)
192.90
(169.20)
192.90
(169.20)
295.10
(258.90)
295.10
(258.90)
192.90
(169.20)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
190.80
(167.40)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
204.30
(179.20)
192.90
(169.20)
192.90
(169.20)
192.90
(169.20)
295.10
(258.90)
295.10
(258.90)
192.90
(169.20)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
190.80
(167.40)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
204.30
(179.20)
192.90
(169.20)
192.90
(169.20)
192.90
(169.20)
295.10
(258.90)
295.10
(258.90)
192.90
(169.20)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
190.80
(167.40)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
204.30
(179.20)
192.90
(169.20)
192.90
(169.20)
192.90
(169.20)
295.10
(258.90)
295.10
(258.90)
192.90
(169.20)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
190.80
(167.40)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
204.30
(179.20)
192.90
(169.20)
192.90
(169.20)
192.90
(169.20)
295.10
(258.90)
295.10
(258.90)
192.90
(169.20)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
190.80
(167.40)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
295.10
(258.90)
204.30
(179.20)
192.90
(169.20)
192.90
(169.20)
192.90
(169.20)
295.10
(258.90)
295.10
(258.90)
192.90
(169.20)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
Psychiatry
Pulmonology
Radiation Oncology
13 Mar 2008
170.20
(149.30)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
Anaesthesiology
RVU
Fee
170.20
(149.30)
68.10
(59.70)
90.80
(79.60)
158.90
(139.40)
-
-
203.00
(178.10)
81.20
(71.20)
108.30
(95.00)
189.50
(166.20)
-
-
255.40
(224.00)
255.40
(224.00)
203.00
(178.10)
295.10
(258.90)
192.90
(169.20)
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
295.10
(258.90)
192.90
(169.20)
Page 8 of 151
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Radiology
Rheumatology
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
192.90
(169.20)
295.10
(258.90)
Urology
170.20
(149.30)
192.90
(169.20)
192.90
(169.20)
192.90
(169.20)
192.90
(169.20)
192.90
(169.20)
192.90
(169.20)
192.90
(169.20)
192.90
(169.20)
192.90
(169.20)
192.90
(169.20)
Anaesthesiology
RVU
Fee
192.90
(169.20)
295.10
(258.90)
Specialists
Surgery
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
170.20
(149.30)
68.10
(59.70)
90.80
(79.60)
158.90
(139.40)
-
-
192.90
(169.20)
192.90
(169.20)
I.e
0151
Pre-anaesthetic assessment
Pre-anaesthetic assessment: Pre-anaesthetic assessment of patient (all hours). Problem focused history and clinical
06.52
16.000
181.60 16.000
181.60
examination and straightforward decision making for minor problem. Typically occupies the doctor face-to-face with the
(159.30)
(159.30)
patient for between 10 and 20 minutes
0152
Pre-anaesthetic assessment: Pre-anaesthetic assessment of patient (all hours). Detailed history and clinical examination 06.52
16.000
181.60 16.000
181.60
and straightforward decision making and counselling. Typically occupies the doctor face-to-face with the patient for
(159.30)
(159.30)
between 20 and 35 minutes
0153
Pre-anaesthetic assessment: Pre-anaesthetic assessment of patient or other consultative service. Consultation with
06.52
16.000
181.60 16.000
181.60
detailed history, complete examination and moderate complex decision making and counselling. Typically occupies the
(159.30)
(159.30)
doctor face-to-face for between 30 and 45 minutes
I.f
Prenatal visits and new born attendance
0113
New born attendance: Emergency attendance to newborn at all hours (once per patient) (items 0107, 0109, 0111, 0145, 06.52
45.000
510.70 45.000
510.70
0146 and/or 0147 may not be added to item 0113)
(448.00)
(448.00)
I.g
Consultative services: Miscellaneous
0130
Telephone consultation (all hours)
06.52
0132
Consulting service e.g. writing of repeat scripts or requesting routine pre-authorisation without the physical presence of the patient (needs not be face-to-face contact) (“Consultation” via SMS or 06.52
electronic media included)
0133
Writing of special motivations for procedures and treatment without the physical presence of a patient (includes report on the clinical condition of a patient) requested by or on behalf of a third
06.52
party funder or its agent
Practice Type
0130
0132
0133
Anaesthesiology
136.20 (119.50)
Cardiology
204.30 (179.20)
Cardiothoracic Surgery
192.90 (169.20)
Dermatology
136.20 (119.50)
Gastroenterology
204.30 (179.20)
General Medical Practice
136.20 (119.50)
56.70 (49.70)
102.10 (89.60)
Medical Oncology
204.30 (179.20)
Medicine (Specialist Physician)
204.30 (179.20)
Neurology
204.30 (179.20)
Neurosurgery
204.30 (179.20)
Nuclear Medicine
204.30 (179.20)
Obstetrics and Gynaecology
136.20 (119.50)
Opthalmology
136.20 (119.50)
13 Mar 2008
Page 9 of 151
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Orthopaedics
136.20 (119.50)
Otorhinolaryngology
136.20 (119.50)
Paediatric Cardiology
204.30 (179.20)
Paediatrics
204.30 (179.20)
Pathology (Anatomical)
136.20 (119.50)
Pathology (Clinical)
136.20 (119.50)
Physical Medicine
204.30 (179.20)
Plastic and Reconstructive Surgery
136.20 (119.50)
Psychiatry
162.40 (142.50)
Pulmonology
204.30 (179.20)
Radiation Oncology
136.20 (119.50)
Radiology
136.20 (119.50)
Rheumatology
204.30 (179.20)
Specialists
Surgery
136.20 (119.50)
Urology
136.20 (119.50)
II.
Medicine, material, supplies and use of own equipment
II.a
Medicine codes
II.a.1
Dispensing of medicine by licensed dispensing medical practitioners
0197
Licensed dispensing medical practitioners: Dispensing cost - R16.00 for medicine with a cost of R100, 00 or more (VAT
inclusive), or 16% for medicine costing less than R100, 00 (VAT inclusive). Add to each Nappi code to provide for the
dispensing cost.
II.a.2
Once-off administration of medicine used during a consultation
0198
Once-off administration of medicines: This item provides for medicines used at a consultation, viz, once off administration
of medicine, special medicine used in treatment, or emergency dispensing. Charge for medicine used according to the
Single Exit Price (SEP) PLUS R16,00 for medicine with a cost of R100,00 or more, or 16% for medicine costing less than
R100,00 PLUS VAT on the 16%/R16,00. (Where applicable, VAT should be added to the 16%/R 16,00 only and not to
the SEP, since the SEP is VAT inclusive). [According to Section 18(8) of the Medicines and Related Substances Act (Act
101 of 1965) compounding and dispensing does not refer to a medicine requiring preparation for a once-off
administration to a patient during a consultation]. The appropriate Ethical Medicine Nappi code(s), selected from those
codes commencing with 7, 8 or 9 (provided that it is not a reference code), should be added applicable to the medicine
used. Please note: Refer to item 0201 for cost of material used in treatment.
II.b
Material codes
II.b.1
Prosthesis and/or internal fixation
0200
Prosthesis and/or internal fixation: This item provides for a charge for prosthesis and/or internal fixation. Charge for
prosthesis and/or internal fixation at cost price PLUS 26% (up to a maximum of R 26,00). (Where applicable, VAT should
be added to the above). The appropriate Nappi code(s), where applicable, for the prosthesis and/or internal fixation used,
must be provided.
II.b.2
Material used during a consultation
0201
Cost of material in treatment: This item provides for a charge for material used in treatment. Charge for material at cost
price PLUS 26% (up to a maximum of R26,00). (Where applicable, VAT should be added to the above). The appropriate
Surgical and Material Nappi code(s), selected from those codes commencing with 4, 5, 6, where applicable, for the
material used, must be provided. Please note: Refer to item 0198 for once off administration of medicine.
13 Mar 2008
Page 10 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
67.70 (59.40)
135.40 (118.80)
56.70 (49.70)
102.10 (89.60)
06.52
06.52
06.52
06.52
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
II.c
0202
II.d
5930
Setting of sterile tray
Setting of sterile tray: A fee of 10,00 clinical procedure units may be charged for the setting of a sterile tray where a
06.52
sterile procedure is performed in the rooms. Cost of stitching material, if applicable, shall be charged for according to item
0201, as appropriate
Own equipment used in treatment
Surgical laser apparatus: Hire fee for own equipment
06.52
Fee
10.000 70.30 (61.70)
109.000
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
10.000 70.30 (61.70)
766.10 109.000
(672.00)
766.10
(672.00)
5932
III.
6999
Candella laser apparatus: Hire fee for own equipment (Rates by arrangement with the scheme concerned)
06.52
PROCEDURES
Unlisted procedure/service: A procedure/service may be provided that is not listed in this edition of the coding structure.
06.52
Refer to General Rule C for the criteria to use item 6999
GENERAL MODIFIERS GOVERNING THIS SECTION
0011
Emergency procedures: Any bona fide, justifiable emergency procedure (all hours) undertaken in an operating theatre and/or in another setting in lieu of an operating theatre, will attract an additional
12,00 clinical procedure units per half-hour or part thereof of the operating time for all members of the surgical team. Modifier 0011 does not apply in respect of patients on scheduled lists. (A medical
emergency is any condition where death or irreparable harm to the patient will result if there are undue delays in receiving appropriate medical treatment)
0013
Endoscopic examinations done at operations: Where a related endoscopic examination is done at an operation by the operating surgeon or the attending anaesthesiologist, only 50% of the fee for the
endoscopic examination may be charged
0014
Operations previously performed by other surgeons: Where an operation is performed which has been previously performed by another surgeon, e.g. a revision or repeat operation, the fee shall be
calculated according to the tariff for the full operation
MODIFIERS GOVERNING SECTION 1
0015
Intravenous infusions: Where intravenous infusions (including blood and blood cellular products) are administered as part of the after-treatment after the operation or confinement, no extra fees shall
be charged as this is included in the global operative or maternity fees. Should the practitioner doing the operation or attending to the maternity case prefer to ask another practitioner to perform postoperative or post-confinement intravenous infusions, then the practitioner himself (and not the patient) shall be responsible for remunerating such practitioner for the infusions
0017
Injections administered by practitioners: When desensitisation, intravenous, intramuscular or subcutaneous injections are 06.52
7.500 85.12 (74.67)
7.500 85.12 (74.67)
administered by the practitioner him-/herself to patients who attend the consulting rooms, a first injection forms part of the
consultation/visit and only all subsequent injections for the same condition should be charged at 7.50 consultative
services units using modifier 0017 to reflect the amount (not chargeable together with a consultation item)
1
General
1.1
Injections, Infusions and Inhalation Sedation Treatment
0203
Inhalation sedation: Use of analgesic nitrous oxide for alcohol and other withdrawal states: First quarter-hour or part
06.52
6.000 42.20 (37.00)
6.000 42.20 (37.00)
thereof
0204
Inhalation sedation: Per additional quarter-hour or part thereof
06.52
3.000 21.10 (18.50)
3.000 21.10 (18.50)
0205
Intravenous treatment: Intravenous infusions (cut-down or push-in) (patients under three years): Cut-down and/or
06.52
12.000 84.30 (73.90) 12.000 84.30 (73.90)
insertion of cannula - chargeable once per 24 hours
0206
Intravenous treatment: Intravenous infusions (push-in) (patients over three years): Insertion of cannula - chargeable once 06.52
6.000 42.20 (37.00)
6.000 42.20 (37.00)
per 24 hours
0207
Intravenous treatment: Intravenous infusions (cut-down) (patients over three years): Cut-down and insertion of cannula - 06.52
8.000 56.20 (49.30)
8.000 56.20 (49.30)
chargeable once per 24 hours
0208
Venesection: Therapeutic venesection (Not to be used when blood is drawn for the purpose of laboratory investigations) 06.52
6.000 42.20 (37.00)
6.000 42.20 (37.00)
0209
Umbilical artery cannulation at birth
06.52
18.000
126.50 18.000
126.50
(111.00)
(111.00)
0210
Collection of blood specimen(s) by medical practitioner for pathology examination, per venesection (not to be used by
06.52
3.250 22.80 (20.00)
3.250 22.80 (20.00)
pathologists)
13 Mar 2008
Page 11 of 151
06.52
06.52
06.52
06.52
Version 2008.50
Code
0211
Description
Ver
Exchange transfusion: First and subsequent (including after-care)
06.52
Add
Specialists
RVU
Fee
80.000
562.20
(493.20)
General Practitioners
/ non-designated
Specialists
RVU
Fee
80.000
Anaesthesiology
RVU
Fee
562.20
(493.20)
Note: HOW TO CHARGE FOR INTRAVENOUS INFUSIONS:
06.52
Practitioners are entitled to charge according to the appropriate item whenever they personally insert the cannula (but
may only charge for this service once every 24 hours). For managing the infusion as such, e.g. checking it when visiting
the patient or prescribing the substance, no fee may be charged since this service is regarded as part of the services the
doctor renders during consultations (not applicable to item 0205)
MODIFIERS GOVERNING THE ADMINISTRATION OF ANAESTHETICS FOR ALL PROCEDURES AND OPERATIONS
0020
Conscious sedation: Any case that is conducted outside of a hospital theatre shall be coded with the relevant procedure code. To identify these cases, the above modifier should be used to indicate
to the Fund that there will be no hospital/theatre account.
0021
Determination of anaesthetic fees: Anaesthetic fees are determined by obtaining the sum of the basic anaesthetic units (allocated to each procedure that might be performed under anaesthetic as
indicated in the "Anaesthetic Performed" column) plus the time units (calculated according to the formula in Modifier 0023) and the appropriate modifers (see Modifiers 0037-0044). In cases of
operative procedures on the musculoskeletal system, open fractures and open reduction of fractures or dislocations add units as laid down by Modifiers 5441 to 5448
0023
The basic anaesthetic units are laid down in the tariff and are reflected in the anaesthetic column. These basic anaesthetic units reflect the additional anaesthetic risk, the technical skill required of the
anaesthesiologist/anaesthetist and the scope of the surgical procedure, but exclude the value of the actual time spent administering the anaesthetic. The time units (indicated by “T”) will be added to
the listed basic anaesthetic units in all cases on the following basis: Anaesthetic time: The remuneration for anaesthetic time shall be per 15 minute period or part thereof, calculated from the
commencement of the anaesthetic, i.e. 2,00 anaesthetic units per 15 minute period or part thereof, provided that should the duration of the anaesthetic be longer than one (1) hour the number of units
shall, after one (1) hour, be 3,00 anaesthetic units per 15 minute period or part thereof.
0024
Pre-operative assessments not followed by procedures: If a pre-operative assessment of a patient by the anaesthesiologist/anaesthetist is not followed by an operation, it will be regarded as a visit at
hospital or nursing home and the appropriate hospital visit item should be charged.
0025
Calculation of anaesthetic time: Anaesthetic time is calculated from the time the anaesthesiologist/anaesthetist begins to prepare the patient for the induction of anaesthesia in the operating theatre or
in a similar equivalent area and ends when the anaesthesiologist/anaesthetist is no longer required to give his/her personal professional attention to the patient, i.e. when the patient may, with
reasonable safety, be placed under the customary post-operative supervision. Where prolonged personal professional attention is necessary for the well-being and safety of such patient, the
necessary time will be valued on the same basis as indicated above for the anaesthetic time. The anaesthesiologist/anaesthetist must show on his/her account the exact anaesthetic time, including
the supervision time spent with the patient.
0027
More than one procedure under the same anaesthetic: Where more than one operation is performed under the same anaesthetic, the basic anaesthetic units will be that of the major operation with
the highest number of units
0028
Indicator for use of low flow anaesthetic technique less than 1litre/minute: Fresh gas flow of less than 1 litre/minute
0029
Assistant anaesthesiologists: When rendered necessary by the scope of the anaesthetic, an assistant anaesthesiologist may be employed. The remuneration of the assistant anaesthesiologist shall
be calculated on the same basis as in the case where a general practitioner administers the anaesthetic
0030
Indicator for use of low flow anaesthetic technique 1-2 litre/minute: Fresh gas flow of 1 to 2 litre/minute
0031
Intravenous drips and transfusions: Treatment with intravenous drips and transfusions is considered part of the normal treatment in administering an anaesthetic. No additional fees may be charged
for such services when rendered either prior to, or during actual theatre or operating time
0032
Patients in prone position: Anaesthesia administered to patients in the prone position shall have a minimum of 4,00 basic anaesthetic units. When the basic anaesthetic units for the procedure is 3,
00, one extra anaesthetic unit should be added. If the basic anaesthetic units for the procedure is 4,00 or more, no extra units should be added
0033
Participating in general care of patients: When an anaesthesiologist/anaesthetist is required to participate in the general care of a patient during a surgical procedure, but does not administer the
anaesthetic, such services may be remunerated at full anaesthetic rate, subject to the provisos of modifier 0035: Anaesthetic administered by an anaesthesiologist/anaesthetist. and modifier 0036:
Anaesthetic administered by general practitioners.
0034
Head and neck procedures: All anaesthetics administered for diagnostic, surgical or X-ray procedures on the head and neck shall have a minimum of 4,00 basic anaesthetic units. When the basic
anaesthetic units for the procedure is 3,00, one extra anaesthetic unit should be added. If the basic anaesthetic units for the procedure is 4,00 or more, no extra units should be added
0035
Anaesthetic administered by an anaesthesiologist/anaesthetist: No anaesthetic administered shall have a total value of less than 7,00 anaesthetic units (basic units, time units plus appropriate
modifiers).
13 Mar 2008
Page 12 of 151
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
0036
Anaesthetic administered by general practitioners: The units (basic units plus time plus the appropriate modifiers) used to calculate the fee for an anaesthetic administered by a general practitioner
06.52
lasting one hour or less shall be the same as that for an anaesthesiologist. For anaesthetic lasting more than one hour, the units used to calculate the fee for an anaesthetic administered by a general
practitioner will be 4/5 (80%) of the total number of units (basic units plus time [refer to modifier 0023] plus the appropriate modifiers) applicable to an anaesthesiologist. Please note that the 4/5 (80%)
principle will be applied to all anaesthetics administered by general practitioners with the proviso that no anaesthetic with a total number of units higher than 11.00 will be reduced to less than 11,00
units in total. The monetary value of the unit is the same for both an anaesthesiologist/anaesthetist.
0037
Body hypothermia: Utilisation of total body hypothermia: Add 3,00 anaesthetic units
06.52
3.000
132.33
(116.08)
0038
Peri-operative blood salvage: Add 4,00 anaesthetic units for intra-operative blood salvage and 4,00 anaesthetic units for post-operative blood salvage
06.52
0039
Control of blood pressure: Deliberate control of the blood pressure: All cases up to one hour: Add 3,00 anaesthetic units, thereafter add 1,00 (one) additional anaesthetic unit per quarter hour or part 06.52
thereof
0040
Phaeochromocytoma: The basic anaesthetic units for procedures performed for phaeochromocytoma shall be 15,00 anaesthetic units
06.52
0041
Hyperbaric pressurisation: Utilisation of hyperbaric pressurisation: Add 3,00 anaesthetic units
06.52
3.000
132.33
(116.08)
0042
Extracorporeal circulation: Utilisation of extracorporeal circulation: Add 3,00 anaesthetic units
06.52
3.000
132.33
(116.08)
0043
Patients under one year of age: For all cases where the patient is under one year of age – 3,00 anaesthetic units to be
06.52
3.000
132.33
added
(116.08)
0044
Neonates (i.e up to and including 28 days after birth): 3,00 anaesthetic units to be added to the basic anaesthetic units for 06.52
3.000
132.33
the particular procedure. This modifier is charged in addition to Modifier 0043: Cases under one year of age
(116.08)
0100
Intra-aortic balloon pump: Where an anaesthesiologist would be responsible for operating an intra-aortic balloon pump, a fee of 75,00 clinical procedure units is applicable.
06.52
Modifiers 5441 to 5448
06.52
Modification of the anaesthetic fee in cases of operative procedures on the musculo-skeletal system, open fractures and open reduction of fractures and dislocations is governed by adding units
indicated by modifiers 5441 to 5448. (The letter "M" is annotated next to the number of units of the appropriate items, for facilitating identification of the relevant items)
5441
Add one (1,00) anaesthetic unit, except where the procedure refers to the bones named in Modifiers 5442 to 5448
06.52
1.000 44.11 (38.69)
5442
Shoulder, scapula, clavicle, humerus, elbow joint, upper 1/3 tibia, knee joint, patella, mandible and tempero-mandibular
06.52
2.000 88.22 (77.39)
joint: Add two (2,00) anaesthetic units
5443
Maxillary and orbital bones: Add three (3,00) anaesthetic units
06.52
3.000
132.33
(116.08)
5444
Shaft of femur: Add four (4,00) anaesthetic units
06.52
4.000
176.44
(154.77)
5445
Spine (except coccyx), pelvis, hip, neck of femur: Add five (5,00) anaesthetic units
06.52
5.000
220.55
(193.46)
5448
Sternum and/or ribs and musculo-skeletal procedures which involve an intra-thoracic approach: Add eight (8,00)
06.52
8.000
352.88
anaesthetic units
(309.54)
POST-OPERATIVE ALLEVIATION OF PAIN
0045
Post-operative alleviation of pain:
06.52
(a) When a regional or nerve block procedure is performed, the appropriate procedure item to patient in ward or nursing facility, can be charged, provided that it is not the primary anaesthetic
technique
(b) When a second medical practitioner has administered the regional or nerve block for post-operative alleviation of pain, it shall be charged according to the particular procedure for instituting
therapy. Revisits shall be charged according to the appropriate hospital follow-up visit to patient in ward or nursing facility.
(c) None of the above is applicable for routine post-operative pain management i.e. intramuscular, intravenous or subcutaneous administration of opiates or NSAID (non-steroidal anti-inflammatory
drug)
13 Mar 2008
Page 13 of 151
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
2
2.2
0222
0223
0233
Integumentary System
Skin (general)
Intralesional injection into areas of pathology e.g. Keloid: Single
Intralesional injection into areas of pathology e.g. Keloids: Multiple
Biopsy without suturing: First lesion
06.52
06.52
06.52
4.000 28.10 (24.60)
8.000 56.20 (49.30)
6.000 42.20 (37.00)
4.000 28.10 (24.60)
8.000 56.20 (49.30)
6.000 42.20 (37.00)
3.000
0234
Biopsy without suturing: Subsequent lesions (each)
06.52
3.000 21.10 (18.50)
3.000 21.10 (18.50)
3.000
0235
Biopsy without suturing: Maximum for multiple additional lesions
06.52
0237
Deep skin biopsy by surgical incision with local anaesthetic and suturing
0244
18.000
126.50
(111.00)
12.000 84.30 (73.90)
3.000
06.52
126.50
(111.00)
12.000 84.30 (73.90)
Repair of nail bed
06.52
30.000
30.000
Drainage of subcutaneous abscess onychia, paronychia, pulp space or avulsion of nail
06.52
20.000
0257
06.52
87.000
0259
Drainage of major hand or foot infection: Drainage of major abscess with necrosis of tissue, involving deep fascia or
requiring debridement; complete excision of pilonidal cyst or sinus
Removal of foreign body superficial to deep fascia (except hands)
06.52
20.000
0261
Removal of foreign body deep to deep fascia (except hands)
06.52
31.000
210.80
(184.90)
140.60
(123.30)
611.40
(536.30)
140.60
(123.30)
217.90
(191.10)
3.000
0255
210.80
(184.90)
140.60
(123.30)
611.40
(536.30)
140.60
(123.30)
217.90
(191.10)
2.3
0289
Major plastic repair
Large skin grafts, composite skin grafts, large full thickness free skin grafts
06.52
234.000
187.200
Reconstructive procedures (including all stages) and skin graft by myo-cutaneous or fascio-cutaneous flap
06.52
410.000
0291
Reconstructive procedures (including all stages) grafting by micro-vascular re-anastomosis
06.52
800.000
0292
Distant flaps: First stage
06.52
206.000
0293
Contour grafts (excluding cost of material)
06.52
206.000
0294
Vascularised bone graft with or without soft tissue with one or more sets of micro-vascular anastomoses
06.52
0295
Local skin flaps (large, complicated)
06.52
1200.00
0
206.000
0296
Other procedures of major technical nature
06.52
206.000
0297
Subsequent major procedures for repair of same lesion
06.52
104.000
0298
Lower abdominal dermo-lipectomy
06.52
170.000
1315.60
(1154.00)
2305.20
(2022.10)
4497.90
(3945.50)
1158.20
(1016.00)
1158.20
(1016.00)
6746.90
(5918.30)
1158.20
(1016.00)
1158.20
(1016.00)
730.90
(641.10)
955.80
(838.40)
4.000
0290
1644.60
(1442.60)
2881.50
(2527.60)
5622.40
(4931.90)
1447.80
(1270.00)
1447.80
(1270.00)
8433.60
(7397.90)
1447.80
(1270.00)
1447.80
(1270.00)
730.90
(641.10)
1194.80
(1048.10)
13 Mar 2008
Page 14 of 151
18.000
20.000
87.000
20.000
31.000
328.000
640.000
164.800
164.800
960.000
164.800
164.800
104.000
136.000
3.000
3.000
3.000
3.000
3.000
4.000
4.000
4.000
4.000
6.000
4.000
4.000
4.000
5.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
264.70
(232.20)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
0299
Major abdominal lipectomy with repositioning of umbilicus
06.52
2.4
0300
Lacerations, scars, tumours, cysts and other skin lesions
Stitching of soft-tissue injuries: Stitching of wound (with or without local anaesthesia): Including normal after-care)
06.52
0301
Stitching of soft-tissue injuries: Additional wounds stitched at same session (each)
06.52
0302
Stitching of soft-tissue injuries: Deep laceration involving limited muscle damage
06.52
64.000
0303
Stitching of soft-tissue injuries: Deep laceration involving extensive muscle damage
06.52
128.000
0304
Major debridement of wound, sloughectomy or secondary suture
06.52
50.000
0305
Needle biopsy - soft tissue
06.52
25.000
0307
Excision and repair by direct suture; excision nail fold or other minor procedures of similar magnitude
06.52
27.000
0308
Each additional small procedure done at the same time
06.52
14.000
0310
Radical excision of nailbed
06.52
38.000
0314
Requiring repair by large skin graft or large local flap or other procedures of similar magnitude
06.52
104.000
0315
Requiring repair by small skin graft or small local flap or other procedures of similar magnitude
06.52
55.000
2.5
0316
Breasts
Fine needle aspiration for soft tissue (all areas)
06.52
15.000
0317
Aspiration of cyst or tumour
06.52
0319
Mastotomy with exploration, drainage of abscess or removal of mammary implant
06.52
42.000
0321
Biopsy or excision of cyst, benign tumour, aberrant breast tissue, duct papilloma
06.52
94.200
0323
Subareolar cone excision of ducts of wedge excision of breast
06.52
90.000
0324
Wedge excision of breast and axillary dissection
06.52
225.000
0325
Total mastectomy
06.52
155.000
0327
Total mastectomy with axillary gland biopsy
06.52
185.000
0329
Total mastectomy with axillary gland dissection
06.52
275.000
13 Mar 2008
Page 15 of 151
275.000
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
1932.70 220.000
(1695.40)
Anaesthesiology
RVU
Fee
1546.20
(1356.30)
5.000
220.60
(193.50)
14.000 98.40 (86.30)
14.000 98.40 (86.30)
3.000
7.000 49.20 (43.20)
7.000 49.20 (43.20)
3.000
449.80 64.000
449.80
(394.60)
(394.60)
899.60 120.000
843.40
(789.10)
(739.80)
351.40 50.000
351.40
(308.20)
(308.20)
175.70 25.000
175.70
(154.10)
(154.10)
189.80 27.000
189.80
(166.50)
(166.50)
98.40 (86.30) 14.000 98.40 (86.30)
4.000
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
132.30
(116.10)
267.10 38.000
(234.30)
730.90 104.000
(641.10)
386.50 55.000
(339.00)
105.40
(92.50)
9.000 63.30 (55.50)
295.20
(258.90)
662.00
(580.70)
632.50
(554.80)
1581.30
(1387.10)
1089.30
(955.50)
1300.20
(1140.50)
1932.70
(1695.40)
267.10
(234.30)
730.90
(641.10)
386.50
(339.00)
105.40
(92.50)
9.000 63.30 (55.50)
4.000
3.000
3.000
3.000
3.000
3.000
4.000
3.000
15.000
42.000
94.200
90.000
180.000
124.000
148.000
220.000
295.20
(258.90)
662.00
(580.70)
632.50
(554.80)
1265.00
(1109.60)
871.50
(764.50)
1040.10
(912.40)
1546.20
(1356.30)
3.000
3.000
3.000
3.000
5.000
5.000
5.000
5.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
0330
Nipple and areola reconstruction
06.52
95.000
0331
Subcutaneous mastectomy for disease of breast; including reconstruction but excluding cost of prosthesis: Unilateral
06.52
234.000
0333
Subcutaneous mastectomy for disease of breast; including reconstruction but excluding cost of prosthesis: Bilateral
06.52
410.000
0334
Removal of breast implant by means of capsulectomy: Per breast
06.52
234.000
0335
Implantation of internal subpectoral mammary prosthesis in post mastectomy patients
06.52
150.000
2.6
0351
Burns
Major Burns: Resuscitation (including supervision and intravenous therapy - first 48 hours)
06.52
276.000
0353
Tangential excision and grafting: Small
06.52
100.000
0354
Tangential excision and grafting: Large
06.52
200.000
2.7
0355
06.52
147.400
0357
Hands (skin)
Skin flap in acute hand injuries where a flap is taken from a site remote from the injured finger or in cases of
advancement flag e.g. Cutler
Small skin graft in acute hand injury
06.52
45.000
0359
Release of extensive skin contracture and/or excision of scar tissue with major skin graft resurfacing
06.52
192.000
0361
Z-plasty
06.52
220.100
0363
Local flap and skin graft
06.52
150.000
0365
Cross finger flap (all stages)
06.52
192.000
0367
Palmar flap (all stages)
06.52
192.000
0369
Distant flap: First stage
06.52
158.000
0371
Distant flap: Subsequent stage (not subject to general modifier 0007)
06.52
77.000
0373
Transfer neurovascular island flap
06.52
230.500
0374
Syndactyly: Separation of, including skin graft for one web (with skin flap and graft)
06.52
242.400
0375
Dupuytren's contracture: Fasciotomy
06.52
51.000
0376
Dupuytren's contracture: Fasciectomy
06.52
218.000
13 Mar 2008
Page 16 of 151
Fee
667.70
(585.70)
1644.60
(1442.60)
2881.50
(2527.60)
1644.60
(1442.60)
1054.20
(924.70)
General Practitioners
/ non-designated
Specialists
RVU
Fee
95.000
Anaesthesiology
RVU
Fee
667.70
(585.70)
1315.60
(1154.00)
2305.20
(2022.10)
1315.60
(1154.00)
843.40
(739.80)
4.000
1939.70 220.800
(1701.50)
702.80 100.000
(616.50)
1405.60 160.000
(1233.00)
1551.80
(1361.20)
702.80
(616.50)
1124.50
(986.40)
5.000
1035.90
(908.70)
316.30
(277.50)
1349.40
(1183.70)
1546.90
(1356.90)
1054.20
(924.70)
1349.40
(1183.70)
1349.40
(1183.70)
1110.40
(974.00)
541.20
(474.70)
1620.00
(1421.10)
1703.60
(1494.40)
358.40
(314.40)
1532.10
(1343.90)
843.40
(739.80)
316.30
(277.50)
1079.50
(946.90)
1237.50
(1085.50)
843.40
(739.80)
1079.50
(946.90)
1079.50
(946.90)
888.30
(779.20)
541.20
(474.70)
1296.00
(1136.80)
1362.90
(1195.50)
358.40
(314.40)
1225.70
(1075.20)
4.000
187.200
328.000
187.200
120.000
120.000
45.000
153.600
176.080
120.000
153.600
153.600
126.400
77.000
184.400
193.920
51.000
174.400
4.000
4.000
4.000
4.000
5.000
5.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
RULES GOVERNING THE SECTION ACUPUNCTURE
3
Musculo-skeletal System
MODIFIERS GOVERNING ORTHOPAEDIC OPERATIONS AND ANAESTHETIC FEES FOR ORTHOPAEDIC OPERATIONS
0047
A fracture NOT requiring reduction shall be charged on a fee per service basis
0048
Where in the treatment of a fracture or dislocation, an initial closed reduction is followed within one month by further
06.52
27.000
189.76 27.000
189.76
closed reductions under general anaesthesia, the fee for such subsequent reductions will be 27,00 clinical procedure
(166.46)
(166.46)
units (not including after-care)
0049
Except where otherwise specified, in cases of compound fractures, 77,00 clinical procedure units (specialists) and 77,00 06.52
77.000
541.16 77.000
541.16
clinical procedure units (general practitioners) are to be added to the units for the fractures including debridement
(474.70)
(474.70)
0050
In cases of a compound fracture where a debridement is followed by internal fixation (excluding fixation with Kirschner
06.52
115.500
811.73 115.500
811.73
wires, as well as fractures of hands and feet), the full amount according to either Modifier 0049: Cases of compound
(712.04)
(712.04)
fractures, or Modifier 0051: Fractures requiring open reduction, internal fixation, external skeletal fixation and/or bone
grafting, may be added to the fee for the procedure involved, plus half of the amount according to the second modifier
(either Modifier 0049: Cases of compound fractures or Modifier 0051: Fractures requiring open reduction, internal fixation,
external skeletal fixation and/or bone grafting, as applicable)
0051
Fractures requiring open reduction, internal fixation, external skeletal fixation and/or bone grafting: Specialists add 77,00 06.52
77.000
541.16 77.000
541.16
clinical procedure units. General practitioners add 77,00 clinical procedure units
(474.70)
(474.70)
0053
Fracture requiring percutaneous internal fixation [insertion and removal of fixatives (wires) in respect of fingers and toes
06.52
32.000
224.90 32.000
224.90
included]: Specialists and general practitioners add 32,00 clinical procedure units
(197.28)
(197.28)
0055
Dislocation requiring open reduction: Units for the specific joint plus 77,00 clinical procedure units for specialists. General 06.52
77.000
541.16 77.000
541.16
practitioners add 77,00 clinical procedure units
(474.70)
(474.70)
0057
Multiple procedures on feet: In multiple procedures on feet, fees for the first foot are calculated according to Modifier 0005: Multiple procedures/operations under the same anaesthetic. Calculate fees
for the second foot in the same way, reduce the total to 75% and add to the total for the first foot
0058
Revision operation for total joint replacement and immediate re-substitution (infected or non-infected): per fee for total joint replacement + 100%
3.1
Bones
3.1.1
Bones: Fractures (reduction under general anaesthetic - refer to modifier 0047)
0383
Fracture (reduction under general anaesthetic): Scapula
06.52
3.000
0387
Fracture (reduction under general anaesthetic): Clavicle
06.52
77.000
0388
Percutaneous pinning of supracondylar fracture: Elbow - stand alone procedure
06.52
175.700
0389
Fracture (reduction under general anaesthetic): Humerus
06.52
111.600
0391
Fracture (reduction under general anaesthetic): Radius and/or Ulna
06.52
77.000
0392
Fracture (reduction under general anaesthetic): Open reduction of both radius and ulna (modifier 0051 not applicable)
06.52
210.000
0402
Fracture (reduction under general anaesthetic): Carpal bone
06.52
64.000
0403
Fracture (reduction under general anaesthetic): Bennett fracture-dislocation
06.52
51.000
0405
Fracture (reduction under general anaesthetic): Open treatment of metacarpal: Simple
06.52
118.300
13 Mar 2008
Page 17 of 151
541.20
(474.70)
1234.80
(1083.20)
784.30
(688.00)
541.20
(474.70)
1475.90
(1294.60)
449.80
(394.60)
358.40
(314.40)
831.40
(729.30)
77.000
140.560
111.600
77.000
168.000
64.000
51.000
118.300
541.20
(474.70)
987.90
(866.60)
784.30
(688.00)
541.20
(474.70)
1180.70
(1035.70)
449.80
(394.60)
358.40
(314.40)
831.40
(729.30)
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
06.52
06.52
06.52
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
0409
Fracture (reduction under general anaesthetic): Finger phalanx: Distal: Simple
06.52
-
0411
Fracture (reduction under general anaesthetic): Finger phalanx: Distal: Compound
06.52
52.000
0413
Fracture (reduction under general anaesthetic): Proximal or middle: Simple
06.52
48.000
0415
Fracture (reduction under general anaesthetic): Proximal or middle: Compound
06.52
102.000
0417
Fracture (reduction under general anaesthetic): Pelvis fracture: Closed
06.52
-
0419
Fracture (reduction under general anaesthetic): Pelvis: Operative reduction and fixation
06.52
320.000
0421
Fracture (reduction under general anaesthetic): Femur: Neck or Shaft
06.52
237.000
0425
Fracture (reduction under general anaesthetic): Patella
06.52
51.000
0429
Fracture (reduction under general anaesthetic): Tibia with or without fibula
06.52
128.000
0433
Fracture (reduction under general anaesthetic): Fibula shaft
06.52
-
0435
Fracture (reduction under general anaesthetic): Malleolus of ankle
06.52
58.000
0437
Fracture (reduction under general anaesthetic): Fracture-dislocation of ankle
06.52
128.000
0438
Fracture (reduction under general anaesthetic): Open reduction Talus fracture (modifier 0051 not applicable)
06.52
198.700
0439
Fracture (reduction under general anaesthetic): Tarsal bones (excluding talus and calcaneus)
06.52
64.000
0440
Fracture (reduction under general anaesthetic): Open reduction Calcaneus fracture (modifier 0051 not applicable)
06.52
403.500
0441
Fracture (reduction under general anaesthetic): Metatarsal
06.52
41.800
0443
Fracture (reduction under general anaesthetic): Toe phalanx: Distal Simple
06.52
-
0445
Fracture (reduction under general anaesthetic): Toe phalanx: Compound
06.52
32.000
0447
Fracture (reduction under general anaesthetic): Other: Simple
06.52
26.000
0449
Fracture (reduction under general anaesthetic): Other: Compound
06.52
52.000
0451
Fracture (reduction under general anaesthetic): Sternum and/or ribs: Closed
06.52
-
0452
Fracture (reduction under general anaesthetic): Sternum and/or ribs: Open reduction and fixation of multiple fractured ribs 06.52
for flail chest
230.000
13 Mar 2008
Page 18 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
-
Anaesthesiology
RVU
Fee
-
-
3.000
365.50 52.000
(320.60)
337.30 48.000
(295.90)
716.90 102.000
(628.90)
-
365.50
(320.60)
337.30
(295.90)
716.90
(628.90)
-
3.000
2249.00 256.000
(1972.80)
1665.60 189.600
(1461.10)
358.40 51.000
(314.40)
899.60 120.000
(789.10)
-
1799.20
(1578.20)
1332.50
(1168.90)
358.40
(314.40)
843.40
(739.80)
-
3.000
407.60 58.000
(357.50)
899.60 120.000
(789.10)
1396.50 158.960
(1225.00)
449.80 64.000
(394.60)
2835.80 322.500
(2487.50)
293.80 41.800
(257.70)
-
407.60
(357.50)
843.40
(739.80)
1117.20
(980.00)
449.80
(394.60)
2266.50
(1988.20)
293.80
(257.70)
-
3.000
3.000
-
224.90
(197.30)
182.70
(160.30)
365.50
(320.60)
-
1616.40 184.000
(1417.90)
1293.20
(1134.40)
3.000
224.90
(197.30)
182.70
(160.30)
365.50
(320.60)
-
32.000
26.000
52.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
General Practitioners
/ non-designated
Specialists
RVU
Fee
Fee
Anaesthesiology
RVU
Fee
0455
Fracture (reduction under general anaesthetic): Spine: With or without paralysis: Cervical
06.52
-
-
-
-
3.000
0456
Fracture (reduction under general anaesthetic): Spine: With or without paralysis: Rest
06.52
-
-
-
-
3.000
0461
Fracture (reduction under general anaesthetic): Compression fracture: Cervical
06.52
-
-
-
-
3.000
0462
Fracture (reduction under general anaesthetic): Compression fracture: Rest
06.52
-
-
-
-
3.000
0463
Fracture (reduction under general anaesthetic): Spinous or transverse processes: Cervical
06.52
-
-
-
-
3.000
0464
Fracture (reduction under general anaesthetic): Spinous or transverse processes: Rest
06.52
-
-
-
-
3.000
3.1.1.1 Bones: Fractures (reduction under general anaesthetic - refer to modifier 0047): Operations for fractures
0465
Fractures involving large joints (includes the item for the relative bone) (this item may not be used as a modifier)
06.52
288.000
06.52
43.000
0475
Percutaneous insertion plus subsequent removal of Kirschner wires or Steinmann pins (no after-care) (modifier 0005 not
applicable)
Bonegrafting or internal fixation for malunion or non-union: Femur, Tibia, Humerus, Radius and Ulna
06.52
282.000
0479
Bonegrafting or internal fixation for malunion or non-union: Other bones
06.52
154.000
1619.30
(1420.40)
302.20
(265.10)
1585.50
(1390.80)
865.80
(759.50)
3.000
0473
2024.10 230.400
(1775.50)
302.20 43.000
(265.10)
1981.90 225.600
(1738.50)
1082.30 123.200
(949.40)
3.1.2
Bony operations
3.1.2.1 Bony operations: Bone grafting
0497
Resection of bone or tumour with or without grafting (benign)
06.52
282.000
225.600
Resection of bone or tumour with or without grafting (malignant) - does not include digits
06.52
340.000
0499
Grafts to cysts: Large bones
06.52
192.000
0501
Grafts to cysts: Small bones
06.52
128.000
0503
Grafts to cysts: Cartilage graft
06.52
206.000
0505
Grafts to cysts: Inter-metacarpal bone graft
06.52
147.000
0507
Removal of autogenous bone for grafting (not subject to general modifier 0005)
06.52
50.000
1585.50
(1390.80)
1911.60
(1676.80)
1079.50
(946.90)
843.40
(739.80)
1158.20
(1016.00)
843.40
(739.80)
351.40
(308.20)
3.000
0498
1981.90
(1738.50)
2389.50
(2096.10)
1349.40
(1183.70)
899.60
(789.10)
1447.80
(1270.00)
1033.10
(906.20)
351.40
(308.20)
06.52
06.52
-
-
-
-
06.52
128.000
899.60 120.000
(789.10)
843.40
(739.80)
3.1.2.2 Bony operations: Acute or chronic osteomyelitis
0509
Acute or chronic osteomyelitis: Conservative treatment
0511
Acute or chronic osteomyelitis: Operation: Tariff which would be applicable for compound fracture of the bone involved,
including six weeks post-operative care
0512
Acute or chronic osteomyelitis: Sternum sequestrectomy and drainage: Including six weeks after-care
13 Mar 2008
Page 19 of 151
272.000
153.600
120.000
164.800
120.000
50.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3.1.2.3 Bony operations: Osteotomy
0514
Osteotomy: Sternum: Repair of pectus excavatum
06.52
330.000
0515
Osteotomy: Sternum: Repair of pectus carinatum
06.52
330.000
0516
Osteotomy: Pelvic
06.52
320.000
0521
Osteotomy: Femoral: Proximal
06.52
320.000
0527
Osteotomy: Knee region
06.52
320.000
0528
Osteotomy: Os Calcis (Dwyer operation)
06.52
115.000
0530
Osteotomy: Metacarpal and phalanx: Corrective for malunion or rotation
06.52
120.000
0531
Rotational osteotomy of tibia and fibula - stand alone procedure
06.52
278.900
0532
Osteotomy: Rotation osteotomy of the Radius, Ulna or Humerus
06.52
160.000
0533
Osteotomy: Single metatarsal
06.52
60.000
0534
Osteotomy: Multiple metatarsal osteotomies
06.52
150.000
3.1.2.4 Bony operations: Exostosis
0535
Exostosis: Excision: Readily accessible sites
06.52
60.000
0537
06.52
96.000
3.1.2.5 Bony operations: Biopsy
0539
Needle Biopsy: Spine (no after-care) (modifier 0005 not applicable)
06.52
50.000
0541
Needle Biopsy: Other sites (no after-care) (modifier 0005 not applicable)
06.52
32.000
0543
Biopsy: Open (modifier 0005 not applicable): Readily accessible site
06.52
64.000
0545
Biopsy: Open (modifier 0005 not applicable): Less accessible site
06.52
96.000
3.2
3.2.1
0547
Joints
Joints: Dislocations
Joint: Dislocation: Clavicle either end
06.52
38.000
0549
Joint: Dislocation: Shoulder
06.52
51.000
Exostosis: Excision: Less accessible sites
13 Mar 2008
Page 20 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
2319.20
(2034.40)
2319.20
(2034.40)
2249.00
(1972.80)
2249.00
(1972.80)
2249.00
(1972.80)
808.20
(708.90)
843.40
(739.80)
1960.10
(1719.40)
1124.50
(986.40)
421.70
(369.90)
1054.20
(924.70)
264.000
421.70
(369.90)
674.70
(591.80)
60.000
351.40
(308.20)
224.90
(197.30)
449.80
(394.60)
674.70
(591.80)
50.000
267.10
(234.30)
358.40
(314.40)
38.000
264.000
256.000
256.000
256.000
115.000
120.000
223.120
128.000
60.000
120.000
96.000
32.000
64.000
96.000
51.000
Anaesthesiology
RVU
Fee
1855.40
(1627.50)
1855.40
(1627.50)
1799.20
(1578.20)
1799.20
(1578.20)
1799.20
(1578.20)
808.20
(708.90)
843.40
(739.80)
1568.10
(1375.50)
899.60
(789.10)
421.70
(369.90)
843.40
(739.80)
3.000
421.70
(369.90)
674.70
(591.80)
3.000
351.40
(308.20)
224.90
(197.30)
449.80
(394.60)
674.70
(591.80)
4.000
267.10
(234.30)
358.40
(314.40)
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
4.000
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
0551
Joint: Dislocation: Elbow
06.52
51.000
0552
Joint: Dislocation: Wrist
06.52
77.000
0553
Joint: Dislocation: Perilunar trans-scaphoid fracture dislocation
06.52
130.000
0555
Joint: Dislocation: Lunate
06.52
77.000
0556
Joint: Dislocation: Carpo-metacarpo dislocation
06.52
51.000
0557
Joint: Dislocation: Metacarpo-phalangeal or interphalangeal (hand)
06.52
26.000
0559
Joint: Dislocation: Hip
06.52
109.000
0561
Joint: Dislocation: Knee
06.52
96.000
0563
Joint: Dislocation: Patella
06.52
32.000
0565
Joint: Dislocation: Ankle
06.52
90.000
0567
Joint: Dislocation: Sub-Talar dislocation
06.52
90.000
0569
Joint: Dislocation: Intertarsal or Tarsometatarsal or Mid-tarsal
06.52
77.000
0571
Joint: Dislocation: Meta-tarsophalangeal or interphalangeal joints (foot)
06.52
14.000
0573
3.2.2
0578
Joint: Dislocation: Spine with or without paralysis
Joints: Operations for dislocations
Operations for dislocations: Recurrent dislocation of shoulder
06.52
-
06.52
200.000
0579
Operations for dislocations: Recurrent dislocation of all other joints
06.52
161.000
3.2.3
0582
Joints: Capsular operations
Capsulotomy or arthrotomy or biopsy or drainage of joint: Small joint (including three weeks after-care)
06.52
51.000
0583
Capsulotomy or arthrotomy or biopsy or drainage of joint: Large joint (including three weeks after-care)
06.52
96.000
0585
Capsulectomy digital joint
06.52
64.000
0586
Multiple percutaneous capsulotomies of metacarpophalangeal joints
06.52
90.000
0587
Release of digital joint contracture
06.52
128.000
13 Mar 2008
Page 21 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
358.40 51.000
358.40
(314.40)
(314.40)
541.20 77.000
541.20
(474.70)
(474.70)
913.60 120.000
843.40
(801.40)
(739.80)
541.20 77.000
541.20
(474.70)
(474.70)
358.40 51.000
358.40
(314.40)
(314.40)
182.70 26.000
182.70
(160.30)
(160.30)
766.10 109.000
766.10
(672.00)
(672.00)
674.70 96.000
674.70
(591.80)
(591.80)
224.90 32.000
224.90
(197.30)
(197.30)
632.50 90.000
632.50
(554.80)
(554.80)
632.50 90.000
632.50
(554.80)
(554.80)
541.20 77.000
541.20
(474.70)
(474.70)
98.40 (86.30) 14.000 98.40 (86.30)
-
Anaesthesiology
RVU
Fee
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
-
-
1405.60 160.000
(1233.00)
1131.50 128.800
(992.50)
1124.50
(986.40)
905.20
(794.00)
3.000
358.40 51.000
(314.40)
674.70 96.000
(591.80)
449.80 64.000
(394.60)
632.50 90.000
(554.80)
899.60 120.000
(789.10)
358.40
(314.40)
674.70
(591.80)
449.80
(394.60)
632.50
(554.80)
843.40
(739.80)
3.000
3.000
3.000
3.000
3.000
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3.2.4
0589
Joints: Synovectomy
Synovectomy: Digital joint
06.52
77.000
0592
Synovectomy: Large joint
06.52
160.000
0593
Tendon synovectomy
06.52
203.700
3.2.5
0597
Joints: Arthrodesis
Arthrodesis: Shoulder
06.52
224.000
0598
Arthrodesis: Elbow
06.52
180.000
0599
Arthrodesis: Wrist
06.52
180.000
0600
Arthrodesis: Digital joint
06.52
128.000
0601
Arthrodesis: Hip
06.52
320.000
0602
Arthrodesis: Knee
06.52
180.000
0603
Arthrodesis: Ankle
06.52
180.000
0604
Arthrodesis: Sub-talar
06.52
130.000
0605
Arthrodesis: Stabilisation of foot (triple-arthrodesis)
06.52
180.000
0607
Arthrodesis: Mid-tarsal wedge resection
06.52
180.000
3.2.6
0614
Joints: Arthroplasty
Arthroplasty: Debridement large joints
06.52
160.000
0615
Arthroplasty: Excision medial or lateral end of clavicle
06.52
116.000
0617
Shoulder: Acromioplasty
06.52
192.000
0619
Shoulder: Partial replacement
06.52
277.000
0620
Shoulder: Total replacement
06.52
416.000
0621
Elbow: Excision head of radius
06.52
96.000
0622
Elbow: Excision
06.52
192.000
13 Mar 2008
Page 22 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
541.20 77.000
(474.70)
1124.50 128.000
(986.40)
1431.60 162.960
(1255.80)
541.20
(474.70)
899.60
(789.10)
1145.30
(1004.60)
3.000
1574.30
(1381.00)
1265.00
(1109.60)
1265.00
(1109.60)
899.60
(789.10)
2249.00
(1972.80)
1265.00
(1109.60)
1265.00
(1109.60)
913.60
(801.40)
1265.00
(1109.60)
1265.00
(1109.60)
179.200
1259.40
(1104.70)
1012.00
(887.70)
1012.00
(887.70)
843.40
(739.80)
1799.20
(1578.20)
1012.00
(887.70)
1012.00
(887.70)
843.40
(739.80)
1012.00
(887.70)
1012.00
(887.70)
3.000
1124.50
(986.40)
815.20
(715.10)
1349.40
(1183.70)
1946.80
(1707.70)
2923.60
(2564.60)
674.70
(591.80)
1349.40
(1183.70)
128.000
899.60
(789.10)
815.20
(715.10)
1079.50
(946.90)
1557.40
(1366.10)
2338.90
(2051.70)
674.70
(591.80)
1079.50
(946.90)
3.000
144.000
144.000
120.000
256.000
144.000
144.000
120.000
144.000
144.000
116.000
153.600
221.600
332.800
96.000
153.600
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
5.000
5.000
3.000
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
220.60
(193.50)
220.60
(193.50)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
General Practitioners
/ non-designated
Specialists
RVU
Fee
Fee
0623
Elbow: Partial replacement
06.52
188.000
0624
Elbow: Total replacement
06.52
282.000
0625
Wrist: Excision distal end of ulna
06.52
96.000
0626
Wrist: Excision single bone
06.52
110.000
0627
Wrist: Excision proximal row
06.52
166.000
0631
Wrist: Total replacement
06.52
249.000
0635
Digital Joint: Total replacement
06.52
192.000
0637
Hip: Total replacement
06.52
416.000
0641
Hip: Prosthetic replacement of femoral head
06.52
288.000
0643
Hip: Girdlestone
06.52
320.000
0645
Knee: Partial replacement
06.52
277.000
0646
Knee: Total replacement
06.52
416.000
0649
Ankle: Total replacement
06.52
290.400
0650
Ankle: Astragalectomy
06.52
154.000
3.2.7
0661
Joints: Miscellaneous (joints)
Aspiration of joint or intra-articular injection (not including after-care) (modifier 0005 not applicable)
06.52
0663
Multiple intra-articular injections for rheumatoid arthritis (excluding after-care) (modifier 0005 not applicable): First joint
0665
Fee
3.000
9.000 63.30 (55.50)
9.000 63.30 (55.50)
3.000
06.52
7.500 52.70 (46.20)
7.500 52.70 (46.20)
3.000
06.52
4.000 28.10 (24.60)
4.000 28.10 (24.60)
3.000
0667
Multiple intra-articular injections for rheumatoid arthritis (excluding after-care) (modifier 0005 not applicable): Additional
(each)
Arthroscopy (excluding after-care) (modifiers 0005 and 0013 not applicable)
0669
Manipulation large joint under general anaesthetic (not including after-care) (modifier 0005 not applicable)
0669a
0670
0670a
225.600
96.000
110.000
132.800
199.200
153.600
332.800
230.400
256.000
221.600
332.800
232.320
123.200
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
60.000
421.70
(369.90)
14.000 98.40 (86.30)
3.000
06.52
421.70
(369.90)
14.000 98.40 (86.30)
Manipulation large joint under general anaesthetic (not including after-care) (modifier 0005 not applicable)
06.52
14.000 98.40 (86.30)
14.000 98.40 (86.30)
4.000
Only the consultation fee should be charged when manipulation of a large joint is performed with or without local
anaesthetic
The consultation fee only should be charged when manipulation of a large joint is performed with or without local
anaesthetic
06.52
-
-
-
-
3.000
06.52
-
-
-
-
4.000
13 Mar 2008
Page 23 of 151
60.000
150.400
RVU
1057.00
(927.20)
1585.50
(1390.80)
674.70
(591.80)
773.10
(678.20)
933.30
(818.70)
1400.00
(1228.10)
1079.50
(946.90)
2338.90
(2051.70)
1619.30
(1420.40)
1799.20
(1578.20)
1557.40
(1366.10)
2338.90
(2051.70)
1632.70
(1432.20)
