Cimas ZRVS - Effective 1 June 2023

CIMAS TARIFFS FOR ZIMBABWE RELATIVE VALUE SCHEDULE - EFFECTIVE 1 JUNE 2023
SECURE &
STANDARD COMPREHENSIVE
TARIFF CODE TARIFF DESCRIPTION TARIFF CATEGORY HEALTHGUARD
PACKAGES PACKAGES
PACKAGES
ZWL ZWL USD
INTEGUMENTARY SYSTEM
10000 Incision and drainage of infected or non-infected sebaceous cyst, one lesion Integumentary system 31,500.00 42,000.00 21.00
10001 second lesion Integumentary system 19,500.00 26,000.00 13.00
10002 - over two, each additional lesion Integumentary system 7,500.00 10,000.00 5.00
Incision and drainage of infected or non-infected epithelial inclusion cyst

10003 Integumentary system 55,500.00 74,000.00 37.00
("sebaceous cyst") with complete removal of and treatment of cavity
10020 Incision and drainage of furuncle Integumentary system 31,500.00 42,000.00 21.00
Acne surgery (eg. marsupialization, opening or removal of multiple milia,

comedones, cysts, pustules)
Acne surgery (eg. marsupialization, opening or removal of multiple milia,

comedones, cysts, pustules)[undertaken by Nursing Sister]
Incision and drainage of abscess (eg. carbuncle supportive, hydradenitis and other
cutaneous or subcutaneous abscesses): simple
10061 - under general anaesthetic Integumentary system 436,500.00 582,000.00 291.00
10100 Drainage of onychia or paranychia: simple Integumentary system 24,000.00 32,000.00 16.00
10101 - multiple or complicated Integumentary system 19,500.00 26,000.00 13.00
10120 Incision and removal of foreign body, subcutaneous tissues:simple Integumentary system 261,000.00 348,000.00 174.00
10121 - complicated Integumentary system 546,000.00 728,000.00 364.00
10122 Incision and removal of foreign body, subcutaneous tissues: intermediate Integumentary system 52,500.00 70,000.00 35.00
10140 Drainage of haematoma: simple Integumentary system 300,000.00 400,000.00 200.00
10141 - under general anaesthetic Integumentary system 72,000.00 96,000.00 48.00
10160 Puncture aspiration of abscess or haematoma Integumentary system 240,000.00 320,000.00 160.00
Biopsy of skin or subcutaneous tissue (including simple closure), unless otherwise

listed (independent procedure)
11101 - each additional lesion Integumentary system 91,500.00 122,000.00 61.00
11102 Biopsy, punch Integumentary system 19,500.00 26,000.00 13.00
11200 Excision, skin tags, multiple (fibro-cutaneous tags), any area, up to 15 Integumentary system 166,500.00 222,000.00 111.00
SECURE &
PACKAGES PACKAGES
PACKAGES
11201 - each additional 10 lesions Integumentary system 84,000.00 112,000.00 56.00
11400 - lesion diameter up to 0.5 cm Integumentary system 220,500.00 294,000.00 147.00
11401 - lesion diameter 0.5 to 1.0 cm Integumentary system 291,000.00 388,000.00 194.00
11403 - each additional 2 cm or part thereof add Integumentary system 427,500.00 570,000.00 285.00
11421 - lesion diameter 0.5 up to 1.0 cm Integumentary system 322,500.00 430,000.00 215.00
11430 Lesions less than 3.00 mm in diameter Integumentary system 72,000.00 96,000.00 48.00
11431 Lesions up to 0.5 cm in diameter Integumentary system 193,500.00 258,000.00 129.00
11432 - each additional 0.5 cm or part thereof add Integumentary system 96,000.00 128,000.00 64.00
11441 - lesion diameter 0.5 cm to 1.0 cm Integumentary system 352,500.00 470,000.00 235.00
Excision of skin and subcutaneous tissue for hydradentis, axillary; with simple or
11450 Integumentary system 769,500.00 1,026,000.00 513.00
intermediate repair
11451 - with complex repair Integumentary system 991,500.00 1,322,000.00 661.00
Excision of skin and subcutaneous tissue for hydradentis, inguinal; with simple or
intermediate repair
11463 - with coplex repair Integumentary system 909,000.00 1,212,000.00 606.00
Excision of skin and subcutaneous tissue for hydradentis, perianal, perineal, or

umbilical; with simple or intermediate repair
11471 - with complex repair Integumentary system 1,015,500.00 1,354,000.00 677.00
SECURE &
PACKAGES PACKAGES
PACKAGES
11603 - each additional 2 cm or part thereof, add Integumentary system 630,000.00 840,000.00 420.00
11622 - lesions diameter 1.0 to 2.0 cm Integumentary system 609,000.00 812,000.00 406.00
11643 - lesion diameter 0.5 to 1.0 cm Integumentary system 852,000.00 1,136,000.00 568.00
11730 Avulsion nail plate, partial or complete, simple, single Integumentary system 223,500.00 298,000.00 149.00
11731 - second nail plate Integumentary system 24,000.00 32,000.00 16.00
11732 - each additional nail plate Integumentary system 93,000.00 124,000.00 62.00
Excision of nail and nail matrix, partial or complete (e.g. ingrown or deformed nail)
for permanent removal
11770 Excision of pilonidal cyst or sinus, simple Integumentary system 703,500.00 938,000.00 469.00
11771 Excision of pilonidal cyst or sinus, extensive Integumentary system 1,332,000.00 1,776,000.00 888.00
11900 Injection, intralesional Integumentary system 114,000.00 152,000.00 76.00
11901 - more than 7 lesions Integumentary system 165,000.00 220,000.00 110.00
Tattooing, intradermal, introduction of insoluble opaque pigments to correct colour

defects up to 6 sq cm
11921 - 6 to 20 sq cm Integumentary system 493,500.00 658,000.00 329.00
11922 - over 20 sq cm Integumentary system 114,000.00 152,000.00 76.00
11950 Subcutaneous injection of 'filling' material, e.g. silicon, up to 1 ml Integumentary system 252,000.00 336,000.00 168.00
11951 1 to 5 ml Integumentary system 303,000.00 404,000.00 202.00
11952 - 6 to 10 ml Integumentary system 384,000.00 512,000.00 256.00

SECURE &
PACKAGES PACKAGES
PACKAGES
11953 - over 10 ml Integumentary system 84,000.00 112,000.00 56.00
12001 Up to 2.5 cm Integumentary system 297,000.00 396,000.00 198.00
12002 2.5 to 7.5 cm Integumentary system 336,000.00 448,000.00 224.00
12005 12.5 to 20 cm Integumentary system 532,500.00 710,000.00 355.00
12006 20 to 30 cm Integumentary system 670,500.00 894,000.00 447.00
12007 For every 12.5 cm over 30 cm add Integumentary system 807,000.00 1,076,000.00 538.00
12011 Up to 2.5 cm Integumentary system 324,000.00 432,000.00 216.00
12016 12.5 to 20 cm Integumentary system 744,000.00 992,000.00 496.00
12017 For every 12.5 cm over 20 cm add Integumentary system 877,500.00 1,170,000.00 585.00
12060 Suture of multiple surface wounds - first half hour Integumentary system 87,000.00 116,000.00 58.00
12061 - first hour Integumentary system 169,500.00 226,000.00 113.00
12062 - each quater of an hour thereafter Integumentary system 121,500.00 162,000.00 81.00
13001 Suture of single simple muscle and deeper tissue wound Integumentary system 60,000.00 80,000.00 40.00
13002 Suture of large complicated wounds of muscle and deeper tissues - first half hour Integumentary system 121,500.00 162,000.00 81.00
13004 - each quater of an hour thereafter Integumentary system 48,000.00 64,000.00 32.00
13006 Debridement of single simple muscle and deeper tissue wound Integumentary system 169,500.00 226,000.00 113.00
Debridement of large complicated wounds of muscle and deeper tissues - first half
hour
13009 - each quarter of an hour thereafter Integumentary system 121,500.00 162,000.00 81.00
SECURE &
PACKAGES PACKAGES
PACKAGES
13011 Debribement and cleaning of superficial wound under general anaesthetic Integumentary system 181,500.00 242,000.00 121.00
13100 Linear repair complex up to 2.5 cm Integumentary system 634,500.00 846,000.00 423.00
13101 -2.5 to 7.5 cm Integumentary system 856,500.00 1,142,000.00 571.00
13102 - each additional 7.5 cm Integumentary system 253,500.00 338,000.00 169.00
13121 -2.5 to 7.5 cm Integumentary system 981,000.00 1,308,000.00 654.00
13141 -2.5 to 7.5 cm Integumentary system 241,500.00 322,000.00 161.00
13160 Linear repair complex up to 2.5 cm Integumentary system 1,843,500.00 2,458,000.00 1,229.00
13161 -2.5 to 7.5 cm Integumentary system 313,500.00 418,000.00 209.00
14020 For defects up to 10 sq cm Integumentary system 1,581,000.00 2,108,000.00 1,054.00
14021 - 10 sq cm to 30 sq cm Integumentary system 2,200,500.00 2,934,000.00 1,467.00
14050 Filleted finger or toe flap, including preparation of recipient site Integumentary system 966,000.00 1,288,000.00 644.00
Excision of intact skin or scar in preparation of recipient site prior to repair with free
15000 Integumentary system Add 50% Add 50% Add 50%
skin graft - add 50% of the listed value of the skin graft.
Pinch, split or full thickness graft to cover small ulcer, or minimal open area (except
on face) type of graft up to 2.5 cm diameter.
Split skin graft, trunk, scalp, legs, hands and feet (except multiple digits), up to 100
15100 Integumentary system 1,887,000.00 2,516,000.00 1,258.00
sq cm or each one per cent of the body area of infants and children (except 15050)
- each additional 100 sq cm or each one per cent of body area of infants and
children or part thereof
SECURE &
PACKAGES PACKAGES
PACKAGES
- face, mouth, neck, ears, eyelids. Orbit, genitalia or multiple digits, up to 100 sq
cm or each one per cent of body area of infants and children (except 15050)
- each additional 100 sq cm or each one percent of body area of infants and childre,
or part thereof
15200 Full thickness, free, including direct closure of donor site, trunk up to 20 sq cm Integumentary system 1,707,000.00 2,276,000.00 1,138.00
15201 - each addition 20 sq cm Integumentary system 453,000.00 604,000.00 302.00
15220 Scalp, arms and legs, up to 20 sq cm Integumentary system 1,750,500.00 2,334,000.00 1,167.00
15221 - each additional 20 sq cm Integumentary system 426,000.00 568,000.00 284.00
Forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and feet, up to 20 sq
cm
15260 Eyelids, nose, ears and lips up to 20 sq cm Integumentary system 2,350,500.00 3,134,000.00 1,567.00
15500 Formation of tube pedicle without transfer or major delay Integumentary system 567,000.00 756,000.00 378.00
15505 - scalp, arms and legs, up to 50 sq cm Integumentary system 567,000.00 756,000.00 378.00
15507 - up to 100 sq cm Integumentary system 664,500.00 886,000.00 443.00
- forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and feet, up to 12.5
sq cm
15513 - up to 50 sq cm Integumentary system 796,500.00 1,062,000.00 531.00
15515 - eyelids, nose, ears and lips, up to 12.5 sq cm Integumentary system 567,000.00 756,000.00 378.00
15517 - each additional 12.5 sq cm Integumentary system 181,500.00 242,000.00 121.00
Transfer including simultaneous formation of open or tubed pedicle flap to recipient

site requiring minimal preparation, trunk up to 100 sq cm
15545 - scalp, arms and legs, up to 50 sq cm Integumentary system 313,500.00 418,000.00 209.00
SECURE &
PACKAGES PACKAGES
PACKAGES
forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and feet, up to 12.5
sq cm
15556 - each additional 12.5 sq cm Integumentary system 72,000.00 96,000.00 48.00
Intermediate "delay" of any flap , primary "delay" to flap or sections of pedicle of

tubed or open flap, trunk
15610 - scalp, arms and legs Integumentary system 780,000.00 1,040,000.00 520.00
15620 - forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and feet Integumentary system 993,000.00 1,324,000.00 662.00
15630 - eyelids, nose, ears and lips Integumentary system 1,060,500.00 1,414,000.00 707.00
Intermediate transfer of any pedicle flap (eg abdomen to wrist, walking tube, etc),
15650 Integumentary system 1,179,000.00 1,572,000.00 786.00
any location up to 12.5 sq cm
Excision of lesion and/or excisional preparation of recipient site and attachment of

direct or tubed pidicle flap including simultaneous formation, trunk up to 100 sq cm
15710 - scalp, arms and legs up to 50 sq cm Integumentary system 399,000.00 532,000.00 266.00
- forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and feet up to 25 sq
cm
SECURE &
PACKAGES PACKAGES
PACKAGES
15731 - each additional 12.5 sq cm Integumentary system 2,718,000.00 3,624,000.00 1,812.00
15732 Division of pedicle flap and return of unused pedicle to donor area, trunk Integumentary system 3,876,000.00 5,168,000.00 2,584.00
15734 - scalp, arms and legs Integumentary system 4,635,000.00 6,180,000.00 3,090.00
15736 - forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and feet Integumentary system 4,134,000.00 5,512,000.00 2,756.00
15738 - eyelids, nose, ears and lips Integumentary system 3,447,000.00 4,596,000.00 2,298.00
15740 Island pedicle flap, scalp, face, etc Integumentary system 2,649,000.00 3,532,000.00 1,766.00
15750 Neurovascular pedicle flap, hand or digit including skin graft Integumentary system 2,889,000.00 3,852,000.00 1,926.00
Composite (full thickness of external ear or nasal ala), including primary closure,
donor area
15770 Derma-fat facia Integumentary system 1,870,500.00 2,494,000.00 1,247.00
15775 Punch graft for hair transplant, 1 to 15, each punch graft Integumentary system 904,500.00 1,206,000.00 603.00
Abrasion of skin, for removal of scars, tattoos, actinic changes (keratoses), primary
or secondary, total face
15785 - region (Quater face, cheeks, chin, fore-head or elsewhere), primary or secondary Integumentary system 133,500.00 178,000.00 89.00
15786 Abrasion, single lesion (eg. keratosis, scar, etc) Integumentary system 424,500.00 566,000.00 283.00
15787 - each additional four lesions or less Integumentary system 94,500.00 126,000.00 63.00
15820 Rhytidectomy, lower eyelids Integumentary system 1,446,000.00 1,928,000.00 964.00
15821 - with excision of extensive herniated fat pad Integumentary system 1,597,500.00 2,130,000.00 1,065.00
15822 - upper eyelids Integumentary system 1,275,000.00 1,700,000.00 850.00
15824 - forehead Integumentary system 2,214,000.00 2,952,000.00 1,476.00
15826 - glabellar frown Integumentary system 2,092,500.00 2,790,000.00 1,395.00
Excision, excessive skin and subcutaneous tissue (including lipectomy); abdomen

(abdominoplasty)
15832 - with muscle plication Integumentary system 2,539,500.00 3,386,000.00 1,693.00
15833 - simple abdominal cresent (not involving umbilicus) Integumentary system 2,200,500.00 2,934,000.00 1,467.00
15840 Repair for facial nerve paralysis, free fascia graft (includes obtaining fascia) Integumentary system 3,460,500.00 4,614,000.00 2,307.00
15850 Removal of sutures under anaesthesia (other than local), same surgeon Integumentary system BR BR BR
SECURE &
PACKAGES PACKAGES
PACKAGES
15852 Dressing change (for other than burns) under anaesthesia (other than local) Integumentary system 363,000.00 484,000.00 242.00
15920 Coccygectomy and primary closure Integumentary system 1,437,000.00 1,916,000.00 958.00
15922 - with flap closure Integumentary system 2,037,000.00 2,716,000.00 1,358.00
15930 Excision sacral decubitus ulcer with skin flap closure Integumentary system 435,000.00 580,000.00 290.00
15932 - with ostectomy Integumentary system 543,000.00 724,000.00 362.00
15940 Excision ischial decubitus ulcer with direct closure Integumentary system 1,651,500.00 2,202,000.00 1,101.00
15942 - with skin (and muscle flap closure) Integumentary system 543,000.00 724,000.00 362.00
15944 - with ostectomy Integumentary system 2,563,500.00 3,418,000.00 1,709.00
15950 Excision trochanteric decubitus ulcer with direct closure Integumentary system 1,375,500.00 1,834,000.00 917.00
15952 - with skin flap closure Integumentary system 2,319,000.00 3,092,000.00 1,546.00
15954 - with ostectomy Integumentary system 1,449,000.00 1,932,000.00 966.00
16000 Initial treatment, first degree burn, where local treatment only required. Integumentary system 156,000.00 208,000.00 104.00
Dressing and/or debridement, initial or subsequent, under anaesthesia, small (less

than 9 % surface area)
16013 - moderate (9 - 18% surface area) Integumentary system 241,500.00 322,000.00 161.00
16014 - large, or with debridement (more than 18% surface area) first half-hour Integumentary system 313,500.00 418,000.00 209.00
- large, or with debridement (more than 18% surface area) each quarter of an hour
thereafter
16020 - without anaesthesia, office or hospital, small (up to 9% of surface area) Integumentary system 159,000.00 212,000.00 106.00
16025 - medium (9 - 18% surface area) Integumentary system 331,500.00 442,000.00 221.00
16030 - large (more than 18% surface area) Integumentary system 382,500.00 510,000.00 255.00
Destruction by any method (other than by Cryotherapy Co2 snow, liquid N2) with or
17000 without surgical curettement, all facial lesions or premalignant lesions in any Integumentary system 157,500.00 210,000.00 105.00
location, with the exception of warts
17001 - second and third lesions, each Integumentary system 24,000.00 32,000.00 16.00
17002 - over 3 lesion Integumentary system 129,000.00 172,000.00 86.00
17010 - complicated lesion(s) Integumentary system BR BR BR
Destruction by any method of benign skin lesion on any area other than face, and
warts of any area
SECURE &
PACKAGES PACKAGES
PACKAGES
17101 - second lesion Integumentary system 12,000.00 16,000.00 8.00
17102 - over 2 lesions, each adition lesion Integumentary system 7,500.00 10,000.00 5.00
17104 - 15 or more lesions Integumentary system 121,500.00 162,000.00 81.00
17105 - complicated lesion(s) Integumentary system BR BR BR
17110 - molluscum contagiosum, milia, up to 15 Integumentary system 163,500.00 218,000.00 109.00
17200 Electro-surgical destruction of multiple fibrocutaneous tags, up to 15 Integumentary system 24,000.00 32,000.00 16.00
17201 - each additional 10 lesions Integumentary system 31,500.00 42,000.00 21.00
17340 Cryotherapy (CO2 snow, liquid N2) Integumentary system 130,500.00 174,000.00 87.00
17341 - each additional lesion Integumentary system 24,000.00 32,000.00 16.00
17342 - to a maximum of 16 lesions Integumentary system 79,500.00 106,000.00 53.00
17380 Electrolysis epilation, each half hour Integumentary system 100,500.00 134,000.00 67.00
19000 Puncture aspiration of cyst Integumentary system 205,500.00 274,000.00 137.00
19020 Mastotomy with exploration or drainage of abscess, deep Integumentary system 784,500.00 1,046,000.00 523.00
19100 Biopsy of breast, needle (independent procedure) Integumentary system 292,500.00 390,000.00 195.00
19101 - incisional Integumentary system 777,000.00 1,036,000.00 518.00
Excision of cyst, fibro-adenoma or other benign tumour, aberrant breast tissue, duct
19120 lesion or nipple lesion (except 19140 - 19141) male or female, one or more lesions, Integumentary system 1,092,000.00 1,456,000.00 728.00
unilateral
19121 Microdochectomy Integumentary system 363,000.00 484,000.00 242.00
19140 Mastectomy for gynaecomastia through circumareola or other incision, unilateral Integumentary system 483,000.00 644,000.00 322.00
19160 Mastectomy, partial (quadrectomy or more), unilateral Integumentary system 724,500.00 966,000.00 483.00
19180 Mastectomy, simple, complete, unilateral Integumentary system 589,500.00 786,000.00 393.00
19182 Mastectomy, subcutaneous, unilateral Integumentary system 789,000.00 1,052,000.00 526.00
19184 - with immediate prosthetic implant, unilateral Integumentary system 879,000.00 1,172,000.00 586.00
Mastectomy, radical, including breast pectoral muscles and axillary lymph nodes,
unilateral
Mastectomy, modified radical, with modified axillary dissection, but leaving pectoral
muscles, unilateral
SECURE &
PACKAGES PACKAGES
PACKAGES
Excision of chest wall tumour including ribs with plastic reconstruction without
mediastinal lymphadenectomy
Mammoplasty, plastic operation on breast, reduction or repositioning, one stage

operation, unilateral
Mammoplasty, augmentation (unilateral); with prosthetic implant or expander.

Cost of prosthesis not included
19328 Removal of intact mammary implant or expander (unilateral) Integumentary system 1,249,500.00 1,666,000.00 833.00
19330 Removal of mammary implant material (gel) (unilateral) Integumentary system 1,539,000.00 2,052,000.00 1,026.00
19350 Nipple/areola reconstruction Integumentary system 2,166,000.00 2,888,000.00 1,444.00
19351 Operation for inversion of nipple, unilateral Integumentary system 559,500.00 746,000.00 373.00
Breast reconstruction, immediate or delayed, with tissue expander, including

subsequent expansion
19358 Removal of expander and replacement by definitive prosthesis Integumentary system 808,500.00 1,078,000.00 539.00
Breast reconstruction with transverse rectus abdominis flap (TRAM), including

19362 closure of donor site, single or double pedicle, with or without micro vascular Integumentary system 2,697,000.00 3,596,000.00 1,798.00
anastomosis
19367 - with simultaneous insertion of prosthesis. Cost of prosthesis not included Integumentary system 5,767,500.00 7,690,000.00 3,845.00
Insertion of prosthesis under previously prepared flap. Separate procedure. Cost

of prosthesis not included
19371 Periprosthetic capsulectomy, breast Integumentary system 2,227,500.00 2,970,000.00 1,485.00
19380 Revision of reconstructive breast Integumentary system 2,212,500.00 2,950,000.00 1,475.00
MUSCULO-SKELETAL SYSTEM
20000 Incision of soft tissue abscess or haematoma Musculoskeletal system FFS FFS FFS
Bone abscess: as per consultation and/or visits plus the tariff which would be
20001 applicable for compound fracture involved, including three weeks post-operative Musculoskeletal system FFS FFS FFS
care
20005 Incision and drainage deep abscess or haematoma, any area Musculoskeletal system 432,000.00 576,000.00 288.00
20200 Biopsy, muscle, superficial Musculoskeletal system 244,500.00 326,000.00 163.00
20205 deep (for excision of muscle tumour,deep,see specific anatomical section) Musculoskeletal system 378,000.00 504,000.00 252.00
20220 - bone, trochar, superficial (eg. ilium, spinous process) Musculoskeletal system 228,000.00 304,000.00 152.00
20240 Marrow Aspirate only + Slides Musculoskeletal system 405,000.00 540,000.00 270.00
20245 - bone, deep (eg. Humerus, ischium, femur) Musculoskeletal system 724,500.00 966,000.00 483.00
20260 Osteotomy, partial, superficial eg. bone spur or exostosis (independent procedure) Musculoskeletal system 336,000.00 448,000.00 224.00
SECURE &
PACKAGES PACKAGES
PACKAGES
20268 - deep or complicated (independent procedure) Musculoskeletal system 504,000.00 672,000.00 336.00
20270 Resection of cyst or tumour - as for malunion of that bone with or without graft. Musculoskeletal system BR BR BR
20271 - with extensive dissection Musculoskeletal system BR BR BR
20275 Incision of superficial soft tissue abscess secondary to osteomyelitis Musculoskeletal system 21,000.00 28,000.00 14.00
20276 Drainage of infected bursa Musculoskeletal system 25,500.00 34,000.00 17.00
20280 Excision tumour benign, deep, subfascial or intra-muscular Musculoskeletal system BR BR BR
20500 Injections of sinus tract, therapeutic (independent procedure) Musculoskeletal system 139,500.00 186,000.00 93.00
20502 Removal of deep foreign body, hand or foot Musculoskeletal system 126,000.00 168,000.00 84.00
20550 Injection, tendon sheath, ligament or trigger points Musculoskeletal system 93,000.00 124,000.00 62.00
20600 Arthrocentesis, apsiration or injection, small joint (eg. fingers, toes) Musculoskeletal system 93,000.00 124,000.00 62.00
20605 - intermediate joint, large joint or bursa Musculoskeletal system 96,000.00 128,000.00 64.00
- major joint or bursa (eg. shoulder, hip, knee joint,subacromial bursa) [Initial -
20610 Musculoskeletal system 103,500.00 138,000.00 69.00
subsequent]
Insertion of wire or pin for skeletal traction including removal (independent

procedure)
Application of cranial tongs, caliper, or stereotactic frame, including removal

(separate procedure)
Application and subsequent removal, caliper or tongs (independent

procedure)cranial
20665 Removal of tongs or halo applied by another physician Musculoskeletal system 166,500.00 222,000.00 111.00
Removal of buried wire, pin, screw, or metal band, rod, nail or plate, superficial
(independent procedure)
20680 - deep Musculoskeletal system 672,000.00 896,000.00 448.00
20685 - completely embedded in bone, By Report Musculoskeletal system 454,500.00 606,000.00 303.00
20902 Autogenous bone,any donor area(no reduction in fee for secondary incision) Musculoskeletal system 955,500.00 1,274,000.00 637.00
20950 Examination of joint(s) under general anaesthesia (independent procedure) Musculoskeletal system 274,500.00 366,000.00 183.00
21298 Dislocations not requiring anaesthesia for reduction Musculoskeletal system FFS FFS FFS
21299 Fractures not requiring reduction Musculoskeletal system FFS FFS FFS
21314 Therapeutic dislocation of turbinates Musculoskeletal system 184,500.00 246,000.00 123.00