865.80
(759.50)
06.52
1321.30
(1159.00)
1981.90
(1738.50)
674.70
(591.80)
773.10
(678.20)
1166.60
(1023.30)
1750.00
(1535.10)
1349.40
(1183.70)
2923.60
(2564.60)
2024.10
(1775.50)
2249.00
(1972.80)
1946.80
(1707.70)
2923.60
(2564.60)
2040.90
(1790.30)
1082.30
(949.40)
Anaesthesiology
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
132.30
(116.10)
176.40
(154.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
0673
Meniscectomy or operation for other internal derangement of knee
06.52
109.000
3.2.8
0675
Joints: Joint ligament reconstruction or suture
Joint ligament reconstruction or suture: Ankle: Collateral
06.52
160.000
0677
Joint ligament reconstruction or suture: Knee: Collateral
06.52
160.000
0678
Joint ligament reconstruction or suture: Knee: Cruciate
06.52
160.000
0679
Joint ligament reconstruction or suture: Ligament augmentation procedure of knee
06.52
280.000
0680
Joint ligament reconstruction or suture: Digital joint ligament
06.52
165.000
3.3
3.3.1
0682
Amputations
Amputations: Specific Amputations
Amputation: Fore-quarter amputation
06.52
294.000
0683
Amputation: Through shoulder
06.52
148.000
0685
Amputation: Upper arm or fore-arm
06.52
116.000
0687
Partial amputation of the hand: One ray
06.52
102.000
0691
Amputation: Whole or part of finger
06.52
116.800
0693
Hindquarter amputation
06.52
420.000
0695
Amputation: Through hip joint region
06.52
192.000
0697
Amputation: Through thigh
06.52
205.000
0699
Amputation: Below knee, through knee or Syme
06.52
194.000
0701
Amputation: Trans-metatarsal or trans-tarsal
06.52
142.000
0703
Amputation: Foot: One ray
06.52
97.000
0705
Amputation: Toe
06.52
66.000
3.3.2
0706
Amputations: Post-amputation reconstruction
Post-amputation reconstruction: Skin flap taken from a site remote from the injured finger or in cases of an advanced flap 06.52
e.g. Cutler
Post-amputation reconstruction: Krukenberg reconstruction
06.52
0707
13 Mar 2008
Page 24 of 151
75.000
206.000
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
766.10 109.000
(672.00)
1124.50
(986.40)
1124.50
(986.40)
1124.50
(986.40)
1967.80
(1726.10)
1159.60
(1017.20)
128.000
2066.20
(1812.50)
1040.10
(912.40)
815.20
(715.10)
716.90
(628.90)
820.90
(720.10)
2951.80
(2589.30)
1349.40
(1183.70)
1440.70
(1263.80)
1363.40
(1196.00)
998.00
(875.40)
681.70
(598.00)
463.80
(406.80)
235.200
128.000
128.000
224.000
132.000
120.000
116.000
102.000
116.800
336.000
153.600
164.000
155.200
120.000
97.000
66.000
527.10 75.000
(462.40)
1447.80 164.800
(1270.00)
Anaesthesiology
RVU
Fee
766.10
(672.00)
3.000
132.30
(116.10)
899.60
(789.10)
899.60
(789.10)
899.60
(789.10)
1574.30
(1381.00)
927.70
(813.80)
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
1653.00
(1450.00)
843.40
(739.80)
815.20
(715.10)
716.90
(628.90)
820.90
(720.10)
2361.40
(2071.40)
1079.50
(946.90)
1152.60
(1011.10)
1090.70
(956.80)
843.40
(739.80)
681.70
(598.00)
463.80
(406.80)
9.000
527.10
(462.40)
1158.20
(1016.00)
3.000
3.000
3.000
3.000
3.000
5.000
3.000
3.000
3.000
6.000
6.000
6.000
5.000
3.000
3.000
3.000
3.000
397.00
(348.20)
220.60
(193.50)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
220.60
(193.50)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
0709
Post-amputation reconstruction: Metacarpal transfer
06.52
192.000
0711
Post-amputation reconstruction: Pollicisation of the finger (to include all stages)
06.52
282.000
0712
Post-amputation reconstruction: Toe to thumb transfer
06.52
800.000
3.4
3.4.1
0713
Muscles, tendons and fasciae
Muscles, tendons and fasciae: Investigations
Electromyography
06.52
75.000
0714
Electro-myographic neuromuscular junctional study, including edrophonium response (not to be used with item 2730)
06.52
0715
Strength duration curve per session
06.52
527.10
(462.40)
57.000
400.60
(351.40)
10.500 73.80 (64.70)
0717
Electrical examination of single nerve or muscle
06.52
9.000 63.30 (55.50)
0718
Oxidative study for mitochondrial function
06.52
0721
Voltage integration during isometric contraction
06.52
449.80
(394.60)
12.000 84.30 (73.90)
0723
Tonometry with edrophonium
06.52
0725
Isometric tension studies with edrophonium
0727
General Practitioners
/ non-designated
Specialists
RVU
Fee
1349.40 153.600
(1183.70)
1981.90 225.600
(1738.50)
5622.40 640.000
(4931.90)
RVU
Fee
1079.50
(946.90)
1585.50
(1390.80)
4497.90
(3945.50)
3.000
527.10
(462.40)
57.000
400.60
(351.40)
10.500 73.80 (64.70)
3.000
9.000 63.30 (55.50)
3.000
75.000
3.000
3.000
3.000
3.000
449.80
(394.60)
12.000 84.30 (73.90)
3.000
8.000 56.20 (49.30)
8.000 56.20 (49.30)
3.000
06.52
10.000 70.30 (61.70)
10.000 70.30 (61.70)
3.000
Cranial reflex study (both early and late responses) supra occulofacial or corneofacial or flabellofacial: Unilateral
06.52
8.000 56.20 (49.30)
8.000 56.20 (49.30)
3.000
0728
Cranial reflex study (both early and late responses) supra occulofacial or corneofacial or flabellofacial: Bilateral
06.52
14.000 98.40 (86.30)
14.000 98.40 (86.30)
3.000
0729
Tendon reflex time
06.52
7.000 49.20 (43.20)
7.000 49.20 (43.20)
3.000
0730
Limb brain somatosensory studies (per limb)
06.52
49.000
0731
Vision and audio-sensory studies
06.52
49.000
0733
Motor nerve conduction studies (single nerve)
06.52
26.000
0735
Examinations of sensory nerve conduction by sweep averages (single nerve)
06.52
31.000
0737
Biopsy for motor nerve terminals and end plates
06.52
20.000
0739
Combined muscle biopsy with end plates and nerve terminal biopsy
06.52
34.000
0740
Muscle fatigue studies
06.52
20.000
13 Mar 2008
Page 25 of 151
64.000
Anaesthesiology
344.40
(302.10)
344.40
(302.10)
182.70
(160.30)
217.90
(191.10)
140.60
(123.30)
239.00
(209.60)
140.60
(123.30)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
64.000
49.000
49.000
26.000
31.000
20.000
34.000
20.000
344.40
(302.10)
344.40
(302.10)
182.70
(160.30)
217.90
(191.10)
140.60
(123.30)
239.00
(209.60)
140.60
(123.30)
3.000
3.000
8.000
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
352.90
(309.60)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
0741
Muscle biopsy
06.52
20.000
0742
Global fee for all muscle studies, including histochemical studies
06.52
262.000
4701
Biochemical estimations on muscle biopsy specimens: Creatine kinase
06.52
20.250
4703
Biochemical estimations on muscle biopsy specimens: Adenylate kinase
06.52
33.300
4705
4707
4709
4711
4713
Biochemical estimations on muscle biopsy specimens: Pyruvate kinase
Biochemical estimations on muscle biopsy specimens: Lactate dehydrogenase
Biochemical estimations on muscle biopsy specimens: Adenylate deaminase
Biochemical estimations on muscle biopsy specimens: Phosphoglycerate kinase
Biochemical estimations on muscle biopsy specimens: Phosphoglycerate mutase
06.52
06.52
06.52
06.52
06.52
5.700
1.600
9.900
13.700
25.900
4715
Biochemical estimations on muscle biopsy specimens: Enolase
06.52
32.700
4717
Biochemical estimations on muscle biopsy specimens: Phosphofructokinase
06.52
37.700
4719
Biochemical estimations on muscle biopsy specimens: Aldolase
06.52
15.750
4721
4723
Biochemical estimations on muscle biopsy specimens: Glyceraldehyde 3 phosphate dehydrogenase
Biochemical estimations on muscle biopsy specimens: Phosphorylase
06.52
06.52
11.060
34.700
4725
Biochemical estimations on muscle biopsy specimens: Phosphoglucomutase
06.52
40.300
4727
Biochemical estimations on muscle biopsy specimens: Phosphohexose Isomerase
06.52
28.800
4729
Biochemical estimations on muscle biopsy specimens: Muscle biopsy for muscle tension study
06.52
43.000
4731
4733
Biochemical estimations on muscle biopsy specimens: H-response study (per nerve)
Biochemical estimations on muscle biopsy specimens: Late response study (per nerve)
06.52
06.52
14.000
20.000
4735
Biochemical estimations on muscle biopsy specimens: Single fibre studies
06.52
71.000
4737
Biochemical estimations on muscle biopsy specimens: Somatosensory study (limb-spine)
06.52
69.000
4739
Biochemical estimations on muscle biopsy specimens: Dystrophin estimation
06.52
82.000
4745
Biochemical estimations on muscle biopsy specimens: Electron microscopy
06.52
75.000
3.4.2
0743
Muscles, tendons and fasciae: Decompression Operations
Major compartmental decompression
06.52
132.000
13 Mar 2008
Page 26 of 151
Fee
140.60
(123.30)
1841.30
(1615.20)
142.30
(124.80)
234.00
(205.30)
40.10 (35.20)
11.20 (9.82)
69.60 (61.10)
96.30 (84.50)
182.00
(159.60)
229.80
(201.60)
265.00
(232.50)
110.70
(97.10)
77.70 (68.20)
243.90
(213.90)
283.20
(248.40)
202.40
(177.50)
302.20
(265.10)
98.40 (86.30)
140.60
(123.30)
499.00
(437.70)
484.90
(425.40)
576.30
(505.50)
527.10
(462.40)
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
20.000
140.60
(123.30)
8.000
352.90
(309.60)
927.70 120.000
(813.80)
843.40
(739.80)
3.000
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
0744
Decompression operation: Fasciotomy only
06.52
60.000
421.70
(369.90)
60.000
421.70
(369.90)
3.000
132.30
(116.10)
3.4.3
0745
Muscles, tendons and fasciae: Muscle and tendon repair
Muscle and tendon repair: Biceps humeri
06.52
109.000
109.000
Muscle and tendon repair: Removal of calcification in Rotator cuff
06.52
96.000
0747
Muscle and tendon repair: Rotator cuff
06.52
134.000
0748
Muscle and tendon repair: Debridement rotator cuff
06.52
139.700
0749
Muscle and tendon repair: Scapulopexy - stand alone procedure
06.52
271.900
0755
Muscle and tendon repair: Infrapatellar of quadriceps tendon
06.52
128.000
0757
Muscle and tendon repair: Achilles tendon repair
06.52
197.600
0759
Muscle and tendon repair: Other single tendon
06.52
77.000
0763
Muscle and tendon repair: Tendon or ligament injection
06.52
9.000
766.10
(672.00)
674.70
(591.80)
843.40
(739.80)
843.40
(739.80)
1528.70
(1341.00)
843.40
(739.80)
1111.00
(974.60)
541.20
(474.70)
63.30 (55.50)
3.000
0746
766.10
(672.00)
674.70
(591.80)
941.80
(826.10)
981.80
(861.20)
1910.90
(1676.20)
899.60
(789.10)
1388.70
(1218.20)
541.20
(474.70)
63.30 (55.50)
0767
Hand: Flexor tendon suture: Primary (per tendon)
06.52
128.000
120.000
Hand: Flexor tendon suture: Secondary (per tendon)
06.52
160.000
0771
Extensor tendon suture: Primary (per tendon)
06.52
129.700
0773
Extensor tendon suture: Secondary (per tendon)
06.52
80.000
0774
Repair of Boutonniere deformity or Mallet finger with graft
06.52
183.700
843.40
(739.80)
899.60
(789.10)
843.40
(739.80)
562.20
(493.20)
1032.80
(906.00)
3.000
0769
899.60
(789.10)
1124.50
(986.40)
911.50
(799.60)
562.20
(493.20)
1291.00
(1132.50)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
132.30
(116.10)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
3.4.4
0775
Muscles, tendons and fasciae: Tendon graft
Free tendon graft
06.52
160.000
128.000
Reconstruction of pulley for flexor tendon
06.52
50.000
0777
Tendon graft: Finger: Flexor
06.52
192.000
0779
Tendon graft: Finger: Extensor
06.52
122.000
0780
Two stage flexor tendon graft using silastic rod
06.52
240.000
899.60
(789.10)
351.40
(308.20)
1079.50
(946.90)
843.40
(739.80)
1349.40
(1183.70)
3.000
0776
1124.50
(986.40)
351.40
(308.20)
1349.40
(1183.70)
857.40
(752.10)
1686.70
(1479.60)
13 Mar 2008
Page 27 of 151
96.000
120.000
120.000
217.520
120.000
158.080
77.000
9.000
128.000
120.000
80.000
146.960
50.000
153.600
120.000
192.000
3.000
4.000
4.000
4.000
3.000
4.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
3.4.5
0781
Muscles, tendons and fasciae: Tendolysis
Tendon freeing operation, except where specified elsewhere
06.52
64.000
0782
Carpal tunnel syndrome
06.52
98.700
0783
Tenolysis: De Quervain
06.52
38.000
0784
Trigger finger
06.52
38.000
0785
Flexor tendon freeing operation following free tendon graft or suture
06.52
186.800
0787
Extensor tendon freeing operation following graft or suture in finger, hand or forearm, each tendon
06.52
180.900
0788
Intrinsic tendon release per finger
06.52
64.000
0789
Central tendon tenotomy for Boutonniere deformity
06.52
64.000
3.4.6
0790
Muscles, tendons and fasciae: Tenodesis
Tenodesis: Digital joint
06.52
90.000
632.50
(554.80)
3.4.7
0791
Muscles, tendons and fasciae: Muscle tendon and facia transfer
Single tendon transfer
06.52
96.000
0792
Multiple tendon transfer
06.52
128.000
0793
Hamstring to quadriceps transfer
06.52
141.000
0794
Pectoralis major or Latissimus dorsi transfer to biceps tendon
06.52
320.000
0795
Tendon transfer at elbow
06.52
116.000
0802
Radial club hand repair - stand alone procedure
06.52
360.300
0803
Hand tendons: Single tendon transfer (first)
06.52
96.000
0809
Hand tendons: Substitution for intrinsic paralysis of hand
06.52
224.000
0811
Hand tendons: Opponens tendon transfer (including obtaining of graft)
06.52
220.600
674.70
(591.80)
899.60
(789.10)
990.90
(869.20)
2249.00
(1972.80)
815.20
(715.10)
2532.20
(2221.20)
674.70
(591.80)
1574.30
(1381.00)
1550.40
(1360.00)
3.4.8
0812
Muscles, tendons and fasciae: Muscle slide operations and tendon lengthening
Percutaneous Tenotomy: All sites
06.52
38.000
0813
Torticollis
06.52
96.000
13 Mar 2008
Page 28 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
449.80 64.000
(394.60)
693.70 98.700
(608.50)
267.10 38.000
(234.30)
267.10 38.000
(234.30)
1312.80 149.440
(1151.60)
1271.40 144.720
(1115.30)
449.80 64.000
(394.60)
449.80 64.000
(394.60)
267.10
(234.30)
674.70
(591.80)
Anaesthesiology
RVU
Fee
449.80
(394.60)
693.70
(608.50)
267.10
(234.30)
267.10
(234.30)
1050.30
(921.30)
1017.10
(892.20)
449.80
(394.60)
449.80
(394.60)
3.000
90.000
632.50
(554.80)
3.000
132.30
(116.10)
96.000
674.70
(591.80)
843.40
(739.80)
843.40
(739.80)
1799.20
(1578.20)
815.20
(715.10)
2025.80
(1777.00)
674.70
(591.80)
1259.40
(1104.70)
1240.30
(1088.00)
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
220.60
(193.50)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
267.10
(234.30)
674.70
(591.80)
3.000
120.000
120.000
256.000
116.000
288.240
96.000
179.200
176.480
38.000
96.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
5.000
3.000
3.000
3.000
3.000
3.000
5.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
0815
Scalenotomy
06.52
132.000
0817
Scalenotomy with excision of first rib
06.52
190.000
0821
Tennis elbow
06.52
96.000
0822
Open release elbow (Mitals) - stand alone procedure
06.52
278.200
0823
Excision or slide for Volkmann's Contracture
06.52
192.000
0825
Hip: Open muscle release
06.52
116.000
0829
Knee: Quadriceps plasty
06.52
160.000
0831
Knee: Open tenotomy
06.52
141.000
0835
Calf
06.52
96.000
0837
Open elongation tendon Achilles
06.52
96.000
0838
Percutaneous "Hoke" elongation tendo Achilles
06.52
79.300
0845
Foot: Plantar fasciotomy
06.52
70.000
0846
Foot: Postero-medial release for club-foot
06.52
192.000
3.5
0847
Bursae and ganglia
Excision: Semimembranosus
06.52
90.000
0849
Excision: Prepatellar
06.52
45.000
0851
Excision: Olecranon
06.52
81.800
0853
Excision: Small bursa or ganglion
06.52
80.900
0855
Excision: Compound palmar ganglion or synovectomy
06.52
128.000
0857
Bursae and ganglia: Aspiration or injection (no after-care) (modifier 0005 not applicable)
06.52
9.000
3.6
3.6.1
0859
Musculo-skeletal system: Miscellaneous
Musculo-skeletal system: Miscellaneous: Leg equalisation and congenital hips and feet
Leg equalisation and congenital hips and feet: Leg shortening
06.52
282.000
13 Mar 2008
Page 29 of 151
Fee
927.70
(813.80)
1335.30
(1171.30)
674.70
(591.80)
1955.20
(1715.10)
1349.40
(1183.70)
815.20
(715.10)
1124.50
(986.40)
990.90
(869.20)
674.70
(591.80)
674.70
(591.80)
557.30
(488.90)
492.00
(431.60)
1349.40
(1183.70)
General Practitioners
/ non-designated
Specialists
RVU
Fee
120.000
Anaesthesiology
RVU
Fee
843.40
(739.80)
1068.30
(937.10)
674.70
(591.80)
1564.20
(1372.10)
1079.50
(946.90)
815.20
(715.10)
899.60
(789.10)
843.40
(739.80)
674.70
(591.80)
674.70
(591.80)
557.30
(488.90)
492.00
(431.60)
1079.50
(946.90)
5.000
632.50 90.000
632.50
(554.80)
(554.80)
316.30 45.000
316.30
(277.50)
(277.50)
574.90 81.800
574.90
(504.30)
(504.30)
568.60 80.900
568.60
(498.80)
(498.80)
899.60 128.000
899.60
(789.10)
(789.10)
63.30 (55.50)
9.000 63.30 (55.50)
4.000
152.000
96.000
222.560
153.600
116.000
128.000
120.000
96.000
96.000
79.300
70.000
153.600
1981.90 225.600
(1738.50)
1585.50
(1390.80)
3.000
3.000
3.000
3.000
7.000
3.000
3.000
4.000
4.000
4.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
220.60
(193.50)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
308.80
(270.90)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
2923.60
(2564.60)
815.20
(715.10)
766.10
(672.00)
1124.50
(986.40)
1307.20
(1146.70)
224.90
(197.30)
182.70
(160.30)
91.40 (80.20)
0861
Leg equalisation and congenital hips and feet: Leg lengthening
06.52
416.000
0863
Leg equalisation and congenital hips and feet: Epiphysiodesis at one level
06.52
116.000
0865
Congenital dislocation of hip: Initial non-operative reduction and application of plaster cast: One hip
06.52
109.000
0867
Congenital dislocation of hip: Initial non-operative reduction and application of plaster cast: Both hips
06.52
160.000
0868
Open reduction of congenital dislocation of the hip
06.52
186.000
0869
Subsequent plasters
06.52
32.000
0873
Congenital club foot: Manipulation and plaster: One foot
06.52
26.000
0874
3.6.2
0883
Ponseti technique assistant (medical practitioner)
Musculo-skeletal system: Miscellaneous: Removal of internal fixatives of prosthesis
Removal of internal fixatives or prosthesis: Readily accessible
06.52
13.000
06.52
36.600
0884
Removal of internal fixatives: Less accessible
06.52
75.500
0885
Removal of prosthesis for infection soon after operation
06.52
128.000
0886
06.52 +
64.000
3.7
0887
Late removal of infected or not infected total joint replacement prosthesis (including six weeks after-care): ADD to the
item for total joint replacement of the specific joint
Plasters (exclusive of after-care)
Limb cast (excluding after-care) (modifier 0005 not applicable)
06.52
13.000 91.40 (80.20)
0889
Spica, plaster jacket or hinged cast brace (excluding after-care)
06.52
32.000
0891
Turnbuckle cast for scoliosis (excluding after-care)
06.52
51.000
0893
Adjustment or repair of turnbuckle cast for scoliosis (excluding after-care)
06.52
19.000
3.8
3.8.1
0895
Musculo-skeletal system: Special areas
Special areas: Foot and Ankle
Club foot: Revision club foot release - stand alone procedure
06.52
302.700
0896
Club foot: Posterior release only - stand alone procedure
06.52
159.300
0900
Excision tarsal coalition - stand alone procedure
06.52
141.500
0901
Tenotomy: Single tendon
06.52
63.300
13 Mar 2008
Page 30 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
13.000
2338.90
(2051.70)
815.20
(715.10)
766.10
(672.00)
899.60
(789.10)
1045.80
(917.40)
224.90
(197.30)
182.70
(160.30)
91.40 (80.20)
257.20 36.600
(225.60)
530.60 75.500
(465.40)
899.60 120.000
(789.10)
449.80 64.000
(394.60)
257.20
(225.60)
530.60
(465.40)
843.40
(739.80)
449.80
(394.60)
224.90
(197.30)
358.40
(314.40)
133.50
(117.10)
332.800
116.000
109.000
128.000
148.800
32.000
26.000
Anaesthesiology
RVU
Fee
3.000
3.000
3.000
3.000
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
3.000
132.30
(116.10)
6.000
264.70
(232.20)
13.000 91.40 (80.20)
3.000
32.000
224.90
(197.30)
358.40
(314.40)
133.50
(117.10)
4.000
132.30
(116.10)
176.40
(154.70)
220.60
(193.50)
220.60
(193.50)
1701.90
(1492.90)
895.60
(785.60)
843.40
(739.80)
444.90
(390.30)
3.000
51.000
19.000
2127.40 242.160
(1866.10)
1119.60 127.440
(982.10)
994.50 120.000
(872.40)
444.90 63.300
(390.30)
5.000
5.000
3.000
3.000
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
0903
Hammer toe: One toe
06.52
99.500
0905
Filleting of toe or Ruiz-Mora procedure
06.52
99.500
0906
Arthrodesis Hallux
06.52
148.000
0907
Silver bunionectomy or similar for Hallux Valgus
06.52
126.200
0909
Excision arthroplasty
06.52
145.200
0910
Cheilectomy or metatarsophangeal implant Hallux
06.52
183.000
0911
Metatarsal osteotomy or Lapidus or similar or Chevron - stand alone procedure
06.52
189.200
5730
Hallux Valgus double osteotomy etc.
06.52
182.600
5731
Distal soft tissue procedure for Hallux Valgus
06.52
173.600
5732
Aitkin procedure or similar
06.52
166.800
5734
Removal bony prominence foot e.g. bunionette (ò Bunionette not applicable to COID)
06.52
91.000
5735
Repair angular deformity toe (lesser toes)
06.52
97.200
5736
Sesamoidectomy
06.52
97.800
5737
Repair major foot tendons e.g. Tib Post
06.52
147.300
5738
Repair of dislocating peroneal tendons
06.52
173.200
5739
Forefoot reconstruction for rheumatoid arthritis: Clayton or similar: One foot
06.52
202.300
5740
Steindler strip - plantar fascia
06.52
97.200
5741
Kelikian syndactilly (one web space)
06.52
97.200
5742
Tendon transfer foot
06.52
172.000
5743
Capsulotomy metatarsophalangeal joints: Foot
06.52
86.800
3.8.2
3.8.3
0912
Big toe (refer to section 3.8.1 for procedures on big toe)
Special areas: Reimplantations
Replantation of amputated upper limb proximal to wrist joint
06.52
730.000
13 Mar 2008
Page 31 of 151
Fee
699.30
(613.40)
699.30
(613.40)
1040.10
(912.40)
886.90
(778.00)
1020.50
(895.20)
1286.10
(1128.20)
1329.70
(1166.40)
1283.30
(1125.70)
1220.10
(1070.30)
1172.30
(1028.30)
639.50
(561.00)
683.10
(599.20)
687.30
(602.90)
1035.20
(908.10)
1217.20
(1067.70)
1421.80
(1247.20)
683.10
(599.20)
683.10
(599.20)
1208.80
(1060.40)
610.00
(535.10)
General Practitioners
/ non-designated
Specialists
RVU
Fee
99.500
99.500
120.000
120.000
120.000
146.400
151.360
146.080
138.880
133.440
91.000
97.200
97.800
120.000
138.560
161.840
97.200
97.200
137.600
86.800
5130.40 584.000
(4500.40)
Anaesthesiology
RVU
Fee
699.30
(613.40)
699.30
(613.40)
843.40
(739.80)
843.40
(739.80)
843.40
(739.80)
1028.90
(902.50)
1063.80
(933.20)
1026.70
(900.60)
976.00
(856.10)
937.80
(822.60)
639.50
(561.00)
683.10
(599.20)
687.30
(602.90)
843.40
(739.80)
973.80
(854.20)
1137.40
(997.70)
683.10
(599.20)
683.10
(599.20)
967.10
(848.30)
610.00
(535.10)
3.000
4104.40
(3600.40)
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
0913
Replantation of thumb
06.52
670.000
0914
Replantation of a single digit (to be motivated), for multiple digits (modifier 0005 applicable)
06.52
580.000
0915
Replantation operation through the palm
06.52
1270.00
0
3.8.4
0922
Special areas: Hands: (Note: Skin: See Integumentary System)
Removal of foreign bodies requiring incision: Under local anaesthetic
06.52
19.000
0923
Removal of foreign bodies requiring incision: Under general or regional anaesthetic
06.52
32.000
0924
Crushed hand injuries: Initial extensive soft tissue toilet under general anaesthetic (sliding scale) - Minimum
06.52
37.000
06.52
0925
Item 0924: The number of units chargeable under this item ranges from 37.00 to 110.00 for Specialists and General
Practitioners.
Crushed hand injuries: Subsequent dressing changes under general anaesthetic
3.8.5
06.52
16.000
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
4708.80 536.000
(4130.50)
4076.20 464.000
(3575.60)
8925.60 1016.00
(7829.50)
0
133.50
(117.10)
224.90
(197.30)
260.00
(228.10)
19.000
112.40
(98.60)
16.000
32.000
37.000
Anaesthesiology
RVU
Fee
3767.00
(3304.40)
3261.00
(2860.50)
7140.40
(6263.50)
3.000
133.50
(117.10)
224.90
(197.30)
260.00
(228.10)
3.000
112.40
(98.60)
3.000
3.000
3.000
3.000
3.000
Special areas: Spine
Please note the following with regard to section 3.8.5: Spine
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
06.52
a) Modifier 0005 (multiple procedures/operations under the same anaesthetic) is not applicable if the following procedures are performed together:
1. Bone graft procedures and instrumentation are to be charged in addition to arthrodesis.
2. When vertebral procedures are performed by arthrodesis, bone grafts and instrumentation may be charged for in addition.
0929
b) Modifier 0005 (multiple procedures/operations under the same anaesthetic) would be applicable when arthrodesis is performed in addition to another procedure, e.g. Osteotomy, laminectomy.
Excision of one vertebral body, for a lesion within the body (no decompression)
06.52
207.000
1454.80 165.600
1163.80
3.000
(1276.10)
(1020.90)
Excision of each additional vertebral segment for a lesion within the body (no decompression)
06.52 +
42.000
295.20 42.000
295.20
3.000
(258.90)
(258.90)
Manipulation of spine under general anaesthetic: (no after-care) (modifier 0005 not applicable)
06.52
14.000 98.40 (86.30) 14.000 98.40 (86.30)
5.000
0930
Posterior osteotomy of spine: One vertebral segment
06.52
339.000
0931
Posterior spinal fusion: One level
06.52
385.000
0932
Posterior osteotomy of spine: Each additional vertebral segment
06.52 +
103.000
0933
Anterior spinal osteotomy with disc removal: One vertebral segment
06.52
315.000
0936
Anterior spinal osteotomy with disc removal: Each additional vertebral segment
06.52 +
103.000
0938
Anterior fusion base of skull to C2
06.52
449.000
0927
0928
13 Mar 2008
Page 32 of 151
2382.50
(2089.90)
2705.80
(2373.50)
723.90
(635.00)
2213.80
(1941.90)
723.90
(635.00)
3155.60
(2768.10)
271.200
308.000
103.000
252.000
103.000
359.200
1906.00
(1671.90)
2164.60
(1898.80)
723.90
(635.00)
1771.10
(1553.60)
723.90
(635.00)
2524.50
(2214.50)
3.000
3.000
3.000
3.000
3.000
4.000
132.30
(116.10)
132.30
(116.10)
220.60
(193.50)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
0939
Trans-abdominal anterior exposure of the spine for spinal fusion only if done by a second surgeon
06.52
160.000
0940
Trans-thoracic anterior exposure of the spine if done by a second surgeon
06.52
160.000
0941
Anterior interbody fusion: One level
06.52
360.000
0942
Anterior interbody fusion: Each additional level
06.52 +
102.000
0944
Posterior fusion: Occiput to C2
06.52
390.000
0946
Posterior spinal fusion: Each additional level
06.52 +
111.000
0948
Posterior interbody lumbar fusion: One level
06.52
364.000
0950
Posterior interbody lumbar fusion: Each additional interspace
06.52 +
95.000
0959
Excision of coccyx
06.52
96.000
0961
Costo-transversectomy
06.52
198.000
0963
Antero-lateral decompression of spinal cord or anterior debridement
06.52
326.000
Fee
1124.50
(986.40)
1124.50
(986.40)
2530.10
(2219.40)
716.90
(628.90)
2740.90
(2404.30)
780.10
(684.30)
2558.20
(2244.00)
667.70
(585.70)
674.70
(591.80)
1391.50
(1220.60)
2291.10
(2009.70)
General Practitioners
/ non-designated
Specialists
RVU
Fee
128.000
128.000
288.000
102.000
312.000
111.000
291.200
95.000
96.000
158.400
260.800
899.60
(789.10)
899.60
(789.10)
2024.10
(1775.50)
716.90
(628.90)
2192.70
(1923.40)
780.10
(684.30)
2046.60
(1795.30)
667.70
(585.70)
674.70
(591.80)
1113.20
(976.50)
1832.90
(1607.80)
Anaesthesiology
RVU
Fee
3.000
3.000
3.000
3.000
4.000
3.000
3.000
3.000
3.000
3.000
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
MODIFIER
0061
Combined procedures on the spine: In cases of combined procedures on the spine, both the orthopaedic surgeon and the neurosurgeon are entitled to the full fee for the relevant part of the operation 06.52
performed
3.8.6
Special areas: Spinal deformities
Please note : Posterior fusion for spinal deformity (to be used for scoliosis more than 30 degrees or thoracic kyphosis more than 45 degrees).
06.52
0952
Posterior fusion for spinal deformity: Up to 6 levels
06.52
359.000
0954
Posterior fusion for spinal deformity: 7 to 12 levels
06.52
547.000
0955
Posterior fusion for spinal deformity: 13 or more levels
06.52
593.000
0956
Anterior fusion for spinal deformity: 2 or 3 levels
06.52
410.000
0957
Anterior fusion for spinal deformity: 4 to 7 levels
06.52
444.000
0958
Anterior fusion for spinal deformity: 8 or more levels
06.52
539.000
2523.10
(2213.20)
3844.30
(3372.20)
4167.60
(3655.80)
2881.50
(2527.60)
3120.40
(2737.20)
3788.10
(3322.90)
287.200
437.600
474.400
328.000
355.200
431.200
2018.40
(1770.50)
3075.50
(2697.80)
3334.10
(2924.60)
2305.20
(2022.10)
2496.30
(2189.70)
3030.50
(2658.30)
3.000
3.000
3.000
3.000
3.000
3.000
MODIFIER
0065
Additional operative procedures by same surgeon, under section 3.8.6: Spinal deformities, within a period of 12 months: 75% of scheduled fee for the lesser procedure, except where otherwise
specified elsewhere
13 Mar 2008
Page 33 of 151
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
06.52
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3.8.7
0943
Special areas: All spinal problems
Laminectomy with decompression of nerve roots and disc removal: One level
06.52
240.000
0960
Posterior non-segmental instrumentation
06.52
167.000
0962
Posterior segmental instrumentation: 2 to 6 vertebrae
06.52
176.000
0964
Posterior segmental instrumentation: 7 to 12 vertebrae
06.52
201.000
0966
Posterior segmental instrumentation:13 or more vertebrae
06.52
245.000
0968
Anterior instrumentation: 2 to 3 vertebrae
06.52
159.000
0969
Skull or skull-femoral traction including two weeks after-care
06.52
64.000
0970
Anterior instrumentation: 4 to 7 vertebrae
06.52
185.000
0971
Halo-splint and POP jacket including two weeks after-care
06.52
116.000
0972
Anterior instrumentation: 8 or more vertebrae
06.52
206.000
0974
Additional pelvic fixation of instrumentation other than sacrum
06.52
108.000
5750
Reinsertion of instrumentation
06.52
276.000
5751
Removal of posterior non-segmental instrumentation
06.52
173.000
5752
Removal of posterior segmental instrumentation
06.52
175.000
5753
Removal of anterior instrumentation
06.52
204.000
5755
Laminectomy for spinal stenosis (exclude diskectomy, foraminotomy and spondylolisthesis): One or two levels
06.52
295.000
5756
Laminectomy with full decompression for spondylolisthesis (Gill procedure)
06.52
304.000
5757
Laminectomy for decompression without foraminotomy or diskectory more than two levels
06.52
321.000
5758
Laminectomy with decompression of nerve roots and disc removal: Each additional level
06.52 +
5759
Laminectomy for decompression diskectomy, etc. revision operation
06.52
352.000
5760
Laminectomy, facetectomy, decompression for lateral recess stenosis plus spinal stenosis: One level
06.52
301.000
5761
Laminectomy, facetectomy, decompression for lateral recess stenosis plus spinal stenosis: Each additional level
06.52 +
13 Mar 2008
Page 34 of 151
63.000
68.000
Fee
1686.70
(1479.60)
1173.70
(1029.60)
1236.90
(1085.00)
1412.60
(1239.10)
1721.90
(1510.40)
1117.50
(980.30)
449.80
(394.60)
1300.20
(1140.50)
815.20
(715.10)
1447.80
(1270.00)
759.00
(665.80)
1939.70
(1701.50)
1215.80
(1066.50)
1229.90
(1078.90)
1433.70
(1257.60)
2073.30
(1818.70)
2136.50
(1874.10)
2256.00
(1978.90)
442.80
(388.40)
2473.90
(2170.10)
2115.40
(1855.60)
477.90
(419.20)
General Practitioners
/ non-designated
Specialists
RVU
Fee
192.000
133.600
140.800
160.800
196.000
127.200
64.000
148.000
116.000
164.800
108.000
220.800
138.400
140.000
163.200
236.000
243.200
256.800
63.000
281.600
240.800
68.000
1349.40
(1183.70)
938.90
(823.60)
989.50
(868.00)
1130.10
(991.30)
1377.50
(1208.30)
894.00
(784.20)
449.80
(394.60)
1040.10
(912.40)
815.20
(715.10)
1158.20
(1016.00)
759.00
(665.80)
1551.80
(1361.20)
972.70
(853.20)
983.90
(863.10)
1147.00
(1006.10)
1658.60
(1454.90)
1709.20
(1499.30)
1804.80
(1583.20)
442.80
(388.40)
1979.10
(1736.10)
1692.30
(1484.50)
477.90
(419.20)
Anaesthesiology
RVU
Fee
3.000
5.000
5.000
5.000
5.000
5.000
132.30
(116.10)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
5.000
220.60
(193.50)
5.000
220.60
(193.50)
220.60
(193.50)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
5.000
6.000
6.000
6.000
6.000
3.000
3.000
3.000
3.000
4.000
3.000
3.000
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
5763
Anterior disc removal and spinal decompression cervical: One level
06.52
344.000
5764
Anterior disc removal and spinal decompression cervical: Each additional level
06.52 +
5765
Vertebral corpectomy for spinal decompression: One level
06.52
466.000
5766
Vertebral corpectomy for spinal decompression: Each additional level
06.52
88.000
5770
Use of microscope in spinal or intracranial procedures (modifier 0005 not applicable)
06.52
71.000
3.9
Facial bone procedures
Please note: Modifiers 0046 to 0058 are not applicable to section 3.9
81.000
2417.60 275.200
(2120.70)
569.30 81.000
(499.40)
3275.00 372.800
(2872.80)
618.50 88.000
(542.50)
499.00 71.000
(437.70)
1934.10
(1696.60)
569.30
(499.40)
2620.00
(2298.20)
618.50
(542.50)
499.00
(437.70)
Anaesthesiology
RVU
Fee
3.000
3.000
3.000
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
06.52
0987
Repair of orbital floor (blowout fracture)
06.52
184.600
0988
Genioplasty
06.52
263.000
0989
Open reduction and fixation of central mid-third facial fracture with displacement: Le Fort I
06.52
202.200
0990
Open reduction and fixation of central mid-third facial fracture with displacement: Le Fort II
06.52
302.000
0991
Open reduction and fixation of central mid-third facial fracture with displacement: Le Fort III
06.52
433.000
0992
Open reduction and fixation of central mid-third facial fracture with displacement: Le Fort I Osteotomy
06.52
970.000
0993
Open reduction and fixation of central mid-third facial fracture with displacement: Palatal Osteotomy
06.52
302.000
0994
Open reduction and fixation of central mid-third facial fracture with displacement: Le Fort II Osteotomy (team fee)
06.52
0995
Open reduction and fixation of central mid-third facial fracture with displacement: Le Fort III Osteotomy (team fee)
06.52
0996
0997
Open reduction and fixation of central mid-third facial fracture with displacement: Fracture of maxilla without displacement 06.52
Mandible: Fractured nose and zygoma: Open reduction and fixation
06.52
1103.00
0
1654.00
0
302.000
0999
Mandible: Fractured nose and zygoma: Closed reduction by inter-maxillary fixation
06.52
184.000
1001
Temporo-mandibular joint: Reconstruction for dysfunction
06.52
206.000
1003
Manipulation: Immobilisation and follow-up of fractured nose
06.52
35.000
1005
1007
Nasal fracture without manipulation
Mandibulectomy
06.52
06.52
320.000
1009
Maxillectomy
06.52
382.500
13 Mar 2008
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Page 35 of 151
1297.40
(1138.10)
1848.40
(1621.40)
1421.10
(1246.60)
2122.50
(1861.80)
3043.10
(2669.40)
6817.20
(5980.00)
2122.50
(1861.80)
7751.90
(6799.90)
11624.30
(10196.80)
2122.50
(1861.80)
1293.20
(1134.40)
1447.80
(1270.00)
246.00
(215.80)
2249.00
(1972.80)
2688.20
(2358.10)
147.680
210.400
161.760
241.600
346.400
776.000
241.600
882.400
1323.20
0
241.600
147.200
164.800
35.000
256.000
306.000
1037.90
(910.40)
1478.70
(1297.10)
1136.80
(997.20)
1698.00
(1489.50)
2434.50
(2135.50)
5453.70
(4783.90)
1698.00
(1489.50)
6201.50
(5439.90)
9299.40
(8157.40)
1698.00
(1489.50)
1034.50
(907.50)
1158.20
(1016.00)
246.00
(215.80)
1799.20
(1578.20)
2150.60
(1886.50)
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
3.000
3.000
4.000
3.000
5.000
4.000
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
132.30
(116.10)
220.60
(193.50)
176.40
(154.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1011
Bone graft to mandible
06.52
206.000
1012
Adjustment of occlusion by ramisection
06.52
227.000
1013
1015
06.52
06.52
131.000
06.52
262.000
4
4.1
1018
Fracture of arch of zygoma without displacement
Fracture of arch of zygoma with displacement requiring operative manipulation (not including associated fractures),
recent fracture (within four weeks)
Fracture of arch of zygoma with displacement requiring operative manipulation but not including associated fractures
(after four weeks)
Respiratory System
Nose and sinuses
Flexible nasopharyngolaryngoscope examination
06.52
51.940
1019
1020
ENT endoscopy in rooms with rigid endoscope
Repair of perforated septum: Any method
06.52
06.52
12.000
141.900
1022
Functional reconstruction of nasal septum
06.52
121.200
1024
Insertion of silastic obturator into nasal septum perforation (excluding material)
06.52
30.000
1025
Intranasal antrostomy (modifier 0005 to apply to opposite side of nose)
06.52
64.600
1027
Dacrocystorhinostomy
06.52
210.000
1029
Turbinectomy (modifier 0005 to apply to opposite side of nose)
06.52
62.600
1030
Endoscopic turbinectomy: Laser or microdebrider
06.52
90.000
1031
Removal of single nasal polyp at rooms (at initial consultation only)
06.52
25.400
1033
Removal of multiple polyps in hospital under general anaesthetic
06.52
81.800
1034
Autogenous nasal bone transplant: Bone removal included
06.52
100.000
1035
Functional endoscopic sinus surgery: Unilateral
06.52
140.000
1036
Functional endoscopic sinus surgery: Bilateral
06.52
245.000
1037
1039
Diathermy to nose or pharynx exclusive of consultation fee, uni- or bilateral: Under local anaesthetic
Diathermy to nose or pharynx exclusive of consultation fee, uni- or bilateral: Under general anaesthetic
06.52
06.52
8.000
35.000
1041
Control severe epistaxis requiring hospitalisation: Anterior plugging
06.52
40.000
1017
13 Mar 2008
Page 36 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
1447.80
(1270.00)
1595.40
(1399.50)
920.70
(807.60)
1841.30
(1615.20)
164.800
365.00
(320.20)
84.30 (73.90)
997.30
(874.80)
851.80
(747.20)
210.80
(184.90)
454.00
(398.20)
1475.90
(1294.60)
440.00
(386.00)
632.50
(554.80)
178.50
(156.60)
574.90
(504.30)
702.80
(616.50)
983.90
(863.10)
1721.90
(1510.40)
56.20 (49.30)
246.00
(215.80)
281.10
(246.60)
51.940
365.00
(320.20)
120.000
843.40
(739.80)
843.40
(739.80)
210.80
(184.90)
454.00
(398.20)
1180.70
(1035.70)
440.00
(386.00)
632.50
(554.80)
178.50
(156.60)
574.90
(504.30)
702.80
(616.50)
843.40
(739.80)
1377.50
(1208.30)
56.20 (49.30)
246.00
(215.80)
281.10
(246.60)
181.600
120.000
209.600
120.000
30.000
64.600
168.000
62.600
90.000
25.400
81.800
100.000
120.000
196.000
8.000
35.000
40.000
1158.20
(1016.00)
1276.30
(1119.60)
843.40
(739.80)
1473.10
(1292.20)
Anaesthesiology
RVU
Fee
4.000
4.000
3.000
3.000
4.000
4.000
4.000
4.000
5.000
4.000
5.000
4.000
4.000
4.000
4.000
4.000
6.000
176.40
(154.70)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
220.60
(193.50)
176.40
(154.70)
220.60
(193.50)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
264.70
(232.20)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1043
Control severe epistaxis requiring hospitalisation: Anterior and posterior plugging
06.52
60.000
1045
Ligation anterior ethmoidal artery
06.52
135.400
1047
Caldwell-Luc operation: Unilateral
06.52
137.300
1049
Ligation internal maxillary artery
06.52
196.000
1050
Vidian neurectomy (transantral or transnasal)
06.52
113.000
1051
Removal nasopharyngeal fibroma
06.52
285.000
1052
Instrumental examination of the nasopharynx including biopsy under general anaesthetic
06.52
50.000
1053
Frontal sinus drainage, trephine operation
06.52
93.100
1054
Antroscopy through the canine fossa (modifier 0005 to apply to opposite side of nose)
06.52
37.300
1055
External frontal ethmoidectomy
06.52
190.700
1057
External ethmoidectomy and/or sphenoidectomy
06.52
199.400
1058
Sublabial transseptal sphenoidotomy
06.52
137.000
1059
Frontal osteomyelitis
06.52
194.000
1060
Obliteration of frontal sinus
06.52
291.100
1061
Lateral rhinotomy
06.52
164.000
1062
Excision nasolabial cyst
06.52
186.100
1063
1065
Removal of foreign bodies from nose: At rooms
Removal of foreign body from nose: Under general anaesthetic
06.52
06.52
10.000
38.600
1067
Proof puncture at rooms: Unilateral
06.52
10.000
1069
Proof puncture, uni- or bilateral under general anaesthetic
06.52
35.000
1071
1077
1079
Proetz treatment (consultation fee only to be charged for first treatment)
Septum abscess: At rooms, including after-care
Septum abscess: Under general anaesthetic
06.52
06.52
06.52
4.000
8.000
35.000
1081
Oro-antral fistula (without Caldwell-Luc)
06.52
111.800
13 Mar 2008
Page 37 of 151
Fee
421.70
(369.90)
951.60
(834.70)
964.90
(846.40)
1377.50
(1208.30)
794.20
(696.70)
2003.00
(1757.00)
351.40
(308.20)
654.30
(573.90)
262.10
(229.90)
1340.20
(1175.60)
1401.40
(1229.30)
962.80
(844.60)
1363.40
(1196.00)
2045.90
(1794.60)
1152.60
(1011.10)
1307.90
(1147.30)
70.30 (61.70)
271.30
(238.00)
70.30 (61.70)
General Practitioners
/ non-designated
Specialists
RVU
Fee
60.000
Anaesthesiology
RVU
Fee
421.70
(369.90)
843.40
(739.80)
843.40
(739.80)
1102.00
(966.70)
794.20
(696.70)
1602.40
(1405.60)
351.40
(308.20)
654.30
(573.90)
6.000
1072.20
(940.50)
1121.10
(983.40)
843.40
(739.80)
1090.70
(956.80)
1636.70
(1435.70)
922.10
(808.90)
1046.30
(917.80)
70.30 (61.70)
271.30
(238.00)
70.30 (61.70)
4.000
246.00 35.000
246.00
(215.80)
(215.80)
28.10 (24.60)
4.000 28.10 (24.60)
56.20 (49.30)
8.000 56.20 (49.30)
246.00 35.000
246.00
(215.80)
(215.80)
785.70 111.800
785.70
(689.20)
(689.20)
4.000
120.000
120.000
156.800
113.000
228.000
50.000
93.100
152.560
159.520
120.000
155.200
232.880
131.200
148.880
10.000
38.600
10.000
6.000
4.000
6.000
4.000
6.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
264.70
(232.20)
264.70
(232.20)
176.40
(154.70)
264.70
(232.20)
176.40
(154.70)
264.70
(232.20)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1083
Choanal atresia: Intranasal approach
06.52
113.000
1084
Choanal atresia: Transpalatal approach
06.52
194.000
1085
06.52
350.000
1087
Total reconstruction of the nose: Including reconstruction of nasal septum (septum plasty), nasal pyramid (osteotomy)
and nasal tip
Sub-total reconstruction consisting of any two of the following: Septum plasty, osteotomy, nasal tip reconstruction
06.52
210.000
1089
Forehead rhinoplasty (all stages): Total
06.52
552.000
1091
Forehead rhinoplasty (all stages): Partial
06.52
414.000
1093
Forehead rhinoplasty (all stages): Rhinophyma without skin graft
06.52
138.000
1095
Full nasal reconstruction for secondary cleft lip deformity
06.52
357.900
1097
Partial nasal reconstruction for cleft lip deformity
06.52
199.700
1099
Columella reconstruction or lengthening
06.52
138.000
Fee
794.20
(696.70)
1363.40
(1196.00)
2459.80
(2157.70)
1475.90
(1294.60)
3879.50
(3403.10)
2909.60
(2552.30)
969.90
(850.80)
2515.30
(2206.40)
1403.50
(1231.10)
969.90
(850.80)
General Practitioners
/ non-designated
Specialists
RVU
Fee
113.000
155.200
280.000
168.000
441.600
331.200
120.000
286.320
159.760
120.000
794.20
(696.70)
1090.70
(956.80)
1967.80
(1726.10)
1180.70
(1035.70)
3103.60
(2722.50)
2327.70
(2041.80)
843.40
(739.80)
2012.30
(1765.20)
1122.80
(984.90)
843.40
(739.80)
Anaesthesiology
RVU
Fee
5.000
7.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
MODIFIERS GOVERNING NASAL OPERATIONS
0069
When endoscopic instruments are used during intranasal surgery: Add 10% of the fee of the procedure performed. Only applicable to items 1025, 1027, 1030, 1033, 1035, 1036, 1039, 1047, 1054
and 1083
4.2
Throat
1101
Tonsillectomy (dissection of the tonsils)
06.52
75.000
527.10 75.000
527.10
4.000
(462.40)
(462.40)
1102
Laser tonsillectomy
06.52
75.000
527.10 75.000
527.10
6.000
(462.40)
(462.40)
1105
Removal of adenoids
06.52
40.000
281.10 40.000
281.10
4.000
(246.60)
(246.60)
1106
Laser assisted functional reconstruction of palate uvula: In the rooms (+ item 5930 for hire of laser)
06.52
168.300
1182.80 134.640
946.20
5.000
(1037.50)
(830.00)
1107
Opening of quinsy: At rooms
06.52
12.000 84.30 (73.90) 12.000 84.30 (73.90)
6.000
1108
06.52
85.000
1109
Laser assisted functional reconstruction of palate uvula: In the rooms (+ item 5930 for hire of laser): Follow-up operation
performed by the same surgeon
Opening of quinsy: Under general anaesthetic
06.52
35.000
1110
Ludwig's Angina: Drainage
06.52
42.000
1111
Post tonsillectomy or adenoidectomy haemorrhage
06.52
46.000
1112
Pharyngeal pouch operation
06.52
231.800
13 Mar 2008
Page 38 of 151
597.40 85.000
(524.00)
246.00 35.000
(215.80)
295.20 42.000
(258.90)
323.30 46.000
(283.60)
1629.10 185.440
(1429.00)
597.40
(524.00)
246.00
(215.80)
295.20
(258.90)
323.30
(283.60)
1303.30
(1143.20)
5.000
6.000
9.000
6.000
5.000
220.60
(193.50)
308.80
(270.90)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
06.52
176.40
(154.70)
264.70
(232.20)
176.40
(154.70)
220.60
(193.50)
264.70
(232.20)
220.60
(193.50)
264.70
(232.20)
397.00
(348.20)
264.70
(232.20)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
1113
Retropharyngeal abscess: Internal approach
06.52
35.000
1115
Retropharyngeal abscess: External approach
06.52
85.000
1116
Functional reconstruction of palate and uvula
06.52
168.300
4.3
1117
1118
Larynx
Laryngeal intubation
Laryngeal stroboscopy with video capture
06.52
06.52
1119
Laryngectomy without block dissection of the neck
06.52
1123
Botulinus toxin injection for adductor disphonia (+ item 0198 + item 0201 + item 0202)
06.52
1126
Post laryngectomy for voice restoration
06.52
1127
Tracheotomy
06.52
1128
Endolaryngeal operations
06.52
1129
External laryngeal operation e.g. laryngeal stenosis, laryngocele, abductor, paralysis, laryngocele-fissure
06.52
1130
Direct laryngoscopy: Diagnostic laryngoscopy including biopsy (also to be applied when a flexible fibre-optic
laryngoscope was used)
Direct laryngoscopy plus foreign body removal
06.52
10.000 70.30 (61.70) 10.000 70.30 (61.70)
39.000
274.10 39.000
274.10
(240.40)
(240.40)
430.000
3022.00 344.000
2417.60
(2650.90)
(2120.70)
35.000
246.00
(215.80)
139.500
980.40 120.000
843.40
(860.00)
(739.80)
90.000
632.50 90.000
632.50
(554.80)
(554.80)
75.000
527.10 75.000
527.10
(462.40)
(462.40)
294.400
2069.00 235.520
1655.20
(1814.90)
(1451.90)
41.400
291.00 41.400
291.00
(255.30)
(255.30)
64.600
454.00 64.600
454.00
(398.20)
(398.20)
1131
06.52
246.00 35.000
(215.80)
597.40 85.000
(524.00)
1182.80 134.640
(1037.50)
246.00
(215.80)
597.40
(524.00)
946.20
(830.00)
Anaesthesiology
RVU
Fee
6.000
6.000
5.000
6.000
7.000
9.000
9.000
8.000
8.000
6.000
6.000
264.70
(232.20)
264.70
(232.20)
220.60
(193.50)
264.70
(232.20)
308.80
(270.90)
397.00
(348.20)
397.00
(348.20)
352.90
(309.60)
352.90
(309.60)
264.70
(232.20)
264.70
(232.20)
MODIFIERS
0067
Microsurgery of the larynx: Add 25% to the fee of the operation performed (For other operations requiring the use of an operation microscope, the fee include the use of the microscope, except where 06.52
otherwise specified elsewhere in the Tariff)
4.4
Bronchial procedures
Note: Please specify on account if a biopsy was performed together with the bronchoscopy
06.52
1132
Bronchoscopy: Diagnostic bronchoscopy
06.52
1133
Bronchoscopy: Diagnostic bronchoscopy with removal of foreign body
06.52
1134
Bronchoscopy: Bronchoscopy with laser
06.52
1136
1137
Nebulisation (in rooms)
Bronchial lavage
06.52
06.52
1138
Thoracotomy: For broncho-pleural fistula (including ruptured bronchus, any cause)
06.52
13 Mar 2008
Page 39 of 151
65.000
456.80
(400.70)
80.000
562.20
(493.20)
75.000
527.10
(462.40)
12.000 84.30 (73.90)
350.000
65.000
80.000
456.80
(400.70)
562.20
(493.20)
6.000
8.000
8.000
12.000 84.30 (73.90)
2459.80 280.000
(2157.70)
1967.80
(1726.10)
12.000
8.000
12.000
264.70
(232.20)
352.90
(309.60)
352.90
(309.60)
84.30 (73.90)
352.90
(309.60)
529.30
(464.30)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
4.5
1139
Pleura
Pleural needle biopsy (no after-care) (modifier 0005 not applicable)
06.52
1141
Insertion of intercostal catheter (under water drainage)
06.52
1142
Intra-pleural block
06.52
1143
Paracentesis chest: Diagnostic
1145
Fee
50.000
06.52
351.40
(308.20)
50.000
351.40
(308.20)
36.000
253.00
(221.90)
8.000 56.20 (49.30)
Paracentesis chest: Therapeutic
06.52
13.000 91.40 (80.20)
13.000 91.40 (80.20)
1147
Pneumothorax: Induction (diagnostic)
06.52
25.000
1149
Pleurectomy
06.52
250.000
1151
Decortication of lung
06.52
350.000
4.6
4.6.1
1155
Pulmonary procedures
Pulmonary procedures: Surgical
Needle biopsy lung: (no after-care) (modifier 0005 not applicable)
06.52
32.000
1157
Pneumonectomy
06.52
350.000
1159
Pulmonary lobectomy
06.52
389.500
1161
Segmental lobectomy
06.52
365.000
1163
Excision tracheal stenosis: Cervical
06.52
375.000
1164
Excision tracheal stenosis: Intra thoracic
06.52
350.000
1167
Thoracoplasty associated with lung resection or done by the same surgeon within 6 weeks
06.52
215.000
1168
Thoracoplasty: Complete
06.52
250.000
1169
Thoracoplasty: Limited (osteoplastic)
06.52
200.000
1171
Drainage empyema (including six weeks after treatment)
06.52
170.000
1173
Drainage of lung abscess (including six weeks after treatment)
06.52
170.000
1175
Thoracotomy (limited): For lung or pleural biopsy
06.52
115.000
13 Mar 2008
Page 40 of 151
50.000
General Practitioners
/ non-designated
Specialists
RVU
Fee
351.40
(308.20)
50.000
351.40
(308.20)
36.000
253.00
(221.90)
8.000 56.20 (49.30)
175.70 25.000
(154.10)
1757.00 200.000
(1541.20)
2459.80 280.000
(2157.70)
175.70
(154.10)
1405.60
(1233.00)
1967.80
(1726.10)
224.90
(197.30)
2459.80
(2157.70)
2737.40
(2401.20)
2565.20
(2250.20)
2635.50
(2311.80)
2459.80
(2157.70)
1511.00
(1325.40)
1757.00
(1541.20)
1405.60
(1233.00)
1194.80
(1048.10)
1194.80
(1048.10)
808.20
(708.90)
224.90
(197.30)
1967.80
(1726.10)
2189.90
(1921.00)
2052.20
(1800.20)
2108.40
(1849.50)
1967.80
(1726.10)
1208.80
(1060.40)
1405.60
(1233.00)
1124.50
(986.40)
955.80
(838.40)
955.80
(838.40)
808.20
(708.90)
32.000
280.000
311.600
292.000
300.000
280.000
172.000
200.000
160.000
136.000
136.000
115.000
Anaesthesiology
RVU
Fee
3.000
6.000
36.000
3.000
3.000
11.000
11.000
5.000
11.000
11.000
11.000
8.000
12.000
12.000
11.000
11.000
11.000
11.000
11.000
132.30
(116.10)
264.70
(232.20)
253.00
(221.90)
132.30
(116.10)
132.30
(116.10)
485.20
(425.60)
485.20
(425.60)
220.60
(193.50)
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
352.90
(309.60)
529.30
(464.30)
529.30
(464.30)
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1177
Major: Diagnostic, as for inoperable carcinoma
06.52
215.000
1179
Thoracoscopy
06.52
89.000
1183
Excision or plication of emphysematous cyst: Unilateral
06.52
250.000
1184
Excision or plication of emphysematous cyst: Bilateral synchronous (Median sternotomy)
06.52
438.000
1185
Excision or plication of emphysematous cyst: Re-exploration following sternal dehiscence
06.52
100.000
4.6.2
1186
Pulmonary function tests
Flow volume test: Inspiration/expiration
06.52
30.000
1188
06.52
50.000
1189
1190
Flow volume test: Inspiration/expiration/pre- and post bronchodilator (to be charged for only with first consultation thereafter item 1186 applies)
Forced expirogram only
Determination of resistance to airflow in paediatric patients, impulse oscilimetry
06.52
06.52
10.000
45.310
1191
1192
1193
N2 single breath distribution
Peak expiratory flow only
Functional residual capacity or residual volume: Helium method, nitrogen open circuit method, or other method
06.52
06.52
06.52
10.000
5.000
37.760
1195
Thoracic gas volume
06.52
37.930
1196
Determination of resistance to airflow, oscillary or plethysmographic methods
06.52
45.310
1197
Compliance and resistance, using oesophageal balloon
06.52
24.000
1198
06.52
55.890
1199
Prolonged post exposure evaluation of bronchospasm with multiple spirometric determinations after antigen, cold air,
methacholine, other chemical agent or after exercise, with subsequent spirometry
Pulmonary stress testing: For determination of VO2 max
06.52
96.500
1200
Carbon monoxide diffusing capacity, any method
06.52
38.060
General Practitioners
/ non-designated
Specialists
RVU
Fee
RVU
Fee
1511.00
(1325.40)
625.50
(548.70)
1757.00
(1541.20)
3078.30
(2700.30)
702.80
(616.50)
172.000
1208.80
(1060.40)
625.50
(548.70)
1405.60
(1233.00)
2462.60
(2160.20)
702.80
(616.50)
11.000
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
210.80
(184.90)
351.40
(308.20)
70.30 (61.70)
318.40
(279.30)
70.30 (61.70)
35.10 (30.80)
265.40
(232.80)
266.60
(233.90)
318.40
(279.30)
168.70
(148.00)
392.80
(344.60)
678.20
(594.90)
267.50
(234.60)
35.10 (30.80)
30.000
210.80
(184.90)
50.000
351.40
(308.20)
10.000 70.30 (61.70)
30.000
10.000 70.30 (61.70)
5.000 35.10 (30.80)
10.000 70.30 (61.70)
5.000 35.10 (30.80)
24.000
24.000
Fee
89.000
200.000
350.400
100.000
55.890
96.500
168.70
(148.00)
392.80
(344.60)
678.20
(594.90)
Anaesthesiology
11.000
11.000
11.000
11.000
210.80
(184.90)
50.000
351.40
(308.20)
10.000 70.30 (61.70)
168.70
(148.00)
1201
Maximum inspiratory/expiratory pressure
06.52
5.000
5.000 35.10 (30.80)
5.000 35.10 (30.80)
4.7
Intensive care
RULES GOVERNING THIS SECTION
Q.
Intensive care/High Care: Units in respect of items 1204 to 1210 (Categories 1 to 3) EXCLUDE the following: (a) Anaesthetic and/or surgical fees for any condition or procedure, as well as a first
06.52
consultation/visit, which is, regarded as the assessment of the patient, while the daily intensive care/high care fee covers the daily care in the intensive/high care unit. (b) Cost of any drugs and/or
materials. (c) Any other cost which may be incurred before, during or after the consultation/visit and/or the therapy. (d) Blood gases and chemistry tests, including the arterial puncture to obtain the
specimen. (e) Procedural items 1202 and 1212 to 1221. but INCLUDE the following: (f) Performing and interpretation of a resting ECG. (g) Interpretation of chemistry tests and x-rays. (h) Intravenous
treatment (items 0206 and 0207), except intravenous infusion in patients under the age of three years (item 0205) that does not form a part of the daily ICU/High Care fee and may be charged for
separately on a daily basis (fee includes the introduction of the cannula as well as the daily management)
R.
Multiple organ failure: Units for items 1208, 1209 and 1210 (Category 3: Cases with multiple organ failure) include resuscitation (i.e. item 1211: Cardio-respiratory resuscitation)
06.52
13 Mar 2008
Page 41 of 151
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
S.
T.
4.7.1
1202
4.7.2
1204
1205
1206
1207
1208
1209
1210
4.7.3
1211
1212
1213
1214
1215
1216
1217
1218
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
Ventilation: Units for items 1212, 1213 and 1214 (ventilation) include the following: (a) Measurement of minute volume, vital capacity, time- and vital capacity studies. (b) Testing and connecting the
06.52
machine. (c) Putting patient on machine: setting machine, synchronising patient with machine. (d) Instruction to nursing staff. (e) All subsequent visits for 24 hours.
Ventilation (items 1212 to 1214) does not form a part of normal post-operative care, but may not be added to item 1204: Catogory 1: Cases requiring intensive monitoring
06.52
Intensive care: (in intensive care or high care unit): Respiratory, cardiac, general: Neonatal procedures
Insertion of central venous catheter via peripheral vein in neonates
06.52
40.000
281.10 40.000
281.10 40.000
281.10
(246.60)
(246.60)
(246.60)
Intensive care: (in intensive care or high care unit): Respiratory, cardiac, general: Tariff items for intensive care
Intensive care: Category 1: Cases requiring intensive monitoring (to include cases where physiological instability is
06.52
30.000
210.80 30.000
210.80 30.000
210.80
anticipated e.g. diabetic pre-coma, asthma, gastro-intestinal haemorrhage, etc.): Per day
(184.90)
(184.90)
(184.90)
Intensive care: Category 2: Cases requiring active system support (where active specialised intervention is required in
06.52
100.000
702.80 100.000
702.80 100.000
702.80
cases such as acute myocardial infarction, diabetic coma, head injury, severe asthma, acute pancreatitis, eclampsia, flail
(616.50)
(616.50)
(616.50)
chest, etc. Ventilation may or may not be part of the active system support): First day
Intensive care: Category 2: Cases requiring active system support (where active specialised intervention is required in
06.52
50.000
351.40 50.000
351.40 50.000
351.40
cases such as acute myocardial infarction, diabetic coma, head injury, severe asthma, acute pancreatitis, eclampsia, flail
(308.20)
(308.20)
(308.20)
chest, etc. Ventilation may or may not be part of the active system support): Subsequent days, per day
Intensive care: Category 2: Cases requiring active system support (where active specialised intervention is required in
06.52
30.000
210.80 30.000
210.80 30.000
210.80
cases such as acute myocardial infarction, diabetic coma, head injury, severe asthma, acute pancreatitis, eclampsia, flail
(184.90)
(184.90)
(184.90)
chest, etc. Ventilation may or may not be part of the active system support): After two weeks, per day
Please Note: The principal practitioner may charge items 1205 - 1207, other participating practitioners must charge the
06.52
consultation item, e.g. item 0109
Intensive care: Category 3: Cases with multiple organ failure or Category 2 patients which may require multidisciplinary
06.52
137.000
962.80 120.000
843.40 137.000
962.80
intervention: First day (primary practitioner)
(844.60)
(739.80)
(844.60)
Intensive care: Category 3: Cases with multiple organ failure or Category 2 patients which may require multidisciplinary
06.52
58.000
407.60 58.000
407.60 58.000
407.60
intervention: First day (per involved practitioner)
(357.50)
(357.50)
(357.50)
Intensive care: Category 3: Cases with multiple organ failure or Category 2 patients which may require multidisciplinary
06.52
50.000
351.40 50.000
351.40 50.000
351.40
intervention: Subsequent days (per involved practitioner)
(308.20)
(308.20)
(308.20)
Intensive care: (in intensive care or high care unit): Respiratory, cardiac, general: Procedures
Cardio-respiratory resuscitation: Prolonged attendance in cases of emergency (not necessarily in ICU) - 50,00 clinical
06.52
procedure units per half hour or part thereof for the first hour per practitioner, thereafter 25,00 clinical procedure units per
half hour up to a maximum of 150,00 clinical procedure units per practitioner. Resuscitation fee includes all necessary
additional procedures e.g. infusion, intubation, etc.
Ventilation: First day
06.52
75.000
527.10 75.000
527.10 75.000
527.10
(462.40)
(462.40)
(462.40)
Ventilation: Subsequent days, per day
06.52
50.000
351.40 50.000
351.40 50.000
351.40
(308.20)
(308.20)
(308.20)
Ventilation: After two weeks, per day
06.52
25.000
175.70 25.000
175.70 25.000
175.70
(154.10)
(154.10)
(154.10)
Insertion of arterial pressure cannula
06.52
25.000
175.70 25.000
175.70 25.000
175.70
(154.10)
(154.10)
(154.10)
Insertion of Swan Ganz catheter for haemodynamics monitoring
06.52
50.000
351.40 50.000
351.40 50.000
351.40
(308.20)
(308.20)
(308.20)
Insertion of central venous line via peripheral vein
06.52
10.000 70.30 (61.70) 10.000 70.30 (61.70) 10.000 70.30 (61.70)
Insertion of central venous line via subclavian or jugular veins
06.52
25.000
175.70 25.000
175.70 25.000
175.70
(154.10)
(154.10)
(154.10)
13 Mar 2008
Page 42 of 151
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
105.40
(92.50)
210.80
(184.90)
210.80
(184.90)
1219
Hyperalimentation (daily tariff)
06.52
15.000
1220
Patient-controlled analgesic pump: Hire fee: Per 24 hours (Cassette to be charged for according to item 0201 per patient) 06.52
30.000
1221
Professional fee for managing a patient-controlled analgesic pump: First 24 hours (for subsequent days charged the
appropriate hospital follow-up consultation/visit code)
Hyperbaric Oxygen Therapy
Internationally recognized scientific indications for Hyperbaric Oxygen Therapy:
30.000
4.8
4804
4820
4805
4821
4806
4822
4809
4825
4810
4826
4811
4827
a. Arterial gas embolism (traumatic or iatrogenic).
b. Decompression sickness ('the bends')
c. Carbon monoxide poisoning
d. Gas gangrene
e. Crush injuries, compartment syndromes or acute traumatic ischaemias.
f. Necrotising soft tissue infections (e.g. necrotising fasciitis)
g. Acute bloodloss anaemia (transfusion is contraindicated - e.g. Jehovah's Witnesses or haemolytic anaemia).
Monitoring of a patient at the hyperbaric chamber during hyperbaric treatment (includes pre-hyperbaric assessment,
monitoring during treatment, and post treatment evaluation): Low pressure table (1,5-1,8 ATA x 45-60 min):
PROFESSIONAL COMPONENT
Low pressure table (1,5-1,8 ATA x 45-60 min): TECHNICAL COMPONENT
06.52
30.000
06.52
101.130
Monitoring of a patient at the hyperbaric chamber during hyperbaric treatment (includes pre-hyperbaric assessment,
monitoring during treatment, and post treatment evaluation): Routine HBO table (2-2,5 ATA x 90-120 min):
PROFESSIONAL COMPONENT
Routine HBO table (2-2,5 ATA x 90-120 min): TECHNICAL COMPONENT
06.52
60.000
06.52
131.260
Monitoring of a patient at the hyperbaric chamber during hyperbaric treatment (includes pre-hyperbaric assessment,
monitoring during treatment, and post treatment evaluation): Emergency HBO table (2,5-3 ATA x 90-120 min):
PROFESSIONAL COMPONENT
Emergency HBO table (2,5-3 ATA x 90-120 min): TECHNICAL COMPONENT
06.52
80.000
06.52
131.260
Monitoring of a patient at the hyperbaric chamber during hyperbaric treatment (includes pre-hyperbaric assessment,
monitoring during treatment, and post treatment evaluation): USN TT5 (2,8 ATA x 135 min): PROFESSIONAL
COMPONENT
USN TT5 (2,8 ATA x 135 min): TECHNICAL COMPONENT
06.52
90.000
06.52
214.180
Monitoring of a patient at the hyperbaric chamber during hyperbaric treatment (includes pre-hyperbaric assessment,
monitoring during treatment, and post treatment evaluation): USN TT6 (2,8 ATA x 285 min): PROFESSIONAL
COMPONENT
USN TT6 (2,8 ATA x 285 min): TECHNICAL COMPONENT
06.52
190.000
06.52
386.420
Monitoring of a patient at the hyperbaric chamber during hyperbaric treatment (includes pre-hyperbaric assessment,
monitoring during treatment, and post treatment evaluation): USN TT6ext/6A or Cx 30 (2,8-6 ATA x 305-490 min):
PROFESSIONAL COMPONENT
USN TT6ext (2,8-6 ATA x 305-490 min): TECHNICAL COMPONENT
06.52
327.000
06.52
680.850
Page 43 of 151
15.000
30.000
30.000
105.40
(92.50)
210.80
(184.90)
210.80
(184.90)
Anaesthesiology
RVU
Fee
15.000
105.40
(92.50)
210.80
(184.90)
210.80
(184.90)
30.000
30.000
06.52
06.52
13 Mar 2008
General Practitioners
/ non-designated
Specialists
RVU
Fee
210.80
(184.90)
30.000
210.80
(184.90)
710.70 101.130
(623.40)
421.70 60.000
(369.90)
710.70
(623.40)
421.70
(369.90)
922.50 131.260
(809.20)
562.20 80.000
(493.20)
922.50
(809.20)
562.20
(493.20)
922.50 131.260
(809.20)
632.50 90.000
(554.80)
922.50
(809.20)
632.50
(554.80)
1505.30 214.180
(1320.40)
1335.30 190.000
(1171.30)
1505.30
(1320.40)
1335.30
(1171.30)
2715.80 386.420
(2382.30)
2298.20 327.000
(2016.00)
2715.80
(2382.30)
2298.20
(2016.00)
4785.00 680.850
(4197.40)
4785.00
(4197.40)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
4828
USN 6A (2,8-6 ATA x 305-490 min): TECHNICAL COMPONENT
06.52
678.280
4829
USN Cx 30 (2,8-6 ATA x 305-490 min): TECHNICAL COMPONENT
06.52
671.850
4815
5
1223
Prolonged attendance inside a hyperbaric chamber: 40,00 clinical procedure units per half hour or part thereof for the first 06.52
hour, thereafter 20,00 clinical procedure units per half hour: Minimum 40,00 clinical procedure units; maximum 320,00
clinical procedure units
Mediastinal Procedures
Mediastinoscopy
06.52
95.000
1224
Mediastinotomy
6
Cardiovascular System
MODIFIER GOVERNING FEES FOR AN ANAESTHESIOLOGIST OPERATING INTRA-AORTIC BALLOON PUMP
6.1
Cardiovascular system: General
1227
Prolonged neonatal resuscitation
06.52
115.000
06.52
20.000
Fee
4767.00 678.280
(4181.60)
4721.80 671.850
(4141.90)
4767.00
(4181.60)
4721.80
(4141.90)
667.70 95.000
(585.70)
808.20 115.000
(708.90)
667.70
(585.70)
808.20
(708.90)
140.60
(123.30)
140.60
(123.30)
Where ECG is done by a general practitioner but interpreted by a physician, the general practitioner is entitled to a
consultation fee, plus half of fee determined for ECG
General Practitioner's fee for the taking of an ECG only: Without effort: ½ (item 1232)
General Practitioner's fee for the taking of an ECG only: Without and with effort: ½ (item 1233)
Note: Items 1228 and 1229 deal only with the fees for taking of the ECG, the consultation fee must still be added
06.52
06.52
06.52
06.52
6.000 42.20 (37.00)
10.000 70.30 (61.70)
1232
1233
1241
1245
Physician's fee for interpreting an ECG: Without effort
Physician's fee for interpreting an ECG: With and without effort
A specialist physician is entitled to the fees specified in item 1230 and 1231 for interpretation of an ECG tracing referred
for interpretation. This applies also to a paediatrician when an ECG of a child is referred to him for interpretation
Electrocardiogram: Without effort
Electrocardiogram: With and without effort
X-ray Screening: Chest
Angiography cerebral: First two series
06.52
06.52
06.52
06.52
1246
Angiography peripheral: Per limb
06.52
1247
Cardioversion for arrhythmias (any method) with doctor in attendance
06.52
1248
Paracentesis of pericardium
06.52
1271
Cardiological supervision of Dobutamine magnetic resonance stress testing
06.52
9.000 63.30 (55.50)
13.000 91.40 (80.20)
4.000 28.10 (24.60)
34.300
241.10
(211.50)
25.000
175.70
(154.10)
65.000
456.80
(400.70)
50.000
351.40
(308.20)
51.000
358.40
(314.40)
1228
1229
1230
1231
13 Mar 2008
Page 44 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
06.52
06.52
06.52
20.000
Anaesthesiology
RVU
Fee
5.000
11.000
220.60
(193.50)
485.20
(425.60)
20.000
140.60
(123.30)
4.000
176.40
(154.70)
176.40
(154.70)
264.70
(232.20)
397.00
(348.20)
4.500 31.60 (27.70)
6.500 45.70 (40.10)
9.000 63.30 (55.50)
13.000 91.40 (80.20)
4.000 28.10 (24.60)
34.300
241.10
(211.50)
25.000
175.70
(154.10)
65.000
456.80
(400.70)
50.000
351.40
(308.20)
51.000
358.40
(314.40)
4.000
6.000
9.000
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
MODIFIER GOVERNING PAEDIATRIC CARDIAC CATHETERISATION BY PAEDIATRIC CARDIOLOGISTS WITH A "33" PRACTICE NUMBER
6.2
Invasive Cardiology
6.2.1
Invasive cardiology: Cardiac catheterisation
1249
Right and left cardiac catheterisation without coronary angiography (with or without biopsy)
06.52
140.000
1250
Endomyocardial biopsy
06.52
70.000
1251
Transeptal puncture
06.52
70.000
1252
Left heart catheterisation with coronary angiography (with or without biopsy)
06.52
140.000
1253
Right heart catheterisation (with or without biopsy)
06.52
70.000
1254
Catheterisation of coronary artery bypass grafts and/or internal mammary grafts
06.52
40.000
1255
Tilt test
06.52
31.300
6.2.2
1256
Invasive cardiology: Electrophysiological study
Ventricular stimulation study
06.52
160.000
1257
Full electrophysiological study
06.52
300.000
6.2.3
1258
Invasive cardiology: Pacemakers
Pacemaker: Permanent - single chamber
06.52
155.000
1259
Pacemaker: Permanent - dual chamber
06.52
230.000
1260
AV nodal ablation
06.52
300.000
1261
Accessory pathway ablation
06.52
600.000
1262
Electrophysiological mapping
06.52
500.000
1263
Insertion transvenous implantable defibrillator
06.52
212.000
1264
Test for implantable transvenous defibrillator
06.52
120.000
1265
Renewal of pacemaker unit only, team fee
06.52
125.000
1266
Resiting pacemaker generator
06.52
80.000
1267
Repositioning of catheter electrode
06.52
50.000
13 Mar 2008
Page 45 of 151
Fee
983.90
(863.10)
492.00
(431.60)
492.00
(431.60)
983.90
(863.10)
492.00
(431.60)
281.10
(246.60)
220.00
(193.00)
General Practitioners
/ non-designated
Specialists
RVU
Fee
RVU
Fee
9.000
70.000
70.000
492.00
(431.60)
492.00
(431.60)
9.000
9.000
9.000
9.000
40.000
31.300
281.10
(246.60)
220.00
(193.00)
1124.50
(986.40)
2108.40
(1849.50)
1089.30
(955.50)
1616.40
(1417.90)
2108.40
(1849.50)
4216.80
(3698.90)
3514.00
(3082.50)
1489.90
(1306.90)
843.40
(739.80)
878.50
(770.60)
562.20
(493.20)
351.40
(308.20)
Anaesthesiology
9.000
9.000
9.000
124.000
184.000
240.000
480.000
400.000
169.600
120.000
120.000
80.000
50.000
871.50
(764.50)
1293.20
(1134.40)
1686.70
(1479.60)
3373.40
(2959.10)
2811.20
(2466.00)
1191.90
(1045.50)
843.40
(739.80)
843.40
(739.80)
562.20
(493.20)
351.40
(308.20)
9.000
9.000
9.000
9.000
15.000
15.000
9.000
9.000
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
661.70
(580.40)
661.70
(580.40)
397.00
(348.20)
397.00
(348.20)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1268
Threshold testing: Own equipment
06.52
15.000
1269
1270
Threshold testing: Hospital equipment
Programming of atrio-ventricular sequential pacemaker
06.52
06.52
11.000
50.000
1273
Insertion of temporary pacemaker (modifier 0005 not applicable)
06.52
120.000
1275
Termination of arrhythmia - programmed stipulation and lead insertion of temporary pacer
06.52
200.000
6.2.4
1276
Invasive cardiology: Percutaneous translumical angioplasty
Percutaneous transluminal angioplasty: First cardiologist: Single lesion
06.52
260.000
1277
Percutaneous transluminal angioplasty: Second cardiologist: Single lesion
06.52
140.000
1278
Percutaneous transluminal angioplasty: First cardiologist: Second lesion
06.52
60.000
1279
Percutaneous transluminal angioplasty: Second cardiologist: Second lesion
06.52
40.000
1280
Percutaneous transluminal angioplasty: First cardiologist: Third or subsequent lesions (each)
06.52
60.000
1281
Percutaneous transluminal angioplasty: Second cardiologist: Third or subsequent lesions (each)
06.52
40.000
1282
06.52
260.000
1283
Use of balloon procedures including: First cardiologist: Atrial septostomy; Pulmonary valve valvuloplasty; Aortic valve
valvuloplasty; Coarctation dilation; Mitral valve valvuloplasty
Use of balloon procedure as in item 1282: Second cardiologist
06.52
140.000
1284
Atherectomy: Single lesion: First cardiologist
06.52
300.000
1285
Atherectomy: Single lesion: Second cardiologist
06.52
180.000
1286
Insertion of intravascular stent: First cardiologist
06.52
100.000
1287
Insertion of intravascular stent: Second cardiologist
06.52
50.000
1290
06.52
300.000
1291
Use of balloon procedures including: First paediatric cardiologist (33): Atrial septostomy; Pulmonary valve valvuloplasty;
Aortic valve valvuloplasty; Coarctation dilation; Mitral valve valvuloplasty; Closure atrial septal defect; Closure of patient
ductus arteriosus
Use of balloon procedure as in item 1290: Second paediatric cardiologist (33)
06.52
160.000
6.2.5
1288
Invasive cardiology: Paediatric cardiac catheterisation
Cardiac catheterisation for congenital heart disease: All ages above 1 year old
06.52
210.000
1289
Paediatric cardiac catheterisation: Infants below the age of one year
06.52
263.000
13 Mar 2008
Page 46 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
105.40
(92.50)
77.30 (67.80)
351.40 50.000
(308.20)
843.40 120.000
(739.80)
1405.60 160.000
(1233.00)
1827.30
(1602.90)
983.90
(863.10)
421.70
(369.90)
281.10
(246.60)
421.70
(369.90)
281.10
(246.60)
1827.30
(1602.90)
983.90
(863.10)
2108.40
(1849.50)
1265.00
(1109.60)
702.80
(616.50)
351.40
(308.20)
2108.40
(1849.50)
208.000
120.000
60.000
40.000
60.000
40.000
208.000
120.000
240.000
144.000
100.000
50.000
351.40
(308.20)
843.40
(739.80)
1124.50
(986.40)
1461.80
(1282.30)
843.40
(739.80)
421.70
(369.90)
281.10
(246.60)
421.70
(369.90)
281.10
(246.60)
1461.80
(1282.30)
843.40
(739.80)
1686.70
(1479.60)
1012.00
(887.70)
702.80
(616.50)
351.40
(308.20)
1124.50
(986.40)
1475.90 168.000
(1294.60)
1848.40 210.400
(1621.40)
1180.70
(1035.70)
1478.70
(1297.10)
Anaesthesiology
RVU
Fee
9.000
9.000
13.000
13.000
13.000
13.000
13.000
13.000
15.000
15.000
397.00
(348.20)
397.00
(348.20)
573.40
(503.00)
573.40
(503.00)
573.40
(503.00)
573.40
(503.00)
573.40
(503.00)
573.40
(503.00)
661.70
(580.40)
661.70
(580.40)
15.000
661.70
(580.40)
15.000
661.70
(580.40)
12.000
529.30
(464.30)
529.30
(464.30)
12.000
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
6.3
1294
Cardiac surgery
Patent ductus arteriosus
06.52
320.000
1295
Pericardiectomy for constrictive pericarditis
06.52
400.000
1297
Coarctation of aorta
06.52
425.000
1299
Systemo-pulmonary anastomosis
06.52
425.000
1301
Mitral valvotomy: Closed heart technique
06.52
350.000
1305
Operative implantation of cardiac pacemaker by thoracotomy
06.52
220.000
1307
Re-exploration after cardiac surgery
06.52
215.000
1311
Pericardial drainage
06.52
140.000
6.3.1
1312
Cardiac surgery: Open heart surgery
Evaluation of coronary angiogram by cardiothoracic surgeon
06.52
25.000
1320
Repeat open heart surgery (additional fee above procedure fee)
06.52
250.000
1321
Stand-by fee for coronary angioplasty
06.52
30.000
1322
Attendance at other operations or monitoring at bedside, by physician e.g. heart block etc.: Per hour
06.52
20.000
6.3.1.1 Cardiac surgery: Open heart surgery: Congenital conditions
1323
Atrial septal defect: Osteum secundum
06.52
500.000
1325
Atrial septal defect: Sinus venosus or osteum primum
06.52
563.000
1327
Atrial septal defect: Ventricular septal defect
06.52
603.800
1329
Atrial septal defect: Fallot's tetralogy
06.52
563.000
1330
Atrial septal defect: Pulmonary stenosis
06.52
500.000
1331
Transposition of large vessels (venous repair)
06.52
563.000
1332
Transposition of great arteries (arterial repair)
06.52
750.000
1333
Ebstein's Anomaly
06.52
563.000
13 Mar 2008
Page 47 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
RVU
Fee
256.000
1799.20
(1578.20)
2249.00
(1972.80)
2389.50
(2096.10)
2389.50
(2096.10)
1967.80
(1726.10)
1236.90
(1085.00)
1208.80
(1060.40)
843.40
(739.80)
13.000
573.40
(503.00)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
573.40
(503.00)
175.70
(154.10)
1757.00 200.000
(1541.20)
210.80 30.000
(184.90)
140.60
(123.30)
1405.60
(1233.00)
210.80
(184.90)
15.000
3514.00
(3082.50)
3956.80
(3470.90)
4243.50
(3722.40)
3956.80
(3470.90)
3514.00
(3082.50)
3956.80
(3470.90)
5271.00
(4623.70)
3956.80
(3470.90)
2811.20
(2466.00)
3165.40
(2776.70)
3394.80
(2977.90)
3165.40
(2776.70)
2811.20
(2466.00)
3165.40
(2776.70)
4216.80
(3698.90)
3165.40
(2776.70)
15.000
Fee
2249.00
(1972.80)
2811.20
(2466.00)
2986.90
(2620.10)
2986.90
(2620.10)
2459.80
(2157.70)
1546.20
(1356.30)
1511.00
(1325.40)
983.90
(863.10)
320.000
340.000
340.000
280.000
176.000
172.000
120.000
400.000
450.400
483.040
450.400
400.000
450.400
600.000
450.400
Anaesthesiology
15.000
15.000
15.000
15.000
15.000
15.000
13.000
30.000
15.000
15.000
15.000
15.000
15.000
15.000
15.000
661.70
(580.40)
210.80
(184.90)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1334
Aorto-coronary bypass operation as a MidCab procedure (thoracotomy with coronary grafting without bypass or
hypothermal)
Total anomalous venous drainage
06.52
548.800
06.52
563.000
06.52
658.900
1337
Aorto-coronary bypass operation as a OpCab procedure (sternotomy with coronary grafting without bypass or
hypothermia)
Creation of atrial septal defect by thoracotomy with or without cardiac bypass
06.52
500.000
1338
Fontan type repair
06.52
750.000
6.3.1.2 Cardiac surgery: Open heart surgery: Acquired conditions
1339
Mitral valve replacement
06.52
657.000
1340
Mitral valvuloplasty
06.52
688.000
1341
Aortic valve replacement
06.52
623.800
1342
Tricuspid annulo plasty
06.52
188.000
1343
Double valve replacement
06.52
968.900
1344
Acute dissecting aneurysm repair
06.52
750.000
1345
Aortic arch aneurysm repair utilising deep hypothermal and circulatory arrest
06.52
1346
06.52
06.52
175.000
1348
Aorta-coronary bypass operation (including interpretation of angiogram): Harvesting of saphenous veins: Unilateral
(modifier 0005 not applicable)
Aorta-coronary bypass operation (including interpretation of angiogram): Harvesting of saphenous veins: Bilateral
(modifier 0005 not applicable)
Aorta-coronary bypass operation (including interpretation of angiogram): Utilizing saphenous veins
1000.00
0
100.000
06.52
750.000
1349
Aorta-coronary bypass operation (including interpretation of angiogram): Additional arterial implant: Any artery
06.52
781.000
1350
Aorta-coronary bypass operation (including interpretation of angiogram): Additional double arterial implant: Any artery
06.52
813.000
1351
Aorta-coronary bypass operation with valve replacement or excision of cardiac aneurysm
06.52
875.000
1352
Cardiac aneurysm
06.52
563.000
1353
Ascending/descending thoracic aortic aneurysm repair
06.52
625.000
1354
Arrhythmia surgery
06.52
688.000
1356
Insertion and removal of intra-aortic balloon pump (modifier 0005 not applicable)
06.52
188.000
1335
1336
1347
13 Mar 2008
Page 48 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
RVU
Fee
3857.00
(3383.30)
3956.80
(3470.90)
4630.70
(4062.00)
3514.00
(3082.50)
5271.00
(4623.70)
439.040
3085.60
(2706.70)
3165.40
(2776.70)
3704.60
(3249.60)
2811.20
(2466.00)
4216.80
(3698.90)
20.000
882.20
(773.90)
661.70
(580.40)
882.20
(773.90)
661.70
(580.40)
661.70
(580.40)
4617.40
(4050.40)
4835.30
(4241.50)
4384.10
(3845.70)
1321.30
(1159.00)
6809.40
(5973.20)
5271.00
(4623.70)
7028.00
(6164.90)
702.80
(616.50)
1229.90
(1078.90)
5271.00
(4623.70)
5488.90
(4814.80)
5713.80
(5012.10)
6149.50
(5394.30)
3956.80
(3470.90)
4392.50
(3853.10)
4835.30
(4241.50)
1321.30
(1159.00)
525.600
3693.90
(3240.30)
3868.20
(3393.20)
3507.30
(3076.60)
1057.00
(927.20)
5447.50
(4778.50)
4216.80
(3698.90)
5622.40
(4931.90)
702.80
(616.50)
983.90
(863.10)
4216.80
(3698.90)
4391.10
(3851.80)
4571.00
(4009.60)
4919.60
(4315.40)
3165.40
(2776.70)
3514.00
(3082.50)
3868.20
(3393.20)
1057.00
(927.20)
15.000
Fee
450.400
527.120
400.000
600.000
550.400
499.040
150.400
775.120
600.000
800.000
100.000
140.000
600.000
624.800
650.400
700.000
450.400
500.000
550.400
150.400
Anaesthesiology
15.000
20.000
15.000
15.000
15.000
15.000
15.000
15.000
15.000
15.000
15.000
15.000
15.000
15.000
15.000
15.000
15.000
15.000
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1358
Harvesting of radial artery
06.52
175.000
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
1229.90 140.000
(1078.90)
Page 49 of 151
RVU
Fee
983.90
(863.10)
6.4
Peripheral vascular system
MODIFIER GOVERNING THIS SECTION
0072
Non invasive peripheral vascular tests: The number of tests in a single case is restricted to two (2) per diagnosis. Tests are not justified in cases of uncomplicated varicose veins
6.4.1
Peripheral vascular system: Investigations
1357
Skin temperature test: Response to reflex heating
06.52
15.000
105.40 15.000
105.40
(92.50)
(92.50)
1359
Skin temperature test: Response to reflex cooling
06.52
15.000
105.40 15.000
105.40
(92.50)
(92.50)
1361
Cold sensitivity test
06.52
17.000
119.50 17.000
119.50
(104.80)
(104.80)
1363
Oscillometry test
06.52
5.000 35.10 (30.80)
5.000 35.10 (30.80)
1365
Sweating test
06.52
17.000
119.50 17.000
119.50
(104.80)
(104.80)
1366
Transcutaneous oximetry: Transcutaneous oximetry - single site
06.52
26.300
184.80 26.300
184.80
(162.10)
(162.10)
1367
Doppler blood tests
06.52
6.000 42.20 (37.00)
6.000 42.20 (37.00)
5369
Doppler arterial pressures
06.52
6.000 42.20 (37.00)
6.000 42.20 (37.00)
5371
Doppler arterial pressures with exercise
06.52
10.000 70.30 (61.70) 10.000 70.30 (61.70)
5373
Doppler segmental pressures and wave forms
06.52
12.000 84.30 (73.90) 12.000 84.30 (73.90)
5375
Venous doppler examination (both limbs)
06.52
9.000 63.30 (55.50)
9.000 63.30 (55.50)
5377
Venous plethysmography
06.52
16.000
112.40 16.000
112.40
(98.60)
(98.60)
5379
Supra-orbital doppler test
06.52
5.000 35.10 (30.80)
5.000 35.10 (30.80)
5381
Carotid non-invasive complex tests
06.52
39.000
274.10 39.000
274.10
(240.40)
(240.40)
6.4.2
Peripheral vascular system: Arterio-venous abnormalities
1369
Fistula or aneurysm (as for grafting of various arteries)
06.52
6.4.3
Arteries
6.4.3.1 Peripheral vascular system: Arteries: Aorta-iliac and major branches
1372
Abdominal aorta and iliac artery: Unruptured
06.52
540.000
3795.10 432.000
3036.10
(3329.00)
(2663.20)
1373
Abdominal aorta and iliac artery: Ruptured
06.52
600.000
4216.80 480.000
3373.40
(3698.90)
(2959.10)
1375
Grafting and/or thrombo-endarterectomy for thrombosis
06.52
444.000
3120.40 355.200
2496.30
(2737.20)
(2189.70)
1376
Aorta bi-femoral graft, including proximal and distal endarterectomy and preparation for anastomosis
06.52
594.000
4174.60 475.200
3339.70
(3661.90)
(2929.60)
6.4.3.2 Peripheral vascular system: Arteries: Iliac artery
1379
Prosthetic grafting and/or thrombo-endarterectomy
06.52
300.000
2108.40 240.000
1686.70
(1849.50)
(1479.60)
13 Mar 2008
Anaesthesiology
06.52
15.000
15.000
15.000
15.000
13.000
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
573.40
(503.00)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
6.4.3.3 Peripheral vascular system: Arteries: Peripheral
1385
Prosthetic grafting
06.52
255.000
1387
Grafting vein: Vein grafting proximal to knee joint
06.52
300.000
1388
Grafting vein: Distal to knee joint
06.52
444.000
1389
Grafting vein: Endarterectomy when not part of another specified procedure
06.52
264.000
1390
Grafting vein: Carotid endarterectomy
06.52
321.000
1393
Embolectomy: Peripheral embolectomy transfemoral
06.52
168.000
1395
Miscellaneous arterial procedures: Arterial suture: Trauma
06.52
125.000
1396
06.52
264.000
1397
Suture major blood vessel (artery or vein) - trauma (major blood vessels are defined as aorta, innominate artery, carotid
artery and vertebral artery, subclavian artery, axillary artery, iliac artery, common femoral and popliteal arteries are
included because of popliteal artery. The vertebral and popliteal arteries are included because of the relevant
inaccessibility of the arteries and difficult surgical exposure
Profundoplasty
06.52
210.000
1399
Distal tibial (ankle region)
06.52
456.000
1401
Femoro-femoral
06.52
254.000
1402
Carotid-subclavian
06.52
288.000
1403
Axillo-femoral: (Bifemoral + 50%)
06.52
288.000
6.4.4
1407
Peripheral vascular system: Veins
Ligation of saphenous vein
06.52
50.000
1408
Placement of Hickman catheter or similar
06.52
91.000
1410
Litigation of inferior vena cava: Abdominal
06.52
180.000
1412
Umbrella operation on inferior vena cava: Abdominal
06.52
100.000
1413
Combined procedure for varicose veins: Ligation of saphenous vein stripping, multiple ligation including of perforating
veins as indicated: Unilateral
Combined procedure for varicose veins: Ligation of saphenous vein stripping, multiple ligation including of perforating
veins as indicated: Bilateral
Extensive sub-fascial ligation of perforating veins
06.52
141.000
06.52
247.000
06.52
125.000
1415
1417
13 Mar 2008
Page 50 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
1792.10
(1572.00)
2108.40
(1849.50)
3120.40
(2737.20)
1855.40
(1627.50)
2256.00
(1978.90)
1180.70
(1035.70)
878.50
(770.60)
1855.40
(1627.50)
204.000
1475.90
(1294.60)
3204.80
(2811.20)
1785.10
(1565.90)
2024.10
(1775.50)
2024.10
(1775.50)
168.000
351.40
(308.20)
639.50
(561.00)
1265.00
(1109.60)
702.80
(616.50)
990.90
(869.20)
1735.90
(1522.70)
878.50
(770.60)
50.000
240.000
355.200
211.200
256.800
134.400
100.000
211.200
364.800
203.200
230.400
230.400
91.000
144.000
100.000
120.000
197.600
120.000
1433.70
(1257.60)
1686.70
(1479.60)
2496.30
(2189.70)
1484.30
(1302.00)
1804.80
(1583.20)
944.60
(828.60)
702.80
(616.50)
1484.30
(1302.00)
Anaesthesiology
RVU
Fee
5.000
5.000
5.000
5.000
15.000
5.000
5.000
15.000
1180.70
(1035.70)
2563.80
(2248.90)
1428.10
(1252.70)
1619.30
(1420.40)
1619.30
(1420.40)
5.000
351.40
(308.20)
639.50
(561.00)
1012.00
(887.70)
702.80
(616.50)
843.40
(739.80)
1388.70
(1218.20)
843.40
(739.80)
3.000
5.000
5.000
8.000
8.000
4.000
8.000
8.000
3.000
3.000
3.000
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
661.70
(580.40)
220.60
(193.50)
220.60
(193.50)
661.70
(580.40)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
352.90
(309.60)
352.90
(309.60)
132.30
(116.10)
176.40
(154.70)
352.90
(309.60)
352.90
(309.60)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1419
Lesser varicose vein procedures
06.52
1421
06.52
1425
Compression sclerotherapy of varicose veins: Per injection to a maximum of nine (9) injections per leg (excluding cost of
material)
Thrombectomy: Inferior vena cava (Trans-abdominal)
1427
Fee
217.90
(191.10)
9.000 63.30 (55.50)
General Practitioners
/ non-designated
Specialists
RVU
Fee
31.000
31.000
217.90
(191.10)
9.000 63.30 (55.50)
06.52
240.000
Thrombectomy: IIlio-femoral
06.52
175.000
1686.70 192.000
(1479.60)
1229.90 140.000
(1078.90)
6.4.5
1429
Peripheral vascular system: Portal hypertension
Porto-caval shunt
06.52
500.000
6.5
7
7.1
1435
Cardiac rehabilitation
Lympho Reticular System
Spleen
Splenectomy (in all cases)
06.52
221.300
1436
Splenorrhaphy
06.52
231.800
Anaesthesiology
RVU
Fee
3.000
132.30
(116.10)
1349.40
(1183.70)
983.90
(863.10)
11.000
485.20
(425.60)
264.70
(232.20)
3514.00 400.000
(3082.50)
2811.20
(2466.00)
11.000
485.20
(425.60)
1555.30 177.040
(1364.30)
1629.10 185.440
(1429.00)
1244.20
(1091.40)
1303.30
(1143.20)
9.000
397.00
(348.20)
397.00
(348.20)
6.000
9.000
7.2
Lymph nodes and lymphatic channels
8
Digestive System
MODIFIERS GOVERNING THIS SECTION
0074
Endoscopic procedures performed with own equipment: The basic procedure fee plus 33.33% (1/3) of that fee ("+" codes excluded) will apply where endoscopic procedures are performed with own
equipment.
0075
Endoscopic procedures performed in own procedure room: The fee plus 21,00 clinical procedure units will apply where
06.52
21.000
147.59 21.000
147.59
endoscopic procedures are performed in rooms with own equipment. This fee is chargeable by medical practitioners who
(129.46)
(129.46)
own or rent the facility. Please note: Modifier 0075 is not applicable to any of the items for diagnostic procedures in the
otorhinolaryngology sections of the tariff.
8.1
Oral cavity
1461
All dental procedures
06.52
4.000
1463
Surgical biopsy of tongue or palate: Under general anaesthetic
06.52
35.000
1465
Surgical biopsy of tongue or palate: Under local anaesthetic
06.52
15.000
1467
Drainage of intra-oral abscess
06.52
31.000
1469
Local excision of mucosal lesion of oral cavity
06.52
23.000
1473
Complicated reconstruction following major ablative procedure for head and neck cancer
06.52
-
1475
Cleft palate: Repair primary deformity with or without pharyngoplasty
06.52
215.000
1477
Cleft palate: Secondary repair
06.52
174.200
13 Mar 2008
Page 51 of 151
246.00
(215.80)
105.40
(92.50)
217.90
(191.10)
161.60
(141.80)
-
35.000
4.000
-
246.00
(215.80)
105.40
(92.50)
217.90
(191.10)
161.60
(141.80)
-
1511.00 172.000
(1325.40)
1224.30 139.360
(1073.90)
1208.80
(1060.40)
979.40
(859.10)
6.000
15.000
31.000
23.000
4.000
4.000
4.000
7.000
6.000
06.52
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
308.80
(270.90)
264.70
(232.20)
264.70
(232.20)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1478
Velopharyngeal reconstruction with myoneuro-vascular transfer (dynamic repair)
06.52
240.000
1479
Velopharyngeal reconstruction with or without pharyngeal flap (static repair)
06.52
227.000
1480
Repair of oronasal fistula (large) e.g. distant flap
06.52
227.000
1481
Repair of oronasal fistula (small) e.g. trapdoor: One stage or first stage
06.52
138.000
1482
Repair of oronasal fistula (large): Second stage
06.52
138.000
1483
Alveolar periosteal or other flaps for arch closure
06.52
138.000
1486
Closure of anterior nasal floor
06.52
138.000
8.2
1484
Lips
Cleft lip repair: Lip adhesion (cleft lip)
06.52
95.000
1485
Local excision of benign lesion of lip
06.52
27.000
1489
Cleft lip repair: Repair unilateral cleft lip (with muscle reconstruction)
06.52
227.000
1490
Cleft lip repair: Bilateral cleft lip repair (with muscle reconstruction): One of two stages
06.52
251.600
1491
Cleft lip repair: Repair bilateral cleft lip (with muscle reconstruction): One stage
06.52
329.900
1492
Cleft lip repair: Bilateral cleft lip repair: Second stage
06.52
227.000
1493
Cleft lip repair: Total revision of secondary cleft lip deformities
06.52
251.600
1494
Cleft lip repair: Partial revision of secondary cleft lip deformity
06.52
91.000
1495
Abbé or Estlander type flap (all stages included)
06.52
273.100
1497
Vermilionectomy
06.52
94.900
1499
Lip reconstruction following an injury: Direct repair
06.52
105.600
1501
Lip reconstruction following an injury or tumour removal: Flap repair
06.52
206.000
1503
Lip reconstruction following an injury or tumour removal: Total reconstruction (first stage)
06.52
206.000
1504
Lip reconstruction following an injury or tumour removal: Subsequent stages (see item 0297)
06.52
104.000
13 Mar 2008
Page 52 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
1686.70
(1479.60)
1595.40
(1399.50)
1595.40
(1399.50)
969.90
(850.80)
969.90
(850.80)
969.90
(850.80)
969.90
(850.80)
192.000
667.70
(585.70)
189.80
(166.50)
1595.40
(1399.50)
1768.20
(1551.10)
2318.50
(2033.80)
1595.40
(1399.50)
1768.20
(1551.10)
639.50
(561.00)
1919.30
(1683.60)
667.00
(585.10)
742.20
(651.10)
1447.80
(1270.00)
1447.80
(1270.00)
730.90
(641.10)
95.000
181.600
181.600
120.000
120.000
120.000
120.000
27.000
181.600
201.280
263.920
181.600
201.280
91.000
218.480
94.900
105.600
164.800
164.800
104.000
Anaesthesiology
RVU
Fee
1349.40
(1183.70)
1276.30
(1119.60)
1276.30
(1119.60)
843.40
(739.80)
843.40
(739.80)
843.40
(739.80)
843.40
(739.80)
6.000
667.70
(585.70)
189.80
(166.50)
1276.30
(1119.60)
1414.60
(1240.90)
1854.80
(1627.00)
1276.30
(1119.60)
1414.60
(1240.90)
639.50
(561.00)
1535.50
(1346.90)
667.00
(585.10)
742.20
(651.10)
1158.20
(1016.00)
1158.20
(1016.00)
730.90
(641.10)
5.000
6.000
6.000
5.000
5.000
4.000
5.000
4.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
4.000
4.000
4.000
4.000
4.000
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
220.60
(193.50)
220.60
(193.50)
176.40
(154.70)
220.60
(193.50)
220.60
(193.50)
176.40
(154.70)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
8.3
1505
Tongue
Partial glossectomy
06.52
225.000
1507
Local excision of lesion of tongue
06.52
27.000
8.4
1531
Palate, uvula and salivary glands
Drainage of parotid abscess
06.52
25.000
1533
Closure of salivary fistula
06.52
1535
Dilatation of salivary duct
06.52
175.70
(154.10)
91.000
639.50
(561.00)
10.000 70.30 (61.70)
1537
Operative removal of salivary calculus
06.52
55.000
1539
Salivary duct: Meatotomy
06.52
20.000
1541
Branchial cyst and/or fistula: Excision
06.52
140.000
1543
Excision of cystic hygroma
06.52
140.000
1544
Ludwig's Angina: Drainage
06.52
42.000
8.5
1545
Oesophagus
Oesophagoscopy with rigid instrument: First and subsequent
06.52
47.000
1549
Oesophagoscopy with dilatation of stricture
06.52
70.000
1550
Oesophagoscopy with removal of foreign body
06.52
70.000
1551
Oesophagoscopy with insertion of indwelling oesophageal tube
06.52
80.000
1552
Injection and/or ligation of oesophageal varices (endoscopy inclusive)
06.52
80.000
1553
Subsequent injection and/or ligation of oesophageal varices (endoscopy inclusive)
06.52
65.000
1554
Per-oral small bowel biopsy
06.52
25.000
1555
Repair of tracheal oesophageal fistula and oesophageal atresia
06.52
400.000
1557
Oesophageal dilatation
06.52
40.000
1559
Oesophagectomy: Two stage
06.52
500.000
13 Mar 2008
Page 53 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
1581.30 180.000
(1387.10)
189.80 27.000
(166.50)
Anaesthesiology
RVU
Fee
1265.00
(1109.60)
189.80
(166.50)
6.000
175.70
(154.10)
91.000
639.50
(561.00)
10.000 70.30 (61.70)
4.000
25.000
4.000
4.000
4.000
386.50 55.000
(339.00)
140.60 20.000
(123.30)
983.90 120.000
(863.10)
983.90 120.000
(863.10)
295.20 42.000
(258.90)
386.50
(339.00)
140.60
(123.30)
843.40
(739.80)
843.40
(739.80)
295.20
(258.90)
4.000
330.30 47.000
(289.70)
492.00 70.000
(431.60)
492.00 70.000
(431.60)
562.20 80.000
(493.20)
562.20 80.000
(493.20)
456.80 65.000
(400.70)
175.70 25.000
(154.10)
2811.20 320.000
(2466.00)
281.10 40.000
(246.60)
3514.00 400.000
(3082.50)
330.30
(289.70)
492.00
(431.60)
492.00
(431.60)
562.20
(493.20)
562.20
(493.20)
456.80
(400.70)
175.70
(154.10)
2249.00
(1972.80)
281.10
(246.60)
2811.20
(2466.00)
4.000
4.000
5.000
5.000
9.000
4.000
4.000
4.000
4.000
4.000
4.000
15.000
4.000
11.000
264.70
(232.20)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
220.60
(193.50)
220.60
(193.50)
397.00
(348.20)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
661.70
(580.40)
176.40
(154.70)
485.20
(425.60)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1560
Oesophagectomy: Three stage
06.52
550.000
1561
Thoraco-abdominal oesophagogastrectomy
06.52
500.000
1567
Bochdalek hernia repair in newborn
06.52
250.000
1568
Hiatus hernia and diaphragmatic repair: Revision after previous repair
06.52
375.000
1569
Heller's operation
06.52
250.000
1575
Insertion of indwelling oesophageal tube by laparotomy
06.52
142.000
1578
Oesophageal motility (4 channel + pneumograph)
06.52
100.000
1579
Oesophageal substitution (without oesophagectomy) using colon, small bowel or stomach
06.52
400.000
1580
Oesophageal motility (6 Channel + pneumograph + pH pull-through)
06.52
110.000
1582
Oesophageal motility (4 or 6 channel + pneumograph - ECG + provocative tests for oesophageal spasm vs. myocardial
ischaemia)
Excision of intrathoracic oesophageal diverticulum
06.52
150.000
06.52
250.000
06.52
55.000
1585
24 Hour oesophageal pH studies: Hire fee (Item 0201 applicable for pro-rata of probe: 50 examinations per glass
electrode pH probe and 10 examinations per antimone pH probe)
24 Hour oesophageal pH studies: Interpretation
06.52
27.000
8.6
1587
Stomach
Upper gastro-intestinal endoscopy: Hospital equipment
06.52
48.750
1588
Plus polypectomy: ADD to gastro-intestinal endoscopy (Item 1587)
06.52 +
25.000
1589
06.52 +
34.000
1591
Endoscopic control of gastrointestinal haemorrhage from upper gastrointestinal tract, intestines or large bowel by
injection, ligation or application of energy device (endoscopic haemostasis) to be added to gastroscopy (item 1587) or
colonoscopy (item 1653)
Plus removal of foreign bodies (stomach): ADD to gastro-intestinal endoscopy (Item 1587)
06.52 +
25.000
1593
1597
Augmented histamine test: Gastric intubation with x-ray screening
Gastrostomy or Gastrotomy
06.52
06.52
5.000
147.500
1598
Gastrotomy with suture repair of bleeding ulcer
06.52
251.200
1599
Pyloromyotomy (Rammstedt)
06.52
116.000
1601
Local excision of ulcer or benign neoplasm
06.52
195.600
1583
1584
13 Mar 2008
Page 54 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
RVU
Fee
3865.40
(3390.70)
3514.00
(3082.50)
1757.00
(1541.20)
2635.50
(2311.80)
1757.00
(1541.20)
998.00
(875.40)
702.80
(616.50)
2811.20
(2466.00)
773.10
(678.20)
1054.20
(924.70)
1757.00
(1541.20)
386.50
(339.00)
189.80
(166.50)
440.000
3092.30
(2712.50)
2811.20
(2466.00)
1405.60
(1233.00)
2108.40
(1849.50)
1405.60
(1233.00)
843.40
(739.80)
702.80
(616.50)
2249.00
(1972.80)
773.10
(678.20)
843.40
(739.80)
1405.60
(1233.00)
386.50
(339.00)
189.80
(166.50)
11.000
485.20
(425.60)
485.20
(425.60)
617.50
(541.70)
485.20
(425.60)
617.50
(541.70)
264.70
(232.20)
176.40
(154.70)
485.20
(425.60)
176.40
(154.70)
176.40
(154.70)
485.20
(425.60)
342.60
(300.50)
175.70
(154.10)
239.00
(209.60)
48.750
342.60
(300.50)
175.70
(154.10)
239.00
(209.60)
4.000
175.70
(154.10)
35.10 (30.80)
1036.60
(909.30)
1765.40
(1548.60)
815.20
(715.10)
1374.70
(1205.90)
25.000
175.70
(154.10)
35.10 (30.80)
843.40
(739.80)
1412.30
(1238.90)
815.20
(715.10)
1099.70
(964.60)
4.000
176.40
(154.70)
6.000
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
Fee
400.000
200.000
300.000
200.000
120.000
100.000
320.000
110.000
120.000
200.000
55.000
27.000
25.000
34.000
5.000
120.000
200.960
116.000
156.480
Anaesthesiology
11.000
14.000
11.000
14.000
6.000
4.000
11.000
4.000
4.000
11.000
4.000
6.000
6.000
6.000
6.000
176.40
(154.70)
176.40
(154.70)
264.70
(232.20)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1603
Vagotomy: Abdominal
06.52
150.000
1604
Vagotomy: Thoracic
06.52
150.000
1605
Truncal or selective with drainage procedures
06.52
250.000
1607
Vagotomy and antrectomy
06.52
320.000
1609
Highly selective vagotomy
06.52
250.000
1611
Pyloroplasty
06.52
180.200
1613
Gastroenterostomy
06.52
203.600
1615
Suture of perforated gastric or duodenal ulcer or wound or injury
06.52
200.000
1617
Partial gastrectomy
06.52
328.300
1619
Total gastrectomy
06.52
384.430
1621
Revision of gastrectomy or gastro-enterostomy
06.52
375.000
1625
Gastro-esophageal operation for portal hypertension (Tanner)
06.52
375.000
8.7
1626
06.52
120.000
1627
1629
Duodenum
Endoscopic examination of the small bowel beyond the duodenojenunal flexure with biopsy with or without polypectomy
with or without arrest of haemorrhage (enteroscopy)
Duodenal intubation (under X-ray screening)
Duodenal intubation with biliary drainage after gall bladder stimulation
1631
Duodenal intubation: Under 3 years of age
06.52
8.8
1632
1633
Intestines
H2 breath test (intestines)
Complete test using lactose or lactulose
06.52
06.52
1634
Enterotomy or Enterostomy
06.52
1635
Intestinal obstruction of the newborn
06.52
1637
Operation for relief of intestinal obstruction
06.52
1639
Resection of small bowel with enterostomy or anastomosis
06.52
13 Mar 2008
Page 55 of 151
06.52
06.52
Fee
1054.20
(924.70)
1054.20
(924.70)
1757.00
(1541.20)
2249.00
(1972.80)
1757.00
(1541.20)
1266.40
(1110.90)
1430.90
(1255.20)
1405.60
(1233.00)
2307.30
(2023.90)
2701.80
(2370.00)
2635.50
(2311.80)
2635.50
(2311.80)
General Practitioners
/ non-designated
Specialists
RVU
Fee
120.000
120.000
200.000
256.000
200.000
144.160
162.880
160.000
262.640
307.540
300.000
300.000
843.40 120.000
(739.80)
8.000 56.20 (49.30)
21.000
147.60
(129.50)
15.000
105.40
(92.50)
9.000 63.30 (55.50)
27.000
189.80
(166.50)
202.600
1423.90
(1249.00)
240.000
1686.70
(1479.60)
240.000
1686.70
(1479.60)
244.900
1721.20
(1509.80)
843.40
(739.80)
843.40
(739.80)
1405.60
(1233.00)
1799.20
(1578.20)
1405.60
(1233.00)
1013.20
(888.80)
1144.70
(1004.10)
1124.50
(986.40)
1845.80
(1619.10)
2161.40
(1896.00)
2108.40
(1849.50)
2108.40
(1849.50)
843.40
(739.80)
9.000 63.30 (55.50)
27.000
189.80
(166.50)
162.080
1139.10
(999.20)
192.000
1349.40
(1183.70)
192.000
1349.40
(1183.70)
195.920
1376.90
(1207.80)
Anaesthesiology
RVU
Fee
6.000
11.000
6.000
6.000
6.000
6.000
6.000
7.000
7.000
7.000
7.000
11.000
264.70
(232.20)
485.20
(425.60)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
308.80
(270.90)
308.80
(270.90)
308.80
(270.90)
308.80
(270.90)
485.20
(425.60)
6.000
264.70
(232.20)
6.000
264.70
(232.20)
308.80
(270.90)
308.80
(270.90)
264.70
(232.20)
7.000
7.000
6.000
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1641
Entero-enterostomy or entero-colostomy for bypass
06.52
213.100
1642
06.52
150.000
06.52
90.000
1645
Gastrointestinal tract imaging, intraluminal (e.g. video capsule endoscopy): Hire fee (item 0201 applicable for video
capsule - disposable single patient use) (Please note: All patients should have had a normal gastroscopy and
colonoscopy)
Gastrointestinal tract imaging, intraluminal (e.g. video capsule endoscopy), oesophagus through ileum: Doctor
interpretation and report
Suture of intestine (small or large): Perforated ulcer, wound or injury
06.52
185.200
1647
Closure of intestinal fistula
06.52
258.000
1649
Excision of Meckel's diverticulum
06.52
179.800
1651
Excision of lesion of mesentery
06.52
171.600
1652
Laparotomy for mesenteric thrombosis
06.52
300.000
1653
Total colonoscopy: With hospital equipment (including biopsy)
06.52
90.000
1654
Plus removal of polyps: ADD to colonoscopy (Item 1653)
06.52 +
30.000
1656
Left-sided colonoscopy
06.52
60.000
1657
Right or left hemicolectomy or segmental colectomy
06.52
325.000
1658
Reconstruction of colon after Hartman’s procedure
06.52
359.400
1661
Colotomy: Including removal of tumour or foreign body
06.52
205.700
1663
Total colectomy
06.52
390.000
1665
Colostomy or ileostomy isolated procedure
06.52
233.800
1666
Continent ileostomy pouch (all types)
06.52
300.000
1667
Colostomy: Closure
06.52
179.100
1668
Revision of ileostomy pouch
06.52
375.000
1669
Total proctocolectomy and ileostomy
06.52
480.000
1670
Proctocolectomy, ileostomy and ileostomy pouch
06.52
540.000
1671
Colomyotomy (Reilly operation)
06.52
185.000
1643
13 Mar 2008
Page 56 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
1497.70 170.480
(1313.80)
1054.20 120.000
(924.70)
1198.10
(1051.00)
843.40
(739.80)
632.50
(554.80)
1301.60
(1141.80)
1813.20
(1590.50)
1263.60
(1108.40)
1206.00
(1057.90)
2108.40
(1849.50)
632.50
(554.80)
210.80
(184.90)
421.70
(369.90)
2284.10
(2003.60)
2525.90
(2215.70)
1445.70
(1268.20)
2740.90
(2404.30)
1643.10
(1441.30)
2108.40
(1849.50)
1258.70
(1104.10)
2635.50
(2311.80)
3373.40
(2959.10)
3795.10
(3329.00)
1300.20
(1140.50)
632.50
(554.80)
1041.30
(913.40)
1450.60
(1272.50)
1010.90
(886.80)
964.80
(846.30)
1686.70
(1479.60)
632.50
(554.80)
210.80
(184.90)
421.70
(369.90)
1827.30
(1602.90)
2020.70
(1772.50)
1156.50
(1014.50)
2192.70
(1923.40)
1314.50
(1153.10)
1686.70
(1479.60)
1007.00
(883.30)
2108.40
(1849.50)
2698.80
(2367.40)
3036.10
(2663.20)
1040.10
(912.40)
90.000
148.160
206.400
143.840
137.280
240.000
90.000
30.000
60.000
260.000
287.520
164.560
312.000
187.040
240.000
143.280
300.000
384.000
432.000
148.000
Anaesthesiology
RVU
Fee
6.000
264.70
(232.20)
6.000
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
176.40
(154.70)
352.90
(309.60)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
220.60
(193.50)
264.70
(232.20)
308.80
(270.90)
308.80
(270.90)
264.70
(232.20)
6.000
6.000
4.000
8.000
4.000
4.000
4.000
6.000
6.000
6.000
6.000
6.000
6.000
5.000
6.000
7.000
7.000
6.000
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
8.9
1673
Appendix
Drainage of appendix abscess
06.52
150.000
1675
Appendicectomy
06.52
160.000
8.10
1676
Rectum and anus
Flexible sigmoidoscopy (including rectum and anus): Hospital equipment.