SECURE &
PACKAGES PACKAGES
PACKAGES
21315 closed treatment of nasal bone fracture without stabilisation Musculoskeletal system 313,500.00 418,000.00 209.00
21320 with stabilisation Musculoskeletal system 366,000.00 488,000.00 244.00
21335 with concomitant open treatment of fractured septum Musculoskeletal system 1,470,000.00 1,960,000.00 980.00
21336 open treatment of nasal septal fracture with or without stabilisation Musculoskeletal system 867,000.00 1,156,000.00 578.00
21350 Malar area fracture (eg. zygomatic arch, etc) Musculoskeletal system FFS FFS FFS
21351 Fracture of zygonmatic arch or malar complex temporal "lift" without open reduction Musculoskeletal system 225,000.00 300,000.00 150.00
21355 - closed reduction, zygomatic arch (eg. towel clip technique) Musculoskeletal system 502,500.00 670,000.00 335.00
21360 - depressed open reduction Musculoskeletal system 1,047,000.00 1,396,000.00 698.00
- complicated, open reduction with internal skeletal fixation and multiple surgical
21365 Musculoskeletal system 2,097,000.00 2,796,000.00 1,398.00
approaches
21380 Orbital floor fracture, closed or open, without reduction Musculoskeletal system FFS FFS FFS
21385 open treatment of orbital blow out fracture (caldwell luc type procedure) Musculoskeletal system 1,423,500.00 1,898,000.00 949.00
Palatal or alveolar ridge fractures (Le Fort I Type) closed reduction with inter-dental
21421 Musculoskeletal system 979,500.00 1,306,000.00 653.00
wire fixation or fixation of denture or splint
21423 Combination of I, II, III fractures Le Fort Type Musculoskeletal system 1,546,500.00 2,062,000.00 1,031.00
Naso-maxillary complex fracture (Le Fort II type), closed reduction with inter-dental
wire fixation or fixation of denture or splint
Cranio-facial separation (Le Fort III type), closed reduction using inter-dental wire
21431 Musculoskeletal system 1,102,500.00 1,470,000.00 735.00
fixation of denture or splint
21450 Mandibular fracture, closed or open, without reduction Musculoskeletal system FFS FFS FFS
21455 - closed reduction without inter-dental fixation Musculoskeletal system 445,500.00 594,000.00 297.00
21461 - open reduction without inter-dental fixation Musculoskeletal system 1,879,500.00 2,506,000.00 1,253.00
21462 - with inter-dental fixation Musculoskeletal system 2,145,000.00 2,860,000.00 1,430.00
Temporo-mandibular dislocation with uncomplicated closed reduction, initial or

21480 Musculoskeletal system FFS FFS FFS
subsequent
21485 - under general anaesthetic Musculoskeletal system 490,500.00 654,000.00 327.00
21490 - open reduction Musculoskeletal system 1,467,000.00 1,956,000.00 978.00
21556 deep,subfacial,intramusular Musculoskeletal system 741,000.00 988,000.00 494.00
21610 Costotransversectomy (independent procedure) Musculoskeletal system 1,318,500.00 1,758,000.00 879.00

SECURE &
PACKAGES PACKAGES
PACKAGES
21615 Excision compression syndrome or other cause Musculoskeletal system 1,492,500.00 1,990,000.00 995.00
21705 Division of scalenus with/without resection of cervical rib Musculoskeletal system 1,137,000.00 1,516,000.00 758.00
21720 Division of sternocleidomastoid for torticollis, open Musculoskeletal system 739,500.00 986,000.00 493.00
21740 Pectus excavatum or carinatum, plastic repair Musculoskeletal system 1,989,000.00 2,652,000.00 1,326.00
21798 Dislocation not requiring anaesthesia for reduction Musculoskeletal system FFS FFS FFS
21810 "Flail chest", stove-in chest treated by external fixation Musculoskeletal system 1,084,500.00 1,446,000.00 723.00
21820 Sternum, fracture, closed reduction Musculoskeletal system 216,000.00 288,000.00 144.00
21825 - open reduction Musculoskeletal system 1,101,000.00 1,468,000.00 734.00
22031 Excision tumour, benign, deep, subfascial or intramuscular, cervical Musculoskeletal system BR BR BR
Partial resection or vertebral component, spinous process (eg. "Kissing spines"),

cervical
Osteotomy of spine for correction of fixed deformity (eg. Ankylosing spondylitis),

anterior or posterior approach (except scoliosis)
22202 - anterior and posterior Musculoskeletal system BR BR BR
22315 Vertebral body fracture, manipulative reduction with anaesthesia Musculoskeletal system 8,911,500.00 11,882,000.00 5,941.00
22325 - open reduction Musculoskeletal system 2,184,000.00 2,912,000.00 1,456.00
- cervical spine, open reduction and fusion, posterior approach, with local bone
graft and/or skeletal fixation, multiple
22331 - single Musculoskeletal system 1,434,000.00 1,912,000.00 956.00
- anterior approach, with iliac or other autogenous bone graft (includes obtaining
graft)
- thoracic or lumbar spine, open reduction and fusion, posterior approach, local
bone graft and/or skeletal fixation
22372 Spine, closed reduction of dislocation, cervical, thoracic or lumbar Musculoskeletal system 420,000.00 560,000.00 280.00
22500 Spine, and region Musculoskeletal system 16,500.00 22,000.00 11.00
22505 Spine, any region, with anaesthesia Musculoskeletal system 222,000.00 296,000.00 148.00
SECURE &
PACKAGES PACKAGES
PACKAGES
Posterior approach, cranio-cervical fusion (occiput through C2), with iliac or other
autogenous bone graft (includes obtaining graft)
Posterior or anterior approach, atlas-axis fusion (C1 to C2 or C3), with iliac or other
autogenous bone graft (includes obtaining graft)
22604 Posteria approach, cervical below C1 level, local bone graft and/or skeletal fixation Musculoskeletal system 1,344,000.00 1,792,000.00 896.00
Posterior or posteriolateral approach, thoracic or lumbar, local bone graft or skeletal

fixation
Posterior interbody technique, lumbar, with iliac or other autogenous bone graft
(includes obtaining graft) single level
Lateral approach (transverse process to transverse process and/or sacrum) with

22670 iliac or other autogenous bone graft and/or skeletal fixation (includes obtaining Musculoskeletal system 1,764,000.00 2,352,000.00 1,176.00
graft)
Anterior approach (C3 - T1) with iliac or other autogenous bone graft (includes
discectomy and obtaining graft), single
Anterior interbody technique, lumbar (includes discectomy and obtaining graft),

single
22730 Multiple levels, one additional level, add Musculoskeletal system 336,000.00 448,000.00 224.00
22735 - more than two levels Musculoskeletal system BR BR BR
22799 Halo-splint and POP jacket Musculoskeletal system 420,000.00 560,000.00 280.00
Scoliosis correction (includes first postoperative cast), uncomplicated, each stage,

6 or less vertebrae, local bone
22802 - seven or more vertebrae, local bone Musculoskeletal system 4,635,000.00 6,180,000.00 3,090.00
22840 Scoliosis correction, Harrington rod technique Musculoskeletal system 1,366,500.00 1,822,000.00 911.00
22841 - Dryer technique Musculoskeletal system 1,065,000.00 1,420,000.00 710.00
22842 Revision of fusion and repair of pseudoarthrosis at one or more levels Musculoskeletal system 1,420,500.00 1,894,000.00 947.00
Multiple operative techniques by same surgeon within 12 months of scheduled fee

for lesser procedures
23000 Removal of subdeltoid (or intra tendious) careous deposits Musculoskeletal system 691,500.00 922,000.00 461.00
23020 Capsular contracture release (eg. Sever's procedure) for Erb's palsy Musculoskeletal system 1,263,000.00 1,684,000.00 842.00
Arthrotomy or capsulotomy with exploration, drainage, or removal of foreign body,

glenohumeral joint
23045 - acromiclavicular or sternoclavicular joint Musculoskeletal system 277,500.00 370,000.00 185.00
23105 Synovectomy, glenohumeral Musculoskeletal system 1,377,000.00 1,836,000.00 918.00
23120 Claviculectomy, either end (eg. Mumford procedure) Musculoskeletal system 945,000.00 1,260,000.00 630.00
23130 Acromionectomy Musculoskeletal system 1,144,500.00 1,526,000.00 763.00

SECURE &
PACKAGES PACKAGES
PACKAGES
23190 Osteotomy of scapula, partial (eg. superior medical angle) Musculoskeletal system 1,039,500.00 1,386,000.00 693.00
23195 Resection, humeral head Musculoskeletal system 1,438,500.00 1,918,000.00 959.00
23300 Prosthetic implant removal from shoulder joint Musculoskeletal system 613,500.00 818,000.00 409.00
23350 Injection procedure for shoulder arthrography Musculoskeletal system 157,500.00 210,000.00 105.00
23355 Arthroscopy of shoulder, with/without biopsy Musculoskeletal system 336,000.00 448,000.00 224.00
Muscle transfer, any type for paralysis of shoulder, single, including fascial
extension
23400 Scapulopexy (eg. Sprengel's deformity or paralysis) Musculoskeletal system 1,845,000.00 2,460,000.00 1,230.00
23410 Repair of ruptured supraspinatus tendon or musculotendinous cuff, accute Musculoskeletal system 1,812,000.00 2,416,000.00 1,208.00
23412 - chronic Musculoskeletal system 2,037,000.00 2,716,000.00 1,358.00
Decompression Rotator Cuff (Rookwood) - includes complete or partial

acromionectomy and excision outer clavicle
23420 Repair of complete shoulder cuff avulsion, chronic (includes acromionectomy) Musculoskeletal system 2,154,000.00 2,872,000.00 1,436.00
23430 Tenodesis for rupture of long tendon of biceps Musculoskeletal system 1,375,500.00 1,834,000.00 917.00
Capsulorrhaphy for recurrent dislocation anterior (eg. Putti-Platt or Magnisen

procedure)
23455 - Bankart procedure, with or without stapling Musculoskeletal system 2,269,500.00 3,026,000.00 1,513.00
23457 Osteotomy neck of scapula, with or without skeletal fixation Musculoskeletal system 1,008,000.00 1,344,000.00 672.00
23460 - with bone block Musculoskeletal system 2,266,500.00 3,022,000.00 1,511.00
23462 - with coracoid process transfer Musculoskeletal system 2,320,500.00 3,094,000.00 1,547.00
23465 - posterior, with or without bone block Musculoskeletal system 2,310,000.00 3,080,000.00 1,540.00
23470 Arthroplasty, shoulder, with proximal humeral implant (eg. Neer endoprosthesis) Musculoskeletal system 2,575,500.00 3,434,000.00 1,717.00
23472 - with glenoid and proximal humeral prosthetic replacement ("total should") Musculoskeletal system 3,138,000.00 4,184,000.00 2,092.00
23480 Osteotomy, clavicle, with or without skeletal fixation Musculoskeletal system 1,425,000.00 1,900,000.00 950.00
- with bone graft for non-union or malunion (includes obtaining graft and/or skeletal
fixation)
SECURE &
PACKAGES PACKAGES
PACKAGES
23505 Clavicle fracture, closed manipulative reduction Musculoskeletal system 526,500.00 702,000.00 351.00
23510 - open, with uncomplicated soft tissue closure, manipulative reduction Musculoskeletal system 277,500.00 370,000.00 185.00
23515 - closed or open, open reduction with or without skeletal fixation Musculoskeletal system 1,164,000.00 1,552,000.00 776.00
23525 Sternoclavicular dislocation, closed, manipulative reduction requiring anesthesia Musculoskeletal system 480,000.00 640,000.00 320.00
23530 - closed or open, acute or chronic, open reduction or repair Musculoskeletal system 1,081,500.00 1,442,000.00 721.00
23532 - with fascial graft (includes obtaining graft) Musculoskeletal system 1,191,000.00 1,588,000.00 794.00
23545 Acromioclavicular dislocation, closed reduction and pinning Musculoskeletal system 445,500.00 594,000.00 297.00
Acromioclavicular dislocation, closed or open acute or chronic, open reduction,

includes skeletal fixation and coracoid transfer
23552 - with fascial graft (includes obtaining graft) Musculoskeletal system 1,225,500.00 1,634,000.00 817.00
Scapular fracture, closed, manipulative reduction (with or without shoulder joint

involvements)
Scapular fracture, open. With uncomplicated soft tissue closure, manipulative

reduction
23585 - closed or open, juxta-articular, open reduction, with or without skeletal fixation Musculoskeletal system 1,401,000.00 1,868,000.00 934.00
23605 Humerus, surgical or anatomical neck, fracture, closed, manipulative reduction Musculoskeletal system 778,500.00 1,038,000.00 519.00
23615 - closed or open, open reduction with or without skeletal fixation Musculoskeletal system 1,563,000.00 2,084,000.00 1,042.00
23625 Greater tuberosity fracture, closed, manipulative reduction Musculoskeletal system 624,000.00 832,000.00 416.00
23630 - closed or open, open reduction with or without skeletal fixation Musculoskeletal system 1,290,000.00 1,720,000.00 860.00
23656 Shoulder dislocation, closed, manipulative reduction, requiring anaesthesia Musculoskeletal system 277,500.00 370,000.00 185.00
23670 - closed or open, open reduction Musculoskeletal system 1,413,000.00 1,884,000.00 942.00
23680 - plus fractured neck of humerus, closed or open, open reduction Musculoskeletal system 1,726,500.00 2,302,000.00 1,151.00
Manipulation under anaesthesia, including application or fixation apparatus

(dislocation excluded)
23800 Fusion of shoulder joint, with or without local bone graft Musculoskeletal system 1,092,000.00 1,456,000.00 728.00
23900 Interthoracoscapular (forequarter) Musculoskeletal system 2,514,000.00 3,352,000.00 1,676.00
23920 Disarticulation of shoulder Musculoskeletal system 2,182,500.00 2,910,000.00 1,455.00

SECURE &
PACKAGES PACKAGES
PACKAGES
Arthrotomy (Capsulotomy), elbow with exploration, drainage, or removal of foreign

body
24102 Arthrotomy (Capsulotomy), elbow for synovectomy Musculoskeletal system 1,185,000.00 1,580,000.00 790.00
24105 Olecranon bursa excision Musculoskeletal system 1,173,000.00 1,564,000.00 782.00
24130 Radial head excision Musculoskeletal system 1,206,000.00 1,608,000.00 804.00
24155 Resection of elbow joint (arthrectomy) Musculoskeletal system 1,723,500.00 2,298,000.00 1,149.00
24160 Implant removal, elbow joint Musculoskeletal system 1,027,500.00 1,370,000.00 685.00
24164 - from radius or ulna or carpus Musculoskeletal system 919,500.00 1,226,000.00 613.00
Tendoplasty, transplantation or free graft, with muscle transfer and with or without
free graft, elbow to shoulder, single (eg. Seddon Brooks procedure)
24330 Flexor-plasty, elbow (eg. Steindler advancement) Musculoskeletal system 1,426,500.00 1,902,000.00 951.00
Reinsertion ruptured biceps tendon, distal, with or without tendon graft (includes
obtaining graft)
Fasciotomy, lateral or medial (eg "tennis elbow" or epicondylitis), with or without

extensor origin detachment, with or without annular ligament resection
24360 Arthroplasty, elbow, with membrane Musculoskeletal system 2,056,500.00 2,742,000.00 1,371.00
24362 - with distal humeral and proximal ulnar prosthetic replacement ("total elbow") Musculoskeletal system 2,103,000.00 2,804,000.00 1,402.00
24365 Arthroplasty, radial head, with implant Musculoskeletal system 1,239,000.00 1,652,000.00 826.00
24400 Osteotomy, humerus, with or without skeletal fixation Musculoskeletal system 1,539,000.00 2,052,000.00 1,026.00
Multiple osteotomies, humerus, with realignment or intramedullary rod (eg. Sofield

procedure)
Repair of non-union or malunion, humerus (include bone grafting and/or internal

fixation)
24498 Dislocations not requiring anaesthesia for reduction Musculoskeletal system 1,728,000.00 2,304,000.00 1,152.00
24505 Humeral shaft fracture, manipulative reduction Musculoskeletal system 793,500.00 1,058,000.00 529.00
24515 - closed or open, open reduction, with or without skeletal fixation Musculoskeletal system 1,660,500.00 2,214,000.00 1,107.00
24535 Humerus supracondylar fracture, closed, manipulative reduction Musculoskeletal system 972,000.00 1,296,000.00 648.00
24536 - closed, with traction, pin or skin Musculoskeletal system 504,000.00 672,000.00 336.00
SECURE &
PACKAGES PACKAGES
PACKAGES
24540 - open with uncomplicated soft tissue closure manipulative reduction Musculoskeletal system 504,000.00 672,000.00 336.00
24565 Condylar or epicondylar fracture, medial or lateral, closed, manipulative reduction Musculoskeletal system 760,500.00 1,014,000.00 507.00
Comminuted elbow fracture eg. fracture distal humerus and/or proximal radius),
closed, manipulated reduction
24585 - closed or open, open reduction with or without skeletal fixation Musculoskeletal system 882,000.00 1,176,000.00 588.00
24605 Elbow dislocation, closed, manipulative reduction requiring anaesthisia Musculoskeletal system 655,500.00 874,000.00 437.00
24615 Elbow dislation, closed or open, open reduction Musculoskeletal system 1,432,500.00 1,910,000.00 955.00
Monteggia type of fracture dislation at elbow (fracture proximal end of ulna with
dislocation or radial head), closed, manipulative reduction
24635 - closed or open, open reduction, with or without fixation Musculoskeletal system 1,822,500.00 2,430,000.00 1,215.00
24655 Olecranon, radial head or neck fracture, closed, manipulative reduction Musculoskeletal system 633,000.00 844,000.00 422.00
24666 - with implant Musculoskeletal system 1,506,000.00 2,008,000.00 1,004.00
24685 - closed or open, open reduction with or without skeletal fixation or excision Musculoskeletal system 1,324,500.00 1,766,000.00 883.00
Manipulation of elbow joint under general anaesthesia (includes application of

traction or other fixation device)
24800 Fusion of elbow joint, with or without local or non-autogenous graft Musculoskeletal system 1,669,500.00 2,226,000.00 1,113.00
24900 Arm, through humerus, with primary closure Musculoskeletal system 1,333,500.00 1,778,000.00 889.00
25000 Tenovaginotomy at wrist (eg. De Quervain's Disease). Musculoskeletal system 609,000.00 812,000.00 406.00
25030 Incision and drainage of deep abscess or haematoma Musculoskeletal system 277,500.00 370,000.00 185.00
25100 Arthrotmy (Capsulotomy), wrist joint, for biopsy Musculoskeletal system 676,500.00 902,000.00 451.00
25111 Excision of ganglion, wrist (volar or dorsal) Musculoskeletal system 543,000.00 724,000.00 362.00
SECURE &
PACKAGES PACKAGES
PACKAGES
25112 - recurrent Musculoskeletal system 675,000.00 900,000.00 450.00
25116 Tenosynovectomy, tendon sheath, one or more sheaths, forearm or wrist Musculoskeletal system 1,225,500.00 1,634,000.00 817.00
Synovectomy, distal radio-ulnar joint with excision of distal ulna for rheumatoid
arthritis (independent procedure)
25210 Carpectomy, one bone Musculoskeletal system 868,500.00 1,158,000.00 579.00
25215 - all bone of proximal row Musculoskeletal system 1,282,500.00 1,710,000.00 855.00
25230 Radial styloidectomy (independent procedure) Musculoskeletal system 841,500.00 1,122,000.00 561.00
25240 Excision distal ulna (e.g. Darrach procedure) Musculoskeletal system 837,000.00 1,116,000.00 558.00
25260 Repair, flexor muscle or tendon, forearm or wrist, primary, single Musculoskeletal system 1,072,500.00 1,430,000.00 715.00
25261 - each additional muscle or tendon Musculoskeletal system 75,000.00 100,000.00 50.00
25262 - secondary, single Musculoskeletal system 453,000.00 604,000.00 302.00
25263 - each additional muscle or tendon Musculoskeletal system 1,144,500.00 1,526,000.00 763.00
25280 Lengthening or shortening of flexor or extensor tendon (independent procedure) Musculoskeletal system 990,000.00 1,320,000.00 660.00
25281 - each additional tendon Musculoskeletal system 75,000.00 100,000.00 50.00
25290 Tenotomy, open, single flexor or extensor tendon Musculoskeletal system 748,500.00 998,000.00 499.00
25300 Tenodesis at wrist, one or more flexors or extensors of digits Musculoskeletal system 1,284,000.00 1,712,000.00 856.00
25308 Tendon transplant or transfer, flexor or extensor, single tendon Musculoskeletal system 529,500.00 706,000.00 353.00
25317 Flexor origin slide, forearm - Seddon or Scaglietti Musculoskeletal system 756,000.00 1,008,000.00 504.00
25330 Arthroplasty, wrist Musculoskeletal system 630,000.00 840,000.00 420.00
25350 Osteotomy, radius or ulna, distal third Musculoskeletal system 1,341,000.00 1,788,000.00 894.00
25355 - middle or proximal two - thirds Musculoskeletal system 1,552,500.00 2,070,000.00 1,035.00
25365 - radius and ulna Musculoskeletal system 1,819,500.00 2,426,000.00 1,213.00
Repair of non-union or mal-union, radius or ulna (includes bone grafting and/or

internal fixation)[eg. compression technique]
SECURE &
PACKAGES PACKAGES
PACKAGES
- radius and ulna (includes bone grafting and/or internal fixation)[eg. compression
technique]
25430 Centralisation of wrist on ulna (eg. radial club hand) Musculoskeletal system 1,278,000.00 1,704,000.00 852.00
Repair of non-union, carpal scaphoid (navicular), with or without radial

styloidectomy
25441 Arthroplasty with prosthetic replacement, distal radius Musculoskeletal system 1,878,000.00 2,504,000.00 1,252.00
25442 - distal ulna Musculoskeletal system 1,434,000.00 1,912,000.00 956.00
25444 - lunate, scaphoid or trapezium Musculoskeletal system 1,650,000.00 2,200,000.00 1,100.00
25446 distal radius and partial or entire carpus ("total wrist") Musculoskeletal system 2,716,500.00 3,622,000.00 1,811.00
Radial or ulna fracture, includes distal ends, eg. Colles' or Smith's or epiphyseal
separation, with or without fracture of ulna styloid, closed manipulative reduction
25514 - closed or open, open reduction, with or without skeletal fixation Musculoskeletal system 562,500.00 750,000.00 375.00
25564 Radial and ulna shaft fractures, closed reduction Musculoskeletal system 336,000.00 448,000.00 224.00
25574 - closed or open, open reduction, with or without skeletal fixation Musculoskeletal system 1,189,500.00 1,586,000.00 793.00
Carpal bone fracture(s), open, with or uncomplicated soft tissue closure,

manipulative reduction
25645 -closed or open, open reduction Musculoskeletal system 1,086,000.00 1,448,000.00 724.00
Radio-carpal or inter-carpal dislocation, closed, one or more bones, manipulative

reduction requiring anaesthesia
Trans-scapho-perilunar fracture dislocation, closed, manipulative reduction

requiring anaesthesia
25690 Lunate dislocation, manipulative reduction Musculoskeletal system 822,000.00 1,096,000.00 548.00
25691 - closed or open, open reduction Musculoskeletal system 420,000.00 560,000.00 280.00
25800 Wrist joint, without autogenous bone graft Musculoskeletal system 1,582,500.00 2,110,000.00 1,055.00
SECURE &
PACKAGES PACKAGES
PACKAGES
25900 Forearm, through radius and ulna Musculoskeletal system 1,302,000.00 1,736,000.00 868.00
25910 Kurkenberg Musculoskeletal system 840,000.00 1,120,000.00 560.00
25920 Amputation through wrist Musculoskeletal system 1,236,000.00 1,648,000.00 824.00
25927 Transmetacarpal Musculoskeletal system 1,263,000.00 1,684,000.00 842.00
Drainage of finger tip abscess, complicated (eg. Felon), requiring general or

regional anaesthesia
26020 Drainage of tendon sheath, acute suppurative tenosynovitis, one finger and/or palm Musculoskeletal system 666,000.00 888,000.00 444.00
Drainage of tendon sheath, acute suppurative tenosynovitis, multiple or