06.52
48.750
1677
Sigmoidoscopy: First and subsequent, with or without biopsy
06.52
342.60
(300.50)
13.000 91.40 (80.20)
1678
Plus polypectomy: ADD to sigmoidoscopy (Item 1676)
06.52 +
25.000
1679
Sigmoidoscopy with removal of polyps, first and subsequent
06.52
30.000
1681
Proctoscopy with removal of polyps: First time
06.52
21.000
1683
Proctoscopy with removal of polyps: Subsequent times
06.52
15.000
1687
Anterior resection of rectum performed for carcinoma of rectum including excision of any part of proximal colon necessary 06.52
381.300
1688
Total mesorectal excision with colo-anal anastomosis and defunctioning enterostomy or colostomy
06.52
445.000
1689
Perineal resection of rectum
06.52
141.000
Please note: Items 1691 and 1692: Abdominal and/or perineal assistant's fee to be charged additionally.
06.52
1691
Abdomino-perineal resection of rectum: Abdominal surgeon
06.52
409.300
1692
Abdomino-perineal resection of rectum: Perineal surgeon
06.52
158.500
1697
Repair of prolapsed rectum: Abdominal: Roscoe Graham Moskovitz
06.52
300.000
1699
Repair of prolapsed rectum: Abdominal: Ivalon sponge
06.52
200.000
1701
Repair of prolapsed rectum: Abdominal: Perineal
06.52
150.000
1703
Repair of prolapsed rectum: Abdominal: Thierisch suture
06.52
35.000
1705
Incision and drainage of peri-anal abscess
06.52
40.000
1707
Drainage of submucous abscess
06.52
40.000
1709
Drainage of ischio-rectal abscess
06.52
87.000
13 Mar 2008
Page 57 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
1054.20 120.000
(924.70)
1124.50 128.000
(986.40)
Anaesthesiology
RVU
Fee
843.40
(739.80)
899.60
(789.10)
5.000
342.60
(300.50)
13.000 91.40 (80.20)
3.000
48.750
4.000
3.000
220.60
(193.50)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
264.70
(232.20)
352.90
(309.60)
220.60
(193.50)
175.70 25.000
(154.10)
210.80 30.000
(184.90)
147.60 21.000
(129.50)
105.40 15.000
(92.50)
2679.80 305.040
(2350.70)
3127.50 356.000
(2743.40)
990.90 120.000
(869.20)
175.70
(154.10)
210.80
(184.90)
147.60
(129.50)
105.40
(92.50)
2143.80
(1880.50)
2502.00
(2194.70)
843.40
(739.80)
3.000
2876.60
(2523.30)
1113.90
(977.10)
2108.40
(1849.50)
1405.60
(1233.00)
1054.20
(924.70)
246.00
(215.80)
281.10
(246.60)
281.10
(246.60)
611.40
(536.30)
2301.20
(2018.60)
891.20
(781.80)
1686.70
(1479.60)
1124.50
(986.40)
843.40
(739.80)
246.00
(215.80)
281.10
(246.60)
281.10
(246.60)
611.40
(536.30)
7.000
308.80
(270.90)
6.000
264.70
(232.20)
264.70
(232.20)
176.40
(154.70)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
327.440
126.800
240.000
160.000
120.000
35.000
40.000
40.000
87.000
3.000
3.000
3.000
6.000
8.000
5.000
6.000
4.000
4.000
3.000
3.000
3.000
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1711
Excision of pelvi-rectal fistula
06.52
1713
Excision of fistula-in-ano
06.52
1715
Operation for fissure-in-ano
06.52
1719
Rubber band ligation of haemorrhoids: Per haemorrhoid
06.52
1721
1723
Sclerosing injection for haemorrhoids: Per injection
Haemorrhoidectomy
06.52
06.52
1725
Drainage of external thrombosed pile
06.52
1727
Multiple procedures (haemorrhoids, fissure, etc.)
06.52
90.000
1728
Biopsy of ano-rectal wall, for congenital megacolon
06.52
60.600
1729
Excision of anal skin tags
06.52
25.000
1731
Operation for low imperforate anus
06.52
105.000
1733
Anoplasty: Y-V-plasty
06.52
41.000
1735
Anal sphincteroplasty for incontinence
06.52
120.000
1737
Dilation of ano-rectal stricture
06.52
12.500
1739
Closure of recto-vesical fistula
06.52
241.000
1741
Closure of recto-urethral fistula
06.52
241.000
1742
Bio-feedback training for faecal incontinence during anorectal manometry performed by doctor
06.52
27.000
8.11
1743
Liver
Needle biopsy of liver
06.52
30.300
1745
Biopsy of liver by laparotomy
06.52
125.000
1747
Drainage of liver abscess or cyst
06.52
179.100
1748
1749
Body composition measured by bio-electrical impedance
Hemi-hepatectomy: Right
06.52
06.52
3.000
564.000
13 Mar 2008
Page 58 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
200.000
1405.60 160.000
1124.50
(1233.00)
(986.40)
105.000
737.90 105.000
737.90
(647.30)
(647.30)
66.800
469.50 66.800
469.50
(411.80)
(411.80)
10.000 70.30 (61.70) 10.000 70.30 (61.70)
5.000 35.10 (30.80)
5.000 35.10 (30.80)
120.000
843.40 120.000
843.40
(739.80)
(739.80)
12.500 87.90 (77.10) 12.500 87.90 (77.10)
632.50 90.000
632.50
(554.80)
(554.80)
425.90 60.600
425.90
(373.60)
(373.60)
175.70 25.000
175.70
(154.10)
(154.10)
737.90 105.000
737.90
(647.30)
(647.30)
288.10 41.000
288.10
(252.70)
(252.70)
843.40 120.000
843.40
(739.80)
(739.80)
87.90 (77.10) 12.500 87.90 (77.10)
1693.70 192.800
(1485.70)
1693.70 192.800
(1485.70)
189.80 27.000
(166.50)
Anaesthesiology
RVU
Fee
5.000
3.000
3.000
3.000
3.000
3.000
3.000
5.000
3.000
6.000
3.000
3.000
3.000
1355.00
(1188.60)
1355.00
(1188.60)
189.80
(166.50)
5.000
212.90 30.300
212.90
(186.80)
(186.80)
878.50 120.000
843.40
(770.60)
(739.80)
1258.70 143.280
1007.00
(1104.10)
(883.30)
21.10 (18.50)
3.000 21.10 (18.50)
3963.80 451.200
3171.00
(3477.00)
(2781.60)
3.000
5.000
4.000
7.000
9.000
220.60
(193.50)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
220.60
(193.50)
132.30
(116.10)
264.70
(232.20)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
220.60
(193.50)
220.60
(193.50)
132.30
(116.10)
176.40
(154.70)
308.80
(270.90)
397.00
(348.20)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1751
Hemi-hepatectomy: Left
06.52
521.100
1752
Extended right or left hepatectomy
06.52
570.900
1753
Partial or segmental hepatectomy
06.52
378.000
1754
Hepatico-jejunostomy
06.52
369.200
1755
Liver transplant
06.52
1756
Harvesting donor hepatectomy
06.52
1400.80
0
616.200
1757
Suture of liver wound or injury
06.52
214.200
8.12
1759
Biliary tract
Cholecystostomy
06.52
171.600
1761
Cholecystectomy
06.52
225.000
1762
Cholecystectomy and operative cholangiogram
06.52
255.000
1763
With exploration of common bile duct
06.52
264.500
1765
Exploration of common bile duct: Secondary operation
06.52
327.700
1767
Reconstruction of common bile duct
06.52
371.700
1769
Cholecysto-enterostomy or gastrostomy
06.52
236.300
1772
Endoscopic placement of a nasobiliary drainage tube: ADD to ERCP (item 1778)
06.52 +
1773
Transduodenal sphincteroplasty
06.52
225.000
1774
Balloon dilatation of common bile duct strictures
06.52
125.000
1775
Excision choledochal cyst with reconstruction
06.52
327.700
1777
Porto-enterostomy for biliary atresia
06.52
400.000
8.13
1778
Pancreas
Endoscopic Retrograde Cholangiopancreatography (ERCP): Endoscopy + catheterisation of pancreas duct or
choledochus
Endoscopic retrograde removal of stone(s) as for biliary and/or pancreatic duct. ADD to ERCP (item 1778)
06.52
105.900
1779
13 Mar 2008
Page 59 of 151
06.52 +
25.600
15.820
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
3662.30
(3212.50)
4012.30
(3519.60)
2656.60
(2330.40)
2594.70
(2276.10)
9844.80
(8635.80)
4330.70
(3798.90)
1505.40
(1320.50)
416.880
1206.00
(1057.90)
1581.30
(1387.10)
1792.10
(1572.00)
1858.90
(1630.60)
2303.10
(2020.30)
2612.30
(2291.50)
1660.70
(1456.80)
179.90
(157.80)
1581.30
(1387.10)
878.50
(770.60)
2303.10
(2020.30)
2811.20
(2466.00)
137.280
456.720
302.400
295.360
1120.64
0
492.960
171.360
180.000
204.000
211.600
262.160
297.360
189.040
25.600
180.000
100.000
262.160
320.000
744.30 105.900
(652.90)
111.20 15.820
(97.50)
2929.80
(2570.00)
3209.80
(2815.60)
2125.30
(1864.30)
2075.80
(1820.90)
7875.90
(6908.70)
3464.50
(3039.00)
1204.30
(1056.40)
964.80
(846.30)
1265.00
(1109.60)
1433.70
(1257.60)
1487.10
(1304.50)
1842.50
(1616.20)
2089.80
(1833.20)
1328.60
(1165.40)
179.90
(157.80)
1265.00
(1109.60)
702.80
(616.50)
1842.50
(1616.20)
2249.00
(1972.80)
744.30
(652.90)
111.20
(97.50)
Anaesthesiology
RVU
Fee
9.000
9.000
9.000
9.000
15.000
5.000
9.000
6.000
6.000
6.000
6.000
6.000
6.000
6.000
6.000
6.000
6.000
6.000
11.000
4.000
4.000
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
661.70
(580.40)
220.60
(193.50)
397.00
(348.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
485.20
(425.60)
176.40
(154.70)
176.40
(154.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1780
1781
Gastric and duodenal intubation
Procedure (excluding laboratory tests)
06.52
06.52
1782
Endoscopic Sphincterotomy: ADD to ERCP (item 1778)
06.52 +
1783
Drainage of pancreatic abscess
06.52
1784
Debridement pancreatic necrosis
06.52
1785
Internal drainage of pancreatic cyst
06.52
1770
Endoscopic placement of biliduodenal endoprosthesis: ADD to ERCP (item 1778)
06.52 +
1786
Internal drainage of pancreatic cyst with Roux-Y
06.52
1787
1788
Operative pancreatogram: ADD
Biopsy of pancreas
06.52 +
06.52
1789
Pancreatico-duodenectomy
06.52
1791
Local, partial or subtotal pancreatectomy
06.52
1793
Distal pancreatectomy with internal drainage
06.52
8.14
1797
Peritoneal cavity
Pneumo-peritoneum: First
1799
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
8.000 56.20 (49.30)
21.000
147.60
(129.50)
30.000
210.80
(184.90)
239.300
1681.80
(1475.30)
348.400
2448.60
(2147.90)
250.600
1761.20
(1544.90)
30.000
210.80
(184.90)
306.800
2156.20
(1891.40)
10.000 70.30 (61.70)
177.700
1248.90
(1095.50)
704.800
4953.30
(4345.00)
351.300
2468.90
(2165.70)
377.400
2652.40
(2326.70)
8.000 56.20 (49.30)
21.000
147.60
(129.50)
30.000
210.80
(184.90)
191.440
1345.40
(1180.20)
278.720
1958.80
(1718.20)
200.480
1409.00
(1236.00)
30.000
210.80
(184.90)
245.440
1725.00
(1513.20)
10.000 70.30 (61.70)
142.160
999.10
(876.40)
563.840
3962.70
(3476.10)
281.040
1975.10
(1732.50)
301.920
2121.90
(1861.30)
06.52
13.000 91.40 (80.20)
13.000 91.40 (80.20)
4.000
Pneumo-peritoneum: Repeat
06.52
6.000 42.20 (37.00)
6.000 42.20 (37.00)
4.000
1800
Peritoneal lavage
06.52
20.000
1801
1803
1807
Diagnostic paracentesis: Abdomen
Therapeutic paracentesis: Abdomen
ADD to open procedure where procedure was performed through a laparoscope (for anaesthetic refer to modifier 0027)
06.52
06.52
06.52 +
8.000
13.000
45.000
1809
Laparotomy
06.52
196.000
1811
Suture of burst abdomen
06.52
188.300
1812
Laparotomy for control of surgical haemorrhage
06.52
105.000
1813
Drainage of sub-phrenic abscess
06.52
180.000
13 Mar 2008
Page 60 of 151
140.60
(123.30)
56.20 (49.30)
91.40 (80.20)
316.30
(277.50)
1377.50
(1208.30)
1323.40
(1160.90)
737.90
(647.30)
1265.00
(1109.60)
20.000
8.000
13.000
45.000
156.800
150.640
105.000
144.000
140.60
(123.30)
56.20 (49.30)
91.40 (80.20)
316.30
(277.50)
1102.00
(966.70)
1058.70
(928.70)
737.90
(647.30)
1012.00
(887.70)
4.000
6.000
6.000
6.000
6.000
6.000
6.000
8.000
8.000
8.000
5.000
4.000
7.000
9.000
7.000
176.40
(154.70)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
352.90
(309.60)
352.90
(309.60)
352.90
(309.60)
176.40
(154.70)
176.40
(154.70)
220.60
(193.50)
176.40
(154.70)
308.80
(270.90)
397.00
(348.20)
308.80
(270.90)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1815
Drainage of other intraperitoneal abscess (excluding appendix abscess): Transabdominal
06.52
248.400
1817
Drainage of other intraperitoneal abscess (excluding appendix abscess): Transrectal drainage of pelvic abscess
06.52
75.000
9
1819
Herniae
Inguinal or femoral hernia: Adult
06.52
125.000
1821
Inguinal or femoral hernia: Child under 14 years
06.52
90.000
1823
Inguinal hernia: Infant under one year
06.52
100.000
1825
Recurrent inguinal or femoral hernia
06.52
155.000
1827
Strangulated hernia or femoral hernia
06.52
238.000
1829
Epigastric hernia
06.52
93.300
1831
Umbilical hernia: Adult
06.52
140.000
1833
Umbilical hernia: Child under 14 years
06.52
60.000
1835
Incisional hernia
06.52
166.800
1836
Implantation of mesh or other prosthesis for incisional or ventral hernia repair (List separately in addition to item for the
incisional or ventral hernia repair)
Repair of omphalocele in new-born (one or more procedures)
06.52 +
1837
06.52
77.000
275.000
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
1745.80 198.720
(1531.40)
527.10 75.000
(462.40)
1396.60
(1225.10)
527.10
(462.40)
5.000
878.50
(770.60)
632.50
(554.80)
702.80
(616.50)
1089.30
(955.50)
1672.70
(1467.30)
655.70
(575.20)
983.90
(863.10)
421.70
(369.90)
1172.30
(1028.30)
541.20
(474.70)
1932.70
(1695.40)
843.40
(739.80)
632.50
(554.80)
702.80
(616.50)
871.50
(764.50)
1338.10
(1173.80)
655.70
(575.20)
843.40
(739.80)
421.70
(369.90)
937.80
(822.60)
541.20
(474.70)
1546.20
(1356.30)
4.000
120.000
90.000
100.000
124.000
190.400
93.300
120.000
60.000
133.440
77.000
220.000
4.000
4.000
4.000
4.000
7.000
4.000
4.000
4.000
4.000
4.000
7.000
10
Urinary System
RULES GOVERNING THE SECTION URINARY SYSTEM
FF.
(a) When a cystoscopy precedes a related operation, Modifier 0013: Endoscopic examination done at an operation, applies, e.g. cystoscopy followed by transurethral (TUR) prostatectomy. (b) When
a cystoscopy precedes an unrelated operation, Modifier 0005: Multiple procedures/operations under the same anaesthetic, applies, e.g. cystoscopy for urinary tract infection followed by inguinal
hernia repair. (c) No modifier applies to item 1949: Cystoscopy, when performed together with any of items 1951 to 1973.
10.1
Kidney
1839
Renal biopsy: Per kidney: Open
06.52
71.000
499.00 71.000
499.00
5.000
(437.70)
(437.70)
1841
Renal biopsy: Needle
06.52
30.000
210.80 30.000
210.80
3.000
(184.90)
(184.90)
1853
Nephrectomy: Primary nephrectomy
06.52
225.000
1581.30 180.000
1265.00
5.000
(1387.10)
(1109.60)
1855
Nephrectomy: Secondary nephrectomy
06.52
267.000
1876.50 213.600
1501.20
5.000
(1646.10)
(1316.80)
1859
Nephrectomy: Partial
06.52
267.000
1876.50 213.600
1501.20
5.000
(1646.10)
(1316.80)
13 Mar 2008
Page 61 of 151
220.60
(193.50)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
308.80
(270.90)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
308.80
(270.90)
06.52
220.60
(193.50)
132.30
(116.10)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1861
Symphysiotomy for horse-shoe kidney
06.52
287.000
1863
Nephro-ureterectomy
06.52
305.000
1865
Nephrotomy with drainage nephrostomy
06.52
189.000
1869
Nephrolithotomy
06.52
227.000
1870
Nephrolithotomy: Multiple calculi: Repeat open operation + 25%
06.52
284.000
1871
Staghorn stone: Surgical
06.52
341.000
1873
Suture renal laceration (renorraphy)
06.52
193.000
1875
Percutaneous aspiration cyst: Nephrostomy, pyelostomy
06.52
34.000
1877
Operation for renal cyst: Marsupialisation or excision
06.52
189.000
1879
Closure renal fistula
06.52
189.000
1881
Pyeloplasty
06.52
252.000
1883
Pyelostomy
06.52
189.000
1885
Pyelolithotomy
06.52
189.000
1887
Complicated pyelo-lithotomy (e.g. solitary, ectopic, horse-shoe kidney or secondary operation)
06.52
223.000
1889
Nephrectomy for Allograft: Living or dead
06.52
255.000
1891
Perinephric abscess or renal abscess: Drainage
06.52
200.000
1893
Aberrant renal vessels: Repositioning with pyeloplasty
06.52
210.000
1894
Auto transplantation of kidney
06.52
420.000
1895
Allo transplantation of kidney
06.52
420.000
10.2
1897
Ureter
Ureterorraphy: Suture of ureter
06.52
147.000
1898
Ureterorraphy: Lumbar approach
06.52
189.000
1899
Ureteroplasty
06.52
181.000
13 Mar 2008
Page 62 of 151
Fee
2017.00
(1769.30)
2143.50
(1880.30)
1328.30
(1165.20)
1595.40
(1399.50)
1996.00
(1750.90)
2396.50
(2102.20)
1356.40
(1189.80)
239.00
(209.60)
1328.30
(1165.20)
1328.30
(1165.20)
1771.10
(1553.60)
1328.30
(1165.20)
1328.30
(1165.20)
1567.20
(1374.70)
1792.10
(1572.00)
1405.60
(1233.00)
1475.90
(1294.60)
2951.80
(2589.30)
2951.80
(2589.30)
General Practitioners
/ non-designated
Specialists
RVU
Fee
229.600
244.000
151.200
181.600
227.200
272.800
154.400
34.000
151.200
151.200
201.600
151.200
151.200
178.400
204.000
160.000
168.000
336.000
336.000
1033.10 120.000
(906.20)
1328.30 151.200
(1165.20)
1272.10 144.800
(1115.90)
1613.60
(1415.40)
1714.80
(1504.20)
1062.60
(932.10)
1276.30
(1119.60)
1596.80
(1400.70)
1917.20
(1681.80)
1085.10
(951.80)
239.00
(209.60)
1062.60
(932.10)
1062.60
(932.10)
1416.80
(1242.80)
1062.60
(932.10)
1062.60
(932.10)
1253.80
(1099.80)
1433.70
(1257.60)
1124.50
(986.40)
1180.70
(1035.70)
2361.40
(2071.40)
2361.40
(2071.40)
843.40
(739.80)
1062.60
(932.10)
1017.70
(892.70)
Anaesthesiology
RVU
Fee
6.000
5.000
6.000
5.000
5.000
6.000
6.000
3.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
7.000
5.000
10.000
10.000
5.000
5.000
5.000
264.70
(232.20)
220.60
(193.50)
264.70
(232.20)
220.60
(193.50)
220.60
(193.50)
264.70
(232.20)
264.70
(232.20)
132.30
(116.10)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
308.80
(270.90)
220.60
(193.50)
441.10
(386.90)
441.10
(386.90)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1901
Ureterolysis
06.52
118.000
1902
Ureterolysis: Lumbar approach
06.52
189.000
1903
Ureterectomy only
06.52
137.000
1905
Ureterolithotomy
06.52
265.800
1907
Cutaneous ureterostomy: Unilateral
06.52
108.000
1909
Cutaneous ureterostomy: Bilateral
06.52
189.000
1911
Uretero-enterostomy: Unilateral
06.52
137.000
1913
Uretero-enterostomy: Bilateral
06.52
240.000
1915
Uretero-ureterostomy
06.52
137.000
1917
Transuretero-ureterostomy
06.52
155.000
1919
Closure of ureteric fistula
06.52
147.000
1921
Immediate deligation of ureter
06.52
147.000
1923
Ureterolysis for retrocaval ureter with anastomosis
06.52
168.000
1925
Uretero-pyelostomy
06.52
252.000
1927
Uretero-neo-cystostomy: Unilateral
06.52
316.100
1929
Uretero-neo-cystostomy: Bilateral
06.52
474.150
1931
Uretero-neo-cystostomy: With Boariplasty
06.52
351.800
1933
Uretero-sigmoidostomy with rectal bladder and colostomy
06.52
252.000
1935
Uretero-ileal conduit
06.52
388.000
1937
Replacement of ureter by bowel segment: Unilateral
06.52
277.000
1939
Replacement of ureter by bowel segment: Bilateral
06.52
485.000
1941
Ureterostomy-in-situ: Unilateral
06.52
100.000
13 Mar 2008
Page 63 of 151
Fee
829.30
(727.50)
1328.30
(1165.20)
962.80
(844.60)
1868.00
(1638.60)
759.00
(665.80)
1328.30
(1165.20)
962.80
(844.60)
1686.70
(1479.60)
962.80
(844.60)
1089.30
(955.50)
1033.10
(906.20)
1033.10
(906.20)
1180.70
(1035.70)
1771.10
(1553.60)
2221.60
(1948.80)
3332.30
(2923.10)
2472.50
(2168.90)
1771.10
(1553.60)
2726.90
(2392.00)
1946.80
(1707.70)
3408.60
(2990.00)
702.80
(616.50)
General Practitioners
/ non-designated
Specialists
RVU
Fee
118.000
151.200
120.000
212.640
108.000
151.200
120.000
192.000
120.000
124.000
120.000
120.000
134.400
201.600
252.880
379.320
281.440
201.600
310.400
221.600
388.000
100.000
829.30
(727.50)
1062.60
(932.10)
843.40
(739.80)
1494.40
(1310.90)
759.00
(665.80)
1062.60
(932.10)
843.40
(739.80)
1349.40
(1183.70)
843.40
(739.80)
871.50
(764.50)
843.40
(739.80)
843.40
(739.80)
944.60
(828.60)
1416.80
(1242.80)
1777.20
(1558.90)
2665.90
(2338.50)
1978.00
(1735.10)
1416.80
(1242.80)
2181.50
(1913.60)
1557.40
(1366.10)
2726.90
(2392.00)
702.80
(616.50)
Anaesthesiology
RVU
Fee
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1943
Ureterostomy-in-situ: Bilateral
06.52
10.3
1952
Bladder
J J Stent catheter
06.52 +
1953
With hydrodilatation of the bladder for interstitial cystitis
06.52 +
1954
Uretroscopy
06.52 +
35.000
1955
And bilateral ureteric catheterisation with differential function studies requiring additional attention time
06.52 +
35.000
1957
With dilatation of the ureter or ureters
06.52 +
25.000
1959
With manipulation of ureteral calculus
06.52 +
20.000
1961
With removal of foreign body or calculus from urethra or bladder
06.52 +
20.000
1963
With fulguration or treatment of minor lesions, with or without biopsy
06.52 +
15.000
1964
And control of haemorrhage and blood clot evacuation
06.52 +
15.000
1965
And catheterisation of the ejaculatory duct
06.52 +
10.000
1967
With ureteric meatotomy: Unilateral or bilateral
06.52 +
15.000
1969
And cold biopsy
06.52 +
15.000
1971
With cryosurgery for bladder or prostatic disease
06.52 +
55.000
1973
06.52 +
35.000
1976
With incision fulguration, or resection of bladder neck and/or posterior urethra for congenital valves or obstructive
hypertrophic bladder neck in a child
Optic urethrotomy
06.52
80.000
1977
Transurethral resection of ejaculatory duct
06.52
60.700
1979
Internal urethrotomy: Female
06.52
50.000
1981
Internal urethrotomy: Male
06.52
76.200
1985
Transurethral resection of bladder neck: Female or child
06.52
105.000
1986
Transurethral resection of bladder neck: Male
06.52
125.000
1987
Litholapaxy
06.52
80.000
13 Mar 2008
Page 64 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
175.000
1229.90 140.000
(1078.90)
44.000
44.000
309.20
(271.20)
5.000 35.10 (30.80)
246.00
(215.80)
246.00
(215.80)
175.70
(154.10)
140.60
(123.30)
140.60
(123.30)
105.40
(92.50)
105.40
(92.50)
70.30 (61.70)
Anaesthesiology
RVU
Fee
983.90
(863.10)
5.000
220.60
(193.50)
309.20
(271.20)
5.000 35.10 (30.80)
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
3.000
3.000
35.000
3.000
10.000
246.00
(215.80)
175.70
(154.10)
140.60
(123.30)
140.60
(123.30)
105.40
(92.50)
105.40
(92.50)
70.30 (61.70)
105.40 15.000
(92.50)
105.40 15.000
(92.50)
386.50 55.000
(339.00)
246.00 35.000
(215.80)
562.20 80.000
(493.20)
426.60 60.700
(374.20)
351.40 50.000
(308.20)
535.50 76.200
(469.70)
737.90 105.000
(647.30)
878.50 120.000
(770.60)
562.20 80.000
(493.20)
105.40
(92.50)
105.40
(92.50)
386.50
(339.00)
246.00
(215.80)
562.20
(493.20)
426.60
(374.20)
351.40
(308.20)
535.50
(469.70)
737.90
(647.30)
843.40
(739.80)
562.20
(493.20)
3.000
25.000
20.000
20.000
15.000
15.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
5.000
5.000
5.000
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
1989
Cystometrogram
06.52
25.000
1991
Flometric bladder, studies with videocystograph
06.52
40.000
1992
Without videocystograph
06.52
25.000
1993
Voiding cysto-urethrogram
06.52
21.000
1994
Rigiscan examination
06.52
66.000
1995
Percutaneous aspiration of bladder
06.52
10.000
1996
Bladder catheterisation: Male (not at operation)
06.52
1997
1999
Bladder catheterisation: Female (not at operation)
Percutaneous cystostomy
06.52
06.52
1945
Instillation of radio-opaque material for cystography or urethrocystography
1947
Fee
RVU
Fee
3.000
6.000 42.20 (37.00)
6.000 42.20 (37.00)
3.000
06.52
3.000 21.10 (18.50)
24.000
168.70
(148.00)
5.000 35.10 (30.80)
3.000 21.10 (18.50)
24.000
168.70
(148.00)
5.000 35.10 (30.80)
Instillation of anti-carcinogenic agent including retention time, but not cost of material or hydro-dilatation of bladder
06.52
10.000 70.30 (61.70)
10.000 70.30 (61.70)
3.000
1949
Cystoscopy: Hospital equipment
06.52
44.000
44.000
3.000
1951
And retrograde pyelography or retrograde ureteral catheterisation: Unilateral or bilateral
06.52 +
2001
Total cystectomy: After previous urinary diversion
06.52
294.000
2003
Total cystectomy: With conduit construction and ureteric anastomosis
06.52
554.700
2005
Cystectomy with substitute bowel bladder construction with anastomosis to urethra or trigone
06.52
650.000
2006
Cystectomy with continent urinary diversion (e.g. Kocks Pouch)
06.52
700.000
2007
Partial cystectomy
06.52
147.000
2008
Continent urinary diversion without cystectomy (e.g. Kocks Pouch)
06.52
600.000
2009
Radical total cystectomy with block dissection, ileal conduit and transplantation of ureters
06.52
462.000
2010
Reversion of temporary conduit
06.52
360.000
2011
Partial cystectomy with uretero-neo-cystostomy
06.52
202.000
2012
Reversion of conduit with major urinary tract reconstruction
06.52
600.000
Page 65 of 151
309.20
(271.20)
10.000 70.30 (61.70)
2066.20
(1812.50)
3898.40
(3419.60)
4568.20
(4007.20)
4919.60
(4315.40)
1033.10
(906.20)
4216.80
(3698.90)
3246.90
(2848.20)
2530.10
(2219.40)
1419.70
(1245.40)
4216.80
(3698.90)
25.000
Anaesthesiology
175.70
(154.10)
281.10
(246.60)
175.70
(154.10)
147.60
(129.50)
463.80
(406.80)
70.30 (61.70)
13 Mar 2008
175.70
(154.10)
281.10
(246.60)
175.70
(154.10)
147.60
(129.50)
463.80
(406.80)
70.30 (61.70)
General Practitioners
/ non-designated
Specialists
RVU
Fee
40.000
25.000
21.000
66.000
10.000
309.20
(271.20)
10.000 70.30 (61.70)
235.200
443.760
520.000
560.000
120.000
480.000
369.600
288.000
161.600
480.000
1653.00
(1450.00)
3118.70
(2735.70)
3654.60
(3205.80)
3935.70
(3452.40)
843.40
(739.80)
3373.40
(2959.10)
2597.50
(2278.50)
2024.10
(1775.50)
1135.70
(996.20)
3373.40
(2959.10)
3.000
3.000
3.000
3.000
3.000
3.000
3.000
8.000
8.000
8.000
8.000
6.000
8.000
8.000
8.000
6.000
8.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
352.90
(309.60)
352.90
(309.60)
352.90
(309.60)
352.90
(309.60)
264.70
(232.20)
352.90
(309.60)
352.90
(309.60)
352.90
(309.60)
264.70
(232.20)
352.90
(309.60)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
2013
Diverticulectomy (independent procedure): Multiple or single
06.52
137.000
2015
Suprapubic cystostomy
06.52
67.000
2016
Abdomino-neo-urethrostomy
06.52
252.000
2019
Operation for vesico-vaginal or urethra-vaginal fistula
06.52
155.000
2020
Repair of vesico vaginal fistula: Abdominal approach
06.52
255.000
2021
Vesico-plication (Hamilton Stewart)
06.52
118.000
2023
Vesico-urethropexy for correction or urinary incontinence: Abdominal approach
06.52
195.000
2025
Vesico-urethropexy with rectus sling
06.52
229.400
2027
Open operation for ureterocele: Unilateral
06.52
118.000
2029
Open operation for ureterocele: Bilateral
06.52
207.000
2031
Reconstruction of ectopic bladder exclusive of orthopaedic operation (if required): Initial
06.52
264.000
2033
Reconstruction of ectopic bladder exclusive of orthopaedic operation (if required): Subsequent
06.52
53.000
2035
Cutaneous vesicostomy
06.52
118.000
2037
Cystoplasty, cysto-urethraplasty, vesicolysis
06.52
126.000
2039
Operation for ruptured bladder
06.52
137.000
2042
Enterocystoplasty plus bowel anastomosis
06.52
419.900
2043
Cysto-lithotomy
06.52
132.000
2045
Excision of patent-urachus or urachal cyst
06.52
112.000
2047
Drainage of perivesical or prevesical abscess
06.52
105.000
2049
Evacuation of clots from bladder: Other than post-operative
06.52
132.100
2050
Evacuation of clots from bladder: Post-operative
06.52
2051
Simple bladder lavage: Including catheterisation
06.52
13 Mar 2008
Page 66 of 151
Fee
962.80
(844.60)
470.90
(413.10)
1771.10
(1553.60)
1089.30
(955.50)
1792.10
(1572.00)
829.30
(727.50)
1370.50
(1202.20)
1612.20
(1414.20)
829.30
(727.50)
1454.80
(1276.10)
1855.40
(1627.50)
372.50
(326.80)
829.30
(727.50)
885.50
(776.80)
962.80
(844.60)
2951.10
(2588.70)
927.70
(813.80)
787.10
(690.40)
737.90
(647.30)
928.40
(814.40)
General Practitioners
/ non-designated
Specialists
RVU
Fee
120.000
67.000
201.600
124.000
204.000
118.000
156.000
183.520
118.000
165.600
211.200
53.000
118.000
120.000
120.000
335.920
120.000
112.000
105.000
120.000
843.40
(739.80)
470.90
(413.10)
1416.80
(1242.80)
871.50
(764.50)
1433.70
(1257.60)
829.30
(727.50)
1096.40
(961.80)
1289.80
(1131.40)
829.30
(727.50)
1163.80
(1020.90)
1484.30
(1302.00)
372.50
(326.80)
829.30
(727.50)
843.40
(739.80)
843.40
(739.80)
2360.80
(2070.90)
843.40
(739.80)
787.10
(690.40)
737.90
(647.30)
843.40
(739.80)
Anaesthesiology
RVU
Fee
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
8.000
8.000
5.000
5.000
6.000
5.000
5.000
5.000
5.000
3.000
4.000
12.000 84.30 (73.90)
12.000 84.30 (73.90)
3.000
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
352.90
(309.60)
352.90
(309.60)
220.60
(193.50)
220.60
(193.50)
264.70
(232.20)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
132.30
(116.10)
176.40
(154.70)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
2053
Bladder neck plasty: Male
06.52
137.000
2057
Bladder neck plasty: Female
06.52
137.000
10.4
2059
Urethra
Open biopsy of urethra: Male
06.52
45.000
2061
Open biopsy of urethra: Female
06.52
2063
Dilatation of urethra stricture: By passage sound: Initial (male)
06.52
2065
Dilatation of urethra stricture: By passage sound: Subsequent (male)
2067
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
962.80 120.000
(844.60)
962.80 120.000
(844.60)
Anaesthesiology
RVU
Fee
843.40
(739.80)
843.40
(739.80)
5.000
5.000
45.000
316.30
(277.50)
45.000
316.30
(277.50)
20.000
140.60
(123.30)
10.000 70.30 (61.70)
3.000
06.52
316.30
(277.50)
45.000
316.30
(277.50)
20.000
140.60
(123.30)
10.000 70.30 (61.70)
Dilatation of urethra stricture: By passage sound: By passage of filiform and follower (male)
06.52
20.000
20.000
3.000
2069
Dilatation of female urethra
06.52
2071
Urethrorraphy: Suture of urethral wound or injury
06.52
139.000
2073
External urethrotomy: Pendulous urethra (anterior)
06.52
67.000
2075
Urethraplasty: Pendulous urethra: First stage
06.52
71.000
2077
Urethraplasty: Pendulous urethra: Second stage
06.52
145.000
2079
Reconstruction of female urethra
06.52
147.000
2081
Reconstruction or repair of male anterior urethra (one stage)
06.52
261.600
2083
Reconstruction or repair of prostatic or membranous urethra: First stage
06.52
168.000
2085
Reconstruction or repair of prostatic or membranous urethra: Second stage
06.52
168.000
2086
Reconstruction or repair of prostatic or membranous urethra: If done in one stage
06.52
294.000
2087
Urethral diverticulectomy: Male or female
06.52
147.000
2088
Peri-urethral teflon injection: Male or female - fee as for cystoscopy (item 1949) plus 42,00 clinical procedure units
06.52
86.000
2089
Marsupialisation of urethral diverticula: Male or female
06.52
115.100
2091
Total urethrectomy: Female
06.52
147.000
2093
Total urethrectomy: Male
06.52
189.000
13 Mar 2008
Page 67 of 151
140.60
(123.30)
5.000 35.10 (30.80)
976.90
(856.90)
470.90
(413.10)
499.00
(437.70)
1019.10
(893.90)
1033.10
(906.20)
1838.50
(1612.70)
1180.70
(1035.70)
1180.70
(1035.70)
2066.20
(1812.50)
1033.10
(906.20)
604.40
(530.20)
808.90
(709.60)
1033.10
(906.20)
1328.30
(1165.20)
140.60
(123.30)
5.000 35.10 (30.80)
120.000
67.000
71.000
120.000
120.000
209.280
134.400
134.400
235.200
120.000
86.000
115.100
120.000
151.200
843.40
(739.80)
470.90
(413.10)
499.00
(437.70)
843.40
(739.80)
843.40
(739.80)
1470.80
(1290.20)
944.60
(828.60)
944.60
(828.60)
1653.00
(1450.00)
843.40
(739.80)
604.40
(530.20)
808.90
(709.60)
843.40
(739.80)
1062.60
(932.10)
3.000
3.000
3.000
3.000
4.000
3.000
4.000
4.000
4.000
4.000
6.000
6.000
6.000
4.000
4.000
5.000
5.000
220.60
(193.50)
220.60
(193.50)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
132.30
(116.10)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
176.40
(154.70)
176.40
(154.70)
220.60
(193.50)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
2095
Drainage of simple localised perineal urinary extravasation
06.52
128.800
2097
Drainage of extensive perineal and/or abdominal urinary extravasation
06.52
137.000
2099
Fulguration for urethral caruncle or polyp
06.52
53.600
2101
Excision of urethral caruncle
06.52
53.600
2103
Simple urethral meatotomy
06.52
26.300
2105
Incision of deep peri-urethral abscess: Female
06.52
123.100
2107
Incision of deep peri-urethral abscess: Male
06.52
123.100
2109
Badenoch pull-through for intractable stricture or incontinence
06.52
181.000
2111
External sphincterotomy
06.52
108.000
2113
Drainage of Skene gland abscess or cyst
06.52
42.300
2115
06.52
168.000
2116
Operation for correction of male urinary incontinence with or without introduction of prostheses (excluding cost of
prostheses)
Urethral meatoplasty
06.52
101.500
2117
Closure of urethrostomy or urethro-cutaneous fistula (independent procedure)
06.52
150.300
2121
Closure of urethrovaginal fistula: Including diversionary procedures
06.52
189.000
11
11.1
2123
Male Genital System
Penis
Biopsy of penis (independent procedure)
06.52
52.100
2125
Destruction of condylomata/chemo- or cryotherapy: Limited number (see item 2317)
06.52
16.600
2127
Destruction of condylomata/chemo-or cryotherapy: Multiple extensive
06.52
41.600
2129
Electrodesiccation: Limited number
06.52
20.800
2131
Electrodesiccation: Multiple extensive
06.52
41.600
2132
Ligation of abnormal venous drainage
06.52
106.100
2141
Reconstructive operation of penis: Reconstructive operation for insertion of prostheses
06.52
101.000
13 Mar 2008
Page 68 of 151
Fee
905.20
(794.00)
962.80
(844.60)
376.70
(330.40)
376.70
(330.40)
184.80
(162.10)
865.10
(758.90)
865.10
(758.90)
1272.10
(1115.90)
759.00
(665.80)
297.30
(260.80)
1180.70
(1035.70)
713.30
(625.70)
1056.30
(926.60)
1328.30
(1165.20)
General Practitioners
/ non-designated
Specialists
RVU
Fee
120.000
120.000
53.600
53.600
26.300
120.000
120.000
144.800
108.000
42.300
134.400
101.500
120.240
151.200
366.20 52.100
(321.20)
116.70 16.600
(102.40)
292.40 41.600
(256.50)
146.20 20.800
(128.20)
292.40 41.600
(256.50)
745.70 106.100
(654.10)
709.80 101.000
(622.60)
Anaesthesiology
RVU
Fee
843.40
(739.80)
843.40
(739.80)
376.70
(330.40)
376.70
(330.40)
184.80
(162.10)
843.40
(739.80)
843.40
(739.80)
1017.70
(892.70)
759.00
(665.80)
297.30
(260.80)
944.60
(828.60)
713.30
(625.70)
845.00
(741.20)
1062.60
(932.10)
5.000
366.20
(321.20)
116.70
(102.40)
292.40
(256.50)
146.20
(128.20)
292.40
(256.50)
745.70
(654.10)
709.80
(622.60)
3.000
5.000
3.000
3.000
3.000
3.000
3.000
5.000
5.000
3.000
5.000
3.000
3.000
5.000
3.000
3.000
3.000
3.000
3.000
3.000
220.60
(193.50)
220.60
(193.50)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
220.60
(193.50)
220.60
(193.50)
132.30
(116.10)
220.60
(193.50)
132.30
(116.10)
132.30
(116.10)
220.60
(193.50)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
1325.50
(1162.70)
1578.50
(1384.60)
1180.70
(1035.70)
1180.70
(1035.70)
1180.70
(1035.70)
112.40
(98.60)
1314.20
(1152.80)
590.40
(517.90)
2108.40
(1849.50)
1475.90
(1294.60)
2361.40
(2071.40)
1475.90
(1294.60)
590.40
(517.90)
98.40 (86.30)
2143
Reconstructive operation of penis: For straightening of chordee e.g. hypospadias with or without mobilisation of urethra
06.52
188.600
2145
Reconstructive operation of penis: For straightening of chordee with transplantation of prepuce
06.52
224.600
2147
Reconstructive operation of penis: For injury: Including fracture of penis and skin graft, if required
06.52
168.000
2149
Reconstructive operation of penis: For epispadias distal to the external sphincter
06.52
168.000
2153
Reconstructive operation for epispadias with incontinence
06.52
168.000
2154
Induction of artificial erection
06.52
16.000
2155
Hypospadias: Urethral reconstruction
06.52
187.000
2157
Hypospadias: Subsequent procedures for repair of urethra: Total
06.52
84.000
2159
Hypospadias: Urethraplasty: Complete, one stage for hypospadias
06.52
300.000
2161
Total amputation of penis: Without gland dissection
06.52
210.000
2163
Total amputation of penis: With gland-dissection
06.52
336.000
2165
Partial amputation of penis: With gland-dissection
06.52
210.000
2167
Partial amputation of penis: Without gland-dissection
06.52
84.000
2169
Injection procedure for Peyronie's disease
06.52
14.000
2171
Priapism operation: Irrigation of corpora cavernosa for priapism
06.52
42.000
2173
Priapism operation: Shunt procedure: Any type
06.52
252.000
2174
Priapism operation: Stab shunt
06.52
114.400
11.2
2175
Testis and epididymis
Testis biopsy: Needle (independent procedure)
06.52
18.500
2177
Testis biopsy: Incisional: Independent procedure: Unilateral
06.52
58.900
2179
Testis biopsy: Incisional: Independent procedure: Bilateral
06.52
58.900
2181
Epididymis biopsy: Needle
06.52
86.100
2183
Puncture aspiration hydrocele with or without injection of medication
06.52
10.000
13 Mar 2008
Page 69 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
RVU
Fee
3.000
14.000
1060.40
(930.20)
1262.80
(1107.70)
944.60
(828.60)
944.60
(828.60)
944.60
(828.60)
112.40
(98.60)
1051.40
(922.30)
590.40
(517.90)
1686.70
(1479.60)
1180.70
(1035.70)
1889.10
(1657.10)
1180.70
(1035.70)
590.40
(517.90)
98.40 (86.30)
295.20 42.000
(258.90)
1771.10 201.600
(1553.60)
804.00 114.400
(705.30)
295.20
(258.90)
1416.80
(1242.80)
804.00
(705.30)
3.000
130.00
(114.00)
413.90
(363.10)
413.90
(363.10)
605.10
(530.80)
70.30 (61.70)
3.000
130.00
(114.00)
413.90
(363.10)
413.90
(363.10)
605.10
(530.80)
70.30 (61.70)
150.880
Anaesthesiology
179.680
134.400
134.400
134.400
16.000
149.600
84.000
240.000
168.000
268.800
168.000
84.000
18.500
58.900
58.900
86.100
10.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
4.000
6.000
6.000
4.000
3.000
4.000
4.000
3.000
3.000
3.000
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
264.70
(232.20)
264.70
(232.20)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
2185
Operation for maldescended testicle: Including herniotomy
06.52
135.000
2187
Operation for torsion appendix testis
06.52
119.200
2189
Operation for torsion testis with fixation of contralateral testis
06.52
119.200
2191
Orchidectomy (total or subcapsular): Unilateral
06.52
98.000
2193
Orchidectomy (total or subcapsular): Bilateral
06.52
147.000
2197
Operation for hydrocele or spermatocele
06.52
99.800
2199
Varicocelectomy
06.52
106.100
2201
Abdominal ligation of spermatic vein for varicocele
06.52
112.800
2203
Epididymectomy: Unilateral
06.52
114.400
2205
Epididymectomy: Bilateral
06.52
158.200
2207
Vasectomy: Unilateral or bilateral (no extra fee to be charged if done in combination with prostatectomy)
06.52
55.900
2209
Vasotomy: Unilateral or bilateral
06.52
70.400
2210
Vasogram, seminal vesiculogram: Unilateral
06.52
58.100
2211
Vasogram, seminal vesiculogram: Bilateral
06.52
58.100
2212
Insertion of testicular prosthesis: Independent procedure (exclusive of cost of material)
06.52
91.200
2213
Suture or repair of testicular injury
06.52
110.300
2215
Incision and drainage of testis or epididymis e.g. abscess or haematoma
06.52
90.000
2217
Excision of local lesion of testis or epididymis
06.52
90.800
2219
Vaso-vasostomy: Unilateral
06.52
67.000
2221
Vaso-vasostomy: Bilateral
06.52
117.000
2223
Epididymo-vasostomy: Unilateral
06.52
67.000
2225
Epididymo-vasostomy: Bilateral
06.52
117.000
13 Mar 2008
Page 70 of 151
Fee
948.80
(832.30)
837.70
(734.80)
837.70
(734.80)
688.70
(604.10)
1033.10
(906.20)
701.40
(615.30)
745.70
(654.10)
792.80
(695.40)
804.00
(705.30)
1111.80
(975.30)
392.90
(344.60)
494.80
(434.00)
408.30
(358.20)
408.30
(358.20)
641.00
(562.30)
775.20
(680.00)
632.50
(554.80)
638.10
(559.70)
470.90
(413.10)
822.30
(721.30)
470.90
(413.10)
822.30
(721.30)
General Practitioners
/ non-designated
Specialists
RVU
Fee
120.000
119.200
119.200
98.000
120.000
99.800
106.100
112.800
114.400
126.560
55.900
70.400
58.100
58.100
91.200
110.300
90.000
90.800
67.000
117.000
67.000
117.000
843.40
(739.80)
837.70
(734.80)
837.70
(734.80)
688.70
(604.10)
843.40
(739.80)
701.40
(615.30)
745.70
(654.10)
792.80
(695.40)
804.00
(705.30)
889.50
(780.30)
392.90
(344.60)
494.80
(434.00)
408.30
(358.20)
408.30
(358.20)
641.00
(562.30)
775.20
(680.00)
632.50
(554.80)
638.10
(559.70)
470.90
(413.10)
822.30
(721.30)
470.90
(413.10)
822.30
(721.30)
Anaesthesiology
RVU
Fee
4.000
4.000
4.000
3.000
3.000
4.000
4.000
4.000
3.000
3.000
3.000
3.000
3.000
3.000
4.000
4.000
4.000
4.000
3.000
3.000
3.000
3.000
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
2227
Incision and drainage of scrotal wall abscess
06.52
42.700
2229
Excision of Mullerian duct cyst
06.52
189.000
2231
Excision of lesion of spermatic cord
06.52
84.000
2233
Seminal Vesiculectomy
06.52
220.000
11.3
2235
Prostate
Biopsy prostate: Needle or punch, single or multiple, any approach
06.52
23.300
2237
Biopsy prostate: Incisional, any approach
06.52
105.000
2239
Transurethral drainage of prostatic abscess
06.52
117.400
2241
Perineal drainage of prostatic abscess
06.52
77.000
2243
Trans-urethral cryo-surgical removal of prostate
06.52
126.000
2245
Trans-urethral resection of prostate
06.52
252.000
2247
Trans-urethral resection of residual prostatic tissue 90 days post-operative or longer
06.52
126.000
2249
Trans-urethral resection of post-operative bladder neck contracture
06.52
126.000
2251
Prostatectomy: Perineal: Sub-total
06.52
252.000
2253
Prostatectomy: Perineal: Radical
06.52
336.000
2254
Pelvic lymph adenectomy
06.52
175.000
2255
Supra-pelvic, transversical
06.52
252.000
2257
Retropubic: Sub-total
06.52
252.000
2259
Retropubic: Radical
06.52
336.000
2260
Prostate brachytherapy
06.52
230.000
12
12.1
2271
Female Genital System
Vulva and introitus
Removal of tag or polyp
06.52
13 Mar 2008
Page 71 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
300.10 42.700
(263.20)
1328.30 151.200
(1165.20)
590.40 84.000
(517.90)
1546.20 176.000
(1356.30)
300.10
(263.20)
1062.60
(932.10)
590.40
(517.90)
1236.90
(1085.00)
3.000
163.80
(143.70)
737.90
(647.30)
825.10
(723.80)
541.20
(474.70)
885.50
(776.80)
1771.10
(1553.60)
885.50
(776.80)
885.50
(776.80)
1771.10
(1553.60)
2361.40
(2071.40)
1229.90
(1078.90)
1771.10
(1553.60)
1771.10
(1553.60)
2361.40
(2071.40)
1616.40
(1417.90)
163.80
(143.70)
737.90
(647.30)
825.10
(723.80)
541.20
(474.70)
843.40
(739.80)
1416.80
(1242.80)
843.40
(739.80)
843.40
(739.80)
1416.80
(1242.80)
1889.10
(1657.10)
983.90
(863.10)
1416.80
(1242.80)
1416.80
(1242.80)
1889.10
(1657.10)
1293.20
(1134.40)
3.000
6.000 42.20 (37.00)
3.000
6.000 42.20 (37.00)
23.300
105.000
117.400
77.000
120.000
201.600
120.000
120.000
201.600
268.800
140.000
201.600
201.600
268.800
184.000
4.000
3.000
5.000
4.000
4.000
4.000
6.000
6.000
6.000
5.000
6.000
8.000
8.000
6.000
6.000
8.000
8.000
132.30
(116.10)
176.40
(154.70)
132.30
(116.10)
220.60
(193.50)
132.30
(116.10)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
220.60
(193.50)
264.70
(232.20)
352.90
(309.60)
352.90
(309.60)
264.70
(232.20)
264.70
(232.20)
352.90
(309.60)
352.90
(309.60)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
2272
Removal of small superficial benign lesions
06.52
23.000
2273
Biopsy with suture in theatre (excluding after-care)
06.52
27.000
2274
Laser therapy of vulva and/or vagina (colposcopically directed)
06.52
71.000
2275
Reduction labial hypertrophy
06.52
67.000
2279
Secondary perineal repair: Repair second degree tear
06.52
45.000
2280
Secondary perineal repair: Repair third degree tear
06.52
96.000
2281
Excision of inclusion cyst
06.52
43.000
2283
Hymenectomy
06.52
43.000
2285
Drainage haematocolpos
06.52
54.000
2287
Clitoris repair for injury: Including skin graft, if required
06.52
67.000
2288
Clitoral reduction
06.52
160.000
2289
Denervation or alcohol infiltration vulva (Woodruff)
06.52
54.000
2291
Vulva: Undercutting skin (ball)
06.52
58.000
2293
Vulva and introitus: Drainage of abscess
06.52
27.000
2295
Bartholin gland: Bartholin abscess marsupialisation
06.52
36.000
2297
Bartholin gland: Bartholin gland excision
06.52
45.000
2301
Operation for enlarging introitus: Fenton plasty
06.52
50.000
2303
Operation for enlarging introitus: Bilateral Z-plastic
06.52
88.000
2305
Vulvectomy: Partial
06.52
161.000
2307
Vulvectomy
06.52
225.000
2309
Radical vulvectomy with bilateral lymphdenectomy
06.52
357.000
2311
Radical vulvectomy with bilateral lymphadenectomy, plus deep lymph gland dissection