26030 Musculoskeletal system BR BR BR
complicated
26045 Fasciotomy, palmar, for Dupuytren's contracture - open Musculoskeletal system 831,000.00 1,108,000.00 554.00
26055 Tenovaginotomy for "Trigger" finger or thumb Musculoskeletal system 640,500.00 854,000.00 427.00
Capsulotomy or arthrotomy for biopsy carpometacarpal joint; metacarpophalangeal

joint and interphalangeal joint
26120 Palmar fasciectomy, partial, simple for Dupuytren's contracture Musculoskeletal system 345,000.00 460,000.00 230.00
- up to one-half palma fascia, with single finger involvement, with or without Z-

plasty or other local tissue rearrangement
26124 - complicated, requiring skin graft (including obtaining graft) Musculoskeletal system 840,000.00 1,120,000.00 560.00
26127 - each additional finger Musculoskeletal system 168,000.00 224,000.00 112.00
26130 Synovectomy, carpometacarpal and intercarpal joint Musculoskeletal system 828,000.00 1,104,000.00 552.00
26135 - metacarpophalangeal joint, including intrinsic release and extensor reconstruction Musculoskeletal system 957,000.00 1,276,000.00 638.00
26140 - interphalangeal joint, including extensor reconstruction Musculoskeletal system 858,000.00 1,144,000.00 572.00
26142 - each additional joint, including extensor reconstruction Musculoskeletal system 177,000.00 236,000.00 118.00
26160 Excision of lesion of tendon sheath or capsule (eg. cyst or ganglion) hand or finger Musculoskeletal system 597,000.00 796,000.00 398.00
Flexor tendon repair or advancement, single (without free tendon graft) primary or
secondary
26352 Flexor tendon repair, with tendon graft (includes obtaining graft), single Musculoskeletal system 1,242,000.00 1,656,000.00 828.00
Excision of flexor tendon with implantation of plastic tube or rod or sheath, for
delayed tendon graft, single finger
26392 Removal of tube or rod and insertion of tendon graft (includes obtaining graft) Musculoskeletal system 1,590,000.00 2,120,000.00 1,060.00
Extensor tendon repair, dorsum of hand, dorsum of finger, primary or secondary,

single
SECURE &
PACKAGES PACKAGES
PACKAGES
26420 - with graft (includes obtaining graft) Musculoskeletal system 1,087,500.00 1,450,000.00 725.00
26426 - central slip repair, secondary local tissues Musculoskeletal system 1,042,500.00 1,390,000.00 695.00
26428 - with graft (includes obtaining graft) Musculoskeletal system 1,123,500.00 1,498,000.00 749.00
26432 - distal insertion repair, secondary ("mallet finger") Musculoskeletal system 672,000.00 896,000.00 448.00
26440 Tenolysis, flexor tendon, hand or fingers, single Musculoskeletal system 819,000.00 1,092,000.00 546.00
26441 - multiple, through same incision Musculoskeletal system 420,000.00 560,000.00 280.00
26447 Tenolysis, extensor tendon Musculoskeletal system 210,000.00 280,000.00 140.00
26471 Tenodesis for proximal interphalangeal joint stabilization Musculoskeletal system 888,000.00 1,184,000.00 592.00
26474 - for distal joint stabilization Musculoskeletal system 883,500.00 1,178,000.00 589.00
26480 Tendon transfer or transplant, carpometacarpal area or dorsum of hand, single Musculoskeletal system 1,167,000.00 1,556,000.00 778.00
26481 - multiple Musculoskeletal system 630,000.00 840,000.00 420.00
26490 Opponens-plasty (transfer), sublimis tendon transfer type, with or without graft Musculoskeletal system 1,339,500.00 1,786,000.00 893.00
26502 Tendon pulley reconstruction with tendon or fascial graft (includes obtaining graft) Musculoskeletal system 1,072,500.00 1,430,000.00 715.00
26516 Capsulodesis for metacarpophalangeal joint stabilization, single finger Musculoskeletal system 1,003,500.00 1,338,000.00 669.00
26518 - multiple, same hand Musculoskeletal system 1,315,500.00 1,754,000.00 877.00
26530 Arthroplasty, metacarpophalangeal joint, single Musculoskeletal system 948,000.00 1,264,000.00 632.00
26531 - with prosthetic implant Musculoskeletal system 1,153,500.00 1,538,000.00 769.00
- multiple, with or without prosthetic implant (add 50% for second joint, 23% for
each additional joint)
26535 - each interphalangeal joint, single Musculoskeletal system 771,000.00 1,028,000.00 514.00
26536 - with prosthetic implant Musculoskeletal system 1,119,000.00 1,492,000.00 746.00
- multiple, with or without prosthetic implant (add 50% for second joint, 25% for
each additional joint)
26540 Reconstruction, collateral ligament, metacarpophalangeal joint Musculoskeletal system 1,095,000.00 1,460,000.00 730.00
26550 Pollicization of finger Musculoskeletal system 3,198,000.00 4,264,000.00 2,132.00
26560 Repair of syndactyly (web finger) with skin flaps Musculoskeletal system 865,500.00 1,154,000.00 577.00
SECURE &
PACKAGES PACKAGES
PACKAGES
26561 - with skin flaps and grafts (includes obtaining graft) Musculoskeletal system 1,608,000.00 2,144,000.00 1,072.00
26565 Osteotomy for correction of deformity, metacarpal or phalanx Musculoskeletal system 1,074,000.00 1,432,000.00 716.00
26570 Bone graft, metacarpal or phalanx (includes obtaining graft and/or internal fixation) Musculoskeletal system 420,000.00 560,000.00 280.00
Crushed hand - inital treatment, including removal of dead tissue under general
anaesthetic and six weeks' after care
26605 Metacarpal fracture, single, closed, manipulative reduction Musculoskeletal system 444,000.00 592,000.00 296.00
26610 - open, with manipulative reduction Musculoskeletal system 177,000.00 236,000.00 118.00
26615 - closed or open, open reduction, with or without skeletal fixation Musculoskeletal system 853,500.00 1,138,000.00 569.00
26625 - multiple, manipulative reduction Musculoskeletal system 210,000.00 280,000.00 140.00
- open reduction metacarpal fracture closed or open, multiple, with or without

internal or external skeletal fixation
Carpometacarpal fracture and/or dislocation, thump (eg. Bennett fracture) closed,

with manipulative reduction
26650 - closed, with skeletal fixation Musculoskeletal system 795,000.00 1,060,000.00 530.00
Intercarpal, carpometacarpal or metacarpophalangeal dislocation, closed, single,

manipulative reduction with anaesthesia
Phalangeal fracture, proximal or middle, finger or thumb, closed, manipulative

reduction
26735 closed or open, open reduction, with or without skeletal fixation Musculoskeletal system 826,500.00 1,102,000.00 551.00
26755 - distal phalanx, finger or thumb, closed manipulative reduction Musculoskeletal system 430,500.00 574,000.00 287.00
26765 - closed or open reduction, with or without skeletal fixation Musculoskeletal system 610,500.00 814,000.00 407.00
26766 - intra-articular fracture, complex, open reduction, with or without skeletal fixation Musculoskeletal system 352,500.00 470,000.00 235.00
SECURE &
PACKAGES PACKAGES
PACKAGES
Inter-phalangeal joint dislocation, closed, single, manipulative reduction requiring

anaesthesia
Fusion in apposition, thumb, intermetacarpal with autogenous graft (includes

obtaining graft)
26841 Carpometacarpal joint, thumb or finger, with or without skeletal fixation Musculoskeletal system 1,146,000.00 1,528,000.00 764.00
26850 Metacarpophalangeal joint, with or without skeletal fixation Musculoskeletal system 1,017,000.00 1,356,000.00 678.00
26860 Interphalangeal joint, with or without skeletal fixation Musculoskeletal system 810,000.00 1,080,000.00 540.00
Metacarpal, with finger or thumb (ray amputation), single, with or without

interosseous transfer
26951 Finger or thumb Musculoskeletal system 733,500.00 978,000.00 489.00
26952 - with local advancement flaps (V-Y hood) Musculoskeletal system 924,000.00 1,232,000.00 616.00
Tenotomy, adductor, subcutaneous, closed (independent procedure) requiring

anaesthesia
27001 - open Musculoskeletal system 861,000.00 1,148,000.00 574.00
27015 Iliac crest fasciotomy (eg. Soutter or Campbel procedures) with stripping of ilium Musculoskeletal system 445,500.00 594,000.00 297.00
27030 Arthrotomy (capsulotomy), dip, for drainage Musculoskeletal system 1,875,000.00 2,500,000.00 1,250.00
27054 Arthrotomy (capsulotomy) for synovectomy hip Musculoskeletal system 1,447,500.00 1,930,000.00 965.00
27062 Hip excision of bursa or calcification Musculoskeletal system 852,000.00 1,136,000.00 568.00
27081 Excision, saco-coccygeal teratoma, perineal approach Musculoskeletal system BR BR BR
27082 - abdominal and perineal approach Musculoskeletal system BR BR BR
27090 Removal of hip prosthesis (independent procedure) Musculoskeletal system 1,672,500.00 2,230,000.00 1,115.00
27091 Removal of "total hip" component(s) Musculoskeletal system 3,193,500.00 4,258,000.00 2,129.00
27110 Iliopsoas transfer to greater trochanter (eg. Mustard or Sharrad) Musculoskeletal system 1,851,000.00 2,468,000.00 1,234.00
27115 Muscle release, complete ("Hanging hip") procedure Musculoskeletal system 1,134,000.00 1,512,000.00 756.00
27120 Acetabuloplasty (eg. Colonna or Whittman) Musculoskeletal system 2,706,000.00 3,608,000.00 1,804.00
27122 - resection femoral head (eg. Girdlestone procedure) Musculoskeletal system 2,407,500.00 3,210,000.00 1,605.00
SECURE &
PACKAGES PACKAGES
PACKAGES
27126 Arthroplasty, cup Musculoskeletal system 1,386,000.00 1,848,000.00 924.00
27127 - with acetabuloplasty Musculoskeletal system 1,680,000.00 2,240,000.00 1,120.00
27130 Acetabular and proximal femoral prosthetic replacement ("total hip") Musculoskeletal system 3,292,500.00 4,390,000.00 2,195.00
Giliberty or similar Endo Prosthesis where the acetabular component is not

cemented into position
27140 Osteotomy and transfer of greater trochanter (independent procedure) Musculoskeletal system 1,789,500.00 2,386,000.00 1,193.00
27147 Osteotomy, iliac or acetabular (eg. Pemberton, Chiari, or Salter procedure) Musculoskeletal system 2,784,000.00 3,712,000.00 1,856.00
27154 - with open reduction of hip Musculoskeletal system 1,218,000.00 1,624,000.00 812.00
27162 Osteotomy, femoral neck (independent procedure) Musculoskeletal system 1,218,000.00 1,624,000.00 812.00
27165 Osteotomy, inter or subtrochanteric, including skeletal fixation and/or cast Musculoskeletal system 2,638,500.00 3,518,000.00 1,759.00
Bone graft for non-union, femoral head, neck intertrochanteric or subtrochanteric

area (includes obtaining graft and/or internal fixation)
27173 Slipped femoral epiphysis, treated by single or multiple pinning, in situ Musculoskeletal system 1,134,000.00 1,512,000.00 756.00
27174 - closed reduction, with single or multiple pinning Musculoskeletal system 1,176,000.00 1,568,000.00 784.00
27177 - open reduction, single or multiple pinning or bone graft (includes ontaining graft) Musculoskeletal system 2,110,500.00 2,814,000.00 1,407.00
27181 - osteotomy and internal fixation Musculoskeletal system 2,136,000.00 2,848,000.00 1,424.00
27188 Dislocations not requiring anaesthesia for reduction Musculoskeletal system FFS FFS FFS
Iliac, pubic and or ischial fracture(s), closed or open, open reduction, with or without
skeletal fixation
27222 Acetabulum fracture(s), manipulative reduction, with or without skeletal traction Musculoskeletal system 1,506,000.00 2,008,000.00 1,004.00
27224 - closed skeletal fixation Musculoskeletal system 1,218,000.00 1,624,000.00 812.00
Femur, fracture, proximal end, neck, intertrochanteric or pertrochanteric, closed,

manipulative reduction, including skeletal traction
- open, with uncomplicated soft tissue closure, manipulative reduction including

skeletal traction
27236 - closed or open, internal fixation or prosthetic replacement Musculoskeletal system 2,443,500.00 3,258,000.00 1,629.00
27252 Hip dislocation, traumatic, closed manipulative reduction requiring anaesthesia Musculoskeletal system 1,186,500.00 1,582,000.00 791.00
27253 - closed or open, open reduction Musculoskeletal system 1,974,000.00 2,632,000.00 1,316.00
SECURE &
PACKAGES PACKAGES
PACKAGES
27255 - with acetabular lip fracture, with or without skeletal fixation Musculoskeletal system 1,218,000.00 1,624,000.00 812.00
27256 - congenital, by abduction, splint or traction, any method Musculoskeletal system FFS FFS FFS
27257 - closed reduction requiring anaesthesia Musculoskeletal system 730,500.00 974,000.00 487.00
27258 - open reduction, including tenotomy Musculoskeletal system 2,232,000.00 2,976,000.00 1,488.00
27275 Hip joints, requiring general anaesthesia Musculoskeletal system 321,000.00 428,000.00 214.00
27276 - with hip spica, requiring general anaesthesia Musculoskeletal system 198,000.00 264,000.00 132.00
27280 Sacro-iliac joint (includes obtaining graft) Musculoskeletal system 1,983,000.00 2,644,000.00 1,322.00
27284 Hip joint (includes obtaining graft) Musculoskeletal system 2,581,500.00 3,442,000.00 1,721.00
27286 - with subtrochanteric osteotomy Musculoskeletal system 2,622,000.00 3,496,000.00 1,748.00
27290 Interpelviabdominial amputation (hind-quarter amputation) Musculoskeletal system 4,138,500.00 5,518,000.00 2,759.00
27295 Disarticulation of hip Musculoskeletal system 2,658,000.00 3,544,000.00 1,772.00
27305 Ilio-tibial fasciotomy (tenotomy), open (Ober-Yount) Musculoskeletal system 778,500.00 1,038,000.00 519.00
Tenotomy, subcutaneous (closed), distal hamstrings, multiple, with or without

adductor (independent procedure)
Arthrotomy or capsulotomy, knee, with exploration, drainage or removal of foreign

body
27315 Hamstring or popliteal (gastrocnemius) neurectomy Musculoskeletal system 487,500.00 650,000.00 325.00
27331 Arthrotomy with joint exploration, for removal of loose bodies Musculoskeletal system 1,018,500.00 1,358,000.00 679.00
Arthrotomy (capsulotomy) knee, for excision of semilunar cartilage (meniscectomy),

medial or lateral
27333 - meniscectomy, medial and lateral Musculoskeletal system 1,390,500.00 1,854,000.00 927.00
27335 - for synovectomy, anterior or posterior Musculoskeletal system 1,639,500.00 2,186,000.00 1,093.00
27336 - anterior and posterior (includes popliteal area) Musculoskeletal system 966,000.00 1,288,000.00 644.00
27337 - including medial and lateral meniscectomies add Musculoskeletal system 675,000.00 900,000.00 450.00
27338 - with pes anserinus transfer Musculoskeletal system 966,000.00 1,288,000.00 644.00
27340 Excision, prepatella bursa Musculoskeletal system 642,000.00 856,000.00 428.00
27345 Excision of synovial cyst of popliteal space (eg. Baker's cyst) Musculoskeletal system 909,000.00 1,212,000.00 606.00
SECURE &
PACKAGES PACKAGES
PACKAGES
27350 Patellectomy or hemipatellectomy Musculoskeletal system 1,333,500.00 1,778,000.00 889.00
27371 Removal of total knee components Musculoskeletal system 672,000.00 896,000.00 448.00
27376 Arthroscopy of knee with or without biopsy Musculoskeletal system 336,000.00 448,000.00 224.00
27380 Suture of infrapatellar tendon, primary Musculoskeletal system 1,165,500.00 1,554,000.00 777.00
27381 - secondary reconstruction, including fascial or tendon graft Musculoskeletal system 1,651,500.00 2,202,000.00 1,101.00
27385 Suture of quadriceps muscle or tendon rupture, primary Musculoskeletal system 1,272,000.00 1,696,000.00 848.00
27386 - secondary reconstruction, including fascial or tendon graft Musculoskeletal system 1,741,500.00 2,322,000.00 1,161.00
27387 Tenotomy, open, hamstring, knee to hip, single Musculoskeletal system 277,500.00 370,000.00 185.00
27388 - multiple, one leg Musculoskeletal system 394,500.00 526,000.00 263.00
27391 Lengthening of hamstring tendon, single Musculoskeletal system 1,002,000.00 1,336,000.00 668.00
27393 - multiple, one leg Musculoskeletal system 943,500.00 1,258,000.00 629.00
27397 - transplant of hamstring tendon to patella, multiple, one leg Musculoskeletal system 1,521,000.00 2,028,000.00 1,014.00
27400 Tendon or muscle transfer, hamstrings to femur (eg. Egger's procedure) Musculoskeletal system 1,309,500.00 1,746,000.00 873.00
Repair, primary. torn ruptured or severed collateral ligament, with or without

menisetomy
27407 - cruciate ligament Musculoskeletal system 1,476,000.00 1,968,000.00 984.00
27408 - with pes anserinus transfer Musculoskeletal system 966,000.00 1,288,000.00 644.00
27409 - collateral and cruciate ligament Musculoskeletal system 2,091,000.00 2,788,000.00 1,394.00
- secondary repair, collateral or cruciate ligament with pes anserinus transfer of

fascial or tendon graft
- collateral and cruciate ligaments with pes anserinus transfer of fascial or tendon
graft
27419 Pes anserinus transfer (independent procedure) Musculoskeletal system 840,000.00 1,120,000.00 560.00
Reconstruction for recurrent dislocating patella (eg. Hauser, Campbell or

Goldthwaite procedure) with or without patellectomy
Elevation anterior tibial tubercle (Maquet procedure), including bone graft with or
without patellectomy
27426 Arthroplasty, prosthetic replacement of patella Musculoskeletal system 840,000.00 1,120,000.00 560.00
27430 Quadricepsplasty (eg. Bennett or Thompson procedure) Musculoskeletal system 1,459,500.00 1,946,000.00 973.00
SECURE &
PACKAGES PACKAGES
PACKAGES
Arthroplasty, knee, with femoral condyle and tibial plateau replacement, medial and
lateral compartments, with or without patella ("total knee")
27449 Osteotomy, femur, shaft or supracondylar, without fixation Musculoskeletal system 730,500.00 974,000.00 487.00
27451 - with fixation Musculoskeletal system 1,050,000.00 1,400,000.00 700.00
27452 - multiple femoral shaft (eg. Sofield procedure) and rodding Musculoskeletal system 1,134,000.00 1,512,000.00 756.00
Osteotomy proximal tibia, including fibular excision or osteotomy (includes

27455 correction of genu varus or valgus) unilateral, before epiphseal closure and/or Musculoskeletal system 1,906,500.00 2,542,000.00 1,271.00
skeletal fixation
27456 - after epiphyseal closure Musculoskeletal system 781,500.00 1,042,000.00 521.00
27465 Osteotomy, femoral, shortening Musculoskeletal system 2,080,500.00 2,774,000.00 1,387.00
27466 - lengthening Musculoskeletal system 2,292,000.00 3,056,000.00 1,528.00
27470 Repair, non-union or malunion, femur, distal to head and neck Musculoskeletal system 2,469,000.00 3,292,000.00 1,646.00
27475 Epiphyseal arrest by epiphysiodesis or stapling, distal femur Musculoskeletal system 1,270,500.00 1,694,000.00 847.00
27477 - proxima tibia and fibula Musculoskeletal system 1,710,000.00 2,280,000.00 1,140.00
27479 - combined, distal femur and proximal tibia and fibula (knee) Musculoskeletal system 1,902,000.00 2,536,000.00 1,268.00
hemi-epiphyseal arrest, distal femur or proximal tibia or fibula (eg. for genu varus or
valgus)
27499 Fractures not requiring reductions Musculoskeletal system FFS FFS FFS
Femur, shaft or condylar or epiphyseal fracture, closed with manipulative reduction

(includes traction)
27504 - open with uncomplicated soft tissue closure, manipulative reduction Musculoskeletal system 562,500.00 750,000.00 375.00
27506 - closed or open reduction, with or without skeletal fixation Musculoskeletal system 2,563,500.00 3,418,000.00 1,709.00
27522 Patella, fracture, open, with uncomplicated soft tissue closure Musculoskeletal system 226,500.00 302,000.00 151.00
27524 - closed or open, open reduction, with repair and/or excision Musculoskeletal system 1,555,500.00 2,074,000.00 1,037.00
27532 Tibia, fracture, proximal (palteau) closed, with manipulative reduction Musculoskeletal system 1,042,500.00 1,390,000.00 695.00
27552 Knee dislocation, closed manipulative reduction, with anaesthesia Musculoskeletal system 942,000.00 1,256,000.00 628.00
SECURE &
PACKAGES PACKAGES
PACKAGES
27562 patellar dislocation, closed manipulative reduction with anaesthesia Musculoskeletal system 855,000.00 1,140,000.00 570.00
27566 - closed or open, open reduction, with or without partial or total patellectomy Musculoskeletal system 1,762,500.00 2,350,000.00 1,175.00
Manipulation of knee joint under general anaesthesia (includes application of

traction or other fixation devices)
27580 Fusion of knee, any technique, includes local graft Musculoskeletal system 2,376,000.00 3,168,000.00 1,584.00
27590 Thigh, through femur, any level, with primary closere Musculoskeletal system 1,566,000.00 2,088,000.00 1,044.00
27594 - secondary closure or scar revision Musculoskeletal system 843,000.00 1,124,000.00 562.00
27598 Disarticulation at knee Musculoskeletal system 1,545,000.00 2,060,000.00 1,030.00
27600 Fasciotomy, leg, anterior compartment, for closed spaced decompression Musculoskeletal system 709,500.00 946,000.00 473.00
27606 Tenotomy, Archilles tendon, subcutaneous, under general anaesthesia Musculoskeletal system 505,500.00 674,000.00 337.00
Posterior capsular release, with or without Archilles tendon lengthening (see also
27685)
27620 Arthrotomy (capsulotomy), ankle, for biopsy Musculoskeletal system 931,500.00 1,242,000.00 621.00
27625 - for synovectomy Musculoskeletal system 1,290,000.00 1,720,000.00 860.00
27630 Excision of lesion of tendon, sheath or capsule (eg. Cyst or ganglion) Musculoskeletal system 715,500.00 954,000.00 477.00
27650 Repair, ruptured Achilles tendon, primary Musculoskeletal system 1,429,500.00 1,906,000.00 953.00
27654 - secondary, with or without graft Musculoskeletal system 1,566,000.00 2,088,000.00 1,044.00
27655 Repair, fascial defect of leg Musculoskeletal system 336,000.00 448,000.00 224.00
27660 Repair, tendon, primary, without graft, single tendon Musculoskeletal system 352,500.00 470,000.00 235.00
27662 - secondary, with or without free graft, single tendon Musculoskeletal system 445,500.00 594,000.00 297.00
27675 Repair, for dislocating paroneal tendons, with or without fibular osteotomy Musculoskeletal system 1,045,500.00 1,394,000.00 697.00
Lengthening or shortening of tendon single (independent procedure) (eg. Achilles

tendon)[see also 27606 - 27612]
27686 Lengthening or shortening of tendon multiple (through same incision) Musculoskeletal system 1,084,500.00 1,446,000.00 723.00
SECURE &
PACKAGES PACKAGES
PACKAGES
27687 Gastrocnemius recession (eg. Strayer procedure) Musculoskeletal system 904,500.00 1,206,000.00 603.00
Transfer or transplant of tendon (with muscle redirection or rerouting), single,

superficial (eg. anterior tibial or extensors into mid foot)
- each additional tendon (toe extensors as a group are considered to be a single

tendon when transplanted into mid-foot)
27693 - anterior or posterior tibial, through interosseus space Musculoskeletal system 562,500.00 750,000.00 375.00
27695 Repair, primary, torn, ruptured or severed ankle, collateral ligament Musculoskeletal system 1,084,500.00 1,446,000.00 723.00
27696 - both collateral ligaments Musculoskeletal system 1,180,500.00 1,574,000.00 787.00
27698 Repair, secondary, collateral ligament (eg. Watson-Jones procedure) Musculoskeletal system 1,548,000.00 2,064,000.00 1,032.00
27702 Arthroplasty, total ankle replacement Musculoskeletal system 2,403,000.00 3,204,000.00 1,602.00
Osteotomy, tibia or fibula multiple, with realignment and rodding (eg. Sofield
procedure)
27715 Osteoplasty, tibia and fibula, lengthening Musculoskeletal system 2,052,000.00 2,736,000.00 1,368.00
Repair of non-union or malunion, tibia (includes bone grafting and/or internal

fixation)
27722 - with sliding graft, local bone with or without internal fixation Musculoskeletal system 1,714,500.00 2,286,000.00 1,143.00
Distal and (medial, posterior or lateral) ie. uni-malleolar, closed, with manipulative
reduction
27766 - closed or open, open reduction, with skeletal fixation Musculoskeletal system 1,230,000.00 1,640,000.00 820.00
Fibula, fracture, proximal end or shaft, open, with uncomplicated soft tissue closure,
manipulative reduction
27784 - closed or open, open reduction, with skeletal fixation Musculoskeletal system 1,042,500.00 1,390,000.00 695.00
Tibia and fibula, fractures, shafts, closed with manipulative reduction, with or
without external skeletal pinning
27804 - open, with manipulative reduction (eg. "pins above and below") Musculoskeletal system 562,500.00 750,000.00 375.00
Bi-malleolar and tri-malleolar, closed, with manipulative reduction, requiring

anaesthesia
SECURE &
PACKAGES PACKAGES
PACKAGES
- closed or open, open reduction, with or without skeletal fixation, medial and lateral
malleoli only
27823 - with skeletal fixation of posterior lip (malleolus) Musculoskeletal system 1,902,000.00 2,536,000.00 1,268.00
Proximal tibio-fibular joint dislocation, closed or open reduction and fixation or

excision
27842 Ankle dislocation, closed, manipulative reduction with anaesthesia Musculoskeletal system 702,000.00 936,000.00 468.00
27860 Manipulation (includes application of traction or other fixation apparatus) Musculoskeletal system 306,000.00 408,000.00 204.00
27870 Fusion , ankle, includes local graft Musculoskeletal system 1,939,500.00 2,586,000.00 1,293.00
27880 Leg, through tibia and fibula, any method Musculoskeletal system 1,587,000.00 2,116,000.00 1,058.00
27888 Ankle, through malleoli of tibia and fibula (eg. Syme or Pirogoff procedures) Musculoskeletal system 1,443,000.00 1,924,000.00 962.00
28008 Fasciotomy, plantar and/or toe, subcutaneous (see also 28060, 28250) Musculoskeletal system 604,500.00 806,000.00 403.00
28010 Tenetomy, subcutaneous, toe, single Musculoskeletal system 502,500.00 670,000.00 335.00
28011 - multiple Musculoskeletal system 498,000.00 664,000.00 332.00
Arthrotomy (Capsulotomy), with exploration, drainage or removal of foreign body,

intertarsal or tarsometatarsal joint
28022 - metatarsophalangeal joint Musculoskeletal system 639,000.00 852,000.00 426.00
28024 - interphalangeal joint Musculoskeletal system 591,000.00 788,000.00 394.00
28035 Tarsal tunnel release (posterior tibial nerve decompositions) Musculoskeletal system 897,000.00 1,196,000.00 598.00
28060 Fasciotomy, excision of plantar fascia, partial (independent procedure) Musculoskeletal system 784,500.00 1,046,000.00 523.00
28070 Synovectomy, intertarsal or tarsometatarsal joint Musculoskeletal system 777,000.00 1,036,000.00 518.00
28072 - metatarsophalangeal joint Musculoskeletal system 673,500.00 898,000.00 449.00
28073 - multiple, same foot Musculoskeletal system 277,500.00 370,000.00 185.00
28080 Excision of Morton's neuroma Musculoskeletal system 646,500.00 862,000.00 431.00
Excision of lesion of tendon, or fibrous sheath or capsule (eg. cyst or ganglion) foot
or toe
28111 Ostectomy complete, first metatarsal head Musculoskeletal system 813,000.00 1,084,000.00 542.00
28112 - other metatarsal head, single Musculoskeletal system 708,000.00 944,000.00 472.00
SECURE &
PACKAGES PACKAGES
PACKAGES
28113 - each additional, either foot Musculoskeletal system 763,500.00 1,018,000.00 509.00
- all metatarsal heads, with or without partial proximal phalangectomies (eg.

Clayton procedure)
28116 Excision of tarsal coalition Musculoskeletal system 1,026,000.00 1,368,000.00 684.00
28130 Astragalectomy Musculoskeletal system 1,171,500.00 1,562,000.00 781.00
28150 Phalangectomy, single (filleting) Musculoskeletal system 618,000.00 824,000.00 412.00
28152 - each additional, either foot Musculoskeletal system 54,000.00 72,000.00 36.00
28200 Repair of tendon, flexor, single, primary or secondary, without free graft Musculoskeletal system 777,000.00 1,036,000.00 518.00
28208 - extensor, single, primary or secondary Musculoskeletal system 613,500.00 818,000.00 409.00
28220 Tenolysis, flexor, single Musculoskeletal system 685,500.00 914,000.00 457.00
28222 - multiple (through same incision) Musculoskeletal system 927,000.00 1,236,000.00 618.00
28225 - extensor, single Musculoskeletal system 519,000.00 692,000.00 346.00
28226 - multiple (through same incision) Musculoskeletal system 663,000.00 884,000.00 442.00
28230 Tenotomy, open, flexor, foot, single or multiple (independent procedure) Musculoskeletal system 574,500.00 766,000.00 383.00
28234 - extensor, foot or toe Musculoskeletal system 456,000.00 608,000.00 304.00
Advancement of posterior tibial tendon with excision of accessory scaphoid bone

(eg. Kidner procedure)
28240 Tenotomy or release, abductor hallucis muscle (eg. McMauley procedure) Musculoskeletal system 567,000.00 756,000.00 378.00
Division of plantar fascia and muscle (eg. "Steindler stripping") [independent

procedure]
28260 Capsulotomy, mid-foot medial release only (independent procedure) Musculoskeletal system 1,020,000.00 1,360,000.00 680.00
28262 - with tendon lengthening Musculoskeletal system 2,070,000.00 2,760,000.00 1,380.00
- extensive, including posterior talotibial capsulotomy (eg. resistant club foot

deformity)
28264 - midtarsal (eg. Heyman procedure) Musculoskeletal system 1,552,500.00 2,070,000.00 1,035.00
28286 Plastic procedure for "cock-up" fifth toe (eg. Ruiz-Mora procedure) Musculoskeletal system 679,500.00 906,000.00 453.00
SECURE &
PACKAGES PACKAGES
PACKAGES
28290 Hallux valgus, correction by exostectomy (eg. Silver procedure) Musculoskeletal system 900,000.00 1,200,000.00 600.00
28292 - (eg. Keller, McBride or Mayo type procedure) Musculoskeletal system 1,135,500.00 1,514,000.00 757.00
28293 - with resection of joint with implant Musculoskeletal system 1,521,000.00 2,028,000.00 1,014.00
28294 - with tendon transplant (eg. Joplin procedure) Musculoskeletal system 1,369,500.00 1,826,000.00 913.00
28296 - with metatarsal osteotomy (eg. Mitchell or Lapidus procedures) Musculoskeletal system 1,407,000.00 1,876,000.00 938.00
28298 - with phalangeal osteotomy Musculoskeletal system 1,300,500.00 1,734,000.00 867.00
Osteotomy, with or without internal fixation of calcis (eg Dwyer or Chambers

procedures)
28302 - talus Musculoskeletal system 1,407,000.00 1,876,000.00 938.00
28304 - other mid-tarsal bones Musculoskeletal system 1,260,000.00 1,680,000.00 840.00
- metatarsals, base or shaft, single, for shortening or angular correction, first

metatarsal
28308 - other metatarsals Musculoskeletal system 883,500.00 1,178,000.00 589.00
- proximal phalanx, first toe, for shortening, angularly or rotational correction

28312 - other phalanges, any toe Musculoskeletal system 745,500.00 994,000.00 497.00
Repair of non-union or malunion, matatarsal, with or without bone graft (includes

obtaining graft and/or fixation)
28435 Talus or calcaneum, closed, with manpulative reduction Musculoskeletal system 546,000.00 728,000.00 364.00
28455 Navicular, cuneiforms or cuboid, closed with manipulative reduction Musculoskeletal system 462,000.00 616,000.00 308.00
28475 Metatarsal(s), fracture(s), closed, with manipulative reduction Musculoskeletal system 429,000.00 572,000.00 286.00
SECURE &
PACKAGES PACKAGES
PACKAGES
28495 Phalanx or phalanges, fracture, big toe closed with manipulative reduction Musculoskeletal system 232,500.00 310,000.00 155.00
28515 Phalanges other than big toe, closed, with manipulative reduction Musculoskeletal system 217,500.00 290,000.00 145.00
28575 Astragalo-tarsal joint, dislocation, closed, manipulative reduction with anaesthesia Musculoskeletal system 490,500.00 654,000.00 327.00
28605 Tarsometatarsal joint, dislocation, closed, manipulative reduction, with anaesthesia Musculoskeletal system 406,500.00 542,000.00 271.00
28606 - with percutaneous skeletal fixation Musculoskeletal system 669,000.00 892,000.00 446.00
Metatarsophalangeal joint, dislocation, closed, manipulative reduction with

anaesthesia
Interphalangeal joint, closed or open, with uncomplicated soft tissue closure,

manipulative reduction requiring anaesthesia
28705 Plantar arthrodesis, includes local graft Musculoskeletal system 2,403,000.00 3,204,000.00 1,602.00
28715 Triple arthrodesis, includes local graft Musculoskeletal system 1,951,500.00 2,602,000.00 1,301.00
28725 Subastragalar arthrodesis (eg. Grice procedure, Batchelor) Musculoskeletal system 1,617,000.00 2,156,000.00 1,078.00
28730 Midtarsal or tarsometatarsal arthrodesis, multiple or transverse Musculoskeletal system 1,542,000.00 2,056,000.00 1,028.00
28750 Big toe, metatarsophalangeal joint, arthrodesis Musculoskeletal system 991,500.00 1,322,000.00 661.00
28755 - interphalangeal joint Musculoskeletal system 715,500.00 954,000.00 477.00
28760 - with extensor hallucis longus transfer to first matatarsal neck (Jones procedure) Musculoskeletal system 996,000.00 1,328,000.00 664.00
28761 Interphalangeal joint arthrodesis, other than big toe Musculoskeletal system 193,500.00 258,000.00 129.00
SECURE &
PACKAGES PACKAGES
PACKAGES
28800 Foot, midtarsal (eg. Chopart procedure) Musculoskeletal system 1,128,000.00 1,504,000.00 752.00
28805 - transmetatarsal Musculoskeletal system 1,191,000.00 1,588,000.00 794.00
28810 Metatarsal, with toe, single Musculoskeletal system 786,000.00 1,048,000.00 524.00
28820 Toe, metatarsophalangeal joint Musculoskeletal system 613,500.00 818,000.00 409.00
28825 - interphalangeal or transphalangeal joint Musculoskeletal system 544,500.00 726,000.00 363.00
29010 Turnbuckle jacket, localizer, body only Musculoskeletal system 384,000.00 512,000.00 256.00
29015 - including head Musculoskeletal system 397,500.00 530,000.00 265.00
29035 Body, shoulder to hip, plaster jacket Musculoskeletal system 333,000.00 444,000.00 222.00
29040 - including head, Minerva type Musculoskeletal system 357,000.00 476,000.00 238.00
29049 Plaster figure of 8 (eg. Clavicle fracture) Musculoskeletal system 120,000.00 160,000.00 80.00
29055 Shoulder spica Musculoskeletal system 273,000.00 364,000.00 182.00
29065 Above elbow plaster cast Musculoskeletal system 144,000.00 192,000.00 96.00
29075 Below elbow plaster cast Musculoskeletal system 123,000.00 164,000.00 82.00
29305 Hip spica, unilateral Musculoskeletal system 343,500.00 458,000.00 229.00
29325 Hip spica, bilateral Musculoskeletal system 372,000.00 496,000.00 248.00
29340 Hinged thigh cast with pelvic band Musculoskeletal system 42,000.00 56,000.00 28.00
29355 Above knee Musculoskeletal system 222,000.00 296,000.00 148.00
29356 Hinged above knee plaster of paris cast Musculoskeletal system 93,000.00 124,000.00 62.00
29365 Cylinger cast (thigh to ankle) Musculoskeletal system 178,500.00 238,000.00 119.00
29366 Hinged cylinder cast Musculoskeletal system 54,000.00 72,000.00 36.00
29425 Short leg (below knee to toes) Musculoskeletal system 163,500.00 218,000.00 109.00
29435 Platella tendon bearing (P.T.B. cast) Musculoskeletal system 196,500.00 262,000.00 131.00
Club foot strapping or cast with moulding or manipulation, long or short leg, under
24 months, single
29456 Club foot manipulation under general anaesthesia and application of plaster of paris Musculoskeletal system 79,500.00 106,000.00 53.00
SECURE &
PACKAGES PACKAGES
PACKAGES
29460 Plaster of Paris, wool, crepe and other supportive orthopaedic bandages Musculoskeletal system At cost At cost At cost
RESPIRATORY SYSTEM
30000 Drainage abscess or haematoma ( nasal, internal approach) Respiratory 382,500.00 510,000.00 255.00
30001 - under local anaesthesia. Respiratory 114,000.00 152,000.00 76.00
30110 Excision , nasal polyps ( simple) office Respiratory 271,500.00 362,000.00 181.00
30115 Excision , nasal polyps ( extensive ,hospital) Respiratory 621,000.00 828,000.00 414.00
30120 Excision of rhinophyma Respiratory 996,000.00 1,328,000.00 664.00
30130 Excision inferior turbinate partial or complete any method Respiratory 640,500.00 854,000.00 427.00
30210 Displacement therapy ( PROETZ type) Respiratory 133,500.00 178,000.00 89.00
30300 intranasal , office Respiratory 286,500.00 382,000.00 191.00
30301 - requiring local anaesthetic Respiratory 168,000.00 224,000.00 112.00
30310 - requiring general anaesthetic Respiratory 181,500.00 242,000.00 121.00
30400 Rhinoplasty primary, lateral & alar cartilages & or tip elevation Respiratory 997,500.00 1,330,000.00 665.00
30410 Complete , external bony pyramid lateral & alar cartilages & tip elevation Respiratory 2,220,000.00 2,960,000.00 1,480.00
30420 including major septal repair Respiratory 2,644,500.00 3,526,000.00 1,763.00
30430 Rhinoplasty secondary, minor revision & or tip work Respiratory 1,203,000.00 1,604,000.00 802.00
30440 - new patient Respiratory 1,032,000.00 1,376,000.00 688.00
30460 Rhinoplasty for post congenital cleft lip & palate repair columelar & tip work Respiratory 1,450,500.00 1,934,000.00 967.00
30462 tip, septum ,& osteotomies Respiratory 2,905,500.00 3,874,000.00 1,937.00
30500 Submucous resection, nasal septum, classic Respiratory 861,000.00 1,148,000.00 574.00
30540 Repair of choanal atresia, intranasal Respiratory 1,165,500.00 1,554,000.00 777.00
30545 transpalatine Respiratory 1,752,000.00 2,336,000.00 1,168.00
30580 Repair oro-enteral fistula ,add 31030 if antrotomy is included Respiratory 1,050,000.00 1,400,000.00 700.00
30620 Septal or intranasal dermoplasty Respiratory 1,440,000.00 1,920,000.00 960.00

SECURE &
PACKAGES PACKAGES
PACKAGES
30799 Diathermy to turbinates Respiratory 261,000.00 348,000.00 174.00
30800 - with local anaesthetic Respiratory 84,000.00 112,000.00 56.00
30900 Cautery nasal (unilateral or bilateral), with local anaesthetic Respiratory 147,000.00 196,000.00 98.00
30905 Control nasal haemorrhage, posteror with posterior nasal packs& or cautery initial Respiratory 363,000.00 484,000.00 242.00
30910 Nasal and/or post-nasal pack for severe epistaxis under general anaesthetic Respiratory 258,000.00 344,000.00 172.00
30911 - under local anaesthetic Respiratory 141,000.00 188,000.00 94.00
30915 ligation arteries , ethmoidal Respiratory 966,000.00 1,288,000.00 644.00
30999 unlisted procedure ,nose Respiratory BR BR BR
31000 lavage by cannulation , maxillary sinus ( antral puncture or natural ostium) Respiratory 172,500.00 230,000.00 115.00
31002 sphenoid sinus Respiratory 232,500.00 310,000.00 155.00
31003 - under general anaesthetic Respiratory 240,000.00 320,000.00 160.00
31004 Antrum puncture, unilateral or bilateral, general anaesthetic Respiratory 321,000.00 428,000.00 214.00
31005 Antral lavage Respiratory 240,000.00 320,000.00 160.00
31020 Sinusotomy , maxillary, intranasal` Respiratory 550,500.00 734,000.00 367.00
31030 Radical (Caldwell Luc) without removal of antrochoanal polyps Respiratory 1,095,000.00 1,460,000.00 730.00
31049 Intranasal, frontal Respiratory 643,500.00 858,000.00 429.00
31050 Sinusotomy ,sphenoid with or without biopsy Respiratory 888,000.00 1,184,000.00 592.00
31070 Sinusotomy ,frontal,external ,simple trephine Respiratory 723,000.00 964,000.00 482.00
31075 transorbital, unilateral Lynch type for mucocoele or osteoma Respiratory 1,507,500.00 2,010,000.00 1,005.00
31085 obliterative with osteoplastic flap (Coronal incision) Respiratory 2,319,000.00 3,092,000.00 1,546.00
31200 Ethmoidectomy , Intranasal , anterior Respiratory 811,500.00 1,082,000.00 541.00
31201 intranasal , total Respiratory 1,234,500.00 1,646,000.00 823.00
31220 External ethmoidectomy (Pattersons operation) Respiratory 1,503,000.00 2,004,000.00 1,002.00
31225 maxillectomy , without orbital exenteration Respiratory 2,908,500.00 3,878,000.00 1,939.00

SECURE &
PACKAGES PACKAGES
PACKAGES
31230 maxillectomy , with orbital exenteration Respiratory 4,050,000.00 5,400,000.00 2,700.00
31240 with conca bullosa resection Respiratory 1,008,000.00 1,344,000.00 672.00
31245 Ultrasound to pituitary, exclusive of operation Respiratory 423,000.00 564,000.00 282.00
Nasal endoscopy, diagnostic (includes examination of the medial meatus,

31250 Respiratory 181,500.00 242,000.00 121.00
infundibulum and sinus ostia)
31252 Nasal endoscopy, surgical with nasal polypectomy Respiratory 412,500.00 550,000.00 275.00
31254 nasal sinus endoscopy , surgical, with ethmoidectomy, partial (anterior) Respiratory 775,500.00 1,034,000.00 517.00
31255 with ethmoidectomy , total (anterior & posterior) Respiratory 1,159,500.00 1,546,000.00 773.00
31256 nasal sinus endoscopy , surgical with maxillary antrostomy Respiratory 523,500.00 698,000.00 349.00
31258 - with removal of foreign body(s) Respiratory 312,000.00 416,000.00 208.00
31260 Maxillary sinus endoscopy, diagnostic, with or without biopsy Respiratory 312,000.00 416,000.00 208.00
31263 Maxillary sinus endoscopy, surgical; with removal of foreign body(s) Respiratory 414,000.00 552,000.00 276.00
31265 - with removal of cyst Respiratory 400,500.00 534,000.00 267.00
31267 - with removal of mucous membrane and/or polyp(s) Respiratory 807,000.00 1,076,000.00 538.00
31268 - with removal of fungus ball Respiratory 525,000.00 700,000.00 350.00
31270 Sphenoid endoscopy, diagnostic Respiratory 342,000.00 456,000.00 228.00
31275 Sphenoid endoscopy, surgical; including sphenoidotomy Respiratory 504,000.00 672,000.00 336.00
31277 - with removal of mucous membrane Respiratory 589,500.00 786,000.00 393.00
31300 Laryngotomy , with removal of tumour or laryngocoele , cordectomy Respiratory 2,071,500.00 2,762,000.00 1,381.00
31320 diagnostic Respiratory 808,500.00 1,078,000.00 539.00
31360 Laryngectomy ,total, without radical neck dissection Respiratory 2,955,000.00 3,940,000.00 1,970.00
31395 with reconstruction Respiratory 4,938,000.00 6,584,000.00 3,292.00
31396 Laryngecotomy with laryngoplasty Respiratory 2,967,000.00 3,956,000.00 1,978.00
31400 arytenoidectomy or arytenoidopexy, external approach Respiratory 1,480,500.00 1,974,000.00 987.00
31500 Intubation` , endotracheal , emergency procedure Respiratory 235,500.00 314,000.00 157.00

SECURE &
PACKAGES PACKAGES
PACKAGES
31505 Laryngoscopy,indirect , diagnostic Respiratory 102,000.00 136,000.00 68.00
31510 with biopsy Respiratory 247,500.00 330,000.00 165.00
31526 diagnostic , with operating microscope or telescope Respiratory 466,500.00 622,000.00 311.00
31530 - direct operative, including foreign body removal Respiratory 522,000.00 696,000.00 348.00
31536 with operative microscope or telescope Respiratory 586,500.00 782,000.00 391.00
laryngoscopy , direct operative, with excision of tumour & or stripping vocal cord
31540 Respiratory 687,000.00 916,000.00 458.00
/epiglottis
31541 with operative microscope or telescope Respiratory 666,000.00 888,000.00 444.00
31572 Ultrasound to larynx for papillomatosis, exclusive of operation fee Respiratory 600,000.00 800,000.00 400.00
31600 Tracheostomy, planned Respiratory 652,500.00 870,000.00 435.00
31619 Bronchial lavage - short Respiratory 328,500.00 438,000.00 219.00
31620 Bronchoscopy, diagnostic (initial) Respiratory 543,000.00 724,000.00 362.00
31621 - prolonged or repeat Respiratory 417,000.00 556,000.00 278.00
31625 with bronchial biopsy Respiratory 549,000.00 732,000.00 366.00
31635 with removal of foreign body Respiratory 672,000.00 896,000.00 448.00
31636 - with removal of foreign body, infant, under 5 years of age Respiratory 477,000.00 636,000.00 318.00
31640 - with radium insertion Respiratory 732,000.00 976,000.00 488.00
31645 - with therapeutic aspiration of tracheobronchial tree Respiratory 508,500.00 678,000.00 339.00
31646 - with excision of tumour Respiratory 442,500.00 590,000.00 295.00
Installation of contrast material for laryngograph or bronchography without

31708 Respiratory 328,500.00 438,000.00 219.00
catheterization
31710 Catheterization for bronchography, with or without instillation of contrast material Respiratory 328,500.00 438,000.00 219.00
31715 Transtracheal injection for bronchography Respiratory 142,500.00 190,000.00 95.00
31750 Tracheoplasty , cervical Respiratory 1,693,500.00 2,258,000.00 1,129.00
31760 - intrathoracic Respiratory 2,601,000.00 3,468,000.00 1,734.00
31765 Excision, tracheal stenosis and anastomosis, cervical Respiratory 1,983,000.00 2,644,000.00 1,322.00
SECURE &
PACKAGES PACKAGES
PACKAGES
31775 Brochoplasty, excision stenoids, with asnastomosis Respiratory 3,003,000.00 4,004,000.00 2,002.00
31822 Surgical closure tracheostomy or fistula, with or without plastic repair Respiratory 495,000.00 660,000.00 330.00
31899 Unlisted procedure ,trachea Respiratory 2,082,000.00 2,776,000.00 1,388.00
Thoracentesis: puncuture of pleural cavity for aspiration, initial or subsequent

32000 Respiratory 37,500.00 50,000.00 25.00
(diagnostic or therapeutic)
32001 - detention time - after the first 15 minutes Respiratory 25,500.00 34,000.00 17.00
32014 Intercostal drain - needle Respiratory 37,500.00 50,000.00 25.00
32015 Tube thoracostomy with water seal (independent procedure) catheter Respiratory 168,000.00 224,000.00 112.00
32035 Thoracostomy, with rib resection for emphyema Respiratory 1,140,000.00 1,520,000.00 760.00
32036 - with open flap drainage for emphyema Respiratory 1,252,500.00 1,670,000.00 835.00
32095 Thoractomy, limited Respiratory 1,233,000.00 1,644,000.00 822.00
32100 Thoractomy, diagnostic, for inoperable Carcinoma Respiratory 1,759,500.00 2,346,000.00 1,173.00
32101 Thoractomy, with major dissection Respiratory 909,000.00 1,212,000.00 606.00
32141 - with excision-plication of bullae, pulmonary or emphysematous cysts Respiratory 2,223,000.00 2,964,000.00 1,482.00
32150 - with removal of intrapleural or intra-pulmonary foreign or fibrin body Respiratory 1,858,500.00 2,478,000.00 1,239.00
32160 - with cardiac massage Respiratory 1,341,000.00 1,788,000.00 894.00
32161 with repair of bronchial Fracture Respiratory 1,176,000.00 1,568,000.00 784.00
32200 Pneumonostomy, with open drainage of pulmonary abscess or cyst Respiratory 1,725,000.00 2,300,000.00 1,150.00
32215 Introduction: for introduction of contrast medium for pleurography Respiratory 1,453,500.00 1,938,000.00 969.00
32220 Decortication, pulmonary (independent procedure) Respiratory 2,794,500.00 3,726,000.00 1,863.00
32320 Decortication and major pleurectomy Respiratory 3,028,500.00 4,038,000.00 2,019.00
32321 Thoracoplasty: 1st stage Respiratory 958,500.00 1,278,000.00 639.00
32322 - all stages Respiratory 1,341,000.00 1,788,000.00 894.00
Thoracoplasty, total (Schede type or extrapleural) with or without closure of

32325 Respiratory 1,176,000.00 1,568,000.00 784.00
bronchopleural fistula, all stages
32420 Biopsy, pleural or lung, needle Respiratory 246,000.00 328,000.00 164.00

SECURE &
PACKAGES PACKAGES
PACKAGES
32421 Pleaural, open method Respiratory 192,000.00 256,000.00 128.00
32440 Pneumonectomy Respiratory 3,066,000.00 4,088,000.00 2,044.00
32441 Radical pneumonectomy, with mediastinal lymphadenectomy Respiratory 1,705,500.00 2,274,000.00 1,137.00
32480 Lobectomy, total or segmental Respiratory 2,791,500.00 3,722,000.00 1,861.00
32485 Lobectomy, total or segmental with bronchoplasty Respiratory 532,500.00 710,000.00 355.00
32490 - with decortication Respiratory 2,329,500.00 3,106,000.00 1,553.00
32500 Wedge resection or enucleation of lesion, single or multiple Respiratory 2,311,500.00 3,082,000.00 1,541.00
Pulmonary resection, with thoracoplasty with resection and reconstruction of chest