06.52
402.000
13 Mar 2008
Page 72 of 151
Fee
161.60
(141.80)
189.80
(166.50)
499.00
(437.70)
470.90
(413.10)
316.30
(277.50)
674.70
(591.80)
302.20
(265.10)
302.20
(265.10)
379.50
(332.90)
470.90
(413.10)
1124.50
(986.40)
379.50
(332.90)
407.60
(357.50)
189.80
(166.50)
253.00
(221.90)
316.30
(277.50)
351.40
(308.20)
618.50
(542.50)
1131.50
(992.50)
1581.30
(1387.10)
2509.00
(2200.90)
2825.30
(2478.30)
General Practitioners
/ non-designated
Specialists
RVU
Fee
23.000
27.000
71.000
67.000
45.000
96.000
43.000
43.000
54.000
67.000
128.000
54.000
58.000
27.000
36.000
45.000
50.000
88.000
128.800
180.000
285.600
321.600
161.60
(141.80)
189.80
(166.50)
499.00
(437.70)
470.90
(413.10)
316.30
(277.50)
674.70
(591.80)
302.20
(265.10)
302.20
(265.10)
379.50
(332.90)
470.90
(413.10)
899.60
(789.10)
379.50
(332.90)
407.60
(357.50)
189.80
(166.50)
253.00
(221.90)
316.30
(277.50)
351.40
(308.20)
618.50
(542.50)
905.20
(794.00)
1265.00
(1109.60)
2007.20
(1760.70)
2260.20
(1982.60)
Anaesthesiology
RVU
Fee
3.000
3.000
3.000
4.000
6.000
6.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
3.000
3.000
3.000
4.000
4.000
4.000
6.000
6.000
6.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
264.70
(232.20)
264.70
(232.20)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
12.2
2312
2313
Fee
2314
Vaginal procedures and operations
Artificial insemination
Examination under anaesthetic when no other procedures are performed (not limited to female patients only) - Stand
alone procedure
Intra uterine insemination
2315
2316
Simms Hühner test plus wet smear
Destruction of condylomata by chemo-, cryo-, or electrotherapy, or harmonic scalpel: First lesion
06.52
06.52
13.000 91.40 (80.20)
25.500
179.20
(157.20)
18.000
126.50
(111.00)
5.000 35.10 (30.80)
14.000 98.40 (86.30)
2317
Destruction of condylomata by chemo-, cryo-, or electrotherapy, or harmonic scalpel: Repeat - Limited
06.52
7.000 49.20 (43.20)
2318
Destruction of condylomata by chemo-, cryo-, or electrotherapy, or harmonic scalpel: Widespread
06.52
56.000
2319
Excision of cysts or tumours
06.52
54.000
2321
Drainage of vaginal abscess
06.52
54.000
2322
Pudendal nerve block
06.52
15.000
2323
Reconstruction of vagina after atresia
06.52
107.000
2325
Construction of artificial vagina: Labial fusion
06.52
179.000
2327
Construction of artificial vagina: Macindoe type
06.52
196.000
2329
Construction of vagina: Bowel pull-through operation: Two surgeons: Each
06.52
241.000
2331
Vaginal septum removal
06.52
107.000
2333
Vaginal prolapse: Abdominal approach: Sacrocolpopexy with use of mesh
06.52
243.300
2334
Vaginal prolapse: Abdominal approach: Use of rectus sheath or tape
06.52
243.300
2335
Vaginal prolapse: Vaginal approach: Sacrospinous fixations
06.52
166.900
2336
Vaginal prolapse: Vaginal approach: Use of mesh or tape
06.52
166.900
2339
Colpotomy: Diagnostic (excluding after-care)
06.52
20.000
2341
Colpotomy: Therapeutic, with or without sterilisation
06.52
103.000
2343
Vaginal hysterectomy: Without repair
06.52
210.500
13 Mar 2008
Page 73 of 151
06.52
06.52
06.52
393.60
(345.30)
379.50
(332.90)
379.50
(332.90)
105.40
(92.50)
752.00
(659.60)
1258.00
(1103.50)
1377.50
(1208.30)
1693.70
(1485.70)
752.00
(659.60)
1709.90
(1499.90)
1709.90
(1499.90)
1173.00
(1028.90)
1173.00
(1028.90)
140.60
(123.30)
723.90
(635.00)
1479.40
(1297.70)
General Practitioners
/ non-designated
Specialists
RVU
Fee
13.000 91.40 (80.20)
25.500
179.20
(157.20)
18.000
126.50
(111.00)
5.000 35.10 (30.80)
14.000 98.40 (86.30)
7.000 49.20 (43.20)
56.000
54.000
54.000
15.000
107.000
143.200
156.800
192.800
107.000
194.640
194.640
133.520
133.520
20.000
103.000
168.400
393.60
(345.30)
379.50
(332.90)
379.50
(332.90)
105.40
(92.50)
752.00
(659.60)
1006.40
(882.80)
1102.00
(966.70)
1355.00
(1188.60)
752.00
(659.60)
1367.90
(1199.90)
1367.90
(1199.90)
938.40
(823.20)
938.40
(823.20)
140.60
(123.30)
723.90
(635.00)
1183.50
(1038.20)
Anaesthesiology
RVU
Fee
3.000
132.30
(116.10)
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
3.000
3.000
3.000
3.000
5.000
4.000
5.000
6.000
4.000
6.000
6.000
6.000
6.000
4.000
4.000
6.000
220.60
(193.50)
176.40
(154.70)
220.60
(193.50)
264.70
(232.20)
176.40
(154.70)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
176.40
(154.70)
176.40
(154.70)
264.70
(232.20)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
2345
Vaginal hysterectomy: With repair
06.52
231.700
2357
Vaginal hysterectomy and repair with unilateral or bilateral salpingo-oophorectomy
06.52
320.000
2361
Vaginal hysterectomy and repair for total prolapse
06.52
320.000
2363
Fothergill or Manchester repair operation
06.52
196.000
2365
Repair of recurrent enterocele or vault prolapse (except at the time of hysterectomy)
06.52
232.000
2366
Posterior repair alone
06.52
107.000
2367
Other operations for prolapse: Anterior repair - with or without posterior repair
06.52
161.000
2368
Uterovesical fistula
06.52
210.000
2369
Repair of Vesico- or urethro-vaginal fistula
06.52
179.000
2370
Repair of VVF - Obstetric or radiation
06.52
232.000
2371
Closure of uretero-vaginal fistula
06.52
250.000
2372
Closure of uretero-vaginal fistula: Obstetric or radiation
06.52
250.000
2373
Closure of recto-vaginal fistula
06.52
134.000
2374
Closure of recto-vaginal fistula: Obstetric or radiation
06.52
151.000
2375
Colpocleisis
06.52
129.000
2377
Le Fort operation
06.52
129.000
2379
Schauta operation
06.52
357.000
2381
Vaginectomy
06.52
268.000
2383
Synchronous combined hysterocolpectomy: One or two surgeons - total fee
06.52
429.000
2385
Vaginal laceration or trauma: Repair
06.52
50.000
12.3
2389
Cervix
Paracervical (pelvis) nerve block (for neck refer to item 3294)
06.52
20.000
2391
Cervix: Canal reconstruction
06.52
147.000
13 Mar 2008
Page 74 of 151
Fee
1628.40
(1428.40)
2249.00
(1972.80)
2249.00
(1972.80)
1377.50
(1208.30)
1630.50
(1430.30)
752.00
(659.60)
1131.50
(992.50)
1475.90
(1294.60)
1258.00
(1103.50)
1630.50
(1430.30)
1757.00
(1541.20)
1757.00
(1541.20)
941.80
(826.10)
1061.20
(930.90)
906.60
(795.30)
906.60
(795.30)
2509.00
(2200.90)
1883.50
(1652.20)
3015.00
(2644.70)
351.40
(308.20)
General Practitioners
/ non-designated
Specialists
RVU
Fee
185.360
256.000
256.000
156.800
185.600
107.000
128.800
168.000
143.200
185.600
200.000
200.000
120.000
120.800
120.000
120.000
285.600
214.400
343.200
50.000
140.60 20.000
(123.30)
1033.10 120.000
(906.20)
1302.70
(1142.70)
1799.20
(1578.20)
1799.20
(1578.20)
1102.00
(966.70)
1304.40
(1144.20)
752.00
(659.60)
905.20
(794.00)
1180.70
(1035.70)
1006.40
(882.80)
1304.40
(1144.20)
1405.60
(1233.00)
1405.60
(1233.00)
843.40
(739.80)
849.00
(744.70)
843.40
(739.80)
843.40
(739.80)
2007.20
(1760.70)
1506.80
(1321.80)
2412.00
(2115.80)
351.40
(308.20)
140.60
(123.30)
843.40
(739.80)
Anaesthesiology
RVU
Fee
6.000
6.000
6.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
4.000
4.000
8.000
8.000
8.000
4.000
3.000
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
176.40
(154.70)
176.40
(154.70)
352.90
(309.60)
352.90
(309.60)
352.90
(309.60)
176.40
(154.70)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
2392
2395
Cryo- or electro-cauterisation, or Lletz of cervix (excluding cost of disposable loop electrode): In consulting room
Cryo- or electro-cauterisation, or Lletz of cervix (excluding cost of disposable loop electrode): Under anaesthetic
06.52
06.52
2396
Laser or harmonic scalpel treatment of the cervix
06.52
2397
Dilation of cervix for stenosis and insertion of prosthesis and Budge suture
06.52
2399
Punch biopsy (excluding after-care)
2400
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
06.52
14.000 98.40 (86.30)
22.000
154.60
(135.60)
80.000
562.20
(493.20)
31.000
217.90
(191.10)
9.000 63.30 (55.50)
14.000 98.40 (86.30)
22.000
154.60
(135.60)
80.000
562.20
(493.20)
31.000
217.90
(191.10)
9.000 63.30 (55.50)
Biopsy during pregnancy (excluding after-care)
06.52
13.000 91.40 (80.20)
13.000 91.40 (80.20)
3.000
2403
Wedge biopsy: Cervix (excluding after-care)
06.52
18.000
3.000
2404
Biopsy: Wedge during pregnancy: Cervix (excluding after-care)
06.52
24.000
2405
Cone biopsy: Cervix (excluding after-care)
06.52
54.000
2407
Amputation: Cervix
06.52
67.000
2409
Cervix encirclage: McDonald stitch
06.52
35.000
2411
Cervix encirclage: Shirodkar suture
06.52
60.000
2413
Cervix encirclage: Lash
06.52
49.000
2415
2416
Cervix encirclage: Removal items 2409 and 2411: Without anaesthetic
Cervix: Removal items 2409 and 2411: With anaesthetic in theatre
06.52
06.52
5.000
30.000
2417
Repair of tears: Emmet repair of tears
06.52
45.000
2418
Repair of tears: Sturmdorff repair of tears
06.52
54.000
2421
Extirpation of cervical stump: Vaginal
06.52
134.000
2423
Extirpation of cervical stump: Abdominal
06.52
134.000
2425
Removal of cervical polyps (excluding after-care)
06.52
13.000
126.50 18.000
126.50
(111.00)
(111.00)
168.70 24.000
168.70
(148.00)
(148.00)
379.50 54.000
379.50
(332.90)
(332.90)
470.90 67.000
470.90
(413.10)
(413.10)
246.00 35.000
246.00
(215.80)
(215.80)
421.70 60.000
421.70
(369.90)
(369.90)
344.40 49.000
344.40
(302.10)
(302.10)
35.10 (30.80)
5.000 35.10 (30.80)
210.80 30.000
210.80
(184.90)
(184.90)
316.30 45.000
316.30
(277.50)
(277.50)
379.50 54.000
379.50
(332.90)
(332.90)
941.80 120.000
843.40
(826.10)
(739.80)
941.80 120.000
843.40
(826.10)
(739.80)
91.40 (80.20) 13.000 91.40 (80.20)
2427
Removal of cervical myomata
06.52
54.000
2429
Colposcopy (excluding after-care)
06.52
27.000
13 Mar 2008
Page 75 of 151
379.50
(332.90)
189.80
(166.50)
54.000
27.000
379.50
(332.90)
189.80
(166.50)
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
5.000
5.000
3.000
3.000
3.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
220.60
(193.50)
220.60
(193.50)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
316.30 45.000
(277.50)
126.50 18.000
(111.00)
154.60 22.000
(135.60)
281.10 40.000
(246.60)
407.60 58.000
(357.50)
562.20 80.000
(493.20)
442.80 63.000
(388.40)
527.10 75.000
(462.40)
913.60 120.000
(801.40)
126.50 18.000
(111.00)
246.00 35.000
(215.80)
316.30 45.000
(277.50)
351.40 50.000
(308.20)
499.00 71.000
(437.70)
351.40 50.000
(308.20)
351.40 50.000
(308.20)
562.20 80.000
(493.20)
379.50 54.000
(332.90)
562.20 80.000
(493.20)
379.50 54.000
(332.90)
562.20 80.000
(493.20)
1005.00 120.000
(881.60)
12.4
2433
Uterus
Embryo transfer
06.52
45.000
2434
Endometrial biopsy (excluding after-care)
06.52
18.000
2435
Hysterosalpingogram (excluding after-care)
06.52
22.000
2436
Hysteroscopy (excluding after-care)
06.52
40.000
2437
Hysteroscopy and D&C (excluding after-care)
06.52
58.000
2438
Hysteroscopy and removal of uterine septum (excluding after-care)
06.52
80.000
2439
Hysteroscopy and division of endometrial and endocervical bands (excluding after-care)
06.52
63.000
2440
Hysteroscopy and polypectomy (excluding after-care)
06.52
75.000
2441
Hysteroscopy and myomectomy (excluding after-care)
06.52
130.000
2442
Insertion of intra uterine contraceptive device (IUCD) (excluding after-care)
06.52
18.000
2443
Dilatation and curettage (D&C) (excluding after-care)
06.52
35.000
2444
Fractional dilatation and curettage (D&C) (excluding after-care)
06.52
45.000
2445
Evacuation of uterus: Incomplete abortion: Before 12 weeks gestation
06.52
50.000
2447
Evacuation of uterus, incomplete abortion: After 12 weeks gestation
06.52
71.000
2448
Termination of pregnancy before 12 weeks
06.52
50.000
2449
Evacuation: Missed abortion: Before 12 weeks gestation
06.52
50.000
2451
Evacuation: Missed abortion: After 12 weeks gestation
06.52
80.000
2452
Termination of pregnancy after 12 weeks - administration of intra/extra amniotic prostaglandin
06.52
54.000
2453
Evacuation hydatidiform mole
06.52
80.000
2455
Evacuation uterus post-partum
06.52
54.000
2461
Ventrosuspension
06.52
80.000
2463
Uteroplasty: Strassman
06.52
143.000
13 Mar 2008
Page 76 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
316.30
(277.50)
126.50
(111.00)
154.60
(135.60)
281.10
(246.60)
407.60
(357.50)
562.20
(493.20)
442.80
(388.40)
527.10
(462.40)
843.40
(739.80)
126.50
(111.00)
246.00
(215.80)
316.30
(277.50)
351.40
(308.20)
499.00
(437.70)
351.40
(308.20)
351.40
(308.20)
562.20
(493.20)
379.50
(332.90)
562.20
(493.20)
379.50
(332.90)
562.20
(493.20)
843.40
(739.80)
Anaesthesiology
RVU
Fee
4.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
4.000
4.000
4.000
4.000
4.000
4.000
5.000
6.000
4.000
6.000
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
220.60
(193.50)
264.70
(232.20)
176.40
(154.70)
264.70
(232.20)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
2465
Uteroplasty: Tompkins
06.52
143.000
2467
Myomectomy
06.52
143.000
2469
Subtotal hysterectomy with or without unilateral or bilateral salpingo-oophorectomy
06.52
254.100
2471
Total abdominal hysterectomy: With or without unilateral or bilateral salpingo-oophorectomy - uncomplicated
06.52
252.200
2473
Total abdominal hysterectomy plus vaginal cuff with or without unilateral or bilateral salpingo-oophorectomy
06.52
355.000
2475
Radical abdominal hysterectomy with bilateral lymphadenectomy (Wertheim)
06.52
472.800
2477
Abdominal hysterotomy with or without sterilisation
06.52
188.000
2478
Non-surgical endometrial destruction, any method, not utilising hysteroscopic instrumentation or assistance
06.52
200.000
2479
Surgical endometrial destruction: Any method, utilising hysteroscopic instrumentation or assistance
06.52
225.000
2480
Laparoscopy by second gynaecologist during endometrial ablation (item 2479)
06.52
120.000
12.5
0066
2481
Fallopian tubes
Microsurgery of the fallopian-tubes and ovaries: Where micro-surgical techniques are used, with the aid of a microscope, 25% may be added to the fee
Insufflation Fallopian tubes (excluding after-care)
06.52
16.000
112.40
(98.60)
Salpingolysis
06.52
125.000
878.50
(770.60)
Salpingostomy
06.52
161.000
1131.50
(992.50)
Tuboplasty tubal anastomosis or re-implantation
06.52
196.000
1377.50
(1208.30)
Ectopic pregnancy under 12 weeks (salpingectomy)
06.52
125.000
878.50
(770.60)
Ectopic pregnancy under 12 weeks (salpingostomy)
06.52
161.000
1131.50
(992.50)
Ectopic pregnancy - after 12 weeks
06.52
225.000
1581.30
(1387.10)
Salpingectomy: Uni- or bilateral or sterilisation for accepted medical reasons
06.52
94.000
660.60
(579.50)
Note: Use item 1807 for open procedures performed with a laparoscope instead of item 2493. Item 1807 may only be
06.52
added once, and may not be charged together with item 2493 for more than one procedure performed laparoscopically
Diagnostic laparoscopy (excluding after-care)
06.52
94.400
663.40
(581.90)
Laparoscopy: Plus aspiration of a cyst (excluding after-care)
06.52 +
18.000
126.50
(111.00)
2483
2485
2487
2489
2490
2491
2492
2493
2496
13 Mar 2008
Page 77 of 151
1005.00
(881.60)
1005.00
(881.60)
1785.80
(1566.50)
1772.50
(1554.80)
2494.90
(2188.50)
3322.80
(2914.70)
1321.30
(1159.00)
1405.60
(1233.00)
1581.30
(1387.10)
843.40
(739.80)
General Practitioners
/ non-designated
Specialists
RVU
Fee
120.000
120.000
203.280
201.760
284.000
378.240
150.400
160.000
180.000
16.000
120.000
128.800
156.800
120.000
128.800
180.000
94.000
94.400
18.000
Anaesthesiology
RVU
Fee
843.40
(739.80)
843.40
(739.80)
1428.70
(1253.20)
1418.00
(1243.90)
1996.00
(1750.90)
2658.30
(2331.80)
1057.00
(927.20)
1124.50
(986.40)
1265.00
(1109.60)
6.000
112.40
(98.60)
843.40
(739.80)
905.20
(794.00)
1102.00
(966.70)
843.40
(739.80)
905.20
(794.00)
1265.00
(1109.60)
660.60
(579.50)
3.000
663.40
(581.90)
126.50
(111.00)
5.000
6.000
6.000
6.000
6.000
8.000
6.000
6.000
6.000
4.000
4.000
4.000
6.000
6.000
6.000
5.000
5.000
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
352.90
(309.60)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
06.52
132.30
(116.10)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
281.10 40.000
(246.60)
126.50 18.000
(111.00)
358.40 51.000
(314.40)
126.50 18.000
(111.00)
365.50 52.000
(320.60)
281.10 40.000
(246.60)
752.00 107.000
(659.60)
365.50 52.000
(320.60)
407.60 58.000
(357.50)
2497
Laparoscopy: Plus sterilisation
06.52 +
40.000
2499
Laparoscopy: Plus biopsy (excluding after-care)
06.52 +
18.000
2500
Laparoscopy: Plus ablation of endometriosis by laser, harmonic scalpel or cautery
06.52 +
51.000
2501
Laparoscopy: Plus cauterisation and/or lysis of adhesions
06.52 +
18.000
2502
Laparoscopy: Plus aspiration of follicles (IVF) (excluding after-care)
06.52 +
52.000
2503
Laparoscopy: Plus ovarian drilling
06.52 +
40.000
2504
Laparoscopy: Plus Gamete intra fallopian tube transfer (includes follicle aspiration) (GIFT)
06.52 +
107.000
2505
Laparoscopy: Plus laparoscopic uterosacral nerve ablation
06.52 +
52.000
2506
Transcervical gamete/embryo intra-fallopian tube transfer (TET/TEST)
06.52
58.000
12.6
2525
Ovaries
Wedge resection of ovaries, unilateral or bilateral
06.52
105.000
2529
Oophorectomy: Uni- or bilateral
06.52
134.500
2531
Ovarian carcinoma debulking and omentectomy
06.52
357.000
2532
Ovarian carcinoma: Abdominal hysterectomy, bilateral salpingo-oophorectomy, debulking and omentectomy
06.52
469.000
12.7
2535
Miscellaneous procedures
Exenteration: Anterior Exenteration
06.52
402.000
2537
Exenteration: Posterior Exenteration
06.52
402.000
2539
Exenteration: Total
06.52
625.000
2541
Presacral neurectomy
06.52
98.000
2543
Moschowitz operation
06.52
120.000
2544
Laparoscopic vaginal suspension for stress incontinence (item 1807 may not be used together with this item)
06.52
193.100
2545
Operations for stress incontinence: Marshall-Marchetti-Kranz operation
06.52
195.000
2546
Operations for stress incontinence: Urethro-vesicopexy: Abdominal approach
06.52
149.000
13 Mar 2008
Page 78 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
737.90
(647.30)
945.30
(829.20)
2509.00
(2200.90)
3296.10
(2891.30)
105.000
2825.30
(2478.30)
2825.30
(2478.30)
4392.50
(3853.10)
688.70
(604.10)
843.40
(739.80)
1357.10
(1190.40)
1370.50
(1202.20)
1047.20
(918.60)
321.600
120.000
285.600
375.200
321.600
500.000
98.000
120.000
154.480
156.000
120.000
Anaesthesiology
RVU
Fee
281.10
(246.60)
126.50
(111.00)
358.40
(314.40)
126.50
(111.00)
365.50
(320.60)
281.10
(246.60)
752.00
(659.60)
365.50
(320.60)
407.60
(357.50)
5.000
737.90
(647.30)
843.40
(739.80)
2007.20
(1760.70)
2636.90
(2313.10)
4.000
2260.20
(1982.60)
2260.20
(1982.60)
3514.00
(3082.50)
688.70
(604.10)
843.40
(739.80)
1085.70
(952.40)
1096.40
(961.80)
843.40
(739.80)
8.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
4.000
6.000
6.000
8.000
8.000
5.000
5.000
5.000
5.000
6.000
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
176.40
(154.70)
176.40
(154.70)
264.70
(232.20)
264.70
(232.20)
352.90
(309.60)
352.90
(309.60)
352.90
(309.60)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
264.70
(232.20)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
1131.50
(992.50)
1612.20
(1414.20)
1377.50
(1208.30)
1377.50
(1208.30)
1265.00
(1109.60)
527.10
(462.40)
1883.50
(1652.20)
1054.20
(924.70)
1475.90
(1294.60)
358.40
(314.40)
21.10 (18.50)
1581.30
(1387.10)
2547
Operations for stress incontinence: Burch colposuspension
06.52
161.000
2548
Operation for stress incontinence: Use of tape
06.52
229.400
2550
Operations for stress incontinence: Urethro-vesicopexy: Combined abdominal and vaginal approach
06.52
196.000
2551
Laparotomy
06.52
196.000
2554
Drainage of pelvic abscess per abdomen
06.52
180.000
2556
Drainage of pelvic abscess per vagina (refer to item 2341)
06.52
75.000
2558
Drainage intra-abdominal abscess: Delayed closure
06.52
268.000
2560
Surgery for moderate endometriosis (AFS stages 2 + 3): Any method
06.52
150.000
2561
Surgery for severe endometriosis (AFS stage 4 - retrovaginal septum): Any method (may not be used with another
procedure or as a modifier)
Treatment of endometriosis (any method) found as an incidental finding during surgery for unrelated condition (histology
required)
Implantation hormone pellets (excluding after-care)
Ligation of internal iliac vessels (when not part of another procedure)
06.52
210.000
06.52
51.000
06.52
06.52
3.000
225.000
2562
2565
2570
General Practitioners
/ non-designated
Specialists
RVU
Fee
128.800
183.520
156.800
156.800
144.000
75.000
214.400
120.000
168.000
51.000
3.000
180.000
905.20
(794.00)
1289.80
(1131.40)
1102.00
(966.70)
1102.00
(966.70)
1012.00
(887.70)
527.10
(462.40)
1506.80
(1321.80)
843.40
(739.80)
1180.70
(1035.70)
358.40
(314.40)
21.10 (18.50)
1265.00
(1109.60)
Anaesthesiology
RVU
Fee
5.000
5.000
5.000
4.000
6.000
5.000
6.000
6.000
6.000
6.000
8.000
13
Obstetric Procedures
RULES GOVERNING THIS SECTION
U.
Obstetric procedures: (a) When a general practitioner treats a patient in the ante-natal period and, after starting the confinement, requests an obstetrician to take over the case, the general
practitioner shall be entitled to charge for all the ante-natal consultations he/she has performed. (i) If the patient has been in labour for less than 6 hours, the general practitioner shall charge 50,00
clinical procedure units according to item 2614: Global obstetric care. (ii) If the patient has been in labour for more than 6 hours, the general practitioner shall charge 80,00 clinical procedure units
according to item 2614: Global obstetric care. (b) When a general practitioner calls an obstetrician to help with a confinement, take over the management of a confinement, and treats the patient
until after the post-partum visit, the obstetrician shall charge according to item 2614: Global obstetric care. (c) When a general practitioner calls an obstetrician (specialist or general practitioner) to
help with a confinement, or take over the management of a confinement, but the general practitioner treats the patient until after the post-partum visit, the obstetrician shall charge according to item
2616: Intrapartum obstetric care by obstetrician in consultation, and the general practitioner according to item 2614: Global obstetric care.
13.1
Pre-natal care and procedures
2603
External cephalic version (excluding after-care)
06.52
22.000
154.60 22.000
154.60
(135.60)
(135.60)
2605
Amniocentesis (excluding after-care)
06.52
36.000
253.00 36.000
253.00
(221.90)
(221.90)
2607
Amnioscopy (excluding after-care)
06.52
18.000
126.50 18.000
126.50
(111.00)
(111.00)
2609
Intra-uterine transfusion of foetus or cordocentesis
06.52
134.000
941.80 120.000
843.40
(826.10)
(739.80)
2610
Tococardiography - pre-natal and intrapartum (including stress and non-stress test: Own machine) (excluding after-care) 06.52
16.000
112.40 16.000
112.40
(98.60)
(98.60)
2611
Chorion villus sampling (excluding after-care)
06.52
54.000
379.50 54.000
379.50
(332.90)
(332.90)
13 Mar 2008
Page 79 of 151
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
176.40
(154.70)
264.70
(232.20)
220.60
(193.50)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
352.90
(309.60)
06.52
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
13.2
2616
Confinements
Intrapartum obstetric care by obstetrician in consultation (excluding after-care)
06.52
13.3
2653
Global obstetric care includes
o All modes of delivery (including Caesarean)
o All inductions of labour (medical or surgical)
o Intrapartum paracervical and pudential blocks
o Intrapartum amnioscopy
o Foetal blood sampling
o Application of scalp leads
o Symphysiotomy
o Manual removal of placenta
o Repair cervical tears
o Correction of uterine inversion
o Drainage of vulval haematoma
o Repair third degree tear
o Repair second degree tear
o Repair episiotomy
o Resuscitation of newborn by obstetrician
o Tracheal intubation
o Missed confinement
Global obstetric care excludes
o Prenatal consultations
o Prenatal procedures (Items 2603 - 2611)
o Emergency hysterectomy for obstetrical reasons
o Abdominal operation for repair of ruptured gravid uterus
o Intensive care for obstetrical emergencies
o Tubal ligation performed as a post-partum procedure
o Post-partum complications occurring after discharge from the hospital
Operative procedures (excluding antenatal care)
Caesarean-hysterectomy
06.52
335.000
2657
Post-partum hysterectomy
06.52
300.000
2669
Abdominal operation for ruptured gravid uterus: Repair
06.52
250.000
14
14.1
2681
Nervous System
Diagnostic procedures
Visual evoked potentials (VEP): Unilateral
06.52
50.000
2682
Visual evoked potentials (VEP): Bilateral
06.52
88.000
2683
Electro-retinography (Ganzfeld method): Unilateral
06.52
60.000
2684
Electro-retinography (Ganzfeld method): Bilateral
06.52
105.000
13 Mar 2008
06.52
190.000
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
1335.30 152.000
(1171.30)
Anaesthesiology
RVU
Fee
1068.30
(937.10)
06.52
Page 80 of 151
2354.40 268.000
(2065.30)
2108.40 240.000
(1849.50)
1757.00 200.000
(1541.20)
1883.50
(1652.20)
1686.70
(1479.60)
1405.60
(1233.00)
9.000
8.000
9.000
397.00
(348.20)
352.90
(309.60)
397.00
(348.20)
351.40
(308.20)
618.50
(542.50)
421.70
(369.90)
737.90
(647.30)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
210.80
(184.90)
372.50
(326.80)
351.40
(308.20)
618.50
(542.50)
1054.20
(924.70)
2685
Electro-oculography: Unilateral
06.52
30.000
2686
Electro-oculography: Bilateral
06.52
53.000
2687
VEP stable condition (photic drive): Unilateral
06.52
50.000
2689
VEP stable condition (photic drive): Bilateral
06.52
88.000
2690
Total fee for full evaluation of visual tracts including bilateral electroretinography and VEP
06.52
150.000
Note: See items 2691 to 2702 under section 17.5.1: Audiometry
06.52
06.52
48.000
06.52
06.52
6.000
220.000
2708
Somatosensory evoked potentials (SEP) single nerve examination to brachial or lumbosacral plexus, spinal cord and
cortex
Transcutaneous nerve stimulation in the treatment of post-operative and chronic intractable pain, per treatment
Full fee for complete neurological evoked potential evaluation including neurological AEP, bilateral VEP, and bilateral
median and/or posterior tibial stimulation
Evaluation of cognitive evoked potential with visual or audiology stimulus
06.52
80.000
2709
Full spinogram including bilateral median and posterior-tibial studies
06.52
140.000
2710
2711
Morphia saturation testing in rooms (consultation x2 plus item 0206: Intravenous infusion) (excluding injection material)
Electro-encephalography: Taking of record
06.52
06.52
36.100
2712
Electro-encephalography: Interpretation
06.52
24.000
2713
Spinal (lumbar) puncture. For diagnosis, for drainage of spinal fluid or for therapeutic indications
06.52
18.400
2714
Cisternal puncture and/or intrathecal injections
06.52
15.000
2717
Electromyography: First
06.52
75.000
2718
Electromyography: Subsequent
06.52
75.000
2724
Overnight continuous positive airways pressure (CPAP) titration
06.52
155.000
2725
Angiography carotis: Unilateral
06.52
25.000
2726
Angiography carotis: Bilateral
06.52
44.000
2727
Vertebral artery: Direct needling
06.52
50.000
2729
Vertebral catheterisation
06.52
50.000
2703
2705
2707
13 Mar 2008
Page 81 of 151
337.30
(295.90)
42.20 (37.00)
1546.20
(1356.30)
562.20
(493.20)
983.90
(863.10)
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
6.000 42.20 (37.00)
253.70 36.100
(222.50)
168.70 24.000
(148.00)
129.30 18.400
(113.40)
105.40 15.000
(92.50)
527.10 75.000
(462.40)
527.10 75.000
(462.40)
1089.30 124.000
(955.50)
175.70 25.000
(154.10)
309.20 44.000
(271.20)
351.40 50.000
(308.20)
351.40 50.000
(308.20)
253.70
(222.50)
168.70
(148.00)
129.30
(113.40)
105.40
(92.50)
527.10
(462.40)
527.10
(462.40)
871.50
(764.50)
175.70
(154.10)
309.20
(271.20)
351.40
(308.20)
351.40
(308.20)
4.000
4.000
4.000
4.000
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
2731
Air encephalography and posterior fossa tomography: Injection of air (independent procedure)
06.52
14.500
2733
Cortical Stimulation
06.52
58.900
2734
Sodium Amytal Testing (WADA test)
06.52
88.700
2735
Air encephalography and posterior fossa tomography: Posterior fossa tomography attendance by clinician
06.52
31.500
2737
2739
Air encephalography and posterior fossa tomography: Visual field charting on Bjerrum Screen
Ventricular needling without burring: Tapping only
06.52
06.52
7.000
16.000
2741
Ventricular needling without burring: Plus introduction of air and/or contrast dye for ventriculography
06.52
43.000
2743
Subdural tapping: First sitting
06.52
15.000
2745
Subdural tapping: Subsequent
06.52
10.000
14.2
2747
Introduction of burr holes for
Ventriculography
06.52
150.000
2749
Catheterisation for ventriculography and/or drainage
06.52
150.000
2753
Subdural haematoma or hygroma
06.52
150.000
2755
Subdural empyema
06.52
150.000
2757
Brain abscess
06.52
150.000
14.3
2759
Nerve procedures
Nerve biopsy: Peripheral
06.52
37.000
2763
Nerve biopsy: Cranial nerves: Extra-cranial
06.52
20.000
2765
Nerve biopsy: Nerve conduction studies (see items 0733 and 3285)
06.52
26.000
14.3.1
2767
Nerve procedures: Nerve repair or suture
Suture brachial plexus (see also items 2837 and 2839)
06.52
300.000
2769
Suture: Large nerve: Primary
06.52
134.000
2771
Suture: Large nerve: Secondary
06.52
202.000
2773
Digital nerve: Primary
06.52
65.000
13 Mar 2008
Page 82 of 151
Fee
101.90
(89.40)
413.90
(363.10)
623.40
(546.80)
221.40
(194.20)
49.20 (43.20)
112.40
(98.60)
302.20
(265.10)
105.40
(92.50)
70.30 (61.70)
General Practitioners
/ non-designated
Specialists
RVU
Fee
58.900
88.700
-
413.90
(363.10)
623.40
(546.80)
-
7.000 49.20 (43.20)
16.000
112.40
(98.60)
43.000
302.20
(265.10)
15.000
105.40
(92.50)
10.000 70.30 (61.70)
1054.20
(924.70)
1054.20
(924.70)
1054.20
(924.70)
1054.20
(924.70)
1054.20
(924.70)
120.000
260.00
(228.10)
140.60
(123.30)
182.70
(160.30)
37.000
120.000
120.000
120.000
120.000
20.000
26.000
2108.40 240.000
(1849.50)
941.80 120.000
(826.10)
1419.70 161.600
(1245.40)
456.80 65.000
(400.70)
Anaesthesiology
RVU
Fee
4.000
176.40
(154.70)
13.000
573.40
(503.00)
4.000
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
4.000
4.000
4.000
843.40
(739.80)
843.40
(739.80)
843.40
(739.80)
843.40
(739.80)
843.40
(739.80)
8.000
260.00
(228.10)
140.60
(123.30)
182.70
(160.30)
4.000
1686.70
(1479.60)
843.40
(739.80)
1135.70
(996.20)
456.80
(400.70)
6.000
8.000
8.000
8.000
8.000
4.000
4.000
5.000
5.000
3.000
352.90
(309.60)
352.90
(309.60)
352.90
(309.60)
352.90
(309.60)
352.90
(309.60)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
264.70
(232.20)
220.60
(193.50)
220.60
(193.50)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
2775
Digital nerve: Secondary
06.52
96.000
2777
Nerve graft: Simple
06.52
202.000
2779
Fascicular: First fasciculus
06.52
202.000
2781
Fascicular: Each additional fasciculus
06.52
50.000
2783
Fascicular: Nerve flap: To include all stages
06.52
224.000
2785
Fascicular: Facio-accessory or facio-hypoglossal anastomosis
06.52
124.000
2787
Fascicular: Grafting of facial nerve
06.52
215.000
14.3.2
2789
Nerve procedures: Neurectomy
Trigeminal ganglion: Injection of alcohol
06.52
150.000
2791
Trigeminal ganglion: Injection of cortisone
06.52
65.000
2793
Trigeminal ganglion: Coagulation through high frequency
06.52
170.000
2799
Procedures for pain relief: Intrathecal injections for pain
06.52
36.000
2800
Procedures for pain relief: Plexus nerve block
06.52
36.000
2801
36.000
2802
Procedures for pain relief: Epidural injection for pain (refer to modifier 0045 for post-operative pain relief) (refer to modifier 06.52
0021 for epidural anaesthetic)
Procedures for pain relief: Peripheral nerve block
06.52
2803
Alcohol injection in peripheral nerves for pain: Unilateral
06.52
20.000
2804
2805
Inserting an indwelling nerve catheter (includes removal of catheter) (not for bolus technique)
Alcohol injection in peripheral nerves for pain: Bilateral
06.52 +
06.52
10.000
35.000
2809
Peripheral nerve section for pain
06.52
45.000
2811
Pudendal neurectomy: Bilateral
06.52
116.000
2813
Obturator or Stoffels
06.52
96.000
2815
Interdigital
06.52
82.300
2825
Excision: Neuroma: Peripheral
06.52
109.500
13 Mar 2008
Page 83 of 151
25.000
Fee
674.70
(591.80)
1419.70
(1245.40)
1419.70
(1245.40)
351.40
(308.20)
1574.30
(1381.00)
871.50
(764.50)
1511.00
(1325.40)
1054.20
(924.70)
456.80
(400.70)
1194.80
(1048.10)
253.00
(221.90)
253.00
(221.90)
253.00
(221.90)
175.70
(154.10)
140.60
(123.30)
70.30 (61.70)
246.00
(215.80)
316.30
(277.50)
815.20
(715.10)
674.70
(591.80)
578.40
(507.40)
769.60
(675.10)
General Practitioners
/ non-designated
Specialists
RVU
Fee
96.000
161.600
161.600
50.000
179.200
120.000
172.000
120.000
65.000
136.000
36.000
36.000
36.000
25.000
20.000
10.000
35.000
45.000
116.000
96.000
82.300
109.500
Anaesthesiology
RVU
Fee
674.70
(591.80)
1135.70
(996.20)
1135.70
(996.20)
351.40
(308.20)
1259.40
(1104.70)
843.40
(739.80)
1208.80
(1060.40)
3.000
843.40
(739.80)
456.80
(400.70)
955.80
(838.40)
253.00
(221.90)
253.00
(221.90)
253.00
(221.90)
175.70
(154.10)
140.60
(123.30)
70.30 (61.70)
246.00
(215.80)
316.30
(277.50)
815.20
(715.10)
674.70
(591.80)
578.40
(507.40)
769.60
(675.10)
4.000
4.000
4.000
4.000
4.000
6.000
5.000
3.000
3.000
4.000
36.000
25.000
3.000
10.000
3.000
3.000
3.000
3.000
3.000
3.000
132.30
(116.10)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
264.70
(232.20)
220.60
(193.50)
176.40
(154.70)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
253.00
(221.90)
175.70
(154.10)
132.30
(116.10)
70.30 (61.70)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
14.3.3
2827
Nerve procedures: Other nerve procedures
Transposition of ulnar nerve
06.52
100.000
2829
Neurolysis: Minor
06.52
51.000
2831
Neurolysis: Major
06.52
132.000
2833
Neurolysis: Digital
06.52
96.000
2835
Scalenotomy
06.52
132.000
2837
Brachial plexus, suture or neurolysis (item 2767)
06.52
300.000
2839
Total brachial plexus exposure with graft, neurolysis and transplantation
06.52
895.200
2841
Carpal Tunnel
06.52
64.000
2843
Lumbar sympathectomy: Unilateral
06.52
153.000
2845
Lumbar sympathectomy: Bilateral
06.52
268.000
2846
Cervical sympathectomy: Trans-thoracic approach (use item 2847 or item 2848 as appropriate)
06.52
2847
Cervical sympathectomy: Unilateral
06.52
153.000
2848
Cervical sympathectomy: Bilateral
06.52
268.000
2849
Sympathetic block: Other levels: Unilateral
06.52
20.000
2851
Sympathetic block: Other levels: Bilateral
06.52
35.000
2853
06.52
20.000
14.4
2859
Sympathetic block: Other levels: Diagnostic/Therapeutic nerve block (unassociated with surgery) - either intercostal, or
brachial, or peripheral, or stellate ganglion
Skull procedures
Repair of depressed fracture of skull: Without brain laceration: Major
06.52
200.000
2860
Repair of depressed fracture of skull: Without brain laceration: Small
06.52
170.000
2861
Repair of depressed fracture of skull: With brain lacerations: Small
06.52
200.000
2862
Repair of depressed fracture of skull: With brain lacerations: Major
06.52
375.000
2863
Cranioplasty
06.52
280.000
13 Mar 2008
Page 84 of 151
Fee
702.80
(616.50)
358.40
(314.40)
927.70
(813.80)
674.70
(591.80)
927.70
(813.80)
2108.40
(1849.50)
6291.50
(5518.90)
449.80
(394.60)
1075.30
(943.20)
1883.50
(1652.20)
General Practitioners
/ non-designated
Specialists
RVU
Fee
100.000
51.000
120.000
96.000
120.000
240.000
716.160
64.000
122.400
214.400
702.80
(616.50)
358.40
(314.40)
843.40
(739.80)
674.70
(591.80)
843.40
(739.80)
1686.70
(1479.60)
5033.20
(4415.10)
449.80
(394.60)
860.20
(754.60)
1506.80
(1321.80)
Anaesthesiology
RVU
Fee
3.000
3.000
3.000
3.000
6.000
6.000
6.000
3.000
4.000
6.000
11.000
1075.30 122.400
(943.20)
1883.50 214.400
(1652.20)
140.60 20.000
(123.30)
246.00 35.000
(215.80)
140.60 20.000
(123.30)
860.20
(754.60)
1506.80
(1321.80)
140.60
(123.30)
246.00
(215.80)
140.60
(123.30)
4.000
1405.60
(1233.00)
1194.80
(1048.10)
1405.60
(1233.00)
2635.50
(2311.80)
1967.80
(1726.10)
1124.50
(986.40)
955.80
(838.40)
1124.50
(986.40)
2108.40
(1849.50)
1574.30
(1381.00)
8.000
160.000
136.000
160.000
300.000
224.000
6.000
3.000
3.000
4.000
8.000
8.000
8.000
8.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
132.30
(116.10)
176.40
(154.70)
264.70
(232.20)
485.20
(425.60)
176.40
(154.70)
264.70
(232.20)
132.30
(116.10)
132.30
(116.10)
176.40
(154.70)
352.90
(309.60)
352.90
(309.60)
352.90
(309.60)
352.90
(309.60)
352.90
(309.60)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
2864
Encephalocele (excluding frontal)
06.52
200.000
2865
Craniostenosis: Few suturae
06.52
213.000
2867
Craniostenosis: Multiple suturae
06.52
280.000
14.5
2869
Shunt procedures
Ventriculo-cisternostomy
06.52
280.000
2871
Ventriculo-caval shunt
06.52
280.000
2873
Ventriculo-peritoneal shunt
06.52
280.000
2875
Theco-peritoneal C.S.F. shunt
06.52
280.000
14.6
2876
Aneurysm repair
Repair of aneurysms or arteriovenous anomalies (Intracranial)
06.52
700.000
2877
Extracranial to intracranial vascular
06.52
700.000
2878
Posterior fossa arteriovenous anomalies
06.52
700.000
14.7
2879
Posterior fossa surgery
Glosso pharyngeal nerve
06.52
480.000
2881
Eighth nerve: Intracranial
06.52
480.000
2883
Eighth nerve: Extracranial
06.52
480.000
2884
Sub-temporal section of the trigeminal nerve
06.52
375.000
2885
Trigeminal tractotomy
06.52
480.000
2886
450.000
2887
Posterior fossa decompression with or without laminectomy with or without dural insertion for Arnold Chiarri malformation 06.52
or obstructive cysts e.g. Dandy Walker or parasites
Vestibular nerve
06.52
14.7.1
2899
Posterior fossa surgery: Supratentorial procedures
Craniectomy for extra-dural haematoma or empyema
06.52
375.000
14.8
2900
Craniotomy for
Craniotomy for Extra-dural orbital decompression or excision of orbital tumour
06.52
700.000
13 Mar 2008
Page 85 of 151
480.000
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
1405.60 160.000
(1233.00)
1497.00 170.400
(1313.20)
1967.80 224.000
(1726.10)
1124.50
(986.40)
1197.60
(1050.50)
1574.30
(1381.00)
8.000
1967.80
(1726.10)
1967.80
(1726.10)
1967.80
(1726.10)
1967.80
(1726.10)
1574.30
(1381.00)
1574.30
(1381.00)
1574.30
(1381.00)
1574.30
(1381.00)
8.000
224.000
224.000
224.000
224.000
9.000
9.000
11.000
8.000
8.000
352.90
(309.60)
397.00
(348.20)
397.00
(348.20)
352.90
(309.60)
485.20
(425.60)
352.90
(309.60)
352.90
(309.60)
4919.60 560.000
(4315.40)
4919.60 560.000
(4315.40)
4919.60 560.000
(4315.40)
3935.70
(3452.40)
3935.70
(3452.40)
3935.70
(3452.40)
15.000
3373.40
(2959.10)
3373.40
(2959.10)
3373.40
(2959.10)
2635.50
(2311.80)
3373.40
(2959.10)
3162.60
(2774.20)
3373.40
(2959.10)
2698.80
(2367.40)
2698.80
(2367.40)
2698.80
(2367.40)
2108.40
(1849.50)
2698.80
(2367.40)
2530.10
(2219.40)
2698.80
(2367.40)
6.000
2635.50 300.000
(2311.80)
2108.40
(1849.50)
11.000
485.20
(425.60)
4919.60 560.000
(4315.40)
3935.70
(3452.40)
11.000
485.20
(425.60)
384.000
384.000
384.000
300.000
384.000
360.000
384.000
15.000
15.000
8.000
4.000
9.000
9.000
9.000
9.000
661.70
(580.40)
661.70
(580.40)
661.70
(580.40)
264.70
(232.20)
352.90
(309.60)
176.40
(154.70)
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Craniotomy for Abscess, Glioma
06.52
450.000
2904
Craniotomy for Haematoma, foreign body: Cerebral or cerebellar
06.52
450.000
2905
Craniotomy for Focal epilepsy: Excision of cortical scar
06.52
450.000
2906
Craniotomy with anterior fossa meningocele and repair of bony skull defect
06.52
375.000
2907
Craniotomy for Temporal lobectomy
06.52
450.000
2908
Craniotomy for Torkildsen anastomosis
06.52
375.000
2909
Craniotomy for CSF-leaks
06.52
450.000
2910
Craniotomy for removal of arteriovenous malformation
06.52
700.000
14.8.1
2911
Craniotomy for Stereo-tactic cerebral and spinal cord procedures
Stereo-tactic cerebral and spinal cord procedure: First sitting
06.52
280.000
2913
Stereo-tactic cerebral and spinal cord procedure: Repeat
06.52
196.000
2915
Transnasal hypophysectomy
06.52
300.000
2916
Transfrontal hypophysectomy
06.52
480.000
2917
Transnasal hypophyseal implants
06.52
172.000
2918
14.9
Non-operative supervision of paraplegics for all disciplines except urologists. Per service (specified)
Spinal operations
See section 3.8.7 for laminectomy procedures
06.52
-
2923
Chordotomy: Unilateral
06.52
178.000
2925
Chordotomy: Open
06.52
350.000
2927
Rhizotomy: Extradural, but intraspinal
06.52
320.000
2928
Rhizotomy: Intradural
06.52
350.000
2937
Repair of meningocele, involving nerve tissue
06.52
250.000
2938
Simple
06.52
150.000
2939
Excision of arterial vascular malformations and cysts of the spinal cord
06.52
700.000
Page 86 of 151
RVU
Fee
3162.60
(2774.20)
3162.60
(2774.20)
3162.60
(2774.20)
2635.50
(2311.80)
3162.60
(2774.20)
2635.50
(2311.80)
3162.60
(2774.20)
4919.60
(4315.40)
360.000
2530.10
(2219.40)
2530.10
(2219.40)
2530.10
(2219.40)
2108.40
(1849.50)
2530.10
(2219.40)
2108.40
(1849.50)
2530.10
(2219.40)
3935.70
(3452.40)
11.000
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
1967.80
(1726.10)
1377.50
(1208.30)
2108.40
(1849.50)
3373.40
(2959.10)
1208.80
(1060.40)
-
224.000
1574.30
(1381.00)
1102.00
(966.70)
1686.70
(1479.60)
2698.80
(2367.40)
967.10
(848.30)
-
4.000
Fee
2903
13 Mar 2008
General Practitioners
/ non-designated
Specialists
RVU
Fee
360.000
360.000
300.000
360.000
300.000
360.000
560.000
156.800
240.000
384.000
137.600
-
Anaesthesiology
11.000
11.000
11.000
11.000
11.000
11.000
11.000
4.000
11.000
11.000
11.000
176.40
(154.70)
176.40
(154.70)
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
06.52
1251.00
(1097.40)
2459.80
(2157.70)
2249.00
(1972.80)
2459.80
(2157.70)
1757.00
(1541.20)
1054.20
(924.70)
4919.60
(4315.40)
142.400
280.000
256.000
280.000
200.000
120.000
560.000
1000.80
(877.90)
1967.80
(1726.10)
1799.20
(1578.20)
1967.80
(1726.10)
1405.60
(1233.00)
843.40
(739.80)
3935.70
(3452.40)
3.000
3.000
3.000
3.000
9.000
9.000
9.000
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
132.30
(116.10)
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
2940
Lumbar osteophyte removal
06.52
187.000
2941
Cervical or thoracic osteophyte removal
06.52
285.000
14.10
2951
Arterial ligations
Carotis: Trauma
06.52
120.000
2953
Carotis: For aneurysm (AV anomaly)
06.52
150.000
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
1314.20 149.600
(1152.80)
2003.00 228.000
(1757.00)
1051.40
(922.30)
1602.40
(1405.60)
3.000
843.40 120.000
(739.80)
1054.20 120.000
(924.70)
843.40
(739.80)
843.40
(739.80)
8.000
3.000
8.000
14.11 Medical psychotherapy
RULES GOVERNING THE SECTION MEDICAL PSYCHOTHERAPY
V.
(a) Electro-convulsive treatment: Visits at hospital or nursing home during a course of electro-convulsive treatment are justified and may be charged for in addition to the fees for the procedure. (b)
Except where otherwise indicated, the duration of a medical psychotherapeutic session is set at 20 minutes or part thereof, provided that such a part comprises 50% or more of the time of a session.