32520 Respiratory 1,512,000.00 2,016,000.00 1,008.00
wall
32540 Extra pleural enucleation of empyema cavity Respiratory 2,263,500.00 3,018,000.00 1,509.00
32545 - with lobectomy Respiratory 1,512,000.00 2,016,000.00 1,008.00
32546 Excision of cartilage Respiratory 453,000.00 604,000.00 302.00
32700 Thoracoscopy, exploratory (independent procedure) Respiratory 534,000.00 712,000.00 356.00
32705 - with biopsy, adhesion section or pondrage Respiratory 585,000.00 780,000.00 390.00
32900 Extrapleural resection of ribs, any type, first stage Respiratory 2,149,500.00 2,866,000.00 1,433.00
32960 Pneumothorax: intrapleural injection of air (independent procedure) Respiratory 2,575,500.00 3,434,000.00 1,717.00
CARDIOVASCULAR SYSTEM
33010 Pericardiocentesis, initial Cardiovascular system 258,000.00 344,000.00 172.00
33020 Pericardiotomy for removal of clot or foreign body (primary procedure) Cardiovascular system 1,905,000.00 2,540,000.00 1,270.00
33025 Pericardial window or partial resection for drainage Cardiovascular system 1,909,500.00 2,546,000.00 1,273.00
33030 Partial resection for chronic constrictive pericarditis, without by-pass Cardiovascular system 2,919,000.00 3,892,000.00 1,946.00
33120 Excision of intracardiac tumour, resection with cardiopulmonary by-pass Cardiovascular system 3,900,000.00 5,200,000.00 2,600.00
33130 Resection of external cardiac tumour Cardiovascular system 2,856,000.00 3,808,000.00 1,904.00
33200 Insertion of permanent pacemaker, with epicardial electrode by thoracotomy Cardiovascular system 274,500.00 366,000.00 183.00
33201 - by xiphoid approach Cardiovascular system 672,000.00 896,000.00 448.00

SECURE &
PACKAGES PACKAGES
PACKAGES
33205 - with transvenous electrodes, single chamber Cardiovascular system 588,000.00 784,000.00 392.00
33206 - with transvenous electrodes, dual chamber Cardiovascular system 1,069,500.00 1,426,000.00 713.00
33212 Insertion or replacement of pulse generator only Cardiovascular system 816,000.00 1,088,000.00 544.00
Insertion, replacement or repositioning of permanent transvenous electrodes only

33216 Cardiovascular system 723,000.00 964,000.00 482.00
(15 days or more after initial insertion)
33218 Repair of pacemaker electrodes only Cardiovascular system 778,500.00 1,038,000.00 519.00
33222 - with replacement of pulse generator Cardiovascular system 807,000.00 1,076,000.00 538.00
33240 Insertion of temporary transvenous electrode (independent procedure) Cardiovascular system 999,000.00 1,332,000.00 666.00
33241 Tectronic analysis Cardiovascular system 430,500.00 574,000.00 287.00
33300 Repair of cardiac wound; without by-pass Cardiovascular system 2,884,500.00 3,846,000.00 1,923.00
33305 - with cardiopulmonary by-pass Cardiovascular system 3,885,000.00 5,180,000.00 2,590.00
33310 Cardiotomy, exploratory (includes removal of foreign body); without by-pass Cardiovascular system 2,292,000.00 3,056,000.00 1,528.00
33400 Valvoplasty, aortic valve, open with cardiopulmonary by-pass Cardiovascular system 4,029,000.00 5,372,000.00 2,686.00
33404 Construction of apical-aortic conduit Cardiovascular system 4,411,500.00 5,882,000.00 2,941.00
33405 Replacement, aortic valve, with cardiopulmonary by-pass Cardiovascular system 4,716,000.00 6,288,000.00 3,144.00
33407 Valvotomy, aortic valve (commissurotomy); with cardio-pulmonary by-pass Cardiovascular system 1,680,000.00 2,240,000.00 1,120.00
33411 Replacement, aortic valve; with aortic annulus enlargement, non-coronary cusp Cardiovascular system 5,752,500.00 7,670,000.00 3,835.00
33412 - with transventricular aortic annulus enlargement (Konno procedure) Cardiovascular system 5,565,000.00 7,420,000.00 3,710.00
33415 Resection or incision of sub-valvular tissue for discrete sub-valvular aortic stenosis Cardiovascular system 4,339,500.00 5,786,000.00 2,893.00
Ventriculomyotomy (-myectomy) for idiopathic hypertrophic sub-aortic stenosis (eg.

33416 Cardiovascular system 4,402,500.00 5,870,000.00 2,935.00
Asymmetric septal hypertrophy)
33417 Autoplasty (gusset) for supra-valvular stenosis Cardiovascular system 4,621,500.00 6,162,000.00 3,081.00
33420 Valvotomy, mitral valve (commissurotomy); closed Cardiovascular system 3,102,000.00 4,136,000.00 2,068.00
33422 - open, with cardiopulmonary by-pass Cardiovascular system 4,155,000.00 5,540,000.00 2,770.00
33425 Valvoplasty, mitral valve, with cardiopulmonary by-pass Cardiovascular system 4,674,000.00 6,232,000.00 3,116.00
33426 - with prosthetic ring Cardiovascular system 4,686,000.00 6,248,000.00 3,124.00

SECURE &
PACKAGES PACKAGES
PACKAGES
33427 - with radical reconstruction with or without ring Cardiovascular system 5,290,500.00 7,054,000.00 3,527.00
33430 Replacement, mitral valve, with cardiopulmonary by-pass Cardiovascular system 5,217,000.00 6,956,000.00 3,478.00
33452 Valvotomy, triscupid valve, with cardiopulmonary by pass Cardiovascular system 1,848,000.00 2,464,000.00 1,232.00
33460 Valvuloplasty or valvectomy, tricuspid valve, with cardiopulmonary by-pass Cardiovascular system 3,973,500.00 5,298,000.00 2,649.00
33465 - replacement Cardiovascular system 4,846,500.00 6,462,000.00 3,231.00
33468 Tricuspid valve repositioning and application for Ebstein anomaly Cardiovascular system 4,768,500.00 6,358,000.00 3,179.00
33470 Valvotomy, pulmonary valve (commissurotomy); closed (transventricular) Cardiovascular system 2,943,000.00 3,924,000.00 1,962.00
33472 - open, with inflow occlusion Cardiovascular system 3,750,000.00 5,000,000.00 2,500.00
33474 open, with cardiopulmonary by-pass Cardiovascular system 4,035,000.00 5,380,000.00 2,690.00
Right ventricular resection for infundibular stenosis, with or without

commissurotomy
33510 Coronary artery by-pass, vein only; single coronary venous graft Cardiovascular system 4,183,500.00 5,578,000.00 2,789.00
33533 Coronary artery by-pass, using arterial graft(s); single arterial graft Cardiovascular system 4,264,500.00 5,686,000.00 2,843.00
33534 - two coronary arterial grafts Cardiovascular system 4,816,500.00 6,422,000.00 3,211.00
33542 Myocardial resection (eg. ventricular aneurysmectomy) Cardiovascular system 4,677,000.00 6,236,000.00 3,118.00
Repair of post-infraction ventricular septal defect, with or without myocardial

resection
Repair of arterial septal defect, secundum, with cardiopulmonary by-pass, with or

without patch
Direct or patch closure, sinus venosus, with or without anomalous pulmonary

venous drainage
33649 Repair of tricuspid atresia (eg. Fontan, Gago procedures) Cardiovascular system 4,000,500.00 5,334,000.00 2,667.00
Patch closure, endocardial cushion defect with or without repair of mitral and/or
tricuspid cleft
33670 Repair of complete atrioventricular canal, with or without prosthetic valve Cardiovascular system 5,281,500.00 7,042,000.00 3,521.00
33681 Closure of ventricular septal defect, with or without patch Cardiovascular system 4,651,500.00 6,202,000.00 3,101.00
33684 - with pulmonary valvotomy or infundibular resection (Acyanotic) Cardiovascular system 4,780,500.00 6,374,000.00 3,187.00
33688 - with removal of pulmonary artery band, with or without guset, add Cardiovascular system 4,822,500.00 6,430,000.00 3,215.00
33690 Banding of pulmonary artery Cardiovascular system 3,046,500.00 4,062,000.00 2,031.00

SECURE &
PACKAGES PACKAGES
PACKAGES
33692 Complete repair tetralogy of Fallot Cardiovascular system 5,122,500.00 6,830,000.00 3,415.00
33694 - with transannular patch Cardiovascular system 5,172,000.00 6,896,000.00 3,448.00
33696 - with closure of previous shunt, add Cardiovascular system 294,000.00 392,000.00 196.00
33702 Repair of sinus of Valsalva fistula, with cardiopulmonary by-pass Cardiovascular system 4,173,000.00 5,564,000.00 2,782.00
33710 - with repair of ventricular septal defect Cardiovascular system 4,824,000.00 6,432,000.00 3,216.00
33720 Repair of sinus of Valsalva aneurysm, with cardiopulmonary by-pass Cardiovascular system 4,176,000.00 5,568,000.00 2,784.00
33730 Complete repair of anomalous venous return (Supra cardiac, or intracardiac types) Cardiovascular system 3,756,000.00 5,008,000.00 2,504.00
33735 Arterial septectomy or septostomy; closed (Blalock-Hanlon type operation) Cardiovascular system 3,411,000.00 4,548,000.00 2,274.00
33750 Shunt; subclavian to pulmonary artery (Blalock-Taussig type operation) Cardiovascular system 3,184,500.00 4,246,000.00 2,123.00
33764 - central, with prosthetic graft Cardiovascular system 3,240,000.00 4,320,000.00 2,160.00
33766 - vena cava to pulmonary artery (Glen type operation) Cardiovascular system 3,336,000.00 4,448,000.00 2,224.00
Repair of transposition of the great arteries, aortic pulmonary artery reconstruction

(eg. Jatene type)
33779 - with removal of pulmonary band Cardiovascular system 5,722,500.00 7,630,000.00 3,815.00
33780 - with closure of ventricular septal defect Cardiovascular system 5,833,500.00 7,778,000.00 3,889.00
33781 - with repair of subpulmonic obstruction Cardiovascular system 5,758,500.00 7,678,000.00 3,839.00
33786 Total repair, truncus arteriosus (Rastelli Type operation) Cardiovascular system 5,521,500.00 7,362,000.00 3,681.00
33788 Reimplantation of anomalous pulmonary artery Cardiovascular system 4,096,500.00 5,462,000.00 2,731.00
Aortic suspension (aortipexy) for tracheal decompression (eg. For tracheomalacial)

(separate procedure)
33802 Division of aberrant vessel (vascular ring) Cardiovascular system 2,901,000.00 3,868,000.00 1,934.00
33803 - with reanastomosis Cardiovascular system 3,841,500.00 5,122,000.00 2,561.00
33813 Obliteration of aortopulmonary septal defect; without cardio-pulmonary by-pass Cardiovascular system 3,168,000.00 4,224,000.00 2,112.00
33814 - with cardiopulmonary by-pass Cardiovascular system 4,105,500.00 5,474,000.00 2,737.00
33820 Patent ductus arteriosus, ligation (primary procedure) Cardiovascular system 5,137,500.00 6,850,000.00 3,425.00
33822 - division, under 18 years Cardiovascular system 2,875,500.00 3,834,000.00 1,917.00

SECURE &
PACKAGES PACKAGES
PACKAGES
33824 - 18 years and older Cardiovascular system 3,072,000.00 4,096,000.00 2,048.00
33840 Coarctation, excision, with direct anastomosis (with or without association PDA) Cardiovascular system 3,711,000.00 4,948,000.00 2,474.00
33845 - with graft Cardiovascular system 3,855,000.00 5,140,000.00 2,570.00
- repair using either left subclavian artery or prosthetic material as gusset for
enlargement
- repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic

material
33855 - repair of hypoplastic left heart syndrom (eg. Norwood type) Cardiovascular system 4,767,000.00 6,356,000.00 3,178.00
Ascending aorta graft with cardiopulmonary by-pass, with or without coronary

implant, with or without valve suspension; without valve replacement
33865 - with valve replacement Cardiovascular system 2,940,000.00 3,920,000.00 1,960.00
33870 Transverse arch graft, with cardiopulmonary by-pass Cardiovascular system 6,262,500.00 8,350,000.00 4,175.00
33875 Descending thoracia aorta graft, with or without by-pass Cardiovascular system 4,515,000.00 6,020,000.00 3,010.00
Repair of thoracoabdominal aortic aneurysm with graft, with or without

cardiopulmonary by-pass
33960 Prolonged extra-corporeal circulation for cardiopulmonary insufficiency Cardiovascular system 2,071,500.00 2,762,000.00 1,381.00
33970 Intra-aortic balloon counter-pulsation; insertion only Cardiovascular system 1,189,500.00 1,586,000.00 793.00
Removal of intra-aortic balloon assist device including repair of femoral artery, with
33971 Cardiovascular system 895,500.00 1,194,000.00 597.00
or without graft
34000 Carotid Cardiovascular system 783,000.00 1,044,000.00 522.00
34005 Subclavian, cervical approach Cardiovascular system 1,354,500.00 1,806,000.00 903.00
34006 - thoracic approach Cardiovascular system 1,416,000.00 1,888,000.00 944.00
34010 Axillary-brachial Cardiovascular system 1,039,500.00 1,386,000.00 693.00
34015 Innominate Cardiovascular system 1,039,500.00 1,386,000.00 693.00
34020 Renal Cardiovascular system 1,810,500.00 2,414,000.00 1,207.00
34025 Coeliac or mesenteric Cardiovascular system 1,155,000.00 1,540,000.00 770.00
34030 Aorta-iliac, abdominal approach Cardiovascular system 1,810,500.00 2,414,000.00 1,207.00
34032 - bilateral inguinal approach Cardiovascular system 942,000.00 1,256,000.00 628.00
34033 Ilio-femoral, inguinal approach Cardiovascular system 633,000.00 844,000.00 422.00

SECURE &
PACKAGES PACKAGES
PACKAGES
34034 Ilio-femoral-popliteal, inguinal approach Cardiovascular system 781,500.00 1,042,000.00 521.00
34035 Femoral popliteal, unilateral Cardiovascular system 1,155,000.00 1,540,000.00 770.00
34037 Popliteal-tibial region Cardiovascular system 1,296,000.00 1,728,000.00 864.00
35000 Carotid Cardiovascular system 2,046,000.00 2,728,000.00 1,364.00
35011 Brachial Cardiovascular system 1,959,000.00 2,612,000.00 1,306.00
35012 Axillary Cardiovascular system 1,920,000.00 2,560,000.00 1,280.00
35020 Subclavian, cervical approach Cardiovascular system 2,139,000.00 2,852,000.00 1,426.00
35030 Innominate Cardiovascular system 2,218,500.00 2,958,000.00 1,479.00
35070 Aortic Aneurysm Cardiovascular system 2,709,000.00 3,612,000.00 1,806.00
35071 - with iliac and/or femoral anastomoses Cardiovascular system 2,356,500.00 3,142,000.00 1,571.00
35072 - ruptured, add Cardiovascular system 3,264,000.00 4,352,000.00 2,176.00
35073 - with temporary gastrostomy, add Cardiovascular system 187,500.00 250,000.00 125.00
35100 Renal, unilateral Cardiovascular system 3,094,500.00 4,126,000.00 2,063.00
35110 Iliac Cardiovascular system 2,857,500.00 3,810,000.00 1,905.00
35120 Common femoral Cardiovascular system 1,749,000.00 2,332,000.00 1,166.00
35130 Popliteal Cardiovascular system 1,948,500.00 2,598,000.00 1,299.00
35201 Arteriovenous fistula, congenital Cardiovascular system 1,624,500.00 2,166,000.00 1,083.00
35202 Replacement of previous Aortic graft Cardiovascular system BR BR BR
35211 - traumatic Cardiovascular system BR BR BR
35221 - acquired Cardiovascular system 2,281,500.00 3,042,000.00 1,521.00
35250 Creation of arteria-venous fistula, using branchial artery Cardiovascular system 840,000.00 1,120,000.00 560.00
35252 - using radial artery Cardiovascular system 1,008,000.00 1,344,000.00 672.00
35300 Carotid or vertebral Cardiovascular system 1,839,000.00 2,452,000.00 1,226.00
35305 - external carotid Cardiovascular system 2,557,500.00 3,410,000.00 1,705.00

SECURE &
PACKAGES PACKAGES
PACKAGES
35320 Subclavian, cervical approach Cardiovascular system BR BR BR
35321 - thoracic approach Cardiovascular system BR BR BR
35330 Innominate Cardiovascular system BR BR BR
35340 Abdominal aorta Cardiovascular system 2,229,000.00 2,972,000.00 1,486.00
35350 Mesenteric or celiac Cardiovascular system 2,472,000.00 3,296,000.00 1,648.00
35360 Renal, unilateral Cardiovascular system 2,472,000.00 3,296,000.00 1,648.00
35370 Iliac Cardiovascular system 2,100,000.00 2,800,000.00 1,400.00
35375 Aorta - common iliac, unilateral Cardiovascular system 1,743,000.00 2,324,000.00 1,162.00
35376 - bilateral Cardiovascular system 2,565,000.00 3,420,000.00 1,710.00
35381 Combined aorta-ilio-femoral, unilateral Cardiovascular system 2,815,500.00 3,754,000.00 1,877.00
35395 Superficial femoral, localized Cardiovascular system 1,407,000.00 1,876,000.00 938.00
35400 Femoral and popliteal Cardiovascular system 511,500.00 682,000.00 341.00
35410 Popliteal Cardiovascular system 1,320,000.00 1,760,000.00 880.00
35509 Carotid - subclavian, autogenous, cervical approach Cardiovascular system 2,920,500.00 3,894,000.00 1,947.00
35511 - thoracic approach Cardiovascular system 2,161,500.00 2,882,000.00 1,441.00
35512 - non-autogenous, cervical approach Cardiovascular system 2,568,000.00 3,424,000.00 1,712.00
35519 Subclavian-axillary or brachial, autogenous, cervical approach Cardiovascular system 1,975,500.00 2,634,000.00 1,317.00
35527 - thoracic approach Cardiovascular system 1,083,000.00 1,444,000.00 722.00
35532 Axillary-femoral, non-autogenous, unilateral Cardiovascular system 2,229,000.00 2,972,000.00 1,486.00
35570 Spleno-renal Cardiovascular system 1,953,000.00 2,604,000.00 1,302.00
35571 - with splenectomy Cardiovascular system 2,886,000.00 3,848,000.00 1,924.00
35580 Aorta-iliac, unilateral Cardiovascular system 1,555,500.00 2,074,000.00 1,037.00

SECURE &
PACKAGES PACKAGES
PACKAGES
35590 Aorto-femoral, unilateral Cardiovascular system 1,555,500.00 2,074,000.00 1,037.00
35600 Aorta-femoral-popliteal Cardiovascular system 547,500.00 730,000.00 365.00
35610 Femoral-popliteal, autogeneous, unilateral Cardiovascular system 1,507,500.00 2,010,000.00 1,005.00
35612 - attached to existing graft Cardiovascular system 2,374,500.00 3,166,000.00 1,583.00
35615 - non-autogenous, unilateral Cardiovascular system 1,083,000.00 1,444,000.00 722.00
35617 - non-autogenous, unilateral, attached to existing graft Cardiovascular system 1,158,000.00 1,544,000.00 772.00
35620 Femoral-femoral by-pass, autogenous Cardiovascular system 1,849,500.00 2,466,000.00 1,233.00
35621 - non-autogenous Cardiovascular system 2,421,000.00 3,228,000.00 1,614.00
35630 Femoral-tibial, autogenous Cardiovascular system 2,554,500.00 3,406,000.00 1,703.00
35631 - non-autogenous Cardiovascular system 3,439,500.00 4,586,000.00 2,293.00
35635 Autogenous vein graft when a vein is obtained from another part of the body, add Cardiovascular system 165,000.00 220,000.00 110.00
35700 Carotid Cardiovascular system 366,000.00 488,000.00 244.00
35710 External iliact Cardiovascular system 280,500.00 374,000.00 187.00
35720 Femoral Cardiovascular system 651,000.00 868,000.00 434.00
35740 Popliteal Cardiovascular system 651,000.00 868,000.00 434.00
35750 Tibial Cardiovascular system 631,500.00 842,000.00 421.00
35755 Popliteal-tibial Cardiovascular system 631,500.00 842,000.00 421.00
35900 Excision of infected graft Cardiovascular system 124,500.00 166,000.00 83.00
35910 - with re-vascularisation Cardiovascular system BR BR BR
35941 Vena Cava Cardiovascular system 1,449,000.00 1,932,000.00 966.00
35942 Brachial, axillary, femoral Cardiovascular system 885,000.00 1,180,000.00 590.00
35943 Iliac and subclavian Cardiovascular system 967,500.00 1,290,000.00 645.00
35944 Other vessels Cardiovascular system 885,000.00 1,180,000.00 590.00
36000 - unilateral Cardiovascular system 42,000.00 56,000.00 28.00

SECURE &
PACKAGES PACKAGES
PACKAGES
36011 - by placement into a superior or inferior vena cava Cardiovascular system 780,000.00 1,040,000.00 520.00
36013 - pulmonary artery Cardiovascular system 679,500.00 906,000.00 453.00
- selective (eg. renal, adrenal, hepatic, jugular), single vessel, with or without
midstream injection
36100 - carotid or vertebral, unilateral Cardiovascular system 577,500.00 770,000.00 385.00
36120 - retrograde brachial Cardiovascular system 457,500.00 610,000.00 305.00
36140 - extremely artery Cardiovascular system 444,000.00 592,000.00 296.00
36145 - arteriovenous shunt for dialysis (cannula, fistula or graft) Cardiovascular system 388,500.00 518,000.00 259.00
36160 - aortic, translumbar Cardiovascular system 583,500.00 778,000.00 389.00
36200 - aorta (arch, abdominal, midstream renal, aorta-iliac run-off, etc) Cardiovascular system 649,500.00 866,000.00 433.00
- celebral or other arch vessel, selective, single artery, with or without midstream
arch injection
- multiple cerebral arteries or other arch vessels, selective, with or without

midstream arch injection
36230 - coronary, selective, unilateral or bilateral Cardiovascular system 277,500.00 370,000.00 185.00
- renal, celiac, mesenteric, or other artery, selective, single artery, with or without
midstream injection
Venepunture, complex or non-routine, infant under 3 years, femoral, jugular or

sagittal sinus
36401 intravenous infusion, below 3 years Cardiovascular system 22,500.00 30,000.00 15.00
36405 intravenous infusion, below 3 years (Venepuncture- scalp vein) Cardiovascular system 43,500.00 58,000.00 29.00
36410 intravenous infusion over 3 years Cardiovascular system 12,000.00 16,000.00 8.00
36420 Cutdown venepuncture, under age 1 year Cardiovascular system 108,000.00 144,000.00 72.00
36425 - age 1 year or over Cardiovascular system 61,500.00 82,000.00 41.00
36426 - venesection Cardiovascular system 33,000.00 44,000.00 22.00
36450 Exchange transfusion, newborn Cardiovascular system 313,500.00 418,000.00 209.00
36470 Injection of sclerosing solution, single vein Cardiovascular system 147,000.00 196,000.00 98.00
Central venous pressure catheter placement, subclavian, external jugular or other

vein, percutaneous
36485 - by cutdown Cardiovascular system 51,000.00 68,000.00 34.00

SECURE &
PACKAGES PACKAGES
PACKAGES
36491 Insertion of Hickman line, including maintenance of patency Cardiovascular system 504,000.00 672,000.00 336.00
36601 Arterial puncture, withdrawal of blood for diagnosis Cardiovascular system 36,000.00 48,000.00 24.00
36620 Arterial catheterization for monitoring Cardiovascular system 121,500.00 162,000.00 81.00
36625 - cutdown Cardiovascular system 210,000.00 280,000.00 140.00
36810 Arteria-venous, external (Scriber type) Cardiovascular system 699,000.00 932,000.00 466.00
36815 - revision of closure Cardiovascular system 469,500.00 626,000.00 313.00
36821 Arteria-venous anastomosis, direct, any site Cardiovascular system 1,221,000.00 1,628,000.00 814.00
37140 Porto-caval anastomosis, thoracic Cardiovascular system 3,009,000.00 4,012,000.00 2,006.00
37160 Caval-mesentetic anastomosis Cardiovascular system 2,943,000.00 3,924,000.00 1,962.00
37400 Arteriorrhaphy: suture of wound or injury of major artery Cardiovascular system 705,000.00 940,000.00 470.00
37500 Phleborrhaphy: suture of wound or injury or major vein Cardiovascular system 1,450,500.00 1,934,000.00 967.00
37520 - neck Cardiovascular system 471,000.00 628,000.00 314.00
37600 Ligation, external carotid Cardiovascular system 886,500.00 1,182,000.00 591.00
37605 - internal or common carotid Cardiovascular system 1,011,000.00 1,348,000.00 674.00
37610 Ligation or biopsy temporal artery Cardiovascular system 319,500.00 426,000.00 213.00
37640 Ligation of other major veins Cardiovascular system 643,500.00 858,000.00 429.00
Ligation and division of long saphenous vein at spheno-femoral junction

37724 Ligation - multiple of short saphenous system, unilateral Cardiovascular system 640,500.00 854,000.00 427.00
37725 - with ligation and division of short saphenous vein at spheno-popliteal junction, add Cardiovascular system 94,500.00 126,000.00 63.00
Ligation, division and complete stripping of long saphenous system, with ligation of
37730 Cardiovascular system 751,500.00 1,002,000.00 501.00
perforator, initial or recurrent, unilateral
37731 - moderate Cardiovascular system 504,000.00 672,000.00 336.00
37732 - limited Cardiovascular system 330,000.00 440,000.00 220.00
37733 Combined ligation, subcutaneous stripping and sclerotherapy, unilateral Cardiovascular system 604,500.00 806,000.00 403.00
Compression sclerotherapy, complete leg (Fegan's technique) excluding material,

unilateral
SECURE &
PACKAGES PACKAGES
PACKAGES
37760 Radical subfascial stripping (eg. Linton type procedure) Cardiovascular system 1,369,500.00 1,826,000.00 913.00
Ligation and division of short saphenous vein at spheno-popliteal junction

37786 Ligation and excision of minor varicose vein of lower extrimity Cardiovascular system 60,000.00 80,000.00 40.00
37787 Ligation of jagular vein Cardiovascular system 69,000.00 92,000.00 46.00
37999 Unlisted vascular procedure Cardiovascular system BR BR BR
HAEMIC AND LYMPHATIC SYSTEM
38100 Splenectomy Haemic and Lymphatic 1,746,000.00 2,328,000.00 1,164.00
38200 Injection procedure for splenoportography Haemic and Lymphatic 328,500.00 438,000.00 219.00
38250 Splenorraphy Haemic and Lymphatic 750,000.00 1,000,000.00 500.00
38300 drainage of lymph node abscess or lymphadenitis (simple) Haemic and Lymphatic 249,000.00 332,000.00 166.00
38500 biopsy or exision of lymph node(s) open ,superficial Haemic and Lymphatic 414,000.00 552,000.00 276.00
38510 open ,deep cervical node(s) Haemic and Lymphatic 622,500.00 830,000.00 415.00
38520 open ,deep cervical node(s) with excision of scalene fat pad Haemic and Lymphatic 685,500.00 914,000.00 457.00
38526 Excision lymph nodes Haemic and Lymphatic 472,500.00 630,000.00 315.00
Excision of cystic hygroma, axillary or cervical, confined to skin and subcutaneous

38549 Haemic and Lymphatic 450,000.00 600,000.00 300.00
tissue, cervical approach
38700 suprahyoid lymphadenectomy Haemic and Lymphatic 1,392,000.00 1,856,000.00 928.00
38720 cervical lymphadenectomy (complete) Haemic and Lymphatic 2,269,500.00 3,026,000.00 1,513.00
38745 Axillary lymphadenectomy, complete Haemic and Lymphatic 1,384,500.00 1,846,000.00 923.00
Inguino-femoral lymphadenectomy, superficial including Cloquet's node

38760 Haemic and Lymphatic 1,281,000.00 1,708,000.00 854.00
(independent procedure) unilateral
- in continuity with pelvic lymphadenectomy, including external iliac, hypogastric

38765 Haemic and Lymphatic 2,268,000.00 3,024,000.00 1,512.00
and obturator nodes (independent procedure), unilateral
Retroperitoneal lymphadenectomy, extensive, including pelvic, aortic, and renal

38780 Haemic and Lymphatic 2,407,500.00 3,210,000.00 1,605.00
nodes (independent procedure)
38790 Injection procedure for lymphangiography, unilateral Haemic and Lymphatic 202,500.00 270,000.00 135.00
38792 Splenoportography - with pressure studies Haemic and Lymphatic 229,500.00 306,000.00 153.00
MEDIASTINUM AND DIAPHRAGM SYSTEM

SECURE &
PACKAGES PACKAGES
PACKAGES
Mediastinum and Diaphragm

39020 Mediastinotomy, sternal split 975,000.00 1,300,000.00 650.00
system

39220 Excision of mediastinal tumour 2,448,000.00 3,264,000.00 1,632.00
system

39400 Mediastinoscopy, with or without biopsy 885,000.00 1,180,000.00 590.00
system
Repair diaphragmatic hernia (oesophageal hiatus) transabdominal or transthoracic, Mediastinum and Diaphragm
39500 900,000.00 1,200,000.00 600.00
including fundoplasty system
Repair, oesophageal hiatus hernia, transabdominal, with or without fundoplasty with Mediastinum and Diaphragm
39501 1,783,500.00 2,378,000.00 1,189.00
vagotomy and/or pyloroplasty system

39520 - diaphragmatic, any method 2,166,000.00 2,888,000.00 1,444.00
system

39530 - combined, thoraco-abdominal, with or without vagotomy and pyloroplasty 2,178,000.00 2,904,000.00 1,452.00
system
DIGESTIVE SYSTEM
40100 Oesophagoscopy, without gastroscopy, diagnostic initial Digestive system 150,000.00 200,000.00 100.00
40101 - diagnostic, repeat Digestive system 225,000.00 300,000.00 150.00
40102 - with dilatation, direct Digestive system 225,000.00 300,000.00 150.00
40103 - with foreign body removal Digestive system 375,000.00 500,000.00 250.00
40105 - with biopsy, one or more Digestive system 375,000.00 500,000.00 250.00
40109 - with insertion of plastic tube or stent (Souttars tube) Digestive system 675,000.00 900,000.00 450.00
40110 - with injection of varices Digestive system 450,000.00 600,000.00 300.00
40120 Oesophagogastroscopy Digestive system 150,000.00 200,000.00 100.00
40140 Upper gastro-intestinal endoscopy Digestive system 375,000.00 500,000.00 250.00
40145 Oesophagogastroduodenoscopy with biopsy, one or more Digestive system 225,000.00 300,000.00 150.00
- with cannulation of ampulla of Vater for radiographic studies and/or specimen

40148 Digestive system 375,000.00 500,000.00 250.00
collection for cytology
40160 Gastroscopy, without oesophagoscopy Digestive system 150,000.00 200,000.00 100.00
40165 Gastroscopy with biopsy, one or more Digestive system 225,000.00 300,000.00 150.00
40200 Colonoscopy, beyond splenic flexure Digestive system 330,000.00 440,000.00 220.00
40201 - with collection of specimen by brushing or washing for cytology Digestive system 300,000.00 400,000.00 200.00
SECURE &
PACKAGES PACKAGES
PACKAGES
40206 - with removal of polpy Digestive system 600,000.00 800,000.00 400.00
40220 Colonoscopy, beyond 25 cm and below splenic flexure Digestive system 225,000.00 300,000.00 150.00
40221 - with collection of specimen by brushing or washing for cytology Digestive system 225,000.00 300,000.00 150.00
40226 - with removal of polyp Digestive system 525,000.00 700,000.00 350.00
40239 Proctosigmoidoscopy; initial Digestive system 315,000.00 420,000.00 210.00
40240 - subsequent Digestive system 45,000.00 60,000.00 30.00
40246 Proctosigmoidoscopy: initial or subsequent, with removal of polyp Digestive system 75,000.00 100,000.00 50.00
40247 - with removal of multiple excrescences, papillomata or polypi, simple Digestive system 150,000.00 200,000.00 100.00
Endoscopic retrograde cholangio-pancreatography (ERCP); diagonistic, with or

without collection of specimen(s)
40262 - with sphincterotomy/papillotomy Digestive system 450,000.00 600,000.00 300.00
40268 - with endoscopic retrograde insertion of tube or stent into bile or pancreatic duct Digestive system 525,000.00 700,000.00 350.00
40500 Vermilionectomy (lip shave), with mucosal advancement Digestive system 810,000.00 1,080,000.00 540.00
40510 excision of lip (transverse wedge with primary closure) Digestive system 850,500.00 1,134,000.00 567.00
40520 v -excision of lip (with primary closure) Digestive system 780,000.00 1,040,000.00 520.00
40521 Flap repair Digestive system 232,500.00 310,000.00 155.00
40530 resection lip more than one- fourth without closure Digestive system 873,000.00 1,164,000.00 582.00
40650 Repair lip, full thickness; vermilion only, post trauma Digestive system 678,000.00 904,000.00 452.00
40652 - up to half vertical height Digestive system 795,000.00 1,060,000.00 530.00
40654 - over one-half vertical height, or complex Digestive system 976,500.00 1,302,000.00 651.00
40700 Plastic repair of cleft lip, primary, partial or complete, unilateral Digestive system 1,671,000.00 2,228,000.00 1,114.00
40701 - primary bilateral, one stage procedure Digestive system 2,569,500.00 3,426,000.00 1,713.00
SECURE &
PACKAGES PACKAGES
PACKAGES
40702 - primary bilateral, one or two stages, per stage Digestive system 1,708,500.00 2,278,000.00 1,139.00
40720 - secondary, unilateral, by reaction of defect and enclosure Digestive system 1,842,000.00 2,456,000.00 1,228.00
40760 - with cross lip pedicle flap (Abbe Estlander type) Digestive system 1,500,000.00 2,000,000.00 1,000.00
40761 - including sectioning and insetting of pedicle Digestive system 2,002,500.00 2,670,000.00 1,335.00
40799 Unlisted procedure, lips Digestive system BR BR BR
40800 drainage of abscess,cyst,haematoma,vestible of mouth (simple) Digestive system 199,500.00 266,000.00 133.00
40801 complicated Digestive system 387,000.00 516,000.00 258.00
40804 removal of embeded foreign body (simple) Digestive system 199,500.00 266,000.00 133.00
40805 complicated Digestive system 540,000.00 720,000.00 360.00
40806 incision Digestive system 105,000.00 140,000.00 70.00
40808 biopsy , vestible of mouth Digestive system 180,000.00 240,000.00 120.00
40810 excision of mucosal or submucosal lesion without repair Digestive system 235,500.00 314,000.00 157.00
40812 with simple repair Digestive system 349,500.00 466,000.00 233.00
40814 with complex repair Digestive system 559,500.00 746,000.00 373.00
40816 complex with excision of underlying muscle Digestive system 583,500.00 778,000.00 389.00
40818 excsion of mucosa of vestible as donor graft Digestive system 450,000.00 600,000.00 300.00
40819 excision of frenum,labial or buccal (frenulectomy) Digestive system 345,000.00 460,000.00 230.00
40820 destruction of lesion or scar by laser,cryo,chemical or thermal methods Digestive system 219,000.00 292,000.00 146.00
40830 closure of laceration , vestible of mouth, less than 2.5cm Digestive system 252,000.00 336,000.00 168.00
40831 over 2.5cm or complex Digestive system 405,000.00 540,000.00 270.00
40840 vestibuloplasty (anterior) Digestive system BR BR BR
40842 posterior (unilateral) Digestive system BR BR BR
40843 posterior (bilateral) Digestive system BR BR BR
40844 entire arch Digestive system BR BR BR

SECURE &
PACKAGES PACKAGES
PACKAGES
40845 complex Digestive system BR BR BR
40899 Unlisted procedure vestible of mouth Digestive system BR BR BR
41000 intraoral incision & drainage of abscess,cyst,haematoma (tongue/mouth floor) Digestive system 193,500.00 258,000.00 129.00
41005 sublingual Digestive system 208,500.00 278,000.00 139.00
41006 sublingual Digestive system 403,500.00 538,000.00 269.00
41007 submental space Digestive system 508,500.00 678,000.00 339.00
41008 submandibular space Digestive system 417,000.00 556,000.00 278.00
41009 masticator space Digestive system 576,000.00 768,000.00 384.00
41010 incision of lingual frenum (frenotomy) Digestive system 184,500.00 246,000.00 123.00
41015 extraoral incision & drainage of abscess,cyst,haematoma (tongue/mouth floor) Digestive system 465,000.00 620,000.00 310.00
41016 submental space Digestive system 639,000.00 852,000.00 426.00
41017 submandibular space Digestive system 502,500.00 670,000.00 335.00
41018 masticator space Digestive system 745,500.00 994,000.00 497.00
41100 biopsy of tongue Digestive system 219,000.00 292,000.00 146.00
41105 posterior one third Digestive system 219,000.00 292,000.00 146.00
41108 biopsy of floor of mouth Digestive system 175,500.00 234,000.00 117.00
41110 excision Digestive system 294,000.00 392,000.00 196.00
41113 posterior one third Digestive system 552,000.00 736,000.00 368.00
41114 with local tongue flap Digestive system 1,497,000.00 1,996,000.00 998.00
41120 glossectomy (less than one half) Digestive system 1,458,000.00 1,944,000.00 972.00
41130 hemiglossectomy Digestive system 1,755,000.00 2,340,000.00 1,170.00

SECURE &
PACKAGES PACKAGES
PACKAGES
41135 partial ,with unilateral radical neck dissection Digestive system 2,943,000.00 3,924,000.00 1,962.00
41140 complete with or without tracheostomy, without radical neck dissection Digestive system 3,576,000.00 4,768,000.00 2,384.00
41145 complete with or without tracheostomy, with radical neck dissection Digestive system 4,299,000.00 5,732,000.00 2,866.00
41150 composite with resection mouth floor,mandible without neck dissection Digestive system 3,310,500.00 4,414,000.00 2,207.00
41153 composite with resection mouth floor,mandible &suprahyoid neck dissection Digestive system 3,856,500.00 5,142,000.00 2,571.00
41155 composite with resection mouth floor,mandible & radical neck dissection Digestive system 4,525,500.00 6,034,000.00 3,017.00
41250 repair laceration less than 2.5cm mouth floor or anterior two thirds tongue Digestive system 328,500.00 438,000.00 219.00
41251 posterior one third tongue Digestive system 525,000.00 700,000.00 350.00
41252 repair laceration over 2.5cm or complex floor of mouth or tongue Digestive system 456,000.00 608,000.00 304.00
41520 frenoplasty Digestive system 484,500.00 646,000.00 323.00
41599 Unlisted procedure tongue,floor of mouth Digestive system BR BR BR
42000 drainage of abscess of palate,uvula Digestive system 180,000.00 240,000.00 120.00
42100 biopsy of palate , uvula Digestive system 190,500.00 254,000.00 127.00
42104 excision lesion of palate,uvula without closure Digestive system 321,000.00 428,000.00 214.00
42120 resection palate or extensive resection of lesion Digestive system 1,183,500.00 1,578,000.00 789.00
42140 uvulectomy Digestive system 285,000.00 380,000.00 190.00
42200 Palatoplasty for cleft palate, soft and/or hard palate Digestive system 1,420,500.00 1,894,000.00 947.00
42205 - with closure of alveolar ridge, soft tissue Digestive system 1,606,500.00 2,142,000.00 1,071.00
42210 - with bone graft to alveolar ridge (includes obtaining graft) Digestive system 1,846,500.00 2,462,000.00 1,231.00
42215 - major revision Digestive system 1,305,000.00 1,740,000.00 870.00
42220 - secondary lengthening procedure Digestive system 1,425,000.00 1,900,000.00 950.00
42225 attachment of pharyngeal flap Digestive system 1,434,000.00 1,912,000.00 956.00
42235 Repair, anterior palate, including vomerine flap Digestive system 1,146,000.00 1,528,000.00 764.00
42250 Repair, oroantral or oronasal fistula, up to 1cm Digestive system 750,000.00 1,000,000.00 500.00
SECURE &
PACKAGES PACKAGES
PACKAGES
42251 Palatal fistula Digestive system BR BR BR
42300 drainage of abscess,parotid simple Digestive system 265,500.00 354,000.00 177.00
42330 sialolithotomy submandibular,sublingual, parotid simple intraoral Digestive system 300,000.00 400,000.00 200.00
42335 submandibular complicated intraoral Digestive system 507,000.00 676,000.00 338.00
42410 excision of parotid tumour or gland,lateral lobe without nerve dissection Digestive system 1,189,500.00 1,586,000.00 793.00
42415 lateral lobe with facial nerve dissection Digestive system 2,265,000.00 3,020,000.00 1,510.00
42420 total with facial nerve dissection Digestive system 2,620,500.00 3,494,000.00 1,747.00
42425 total en bloc removal with facial nerve sacrifice Digestive system 1,815,000.00 2,420,000.00 1,210.00
42426 total with unilateral radical neck dissection Digestive system 3,307,500.00 4,410,000.00 2,205.00
42440 excision of submandibular tumour or gland Digestive system 1,098,000.00 1,464,000.00 732.00
42550 injection for sialography Digestive system 165,000.00 220,000.00 110.00
42600 closure of salivary fistula Digestive system 729,000.00 972,000.00 486.00
42650 dilation of salivary duct Digestive system 108,000.00 144,000.00 72.00
42699 unlisted procedure ,salivary glands or ducts Digestive system 525,000.00 700,000.00 350.00
42720 retropharyngeal or parapharyngeal (intraoral) Digestive system 474,000.00 632,000.00 316.00
42725 retropharyngeal or parapharyngeal (external) Digestive system 1,096,500.00 1,462,000.00 731.00
42730 Quinsy opening - general anaesthetic Digestive system 330,000.00 440,000.00 220.00
42731 Quinsy opening - local anaesthetic Digestive system 114,000.00 152,000.00 76.00
42804 nasopharynx (visible , simple) Digestive system 231,000.00 308,000.00 154.00
42806 nasopharynx (survey , unknown primary) Digestive system 282,000.00 376,000.00 188.00
42810 excision branchial cleft cyst or vestige (skin & subcutaneous tissue) Digestive system 562,500.00 750,000.00 375.00
42815 excision branchial cleft cyst ,vestige,fistula ( deep to subcut to pharynx) Digestive system 1,180,500.00 1,574,000.00 787.00
42830 Quinsy Tonsillectomy Digestive system 750,000.00 1,000,000.00 500.00
42840 Adenotonsillectomy Digestive system 562,500.00 750,000.00 375.00

SECURE &
PACKAGES PACKAGES
PACKAGES
42841 - age 12 years or over Digestive system 600,000.00 800,000.00 400.00
42842 radical resection tonsil,pillars,& or retromolar trigone without closure Digestive system 1,329,000.00 1,772,000.00 886.00
42850 adenoidectomy (primary under 12 years) Digestive system 562,500.00 750,000.00 375.00
42880 Excision, nasopharyngeal lesion (eg. fibroma) Digestive system 367,500.00 490,000.00 245.00
42896 Pharyngeal neoplasm, excision, benign, per oral Digestive system 352,500.00 470,000.00 235.00
42897 Pharyngotomy - lateral for neoplasm Digestive system 1,147,500.00 1,530,000.00 765.00
42950 pharyngoplasty (reconstruction of pharynx) Digestive system 1,434,000.00 1,912,000.00 956.00
42962 with secondary surgical intervention Digestive system 1,003,500.00 1,338,000.00 669.00
42965 Injection of Teflon into naso pharynx Digestive system 180,000.00 240,000.00 120.00
43030 cricopharygeal myotomy Digestive system 1,233,000.00 1,644,000.00 822.00
Oesophagectomy: resection of oesophagus (upper two-thirds) with gastric

43110 Digestive system 1,650,000.00 2,200,000.00 1,100.00
anastomosis, with or without vagotomy or pyloroplasty
Oesophagogastrectomy for lower one-third of oesophagus, combined

thoracoabdominal vagotomy and pyloroplasty, one or two stages
43130 diverticulectomy with or without myotomy Digestive system 1,656,000.00 2,208,000.00 1,104.00
43312 Oesophagoplasty, with repair of tracheo-oesophageal fistula Digestive system 3,274,500.00 4,366,000.00 2,183.00
Oesophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty,

43321 Digestive system 900,000.00 1,200,000.00 600.00
abdominal approach
43322 - thoracic approach Digestive system 900,000.00 1,200,000.00 600.00
43325 Oesophagogastric fundoplasty (eg. Nissen II) Digestive system 2,196,000.00 2,928,000.00 1,464.00
Oesophagomyotomy (Heller type), with or without hiatus hernia repair, thoracic

approach
43340 Oesophagojejunostomy (without total gastrectomy) abdominal Digestive system 2,235,000.00 2,980,000.00 1,490.00
43500 Gastrotomy, with exploration or foreign body removal Digestive system 1,177,500.00 1,570,000.00 785.00
43520 Pyloromyotomy: cutting of pyloric muscle (Fredet-Rammstedt type operation) Digestive system 1,009,500.00 1,346,000.00 673.00
43610 Local excision of ulcer or tumour Digestive system 1,546,500.00 2,062,000.00 1,031.00
43620 Total gastrectomy, including intestinal anastomosis Digestive system 3,091,500.00 4,122,000.00 2,061.00
Sub-total or hemi-gastrectomy, including pyloroplasty, gastroduodenostomy or

43630 Digestive system 1,050,000.00 1,400,000.00 700.00
gastrojejunostomy
SECURE &
PACKAGES PACKAGES
PACKAGES
43635 Sub-total gastrectomy, with vagotomy, any type Digestive system 1,219,500.00 1,626,000.00 813.00
43640 Vagotomy and pyloroplasty, with or without gastrostomy Digestive system 1,957,500.00 2,610,000.00 1,305.00
43641 Highly selective vagotomy Digestive system 1,966,500.00 2,622,000.00 1,311.00
43800 Pyloroplasty Digestive system 1,401,000.00 1,868,000.00 934.00
43820 Gastrojejunostomy Digestive system 1,695,000.00 2,260,000.00 1,130.00
43825 - with vagotomy, any type Digestive system 2,056,500.00 2,742,000.00 1,371.00
43830 Gastrotomy, temporary (tube, rubber or plastic) [independent procedure] Digestive system 975,000.00 1,300,000.00 650.00
43831 - with retrograde intubation Digestive system 960,000.00 1,280,000.00 640.00
43840 Gastrorrhaphy: suture of perforated duodenal or gastric ulcer, wound or injury. Digestive system 1,677,000.00 2,236,000.00 1,118.00
Revision of gastroenteric anastomosis with reconstruction, without vagotomy, with

or without partial gastrectomy or bowel resection
43870 Closure of gastrotomy, surgical Digestive system 1,059,000.00 1,412,000.00 706.00
43880 Closure of gastro-colic fistula Digestive system 2,308,500.00 3,078,000.00 1,539.00
44006 Intestinal obstruction of newborn Digestive system 750,000.00 1,000,000.00 500.00
Enterotomy, other than duodenum, with exploration or foreign body removal, large
or small bowel
44050 Reduction of volvulus, intussusception, internal hernia, by laporotomy Digestive system 1,500,000.00 2,000,000.00 1,000.00
44100 Biopsy by capsule, per oral, via tube (one or more specimens) Digestive system 232,500.00 310,000.00 155.00
44120 Entertectomy: resection of small intestine, with anastomosis Digestive system 1,912,500.00 2,550,000.00 1,275.00
44130 Enteroenterostomy: anastomosis of intestine Digestive system 1,749,000.00 2,332,000.00 1,166.00
44132 Ilio-transversostomy Digestive system 825,000.00 1,100,000.00 550.00
44140 Colectomy, partial, with anastomosis Digestive system 2,326,500.00 3,102,000.00 1,551.00
44141 - right or left hemicolectomy Digestive system 2,545,500.00 3,394,000.00 1,697.00
44143 - with end colostomy and closure of distal segment (Hartmann type procedure) Digestive system 2,391,000.00 3,188,000.00 1,594.00
44144 - with resection, with colostomy and creation of mucofistula Digestive system 2,401,500.00 3,202,000.00 1,601.00
44145 - with coloproctostomy (low pelvic anastomosis) Digestive system 2,850,000.00 3,800,000.00 1,900.00
SECURE &
PACKAGES PACKAGES
PACKAGES
44146 - with colostomy Digestive system 3,181,500.00 4,242,000.00 2,121.00
44150 Colectomy, total, abdominal, with ileostomy, or ileoproctostomy, without protectomy Digestive system 2,875,500.00 3,834,000.00 1,917.00
44155 - with proctectomy and ileostomy Digestive system 3,267,000.00 4,356,000.00 2,178.00
44156 Excision of lesion or mesentery Digestive system 2,926,500.00 3,902,000.00 1,951.00
44300 Tube enterostomy or caecostomy (independent procedure) Digestive system 1,210,500.00 1,614,000.00 807.00
44310 Ileostomy Digestive system 1,555,500.00 2,074,000.00 1,037.00
44320 Colostomy or skin level caecostomy (independent procedure) Digestive system 1,671,000.00 2,228,000.00 1,114.00
Suture of intestine (enterorrhaphy), large or small, for perforated ulcer, wound,

injury or rupture, single
44620 Closure of enterostomy, large or small intestine Digestive system 1,492,500.00 1,990,000.00 995.00
44625 - with resection and anastomosis Digestive system 1,612,500.00 2,150,000.00 1,075.00
44640 Closure of intestinal cutaneous fistula Digestive system 1,824,000.00 2,432,000.00 1,216.00
44650 Closure of enteroenteric or enterocolic fistula Digestive system 1,921,500.00 2,562,000.00 1,281.00
44660 Closure of enterovesical fistula (without intestinal or bladder resection) Digestive system 1,911,000.00 2,548,000.00 1,274.00
44661 - wiht bowel and/or bladder resection Digestive system 2,484,000.00 3,312,000.00 1,656.00
44680 Intestinal suture plication, complete (Noble type) [independent procedure] Digestive system 1,824,000.00 2,432,000.00 1,216.00
44800 Excision of Meckel's diverticulum (diverticulectomy) or omphalomesenteric duct Digestive system 1,272,000.00 1,696,000.00 848.00
44900 Incision and drainage of appendiceal abscess transabdominal Digestive system 1,068,000.00 1,424,000.00 712.00
44950 Appendicectomy Digestive system 951,000.00 1,268,000.00 634.00
44960 - for ruptured appendix, with abscess or generalised peritonitis Digestive system 1,333,500.00 1,778,000.00 889.00
45102 Formal dissection, excision/biopsy plus repair of the anorectal region Digestive system 225,000.00 300,000.00 150.00
45106 Local excision of rectal tumour (posterior approach) Digestive system 750,000.00 1,000,000.00 500.00
45110 Potectomy, complete, combined abdominoperineal Digestive system 3,141,000.00 4,188,000.00 2,094.00
45120 - for congenital megacolon (Swenson, Duhamel or Soave type procedure) Digestive system 3,091,500.00 4,122,000.00 2,061.00
45130 Excision of rectal procidential, with anastomosis, perineal approach Digestive system 1,815,000.00 2,420,000.00 1,210.00
SECURE &
PACKAGES PACKAGES
PACKAGES
45150 Division of stricture of rectum, initial, with anaesthetic Digestive system 697,500.00 930,000.00 465.00
45151 - subsequent, dilation, with anaesthetic Digestive system 60,000.00 80,000.00 40.00
45160 Excision, tumour, rectum, with resection and anastomosis (Kraske type procedure) Digestive system 1,641,000.00 2,188,000.00 1,094.00
45500 Proctoplasty, for stenosis Digestive system 991,500.00 1,322,000.00 661.00
45505 - for prolapse of mucous membrane Digestive system 966,000.00 1,288,000.00 644.00
45540 Proctopexy for prolapse, abdominal Digestive system 1,801,500.00 2,402,000.00 1,201.00
45555 Prolapse of rectum - Rosco Graham Moskovitz Digestive system 1,125,000.00 1,500,000.00 750.00
45556 Ivalon Sponge Digestive system 675,000.00 900,000.00 450.00
45800 Closure of rectovesical fistula Digestive system 1,900,500.00 2,534,000.00 1,267.00
45820 Closure of rectourethral fistula Digestive system 1,878,000.00 2,504,000.00 1,252.00
45900 Reduction of procidentia (independent procedure) Digestive system 222,000.00 296,000.00 148.00
46040 Incision and drainage of perirectal abscess (independent procedure) Digestive system 618,000.00 824,000.00 412.00
Incision and drainage of ischiorectal, intramural, intramuscular or submucosal

abscess, under anaesthesia
46050 Incision and drainage, perianal abscess, superficial (see also 46060) Digestive system 184,500.00 246,000.00 123.00
Incision and drainage of ischiorectal or intramural abscess, with fistulectomy,

submuscular
Sphincterotomy anal: division of anal sphincter or manual stretching of anal

sphincter
46200 Fissurectomy, with or without sphincterotomy Digestive system 552,000.00 736,000.00 368.00
46211 Cryptectomy, multiple or single, hospital (independent proceure) Digestive system 120,000.00 160,000.00 80.00
46220 Paillectomy or excision of single tag, office (independent procedure) Digestive system 211,500.00 282,000.00 141.00
46225 Haemorrhoidectomy by cryosurgery Digestive system BR BR BR
46230 Excision of external haemorrhoid tags and/or multiple papillae, office Digestive system 315,000.00 420,000.00 210.00
46250 Haemorrhoidectomy, external Digestive system 624,000.00 832,000.00 416.00
46255 - internal and external, simple Digestive system 802,500.00 1,070,000.00 535.00
46257 - with fissurectomy Digestive system 856,500.00 1,142,000.00 571.00