This set duration is also applicable for psychiatric examination methods
0079
When a first consultation/visit proceeds into, or is immediately followed by a medical psychotherapeutic procedure, fees for the procedure are calculated according to the appropriate individual
psychotherapy code (items 2957, 2974 or 2975)
14.12 Physical treatment methods
14.13 Psychiatric examination methods
15
Endocrine System
15.1
Thyroid
2983
Lobectomy: Partial
06.52
198.100
1392.20 158.480
1113.80
5.000
(1221.20)
(977.00)
2985
Lobectomy: Total
06.52
200.000
1405.60 160.000
1124.50
5.000
(1233.00)
(986.40)
2987
Thyroidectomy: Subtotal
06.52
266.000
1869.40 212.800
1495.60
5.000
(1639.80)
(1311.90)
2989
Thyroidectomy: Total
06.52
279.000
1960.80 223.200
1568.60
5.000
(1720.00)
(1376.00)
2991
Thyroglossal cyst or fistula excision
06.52
126.200
886.90 120.000
843.40
5.000
(778.00)
(739.80)
15.2
Parathyroid
2993
Exploration of parathyroid glands for hyperparathyroidism including removal
06.52
275.000
1932.70 220.000
1546.20
5.000
(1695.40)
(1356.30)
15.3
Adrenals
2995
Adrenalectomy: Unilateral
06.52
225.000
1581.30 180.000
1265.00
9.000
(1387.10)
(1109.60)
2997
Bilateral exploration of adrenal glands: Including removal
06.52
394.000
2769.00 315.200
2215.20 11.000
(2428.90)
(1943.20)
15.4
Hypophysis
2999
Transethmoidal hypophysectomy
06.52
300.000
2108.40 240.000
1686.70 11.000
(1849.50)
(1479.60)
3000
Transnasal hypophysectomy (see also item 2915)
06.52
300.000
2108.40 240.000
1686.70 11.000
(1849.50)
(1479.60)
13 Mar 2008
Page 87 of 151
132.30
(116.10)
132.30
(116.10)
352.90
(309.60)
352.90
(309.60)
06.52
06.52
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
397.00
(348.20)
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
15.5
3001
16
16.1
16.1.1
3002
3003
3004
3006
3009
3012
3013
3014
3021
16.1.2
3005
3007
3008
3010
3011
3015
3016
3017
3018
3019
3020
3022
3023
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
Endocrine system: General
Implantation of pellets (excluding cost of material) (excluding after-care)
06.52
3.000 21.10 (18.50)
3.000 21.10 (18.50)
Eye
Eye: Procedures performed in rooms
(a) Eye investigations and photography refer to both eyes except where otherwise indicated. No extra fee may be charged where each eye is examined separately on two different occasions
(b) Material used is excluded
(c) The fee for photography is not related to the number of photographs taken
Eye investigations
Gonioscopy
06.52
7.000 49.20 (43.20)
7.000 49.20 (43.20)
Fundus contact lens or 90 D lens examination (not to be charged with item 3004 or item 3012)
06.52
7.000 49.20 (43.20)
7.000 49.20 (43.20)
Peripheral fundus examination with indirect ophthalmoscope (not to be charged with item 3003 and/or item 3012)
06.52
7.000 49.20 (43.20)
7.000 49.20 (43.20)
Keratometry
06.52
7.000 49.20 (43.20)
7.000 49.20 (43.20)
Basic capital equipment used in own rooms by ophthalmologists. Only to be charged at first and follow-up consultations. 06.52 +
11.680 82.10 (72.00)
Not to be charged for post-operative follow-up consultations
Pre-surgical retinal examination before retinal surgery
06.52
32.000
224.90 32.000
224.90
(197.30)
(197.30)
Ocular motility assessment: Comprehensive examination
06.52
12.000 84.30 (73.90) 12.000 84.30 (73.90)
Tonometry per test with maximum of 2 tests for provocative tonometry (one or both eyes)
06.52
7.000 49.20 (43.20)
7.000 49.20 (43.20)
Special eye investigations: Retinal function assessment including refraction after ocular surgery (within four months),
06.52
9.000 63.30 (55.50)
9.000 63.30 (55.50)
maximum two examinations
Special eye investigations
Endothelial cell count
06.52
7.000 49.20 (43.20)
7.000 49.20 (43.20)
Potential acuity measurement
06.52
7.000 49.20 (43.20)
7.000 49.20 (43.20)
Contrast sensitivity test
06.52
7.000 49.20 (43.20)
7.000 49.20 (43.20)
Orthoptics consultation
06.52
10.000 70.30 (61.70) 10.000 70.30 (61.70)
Orthoptic subsequent sessions
06.52
5.000 35.10 (30.80)
5.000 35.10 (30.80)
Charting of visual field with manual perimeter
06.52
28.000
196.80 28.000
196.80
(172.60)
(172.60)
Retinal threshold test without storage facilities
06.52
30.000
210.80 30.000
210.80
(184.90)
(184.90)
Retinal threshold test inclusive of computer disc storage for Delta of Statpak programs
06.52
74.000
520.10 74.000
520.10
(456.20)
(456.20)
Retinal threshold trend evaluation (additional to item 3017)
06.52
16.000
112.40 16.000
112.40
(98.60)
(98.60)
Ocular muscle function with Hess screen or perimeter
06.52
16.000
112.40 16.000
112.40
(98.60)
(98.60)
Special eye investigations: Pachymetry: Only when own instrument is used, per eye. Only in addition to corneal surgery 06.52
46.000
323.30 46.000
323.30
(283.60)
(283.60)
Digital fluorescein video angiography
06.52
68.000
477.90 68.000
477.90
9.000
(419.20)
(419.20)
Digital indocyanine video angiography
06.52
110.000
773.10 110.000
773.10
9.000
(678.20)
(678.20)
13 Mar 2008
Page 88 of 151
06.52
397.00
(348.20)
397.00
(348.20)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3024
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
12.000 84.30 (73.90)
12.000 84.30 (73.90)
3025
Infusion of dye used during Fluorescein Angiography, Indocyanine Green Video Angiography and Photodynamic therapy. 06.52
Linked to items 3022, 3023, 3031, 3039
Electronic tonography
06.52
19.000
19.000
3026
Digital Tomography of optic nerve with Scanning Laser Ophthalmoscope (SLO). Limited to two exams per annum
06.52
19.300
3027
Fundus photography
06.52
21.000
3028
Optical Coherent Tomography (OCT) of Optic nerve or macula: Per eye
06.52
40.000
3029
Anterior segment microphotography
06.52
21.000
3031
Fluorescein Angiography: One or both eyes (not to be used with item 3022)
06.52
45.000
3032
3033
Eyelid and orbit photography
Interpretation of items 3022, 3023 and 3031 referred by other clinicians
06.52
06.52
9.000
16.000
3034
Determination of lens implant power per eye
06.52
15.000
3035
Where a minor procedure usually done in the consulting rooms requires a general anaesthetic or use of an operating
theatre, an additional fee may be charged
Corneal topography: For pathological corneas only on special motivation. For refractive surgery - may be charged once
pre-operative and once post-operative per sitting (for one or both eyes)
Retina
Surgical treatment of retinal detachment including vitreous replacement but excluding vitrectomy
06.52
22.000
06.52
36.000
133.50
(117.10)
135.60
(118.90)
147.60
(129.50)
281.10
(246.60)
147.60
(129.50)
316.30
(277.50)
63.30 (55.50)
112.40
(98.60)
105.40
(92.50)
154.60
(135.60)
253.00
(221.90)
06.52
306.900
245.520
06.52
105.000
3041
Prophylaxis and treatment of retina and choroid by cryotherapy and/or diathermy and/or photocoagulation and/or laser
per eye
Pan retinal photocoagulation (per eye): Done in one sitting
06.52
150.000
3044
Removal of encircling band and/or buckling material
06.52
105.000
2156.90
(1892.00)
737.90
(647.30)
1054.20
(924.70)
737.90
(647.30)
16.3
3045
Cataract
Cataract: Intra-capsular
06.52
210.000
168.000
3047
Cataract: Extra-capsular (including capsulotomy)
06.52
210.000
3049
Insertion of lenticulus in addition to item 3045 or item 3047 (cost of lens excluded) (modifier 0005 not applicable)
06.52
57.000
3050
Repositioning of intra ocular lens
06.52
171.100
3051
Needling or capsulotomy
06.52
130.000
1475.90
(1294.60)
1475.90
(1294.60)
400.60
(351.40)
1202.50
(1054.80)
913.60
(801.40)
3036
16.2
3037
3039
13 Mar 2008
Page 89 of 151
19.300
21.000
40.000
21.000
45.000
9.000
16.000
15.000
22.000
36.000
105.000
120.000
105.000
168.000
57.000
136.880
120.000
Anaesthesiology
RVU
Fee
133.50
(117.10)
135.60
(118.90)
147.60
(129.50)
281.10
(246.60)
147.60
(129.50)
316.30
(277.50)
63.30 (55.50)
112.40
(98.60)
105.40
(92.50)
154.60
(135.60)
253.00
(221.90)
1725.50
(1513.60)
737.90
(647.30)
843.40
(739.80)
737.90
(647.30)
6.000
1180.70
(1035.70)
1180.70
(1035.70)
400.60
(351.40)
962.00
(843.90)
843.40
(739.80)
7.000
6.000
6.000
6.000
7.000
7.000
7.000
4.000
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
308.80
(270.90)
308.80
(270.90)
308.80
(270.90)
308.80
(270.90)
176.40
(154.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
737.90
(647.30)
1475.90
(1294.60)
1658.60
(1454.90)
1475.90
(1294.60)
28.10 (24.60)
105.000
1740.10
(1526.40)
421.70
(369.90)
737.90
(647.30)
737.90
(647.30)
737.90
(647.30)
1475.90
(1294.60)
198.080
3052
Laser capsulotomy
06.52
105.000
3057
Removal of lenticulus
06.52
210.000
3058
Exchange of intra ocular lens
06.52
236.000
3059
Insertion of lenticulus when item 3045 or item 3047 was not executed (cost of lens excluded)
06.52
210.000
3060
06.52
4.000
16.4
3061
Use of own surgical microscope for surgery or examination (not for slit lamp microscope) (for use by ophthalmologists
only)
Glaucoma
Drainage operation
06.52
247.600
3062
Implantation of aqueous shunt device/seton in glaucoma (additional to item 3061)
06.52
60.000
3063
Cyclocryotherapy or cyclodiathermy
06.52
105.000
3064
Laser trabeculoplasty
06.52
105.000
3065
Removal of blood from anterior chamber
06.52
105.000
3067
Goniotomy
06.52
210.000
16.5
3071
Intra-ocular foreign body
Intra-ocular foreign body: Anterior to Iris
06.52
127.000
3073
Intra-ocular foreign body: Posterior to Iris (including prophylactic thermal treatment to retina)
06.52
210.000
16.6
3074
06.52
20.000
3075
Strabismus
Strabismus (whether operation performed on one eye or both): Adjustment of sutures if not done at the time of the
operation. Additional fee for sterile tray (refer to item 0202)
Strabismus (whether operation performed on one eye or both): Operation on one or two muscles
06.52
175.600
3076
Strabismus (whether operation performed on one eye or both): Operation on three or four muscles
06.52
200.000
3077
Strabismus (whether operation performed on one eye or both): Subsequent operation one or two muscles
06.52
120.000
3078
Strabismus (whether operation performed on one eye or both): Subsequent operation on three or four muscles
06.52
150.000
16.7
3079
Globe
Transcleral biopsy
06.52
132.000
3080
Examination of eyes under general anaesthetic where no surgery is done
06.52
80.000
13 Mar 2008
Page 90 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
168.000
188.800
168.000
60.000
105.000
105.000
105.000
168.000
892.60 120.000
(783.00)
1475.90 168.000
(1294.60)
140.60
(123.30)
1234.10
(1082.50)
1405.60
(1233.00)
843.40
(739.80)
1054.20
(924.70)
20.000
140.480
160.000
120.000
120.000
927.70 120.000
(813.80)
562.20 80.000
(493.20)
Anaesthesiology
RVU
Fee
737.90
(647.30)
1180.70
(1035.70)
1326.90
(1163.90)
1180.70
(1035.70)
4.000
1392.10
(1221.10)
421.70
(369.90)
737.90
(647.30)
737.90
(647.30)
737.90
(647.30)
1180.70
(1035.70)
6.000
843.40
(739.80)
1180.70
(1035.70)
4.000
140.60
(123.30)
987.30
(866.10)
1124.50
(986.40)
843.40
(739.80)
843.40
(739.80)
843.40
(739.80)
562.20
(493.20)
7.000
7.000
7.000
6.000
6.000
6.000
4.000
7.000
6.000
5.000
5.000
5.000
5.000
4.000
4.000
176.40
(154.70)
308.80
(270.90)
308.80
(270.90)
308.80
(270.90)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
176.40
(154.70)
308.80
(270.90)
176.40
(154.70)
264.70
(232.20)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
176.40
(154.70)
176.40
(154.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
1135.70
(996.20)
1880.00
(1649.10)
737.90
(647.30)
1124.50
(986.40)
281.10
(246.60)
70.30 (61.70)
129.280
334.50
(293.40)
112.40
(98.60)
372.50
(326.80)
1740.10
(1526.40)
737.90
(647.30)
913.60
(801.40)
1967.80
(1726.10)
1967.80
(1726.10)
2944.70
(2583.10)
210.80
(184.90)
47.600
3081
Treatment of minor perforating injury
06.52
161.600
3083
Treatment of major perforating injury
06.52
267.500
3085
Enucleation or Evisceration
06.52
105.000
3087
Enucleation or Evisceration with mobile implant: Excluding cost of implant and prosthesis
06.52
160.000
3088
Hydroxyapetite insertion (additional to item 3087)
06.52 +
40.000
3089
Subconjunctival injection if not done at time of operation
06.52
10.000
3090
Intra vitreal injection drug
06.52
47.600
3091
Retrobulbar injection (if not done at time of operation)
06.52
16.000
3092
External laser treatment for superficial lesions
06.52
53.000
3094
Implantation of intra vitreal drug delivery system
06.52
247.600
3095
Biopsy of vitreous body or anterior chamber contents
06.52
105.000
3096
Adding of air or gas in vitreous as a post-operative procedure or pneumo-retinopexy
06.52
130.000
3097
Anterior vitrectomy
06.52
280.000
3098
Removal of silicon from globe
06.52
280.000
3099
Posterior vitrectomy including anterior vitrectomy, encircling of globe and vitreous replacement
06.52
419.000
3100
Lensectomy done at time of posterior vitrectomy
06.52
30.000
16.8
3101
Orbit
Drainage of orbital abscess
06.52
105.000
3104
Removal orbital prosthesis
06.52
212.700
3105
Orbit: Exenteration
06.52
275.000
3107
Orbitotomy requiring bone flap
06.52
393.000
3108
Eye socket reconstruction
06.52
206.000
3109
Hydroxyapetite implantation in eye cavity when evisceration or enucleation was done previously
06.52
300.000
13 Mar 2008
Page 91 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
737.90
(647.30)
1494.90
(1311.30)
1932.70
(1695.40)
2762.00
(2422.80)
1447.80
(1270.00)
2108.40
(1849.50)
214.000
105.000
128.000
40.000
10.000
16.000
53.000
198.080
105.000
120.000
224.000
224.000
335.200
30.000
105.000
170.160
220.000
314.400
164.800
240.000
Anaesthesiology
RVU
Fee
908.60
(797.00)
1504.00
(1319.30)
737.90
(647.30)
899.60
(789.10)
281.10
(246.60)
70.30 (61.70)
6.000
334.50
(293.40)
112.40
(98.60)
372.50
(326.80)
1392.10
(1221.10)
737.90
(647.30)
843.40
(739.80)
1574.30
(1381.00)
1574.30
(1381.00)
2355.80
(2066.50)
210.80
(184.90)
4.000
737.90
(647.30)
1195.90
(1049.00)
1546.20
(1356.30)
2209.60
(1938.20)
1158.20
(1016.00)
1686.70
(1479.60)
5.000
6.000
5.000
5.000
5.000
5.000
4.000
4.000
6.000
7.000
6.000
6.000
6.000
7.000
5.000
5.000
5.000
5.000
5.000
264.70
(232.20)
264.70
(232.20)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
264.70
(232.20)
308.80
(270.90)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
308.80
(270.90)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
3110
Second stage hydroxyapetite implantation
16.9
3111
3112
3113
3117
Cornea
Contact lenses: Assessment involving preliminary fittings and tolerance visits (costs of lenses borne by patient)
Fitting of contact lens for treatment of disease including supply of lens
Fitting of contact lenses and instructions to patient: Includes eye examination, first fitting of the contact lenses and further
post-fitting visits for one (1) year
Wavefront analysis (Aberometry) for customized ablation of pathological corneas prior to LASIK surgery - EQUIPMENT
component only
Fitting of only one contact lens and instructions to the patient: Eye examination, first fitting of the contact lens and further
post-fitting visits for one year included
Astigmatic correction with T-cuts or wedge resection in pathological corneal astigmatism following trauma, intra ocular
surgery or penetrating keratoplasty
Removal of foreign body: On the basis of fee per consultation
3118
3119
Curettage of cornea after removal of foreign body (after-care excluded)
Tattooing
06.52
06.52
3120
06.52
3121
Excimer laser (per eye) for refractive keratectomy or Holmium laser thermo keratoplasty (LTK) (For machine hire fee for
LTK: Use item 3201)
Corneal graft (Lamellar or full thickness)
3122
Epikeratophakia
06.52
3123
Insertion of intra-corneal or intrascleral prosthesis for refractive surgery
06.52
3124
3125
Removal of corneal stitches under microscope (maximum of 2 procedures). Additional fee for sterile tray (see item 0202)
Keratectomy
06.52
06.52
3126
Additional to item 3120 for the use of own microkeratome used with a excimer laser
06.52 +
3127
Cauterisation of cornea (by chemical, thermal or cryotherapy methods)
06.52
10.000 70.30 (61.70)
26.000
182.70
(160.30)
150.000
1054.20
(924.70)
289.000
2031.10
(1781.70)
289.000
2031.10
(1781.70)
254.000
1785.10
(1565.90)
9.000 63.30 (55.50)
127.000
892.60
(783.00)
52.180
366.70
(321.70)
10.000 70.30 (61.70)
3128
Radial keratotomy or keratoplasty for astigmatism (cosmetic unless medical reasons can be proved)
06.52
150.000
3129
Additional to item 3128 for the use of own diamond knives
06.52 +
40.000
3131
Cornea: Paracentesis
06.52
53.000
3132
Lamellar keratectomy for refractive surgery (LK, ALK, MLK)
06.52
150.000
3136
Conjunctival flap or graft (not for use with pterigium surgery)
06.52
95.700
3114
3115
3116
13 Mar 2008
Page 92 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
06.52
110.000
06.52
06.52
06.52
12.200 85.70 (75.20) 12.200 85.70 (75.20)
200.000
1405.60 160.000
1124.50
(1233.00)
(986.40)
78.850
554.20
(486.10)
166.000
1166.60 132.800
933.30
(1023.30)
(818.70)
135.200
950.20 120.000
843.40
(833.50)
(739.80)
-
06.52
06.52
06.52
06.52
06.52
773.10 110.000
(678.20)
773.10
(678.20)
10.000 70.30 (61.70)
26.000
182.70
(160.30)
120.000
843.40
(739.80)
231.200
1624.90
(1425.40)
231.200
1624.90
(1425.40)
203.200
1428.10
(1252.70)
9.000 63.30 (55.50)
120.000
843.40
(739.80)
52.180
366.70
(321.70)
10.000 70.30 (61.70)
1054.20 120.000
(924.70)
281.10 40.000
(246.60)
372.50 53.000
(326.80)
1054.20 120.000
(924.70)
672.60 95.700
(590.00)
843.40
(739.80)
281.10
(246.60)
372.50
(326.80)
843.40
(739.80)
672.60
(590.00)
Anaesthesiology
RVU
Fee
5.000
220.60
(193.50)
6.000
264.70
(232.20)
176.40
(154.70)
4.000
4.000
6.000
6.000
176.40
(154.70)
264.70
(232.20)
264.70
(232.20)
6.000
264.70
(232.20)
6.000
264.70
(232.20)
4.000
176.40
(154.70)
264.70
(232.20)
6.000
4.000
6.000
6.000
176.40
(154.70)
264.70
(232.20)
264.70
(232.20)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
488.40
(428.40)
3138
Removal corneal epithelium and chelating agent for band keratopathy
06.52
69.500
16.10
3133
Ducts
Probing and/or syringing, per duct
06.52
10.000 70.30 (61.70)
3135
Insert polythene tubes
06.52
51.800
3137
Excision of lacrimal sac: Unilateral
06.52
132.000
3139
Dacrocystorhinostomy (Single) with or without polythene tube
06.52
210.000
3141
Sealing Punctum surgical or by cautery: Per eye
06.52
24.900
3142
Sealing Punctum with plugs: Per eye
06.52
20.000
3143
Three-snip operation
06.52
10.000
3145
Repair of caniculus: Primary procedure
06.52
132.000
3147
Repair of caniculus: Secondary procedure
06.52
175.000
16.11
3149
Iris
Iridectomy or iridotomy by open operation as isolated procedure
06.52
132.000
3153
Iridectomy or iridotomy by laser or photocoagulation as isolated procedure (maximum one procedure)
06.52
105.000
3157
Division of anterior synechiae as isolated procedure
06.52
132.000
3158
Repair iris as in dialysis: Anterior chamber reconstruction
06.52
142.400
16.12
3161
Lids
Tarsorrhaphy
06.52
47.000
3165
Repair of skin laceration lid: Simple
06.52
3167
Diathermy to wart on lid margin
3169
General Practitioners
/ non-designated
Specialists
RVU
Fee
69.500
Fee
4.000
176.40
(154.70)
10.000 70.30 (61.70)
4.000
364.10 51.800
364.10
(319.40)
(319.40)
927.70 120.000
843.40
(813.80)
(739.80)
1475.90 168.000
1180.70
(1294.60)
(1035.70)
175.00 24.900
175.00
(153.50)
(153.50)
140.60 20.000
140.60
(123.30)
(123.30)
70.30 (61.70) 10.000 70.30 (61.70)
4.000
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
220.60
(193.50)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
927.70 120.000
(813.80)
1229.90 140.000
(1078.90)
4.000
5.000
4.000
4.000
4.000
843.40
(739.80)
983.90
(863.10)
4.000
843.40
(739.80)
737.90
(647.30)
843.40
(739.80)
843.40
(739.80)
4.000
330.30
(289.70)
27.300
191.90
(168.30)
12.000 84.30 (73.90)
4.000
120.000
47.000
06.52
330.30
(289.70)
27.300
191.90
(168.30)
12.000 84.30 (73.90)
Electrolysis of any number of eyelashes: Per eye
06.52
15.000
3171
Excision of Meibomian cyst. Additional fee for sterile tray (see item 0202)
06.52
20.400
3173
Epicanthal folds
06.52
128.700
Page 93 of 151
RVU
488.40
(428.40)
927.70
(813.80)
737.90
(647.30)
927.70
(813.80)
1000.80
(877.90)
13 Mar 2008
Anaesthesiology
105.000
120.000
120.000
105.40 15.000
(92.50)
143.40 20.400
(125.80)
904.50 120.000
(793.40)
105.40
(92.50)
143.40
(125.80)
843.40
(739.80)
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3174
Botulinus toxin injection for blepharospasm (+ item 0198 + item 0201 + item 0202)
06.52
25.000
3175
Botulinus toxin injection in extra-ocular muscles (+ item 0198 + item 0201+ item 0202)
06.52
35.000
3176
Lid operation for facial nerve paralysis including tarsorrhaphy but excluding cost of material
06.52
187.000
Fee
175.70
(154.10)
246.00
(215.80)
1314.20 149.600
(1152.80)
16.12.1 Lids: Entropion or ectropion by
3177
Entropion or ectropion by Cautery
06.52
10.000 70.30 (61.70)
3179
Entropion or ectropion by Suture
06.52
49.400
3181
Entropion or ectropion by Open operation
06.52
111.500
3183
Entropion or ectropion by Free skin, mucosal grafting or flap
06.52
122.600
16.12.2 Lids: Reconstruction of eyelid
3185
Staged procedure for partial or total loss of eyelid: First stage
06.52
259.000
3187
Staged procedure for partial or total loss of eyelid: Subsequent stage
06.52
206.000
3189
Full thickness eyelid laceration for tumour or injury: Direct repair
06.52
136.500
3191
Blepharoplasty: Upper lid for improvement in function (unilateral)
06.52
150.200
3172
Blepharoplasty lower eyelid plus fat pad
06.52
125.800
16.12.3 Lids: Ptosis
3193
Repair by superior rectus, levator or frontalis muscle operation
06.52
190.000
3195
Ptosis: By lesser procedure e.g. sling operation: Unilateral
06.52
137.600
3197
Ptosis: By lesser procedure e.g. sling operation: Bilateral
06.52
166.000
16.13
3199
Conjunctiva
Repair of conjunctiva by grafting
06.52
132.000
3200
Repair of lacerated conjunctiva
06.52
47.000
16.14
Eye: General
OWN EQUIPMENT USED IN TREATMENT:
Only the owner of the equipment may charge hire fees for equipment used and not the person using the equipment.
Holmium laser apparatus (ophthalmic): Hire fee for one or both eyes done in one sitting
3190
13 Mar 2008
Page 94 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
1051.40
(922.30)
4.000
176.40
(154.70)
10.000 70.30 (61.70)
4.000
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
347.20 49.400
(304.60)
783.60 111.500
(687.40)
861.60 122.600
(755.80)
347.20
(304.60)
783.60
(687.40)
861.60
(755.80)
4.000
1456.20
(1277.40)
1158.20
(1016.00)
843.40
(739.80)
844.50
(740.80)
843.40
(739.80)
4.000
1335.30 152.000
(1171.30)
967.10 120.000
(848.30)
1166.60 132.800
(1023.30)
1068.30
(937.10)
843.40
(739.80)
933.30
(818.70)
4.000
927.70 120.000
(813.80)
330.30 47.000
(289.70)
843.40
(739.80)
330.30
(289.70)
4.000
1820.30
(1596.80)
1447.80
(1270.00)
959.30
(841.50)
1055.60
(926.00)
884.10
(775.50)
207.200
164.800
120.000
120.160
120.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
06.52
06.52
109.000
766.10
(672.00)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3192
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
06.52
3196
3198
Applicable to Medical Scheme Benefits only: Item 3192: If a practitioner performs the procedure in his own facility an
excimer laser theatre fee of R15,00 per minute may be charged
Diamond knife: Use of own diamond knife during intraocular surgery
Excimer laser: Hire fee (per eye)
3201
Laser apparatus (ophthalmic): Hire fee for one or both eyes done in one sitting (Not to be used with IOL Master)
06.52
3202
Phako emulsification apparatus: Hire fee
06.52
3203
Vitrectomy apparatus: Hire fee
06.52
17
17.1
3270
Ear
External ear (Pinna)
Excision of superficial pre-auricular fistula
06.52
55.000
3271
3272
Partial or total reconstruction for congenital or traumatic absence or following tumour excision of external ear
Excision of complicated pre-auricular fistula
06.52
06.52
140.000
17.2
3204
3205
External ear canal
External ear canal: Removal of foreign body: At rooms
External ear canal: Removal of foreign body: Under general anaesthetic
06.52
06.52
21.000
3215
Meatus atresia: Repair of stenosis of cartilaginous portion
06.52
164.000
3217
Meatus atresia: Congenital
06.52
277.000
3219
Meatus atresia: Removal of osteoma from meatus: Solitary
06.52
77.000
3221
Meatus atresia: Removal of osteoma from meatus: Multiple
06.52
215.000
17.3
3206
3207
Middle ear
Microscopic examination of tympanic membrane including microsuction
Myringotomy: Unilateral
06.52
06.52
3209
Myringotomy: Bilateral
06.52
3211
Unilateral myringotomy with insertion of ventilation tube
06.52
3212
Bilateral myringotomy with insertion of unilateral ventilation tube
06.52
3213
Bilateral myringotomy with insertion of bilateral ventilation tube (modifier 0005 not applicable)
06.52
3214
Reconstruction of middle ear ossicles (ossiculoplasty)
06.52
8.000 56.20 (49.30)
8.000 56.20 (49.30)
28.000
196.80 28.000
196.80
(172.60)
(172.60)
46.000
323.30 46.000
323.30
(283.60)
(283.60)
38.000
267.10 38.000
267.10
(234.30)
(234.30)
57.000
400.60 57.000
400.60
(351.40)
(351.40)
65.000
456.80 65.000
456.80
(400.70)
(400.70)
255.000
1792.10 204.000
1433.70
(1572.00)
(1257.60)
13 Mar 2008
Page 95 of 151
06.52
06.52
Anaesthesiology
RVU
Fee
12.000 84.30 (73.90)
284.130
1996.90
(1751.70)
109.000
766.10
(672.00)
109.000
766.10
(672.00)
120.000
843.40
(739.80)
386.50 55.000
(339.00)
983.90 120.000
(863.10)
386.50
(339.00)
4.000
176.40
(154.70)
843.40
(739.80)
4.000
176.40
(154.70)
147.60 21.000
(129.50)
1152.60 131.200
(1011.10)
1946.80 221.600
(1707.70)
541.20 77.000
(474.70)
1511.00 172.000
(1325.40)
147.60
(129.50)
922.10
(808.90)
1557.40
(1366.10)
541.20
(474.70)
1208.80
(1060.40)
4.000
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
5.000
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
RVU
Fee
Exploratory tympanotomy
06.52
158.900
3243
Myringoplasty
06.52
138.000
3245
Functional reconstruction of tympanic membrane
06.52
277.000
3249
Stapedotomy and stapedectomy
06.52
277.000
3257
Cortical mastoidectomy
06.52
188.500
3259
Radical mastoidectomy (excluding minor procedures)
06.52
277.400
3261
Muscle grafting to mastoid cavity without tympanoplasty
06.52
180.000
3263
Autogenous bone graft to mastoid cavity
06.52
180.000
3264
Tympanomastoidectomy
06.52
375.000
3265
Reconstruction of posterior canal wall, following radical mastoid
06.52
320.000
3266
Gentamycin steroids instillation into the middle ear for Ménière's disease (myringotomy and cost of material excluded)
06.52
30.000
17.4
17.4.1
3223
Facial nerve
Facial nerve: Facial nerve tests
Percutaneous stimulation of the facial nerve
06.52
3224
Electroneurography (ENOG)
06.52
75.000
527.10
(462.40)
75.000
527.10
(462.40)
4.000
17.4.2
3227
Facial nerve: Facial nerve surgery
Exploration of facial nerve: Exploration of tympanomastiod segment
06.52
297.000
237.600
Exploration of facial nerve: Grafting of the tympanomastoid section (including item 3227)
06.52
436.000
3230
Exploration of facial nerve: Extratemporal grafting of the facial nerve
06.52
436.000
3232
Exploration of facial nerve: Facio-assessory or facio-hypoglossal anastomosis
06.52
124.000
1669.90
(1464.80)
2451.40
(2150.40)
2451.40
(2150.40)
843.40
(739.80)
5.000
3228
2087.30
(1831.00)
3064.20
(2687.90)
3064.20
(2687.90)
871.50
(764.50)
17.5
17.5.1
2691
Inner ear
Inner ear: Audiometry
Short latency brainstem evoked potentials (AEP) neurological examination, single decibel: Unilateral
06.52
50.000
2692
Short latency brainstem evoked potentials (AEP) neurological examination, single decibel: Bilateral
06.52
88.000
Page 96 of 151
9.000 63.30 (55.50)
127.120
Anaesthesiology
3237
13 Mar 2008
1116.70
(979.60)
969.90
(850.80)
1946.80
(1707.70)
1946.80
(1707.70)
1324.80
(1162.10)
1949.60
(1710.20)
1265.00
(1109.60)
1265.00
(1109.60)
2635.50
(2311.80)
2249.00
(1972.80)
210.80
(184.90)
General Practitioners
/ non-designated
Specialists
RVU
Fee
893.40
(783.70)
843.40
(739.80)
1557.40
(1366.10)
1557.40
(1366.10)
1059.80
(929.60)
1559.70
(1368.20)
1012.00
(887.70)
1012.00
(887.70)
2108.40
(1849.50)
1799.20
(1578.20)
210.80
(184.90)
5.000
9.000 63.30 (55.50)
4.000
120.000
221.600
221.600
150.800
221.920
144.000
144.000
300.000
256.000
30.000
348.800
348.800
120.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
6.000
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
176.40
(154.70)
176.40
(154.70)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
264.70
(232.20)
351.40
(308.20)
618.50
(542.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
2693
AEP: Audiological examination: Unilateral at a minimum of 4 decibels
06.52
60.000
2694
AEP: Audiological examination: Bilateral at a minimum of 4 decibels
06.52
105.000
2695
Audiology 40Hz response: Unilateral
06.52
30.000
2696
Audiology 40Hz response: Bilateral
06.52
53.000
2697
Mid- and long latency auditory evoked potentials: Unilateral
06.52
30.000
2698
Mid- and long latency auditory evoked potentials: Bilateral
06.52
53.000
2699
Electro-cochleography: Unilateral
06.52
50.000
2700
Electro-cochleography: Bilateral
06.52
88.000
2702
Total fee for audiological evaluation including bilateral AEP and bilateral electro-cochleography
06.52
140.000
3248
Otoacoustic emission performed as a screening test
06.52
33.240
3250
Otoacoustic emission (high risk patients only)
06.52
66.480
3273
3274
3275
3276
3277
3278
17.5.2
3251
3252
Pure tone audiometry (air conduction)
Pure tone audiometry (bone conduction with masking)
Impedance audiometry (tympanometry)
Impedance audiometry (stapedial reflex) - no charge for volume, compliance etc.
Speech audiometry: Fee includes speech audiogram, speech reception threshold, discrimination score
Recruitment tests: Inclusive fee (Bekesy, Fowler, etc.)
Inner ear: Balance tests
Minimal caloric test (excluding consultation fee)
Bithermal Halpike caloric test (excluding consultation fee)
06.52
06.52
06.52
06.52
06.52
06.52
6.500
6.500
6.500
6.500
10.000
6.500
06.52
06.52
3253
Electro-nystagmography for spontaneous and positional nystagmus
06.52
3254
Video nystagmoscopy (monocular)
06.52
3255
Caloric test done with electronystamography
06.52
3256
Video nystagmoscopy (binocular)
06.52
3258
Otolith repositioning manoeuvre
06.52
10.000 70.30 (61.70)
20.000
140.60
(123.30)
25.000
175.70
(154.10)
25.000
175.70
(154.10)
70.000
492.00
(431.60)
50.000
351.40
(308.20)
14.000 98.40 (86.30)
10.000 70.30 (61.70)
20.000
140.60
(123.30)
25.000
175.70
(154.10)
25.000
175.70
(154.10)
70.000
492.00
(431.60)
50.000
351.40
(308.20)
14.000 98.40 (86.30)
3260
Computerised static posturography consists of standing a patient on a Piezo-electric platform which tests the vestibular
and proprioceptive systems
06.52
71.480
71.480
13 Mar 2008
Page 97 of 151
421.70
(369.90)
737.90
(647.30)
210.80
(184.90)
372.50
(326.80)
210.80
(184.90)
372.50
(326.80)
351.40
(308.20)
618.50
(542.50)
983.90
(863.10)
233.60
(204.90)
467.20
(409.80)
45.70 (40.10)
45.70 (40.10)
45.70 (40.10)
45.70 (40.10)
70.30 (61.70)
45.70 (40.10)
General Practitioners
/ non-designated
Specialists
RVU
Fee
502.40
(440.70)
33.240
66.480
6.500
6.500
6.500
6.500
10.000
6.500
Anaesthesiology
RVU
Fee
4.000
176.40
(154.70)
4.000
176.40
(154.70)
233.60
(204.90)
467.20
(409.80)
45.70 (40.10)
45.70 (40.10)
45.70 (40.10)
45.70 (40.10)
70.30 (61.70)
45.70 (40.10)
502.40
(440.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
17.5.3
3233
Inner ear surgery
Labyrinthectomy via the middle ear or mastoid
06.52
277.000
3240
Endolymphatic sac surgery
06.52
277.000
3244
Fenestration and occulasion of the posterior semicircular canal (FOS) for benign paroxysmal positioning vertigo (BPPV)
06.52
310.000
3246
Cochlear implant surgery
06.52
340.500
17.6
17.6.1
3229
Microsurgery of the skull base
Microsurgery of the skull base: Middel fossa approach (i.e transtemporal or supralabyrinthine)
Facial nerve: Exploration of the labyrinthine segment
06.52
420.000
5221
Facial nerve: Grafting of labyrinthine segment (graft removal and exploration of labyrinthine segment are included)
06.52
510.000
5222
06.52
620.000
5224
Facial nerve surgery inside the internal auditory canal (if grafting is required, the grafting and harvesting of graft are
included)
Removal of acoustic neuroma via the middle fossa approach
06.52
660.000
17.6.2
3239
Microsurgery of the skull base: Translabyrinthe approach
Acoustic neuroma removal translabyrinthine
06.52
660.000
5227
Cochleo-vestibular neurectomy
06.52
530.000
5229
06.52
660.000
17.6.3
5232
Facial nerve surgery in the internal auditory canal, translabyrinthine (if grafting is required, the grafting and harvesting of
graft are included)
Microsurgery of the skull base: Transotic approach to the cerebellopontime angle
Removal of acoustic neuroma or cyst of the internal auditory canal
06.52
17.6.4
17.6.5
17.6.6
17.6.7
5247
Microsurgery of the skull base: Intratemporal fossa approach type A
Microsurgery of the skull base: Intratemporal fossa approach type B
Microsurgery of the skull base: Intrafemoral approach type C
Microsurgery of the skull base: Subtotal petrosectomy
Subtotal petrosectomy for CSF leak and/or for total obliteration of the mastoid cavity
06.52
17.6.8
18
3279
Microsurgery of the skull base: Petrosectomy and radical dissection of petromandibular fossa
Physical Treatment
Domiciliary or nursing home treatment (only applicable where a patient is physically incapable of attending the rooms,
and the equipment has to be transported to the patient)
Consultation units for specialists in physical medicine when treatment is given (per treatment)
Ultrasonic therapy
Shortwave diathermy
3280
3281
3282
13 Mar 2008
Page 98 of 151
06.52 +
06.52
06.52
06.52
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
1946.80
(1707.70)
1946.80
(1707.70)
2178.70
(1911.10)
2393.00
(2099.10)
221.600
2951.80
(2589.30)
3584.30
(3144.10)
4357.40
(3822.30)
4638.50
(4068.90)
336.000
221.600
248.000
272.400
408.000
496.000
528.000
Anaesthesiology
RVU
Fee
1557.40
(1366.10)
1557.40
(1366.10)
1742.90
(1528.90)
1914.40
(1679.30)
5.000
2361.40
(2071.40)
2867.40
(2515.30)
3485.90
(3057.80)
3710.80
(3255.10)
5.000
4.000
5.000
5.000
11.000
11.000
11.000
220.60
(193.50)
485.20
(425.60)
485.20
(425.60)
485.20
(425.60)
4638.50 528.000
(4068.90)
3724.80 424.000
(3267.40)
4638.50 528.000
(4068.90)
3710.80
(3255.10)
2979.90
(2613.90)
3710.80
(3255.10)
660.000
4638.50 528.000
(4068.90)
3710.80
(3255.10)
11.000
485.20
(425.60)
480.000
3373.40 384.000
(2959.10)
2698.80
(2367.40)
11.000
485.20
(425.60)
0.750
5.000
220.60
(193.50)
176.40
(154.70)
220.60
(193.50)
220.60
(193.50)
11.000
11.000
220.60
(193.50)
485.20
(425.60)
485.20
(425.60)
5.27 (4.62)
13.500 94.90 (83.20)
10.000 70.30 (61.70)
10.000 70.30 (61.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
3284
Sensory nerve conduction studies
06.52
31.000
3285
Motor nerve conduction studies
06.52
26.000
3287
Spinal joint and ligament injection
06.52
20.000
3288
Epidural injection
06.52
36.000
3289
3290
3291
3292
3293
3294
Multiple injections: First joint
Multiple injections: Each additional joint
Tendon or ligament injection
Aspiration of joint or inter-articular injection
Aspiration or injection of bursa or ganglion
Paracervical (neck) nerve block (for pelvis refer to item 2389)
06.52
06.52
06.52
06.52
06.52
06.52
7.500
4.500
9.000
9.000
9.000
20.000
3295
Paravertebral root block: Unilateral
06.52
20.000
3296
Paravertebral root block: Bilateral
06.52
30.000
3297
3298
3299
Manipulation of spine performed by a specialist in Physical Medicine
Spinal traction
Manipulation of large joints: Under general anaesthesia
06.52
06.52
06.52
14.000
6.000
14.000
3299a
Manipulation of large joints: Under general anaesthesia
06.52
14.000 98.40 (86.30)
3300
3301
Manipulation of large joints: Without anaesthetic
Muscle fatigue studies
06.52
06.52
20.000
3302
3303
Strength duration curve per session
Electromyography
06.52
06.52
3304
217.90
(191.10)
182.70
(160.30)
140.60
(123.30)
253.00
(221.90)
52.70 (46.20)
31.60 (27.70)
63.30 (55.50)
63.30 (55.50)
63.30 (55.50)
140.60
(123.30)
140.60
(123.30)
210.80
(184.90)
98.40 (86.30)
42.20 (37.00)
98.40 (86.30)
140.60
(123.30)
10.500 73.80 (64.70)
75.000
527.10
(462.40)
10.000 70.30 (61.70)
General Practitioners
/ non-designated
Specialists
RVU
Fee
20.000
Anaesthesiology
RVU
Fee
140.60
(123.30)
3.000
4.000
-
-
All other physical treatments carried out: Complete physical treatment: Specify treatment (For subsequent treatments by 06.52
10.000 70.30 (61.70)
a general practitioner, for the same condition within 4 months after initial treatment: A fee for the treatment only, is
applicable: See general rules L and M)
SPECIAL MODIFIER: SECTION ON PHYSICAL TREATMENT
0077
Physical treatment: When two separate areas are treated simultaneously for totally different conditions, such treatment shall be regarded as two treatments for which separate fees may be charged.
(Only applicable if services are provided by a specialist in physical medicine)
19
Radiology
Please note: The calculated amounts in this section (except for sections 19.9 and 19.11) are calculated according to the radiology unit values
RULES GOVERNING THE SECTION RADIOLOGY
Y.
Except where otherwise indicated, radiologists are entitled to charge for contrast material used
Z.
No fee is subject to more than one reduction
13 Mar 2008
Page 99 of 151
132.30
(116.10)
176.40
(154.70)
06.52
06.52
06.52
06.52
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
GG.
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
Capturing and recording of examinations: Images from all radiological, ultrasound and magnetic resonance imaging procedures must be captured during every examination and a permanent record
generated by means of film, paper, or magnetic media. A report of the examination, including the findings and diagnostic comment, must be written and stored for five years
RR.
The radiology section in this price list is not for use by registered specialist radiology practices (Pr No "038") or nuclear medicine practices (Pr No "025"), but only for use by other specialist practices
or general practitioners.
A separate radiology schedule is for the exclusive use of registered specialist radiology practices (Pr No "038") and nuclear medicine practices (Pr No "025").
MODIFIERS GOVERNING THE SECTION
0002
Written report on X-rays: The lowest level code for a new patient office (consulting rooms) visit is applicable only where a radiologist is requested to give a written report on X-rays taken elsewhere
and submitted to him. The above mentioned item and the lowest level initial hospital visit code, as appropriate are not to be used for routine reporting of X-rays taken elsewhere
0080
Multiple examinations: Full Fee
0081
Repeat examinations: No reduction
0082
“+” Means that this item is complementary to a preceding item and is therefore not subject to reduction
0083
A reduction of 33,33% (1/3) in the fee will apply to radiological examinations as indicated in section 19: Radiology where hospital equipment is used
0084
Film costs: In the case of radiological items where films are used, practitioners should adjust the fee upwards or downwards in accordance with changes in the price of films in comparison with
November 1979; the calculation must be done on the basis that film costs comprise 10% of the monetary value of the unit (This information is obtainable from the Radiological Society of SA)
19.1
Skeleton
19.1.1 Skeleton: Limbs
3305
Finger, toe
06.52
6.300 62.70 (55.00)
3309
Smith-Petersen or equivalent control, in theatre
06.52
38.700
385.30
(338.00)
3311
Stress studies, e.g, joint
06.52
7.700 76.70 (67.30)
3313
Full length study, both legs
06.52
15.500
154.30
(135.40)
3315
Skeletal survey under 5 years
06.52
19.900
198.10
(173.80)
3317
Skeletal survey over 5 years
06.52
28.000
278.80
(244.60)
3319
Arthrography per joint
06.52
15.400
153.30
(134.50)
3320
Introduction of contrast medium or air: ADD
06.52 +
13.800
137.40
(120.50)
6500
Hand
06.52
7.700 76.70 (67.30)
6501
Wrist (specify region)
06.52
7.700 76.70 (67.30)
6503
Scaphoid
06.52
7.700 76.70 (67.30)
6504
Radius and ulna
06.52
7.700 76.70 (67.30)
6505
Elbow
06.52
7.700 76.70 (67.30)
6506
Humerus
06.52
7.700 76.70 (67.30)
6507
Shoulder
06.52
7.700 76.70 (67.30)
6508
Acromio-Clavicula joint
06.52
7.700 76.70 (67.30)
6509
Clavicle
06.52
7.700 76.70 (67.30)
6510
Scapula
06.52
7.700 76.70 (67.30)
6511
Foot
06.52
7.700 76.70 (67.30)
6512
Ankle
06.52
7.700 76.70 (67.30)
6513
Calcaneus
06.52
7.700 76.70 (67.30)
13 Mar 2008
Page 100 of 151
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
6514
6515
6516
6517
6518
6519
19.1.2
3321
Tibia and fibula
Knee
Patella
Femur
Hip
Sesamoid Bone
Skeleton: Spinal column
Per region, e.g. cervical, sacral, lumbar coccygeal, one region thoracic
06.52
06.52
06.52
06.52
06.52
06.52
7.700
7.700
7.700
7.700
7.700
7.700
76.70 (67.30)
76.70 (67.30)
76.70 (67.30)
76.70 (67.30)
76.70 (67.30)
76.70 (67.30)
06.52
11.000
3325
Stress studies
06.52
11.000
3329
Scoliosis studies
06.52
21.000
3331
Pelvis (Sacro-iliac or hip joints only to be added where an extra set of view is required)
06.52
11.000
3333
Myelography: Lumbar
06.52
28.900
3334
Myelography: Thoracic
06.52
22.200
3335
Myelography: Cervical
06.52
35.500
109.50
(96.10)
109.50
(96.10)
209.10
(183.40)
109.50
(96.10)
287.70
(252.40)
221.00
(193.90)
353.40
(310.00)
3336
Multiple (lumbar, thoracic, cervical): Same fee as for first segment (no additional introduction of contrast medium)
06.52
3344
Introduction of contrast medium
06.52 +
18.700
3345
Discography
06.52
34.600
3347
Introduction of contrast medium per disc level: ADD
06.52 +
28.200
19.1.3
3349
Skeleton: Skull
Skull studies
06.52
15.700
3351
Paranasal sinuses
06.52
11.000
3353
Facial bones and/or orbits
06.52
12.600
3355
3357
3359
Mandible
Nasal bone
Mastoid: Bilateral
06.52
06.52
06.52
9.400
7.800
18.000
3361
3363
3365
Teeth: One quadrant
Teeth: Two quadrants
Teeth: Full mouth
06.52
06.52
06.52
3.700
6.300
11.000
13 Mar 2008
Page 101 of 151
Anaesthesiology
RVU
Fee
4.000
4.000
4.000
4.000
186.20
(163.30)
344.50
(302.20)
280.80
(246.30)
4.000
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
156.30
(137.10)
109.50
(96.10)
125.40
(110.00)
93.60 (82.10)
77.70 (68.20)
179.20
(157.20)
36.80 (32.30)
62.70 (55.00)
109.50
(96.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
3366
Teeth: Rotation tomography of the teeth and jaws
06.52
13.300
3367
Teeth: Tempero-mandibular joints: Per side
06.52
11.000
3369
Teeth: Tomography: Per side
06.52
11.000
3371
Localisation of foreign body in the eye
06.52
15.700
3381
Ventriculography
06.52
27.300
3385
3387
3389
Post-nasal studies: Lateral neck
Maxillo-facial cephalometry
Dacrocystography
06.52
06.52
06.52
6.300
8.800
11.000
3391
For introduction of contrast medium: ADD
06.52 +
11.000
19.2
3393
3395
Alimentary tract
Bowel washout: ADD
Sialography (plus 80% for each additional gland)
06.52 +
06.52
3397
Introduction of contrast medium (plus 80% for each additional gland: ADD)
06.52 +
3399
Pharynx and oesophagus
06.52
3403
Oesophagus, stomach and duodenum (control film of abdomen included) and limited follow through
06.52
3405
3406
Double contrast: ADD
Small bowel meal (control film of abdomen included except when part of item 3408)
06.52 +
06.52
3408
06.52
3409
Barium meal and dedicated gastro-intestinal tract follow through (including control film of the abdomen, oesophagus,
duodenum, small bowel and colon)
Barium enema (control film of abdomen included)
3411
Air contrast study: ADD
06.52 +
3415
Biliary Tract: ERCP own equipment: Choledogram and/or pancreatography screening included
06.52
3416
Pancreas: ERCP hospital equipment: Choledogram and/or pancreatography screening included
06.52
4.800 47.80 (41.90)
12.700
126.40
(110.90)
11.000
109.50
(96.10)
12.700
126.40
(110.90)
20.000
199.10
(174.60)
7.300 72.70 (63.80)
20.000
199.10
(174.60)
28.900
287.70
(252.40)
18.300
182.20
(159.80)
19.300
192.20
(168.60)
23.300
232.00
(203.50)
15.500
154.30
(135.40)
Note: For items 3415 and 3416: Endoscopy (see item 1778)
06.52
Gastric/oesophageal/duodenal intubation control
Gastric/oesophageal intubation insertion of tube: ADD
Duodenal intubation: Insertion of tube: ADD
06.52
06.52 +
06.52 +
3417
3419
3421
13 Mar 2008
Page 102 of 151
06.52
132.40
(116.10)
109.50
(96.10)
109.50
(96.10)
156.30
(137.10)
271.80
(238.40)
62.70 (55.00)
87.60 (76.80)
109.50
(96.10)
109.50
(96.10)
Anaesthesiology
RVU
Fee
4.000
176.40
(154.70)
4.000
176.40
(154.70)
4.000
176.40
(154.70)
4.000
176.40
(154.70)
176.40
(154.70)
4.000
5.900 58.70 (51.50)
5.600 55.80 (48.90)
11.000
109.50
(96.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
3423
Hypotonic duodenography (item 3403 and item 3405 included)
06.52 +
29.300
291.70
(255.90)
19.3
3425
Biliary tract
Oral cholecystography
06.52
15.700
3427
Cholangiography: Intravenous
06.52
22.000
3431
Operative cholangiography: First series: ADD item 3607 only when the Radiologist attends personally in theatre
06.52
21.000
3433
Post operative: T-tube
06.52
16.700
3435
3437
Introduction of contrast medium: ADD
Trans hepatic, percutaneous
06.52 +
06.52
5.600
18.300
3439
Introduction of contrast medium: ADD
06.52 +
33.100
3441
19.4
3443
Tomography of biliary tract: ADD
Chest
Larynx (Tomography included)
06.52 +
9.400
156.30
(137.10)
219.00
(192.10)
209.10
(183.40)
166.30
(145.90)
55.80 (48.90)
182.20
(159.80)
329.50
(289.00)
93.60 (82.10)
06.52
12.500
3445
3447
Chest (item 3601 included)
Chest and cardiac studies (item 3601)
06.52
06.52
9.400
12.600
3449
Ribs
06.52
12.300
3451
Sternum or sterno-clavicular joints
06.52
12.600
3453
Bronchography: Unilateral
06.52
12.600
3455
Bronchography: Bilateral
06.52
22.100
3457
Introduction of contrast medium included
06.52
35.700
3461
Pleurography
06.52
12.600
3463
3465
For introduction of contrast medium: ADD
Laryngography
06.52 +
06.52
2.800
11.000
3467
3468
19.5
3477
For introduction of contrast medium: ADD
06.52 +
Thoracic inlet
06.52
Abdomen
Control films of the Abdomen (not being part of examination for barium meal, barium enema, pyelogram, cholecystogram, 06.52
cholangiogram etc.)
10.000
6.300
13 Mar 2008
Page 103 of 151
124.50
(109.20)
93.60 (82.10)
125.40
(110.00)
122.50
(107.50)
125.40
(110.00)
125.40
(110.00)
220.00
(193.00)
355.40
(311.80)
125.40
(110.00)
27.90 (24.50)
109.50
(96.10)
99.60 (87.40)
62.70 (55.00)
Anaesthesiology
RVU
Fee
8.000
8.000
3.000
352.90
(309.60)
352.90
(309.60)
132.30
(116.10)
9.400 93.60 (82.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3479
Acute abdomen or equivalent studies
19.6
3487
3493
Urinary tract
Excretory urogram: Control film included and bladder views before and after micturition (intravenous pyelogram) (item
0206 not applicable)
Waterload test: ADD
3497
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
06.52
15.700
156.30
(137.10)
06.52
25.100
06.52 +
12.200
Cystography only or urethrography only (retrograde)
06.52
19.300
3499
Cysto-urethrography: Retrograde
06.52
31.900
3503
3505
Cysto-urethrography: Introduction of contrast medium
Retrograde-prograde pyelography
06.52 +
06.52
3.700
18.300
3511
Aspiration renal cyst
06.52
18.400
3513
19.7
3515
3517
Tomography of renal tract: ADD
Gynaecology and obstetrics
Pregnancy
Pelvimetry
06.52 +
249.90
(219.20)
121.50
(106.60)
192.20
(168.60)
317.60
(278.60)
36.80 (32.30)
182.20
(159.80)
183.20
(160.70)
93.60 (82.10)
3519
Hystero-salpingography
06.52
3521
Introduction of contrast medium: ADD
06.52 +
19.8
Vascular studies
The following rules are applicable to Section 19.8 (Vascular studies) and Section 19.14 (Interventional Radiological Procedures):
06.52
06.52
9.400
9.400 93.60 (82.10)
17.400
173.20
(151.90)
12.500
124.50
(109.20)
15.300
152.30
(133.60)
Anaesthesiology
RVU
Fee
3.000
132.30
(116.10)
3.000
132.30
(116.10)
06.52
a. The machine fee (items 3536 to 3550 includes the cost of the following:
i. All runs (runs may not be billed for separately).
ii. All film costs (modifier 0084 is not applicable).
iii All fluoroscopy (item 3601 does not apply).
iv All minor consumables (defined as any item other than catheters, guidewires, introducer sets, specialised catheters, balloon catheters, stents, embolic agents, drugs and contrast media).
b. The machine fee (items 3536 to 3550) may only be billed for as a once off fee per case per day by the owner of the equipment and is only applicable to radiology practices.
c. If a procedure is performed by a non-radiologist together with a radiologist as a team, in a facility owned by the radiologist, each member of the team will fee at their respective full rates as per
modifiers and the applicable items.
d. If a procedure is performed by a non-radiologists and a radiologist as a team, in a facility not owned by the radiologist, modifiers 6301 and 6302 applies.
Please note : Modifier 0083 is not applicable to section 19.8 (Vascular Studies) and section 19.14 (Interventional Radiological Procedures)
13 Mar 2008
Page 104 of 151
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
MODIFIER GOVERNING VASCULAR STUDIES
0086
Vascular groups: “Film series” and “Introduction of Contrast Media” are complementary and together constitute a single examination: neither fee is therefore subject to increase in terms of Modifier
0080: Multiple examinations
6300
If a procedure lasts less than 30 minutes, only 50% of the machine fees for items 3536-3550 will be allowed (specify time of procedure on account)
6301
If a procedure is performed by a radiologist in a facility not owned by himself, the fee will be reduced by 40% (i.e. 60% of the fee will be charged)
6302
When the procedure is performed by a non-radiologist, the fee will be reduced by 40% (i.e. 60% of the fee will be charged)
6303
When a procedure is performed entirely by a non-radiologist in a facility owned by a radiologist, the radiologist owning the facility may charge 55% of the procedure units used. Modifier 6302 applies
to the non radiologist performing the procedure
6305
When multiple catheterisation procedures are used (items 3557, 3559, 3560, 3562) and an angiogram investigation is performed at each level, the unit value of each such multiple procedure will be
reduced by 20,00 radiological units for each procedure after the initial catheterisation. The first catheterisation is charged at 100% of the unit value
19.8.1 Vascular studies: Film Series
Note: In the case of selective catheterisation of a branch of the aorta, the fee for catheterisation of the aorta is not added.
3536
3537
3538
3539
3540
3545
Dedicated angiography suite: Analogue monoplane unit. Once off charge per patient by owner of equipment
Dedicated angiography suite: Digital monoplane unit. Once off charge per patient by owner of equipment
Analogue monoplane table with DSA attachment
Dedicated angiography suite: Digital bi-plane unit. Once off charge per patient by owner of equipment
Radiography fee for coronary catheterisation laboratory, per radiographer, per half hour or part thereof
Venography: Per limb
06.52
06.52
06.52
06.52
06.52
06.52
16.500
164.30
(144.10)
3548
3550
3551
Analogue monoplane screening table
Digital monoplane screening table
Lymphangiogram per limb (global fee) including lymphatic catheterisation (no machine fee applicable)
06.52
06.52
06.52
166.800
3557
Catheterisation aorta or vena cava, any level, any route, with aortogram/cavogram
06.52
48.600
3558
Translumbar aortic puncture, with full study
06.52
69.600
3559
Selective first order catheterisation, arterial or venous, with angiogram/venogram
06.52
57.000
3560
Selective second order catheterisation, arterial or venous, with angiogram/ venogram
06.52
65.400
3562
Selective third order catheterisation, arterial or venous, with angiogram/venogram
06.52
73.200
3564
Direct femoral arterial or venous or jugular venous puncture
06.52
37.200
3566
Guiding catheter placement, any site arterial or venous, for any intracranial procedure or anteriovenous malformation
(AVM)
Intravascular pressure studies, arterial or venous, once off per case
06.52
85.800
06.52
19.800
Microcatheter insertion, any cranial vessel and/or pulmonary vessel, arterial or venous (including guiding catheter
placement)
Transcatheter selective blood sampling, arterial or venous
06.52
130.800
06.52
32.400
1660.70
(1456.80)
483.90
(424.50)
692.90
(607.80)
567.50
(497.80)
651.10
(571.10)
728.80
(639.30)
370.40
(324.90)
854.20
(749.30)
197.10
(172.90)
1302.20
(1142.30)
322.60
(283.00)
3569
3570
3572
13 Mar 2008
Page 105 of 151
4.000
5.000
4.000
4.000
4.000
06.52
06.52
06.52
06.52
06.52
06.52
06.52
176.40
(154.70)
220.60
(193.50)
176.40
(154.70)
176.40
(154.70)
176.40
(154.70)
5.000
220.60
(193.50)
5.000
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3574
Spinal angiogram (global fee) including all selective catheterisations
06.52
19.8.2
3563
3575
Vascular studies: Introduction of contrast medium
Direct intravenous for limb
Cut-downs for venography: ADD
06.52 +
06.52 +
19.9
Tomography and cinematography
Please note: The calculated amounts in this section are calculated according to the computed tomography unit values
3577
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
480.000
4778.90
(4192.00)
Anaesthesiology
RVU
Fee
5.000
7.400 73.70 (64.60)
11.000
109.50
(96.10)
06.52
06.52
6400
6401
6402
6403
Tomography (conventional except where otherwise specified): ADD 100% provided that if it is more than one dimension
fee shall be charged for the additional investigation at 50% of the tariff with a maximum of two additional investigations
Tomography (multi-dimensional in motion): ADD 150%
Cinematography: For first series: ADD 100%
Cinematography: For each series after the first: ADD 80% of the primary fee
Tomography and cinematography: Computed Tomography
Where a fully digital C-arm portable x-ray unit, with angiography/interventional capability is used in hospital or theatre, per
half hour
Contrast media: General Rule Y applies (Please note: Item 0201 is not applicable for contrast media)
Electron beam computed tomography (EBCT) for assessment of coronary artery calcification (complete fee - no
additions)
Electron beam computed tomography (EBCT) of the heart. Total fee for contract examination excluding cost of contrast
medium (not to be used for coronary artery calcium assessment or scoring - see item 3598)
Plus spiral CT
Plus 3D reconstruction
Plus high resolution study
CT limb uncontrasted
06.52
06.52
06.52
06.52
5.000
6404
CT limb with contrast only
06.52
5.000
6405
CT limb pre- AND post contrast
06.52
5.000
6406
CT joint uncontrasted
06.52
5.000
6407
CT joint with contrast only
06.52
5.000
6408
CT joint pre AND post contrast
06.52
5.000
6409
CT brain uncontrasted (including posterior fossa)
06.52
5.000
6410
CT brain with contrast only (including posterior fossa)
06.52
5.000
6411
CT brain pre AND post contrast (including posterior fossa)
06.52
5.000
3579
3581
3583
19.9.1
3592
3597
3598
3599
13 Mar 2008
Page 106 of 151
220.60
(193.50)
06.52
06.52
06.52
06.52
06.52
06.52
-
-
06.52
-
-
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
6412
CT orbits complete study, axial OR coronal, uncontrasted
06.52
5.000
6413
CT orbits complete study, axial AND coronal, uncontrasted
06.52
5.000
6414
CT orbits complete study, axial OR coronal pre AND post contrast
06.52
5.000
6415
CT orbits complete study, axial AND coronal pre AND post contrast
06.52
5.000
6416
CT paranasal sinuses limited study axial OR coronal
06.52
5.000
6417
CT paranasal sinuses limited study axial AND coronal
06.52
5.000
6418
CT paranasal sinuses complete study, axial or coronal, uncontrasted
06.52
5.000
6419
CT paranasal sinuses complete study, axial AND coronal, uncontrasted
06.52
5.000
6420
CT paranasal sinuses complete study, axial OR coronal, pre AND post contrast
06.52
5.000
6421
CT paranasal sinuses complete study, axial AND coronal, pre AND post contrast
06.52
5.000
6422
CT pituitary fossa, uncontrasted
06.52
5.000
6423
CT pituitary fossa, pre AND post contrast
06.52
5.000
6424
CT internal auditory meati, uncontrasted
06.52
5.000
6425
CT internal audiory meati, pre AND post contrast
06.52
5.000
6426
CT mastoids
06.52
5.000
6427
CT ear structures, limited study
06.52
5.000
6428
CT middle AND inner ear, complete study including reconstructions
06.52
5.000
6429
CT facial bones
06.52
5.000
6430
CT neck soft tissue, uncontrasted
06.52
5.000
6431
CT neck soft tissue with contrast only
06.52
5.000
6432
CT neck pre AND post contrast
06.52
5.000
6433
CT cervical spine uncontrasted
06.52
5.000
13 Mar 2008
Page 107 of 151
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
6434
CT cervical spine pre AND post contrast
06.52
5.000
6435
CT cervical spine post myelogram
06.52
5.000
6436
CT dorsal spine uncontrasted
06.52
5.000
6437
CT dorsal spine pre AND post contrast
06.52
5.000
6438
CT dorsal spine post myelogram
06.52
5.000
6439
CT lumbar spine uncontrasted
06.52
5.000
6440
CT lumbar spine pre AND post contrast
06.52
5.000
6441
CT lumbar spine post myelogram
06.52
5.000
6442
CT pelvimetry (topogram only)
06.52
5.000
6443
CT chest uncontrasted
06.52
5.000
6444
CT chest with contrast
06.52
5.000
6445
CT chest pre AND post contrast
06.52
5.000
6446
CT chest high resolution lungs, limited study
06.52
5.000
6447
CT high resolution lungs, complete study
06.52
5.000
6448
CT abdomen uncontrasted
06.52
5.000
6449
CT abdomen with contrast
06.52
5.000
6450
CT abdomen pre AND post contrast
06.52
5.000
6451
CT abdomen triphasic study
06.52
5.000
6452
CT pelvis uncontrasted
06.52
5.000
6453
CT pelvis with contrast
06.52
5.000
6454
CT pelvis pre AND post contrast
06.52
5.000
6455
CT abdomen AND pelvis uncontrasted
06.52
5.000
13 Mar 2008
Page 108 of 151
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
6456
CT abdomen AND pelvis with contrast
06.52
5.000
6457
CT abdomen AND pelvis pre AND post contrast
06.52
5.000
6458
CT chest, abdomen AND pelvis with contrast
06.52
5.000
6459
CT base of skull to symphysis pubis with contrast
06.52
5.000
6460
6461
6462
CT for dental implants maxilla OR mandible
CT for dental implants maxilla AND mandible
CT angiography per limited region (including spiral, high resolution, AND all reconstructions)
06.52
06.52
06.52
5.000
6463
CT angiography per extensive region (including spiral, high resolution, 3D AND all other reconstructions)
06.52
5.000
6464
CT limited study, any region. Region to be identified on the account
06.52
5.000
6465
CT guidance for aspiration, biopsy or drainage
06.52
11.000
6466
6467
CT guidance for aspiration at time of CT diagnostic study
CT stereotactic localisation for biopsy
06.52
06.52
11.000
485.20
(425.60)
6469
6470
Quantitative CT for bone mineral density
Triphasic study of the liver with CT Abdomen and Pelvis pre and post contrast
06.52
06.52
5.000
6471
CT of the chest, triphasic study of the liver, abdomen and pelvis with contrast
06.52
5.000
220.60
(193.50)
220.60
(193.50)
6472
19.10
3594
3600
Computer Aided Diagnosis for Mammography
Radiology: Miscellaneous
Mammogram of surgically removed breast biopsy specimen
Peripheral bone densitometry utilizing ionizing radiation
06.52
3601
3602
Fluoroscopy: Per half hour: ADD (not applicable for items 3445 and 3447)
Where a C-arm portable X-ray unit is used in hospital or theatre: Per half hour: ADD
06.52 +
06.52
7.700
10.700
3603
Sinography
06.52
18.400
3604
Bone densitometry (to be charged once only for one or more levels done at the same session)
06.52
3605
Mammography: Unilateral or bilateral, including ultrasound and doppler ultrasound examination, where necessary. This
item may not be used together with an item from the ultrasound section. Note that when an ultrasound of the breast is
requested without mammography, item 3629 is used
Attendance at operation in theatre or at radiological procedure performed by a surgeon or physician in X-ray department
(except item 3309): Per half hour: Plus fee or examination performed (Only to be used by radiological technical staff)
06.52
3607
13 Mar 2008
06.52
06.52
Page 109 of 151
06.52
13.000
77.000
129.40
(113.50)
766.60
(672.50)
13.000
77.000
33.000
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
485.20
(425.60)
129.40
(113.50)
76.70 (67.30)
106.50
(93.40)
183.20
(160.70)
766.60
(672.50)
328.50
(288.20)
5.600 55.80 (48.90)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3608
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
RVU
Fee
06.52
40.000
06.52
-
3611
Repeat mammography procedure with minimally invasive breast biopsy, core biopsy or fine needle aspiration biopsy
utilising dedicated stereotactic equipment with patient in erect or prone position
Foreign body localisation: Fee for part examined plus two-thirds for every additional series plus fluoroscopy fee if this is
done
Foreign body localisation: Introduction of sterile needle markers: ADD
06.52 +
11.000
3613
5029
5034
Setting of sterile trays
Mammotome - stereotaxis: Hand held
Fine needle aspiration or biopsy or core biopsy of mamma
06.52
06.52
06.52
25.000
19.11
Ultrasound investigations
Please note: The calculated amounts in this section are calculated according to the ultrasound unit values
06.52
Note: See rule GG for requirements for reports and the keeping of records which are also applicable to ultrasonic investigations.
06.52
3609
Intravascular ultrasound per case, arterial or venous, for intervention
06.52
30.000
3610
Transrectal ultrasonographic prostate volume study for prostate brachytherapy (own equipment)
06.52
110.000
3612
Ultrasonic bone densitometry
06.52
19.000
3614
Transvaginal aspiration of ova
06.52
110.000
3615
Routine obstetric ultrasound at 10 to 20 weeks gestational age preferable at 10 to 14 weeks gestational age to include
nuchal translucency assessment
Contrast media: General Rule Y applies
Routine obstetric ultrasound at 20 to 24 weeks to include detailed anatomical assessment
06.52
50.000
06.52
06.52
50.000
3618
40.000
3620
Pelvic organs ultrasound transabdominal probe (this is a gynaecological ultrasound examination and may not be used in 06.52
pregnancy)
Intravascular ultrasound imaging assesses the atheroschlerotic process to guide the placement of an intracoronary stent. 06.52
This item may be applied once per vessel (left anterior descending territory, circumflex territory and/or right coronary
territory) in which a stent or multiple stents are deployed
Cardiac examination plus Doppler colour mapping
06.52
3621
Cardiac examination (MMode)
06.52
25.000
3622
Cardiac examination: 2 Dimensional
06.52
50.000
3623
3624
3625
Cardiac examination + effort
Cardiac examinations + contrast
Cardiac examinations + doppler
06.52 +
06.52 +
06.52
10.000
10.000
50.000
3626
Cardiac examination + phonocardiography
06.52 +
10.000
3619
13 Mar 2008
Page 110 of 151
3.000
132.30
(116.10)
6.000
264.70
(232.20)
109.50
(96.10)
3.300 32.90 (28.90)
3596
3616
3617
398.20
(349.30)
-
Anaesthesiology
30.000
50.000
248.90
(218.30)
201.00 30.000
(176.30)
736.90 110.000
(646.40)
127.30 19.000
(111.70)
736.90 110.000
(646.40)
335.00 50.000
(293.90)
201.00
(176.30)
736.90
(646.40)
127.30
(111.70)
736.90
(646.40)
335.00
(293.90)
335.00
(293.90)
268.00
(235.10)
201.00
(176.30)
50.000
335.00
(293.90)
268.00
(235.10)
201.00
(176.30)
335.00
(293.90)
167.50
(146.90)
335.00
(293.90)
67.00 (58.80)
67.00 (58.80)
335.00
(293.90)
67.00 (58.80)
50.000
40.000
30.000
25.000
50.000
10.000
10.000
50.000
10.000
5.000
220.60
(193.50)
9.000
397.00
(348.20)
335.00
(293.90)
167.50
(146.90)
335.00
(293.90)
67.00 (58.80)
67.00 (58.80)
335.00
(293.90)
67.00 (58.80)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3627
06.52
60.000
3628
Ultrasound examination includes whole abdomen and pelvic organs, where pelvic organs are clinically indicated
(including liver, gall bladder, spleen, pancreas, abdominal vascular anatomy, para-aortic area, renal tract, pelvic organs)
Renal tract
06.52
50.000
3629
High definition (small parts) scan: Thyroid, breast lump, scrotum, etc.
06.52
50.000
3631
Ophthalmic examination
06.52
50.000
3632
Axial length measurement and calculation of intra ocular lens power. Per eye. Not to be used with item 3034
06.52
50.000
3633
Neonatal head scan
06.52
50.000
3634
Peripheral vascular study, B mode only
06.52
39.000
3635
+ Doppler
06.52
39.000
3636
Trans-oesophageal echocardiography including passing the device
06.52
100.000
3637
06.52
78.000
5026
+ Colour Doppler (may be added onto any other regional exam, but not to be added to items 3605, 5110, 5111, 5112,
5113 or 5114)
Ultrasound guided amniocentesis
06.52
39.000
5100
Pelvic organs ultrasound: Transvaginal or trans rectal probe
06.52
50.000
5101
Pleural space ultrasound
06.52
50.000
5102
Ultrasound of joints (e.g. shoulder, hip, knee), per joint
06.52
50.000
5103
Ultrasound soft tissue, any region
06.52
50.000
5106
Obstetric ultrasound before 10 weeks gestational age for complicated pregnancy i.e. suspected ectopic pregnancy
abortion or discrepancy between gestational age and dates. Not to be used for routine diagnosis of pregnancy
Ultrasound after 24 weeks - motivation required
06.52
25.000
06.52
25.000
Second opinion obstetric ultrasound may be charged by practitioners accepted by SASOG or RSSA (list of names
available from SASOG or RSSA)
Carotid ultrasound vascular study: B mode, pulsed and colour Doppler; bilateral study, internal, external and common
carotid flow and anatomy
Full ultrasonic and colour Doppler evaluation of entire extracranial vascular tree: Carotids, vertebral and subclavian
vessels (not to be used together with items 5110, 5112, 5113 or 5114)
Peripheral arterial ultrasound vascular study: B mode, pulsed and colour Doppler; per limb; to include waveforms at
minimum of three levels, pressure studies at two levels and full interpretation of results
Peripheral venous ultrasound vascular study; B mode, pulsed and colour Doppler; to evaluate deep vein thrombosis
06.52
50.000
06.52
128.000
06.52
206.000
06.52
117.000
06.52
117.000
5107
5108
5110
5111
5112
5113
13 Mar 2008
Page 111 of 151
Fee
401.90
(352.50)
335.00
(293.90)
335.00
(293.90)
335.00
(293.90)
335.00
(293.90)
335.00
(293.90)
261.30
(229.20)
261.30
(229.20)
669.90
(587.60)
522.50
(458.30)
261.30
(229.20)
335.00
(293.90)
335.00
(293.90)
335.00
(293.90)
335.00
(293.90)
167.50
(146.90)
167.50
(146.90)
335.00
(293.90)
857.50
(752.20)
1380.00
(1210.50)
783.80
(687.50)
783.80
(687.50)
General Practitioners
/ non-designated
Specialists
RVU
Fee
60.000
50.000
50.000
50.000
50.000
50.000
39.000
39.000
100.000
78.000
Anaesthesiology
RVU
Fee
401.90
(352.50)
335.00
(293.90)
335.00
(293.90)
335.00
(293.90)
335.00
(293.90)
335.00
(293.90)
261.30
(229.20)
261.30
(229.20)
669.90
(587.60)
522.50
(458.30)
6.000
50.000
50.000
50.000
50.000
25.000
25.000
50.000
120.000
164.800
117.000
117.000
264.70
(232.20)
335.00
(293.90)
335.00
(293.90)
335.00
(293.90)
335.00
(293.90)
167.50
(146.90)
167.50
(146.90)
335.00
(293.90)
803.90
(705.20)
1104.00
(968.40)
783.80
(687.50)
783.80
(687.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
5114
5115
Peripheral venous ultrasound vascular study; B mode, pulsed and colour Doppler; in erect and supine position including
compression manoeuvres and reflux in superficial and deep systems, bilaterally
Intra-operative ultrasound study
5117
06.52
178.000
06.52
50.000
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
1192.40 142.400
(1046.00)
335.00 50.000
(293.90)
589.50 88.000
(517.10)
294.80 44.000
(258.60)
953.90
(836.80)
335.00
(293.90)
589.50
(517.10)
294.80
(258.60)
Anaesthesiology
RVU
Fee
3.000
132.30
(116.10)
Diagnostic intravascular ultrasound (IVUS) imaging or wave wire mapping (without accompanying angioplasty). May be
06.52
88.000
used only once per angiographic procedure
5118
Diagnostic intravascular ultrasound imaging or wave wire imaging (with accompanying angioplasty or accompanying
06.52
44.000
intravascular ultrasound imaging or wave wire mapping in a different coronary artery [LAD (left anterior desending),
Circumflex or Right coronary artery]). May be used a maximum of twice per angiographic procedure
MODIFIERS GOVERNING ULTRASONIC INVESTIGATIONS
0160
Aspiration of biopsy procedure performed under direct ultrasound control by an ultrasound aspiration biopsy transducer (Static Realtime): Fee for part examined plus 30% of the units
0165
Use of contrast during ultrasound study: add 6.00 ultrasound units
06.52
6.000 40.19 (35.25)
6.000 40.19 (35.25)
5104
Ultrasound in pregnancy, multiple gestation, after twenty weeks: plus 30%
GENERAL RULE GOVERNING ULTRASONIC EXAMINATIONS DURING PREGNANCY
EE.
Ultrasound examinations: The international norm approved for use in South Africa for NORMAL PREGNANCY is two ultrasound exams: (a) The first scan should preferably include a nuchal thickness
estimation and be performed between 10 and 14 weeks gestation. The second scan should be performed between 20 and 24 weeks and should include a full anatomical report. All subsequent
ultrasound scans are excluded from the benefits unless accompanied by proper motivation. An ultrasound scan to assess an abnormal early pregnancy may be formed before 10 weeks but this scan
may not be used to diagnose a normal uncomplicated pregnancy. Item 3618 is a gynaecological scan and its use is not approved for use in pregnancy. (b) In cases where the scan is performed by
the attending practitioner, a clear indication for such a scan must be entered on the account rendered, or a letter of motivation must be attached to the account (the practitioner must elect one of the
two options). (c) In case of a referral, the referring doctor must submit a letter of motivation to the radiologist or other practitioner doing the scan. A copy of the letter of motivation must be attached to
the first account rendered to the patient (by the radiologist or the other practitioner doing the scan) and must be attached to the first account submitted to the Fund by the patient or the doctor, as the
case may be. (d) In case of a referral to a radiologist, no motivation should be required from the radiologist
19.12 Portable unit examinations
3639
Where portable X-ray unit is used in the hospital or theatre: ADD
06.52 +
7.000 69.70 (61.10)
3640
Theatre investigations with fixed installation
06.52 +
3.000 29.90 (26.20)
19.13 Diagnostic procedures requiring the use of radio-isotopes
AA.
Procedures to exclude cost of isotope
3641
Tracer test
06.52
33.200
330.50 22.100
220.00
(289.90)
(193.00)
3642
Repeat of further tracer tests for same investigation: Half of above fee
06.52
16.600
165.30 11.100
110.50
(145.00)
(96.90)
3643
If both tracer and therapeutic procedures are done, half fee of tracer test to be charged plus therapeutic fee
06.52
3645
Other organ scanning with use of relevant radio isotopes
06.52
82.200
818.40 54.800
545.60
(717.90)
(478.60)
3646
Thyroid scanning
06.52
28.800
286.70 19.200
191.20
(251.50)
(167.70)
6474
Positron Emission Tomography (PET) imaging of the whole body using a Coincidence Camera
06.52
6475
Positron Emission Tomography (PET) imaging of a limited body region using a Coincidence Camera
06.52
13 Mar 2008
Page 112 of 151
06.52
06.52
06.52
06.52
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
19.14
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
Interventional radiological procedures
The following rules are applicable to Section 19.8 (Vascular studies) and Section 19.14 (Interventional Radiological Procedures):
06.52
a. The machine fee (items 3536 to 3550 includes the cost of the following:
i. All runs (runs may not be billed for separately).
ii. All film costs (modifier 0084 is not applicable).
iii All fluoroscopy (item 3601 does not apply).
iv All minor consumables (defined as any item other than catheters, guidewires, introducer sets, specialised catheters, balloon catheters, stents, embolic agents, drugs and contrast media).
b. The machine fee (items 3536 to 3550) may only be billed for as a once off fee per case per day by the owner of the equipment and is only applicable to radiology practices.
c. If a procedure is performed by a non-radiologist together with a radiologist as a team, in a facility owned by the radiologist, each member of the team will fee at their respective full rates as per
modifiers and the applicable items.
d. If a procedure is performed by a non-radiologists and a radiologist as a team, in a facility not owned by the radiologist, modifiers 6301 and 6302 applies.
Please note : Modifier 0083 is not applicable to section 19.8 (Vascular Studies) and section 19.14 (Interventional Radiological Procedures)
Note: In regard to multiple examinations see modifier 0080
06.52
5002
Percutaneous transluminal angioplasty: Aortic/IVC
06.52
102.600
5004
Percutaneous transluminal angioplasty, arterial or venous, iliac vessel/subclavian vessel
06.52
102.600
5006
Percutaneous transluminal angioplasty: Femoral to popliteal bifurcation, axillary and brachial
06.52
102.600
5008
Percutaneous transluminal angioplasty: Sub-popliteal sub-brachial
06.52
139.200
5010
Percutaneous transluminal angioplasty: Renal/Visceral/Brachiocephalic
06.52
139.200
5012
Percutaneous transluminal angioplasty: Extracranial Carotid/Vertebral - stand alone procedure
06.52
172.200
5014
Atherectomy (per vessel)
06.52
204.600
5016
Aspiration thrombectomy (per vessel)
06.52
131.400
5018
On-table thrombolysis/transcatheter infusion performed in angiography suite
06.52
106.800
5022
Embolisation non-intracranial, per vessel
06.52
106.800
5030
Percutaneous nephrostomy for further procedure or drainage
06.52
73.800
5031
Antegrade ureteric stent insertion
06.52
69.600
5033
Percutaneous cystostomy in radiology suite
06.52
30.000
13 Mar 2008
Page 113 of 151
1021.50
(896.10)
1021.50
(896.10)
1021.50
(896.10)
1385.90
(1215.70)
1385.90
(1215.70)
1714.40
(1503.90)
2037.00
(1786.80)
1308.20
(1147.50)
1063.30
(932.70)
1063.30
(932.70)
734.80
(644.60)
692.90
(607.80)
298.70
(262.00)
13.000
13.000
13.000
13.000
13.000
13.000
5.000
9.000
6.000
6.000
573.40
(503.00)
573.40
(503.00)
573.40
(503.00)
573.40
(503.00)
573.40
(503.00)
573.40
(503.00)
220.60
(193.50)
397.00
(348.20)
264.70
(232.20)
264.70
(232.20)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
5035
Urethral balloon dilatation in radiology suite
06.52
22.800
5036
Percutaneous abdominal/pelvic/other drain insertion, any modality
06.52
34.200
5037
Urethral stenting in radiology suite
06.52
102.600
5038
Intracranial/spinal AVM embolisation (per session)
06.52
335.400
5039
Intracranial thrombolysis (on-table) per session
06.52
139.200
5040
Intracranial aneurysm occlusion
06.52
286.800
5041
Balloon occlusion/Wada test
06.52
106.800
5042
Carotico/cavernous fistula/head and neck AV fistula embolisation
06.52
286.800
5043
Intracranial angioplasty
06.52
204.600
5044
Transhepatic portogram
06.52
139.200
5045
Hepatic arterial infusion catheter insertion
06.52
156.000
5046
Percutaneous biliary drainage (external)
06.52
102.600
5047
Combined internal/external biliary drainage
06.52
102.600
5048
Biliary stent insertion
06.52
139.200
5049
Percutaneous gall bladder drainage
06.52
69.600
5050
Percutaneous or renal gall bladder stone removal
06.52
172.200
5058
Stent insertion: Aortic/IVC - including percutaneous transluminal angioplasty (PTA)
06.52
139.200
5060
Stent insertion: Iliac/subclavian/AV fistula - including percutaneous transluminal angioplasty (PTA)
06.52
139.200
5062
06.52
139.200
5064
Stent insertion: Femoral popliteal bifurcation, axillary and brachial - including percutaneous transluminal angioplasty
(PTA)
Stent insertion: Sub-popliteal - including percutaneous transluminal angioplasty (PTA)
06.52
172.200
5066
Stent insertion: Renal/visceral/brachiocephalic - including percutaneous transluminal angioplasty (PTA)
06.52
204.600
5068
Stent insertion: Extracranial carotid/vertebral - including percutaneous transluminal angioplasty (PTA) - stand alone
procedure
06.52
204.600
13 Mar 2008
Page 114 of 151
227.00
(199.10)
340.50
(298.70)
1021.50
(896.10)
3339.20
(2929.10)
1385.90
(1215.70)
2855.40
(2504.70)
1063.30
(932.70)
2855.40
(2504.70)
2037.00
(1786.80)
1385.90
(1215.70)
1553.10
(1362.40)
1021.50
(896.10)
1021.50
(896.10)
1385.90
(1215.70)
692.90
(607.80)
1714.40
(1503.90)
1385.90
(1215.70)
1385.90
(1215.70)
1385.90
(1215.70)
1714.40
(1503.90)
2037.00
(1786.80)
2037.00
(1786.80)
Anaesthesiology
RVU
Fee
13.000
573.40
(503.00)
573.40
(503.00)
573.40
(503.00)
397.00
(348.20)
573.40
(503.00)
573.40
(503.00)
397.00
(348.20)
264.70
(232.20)
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
397.00
(348.20)
220.60
(193.50)
573.40
(503.00)
573.40
(503.00)
573.40
(503.00)
573.40
(503.00)
573.40
(503.00)
13.000
13.000
9.000
13.000
13.000
9.000
6.000
9.000
9.000
9.000
9.000
5.000
13.000
13.000
13.000
13.000
13.000
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
RVU
Fee
13.000
573.40
(503.00)
220.60
(193.50)
397.00
(348.20)
397.00
(348.20)
220.60
(193.50)
573.40
(503.00)
397.00
(348.20)
264.70
(232.20)
5070
Stent insertion: Aorto-iliac stent graft - including percutaneous transluminal angioplasty (PTA)
06.52
311.400
5072
Tunnelled/subcutaneous arterial/venous line performed in radiology suite
06.52
82.200
5074
IVC filter insertion jugular or femoral route
06.52
156.000
5076
Intravascular foreign body removal, arterial or venous, any route
06.52
204.600
5078
Percutaneous sclerotherapy of an arteriovenous malformation (AVM)
06.52
70.200
5080
Transjugular intrahepatic porto-systemic shunt
06.52
335.400
5082
Transjugular liver biopsy
06.52
69.600
5084
Endoluminal fallopian tube recanalisation
06.52
172.200
5086
Renal cyst aspiration/ablation
06.52
22.800
5088
Oesophageal stent insertion in radiology suite
06.52
102.600
5090
Tracheal stent insertion
06.52
102.600
5091
GIT balloon dilatation under fluoroscopy
06.52
66.600
5092
Other GIT stent insertion
06.52
102.600
5093
Percutaneous gastrostomy in radiology suite
06.52
85.800
5094
Cutting needle biopsy with image guidance
06.52
22.800
5095
Chest drain insertion in radiology suite
06.52
32.400
5097
Vertebroplasty - Introduction of stabilising material under screening or CT control - per level
06.52
3100.30
(2719.60)
818.40
(717.90)
1553.10
(1362.40)
2037.00
(1786.80)
698.90
(613.10)
3339.20
(2929.10)
692.90
(607.80)
1714.40
(1503.90)
227.00
(199.10)
1021.50
(896.10)
1021.50
(896.10)
663.10
(581.70)
1021.50
(896.10)
854.20
(749.30)
227.00
(199.10)
322.60
(283.00)
Anaesthesiology
5.000
9.000
9.000
5.000
13.000
9.000
6.000
6.000
6.000
6.000
6.000
13.000
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
264.70
(232.20)
573.40
(503.00)
MODIFIER GOVERNING INTERVENTIONAL RADIOLOGICAL PROCEDURES
0090
Radiologist’s fee for participation in a team: 30, 00 radiology units per ½ hour or part thereof for all interventional radiological procedures, excluding any pre- or post-operative angiography,
catheterisation, CT-scanning, ultrasound-scanning or x-ray procedures. (Only to be charged if radiologist is hands-on, and not for interpretation of images only)
19.15 Magnetic Resonance Imaging (MRI)
6100
In order to charge the full fee (600,00 magnetic resonance units) for an examination of a specific single anatomical region, it should be performed with the applicable radio frequency coil including T1
and T2 weighted images on at least two planes
6101
Where a limited series of a specific anatomical region is performed (except bone tumour), e.g a T2 weighted image of a bone for an occult stress fracture, not more than two-thirds (2/3) of the fee may
be charged. Also applicable to all radiotherapy planning studies, per region
6102
All post-contrast studies (except bone tumour), including perfusion studies, to be charges at 50% of the fee
6103
Post-contrast study: Bone tumour: 100% of the fee
13 Mar 2008
Page 115 of 151
06.52
06.52
06.52
06.52
06.52
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
6104
6105
6106
6107
6108
6109
6110
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
Limited examination of the hypophysis e.g. where a coronal T1 and sagittal T1 series are performed, two-thirds (2/3) of the fee is applicable
Where, in a limited hypophysis examination, Gadolinium is administered and coronal T1 and sagittal T1 series are repeated, a single full fee for the entire examination is applicable + cost of
Gadolinium + disposable items
Where a magnetic resonance angiography (MRA) of large vessels is performed as primary examination, 100% of the fee is applicable. This modifier is only applicable if the series is performed by use
of a recognised angiographic software package with reconstruction capability
Where a magnetic resonance angiography (MRA) of the vessels is performed additional to an examination of a particular region, 50% of the fee is applicable for the angiography. This modifier is only
applicable if the series is performed by use of a recognised angiographic software package with reconstruction capability
Where only a gradient echo series is performed with a machine without a recognised angiographic software package with reconstruction ability, 20% of the full fee is applicable specifying that it is a
“flow sensitive series”
Very limited studies to be charged at 33,33% of the full fee e.g. MR urography for renal colic, diffusion studies of the brain additional to routine brain
MRI spectroscopy: 50% of fee
Please note: The calculated amounts in this section are calculated according to the magnetic resonance imaging unit value.
06.52
06.52
Items 6200 to 6255 reflect the anatomical region examined. The modifiers above reflect what was done and how the fee was arrived at.
06.52
6200
Magnetic Resonance Imaging: Per anatomical region: Brain
06.52
400.000
6201
Magnetic Resonance Imaging: Per anatomical region: Orbitae
06.52
400.000
6202
Magnetic Resonance Imaging: Per anatomical region: Paranasal sinuses
06.52
400.000
6203
Magnetic Resonance Imaging: Per anatomical region: Soft tissue: Face/skull
06.52
400.000
6204
Magnetic Resonance Imaging: Per anatomical region: Skull basis/cranio-cervical joint
06.52
400.000
6205
Magnetic Resonance Imaging: Per anatomical region: Middle and internal ears
06.52
400.000
6206
Magnetic Resonance Imaging: Per anatomical region: Soft tissue: Neck
06.52
400.000
6207
Magnetic Resonance Imaging: Per anatomical region: Thyroid/para-thyroid
06.52
400.000
6208
06.52
400.000
6210
Magnetic Resonance Imaging: Per anatomical region: Hypophysis (see modifiers 6104 and 6105 for limited
examinations)
Magnetic Resonance Imaging: Per anatomical region: Cervical vertebrae
06.52
400.000
6211
Magnetic Resonance Imaging: Per anatomical region: Thoracic vertebrae
06.52
400.000
6212
Magnetic Resonance Imaging: Per anatomical region: Lumbar vertebrae
06.52
400.000
6213
Magnetic Resonance Imaging: Per anatomical region: Sacrum
06.52
400.000
6214
Magnetic Resonance Imaging: Per anatomical region: Pelvis
06.52
400.000
6215
Magnetic Resonance Imaging: Per anatomical region: Pelvic organs
06.52
400.000
13 Mar 2008
Page 116 of 151
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
06.52
06.52
06.52
06.52
06.52
06.52
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
6216
Magnetic Resonance Imaging: Per anatomical region: Abdomen
06.52
400.000
6217
Magnetic Resonance Imaging: Per anatomical region: Thorax wall
06.52
400.000
6218
Magnetic Resonance Imaging: Per anatomical region: Mediastinum
06.52
400.000
6219
Magnetic Resonance Imaging: Per anatomical region: Soft tissue: Back
06.52
400.000
6220
Magnetic Resonance Imaging: Per anatomical region: Left shoulder
06.52
400.000
6221
Magnetic Resonance Imaging: Per anatomical region: Right shoulder
06.52
400.000
6222
Magnetic Resonance Imaging: Per anatomical region: Both hips
06.52
400.000
6223
Magnetic Resonance Imaging: Per anatomical region: Left hip
06.52
400.000
6224
Magnetic Resonance Imaging: Per anatomical region: Right hip
06.52
400.000
6225
Magnetic Resonance Imaging: Per anatomical region: Left upper-arm
06.52
400.000
6226
Magnetic Resonance Imaging: Per anatomical region: Right upper-arm
06.52
400.000
6227
Magnetic Resonance Imaging: Per anatomical region: Left elbow
06.52
400.000
6228
Magnetic Resonance Imaging: Per anatomical region: Right elbow
06.52
400.000
6229
Magnetic Resonance Imaging: Per anatomical region: Left fore-arm
06.52
400.000
6230
Magnetic Resonance Imaging: Per anatomical region: Right fore-arm
06.52
400.000
6231
Magnetic Resonance Imaging: Per anatomical region: Left wrist and hand
06.52
400.000
6232
Magnetic Resonance Imaging: Per anatomical region: Right wrist and hand
06.52
400.000
6233
Magnetic Resonance Imaging: Per anatomical region: Left upper-leg
06.52
400.000
6234
Magnetic Resonance Imaging: Per anatomical region: Right upper-leg
06.52
400.000
6235
Magnetic Resonance Imaging: Per anatomical region: Left knee
06.52
400.000
6236
Magnetic Resonance Imaging: Per anatomical region: Right knee
06.52
400.000
6237
Magnetic Resonance Imaging: Per anatomical region: Left lower-leg
06.52
400.000
13 Mar 2008
Page 117 of 151
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
Anaesthesiology
RVU
Fee
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
RVU
Fee
6238
Magnetic Resonance Imaging: Per anatomical region: Right lower-leg
06.52
400.000
6239
Magnetic Resonance Imaging: Per anatomical region: Left ankle
06.52
400.000
6240
Magnetic Resonance Imaging: Per anatomical region: Right ankle
06.52
400.000
6241
Magnetic Resonance Imaging: Per anatomical region: Left foot
06.52
400.000
6242
Magnetic Resonance Imaging: Per anatomical region: Right foot
06.52
400.000
6250
Magnetic Resonance angiography (See modifiers 6106 to 6108): Brain
06.52
400.000
6251
Magnetic Resonance angiography (See modifiers 6106 to 6108): Large vessels: Neck
06.52
400.000
6252
Magnetic Resonance angiography (See modifiers 6106 to 6108): Large vessels: Chest
06.52
400.000
6253
Magnetic Resonance angiography (See modifiers 6106 to 6108): Large vessels: Abdomen
06.52
400.000
6254
Magnetic Resonance angiography (See modifiers 6106 to 6108): Large vessels: Legs
06.52
400.000
6255
Magnetic Resonance angiography (See modifiers 6106 to 6108): Heart
06.52
400.000
6260
6270
Contrast medium: Current price according the regular price list published by the Radiology Society of SA
06.52
Low field strength peripheral joint magnetic resonance imaging: Low field strength peripheral joint examination (feet,
06.52
70.000
530.40
5.000
knees, hands, and elbows), in dedicated limb units not able to perform body, spine or head examinations
(465.30)
Clinical Pathology
Pathology tests performed by non-pathologists: Where items under Clinical Pathology (section 21) and Anatomical Pathology (section 22) fall within the province of other specialists or general
practitioners, the fee is to be charged at two-thirds of the pathologists fee
Please note: The calculated amounts in this section are calculated according to the clinical pathology unit values.
Note: For fees for Histology and Cytology refer to items 4561-4593 under Section 22: Anatomical Pathology.
Haematology
Alkali resistant haemoglobin
06.52
4.500 36.60 (32.10)
3.000 24.40 (21.40)
Antiglobulin test (Coombs' or trypsinzied red cells)
06.52
3.650 29.70 (26.10)
2.450 19.90 (17.50)
Antibody titration
06.52
7.200 58.50 (51.30)
4.800 39.00 (34.20)
Arneth count
06.52
2.250 18.30 (16.10)
1.500 12.20 (10.70)
Antibody identification
06.52
8.450 68.70 (60.30)
5.650 45.90 (40.30)
Bleeding time (does not include the cost of the simplate device)
06.52
6.940 56.40 (49.50)
4.630 37.60 (33.00)
Blood volume, dye method
06.52
7.200 58.50 (51.30)
4.800 39.00 (34.20)
Buffy layer examination
06.52
19.900
161.70 13.270
107.80
(141.80)
(94.60)
Mean Cell Volume
06.52
2.250
1.500
Bone marrow cytological examination only
06.52
19.900
161.70 13.270
107.80
(141.80)
(94.60)
Bone marrow: Aspiration
06.52
8.400 68.30 (59.90)
5.600 45.50 (39.90)
21
0097
21.1
3705
3709
3710
3711
3712
3713
3714
3715
3716
3717
3719
13 Mar 2008
Page 118 of 151
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
3030.80
(2658.60)
Anaesthesiology
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
220.60
(193.50)
06.52
06.52
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3720
Bone marrow trephine biopsy
06.52
32.600
3721
Bone marrow aspiration and trephine biopsy (excluding histology)
06.52
36.800
3722
3723
3724
Capillary fragility: Hess
Circulating anticoagulants
Coagulation factor inhibitor assay
06.52
06.52
06.52
2.020
5.850
57.560
3726
Activated protein C resistance
06.52
26.000
3727
3728
Coagulation time
Anti-factor Xa Activity
06.52
06.52
3.160
53.600
3729
3730
Cold agglutinins
Protein S: Functional
06.52
06.52
3.600
37.500
3731
3732
3734
Compatibility for blood transfusion
Cryoglobulin
Protein C (chromogenic)
06.52
06.52
06.52
3.600
3.600
30.290
3735
Anti-thrombin III (chromogenic)
06.52
22.000
3736
Plasminogen (chromogenic)
06.52
61.650
3737
Lupus Russel Viper method
06.52
17.000
3738
Lupus Kaolin Exner method
06.52
25.000
3739
3740
3741
3742
3743
3744
3746
3748
Erythrocyte count
Factors V and VII: Qualitative
Coagulation factor assay: Functional
Coagulation factor assay: Immunological
Erythrocyte sedimentation rate
Fibrin stabilizing factor (urea test)
Fibrin monomers
Plasminogen activator inhibitor (PAI-I)
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
2.250
7.200
9.450
4.500
3.000
4.500
2.700
65.950
3750
Tissue plasminogen Activator (tPA)
06.52
67.790
3751
3752
3753
Osmotic fragility (screen)
Osmotic fragility test: Quantitative
Osmotic fragility (before and after incubation)
06.52
06.52
06.52
2.250
10.000
18.000
13 Mar 2008
Page 119 of 151
Fee
264.90
(232.40)
299.00
(262.30)
16.40 (14.40)
47.50 (41.70)
467.70
(410.30)
211.30
(185.40)
25.70 (22.50)
435.50
(382.00)
29.30 (25.70)
304.70
(267.30)
29.30 (25.70)
29.30 (25.70)
246.10
(215.90)
178.80
(156.80)
500.90
(439.40)
138.10
(121.10)
203.10
(178.20)
18.30 (16.10)
58.50 (51.30)
76.80 (67.40)
36.60 (32.10)
24.40 (21.40)
36.60 (32.10)
21.90 (19.20)
535.80
(470.00)
550.80
(483.20)
18.30 (16.10)
81.30 (71.30)
146.30
(128.30)
General Practitioners
/ non-designated
Specialists
RVU
Fee
21.700
24.500
1.350
3.900
38.370
17.300
2.110
35.730
2.400
25.000
2.400
2.400
20.190
14.700
41.100
11.300
16.700
1.500
4.800
6.300
3.000
2.000
3.000
1.800
43.970
45.190
1.500
6.650
12.000
Anaesthesiology
RVU
Fee
176.30
(154.60)
199.10
(174.60)
11.00 (9.65)
31.70 (27.80)
311.80
(273.50)
140.60
(123.30)
17.10 (15.00)
290.30
(254.60)
19.50 (17.10)
203.10
(178.20)
19.50 (17.10)
19.50 (17.10)
164.00
(143.90)
119.40
(104.70)
333.90
(292.90)
91.80 (80.50)
135.70
(119.00)
12.20 (10.70)
39.00 (34.20)
51.20 (44.90)
24.40 (21.40)
16.30 (14.30)
24.40 (21.40)
14.60 (12.80)
357.30
(313.40)
367.20
(322.10)
12.20 (10.70)
54.00 (47.40)
97.50 (85.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3754
3755
3756
3757
ABO Reverse Group
Full blood count (including items 3739, 3762, 3783, 3785, 3791)
Full cross match
Coagulation factors: Quantitative
06.52
06.52
06.52
06.52
3758
Factor VIII related antigen
06.52
3759
3761
Coagulation factor correction study
Factor XIII related antigen
06.52
06.52
3762
3763
Haemoglobin estimation
Contact activated product assay
06.52
06.52
3764
3765
3766
Grouping: A B and O antigens
Grouping: Rh antigen
PIVKA
06.52
06.52
06.52
3767
Euglobulin Lysis time
06.52
3768
Haemoglobin A2 (column chromatography)
06.52
3769
Haemoglobin electrophoresis
06.52
3770
3771
3772
3773
3775
3776
3781
3783
3785
3786
Haemoglobin-S (solubility test)
Factor III-availability test
Haptoglobin: Quantitative
Ham's acidified serum test
Heinz bodies
Haemosiderin in urinary sediment
Heparin tolerance
Leucocyte differential count
Leucocytes: Total count
QBC malaria concentration and fluorescent staining
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
3787
3789
LE-cells
Neutrophil alkaline phosphatase
06.52
06.52
3791
3792
3793
3794
Packed cell volume: Haematocrit
Plasmodium falciparum: Monoclonal immunological identification
Plasma haemoglobin
Platelet sensitivities
06.52
06.52
06.52
06.52
3795
Platelet aggregation per aggregant
06.52
13 Mar 2008
Page 120 of 151
Fee
5.500
10.500 85.30 (74.80)
7.200 58.50 (51.30)
32.200
261.60
(229.50)
60.460
491.20
(430.90)
11.720 95.20 (83.50)
61.110
496.50
(435.50)
1.800 14.60 (12.80)
16.200
131.60
(115.40)
3.600 29.30 (25.70)
3.600 29.30 (25.70)
43.490
353.40
(310.00)
25.580
207.80
(182.30)
15.000
121.90
(106.90)
26.820
217.90
(191.10)
3.600 29.30 (25.70)
5.850 47.50 (41.70)
9.450 76.80 (67.40)
8.000 65.00 (57.00)
2.250 18.30 (16.10)
2.250 18.30 (16.10)
7.200 58.50 (51.30)
6.200 50.40 (44.20)
1.800 14.60 (12.80)
25.000
203.10
(178.20)
8.300 67.40 (59.10)
28.000
227.50
(199.60)
1.800 14.60 (12.80)
9.000 73.10 (64.10)
6.750 54.80 (48.10)
18.640
151.50
(132.90)
12.140 98.60 (86.50)
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
3.670
7.000 56.90 (49.90)
4.800 39.00 (34.20)
21.470
174.40
(153.00)
40.310
327.50
(287.30)
7.810 63.50 (55.70)
40.740
331.00
(290.40)
1.200
9.75 (8.55)
10.800 87.80 (77.00)
2.400 19.50 (17.10)
2.400 19.50 (17.10)
28.990
235.50
(206.60)
17.050
138.50
(121.50)
10.000 81.30 (71.30)
17.880
2.400
3.900
6.300
5.330
1.500
1.500
4.800
4.150
1.200
16.700
5.550
18.700
1.200
6.000
4.500
12.430
8.090
145.30
(127.50)
19.50 (17.10)
31.70 (27.80)
51.20 (44.90)
43.30 (38.00)
12.20 (10.70)
12.20 (10.70)
39.00 (34.20)
33.70 (29.60)
9.75 (8.55)
135.70
(119.00)
45.10 (39.60)
151.90
(133.20)
9.75 (8.55)
48.80 (42.80)
36.60 (32.10)
101.00
(88.60)
65.70 (57.60)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3796
3797
3799
3801
3803
3805
3806
3807
3809
3810
3811
3814
3816
Platelet antibodies: Agglutination
Platelet count
Platelet adhesiveness
Prothrombin consumption
Prothrombin determination (two stages)
Prothrombin index
Therapeutic drug level: Dosage
Recalcification time
Reticulocyte count
Schumm's test
Sickling test
Sucrose lysis test for PNH
T and B-cells EAC markers (limited to ONE marker only for CD4/8 counts)
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
5.400
2.250
4.500
5.850
5.850
6.000
4.500
2.250
3.000
3.600
2.250
3.600
21.100
3820
Thrombo - Elastogram
06.52
26.000
3825
3829
3830
Fibrinogen titre
Glucose 6-phosphate-dehydrogenase: Qualitative
Glucose 6-phosphate-dehydrogenase: Quantitative
06.52
06.52
06.52
3.600
8.000
16.000
3832
Red cell pyruvate kinase: Quantitative
06.52
16.000
3834
3835
3837
3841
3843
3847
3851
3853
3854
3855
3856
Red cell Rhesus phenotype
Haemoglobin F in blood smear
Partial thromboplastin time
Thrombin time (screen)
Thrombin time (serial)
Haemoglobin H
Fibrin degeneration products (diffusion plate)
Fibrin degeneration products (latex slide)
XDP (Dimer test or equivalent latex slide test)
Haemagglutination inhibition
D-Dimer (quantitative)
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
9.900
5.850
5.850
7.160
7.650
2.250
10.350
4.500
8.500
9.900
27.520
3857
Ristocetin Cofactor
06.52
35.530
3858
Heparin removal
06.52
28.880
21.2
3863
Microscopic and miscellaneous tests
Autogenous vaccine
06.52
12.600
3864
Entomological examination
06.52
20.700
13 Mar 2008
Page 121 of 151
Fee
43.90 (38.50)
18.30 (16.10)
36.60 (32.10)
47.50 (41.70)
47.50 (41.70)
48.80 (42.80)
36.60 (32.10)
18.30 (16.10)
24.40 (21.40)
29.30 (25.70)
18.30 (16.10)
29.30 (25.70)
171.40
(150.40)
211.30
(185.40)
29.30 (25.70)
65.00 (57.00)
130.00
(114.00)
130.00
(114.00)
80.40 (70.50)
47.50 (41.70)
47.50 (41.70)
58.20 (51.10)
62.20 (54.60)
18.30 (16.10)
84.10 (73.80)
36.60 (32.10)
69.10 (60.60)
80.40 (70.50)
223.60
(196.10)
288.70
(253.20)
234.70
(205.90)
102.40
(89.80)
168.20
(147.50)
General Practitioners
/ non-designated
Specialists
RVU
Fee
3.600
1.500
3.000
3.900
3.900
4.000
3.000
1.500
2.000
2.400
1.500
2.400
14.070
17.330
2.400
5.330
10.700
Anaesthesiology
RVU
Fee
29.30 (25.70)
12.20 (10.70)
24.40 (21.40)
31.70 (27.80)
31.70 (27.80)
32.50 (28.50)
24.40 (21.40)
12.20 (10.70)
16.30 (14.30)
19.50 (17.10)
12.20 (10.70)
19.50 (17.10)
114.30
(100.30)
140.80
(123.50)
19.50 (17.10)
43.30 (38.00)
86.90 (76.20)
10.700 86.90 (76.20)
6.600
3.900
3.900
4.770
5.100
1.500
6.900
3.000
5.670
6.600
18.350
53.60 (47.00)
31.70 (27.80)
31.70 (27.80)
38.80 (34.00)
41.40 (36.30)
12.20 (10.70)
56.10 (49.20)
24.40 (21.40)
46.10 (40.40)
53.60 (47.00)
149.10
(130.80)
23.690
192.50
(168.90)
19.250
156.40
(137.20)
8.400 68.30 (59.90)
13.800
112.10
(98.30)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
3865
3867
3868
3869
3873
Parasites in blood smear
Miscellaneous (body fluids, urine, exudate, fungi, puss, scrapings, etc.)
Fungus identification
Faeces (including parasites)
Transmission electron microscopy
06.52
06.52
06.52
06.52
06.52
5.600
4.900
8.300
4.900
85.000
3874
Scanning electron microscopy
06.52
100.000
3875
3878
3879
3880
3881
3882
3883
3884
3885
21.3
3887
3888
3889
Inclusion bodies
Crystal identification polarized light microscopy
Campylobacter in stool: Fastidious culture
Antigen detection with polyclonal antibodies
Mycobacteria
Antigen detection with monoclonal antibodies
Concentration techniques for parasites
Dark field, phase or interference contrast microscopy, Nomarski or Fontana
Cytochemical stain
Bacteriology
Antibiotic susceptibility test: Per organism
Adhesive tape preparation
Clostridium difficile toxin: Monoclonal immunological
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
4.500
4.500
9.900
4.500
3.000
10.800
3.000
6.300
5.450
06.52
06.52
06.52
3890
Antibiotic assay of tissues and fluids
06.52
3891
3892
3893
3894
3895
3896
Blood culture: Aerobic
Blood culture: Anaerobic
Bacteriological culture: Miscellaneous
Radiometric blood culture
Bacteriological culture: Fastidious organisms
In vivo culture: Bacteria
06.52
06.52
06.52
06.52
06.52
06.52
3897
In vivo culture: Virus
06.52
3898
3899
Bacterial exotoxin production (in vitro assay)
Bacterial exotoxin production (in vivo assay)
06.52
06.52
3901
3902
Fungal culture
Clostridium difficile (cytotoxicity neutralisation)
06.52
06.52
3903
3904
3905
Antibiotic level: Biological fluids
Rotavirus latex slide test
Identification of virus or rickettsia
06.52
06.52
06.52
8.000 65.00 (57.00)
2.700 21.90 (19.20)
12.400
100.80
(88.40)
13.900
112.90
(99.00)
5.850 47.50 (41.70)
5.850 47.50 (41.70)
6.300 51.20 (44.90)
10.800 87.80 (77.00)
9.900 80.40 (70.50)
16.000
130.00
(114.00)
16.000
130.00
(114.00)
4.500 36.60 (32.10)
20.700
168.20
(147.50)
4.500 36.60 (32.10)
30.000
243.80
(213.90)
11.700 95.10 (83.40)
5.620 45.70 (40.10)
20.700
168.20
(147.50)
13 Mar 2008
Page 122 of 151
45.50 (39.90)
39.80 (34.90)
67.40 (59.10)
39.80 (34.90)
690.60
(605.80)
812.50
(712.70)
36.60 (32.10)
36.60 (32.10)
80.40 (70.50)
36.60 (32.10)
24.40 (21.40)
87.80 (77.00)
24.40 (21.40)
51.20 (44.90)
44.30 (38.90)
General Practitioners
/ non-designated
Specialists
RVU
Fee
3.730
3.300
5.500
3.270
57.000
67.000
3.000
3.000
6.600
3.000
2.000
7.200
2.000
4.200
3.650
Anaesthesiology
RVU
Fee
30.30 (26.60)
26.80 (23.50)
44.70 (39.20)
26.60 (23.30)
463.10
(406.20)
544.40
(477.50)
24.40 (21.40)
24.40 (21.40)
53.60 (47.00)
24.40 (21.40)
16.30 (14.30)
58.50 (51.30)
16.30 (14.30)
34.10 (29.90)
29.70 (26.10)
5.330 43.30 (38.00)
1.800 14.60 (12.80)
8.270 67.20 (58.90)
9.270 75.30 (66.10)
3.900
3.900
4.200
7.200
6.600
10.650
31.70 (27.80)
31.70 (27.80)
34.10 (29.90)
58.50 (51.30)
53.60 (47.00)
86.50 (75.90)
10.650 86.50 (75.90)
3.000 24.40 (21.40)
13.800
112.10
(98.30)
3.000 24.40 (21.40)
20.000
162.50
(142.50)
7.800 63.40 (55.60)
3.750 30.50 (26.80)
13.800
112.10
(98.30)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3906
Identification: Chlamydia
06.52
16.000
3907
3908
3909
3911
3914
3915
3916
3917
3918
3919
3920
3921
Culture for staphylococcus aureus
Anaerobe culture: Comprehensive
Anaerobe culture: Limited procedure
Beta-lactamase assay
Sterility control test: Biological method
Mycobacterium culture
Radiometric tuberculosis culture
Mycoplasma culture: Limited
Mycoplasma culture: Comprehensive
Identification of mycobacterium
Mycobacterium: Antibiotic sensitivity
Antibiotic synergistic study
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
2.250
9.900
4.500
4.500
4.500
4.500
10.800
2.250
9.900
9.900
9.900
20.700
3922
3923
3924
Viable cell count
Biochemical identification of bacterium: Abridged
Biochemical identification of bacterium: Extended
06.52
06.52
06.52
1.350
3.150
12.500
3925
3926
3927
3928
3929
Serological identification of bacterium: Abridged
Serological identification of bacterium: Extended
Grouping for streptococci
Antimicrobic substances
Radiometric mycobacterium identification
06.52
06.52
06.52
06.52
06.52
3.150
10.200
7.300
3.800
14.000
3930
Radiometric mycobacterium antibiotic sensitivity
06.52
25.000
3931
Helicobacter: Monoclonal immunological
06.52
12.400
4650
4651
Antibiotic MIC per organism per antibiotic
Non-radiometric automated blood cultures
06.52
06.52
8.000
13.900
4652
Rapid automated bacterial identification per organism
06.52
15.000
4653
Rapid automated antibiotic susceptibility per organism
06.52
17.000
4654
Rapid automated MIC per organism per antibiotic
06.52
17.000
4655
Mycobacteria: MIC determination - E Test
06.52
16.500
4656
Mycobacteria: Identification HPLC
06.52
35.000
4657
Mycobacteria: Liquefied, consentrated, fluorochrome stain
06.52
9.900
13 Mar 2008
Page 123 of 151
Fee
130.00
(114.00)
18.30 (16.10)
80.40 (70.50)
36.60 (32.10)
36.60 (32.10)
36.60 (32.10)
36.60 (32.10)
87.80 (77.00)
18.30 (16.10)
80.40 (70.50)
80.40 (70.50)
80.40 (70.50)
168.20
(147.50)
11.00 (9.65)
25.60 (22.50)
101.60
(89.10)
25.60 (22.50)
82.90 (72.70)
59.30 (52.00)
30.90 (27.10)
113.80
(99.80)
203.10
(178.20)
100.80
(88.40)
65.00 (57.00)
112.90
(99.00)
121.90
(106.90)
138.10
(121.10)
138.10
(121.10)
134.10
(117.60)
284.40
(249.50)
80.40 (70.50)
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
10.650 86.50 (75.90)
1.500
6.600
3.000
3.000
3.000
3.000
7.200
1.500
6.600
6.600
6.600
13.800
12.20 (10.70)
53.60 (47.00)
24.40 (21.40)
24.40 (21.40)
24.40 (21.40)
24.40 (21.40)
58.50 (51.30)
12.20 (10.70)
53.60 (47.00)
53.60 (47.00)
53.60 (47.00)
112.10
(98.30)
0.900
7.31 (6.41)
2.100 17.10 (15.00)
8.330 67.70 (59.40)
2.100
6.800
4.850
2.500
9.300
17.10 (15.00)
55.30 (48.50)
39.40 (34.60)
20.30 (17.80)
75.60 (66.30)
16.700
135.70
(119.00)
8.270 67.20 (58.90)
5.330 43.30 (38.00)
9.270 75.30 (66.10)
10.000 81.30 (71.30)
11.330 92.10 (80.80)
11.330 92.10 (80.80)
11.000 89.40 (78.40)
23.330
189.60
(166.30)
6.600 53.60 (47.00)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
21.4
3958
Serology
Anti Gad/Ia2 Ab
06.52
67.950
3959
3960
3961
3962
3963
3965
Rose Waaler agglutination test
Gonococcal, listeria or echinococcus agglutination
Slide agglutination test
Rebuck skin window
Serum complement level: Each component
Anti Ia2 Antibodies
06.52
06.52
06.52
06.52
06.52
06.52
4.500
9.500
2.630
5.400
3.150
36.000
3966
Anti Gad Antibodies
06.52
36.000
3967
3968
Auto-antibody: Sensitized erythrocytes
Herpes virus typing: Monoclonal immunological
06.52
06.52
4.500
20.690
3969
Western blot technique
06.52
74.000
3970
3932
Epstein-Barr virus antibody titer
Antibodies to human immunodeficiency virus (HIV): ELISA
06.52
06.52
6.750
14.100
3933
3934
IgE: Total: EMIT or ELISA
Auto antibodies by labelled antibodies
06.52
06.52
11.700
16.000
3935
Sperm antibodies
06.52
16.000
3936
Virus neutralisation test: First antibody
06.52
75.000
3937
Virus neutralisation test: Each additional antibody
06.52
15.000
3938
3939
3940
3941
3942
3943
3944
Precipitation test per antigen
Agglutination test per antigen
Haemagglutination test: Per antigen
Modified Coombs' test for brucellosis
Hepatitis Rapid Viral Ab
Antibody titer to bacterial exotoxin
IgE: Specific antibody titer: ELISA/EMIT: Per Ag
06.52
06.52
06.52
06.52
06.52
06.52
06.52
4.500
5.500
9.900
4.500
12.240
3.600
12.400
3945
3946
Complement fixation test
IgM: Specific antibody titer:ELISA/EMIT: Per Ag
06.52
06.52
5.850
14.050
3947
3948
C-reactive protein
IgG: Specific antibody titer: ELISA/EMIT: Per Ag
06.52
06.52
10.840
12.950
13 Mar 2008
Page 124 of 151
Fee
552.10
(484.30)
36.60 (32.10)
77.20 (67.70)
21.40 (18.80)
43.90 (38.50)
25.60 (22.50)
292.50
(256.60)
292.50
(256.60)
36.60 (32.10)
168.10
(147.50)
601.30
(527.50)
54.80 (48.10)
114.60
(100.50)
95.10 (83.40)
130.00
(114.00)
130.00
(114.00)
609.40
(534.60)
121.90
(106.90)
36.60 (32.10)
44.70 (39.20)
80.40 (70.50)
36.60 (32.10)
99.50 (87.30)
29.30 (25.70)
100.80
(88.40)
47.50 (41.70)
114.20
(100.20)
88.10 (77.30)
105.20
(92.30)
General Practitioners
/ non-designated
Specialists
RVU
Fee
45.300
3.000
6.300
1.750
3.600
2.100
24.000
24.000
3.000
13.790
49.000
4.500
9.400
Anaesthesiology
RVU
Fee
368.10
(322.90)
24.40 (21.40)
51.20 (44.90)
14.20 (12.50)
29.30 (25.70)
17.10 (15.00)
195.00
(171.10)
195.00
(171.10)
24.40 (21.40)
112.00
(98.20)
398.10
(349.20)
36.60 (32.10)
76.40 (67.00)
7.800 63.40 (55.60)
10.650 86.50 (75.90)
10.650 86.50 (75.90)
50.000
406.30
(356.40)
10.000 81.30 (71.30)
3.000
3.670
6.600
3.000
8.160
2.400
8.270
24.40 (21.40)
29.80 (26.10)
53.60 (47.00)
24.40 (21.40)
66.30 (58.20)
19.50 (17.10)
67.20 (58.90)
3.900 31.70 (27.80)
9.370 76.10 (66.80)
7.227 58.70 (51.50)
8.630 70.10 (61.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3949
3950
Qualitative Kahn, VDRL or other flocculation
Neutrophil phagocytosis
06.52
06.52
3951
3952
Quantitative Kahn, VDRL or other flocculation
Neutrophil chemotaxis
06.52
06.52
3953
3955
3956
3957
3971
3972
Tube agglutination test
Paul Bunnell: Presumptive
Infectious mononucleosis latex slide test (Monospot or equivalent)
Paul Bunnell: Absorption
Immuno-diffusion test: Per antigen
Respiratory syncytial virus (ELISA technique)
06.52
06.52
06.52
06.52
06.52
06.52
3973
3974
Immuno electrophoresis: Per immune serum
Polymerase chain reaction
06.52
06.52
3975
3977
3978
Indirect immuno-fluorescence test (bacterial, viral, parasitic)
Counter immuno-electrophoresis
Lymphocyte transformation
06.52
06.52
06.52
3980
Bilharzia Ag Serum/Urine
06.52
3982
Histone Ab
06.52
4600
Anti-CCP
06.52
4601
Panel typing: Antibody detection: Class I
06.52
4602
Panel typing: Antibody detection: Class II
06.52
4603
HLA test for specific locus/antigen - serology
06.52
4604
HLA typing: Class I - serology
06.52
4605
HLA typing: Class II - serology
06.52
4606
HLA typing: Class I & II - serology
06.52
4607
Cross matching T-cells (per tray)
06.52
4608
Cross matching B-cells
06.52
4609
Cross matching T- & B-cells
06.52
13 Mar 2008
Page 125 of 151
Fee
2.250 18.30 (16.10)
25.200
204.80
(179.60)
3.600 29.30 (25.70)
67.950
552.10
(484.30)
4.150 33.70 (29.60)
2.250 18.30 (16.10)
8.500 69.10 (60.60)
4.500 36.60 (32.10)
3.150 25.60 (22.50)
35.000
284.40
(249.50)
9.450 76.80 (67.40)
75.000
609.40
(534.60)
12.000 97.50 (85.50)
6.750 54.80 (48.10)
51.700
420.10
(368.50)
14.500
117.80
(103.30)
16.000
130.00
(114.00)
17.460
141.90
(124.50)
36.000
292.50
(256.60)
44.000
357.50
(313.60)
27.000
219.40
(192.50)
52.000
422.50
(370.60)
52.000
422.50
(370.60)
90.000
731.30
(641.50)
18.000
146.30
(128.30)
38.000
308.80
(270.90)
48.000
390.00
(342.10)
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
1.500 12.20 (10.70)
16.800
136.50
(119.70)
2.400 19.50 (17.10)
45.300
368.10
(322.90)
2.760 22.40 (19.60)
1.500 12.20 (10.70)
5.670 46.10 (40.40)
3.000 24.40 (21.40)
2.100 17.10 (15.00)
23.000
186.90
(163.90)
6.300 51.20 (44.90)
50.000
406.30
(356.40)
8.000 65.00 (57.00)
4.500 36.60 (32.10)
34.500
280.30
(245.90)
9.670 78.60 (68.90)
10.670 86.70 (76.10)
11.640 94.60 (83.00)
24.000
29.300
18.000
34.700
34.700
60.000
12.000
25.300
32.000
195.00
(171.10)
238.10
(208.90)
146.30
(128.30)
281.90
(247.30)
281.90
(247.30)
487.50
(427.60)
97.50 (85.50)
205.60
(180.40)
260.00
(228.10)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
4610
Helicobacter: Pylori antigen test
06.52
34.600
4611
Erythropoietin
06.52
20.000
4612
HTLV I/II
06.52
20.000
4613
Anti-Gm1 Antibody Assay
06.52
75.000
4614
21.5
21.6
3991
3993
3995
3996
3997
3998
HIV Ab - Rapid Test
Skin tests
Biochemical tests: Blood
Abnormal pigments: Qualitative
Abnormal pigments: Quantitative
Acid phosphate
Serum Amyloid A
Acid phosphatase fractionation
Amino acids Quantitative (Post derivatisation HPLC)
06.52
12.000
06.52
06.52
06.52
06.52
06.52
06.52
4.500
9.000
5.180
8.280
1.800
78.120
3999
4000
Albumin
Alcohol
06.52
06.52
4.800
12.400
4001
4002
4003
4004
4005
4006
4007
Alkaline phosphatase
Alkaline phosphatase-iso-enzymes
Ammonia: Enzymatic
Ammonia: Monitor
Alpha-1-antitrypsin: Total
Amylase
Arsenic in blood, hair or nails
06.52
06.52
06.52
06.52
06.52
06.52
06.52
5.180
11.700
7.710
4.500
7.200
5.180
36.250
4008
4009
4010
4011
Bilirubin - Reflectance
Bilirubin: Total
Bilirubin: Conjugated
Breath Hydrogen Test
06.52
06.52
06.52
06.52
4.770
4.770
3.620
21.560
4012
CSF Nicotinic Acid
06.52
12.420
4013
4014
CSF Glutamine
Cadmium: Atomic absorption
06.52
06.52
11.250
18.120
4016
4017
4018
4019
Calcium: Ionized
Calcium: Spectrophotometric
Calcium: Atomic absorption
Carotene
06.52
06.52
06.52
06.52
6.750
3.620
7.250
2.250
13 Mar 2008
Page 126 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
281.10
(246.60)
162.50
(142.50)
162.50
(142.50)
609.40
(534.60)
97.50 (85.50)
23.070
36.60 (32.10)
73.10 (64.10)
42.10 (36.90)
67.30 (59.00)
14.60 (12.80)
634.70
(556.80)
39.00 (34.20)
100.80
(88.40)
42.10 (36.90)
95.10 (83.40)
62.60 (54.90)
36.60 (32.10)
58.50 (51.30)
42.10 (36.90)
294.50
(258.30)
38.80 (34.00)
38.80 (34.00)
29.40 (25.80)
175.20
(153.70)
100.90
(88.50)
91.40 (80.20)
147.20
(129.10)
54.80 (48.10)
29.40 (25.80)
58.90 (51.70)
18.30 (16.10)
3.000
6.000
3.450
5.520
1.200
52.080
13.330
13.330
50.000
8.000
Anaesthesiology
RVU
Fee
187.40
(164.40)
108.30
(95.00)
108.30
(95.00)
406.30
(356.40)
65.00 (57.00)
24.40 (21.40)
48.80 (42.80)
28.00 (24.60)
44.90 (39.40)
9.75 (8.55)
423.20
(371.20)
3.200 26.00 (22.80)
8.270 67.20 (58.90)
3.450
7.800
5.140
3.000
4.800
3.450
24.170
3.180
3.180
2.410
14.370
8.280
28.00 (24.60)
63.40 (55.60)
41.80 (36.70)
24.40 (21.40)
39.00 (34.20)
28.00 (24.60)
196.40
(172.30)
25.80 (22.60)
25.80 (22.60)
19.60 (17.20)
116.80
(102.50)
67.30 (59.00)
7.500 60.90 (53.40)
12.080 98.20 (86.10)
4.500
2.410
4.830
1.500
36.60 (32.10)
19.60 (17.20)
39.20 (34.40)
12.20 (10.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
4020
4021
Carnitine (Total or free) in biological fluid: Each
Carnitine (Total or free) in muscle: Each
06.52
06.52
4022
Acyl Carnitine
06.52
4023
4025
Chloride
Chol/HDL/LDL/Trig
06.52
06.52