SECURE &
PACKAGES PACKAGES
PACKAGES
46270 Fistulectomy, subcutaneous Digestive system 528,000.00 704,000.00 352.00
46275 Fistula-in-ano, excision of intermediate fistula Digestive system 816,000.00 1,088,000.00 544.00
46276 Fistula-in-ano, high level Digestive system 525,000.00 700,000.00 350.00
46329 Enucleation or excision of external thrombotic haemorrhoid Digestive system 52,500.00 70,000.00 35.00
46330 Manual removal faecal impact Digestive system 135,000.00 180,000.00 90.00
Haemorrhoids, injection of sclerosing solution, per haemorrhoid to a maximum of

three
46700 Anoplasty: plastic operation for stricture, adult Digestive system 1,039,500.00 1,386,000.00 693.00
46705 - infant Digestive system 826,500.00 1,102,000.00 551.00
46765 Thiersch procedure, including removal Digestive system 180,000.00 240,000.00 120.00
46900 Destruction condylomata, multiple, simple, chemical Digestive system 228,000.00 304,000.00 152.00
46910 - electro-desiccation Digestive system 249,000.00 332,000.00 166.00
46920 - surgical excision, simple Digestive system 45,000.00 60,000.00 30.00
47000 Needle biopsy of liver, percutaneous Digestive system 312,000.00 416,000.00 208.00
47001 Needle aspiration Digestive system 246,000.00 328,000.00 164.00
47002 - detention time - after the first thirty minutes, for every additional fifteen Digestive system 22,500.00 30,000.00 15.00
47100 Wedge biopsy Digestive system 970,500.00 1,294,000.00 647.00
47120 Hepatectomy (resection of liver), partial lobectomy Digestive system 2,965,500.00 3,954,000.00 1,977.00
47125 - total left lobectomy Digestive system 4,170,000.00 5,560,000.00 2,780.00
47130 - total right lobectomy Digestive system 4,552,500.00 6,070,000.00 3,035.00
47300 Marsupialization of cyst or abscess of liver Digestive system 1,486,500.00 1,982,000.00 991.00
47350 Hepatorrhaphy: suture of liver, wound or injury, simple Digestive system 1,732,500.00 2,310,000.00 1,155.00
Hepatorrhaphy: suture of liver, wound or injury, with common duct or gall bladder
drainage, complex
Choledochotomy or choledochostomy with exploration, drainange or removal of

calculus, with or without cholecystotomy
47421 - with transduodenal sphincterotomy or sphincteroplasty Digestive system 1,050,000.00 1,400,000.00 700.00
SECURE &
PACKAGES PACKAGES
PACKAGES
47425 Choledochotomy, secondary (exploration of common bile duct) Digestive system 2,215,500.00 2,954,000.00 1,477.00
47460 Transduodenal sphincterotomy or sphincteriplasty Digestive system 2,136,000.00 2,848,000.00 1,424.00
Cholecystotomy or cholecystostomy, with or without exploration, drainage or

47480 Digestive system 1,329,000.00 1,772,000.00 886.00
removal of calculus (independent procedure)
47500 Injection procedure for percutaneous transphepatic cholangiography Digestive system 231,000.00 308,000.00 154.00
47600 Cholecystectomy Digestive system 1,567,500.00 2,090,000.00 1,045.00
47605 - add fee cholangiography Digestive system 1,633,500.00 2,178,000.00 1,089.00
47610 - with open exploration common bile duct Digestive system 1,968,000.00 2,624,000.00 1,312.00
47615 - endoscopic (with no add-on charges for complications) Digestive system 1,185,000.00 1,580,000.00 790.00
47720 Cholecystenterostomy or gastrostomy Digestive system 1,782,000.00 2,376,000.00 1,188.00
47760 Direct anastomosis of extrahepatic biliary ducts and gastrointestinal tract Digestive system 2,856,000.00 3,808,000.00 1,904.00
47800 Plastic reconstruction of extrahepatic biliary ducts and end-to-end anastomosis Digestive system 2,572,500.00 3,430,000.00 1,715.00
48020 Removal of pancreatic calculus Digestive system 1,711,500.00 2,282,000.00 1,141.00
48100 Biopsy of pancreas Digestive system 1,258,500.00 1,678,000.00 839.00
48140 Pancreatectomy, subtotal, with or without splenectomy Digestive system 2,614,500.00 3,486,000.00 1,743.00
48150 - Whipple type Digestive system 5,205,000.00 6,940,000.00 3,470.00
48180 Pancreatic - jejunostomy (eg. Puestow type) procedure Digestive system 1,350,000.00 1,800,000.00 900.00
48500 Marsupialization of cyst of pancreas Digestive system 1,741,500.00 2,322,000.00 1,161.00
49000 Exploratory laparotomy: exploratory celiotomy (independent procedure) Digestive system 1,306,500.00 1,742,000.00 871.00
49001 Staging laparotomy for lymphoma including splenectomy and liver and gland biopsy Digestive system 1,110,000.00 1,480,000.00 740.00
49010 Retroperitoneal exploration (independent procedure) Digestive system 1,519,500.00 2,026,000.00 1,013.00
49040 Drainage subphrenic or subdiaphragmatic abscess Digestive system 1,362,000.00 1,816,000.00 908.00
49080 Peritoneocentesis, abdominal paracentesis, initial Digestive system 205,500.00 274,000.00 137.00
49210 Excision of greater omentum Digestive system 585,000.00 780,000.00 390.00
49300 Peritoneoscopy Digestive system 285,000.00 380,000.00 190.00

SECURE &
PACKAGES PACKAGES
PACKAGES
49301 - with biopsy Digestive system 360,000.00 480,000.00 240.00
49400 Pneumoperitoneum, initial (independent procedure) Digestive system 270,000.00 360,000.00 180.00
49430 Injection procedure for retroperitoneal pneumography Digestive system 105,000.00 140,000.00 70.00
49440 Injection procedure for pelvic pneumography Digestive system 903,000.00 1,204,000.00 602.00
49501 All herniae with strangulation not to be charged; if resection performed, add Digestive system 831,000.00 1,108,000.00 554.00
49508 Inguinal, all types, adult Digestive system 420,000.00 560,000.00 280.00
49509 - infant, under 1 year Digestive system 457,500.00 610,000.00 305.00
49510 - with orchidectomy, with or without implantation of prosthesis Digestive system 525,000.00 700,000.00 350.00
49515 - with excision of hydrocele or spermatocele Digestive system 525,000.00 700,000.00 350.00
49520 - sliding Digestive system 1,078,500.00 1,438,000.00 719.00
49525 - recurrent Digestive system 1,017,000.00 1,356,000.00 678.00
49540 Lumbar Digestive system 1,098,000.00 1,464,000.00 732.00
49550 Femoral, groin incision Digestive system 960,000.00 1,280,000.00 640.00
49552 - Henry approach Digestive system 525,000.00 700,000.00 350.00
49555 - recurrent Digestive system 1,081,500.00 1,442,000.00 721.00
49560 Central or incisional (independent procedure) Digestive system 1,251,000.00 1,668,000.00 834.00
49565 - recurrent (independent procedure) Digestive system 1,308,000.00 1,744,000.00 872.00
49570 Epigastric, simple, propertoneal fat, (independent procedure) Digestive system 721,500.00 962,000.00 481.00
49575 more complex Digestive system BR BR BR
49582 Umbilical, infant (independent procedure) Digestive system 801,000.00 1,068,000.00 534.00
49583 - adult (independent procedure) Digestive system 585,000.00 780,000.00 390.00
49600 Repair of ompalocele small, with primary closure Digestive system 1,213,500.00 1,618,000.00 809.00
49605 - large, with or without prosthesis Digestive system 3,973,500.00 5,298,000.00 2,649.00
49900 Secondary suture of abdominal wall for eviscreration or dehiscence Digestive system 853,500.00 1,138,000.00 569.00
SECURE &
PACKAGES PACKAGES
PACKAGES
URINARY SYSTEM
50010 Renal exploration not necessitating other specific procedures Urinary system 1,903,500.00 2,538,000.00 1,269.00
50020 Drainage of perirenal or renal abscess (independent procedure) Urinary system 2,052,000.00 2,736,000.00 1,368.00
50040 Nephrostomy: nephrostomy with drainage Urinary system 1,941,000.00 2,588,000.00 1,294.00
50045 Nephrostomy with exploration Urinary system 2,383,500.00 3,178,000.00 1,589.00
50060 Nephrolithotomy, remocal of calculus Urinary system 2,973,000.00 3,964,000.00 1,982.00
50065 - secondary surgical operation for calculus Urinary system 3,243,000.00 4,324,000.00 2,162.00
50070 - complicated by congenital kidney abnormality Urinary system 3,141,000.00 4,188,000.00 2,094.00
50075 - large (staghorn) calculus filling renal pelvis and calyces. Urinary system 3,972,000.00 5,296,000.00 2,648.00
50100 Transection of repositioning of aberrant renal vessels (independent procedure) Urinary system 2,511,000.00 3,348,000.00 1,674.00
50120 Pyelotomy, with exploration (independent procedure) Urinary system 2,535,000.00 3,380,000.00 1,690.00
50125 Pyelotomy with drainage, pyelostomy (independent procedure) Urinary system 2,607,000.00 3,476,000.00 1,738.00
50130 - with removal of calculus; pyelolithotomy; pelviolithotomy (independent procedure) Urinary system 2,808,000.00 3,744,000.00 1,872.00
Pyelotomy, with exploration, complicated (eg. secondary operation, congenital

50135 Urinary system 3,333,000.00 4,444,000.00 2,222.00
kidney abnormality etc.)
50200 Renal biopsy, percutaneous, by trochar or needle Urinary system 435,000.00 580,000.00 290.00
50205 - by surgical exposure of kidney Urinary system 1,801,500.00 2,402,000.00 1,201.00
50220 Nephrectomy, including partial ureterectomy, any approach, including rib resection Urinary system 2,833,500.00 3,778,000.00 1,889.00
50225 - complicated because of previous surgery on same kidney Urinary system 3,396,000.00 4,528,000.00 2,264.00
50230 - radical, with regional lymphadenectomy Urinary system 3,712,500.00 4,950,000.00 2,475.00
50234 - with total ureterectomy and bladder cuff, through same incision Urinary system 3,637,500.00 4,850,000.00 2,425.00
50236 Nephrectomy, including partial ureterectomy, through separate incision Urinary system 3,988,500.00 5,318,000.00 2,659.00
50240 - partial Urinary system 3,534,000.00 4,712,000.00 2,356.00
50280 Excision or unroofing of cyst(s) of kidney Urinary system 2,496,000.00 3,328,000.00 1,664.00
50290 Excision of perinephric cyst Urinary system 2,248,500.00 2,998,000.00 1,499.00

SECURE &
PACKAGES PACKAGES
PACKAGES
50366 Renal homotransplantation; uni/bilateral recipient nephrectomy Urinary system 3,045,000.00 4,060,000.00 2,030.00
50380 Renal autotransplantation; reimplantation of kidneys Urinary system 3,036,000.00 4,048,000.00 2,024.00
50390 Aspiration and/or injection of renal cyst or pelvis, by needle, percutaneous Urinary system 387,000.00 516,000.00 258.00
Introduction of intracatheter or catheter into renal pelvis for drainage and/or

50392 Urinary system 640,500.00 854,000.00 427.00
injection, percutaneous
Injection procedure for pyelography (eg. nephrostogram, pyelostogram antegrade

50394 pyloureterogram) through nephrostomy or pyelostomy tube, or indwelling ureteral Urinary system 159,000.00 212,000.00 106.00
catheter (independent procedure)
50395 Intra-Cavemosal Injection Urinary system 675,000.00 900,000.00 450.00
Pyeloplasty, plastic operation on renal pelvis, with or without plastic operation on

50400 Urinary system 3,093,000.00 4,124,000.00 2,062.00
ureter, nephropexy, nephrostomy or ureteral splinting
- complicated (eg. congenital kidney abnormality, secondary pyeloplasty, solitary

50405 Urinary system 3,841,500.00 5,122,000.00 2,561.00
kidney)
50500 Nephrorrhaphy: suture of kidney wound or injury Urinary system 3,024,000.00 4,032,000.00 2,016.00
Symphysiotomy for horseshoe kidney, with or without pyeloplasty and/or other

50540 Urinary system 3,162,000.00 4,216,000.00 2,108.00
plastic procedure, unilateral or bilateral (one operation)
Lithotripsy, extra corporeal shock wave. One or more stones in same kidney, first
50590 Urinary system 2,059,500.00 2,746,000.00 1,373.00
treatment
50591 - second treatment on same kidney. By Report (B.R.) Urinary system 1,216,500.00 1,622,000.00 811.00
50592 Other open operations on the kidney Urinary system 3,583,500.00 4,778,000.00 2,389.00
50600 Ureterotomy, with exploration or drainage (independent procedure) Urinary system 2,412,000.00 3,216,000.00 1,608.00
50610 Ureterolithotomy, upper one-third of ureter Urinary system 2,592,000.00 3,456,000.00 1,728.00
50620 - middle one-third of ureter Urinary system 2,485,500.00 3,314,000.00 1,657.00
50630 - lower one-third of ureter Urinary system 2,547,000.00 3,396,000.00 1,698.00
50650 Ureterectomy, with bladder cuff (independent procedure) Urinary system 2,772,000.00 3,696,000.00 1,848.00
Ureterectomy, total ectopic; combination abdominal, vaginal and/or per perineal

50660 Urinary system 3,036,000.00 4,048,000.00 2,024.00
approach
Injection procedure for ireterography or ureteropyeleohraphy through ureterostomy

50684 Urinary system 219,000.00 292,000.00 146.00
or indwelling ureteral catheter (independent procedure)
Injection procedure for visualization of ilial conduit and/or ureteropyeleography,

50690 Urinary system 177,000.00 236,000.00 118.00
exclusive of radiological service (independent procedure)
50700 Uretoroplasty: plastic operation on ureter (eg. for stricture) Urinary system 2,578,500.00 3,438,000.00 1,719.00
Ureterolysis, with or without repositioning of ureter, for retropertoneal fibrosis,

50715 Urinary system 2,872,500.00 3,830,000.00 1,915.00
unilateral
Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena
50725 Urinary system 2,875,500.00 3,834,000.00 1,917.00
cava
SECURE &
PACKAGES PACKAGES
PACKAGES
50740 Ureteropyelostomy: anastomosis of ureter and renal pelvis Urinary system 2,955,000.00 3,940,000.00 1,970.00
50750 Ureterocalycostomy: anastomosis of ureter to renal calys Urinary system 3,124,500.00 4,166,000.00 2,083.00
50760 Ureteroureterostomy Urinary system 2,974,500.00 3,966,000.00 1,983.00
50770 Transureterouterostomy: anastomosis of ureter to contralateral ureter Urinary system 3,219,000.00 4,292,000.00 2,146.00
Ureteroneocystostomy: anastomosis of ureter to bladder, or other operations for

50780 Urinary system 2,995,500.00 3,994,000.00 1,997.00
corrections of vesicoureteral reflux, unilateral
50785 - with bladder flaps, unilateral Urinary system 3,346,500.00 4,462,000.00 2,231.00
50800 Ureteroenterostomy: direct anastomosis of ureter to intestine, unilateral Urinary system 2,649,000.00 3,532,000.00 1,766.00
Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of

50810 Urinary system 3,088,500.00 4,118,000.00 2,059.00
abdominal or perineal colostomy, including bowel anastomosis
Utereosigmoidostomy, with creation of a defunctioned rectal bladder and

50811 Urinary system 2,310,000.00 3,080,000.00 1,540.00
intrasphincteric perineal colostomy (Gersay procedure)
50820 Ureteroileal conduct (ileal bladder), including bowel anastomosis, unilateral Urinary system 3,759,000.00 5,012,000.00 2,506.00
50821 - bilateral Urinary system 2,100,000.00 2,800,000.00 1,400.00
50822 Construction of substitute bladder, any method Urinary system 2,625,000.00 3,500,000.00 1,750.00
Replacement of all, or part of, ureter by bowel segment, including bowel

50840 Urinary system 3,115,500.00 4,154,000.00 2,077.00
anastomosis, unilateral
50860 Ureterostomy: transplantation of ureter to skin, unilateal Urinary system 2,455,500.00 3,274,000.00 1,637.00
51000 Aspiration of bladder by needle Urinary system 16,500.00 22,000.00 11.00
51005 - by trochar or intracatheter Urinary system 27,000.00 36,000.00 18.00
51010 - with insertion of suprapubic catheter Urinary system 262,500.00 350,000.00 175.00
51020 Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material Urinary system 1,252,500.00 1,670,000.00 835.00
51040 Cystostomy: cystotomy with drainage Urinary system 943,500.00 1,258,000.00 629.00
51050 Cystolithotomy: cystotomy with removal of calculus without vesical neck resection Urinary system 1,275,000.00 1,700,000.00 850.00
51060 Transvesical ureterolithotomy Urinary system 1,740,000.00 2,320,000.00 1,160.00
51080 Drainage of perivesical or prevesical space abscess Urinary system 1,042,500.00 1,390,000.00 695.00
51500 Excision of urachal cyst or sinus, with or without umbilical hernia repair Urinary system 1,636,500.00 2,182,000.00 1,091.00
51520 Cystotomy for simple excision of vesical neck (independent procedure) Urinary system 1,657,500.00 2,210,000.00 1,105.00
SECURE &
PACKAGES PACKAGES
PACKAGES
Cystotomy for excision of bladder diverticulum, single or multiple (independent

51525 Urinary system 2,287,500.00 3,050,000.00 1,525.00
procedure)
51530 Cystotomy for excision of bladder tumour Urinary system 2,020,500.00 2,694,000.00 1,347.00
51535 For excision or incision of ureterocele, unilateral Urinary system 1,938,000.00 2,584,000.00 1,292.00
51550 Cystectomy, partial, simple Urinary system 2,466,000.00 3,288,000.00 1,644.00
51555 - complicated (eg. post-radiation, previous surgery, difficult location) Urinary system 3,168,000.00 4,224,000.00 2,112.00
51565 - with reimplantation of urete(s) into bladder (Ureteroneocystostomy) Urinary system 3,489,000.00 4,652,000.00 2,326.00
51570 - complete (independent procedure) Urinary system 3,744,000.00 4,992,000.00 2,496.00
Cystectomy, complete, with bilateral pelvic lymphdenectomy including external iliac,

51575 Urinary system 4,933,500.00 6,578,000.00 3,289.00
hypogastric and obturator nodes
51580 - with ureterosigmoidostomy or ureterocutaneous transplantation Urinary system 4,780,500.00 6,374,000.00 3,187.00
- with ureterosigmoidostomy and bilateral pelvic lymphadenectomy including

51585 Urinary system 5,599,500.00 7,466,000.00 3,733.00
external iliac hypogastric and obturator nodes
51590 - with ureteroileal conduit or sigmoid bladder including bowel anastomosis Urinary system 5,299,500.00 7,066,000.00 3,533.00
- with ureteroileal conduit or sigmoid bladder including bowel anastomosis and

51595 bilateral pelvic lymphadenectomy including external iliac, hypogastric and obturator Urinary system 6,456,000.00 8,608,000.00 4,304.00
nodes
Continent ileostomy (Montie Bladder) includes both incisional and reconstructive

51596 Urinary system 6,787,500.00 9,050,000.00 4,525.00
phases of procedure
Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with
removal of bladder and ureteral transplantation, with or without hysterectomy,
51597 Urinary system 6,387,000.00 8,516,000.00 4,258.00
and/or abdominoperineal resection of rectum and colon and colostomy, or any
combination there
51600 Injection procedure for cystography or voiding urethrocystography Urinary system 219,000.00 292,000.00 146.00
Injection procedure and placement of chain for contrast and/or chain

51605 Urinary system 132,000.00 176,000.00 88.00
urethrocystography
51610 Injection procedure for retrograde urethrocystography Urinary system 216,000.00 288,000.00 144.00
51700 Bladder irrigation, simple, lavage and/or instillation Urinary system 139,500.00 186,000.00 93.00
Bladder instillation of anticarcinogenic agent, including detention time (excluding

51720 Urinary system 258,000.00 344,000.00 172.00
cost of material)
51740 Cystometrogram (independent procedure) Urinary system 63,000.00 84,000.00 42.00
Cystoplasty or cystourethroplasty: plastic operation on bladder and/or vesical neck

51800 (anterior Y-plasty, vesical fundus resection etc) any procedure with or without Urinary system 826,500.00 1,102,000.00 551.00
wedge resection of posterior vesical neck
Anterior vesicourethropexy, or urethropexy (eg. Marshall-Marchetti type procedure),

51840 Urinary system 1,782,000.00 2,376,000.00 1,188.00
simple
51841 - complicated (eg. secondary repair) Urinary system 2,227,500.00 2,970,000.00 1,485.00
51860 Cystorrhaphy: suture of bladder wound, injury or rupture, simple Urinary system 1,861,500.00 2,482,000.00 1,241.00
SECURE &
PACKAGES PACKAGES
PACKAGES
51865 - complicated Urinary system 2,425,500.00 3,234,000.00 1,617.00
51880 Closure of cystostomy (independent procedure) Urinary system 1,204,500.00 1,606,000.00 803.00
51900 Closure of vesico-vaginal fistula, abdominal approach Urinary system 2,265,000.00 3,020,000.00 1,510.00
51940 Closure of exstrophy Urinary system 4,299,000.00 5,732,000.00 2,866.00
51945 Hysterescopy Urinary system 75,000.00 100,000.00 50.00
51992 Sling operation for stress incontinence (eg. fascia or synthetic) Urinary system 1,926,000.00 2,568,000.00 1,284.00
52000 Cystourethroscopy (independent procedure), rooms Urinary system 385,500.00 514,000.00 257.00
52100 - hospital Urinary system 469,500.00 626,000.00 313.00
Cystourethroscopy, with urethral catherization and/or flexible ureteroscope, with or

52105 Urinary system 937,500.00 1,250,000.00 625.00
without irrigation, instillation or ureteropyelography, exclusive of radiology service
52202 Cystourentroscopy, with biopsy, hospital Urinary system 562,500.00 750,000.00 375.00
- with fulguration (including cryo-surgery) or treatment of minor (less than 0.5cm)

52222 Urinary system 184,500.00 246,000.00 123.00
lesion(s) with or without biopsy, hospital
- with fulguration (including cryo-surgery) and/or resection of small bladder

52232 Urinary system 750,000.00 1,000,000.00 500.00
tumour(s) (0.5cm to 2.0cm)
- with fulguration (including cryo-surgery) and/or resection of medium bladder

52235 Urinary system 1,119,000.00 1,492,000.00 746.00
tumour(s) 2.0cm to 5.0cm)
- with fulguration (including cryo-surgery) and/or resection of large bladder

52240 Urinary system 1,848,000.00 2,464,000.00 1,232.00
tumour(s)
- with insertion of radioactive substances, with or without biopsy or fulguration