4026
4027
4028
4029
4030
4031
4032
4033
4034
4035
4036
LDL cholesterol (chemical determination)
Cholesterol total
HDL cholesterol
Cholinesterase: Serum or erythrocyte: Each
Cholinesterase phenotype (Dibucaine or fluoride each)
Total CO2
Creatinine
CSF-Immunoglobulin G
C1-Esterase Inhibitor
CSF-Albumin
CSF-IgG Index
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
4038
Glutamic acid
06.52
4040
Homocysteine (random)
06.52
4041
Homocysteine (after Methionine load)
06.52
4042
D-Xylose absorption test: Two hours
06.52
4045
4047
Fibrinogen: Quantitative
Hollander test
06.52
06.52
4049
4050
4051
4052
Glucose tolerance test (2 specimens)
Glucose strip-test with photometric reading
Galactose
Glucose tolerance test (3 specimens)
06.52
06.52
06.52
06.52
4053
Glucose tolerance test (4 specimens)
06.52
4057
4061
Glucose: Quantitative
Glucose tolerance test (5 specimens)
06.52
06.52
4062
Galactose-1-phosphate uridyl transferase
06.52
13 Mar 2008
Page 127 of 151
Fee
11.690 95.00 (83.30)
23.380
190.00
(166.70)
23.380
190.00
(166.70)
2.590 21.00 (18.40)
27.070
219.90
(192.90)
6.900 56.10 (49.20)
5.340 43.40 (38.10)
6.900 56.10 (49.20)
7.480 60.80 (53.30)
9.000 73.10 (64.10)
5.180 42.10 (36.90)
3.620 29.40 (25.80)
9.450 76.80 (67.40)
9.450 76.80 (67.40)
9.450 76.80 (67.40)
22.050
179.20
(157.20)
29.060
236.10
(207.10)
15.300
124.30
(109.00)
18.100
147.10
(129.00)
13.150
106.80
(93.70)
3.600 29.30 (25.70)
24.750
201.10
(176.40)
8.970 72.90 (63.90)
1.800 14.60 (12.80)
11.250 91.40 (80.20)
13.170
107.00
(93.90)
17.370
141.10
(123.80)
3.620 29.40 (25.80)
21.560
175.20
(153.70)
16.000
130.00
(114.00)
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
7.790 63.30 (55.50)
15.590
126.70
(111.10)
15.590
126.70
(111.10)
1.730 14.10 (12.40)
18.050
146.70
(128.70)
4.600 37.40 (32.80)
3.560 28.90 (25.40)
4.600 37.40 (32.80)
4.990 40.50 (35.50)
6.000 48.80 (42.80)
3.450 28.00 (24.60)
2.410 19.60 (17.20)
6.300 51.20 (44.90)
6.300 51.20 (44.90)
6.300 51.20 (44.90)
14.700
119.40
(104.70)
19.370
157.40
(138.10)
10.200 82.90 (72.70)
12.060 98.00 (86.00)
8.750 71.10 (62.40)
2.400 19.50 (17.10)
16.500
134.10
(117.60)
5.980 48.60 (42.60)
1.200
9.75 (8.55)
7.500 60.90 (53.40)
8.780 71.30 (62.50)
11.580 94.10 (82.50)
2.410 19.60 (17.20)
14.370
116.80
(102.50)
10.700 86.90 (76.20)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
4063
4064
Fructosamine
HbA1C
06.52
06.52
4066
Immunofixation: Total protein, IgG, IgA, IgM, Kappa, Lambda
06.52
4067
4068
4071
4073
4076
Lithium: Flame ionisation
Lithium: Atomic absorption
Iron
Iron-binding capacity
Blood gases: Astrup/pO2 and ancillary tests - can only be charged to a maximum of 6 times per patient per day
06.52
06.52
06.52
06.52
06.52
4078
4079
4081
4082
Oximetry analysis: MetHb, COHb, O2Hb, RHb, SulfHb
Ketones in plasma: Qualitative
Drug level-biological fluid: Quantitative
Tacrolimus assay
06.52
06.52
06.52
06.52
4083
Lysosomal enzyme assay
06.52
4084
Thymidine kinase
06.52
4085
4086
Lipase
Lactate
06.52
06.52
4091
4092
4093
4094
4095
4096
Lipoprotein electrophoresis
Orosmucoid
Osmolality: Serum or urine
Magnesium: Spectrophotometric
Magnesium: Atomic absorption
Mercury: Atomic absorption
06.52
06.52
06.52
06.52
06.52
06.52
4098
Copper: Atomic absorption
06.52
4105
4106
Protein electrophoresis
IgG sub-class 1, 2, 3 or 4: Per sub-class
06.52
06.52
4109
4111
4113
4114
4117
4121
4123
4125
Phosphate
Phospholipids
Potassium
Sodium
Protein: Total
pH, pCO2 or pO2: Each
Pyruvic acid
Salicylates
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
13 Mar 2008
Page 128 of 151
Fee
7.200 58.50 (51.30)
14.250
115.80
(101.60)
46.880
380.90
(334.10)
5.180 42.10 (36.90)
7.480 60.80 (53.30)
6.750 54.80 (48.10)
7.650 62.20 (54.60)
19.100
155.20
(136.10)
6.750 54.80 (48.10)
2.250 18.30 (16.10)
10.800 87.80 (77.00)
20.100
163.30
(143.20)
36.560
297.10
(260.60)
20.000
162.50
(142.50)
5.180 42.10 (36.90)
16.000
130.00
(114.00)
9.000 73.10 (64.10)
9.450 76.80 (67.40)
6.750 54.80 (48.10)
3.620 29.40 (25.80)
7.250 58.90 (51.70)
18.120
147.20
(129.10)
18.120
147.20
(129.10)
9.000 73.10 (64.10)
20.000
162.50
(142.50)
3.620 29.40 (25.80)
3.150 25.60 (22.50)
3.620 29.40 (25.80)
3.620 29.40 (25.80)
3.110 25.30 (22.20)
6.750 54.80 (48.10)
4.500 36.60 (32.10)
4.500 36.60 (32.10)
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
4.800 39.00 (34.20)
9.500 77.20 (67.70)
31.250
3.450
10.670
253.90
(222.70)
28.00 (24.60)
40.50 (35.50)
36.60 (32.10)
41.40 (36.30)
103.40
(90.70)
36.60 (32.10)
12.20 (10.70)
58.50 (51.30)
108.90
(95.50)
198.00
(173.70)
108.30
(95.00)
28.00 (24.60)
86.70 (76.10)
6.000
6.300
4.500
2.410
4.830
12.080
48.80 (42.80)
51.20 (44.90)
36.60 (32.10)
19.60 (17.20)
39.20 (34.40)
98.20 (86.10)
3.450
4.990
4.500
5.100
12.730
4.500
1.500
7.200
13.400
24.370
13.330
12.080 98.20 (86.10)
6.000 48.80 (42.80)
13.200
107.30
(94.10)
2.410 19.60 (17.20)
2.100 17.10 (15.00)
2.410 19.60 (17.20)
2.410 19.60 (17.20)
2.070 16.80 (14.70)
4.500 36.60 (32.10)
3.000 24.40 (21.40)
3.000 24.40 (21.40)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
4126
Secretin-pancreozymin response
06.52
26.100
4127
4128
4129
4130
4131
4132
4133
4134
4135
4136
4137
4138
4139
4142
4143
4144
4146
Caeruloplasmin
Phenylalanine: Quantitative
Glutamate dehydrogenase (GDH)
Aspartate aminotransferase (AST)
Alanine aminotransferase (ALT)
Creatine kinase (CK)
Lactate dehidrogenase (LD)
Gamma glutamyl transferase (GGT)
Aldolase
Angiotensin converting enzyme (ACE)
Lactate dehydrogenase isoenzyme
CK-MB: Immunoinhibition/precipitation
Adenosine deaminase
Red cell enzymes: Each
Serum/plasma enzymes
Transferrin
Lead: Atomic absorption
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
4.500
11.250
5.400
5.400
5.400
5.400
5.400
5.400
5.400
9.000
10.800
10.800
5.400
7.800
5.400
11.700
15.000
4147
4148
Triglyceride
Tay - Sachs Study
06.52
06.52
7.930
36.560
4149
4151
4152
Red cell magnesium
Urea
CK-MB: Mass determination: Quantitative (Automated)
06.52
06.52
06.52
11.700
3.620
12.400
4153
CK-MB: Mass determination: Quantitative (Not automated)
06.52
17.470
4154
Myoglobin quantitative: Monoclonal immunological
06.52
12.400
4155
4156
Uric acid
Vitamin D3
06.52
06.52
3.780
12.420
4157
Vitamin A-saturation test
06.52
15.300
4158
4159
4160
4161
Vitamin E (tocopherol)
Vitamin A
Vitamin C (ascorbic acid)
Troponin isoforms: Each
06.52
06.52
06.52
06.52
3.600
6.300
2.250
20.000
4163
4165
Apoprotein AI: Turbidometric method
Apoprotein AII: Turbidometric method
06.52
06.52
8.280
8.280
13 Mar 2008
Page 129 of 151
Fee
212.10
(186.10)
36.60 (32.10)
91.40 (80.20)
43.90 (38.50)
43.90 (38.50)
43.90 (38.50)
43.90 (38.50)
43.90 (38.50)
43.90 (38.50)
43.90 (38.50)
73.10 (64.10)
87.80 (77.00)
87.80 (77.00)
43.90 (38.50)
63.40 (55.60)
43.90 (38.50)
95.10 (83.40)
121.90
(106.90)
64.40 (56.50)
297.10
(260.60)
95.10 (83.40)
29.40 (25.80)
100.80
(88.40)
141.90
(124.50)
100.80
(88.40)
30.70 (26.90)
100.90
(88.50)
124.30
(109.00)
29.30 (25.70)
51.20 (44.90)
18.30 (16.10)
162.50
(142.50)
67.30 (59.00)
67.30 (59.00)
General Practitioners
/ non-designated
Specialists
RVU
Fee
17.400
3.000
7.500
3.600
3.600
3.600
3.600
3.600
3.600
3.600
6.000
7.200
7.200
3.600
5.200
3.600
7.800
10.000
Anaesthesiology
RVU
Fee
141.40
(124.00)
24.40 (21.40)
60.90 (53.40)
29.30 (25.70)
29.30 (25.70)
29.30 (25.70)
29.30 (25.70)
29.30 (25.70)
29.30 (25.70)
29.30 (25.70)
48.80 (42.80)
58.50 (51.30)
58.50 (51.30)
29.30 (25.70)
42.30 (37.10)
29.30 (25.70)
63.40 (55.60)
81.30 (71.30)
5.290 43.00 (37.70)
24.370
198.00
(173.70)
7.800 63.40 (55.60)
2.410 19.60 (17.20)
8.270 67.20 (58.90)
11.650 94.70 (83.10)
8.270 67.20 (58.90)
2.520 20.50 (18.00)
8.280 67.30 (59.00)
10.200 82.90 (72.70)
2.400 19.50 (17.10)
4.200 34.10 (29.90)
1.500 12.20 (10.70)
13.330
108.30
(95.00)
5.520 44.90 (39.40)
5.520 44.90 (39.40)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
4167
4170
Apoprotein B: Turbidometric method
Lipoprotein (a)(Lp(a)) assay
06.52
06.52
4171
Sodium + potassium + chloride + CO2 + urea
06.52
4172
ELISA/EMIT technique
06.52
4173
Sirolimus Assay
06.52
4181
4182
4183
Quantitative protein estimation: Mancini method
Quantitative protein estimation: Nephelometer or Turbidometeric method
Quantitative protein estimation: Labelled antibody
06.52
06.52
06.52
4184
4185
4186
C-reactive protein (Ultra sensitive)
Lactose
Vitamin B6
06.52
06.52
06.52
4187
Zinc: Atomic absorption
06.52
21.7
4188
4189
4193
4194
Biochemical tests: Urine
Urine dipstick, per stick (irrespective of the number of tests on stick)
Abnormal pigments
Alkapton test: Homogentisic acid
Amino acids: Quantitative (Post derivatisation HPLC)
06.52
06.52
06.52
06.52
4195
Amino laevulinic acid
06.52
4197
4198
Amylase
Arsenic
06.52
06.52
4199
4201
4203
4204
4205
4206
Ascorbic acid
Bence-Jones protein
Phenol
Calcium: Atomic absorption
Calcium: Spectrophotometric
Calcium: Absorption and excretion studies
06.52
06.52
06.52
06.52
06.52
06.52
4209
Lead: Atomic absorption
06.52
4210
Urine collagen telopeptides
06.52
4211
4213
Bile pigments: Qualitative
Protein: Quantitative
06.52
06.52
13 Mar 2008
Page 130 of 151
Fee
8.280 67.30 (59.00)
12.420
100.90
(88.50)
15.840
128.70
(112.90)
12.420
100.90
(88.50)
78.000
633.80
(556.00)
7.760 63.10 (55.40)
8.280 67.30 (59.00)
12.420
100.90
(88.50)
11.680 94.90 (83.20)
10.800 87.80 (77.00)
15.300
124.30
(109.00)
18.120
147.20
(129.10)
1.500 12.20 (10.70)
4.500 36.60 (32.10)
4.500 36.60 (32.10)
78.120
634.70
(556.80)
18.000
146.30
(128.30)
5.180 42.10 (36.90)
18.120
147.20
(129.10)
2.250 18.30 (16.10)
2.700 21.90 (19.20)
3.600 29.30 (25.70)
7.250 58.90 (51.70)
3.620 29.40 (25.80)
25.000
203.10
(178.20)
15.000
121.90
(106.90)
36.500
296.60
(260.20)
2.250 18.30 (16.10)
2.250 18.30 (16.10)
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
5.520 44.90 (39.40)
8.280 67.30 (59.00)
10.560 85.80 (75.30)
8.280 67.30 (59.00)
52.000
422.50
(370.60)
5.170 42.00 (36.80)
5.520 44.90 (39.40)
8.280 67.30 (59.00)
7.790 63.30 (55.50)
7.200 58.50 (51.30)
10.200 82.90 (72.70)
12.080 98.20 (86.10)
1.000
8.13 (7.13)
3.000 24.40 (21.40)
3.000 24.40 (21.40)
52.080
423.20
(371.20)
12.000 97.50 (85.50)
3.450 28.00 (24.60)
12.080 98.20 (86.10)
1.500
1.800
2.400
4.830
2.410
16.700
12.20 (10.70)
14.60 (12.80)
19.50 (17.10)
39.20 (34.40)
19.60 (17.20)
135.70
(119.00)
10.000 81.30 (71.30)
24.330
197.70
(173.40)
1.500 12.20 (10.70)
1.500 12.20 (10.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
4216
4217
4218
4219
4220
Mucopolysaccharides: Qualitative
Oxalate
Glucose: Quantitative
Steroids: Chromatography (each)
Klinolab Newborn Screen
06.52
06.52
06.52
06.52
06.52
3.600
9.380
2.250
7.200
36.560
4221
4223
4227
4228
Creatinine
Creatinine clearance
Electrophoresis: Qualitative
Fetal Lung Maturity
06.52
06.52
06.52
06.52
3.620
7.650
4.500
36.560
4229
4230
4231
Uric acid clearance
Urine/Fluid - Specific Gravity
Metabolites HPLC (High Pressure Liquid Chromatography)
06.52
06.52
06.52
7.650
0.900
37.500
4232
Metabolites (Gaschromatography/Mass spectrophotometry)
06.52
46.800
4233
Pharmacological/Drugs of abuse: Metabolites HPLC (High Pressure Liquid Chromatography)
06.52
37.500
4234
Pharmacological/Drugs of abuse: Metabolites (Gaschromatography/Mass spectrophotometry)
06.52
46.800
4237
4238
5-Hydroxy-indole-acetic acid: Screen test
5HIAA (Hplc)
06.52
06.52
2.700
78.120
4239
4247
4248
4251
5-Hydroxy-indole-acetic acid: Quantitative
Ketones: Excluding dip-stick method
Reducing substances
Metanephrines: Column chromatography
06.52
06.52
06.52
06.52
6.750
2.250
1.800
22.050
4252
Metanephrine (Hplc)
06.52
78.120
4253
Aromatic amines (gas chromatography/mass spectrophotometry)
06.52
27.000
4254
4255
4256
Nitrosonaphtol test for tyrosine
Orotic Acid - Urine
Very long Chain Fatty Acids
06.52
06.52
06.52
2.250
9.450
129.380
4261
Micro Albumin: Quantitative
06.52
12.420
4262
4263
4265
4266
Micro Albumin: Qualitative
pH: Excluding dip-stick method
Thin layer chromatography: One way
Thin layer chromatography: Two way
06.52
06.52
06.52
06.52
4.500
0.900
6.750
11.250
13 Mar 2008
Page 131 of 151
Fee
29.30 (25.70)
76.20 (66.80)
18.30 (16.10)
58.50 (51.30)
297.10
(260.60)
29.40 (25.80)
62.20 (54.60)
36.60 (32.10)
297.10
(260.60)
62.20 (54.60)
7.31 (6.41)
304.70
(267.30)
380.30
(333.60)
304.70
(267.30)
380.30
(333.60)
21.90 (19.20)
634.70
(556.80)
54.80 (48.10)
18.30 (16.10)
14.60 (12.80)
179.20
(157.20)
634.70
(556.80)
219.40
(192.50)
18.30 (16.10)
76.80 (67.40)
1051.20
(922.10)
100.90
(88.50)
36.60 (32.10)
7.31 (6.41)
54.80 (48.10)
91.40 (80.20)
General Practitioners
/ non-designated
Specialists
RVU
Fee
2.400
6.250
1.500
4.800
24.370
2.410
5.100
3.000
24.370
5.100
0.600
25.000
31.200
25.000
31.200
1.800
52.080
4.500
1.500
1.200
14.700
52.080
18.000
1.500
6.300
86.250
8.280
Anaesthesiology
RVU
Fee
19.50 (17.10)
50.80 (44.60)
12.20 (10.70)
39.00 (34.20)
198.00
(173.70)
19.60 (17.20)
41.40 (36.30)
24.40 (21.40)
198.00
(173.70)
41.40 (36.30)
4.88 (4.28)
203.10
(178.20)
253.50
(222.40)
203.10
(178.20)
253.50
(222.40)
14.60 (12.80)
423.20
(371.20)
36.60 (32.10)
12.20 (10.70)
9.75 (8.55)
119.40
(104.70)
423.20
(371.20)
146.30
(128.30)
12.20 (10.70)
51.20 (44.90)
700.80
(614.70)
67.30 (59.00)
3.000 24.40 (21.40)
0.600
4.88 (4.28)
4.500 36.60 (32.10)
7.500 60.90 (53.40)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
4267
Total organic matter screen: Infrared
06.52
31.250
4268
Organic acids: Quantitative: GCMS
06.52
109.380
4269
4270
Phenylpyruvic acid: Ferric chloride
Chromium Total Urine
06.52
06.52
2.250
18.120
4271
Phosphate excretion index
06.52
22.050
4272
4273
Porphobilinogen qualitative screen: Urine
Porphobilinogen/ALA: Quantitative each
06.52
06.52
5.000
15.000
4283
4284
4285
4287
4288
4293
4297
4298
Magnesium: Spectrophotometric
Magnesium: Atomic absorption
Identification of carbohydrate
Identification of drug: Qualitative
Identification of drug: Quantitative
Urea clearance
Copper: Spectrophotometric
Copper: Atomic absorption
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
3.620
7.250
7.650
4.500
10.800
5.400
3.620
18.120
4300
4301
4307
Indican or indole: Qualitative
Chloride
Ammonium chloride loading test
06.52
06.52
06.52
3.150
2.590
22.050
4309
4313
4315
4316
4319
4321
4322
4323
4325
4326
Urobilinogen: Quantitative
Phosphates
Potassium
Sodium
Urea
Uric acid
Fluoride
Total protein and protein electrophoresis
VMA: Quantitative
Catecholamines (HPLC)
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
6.750
3.620
3.620
3.620
3.620
3.620
5.180
11.250
11.250
78.120
4327
Immunofixation: Total protein, IgG, IgA, IgM, Kappa, Lambda
06.52
46.880
4328
4335
Immunoglobulin D
Cystine: Quantitative
06.52
06.52
9.450
12.600
4336
Dinitrophenol hydrazine test: Ketoacids
06.52
2.250
13 Mar 2008
Page 132 of 151
Fee
253.90
(222.70)
888.70
(779.60)
18.30 (16.10)
147.20
(129.10)
179.20
(157.20)
40.60 (35.60)
121.90
(106.90)
29.40 (25.80)
58.90 (51.70)
62.20 (54.60)
36.60 (32.10)
87.80 (77.00)
43.90 (38.50)
29.40 (25.80)
147.20
(129.10)
25.60 (22.50)
21.00 (18.40)
179.20
(157.20)
54.80 (48.10)
29.40 (25.80)
29.40 (25.80)
29.40 (25.80)
29.40 (25.80)
29.40 (25.80)
42.10 (36.90)
91.40 (80.20)
91.40 (80.20)
634.70
(556.80)
380.90
(334.10)
76.80 (67.40)
102.40
(89.80)
18.30 (16.10)
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
20.830
169.20
(148.40)
72.920
592.50
(519.70)
1.500 12.20 (10.70)
12.080 98.20 (86.10)
14.700
119.40
(104.70)
3.330 27.10 (23.80)
10.000 81.30 (71.30)
2.410
4.830
5.100
3.000
7.200
3.600
2.410
12.080
19.60 (17.20)
39.20 (34.40)
41.40 (36.30)
24.40 (21.40)
58.50 (51.30)
29.30 (25.70)
19.60 (17.20)
98.20 (86.10)
2.100 17.10 (15.00)
1.730 14.10 (12.40)
14.700
119.40
(104.70)
4.500 36.60 (32.10)
2.410 19.60 (17.20)
2.410 19.60 (17.20)
2.410 19.60 (17.20)
2.410 19.60 (17.20)
2.410 19.60 (17.20)
3.450 28.00 (24.60)
7.500 60.90 (53.40)
7.500 60.90 (53.40)
52.080
423.20
(371.20)
31.250
253.90
(222.70)
6.300 51.20 (44.90)
8.400 68.30 (59.90)
1.500 12.20 (10.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
153.60
(134.70)
General Practitioners
/ non-designated
Specialists
RVU
Fee
4337
Hydroxyproline: Quantitative
06.52
18.900
21.8
4339
4343
4345
Biochemical tests: Faeces
Chloride
Fat: Qualitative
Fat: Quantitative
06.52
06.52
06.52
4347
4351
4352
4357
4358
4359
4361
4362
Ph
Occult blood: Chemical test
Occult blood: Monoclonal antibodies
Potassium
Sodium
Secretory IgA
Stercobilin
Elastase quantitative ELISA
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
4363
4364
21.9
4366
4367
Stercobilinogen: Quantitative
Chymotrypsin determination: Enzymatic
Biochemical tests: Miscellaneous
Porphyrin screen qualitative: Urine, stool, red blood cells: Each
Porphyrin qualitative analysis by TLC: Urine, stool, red blood cells: Each
06.52
06.52
2.590 21.00 (18.40)
3.150 25.60 (22.50)
22.050
179.20
(157.20)
0.900
7.31 (6.41)
2.250 18.30 (16.10)
10.000 81.30 (71.30)
3.620 29.40 (25.80)
3.620 29.40 (25.80)
9.450 76.80 (67.40)
2.250 18.30 (16.10)
47.000
381.90
(335.00)
6.750 54.80 (48.10)
7.470 60.70 (53.20)
1.730 14.10 (12.40)
2.100 17.10 (15.00)
14.700
119.40
(104.70)
0.600
4.88 (4.28)
1.500 12.20 (10.70)
6.670 54.20 (47.50)
2.410 19.60 (17.20)
2.410 19.60 (17.20)
6.300 51.20 (44.90)
1.500 12.20 (10.70)
31.330
254.60
(223.30)
4.500 36.60 (32.10)
4.980 40.50 (35.50)
4368
Porphyrin: Total quantisation: Urine, stool, red blood cells: Each
06.52
4369
Porphyrin quantitative analysis by TLC/HPLC: Urine, stool, red blood cells: Each
06.52
4370
Drug level in biological fluid: Monoclonal immunological
06.52
3.330 27.10 (23.80)
13.330
108.30
(95.00)
13.330
108.30
(95.00)
20.000
162.50
(142.50)
8.270 67.20 (58.90)
4371
4372
Amylase in exudate
Fluoride in biological fluids and water
06.52
06.52
4373
4374
Breast milk analysis
Trace metals in biological fluid: Atomic absorption
06.52
06.52
4375
4376
4377
Calcium in fluid: Spectrophotometric
Calcium in fluid: Atomic absorption
Gallstone analysis: (Bilirubin, Ca, P, Oxalate, Cholesterol)
06.52
06.52
06.52
4378
Urea breath test
06.52
4380
Lecithin in amniotic fluid: L/S ratio
06.52
4381
Lamellar body count in amniotic fluid
06.52
5.000 40.60 (35.60)
20.000
162.50
(142.50)
20.000
162.50
(142.50)
30.000
243.80
(213.90)
12.400
100.80
(88.40)
5.180 42.10 (36.90)
15.620
126.90
(111.30)
6.750 54.80 (48.10)
18.130
147.30
(129.20)
3.620 29.40 (25.80)
7.250 58.90 (51.70)
21.880
177.80
(156.00)
58.000
471.30
(413.40)
27.000
219.40
(192.50)
10.000 81.30 (71.30)
13 Mar 2008
06.52
06.52
Page 133 of 151
12.600
Anaesthesiology
RVU
Fee
102.40
(89.80)
3.450 28.00 (24.60)
10.410 84.60 (74.20)
4.500 36.60 (32.10)
12.090 98.20 (86.10)
2.410 19.60 (17.20)
4.830 39.20 (34.40)
14.590
118.50
(103.90)
38.670
314.20
(275.60)
18.000
146.30
(128.30)
6.700 54.40 (47.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
4382
4386
Bilirubin in amniotic fluid: Spectrophotometric essay
Oestrogen/Progesterone receptors: Fluorescent method
06.52
06.52
4387
Oestrogen/Progesterone receptors: Cytosol radio-isotope technique
06.52
4388
Gastric contents: Maximal stimulation test
06.52
4389
4390
4391
4392
Gastric fluid: Total acid per specimen
Foam test: Amniotic fluid
Renal calculus: Chemistry
Renal calculus: Crystallography
06.52
06.52
06.52
06.52
4393
4394
4395
4396
4397
4399
4400
Saliva: Potassium
Saliva: Sodium
Sweat: Sodium
Sweat: Potassium
Sweat: Chloride
Sweat collection by iontophoresis (excluding collection material)
Tryptophane loading test
06.52
06.52
06.52
06.52
06.52
06.52
06.52
21.10
4401
4407
4409
4415
4416
4417
4419
4421
4423
4425
Cerebrospinal fluid
Cell count
Cell count, protein, glucose and chloride
Chloride
Potassium
Sodium
Protein: Qualitative
Protein: Quantitative
Glucose
Urea
Protein electrophoresis
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
06.52
3.450
7.650
2.590
3.620
3.620
0.900
3.110
3.620
3.620
12.600
28.00 (24.60)
62.20 (54.60)
21.00 (18.40)
29.40 (25.80)
29.40 (25.80)
7.31 (6.41)
25.30 (22.20)
29.40 (25.80)
29.40 (25.80)
102.40
(89.80)
2.300
5.100
1.730
2.410
2.410
0.600
2.070
2.410
2.410
8.400
18.70 (16.40)
41.40 (36.30)
14.10 (12.40)
19.60 (17.20)
19.60 (17.20)
4.88 (4.28)
16.80 (14.70)
19.60 (17.20)
19.60 (17.20)
68.30 (59.90)
21.11 RNA/DNA based tests and andrology
21.11.1 RNA/DNA based tests and andrology: RNA/DNA based tests
4424
HLA test for specific allele DNA-PCR
06.52
36.000
24.000
4426
HLA typing low resolution Class I DNA-PCR per locus
06.52
100.000
4427
HLA typing low resolution Class II DNA-PCR per locus
06.52
74.000
4428
HLA typing high resolution Class I or II DNA-PCR per locus
06.52
66.000
292.50
(256.60)
812.50
(712.70)
601.30
(527.50)
536.30
(470.40)
195.00
(171.10)
544.40
(477.50)
400.60
(351.40)
357.50
(313.60)
13 Mar 2008
Page 134 of 151
Anaesthesiology
RVU
Fee
9.450 76.80 (67.40)
6.300 51.20 (44.90)
20.700
168.20 13.800
112.10
(147.50)
(98.30)
230.000
1868.80 153.000
1243.10
(1639.30)
(1090.40)
27.000
219.40 18.000
146.30
(192.50)
(128.30)
2.250 18.30 (16.10)
1.500 12.20 (10.70)
3.150 25.60 (22.50)
2.100 17.10 (15.00)
5.400 43.90 (38.50)
3.600 29.30 (25.70)
16.250
132.00 10.800 87.80 (77.00)
(115.80)
3.620 29.40 (25.80)
2.410 19.60 (17.20)
3.620 29.40 (25.80)
2.410 19.60 (17.20)
3.620 29.40 (25.80)
2.410 19.60 (17.20)
3.620 29.40 (25.80)
2.410 19.60 (17.20)
2.590 21.00 (18.40)
1.730 14.10 (12.40)
4.500 36.60 (32.10)
3.000 24.40 (21.40)
22.050
179.20 14.700
119.40
(157.20)
(104.70)
67.000
49.300
44.000
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
4429
Quantitative PCR (DNA/RNA)
06.52
84.300
4430
Recombinant DNA technique
06.52
25.000
4431
Ribosomal RNA targeting for bacteriological identification
06.52
35.000
4432
Ribosomal RNA amplification for bacteriological identification
06.52
75.000
4433
Bacteriological DNA identification (LCR)
06.52
25.000
4434
Bacteriological DNA identification (PCR)
06.52
75.000
4439
Quantitative PCR - viral load (not HIV) - hepatitis C, hepatitis B, CMV, etc.
06.52
150.000
21.11.2 RNA/DNA based tests and andrology: Andrology
4435
Mixed antiglobulin reaction: Semen
4436
Friberg test: Semen
06.52
06.52
4437
4440
4441
4442
4443
4445
Kremer test: Semen
Semen analysis: Cell count
Semen analysis: Cytology
Semen analysis: Viability + motility - 6 hours
Semen analysis: Supravital stain
Seminal fluid: Alpha glucosidase
06.52
06.52
06.52
06.52
06.52
06.52
4446
4447
21.12
4448
4449
4450
4451
Seminal fluid fructose
Seminal fluid: Acid phosphatase
Immunology
HCG: Latex agglutination: Qualitative (side room)
HCG: Latex agglutination: Semi-quantitative (side room)
HCG: Monoclonal immunological: Qualitative
HCG: Monoclonal immunological: Quantitative
06.52
06.52
4452
Bone Specific Alk Phosphatase
06.52
4455
Anti IgE receptor antibody test (10 samples and dilution)
06.52
4456
Eosinophil cationic protein
06.52
4457
Mast cell tryptase
06.52
4458
Micro-albuminuria: Radio-isotope method
06.52
13 Mar 2008
06.52
06.52
06.52
06.52
Page 135 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
684.90 56.200
(600.80)
203.10 16.670
(178.20)
284.40 23.330
(249.50)
609.40 50.000
(534.60)
203.10 16.670
(178.20)
609.40 50.000
(534.60)
1218.80 100.000
(1069.10)
6.600 53.60 (47.00)
14.500
117.80
(103.30)
3.600 29.30 (25.70)
7.650 62.20 (54.60)
7.200 58.50 (51.30)
6.000 48.80 (42.80)
5.440 44.20 (38.80)
20.000
162.50
(142.50)
3.150 25.60 (22.50)
5.180 42.10 (36.90)
Anaesthesiology
RVU
Fee
456.60
(400.50)
135.40
(118.80)
189.60
(166.30)
406.30
(356.40)
135.40
(118.80)
406.30
(356.40)
812.50
(712.70)
4.400 35.80 (31.40)
9.670 78.60 (68.90)
2.400
5.100
4.800
4.000
3.630
13.330
19.50 (17.10)
41.40 (36.30)
39.00 (34.20)
32.50 (28.50)
29.50 (25.90)
108.30
(95.00)
2.100 17.10 (15.00)
3.450 28.00 (24.60)
4.000 32.50 (28.50)
2.670 21.70 (19.00)
9.310 75.60 (66.30)
6.210 50.50 (44.30)
10.000 81.30 (71.30)
6.670 54.20 (47.50)
12.400
100.80
8.270 67.20 (58.90)
(88.40)
20.000
162.50 13.330
108.30
(142.50)
(95.00)
161.560
1312.70 107.710
875.10
(1151.50)
(767.60)
27.810
226.00 18.540
150.60
(198.20)
(132.10)
96.870
787.10 64.580
524.70
(690.40)
(460.30)
12.420
100.90
8.300 67.40 (59.10)
(88.50)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
4459
Acetyl choline receptor antibody
06.52
158.120
4463
C6 complement functional essay
06.52
45.000
4464
House dust mite antigen ELIZA
06.52
20.310
4466
Beta-2-microglobulin
06.52
12.420
4467
Chromograqnin A
06.52
47.000
4468
CA-549
06.52
20.000
4473
TSH Receptor Ab
06.52
17.480
4474
Cast Per Allergen
06.52
27.810
4475
CA-724
06.52
20.000
4476
Neopterin
06.52
20.000
4477
Neuron specific enolase
06.52
20.000
4478
Osteocalcin
06.52
31.400
4479
4480
Vitamin B12-absorption: Shilling test
Serotonin
06.52
06.52
11.700
18.750
4482
Free thyroxine (FT4)
06.52
17.480
4484
Thyrotropin (TSH) + Free Thyroxine (FT4)
06.52
37.080
4485
Insulin
06.52
12.420
4486
C-Peptide
06.52
12.420
4487
Calcitonin
06.52
18.900
4488
B-Type Natriuretic Peptide
06.52
47.040
4490
Releasing hormone response
06.52
50.000
4491
Vitamin B12
06.52
12.420
4492
Vitamin D3: Calcitroil (RIA)
06.52
75.000
13 Mar 2008
Page 136 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
1284.70 105.410
856.50
(1126.90)
(751.30)
365.60 30.000
243.80
(320.70)
(213.90)
165.00 13.540
110.00
(144.70)
(96.50)
100.90
8.280 67.30 (59.00)
(88.50)
381.90 31.330
254.60
(335.00)
(223.30)
162.50 13.300
108.10
(142.50)
(94.80)
142.00 11.650 94.70 (83.10)
(124.60)
226.00 18.540
150.60
(198.20)
(132.10)
162.50 13.330
108.30
(142.50)
(95.00)
162.50 13.330
108.30
(142.50)
(95.00)
162.50 13.330
108.30
(142.50)
(95.00)
255.10 20.930
170.10
(223.80)
(149.20)
95.10 (83.40)
7.800 63.40 (55.60)
152.30 12.500
101.60
(133.60)
(89.10)
142.00 11.650 94.70 (83.10)
(124.60)
301.30 24.720
200.90
(264.30)
(176.20)
100.90
8.280 67.30 (59.00)
(88.50)
100.90
8.280 67.30 (59.00)
(88.50)
153.60 12.600
102.40
(134.70)
(89.80)
382.20 31.360
254.80
(335.30)
(223.50)
406.30 33.350
271.00
(356.40)
(237.70)
100.90
8.280 67.30 (59.00)
(88.50)
609.40 50.000
406.30
(534.60)
(356.40)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
4493
Drug concentration: Quantitative
06.52
12.420
4494
Free hormone assay
06.52
17.480
4495
Growth hormone
06.52
12.420
4496
Hormone concentration: Quantitative
06.52
12.420
4497
Carbohydrate deficient transferrin
06.52
29.060
4499
Cortisol
06.52
12.420
4500
DHEA sulphate
06.52
12.420
4501
Testosterone
06.52
12.420
4502
Free testosterone
06.52
17.480
4503
Oestradiol
06.52
12.420
4505
4506
Oestriol
Multiple antigen specific IgE screening test for Atopy
06.52
06.52
10.800
37.260
4507
Thyrotropin (TSH)
06.52
19.600
4508
Combined antigen specific IgE
06.52
24.480
4509
Free tri-iodothyronine (FT3)
06.52
17.480
4511
Renin activity
06.52
18.900
4512
Parathormone
06.52
17.080
4513
IgE: Total
06.52
12.420
4514
Antigen specific IgE
06.52
12.420
4515
Aldosterone
06.52
12.420
4516
Follitropin (FSH)
06.52
12.420
4517
Lutropin (LH)
06.52
12.420
4518
Soluble transferrin receptor
06.52
11.250
13 Mar 2008
Page 137 of 151
Fee
100.90
(88.50)
142.00
(124.60)
100.90
(88.50)
100.90
(88.50)
236.10
(207.10)
100.90
(88.50)
100.90
(88.50)
100.90
(88.50)
142.00
(124.60)
100.90
(88.50)
87.80 (77.00)
302.70
(265.50)
159.30
(139.70)
198.90
(174.50)
142.00
(124.60)
153.60
(134.70)
138.80
(121.80)
100.90
(88.50)
100.90
(88.50)
100.90
(88.50)
100.90
(88.50)
100.90
(88.50)
91.40 (80.20)
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
8.280 67.30 (59.00)
11.650 94.70 (83.10)
8.280 67.30 (59.00)
8.280 67.30 (59.00)
19.370
157.40
(138.10)
8.280 67.30 (59.00)
8.280 67.30 (59.00)
8.280 67.30 (59.00)
11.650 94.70 (83.10)
8.280 67.30 (59.00)
7.200 58.50 (51.30)
24.800
201.50
(176.80)
13.070
106.20
(93.20)
16.600
134.90
(118.30)
11.650 94.70 (83.10)
12.600
102.40
(89.80)
11.390 92.50 (81.10)
8.280 67.30 (59.00)
8.280 67.30 (59.00)
8.280 67.30 (59.00)
8.280 67.30 (59.00)
8.280 67.30 (59.00)
7.500 60.90 (53.40)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
117.70
(103.20)
100.90
(88.50)
100.90
(88.50)
100.90
(88.50)
176.60
(154.90)
162.50
(142.50)
100.90
(88.50)
100.90
(88.50)
100.90
(88.50)
100.90
(88.50)
124.30
(109.00)
117.70
(103.20)
100.90
(88.50)
100.90
(88.50)
100.90
(88.50)
142.00
(124.60)
100.90
(88.50)
260.00
(228.10)
373.80
(327.90)
121.90
(106.90)
434.70
(381.30)
273.20
(239.60)
4519
Prostate specific antigen
06.52
14.490
4520
17 Hydroxy progesterone
06.52
12.420
4521
Progesterone
06.52
12.420
4522
Alpha-feto protein
06.52
12.420
4523
ACTH
06.52
21.740
4524
Free PSA
06.52
20.000
4526
Sex hormone binding globulin
06.52
12.420
4527
Gastrin
06.52
12.420
4528
Ferritin
06.52
12.420
4529
Anti-DNA antibodies
06.52
12.420
4530
Antiplatelet antibodies
06.52
15.300
4531
Hepatitis: Per antigen or antibody
06.52
14.490
4532
Transcobalamine
06.52
12.420
4533
Folic acid
06.52
12.420
4534
Prostatic acid phosphatase
06.52
12.420
4536
Erythrocyte folate
06.52
17.480
4537
Prolactin
06.52
12.420
4538
Procalcitonin: Semi-quantitative
06.52
32.000
4539
Procalcitonin: Quantitative
06.52
46.000
4540
HCG: Quantitative as used for Down's screen
06.52
15.000
4546
First trimester Downs screen
06.52
53.500
4552
Second Trimester Down's screen
06.52
33.620
13 Mar 2008
Page 138 of 151
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
9.660 78.50 (68.90)
8.280 67.30 (59.00)
8.280 67.30 (59.00)
8.280 67.30 (59.00)
14.490
117.70
(103.20)
13.330
108.30
(95.00)
8.280 67.30 (59.00)
8.280 67.30 (59.00)
8.280 67.30 (59.00)
8.280 67.30 (59.00)
10.200 82.90 (72.70)
9.660 78.50 (68.90)
8.280 67.30 (59.00)
8.280 67.30 (59.00)
8.280 67.30 (59.00)
11.650 94.70 (83.10)
8.280 67.30 (59.00)
21.330
173.30
(152.00)
30.670
249.20
(218.60)
10.000 81.30 (71.30)
35.670
22.410
289.80
(254.20)
182.10
(159.70)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
162.50
(142.50)
162.50
(142.50)
4553
Thyroglubulin
06.52
20.000
4554
SCC marker
06.52
20.000
21.13
4544
Clinical pathology: Miscellaneous
Attendance in theatre
06.52
27.000
4547
After-hours service: (Monday to Friday) 17:00 to 08:00, Saturday 13:00 to Monday 08:00 and public holidays - Refer to
06.52
General Rule B.
Unlisted pathology service: Fees for items not listed in the current Pathology schedule (sections 21, 22 and 23) will be
06.52
based on the fee for a comparable service in the coding structure. Please contact the SA Medical Association (SAMA)
Private Practice Unit via e-mail on coding@samedical.org to obtain a comparable code for the unlisted pathology service
which will be based on the fee for a comparable service in the coding structure. New items for these unlisted services
should be added to the coding structure within six months or that specific unlisted pathology service should no longer be
performed. Please note General Rule C and item 6999 are not applicable to pathology services (sections 21, 22 and 23)
Where pharmacological preparations (hormones, etc.) are administered as part of metabolic function tests, the cost of
06.52
such preparation shall be charged separately
Anatomical Pathology
Please note: The calculated amounts in this section are calculated according to the anatomical pathology unit values
4551
4555
22
Exfoliative cytology
Sputum, all body fluids and tumour aspirates: First unit
06.52
13.400
4563
4564
Sputum, all body fluids and tumour aspirates: Each additional unit
Performance of fine-needle aspiration for cytology
06.52
06.52
7.800
15.000
4565
Examination of fine needle aspiration in theatre
06.52
90.000
4566
Vaginal or cervical smears, each
06.52
11.000
22.2
4567
Histology
Histology per sample
06.52
20.000
4571
Histology per additional block, each
06.52
11.600
4575
Histology and frozen section in laboratory
06.52
22.700
4577
Histology and frozen section in theatre
06.52
90.000
4578
Second and subsequent frozen sections, each
06.52
20.000
4579
Attendance in theatre - no frozen section performed
06.52
45.000
4582
Serial step sections (including item 4567)
06.52
23.300
Page 139 of 151
13.330
13.330
Anaesthesiology
RVU
Fee
108.30
(95.00)
108.30
(95.00)
219.40
(192.50)
06.52
22.1
4561
13 Mar 2008
General Practitioners
/ non-designated
Specialists
RVU
Fee
125.60
(110.20)
73.10 (64.10)
140.60
(123.30)
843.30
(739.70)
103.10
(90.40)
177.40
(155.60)
102.90
(90.30)
201.30
(176.60)
798.30
(700.30)
177.40
(155.60)
399.20
(350.20)
206.70
(181.30)
8.900 83.40 (73.20)
5.200 48.70 (42.70)
60.000
562.20
(493.20)
7.000 65.60 (57.50)
13.300
118.00
(103.50)
7.700 68.30 (59.90)
15.100
60.000
13.400
30.000
15.600
133.90
(117.50)
532.20
(466.80)
118.90
(104.30)
266.10
(233.40)
138.40
(121.40)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
4584
Serial step sections per additional block, each
06.52
13.500
4587
4589
4591
Histology consultation
Special stains
Immunofluorescence studies
06.52
06.52
06.52
10.100
6.700
20.700
4592
Immunoperoxidase studies
06.52
40.000
4593
Electron microscopy
06.52
94.000
4595
Foetal autopsy excluding histology
06.52
73.000
23
Human Genetics
Please note: The calculated amounts in this section are calculated according to the human genetics unit values
Cytogenitc
Cell culture: Lymphocytes, cord blood
06.52
15.000
4751
Cell culture: Amniotic fluid, fibroblasts, leukaemia bloods, bone marrow, other specialised cultures
06.52
45.000
4752
Cell culture: Chorionic villi
06.52
60.000
4754
Cytogenetic analysis: Lymphocytes: Idiograms, karyotyping, one staining technique
06.52
135.000
4755
06.52
270.000
4757
Cytogenetic analysis: Amniotic fluid, fibroblasts, chorionic villi, products of conception, bone marrow, leukamia bloods:
Idiograms, karyotyping, one straining technique
Specified additional analysis e.g. mosaicism, Fanconi anaemia, Fra X, additional staining techniques
06.52
70.000
4760
FISH procedure, including cell culture
06.52
115.000
4761
FISH analysis per probe system
06.52
35.000
23.2
4763
DNA-testing
Blood: DNA extraction
06.52
45.000
4764
Blood: Genotype per person: Southern blotting
06.52
89.000
4765
Blood: Genotype per person: PCR
06.52
60.000
4766
HIV Drug Resistance Testing
06.52
513.000
4767
Prenatal diagnosis: Amniotic fluid or chorionic tissue: DNA extraction
06.52
90.000
4768
Prenatal diagnosis: Amniotic fluid or chorionic tissue: Genotype per person: Southern blotting
06.52
188.000
Page 140 of 151
119.70
(105.00)
89.60 (78.60)
59.40 (52.10)
183.60
(161.10)
354.80
(311.20)
833.80
(731.40)
647.50
(568.00)
Anaesthesiology
RVU
Fee
9.000 79.80 (70.00)
6.700 59.40 (52.10)
4.500 39.90 (35.00)
13.800
122.40
(107.40)
26.670
236.60
(207.50)
63.000
558.80
(490.20)
48.670
431.70
(378.70)
06.52
23.1
4750
13 Mar 2008
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
124.80 15.000
(109.50)
374.50 45.000
(328.50)
499.30 60.000
(438.00)
1123.50 135.000
(985.50)
2246.90 270.000
(1971.00)
582.50 70.000
(511.00)
957.00 115.000
(839.50)
291.30 35.000
(255.50)
124.80
(109.50)
374.50
(328.50)
499.30
(438.00)
1123.50
(985.50)
2246.90
(1971.00)
582.50
(511.00)
957.00
(839.50)
291.30
(255.50)
374.50 45.000
(328.50)
740.70 89.000
(649.70)
499.30 60.000
(438.00)
4269.20 342.000
(3744.90)
749.00 90.000
(657.00)
1564.50 188.000
(1372.40)
374.50
(328.50)
740.70
(649.70)
499.30
(438.00)
2846.10
(2496.60)
749.00
(657.00)
1564.50
(1372.40)
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Fee
IV.
P.
Travelling Expenses
Travelling fees: (a) Where, in cases of emergency, a practitioner was called out from his residence or rooms to a patient's home or the hospital, travelling fees can be charged according to the section 06.52
on travelling expenses (section IV) if he had to travel more than 16 kilometres in total. (b) If more than one patient would be attended to during the course of a trip, the full travelling expenses must be
divided between the relevant patients. (c) A practitioner is not entitled to charge for any travelling expenses or travelling time to his rooms. (d) Where a practitioner's residence would be more than 8
kilometres away from a hospital, no travelling fees may be charged for services rendered at such hospitals, except in cases of emergency (services not voluntarily scheduled). (e) Where a practitioner
conducts an itinerant practice, he is not entitled to charge fees for travelling expenses except in cases of emergency (services not voluntarily scheduled). (f) For voluntarily scheduled services, fees
for travelling expenses may only be charged where the patient and the practitioner have entered into an agreement to this effect. The Fund benefits will not be applicable in such instances.
R6,67 for each kilometre in excess of 16 kilometres travelled in own car e.g. where a practitioner has to travel 19
06.52
kilometres in total to visit a patient, the fees shall be calculated as follows: 19-16=3 X R6,67 = R20,01
Normal hours: Specialist: 18,00 clinical procedure units per hour or part thereof
06.52
18.000
126.50
(111.00)
Normal hours: General practitioner: 18,00 clinical procedure units per hour or part thereof
06.52
18.000
126.50
(111.00)
Travelling fees are not payable to practitioners who assisted at operations on cases referred to surgeons by them
06.52
LIST OF PROCEDURES WHICH ARE OFTEN DONE IN THE DOCTORS' ROOMS TO WHICH MODIFIER 0004 SHOULD NOT BE APPLIED
Modifier 0004 is not applicable to the following sections:
06.52
5007
5013
V.
998.60 120.000
(876.00)
RVU
Prenatal diagnosis: Amniotic fluid or chorionic tissue: Genotype per person: PCR
5005
120.000
Anaesthesiology
4769
5003
06.52
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
998.60
(876.00)
All anaesthetic services
Section 19: Radiology
Section 20: Radiation Oncology
Section 21: Clinical Pathology (except for items 3719, 3720 and 3721 where modifier 0004 may be applied)
Section 22: Anatomical Pathology
Section 23: Human Genetic
Please note : This is not a conclusive list and practitioners should not be penalised when patients need to be admitted to hospital for these procedures.
Region
Code
Short Description
Skeleton
13 Mar 2008
3305
Finger
3307
Limb - DELETED
6500
Hand
6501
Wrist
6503
Scaphoid
6504
Radius and ulna
6505
Elbow
6506
Humerous
6507
Shoulder
6508
Acromio-Clavicula joint
6509
Clavicle
6510
Scapula
6511
Foot
Page 141 of 151
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Spinal
Skull
13 Mar 2008
6512
Ankle
6513
Calcaneous
6514
Tibia and Fibia
6515
Knee
6516
patella
6517
Femur
6518
Hip
6519
Sesamoid Bone
3309
Smith P
3311
Stress
3313
Length
3315
Survey <5
3317
Survey >5
3319
Arthrography
3321
Region
3325
Stress
3329
Scoliosis
3331
Pelvis
3333
Myl Lumber
3334
Myl Thoracic
3335
Myl Cervical
3345
Discography
3349
Skull
3351
Sinus
3353
Facial bones
3355
Mandible
3357
Nasal Bone
3359
Mastoid
3361
Teeth 1Q
3363
Teeth 2Q
3365
Full mouth
3366
Rotate tomo
3367
TM joint
3369
Tomo
Page 142 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Alimentary Tract
Biliary Tract
Chest
Abdomen
Urinary Tract
13 Mar 2008
3371
Foreign body
3381
Ventriculogr
3385
Post nasal
3387
Cephalometry
3389
Dacrosys
3395
Sialography
3399
Pharynx
3403
Stomach
3406
Small meal
3408
Barium meal
3409
Enema
3415
Billary ERCP
3416
Pancr ERCP
3423
Hyp duoden
3425
Oral cholosys
3427
Cholangiogr
3431
Operative chol
3432
deleted
3433
T tube
3437
Trans hep
3441
Tomo billary
3443
Larynx
3445
Chest
3447
Cardiac
3449
Ribs
3451
Sternum
3453
Boncho unil
3455
Broncho bil
3461
Pleurography
3465
Lryngography
3468
Thoracic inlet
3477
Control film
3479
Acute abdo
3487
Control film
Page 143 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
3493
Waterload
3497
Cystography
3499
Retrograde
3505
Pyelography
3513
Tomo
Obstetricts &
3515
Pregnancy
Gynaecology
3517
Pelvimetry
3519
Hystero sal
Venography
3545
Venography
Tomography &
3577
Tomo
Cinematography
3579
Tomo
3581
Cinemat 1st
3583
Cinemat +
Digital C Arm
3592
Digital C Arm
Sinography
3603
Sinography
Mammography
3594
Biopsy specimen
3605
Mammo
3606
Repeat mam
6472
Computer aided diagnosis mammo
3608
FNA stereo
M0165
Contrast modifier
3615
Obstetric, routine < 10 wk
3617
Obstetric, routine > 20 wk
3618
Pelvic abdo probe
3620
Intravascular
3621
Cardiac M
3622
Cardiac 2d
3623
Cardiac effort
3624
Cardiac contrast
3625
Cardiac doppler
3626
Cardiac phono
3627
Abdo and pelvis
3628
Renal
3629
High def
Ultrasound
13 Mar 2008
Page 144 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
Nuclear
CR (2001 traiffs)
13 Mar 2008
3630
Mass
3631
Opthalmic
3632
Eye,axial,lens
3633
Neonatal head
3634
Periph vasc B mode
3635
+ doppler
3636
Trans oesoph
3637
Colour Doppler
3645
Isotope Scanning
5026
Amniocenthesis
5100
Pelvic vag probe
5101
Pleural space
5102
Joints
5103
Soft tissue
5106
Obstetric < 10 wk - complicated
5107
Obstetric, routine > 24 wk
5108
Obstetric, second opinion
M5104
Multiple gestation modifier
5110
Carotid
5111
Extracranial tree
5112
Arterial limb
5113
Venous DVT
5114
Venous full study
5115
Intra operative
3646
Thyoid Scanning
3599
EBCT
6400
Plus Spiral CT
6401
Plus 3D reconstruction
6402
Plus high resolution study
6403
CT limb uncontrasted
6404
CT limb with contrast only
6405
CT Limb pre and post contrast
6406
CT joint uncontrasted
6407
CT joint with contrast only
Page 145 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
13 Mar 2008
6408
CT joint pre and post contrast
6409
CT brain uncontrasted (including posterior fossa)
6410
CT brain with contrast only (including posterior fossa)
6411
CT brain pre and post contrast (including posterior fossa)
6412
CT orbits complete study, axial or coronal, uncontrasted
6413
CT orbits complete study, axial and coronal, uncontrasted
6414
CT orbits complete study, axial or coronal pre and post contrast
6415
CT orbits complete study, axial and coronal pre and post contrast
6416
CT paranasal sinuses limited study axial or coronal
6417
CT paranasal sinuses limited study axial and coronal
6418
CT paranasal
uncontrasted
6419
CT paranasal sinuses complete study, axial and coronal,
uncontrasted
6420
CT paranasal sinuses complete study, axial or coronal, pre and
post contrast
6421
CT paranasal sinuses complete study, axial and coronal, pre and
post contrast
6422
CT pituitary fossa, uncontrasted
6423
CT pituitary fossa, pre and post contrast.
6424
CT internal auditory meati, uncontrasted
6425
CT internal auditory meati, pre and post contrast
6426
CT mastoids
6427
CT ear structures, limited study
6428
CT middle and inner ear, complete study including reconstructions
6429
CT facial bones
6430
CT neck soft tissue, uncontrasted
6431
CT neck soft tissue with contrast only
6432
CT neck pre and post contrast
6433
CT cervical spine uncontrasted
6434
CT cervical spine pre and post contrast
6435
CT cervical spine post myelogram
6436
CT dorsal spine uncontrasted
6437
CT dorsal spine pre and post contrast
6438
CT dorsal spine post myelogram
sinuses
complete
study,
axial
or
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
coronal,
Page 146 of 151
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
13 Mar 2008
6439
CT lumbar spine uncontrasted
6440
CT lumbar spine pre and post contrast
6441
CT lumbar spine post myelogram
6442
CT pelvimetry (topogram only)
6443
CT chest uncontrasted
6444
CT chest with contrast
6445
CT chest pre and post contrast
6446
CT chest high resolution lungs, limited study
6447
CT high resolution lungs, complete study
6448
CT abdomen uncontrasted
6449
CT abdomen with contrast
6450
CT abdomen pre and post contrast
6451
CT abdomen triphasic study
6452
CT pelvis uncontrasted
6453
CT pelvis with contrast
6454
CT pelvis pre and post contrast
6455
CT abdomen and pelvis uncontrasted
6456
CT abdomen and pelvis with contrast
6457
CT abdomen and pelvis pre and post contrast
6458
CT chest, abdomen and pelvis with contrast
6459
CT base of skull to symphysis pubis with contrast
6460
CT for dental implants maxilla or mandible
6461
CT for dental implants maxilla and mandible
6462
CT angiography per limited region (including spiral and all
reconstructions)
6463
CT angiography per extensive region (including spiral and all
reconstructions)
6464
CT limited study any region
6465
CT guidance for aspiration, biopsy or drainage
6466
CT guidance at time of CT
6467
CT stereotactic localisation for biopsy
6468
CT for radiotherapy planning
6469
Quantitative CT for bone mineral density
6470
Triphasic liver + CT abdo and pelvis
6471
Triphasic liver + CT chest abdo & pelvis
Page 147 of 151
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
Version 2008.50
Code
Description
Ver
Add
Specialists
RVU
MRI
13 Mar 2008
Fee
General Practitioners
/ non-designated
Specialists
RVU
Fee
Anaesthesiology
RVU
Fee
Per Region
6110
Spectroscopy
5097
Vertebroplasty
6474
PET whole body
6475
PET limited region
Page 148 of 151
Version 2008.50
Medical Practitioners 2008
PracticeType
Description
10000
Specialists
10008
Specialist Radiologist/Nuclear Physicians
10099
General Practitioners / non-designated Specialists
11000
Anaesthesiology
11001
Critical Care
11200
Dermatology
11400
General Medical Practice
11600
Obstetrics and Gynaecology
11700
Pulmonology
11800
Medicine (Specialist Physician)
11801
Endocrinology
11802
Geriatric Medicine
11803
Medical Genetics
11804
Nephrology
11805
Medicine : Clinical Haematology
11900
Gastroenterology
12000
Neurology
12100
Cardiology
12200
Psychiatry
12201
Child Psychiatry
12300
Medical Oncology
12400
Neurosurgery
12600
Opthalmology
12700
Clinical Haemotology
12800
Orthopaedics
13000
Otorhinolaryngology
13100
Rheumatology
13200
Paediatrics
13201
Paediatrics : Neurology
13202
Paediatrics : Developmental
13 Mar 2008
Page 149 of 151
Version 2008.50
PracticeType
Description
13203
Neonatology
13300
Paediatric Cardiology
13400
Physical Medicine
13600
Plastic and Reconstructive Surgery
14000
Radiation Oncology
14200
Surgery
14201
Paediatric Surgery
14202
Vascular Surgery
14400
Cardiothoracic Surgery
14600
Urology
15000
Pathology (Chemical)
15100
Pathology (Forensic)
15200
Pathology (Clinical)
15300
Pathology (Anatomical)
15400
Pathology (Haematological)
15500
Pathology (Microbiological)
15600
Pathology (Virological)
19700
Community Health
19701
Occupational Health
19999
Designated Specialists
13 Mar 2008
Page 150 of 151
Version 2008.50
Conversion Factors
Code
Description
Value
A
Anaesthesiologists
49.869
AC
Anatomical Pathology - Cytology
10.594
AH
Anatomical Pathology - Histology
10.029
CL
Clinical Procedures
7.946
CP
Clinical Pathology
9.186
CT
Computed Tomography
8.939
HG
Human Genetics
9.409
MR
Magnetic Resonance Imaging
8.566
PS
Psychiatrists
15.303
RA
Radiology
11.256
RO
Radiation Oncology
U
Ultrasound
V
Consultative Services
12.831
VG
GP Consultative Services (items 0190 - 0192, 0173-0175)
14.384
VP
Consultative Services (Paediatrics and Paediatric Cardiologists)
12.831
13 Mar 2008
9.656
7.574
Page 151 of 151
Version 2008.50