52250 Urinary system 705,000.00 940,000.00 470.00
(excluding cost of material)
- with dilation of bladder for interstitial cystitis, general or conduction (spinal etc.)
52260 Urinary system 583,500.00 778,000.00 389.00
anaesthesia
52270 - with internal urethrotomy, female Urinary system 844,500.00 1,126,000.00 563.00
52275 - with internal urethrotomy Urinary system 1,017,000.00 1,356,000.00 678.00
52277 - with resection of external sphincter (sphincterotomy) Urinary system 1,030,500.00 1,374,000.00 687.00
- with calibration and/or dilation of urethral stricture or stenosis, with or without

52280 Urinary system 562,500.00 750,000.00 375.00
meatotomy of injection procedure for cystography, male or female
with treatment of female urethral syndrome with any or all of the following: urethral
meatotomy, uretheral dilation, internal urethrotomy, lysis of urethrovaginal septal
52285 Urinary system 676,500.00 902,000.00 451.00
fibrosis, lateral incision of the vesical neck, fulguration of polyp(i) of urethra,vesical
neck and/or trigone
52290 - with uretera meatotomy, unilateral or bilateral Urinary system 673,500.00 898,000.00 449.00
52305 - with incision or resection of orifice of bladder diverticulum, single or multiple Urinary system 838,500.00 1,118,000.00 559.00
52310 - with removal of foreign body or calculus from urethra or bladder, simple Urinary system 606,000.00 808,000.00 404.00
SECURE &
PACKAGES PACKAGES
PACKAGES
52315 - complicated Urinary system 1,002,000.00 1,336,000.00 668.00
- with removal of ureteral calculus (uretheral catherization following extration of

52320 Urinary system 873,000.00 1,164,000.00 582.00
calculus in included)
- with incision, fulguration and/or resection of bladder neck and/or posterior urethra
52340 Urinary system 1,125,000.00 1,500,000.00 750.00
(eg. congenital valves, obstructive hypertropic mucosal folds)
52500 Transurethral resection of vesical neck (independent procedure) Urinary system 1,482,000.00 1,976,000.00 988.00
Transuretheral resection of prostate, including control of post-operative bleeding

during the initial hospitalization, complete (vasectomy, meatotomy,
52601 Urinary system 2,260,500.00 3,014,000.00 1,507.00
cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy are
included)
Transurethral fulguration for post-operative bleeding after initial hospitalisation (in
52605 Urinary system 1,207,500.00 1,610,000.00 805.00
hospital)
52610 Transurethral resection of prostate, two stage (planned or medical necessity) Urinary system 984,000.00 1,312,000.00 656.00
Transurethral resection of prostate, two stage (planned or medical necessity) of re-

52630 Urinary system 1,501,500.00 2,002,000.00 1,001.00
growth of obstructive tissue, longer than one year post-operative
52640 - post-operative bladder neck contracture Urinary system 1,183,500.00 1,578,000.00 789.00
52700 Transurethral drainage of prostatic abscess Urinary system 988,500.00 1,318,000.00 659.00
Litholapaxy: crushing of calculus in bladder and removal of fragments, simple, small

52800 Urinary system 609,000.00 812,000.00 406.00
(less that 2.50cm)
52805 Litholapaxy, complicate or large (over 2.50cm) Urinary system 840,000.00 1,120,000.00 560.00
53000 Urethrotomy or urethrostomy, external (independent procedure), pendulous urethra Urinary system 376,500.00 502,000.00 251.00
53010 - perineal urethra, external (independent procedure) Urinary system 670,500.00 894,000.00 447.00
53021 Meatotomy: cutting of meatus (independent procedure), simple, hospital Urinary system 115,500.00 154,000.00 77.00
53040 Drainage of deep periurethral abscess Urinary system 834,000.00 1,112,000.00 556.00
53080 Drainage of perineal urinary extravasation, uncomplicated (independent procedure) Urinary system 1,030,500.00 1,374,000.00 687.00
53085 Litholapaxy: complicated or large (over 2.5cm) Urinary system 1,635,000.00 2,180,000.00 1,090.00
53200 Biopsy of urethra Urinary system 373,500.00 498,000.00 249.00
53210 Urethrectomy, total, including cystostomy, female Urinary system 1,852,500.00 2,470,000.00 1,235.00
53215 - male Urinary system 2,418,000.00 3,224,000.00 1,612.00
53230 Excision of urethral divertoculum Urinary system 1,647,000.00 2,196,000.00 1,098.00
53260 Excision of fulguration, urethral (polyp(i), distal urethra Urinary system 433,500.00 578,000.00 289.00
53265 - urethral caruncle Urinary system 514,500.00 686,000.00 343.00

SECURE &
PACKAGES PACKAGES
PACKAGES
53275 - urethral prolapse Urinary system 672,000.00 896,000.00 448.00
53400 Urethroplasty: first stage, for fistula, diverticulum or sticture (eg. Johannsen type) Urinary system 1,939,500.00 2,586,000.00 1,293.00
53405 - subsequent stage (formation of urethra) including urinary diversion Urinary system 2,353,500.00 3,138,000.00 1,569.00
53410 Urethroplasty: one stage reconstruction of male anterior urethra Urinary system 2,416,500.00 3,222,000.00 1,611.00
Urethroplasty: one stage reconstruction or repair of prostatic membranous urethra

53418 Urinary system 2,415,000.00 3,220,000.00 1,610.00
(Waterhouse Transpubic urethroplasty)
Urethroplasty: two stage reconstruction or repair of prostatic membenous urethra,

53420 Urinary system 2,320,500.00 3,094,000.00 1,547.00
first stage
53425 - subsequent stage Urinary system 2,413,500.00 3,218,000.00 1,609.00
53430 Urethroplasty: reconstruction of female urethra Urinary system 2,293,500.00 3,058,000.00 1,529.00
Operation for correction of male urinary incontinence, with or without introduction of

53440 Urinary system 2,383,500.00 3,178,000.00 1,589.00
prosthesis
53450 Urethromeatoplasty, with mucosal advancement Urinary system 883,500.00 1,178,000.00 589.00
53505 Urethrorrhaphy, suture of urethral wound or injury, penile Urinary system 1,228,500.00 1,638,000.00 819.00
53510 - perineal Urinary system 1,635,000.00 2,180,000.00 1,090.00
53515 - prostatomembranous Urinary system 2,125,500.00 2,834,000.00 1,417.00
53600 Dilation of urethral stricture by passage of sound, male Urinary system 171,000.00 228,000.00 114.00
Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator,

53605 Urinary system 171,000.00 228,000.00 114.00
male, general or conduction (spinal) anaesthesia, hospital
53620 Dilation of urethral stricture by passage of filiform and follower, male, initial Urinary system 238,500.00 318,000.00 159.00
53660 Dilation of female urethra, including suppository and/or instillation, initial Urinary system 123,000.00 164,000.00 82.00
53665 Dilation of female urethra, general or conduction (spinal) anaesthesia, hospital Urinary system 108,000.00 144,000.00 72.00
53670 Catheterization, simple (independent procedure) Urinary system 99,000.00 132,000.00 66.00
53675 - complications(may include difficult removal of balloon catheter) Urinary system 79,500.00 106,000.00 53.00
MALE GENITAL SYSTEM
54000 Dorsal or lateral "slit" of prepuce, newborn independent procedure Male genital system 262,500.00 350,000.00 175.00
54001 - except newborn Male genital system 351,000.00 468,000.00 234.00
54002 Reduction of paraphimosis, under general anaesthesia Male genital system 262,500.00 350,000.00 175.00
SECURE &
PACKAGES PACKAGES
PACKAGES
54015 Incision and drainage of penis, abscess, deep Male genital system 643,500.00 858,000.00 429.00
54050 Condylomata, multiple, simple, chemical Male genital system 192,000.00 256,000.00 128.00
54055 - electra-desiccation Male genital system 205,500.00 274,000.00 137.00
54060 - surgical excision Male genital system 349,500.00 466,000.00 233.00
54065 - extensive Male genital system 478,500.00 638,000.00 319.00
54100 Biopsy of penis, cutaneous (independent procedure) Male genital system 309,000.00 412,000.00 206.00
54105 - deep structure Male genital system 516,000.00 688,000.00 344.00
54110 Excision, penile plague (peyronie's disease) Male genital system 1,566,000.00 2,088,000.00 1,044.00
54115 Removal of foreign body from deep penile tissue (eg. Plastic impact) Male genital system 1,018,500.00 1,358,000.00 679.00
54120 Amputation of penis, partial Male genital system 1,564,500.00 2,086,000.00 1,043.00
54125 - complete Male genital system 2,329,500.00 3,106,000.00 1,553.00
54130 - radical, with bilateral inguinofemoral pymphadenectomy Male genital system 3,255,000.00 4,340,000.00 2,170.00
- in continuity with bilateral pelvic lymphadenectomy, including external iliac,

54135 Male genital system 4,147,500.00 5,530,000.00 2,765.00
hypogastric and obturator nodes
54150 Circumcision, clamp procedure, newborn Male genital system 294,000.00 392,000.00 196.00
54160 Circumcision, infant under 6 months Male genital system 462,000.00 616,000.00 308.00
54161 - infant over 6 months Male genital system 526,500.00 702,000.00 351.00
54162 - adult - 12 years and over Male genital system 589,500.00 786,000.00 393.00
54165 - with frenuloplasty, add Male genital system 375,000.00 500,000.00 250.00
54200 Injection procedure for Peyronie's disease Male genital system 171,000.00 228,000.00 114.00
54205 - with surgical exposure of plaque Male genital system 1,255,500.00 1,674,000.00 837.00
54220 Irrigation of corpora cavernosa for priapism Male genital system BR BR BR
Plastic operation on penis for straightening of chordee (eg. hypospadias) with or

54300 Male genital system 559,500.00 746,000.00 373.00
without mobilization of urethra
54305 - with transplantation prepuce Male genital system 840,000.00 1,120,000.00 560.00
Urethroplasty, formation of urethra (Dennis Brown type procedure), including

54320 Male genital system 1,050,000.00 1,400,000.00 700.00
urinary diversion, penile or penoscrotal
SECURE &
PACKAGES PACKAGES
PACKAGES
54325 - scrotal or perineal Male genital system 1,182,000.00 1,576,000.00 788.00
Urethroplasty and straightening of chordee (including urinary diversion), complete,

one stage, for hypospadias
54380 Plastic operation on penis for epispadias, distal to external sphincter Male genital system 2,146,500.00 2,862,000.00 1,431.00
54385 - with incontinence Male genital system BR BR BR
54390 - with exstrophy of bladder Male genital system BR BR BR
54400 Plastic operation for insertion of penil prosthesis Male genital system 1,809,000.00 2,412,000.00 1,206.00
Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or

bilateral
Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or

bilateral
54440 Plastic operation of penis for injury Male genital system 2,026,500.00 2,702,000.00 1,351.00
54500 Biopsy, needle (independent procedure) Male genital system 178,500.00 238,000.00 119.00
54505 - incisional, unilateral (independent procedure) Male genital system 531,000.00 708,000.00 354.00
54506 - bilateral (independent procedure) Male genital system 241,500.00 322,000.00 161.00
54510 Excision of local lesion of testis Male genital system 367,500.00 490,000.00 245.00
Orchidectomy, simple (including subcapsular) with or without testicular prosthesis,

54520 Male genital system 963,000.00 1,284,000.00 642.00
scrotal or inguinal approach, unilateral
54530 Orchidectomy, radical, for tumour, inguinal approach, unilateral Male genital system 1,494,000.00 1,992,000.00 996.00
54535 - with abdominal exploration Male genital system 1,956,000.00 2,608,000.00 1,304.00
54550 Exploration for undescended testis (inguinal or scrotal area), unilateral Male genital system 1,249,500.00 1,666,000.00 833.00
54560 - with abdominal exploration, unilateral Male genital system 1,753,500.00 2,338,000.00 1,169.00
Reduction of torsion of testis by surgical means, with or without fixation of

contralateral testis
54620 Fixation of contralateral testis (independent procedure) Male genital system 789,000.00 1,052,000.00 526.00
54640 Orchidopexy, any type with or without hernia repair, unilateral Male genital system 1,369,500.00 1,826,000.00 913.00
54645 - secondary stage (Torek type procedure) Male genital system 126,000.00 168,000.00 84.00
54660 Insertion of testicular prosthesis, unilateral (independent procedure) Male genital system 835,500.00 1,114,000.00 557.00
54670 Suture or repair of testicular injury Male genital system 1,030,500.00 1,374,000.00 687.00
SECURE &
PACKAGES PACKAGES
PACKAGES
54680 Transplantation of testis(es) to thigh (because of scrotal destruction) Male genital system 1,971,000.00 2,628,000.00 1,314.00
Incision and drainage of epididymis, testis and/or scrotal space (eg. abscess or
haematoma)
54800 Biopsy of epididymis, needle Male genital system 403,500.00 538,000.00 269.00
54820 Exploration of epididymis, with or without biopsy Male genital system 367,500.00 490,000.00 245.00
54830 Excision of local lesion of epididymis Male genital system 871,500.00 1,162,000.00 581.00
54840 Excision of spermatocele, with or without epididymectomy Male genital system 940,500.00 1,254,000.00 627.00
54860 Epididymectomy, unilateral Male genital system 1,095,000.00 1,460,000.00 730.00
54861 - bilateral Male genital system 1,537,500.00 2,050,000.00 1,025.00
54900 Epididymovasostomy, anastomosis of epididymis to vas deferens, unilateral Male genital system 721,500.00 962,000.00 481.00
54901 - bilateral Male genital system 840,000.00 1,120,000.00 560.00
55000 Puncture aspiration of hydrocele, with or without injection of medication Male genital system 217,500.00 290,000.00 145.00
55040 Excision of hydrocele, unilateral Male genital system 964,500.00 1,286,000.00 643.00
55060 Repair of hydrocele, (Bottle type procedure) Male genital system 936,000.00 1,248,000.00 624.00
55100 Drainage of scrotal wall abscess (see also 54700) Male genital system 340,500.00 454,000.00 227.00
55120 Removal of foreign body in scrotum Male genital system 709,500.00 946,000.00 473.00
55150 Resection of scrotum Male genital system 1,203,000.00 1,604,000.00 802.00
55170 Scrotoplasty: plastic operation on scrotum Male genital system BR BR BR
Vasotomy: cannulization, with or without incision of vas, unilateral or bilateral

55200 Male genital system 807,000.00 1,076,000.00 538.00
Vasectomy, unilateral or bilateral (independent procedure) including post-operative

semen examination(s)
Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or

bilateral
55400 Vasovasostomy, vasovasorrhaphy, unilateral Male genital system 1,423,500.00 1,898,000.00 949.00
Ligation (percutaneous) of vas deferens, unilateral or bilateral (independent

procedure)
55500 Excision of hydrocele of spermatic cord unilateral (independent procedure) Male genital system 955,500.00 1,274,000.00 637.00
55520 Excision of lesion of spermatic cord (independent procedure) Male genital system 912,000.00 1,216,000.00 608.00
SECURE &
PACKAGES PACKAGES
PACKAGES
Excision of varicocele or ligation of spermatic veins for varicocele (independent

procedure)
55535 - abdominal approach Male genital system 1,062,000.00 1,416,000.00 708.00
55540 - with hernia repair Male genital system 1,194,000.00 1,592,000.00 796.00
55600 Vesiculotomy, unilateral or bilateral, simple Male genital system 1,044,000.00 1,392,000.00 696.00
55605 - complicated Male genital system 1,299,000.00 1,732,000.00 866.00
55650 Vesiculectomy, any approach, unilateral or bilateral Male genital system 1,831,500.00 2,442,000.00 1,221.00
55680 Excision of Muellerian duct cyst Male genital system 1,014,000.00 1,352,000.00 676.00
55700 Biopsy, prostate, needle or punch, single or multiple, any approach Male genital system 382,500.00 510,000.00 255.00
55705 - incisional, any approach Male genital system 753,000.00 1,004,000.00 502.00
55720 Prostatotomy: external drainage of prostate abscess, any approach, simple Male genital system 1,122,000.00 1,496,000.00 748.00
55725 - complicated Male genital system 1,356,000.00 1,808,000.00 904.00
55740 Prostatolithotomy: removal of prostatic calculus (independent procedure) Male genital system 1,207,500.00 1,610,000.00 805.00
Prostatectomy, perineal, subtotal with cystourethroscopy, including control of post-

55801 operative bleeding during the initial hospitalization, complete (vasectomy, Male genital system 2,850,000.00 3,800,000.00 1,900.00
meatotomy, urethral calibration and/or dilation, internal urethrotomy are included)
55810 - total, with cystourethroscopy Male genital system 3,747,000.00 4,996,000.00 2,498.00
- suprapubic, subtotal with cystourethroscopy, one or two stages, including control

55821 of post-operative bleeding during the initial hospitalization, complete (vasectomy, Male genital system 2,533,500.00 3,378,000.00 1,689.00
meatotomy, urethral calibration and/or dilation, internal urethrotomy are included)
- retropubic, subtotal with cystourethroscopy including control of post-operative
55831 bleeding during initial hospitalization, complete (vasectomy, meatotomy, urethral Male genital system 2,749,500.00 3,666,000.00 1,833.00
calibration and or dilation, internal urethrotomy are included)
55840 - radical Male genital system 3,663,000.00 4,884,000.00 2,442.00
- with bilateral pelvic lyphadenectomy, including external iliac, hypogastric and

obturator nodes
55970 Male to female Male genital system BR BR BR
55980 Female to male Male genital system BR BR BR
FEMALE GENITAL SYSTEM
56420 Incision and drainage of Bartholin's abscess,unilateral Female genital system 193,500.00 258,000.00 129.00
56440 Marsupialization of Bartholon's cyst or abscess Female genital system 420,000.00 560,000.00 280.00
56441 Plastic enlargement of introitus Female genital system 292,500.00 390,000.00 195.00
SECURE &
PACKAGES PACKAGES
PACKAGES
56500 Condylomata, multiple, simple, chemical Female genital system 21,000.00 28,000.00 14.00
56505 Condylomata, electro-desiccation Female genital system 33,000.00 44,000.00 22.00
56510 Surgical excision Female genital system 46,500.00 62,000.00 31.00
56602 Biopsy of vulva (independent procedure). Female genital system 30,000.00 40,000.00 20.00
56620 Vulvectomy, partial, unilateral or bilateral (but less than 80% of vulval area Female genital system 1,057,500.00 1,410,000.00 705.00
56625 Vulvectomy, simple, complete (skin and subcutaneous tissue), bilateral Female genital system 1,327,500.00 1,770,000.00 885.00
56641 - radical with lymphadenectomy Female genital system 1,230,000.00 1,640,000.00 820.00
56700 Hymenectomy: partial or complete excision of hymen Female genital system 348,000.00 464,000.00 232.00
56740 Excision of Bartholin's tumour or cyst Female genital system 535,500.00 714,000.00 357.00
56750 Excision of benign tumour of vulva Female genital system 109,500.00 146,000.00 73.00
57000 Colpotomy, diagnostic Female genital system 391,500.00 522,000.00 261.00
57010 - with drainage of pelvic abscess Female genital system 691,500.00 922,000.00 461.00
57100 Biopsy of vaginal mucosa (independent procedure) Female genital system 139,500.00 186,000.00 93.00
57105 - extensive, requiring suture (including cysts) Female genital system 262,500.00 350,000.00 175.00
57120 Colpocleisis (Le Fort type procedure) Female genital system 1,086,000.00 1,448,000.00 724.00
57130 Excision of vaginal septum Female genital system 396,000.00 528,000.00 264.00
57210 Colpo-perineorrhaphy: suture of injury of vagina and/or perineum (non-obstetrical) Female genital system 562,500.00 750,000.00 375.00
Anterior colporrhaphy: repair of cystocele with or without repair of urothrocele

57240 Female genital system 831,000.00 1,108,000.00 554.00
57245 - with abdominal colpo-urethra-cystopexy (Marshal-Marchetti-Krantz type) Female genital system 772,500.00 1,030,000.00 515.00
57250 Posterior colporrhaphy: with perineoplasty or perineorrhaphy Female genital system 1,047,000.00 1,396,000.00 698.00
57256 - with repair of enterocele Female genital system 513,000.00 684,000.00 342.00
57260 Combined anterior-posterior colporrhaphy Female genital system 1,362,000.00 1,816,000.00 908.00
57262 - with abdominal colpo-cysto-urethropexy (Marshall-Marchetti-Krantz type) Female genital system 840,000.00 1,120,000.00 560.00
57265 - with enterocele repair Female genital system 1,444,500.00 1,926,000.00 963.00
SECURE &
PACKAGES PACKAGES
PACKAGES
57267 - with Manchester type repair Female genital system 555,000.00 740,000.00 370.00
57280 Colpopexy, abdominal approach. Female genital system 1,485,000.00 1,980,000.00 990.00
57288 Sling operation for stress incontinence (eg fascia or synthetic) Female genital system 1,779,000.00 2,372,000.00 1,186.00
Construction of artificial vagina (vaginal atresia or absence) (for skin graft, see
15000 et seq)
57300 Closure of recto-vaginal fistula, vaginal approach Female genital system 1,153,500.00 1,538,000.00 769.00
57320 Closure of vesica-vaginal fistula, vaginal approach Female genital system 1,270,500.00 1,694,000.00 847.00
57410 Pelvic examination under anaesthesia (independent procedure) Female genital system 106,500.00 142,000.00 71.00
57452 Colposcopy Female genital system 153,000.00 204,000.00 102.00
57500 Biopsy or local excision of lesion Female genital system 160,500.00 214,000.00 107.00
57510 Cauterization of cervix,electro or thermal Female genital system 207,000.00 276,000.00 138.00
Conization,partial, circumferential (cone) with or without dilatation and curettage,

57521 Female genital system 252,000.00 336,000.00 168.00
with or without Sturmdorff type repair
57525 - only Female genital system 100,500.00 134,000.00 67.00
57530 Trachelectomy: cervicectomy: amputation of cervix (independent procedure) Female genital system 655,500.00 874,000.00 437.00
57540 Excision of cervical stump, abdominal approach Female genital system 1,146,000.00 1,528,000.00 764.00
57550 Vaginal approach Female genital system 891,000.00 1,188,000.00 594.00
57560 Cervical mucus oestrogen assay Female genital system 24,000.00 32,000.00 16.00
57600 Insertion of any radioactive material, per application Female genital system 187,500.00 250,000.00 125.00
57700 Tracheloplasty (Shirodkar or Lash type procedure) Female genital system 484,500.00 646,000.00 323.00
57701 Removal of Shirodkar suture Female genital system 30,000.00 40,000.00 20.00
57720 Trachelorrhaphy: plastic repair of uterine cervix, vaginal approach Female genital system 577,500.00 770,000.00 385.00
58101 Endometrial washing (eg for cytology sampling) Female genital system 13,500.00 18,000.00 9.00
Dilatation and curettage, diagnostic and/or therapeutic (non-obstetrical) with or

without biopsy or removal of polypi (see also 57521)
58130 Dilatation and curettage, plus diathermy Female genital system 247,500.00 330,000.00 165.00
Myomectomy: single or multiple, excision of fibroid tumour of uterus, abdominal

58140 Female genital system 1,401,000.00 1,868,000.00 934.00
approach (independent procedure)
SECURE &
PACKAGES PACKAGES
PACKAGES
58145 Vaginal myomectomy, simple Female genital system 1,210,500.00 1,614,000.00 807.00
58146 - complicated Female genital system 2,164,500.00 2,886,000.00 1,443.00
Total hysterectomy (corpus and cervix) with or without tubes, and/or ovaries, one or
58150 Female genital system 1,846,500.00 2,462,000.00 1,231.00
both, with or without dilatation and curettage
- with colpo-urethra-cystopexy (Marshall Marchetti Krantz type), with or without

diagnostic dilatation and currettage
Total hysterectomy, cervical malignancy, with bilateral pelvic lymphadenectomy,
including external iliac, hypogastric and obturator nodes (Wertheim type operation),
58210 Female genital system 3,376,500.00 4,502,000.00 2,251.00
with or without diagnostic dilatation and curettage. ( For lymphadenectomy
[independent procedure
58260 Vaginal hysterectomy, with or without diagnostic dilataion and curettage Female genital system 1,665,000.00 2,220,000.00 1,110.00
- with plastic repair of vagina anterior and/or posterior colporrhaphy, with or without
diagnostic dilatation and curettage
58270 - with repair of enterocele, with or without diagnostic dilatation and curettage Female genital system 1,824,000.00 2,432,000.00 1,216.00
58300 Insertion of intra-uterine device (IUD) Female genital system 148,500.00 198,000.00 99.00
58301 Removal of intra-uterine device (IUD) Female genital system 118,500.00 158,000.00 79.00
58320 Insufflation of uterus and tubes with air or CO2 Female genital system 138,000.00 184,000.00 92.00
58340 Injection procedure for hysterosalpingography Female genital system 156,000.00 208,000.00 104.00
58350 Hydrotubation of oviduct Female genital system 126,000.00 168,000.00 84.00
58352 Initial IVF Consultation Female genital system 150,000.00 200,000.00 100.00
58353 Subsequent IVF Consultations up to a maximum of 8 visits Female genital system 75,000.00 100,000.00 50.00
58354 Gynaecology IVF process including scans and drugs administration. Female genital system 1,500,000.00 2,000,000.00 1,000.00
58355 Embryologist/ Laboratory IVF processes. Female genital system 2,100,000.00 2,800,000.00 1,400.00
58356 IVF Drugs Female genital system 2,130,000.00 2,840,000.00 1,420.00
Uterine suspension, with or without shortening of round ligaments, with or without

shortening of sacrouterine ligaments (independent procedure), any method
58410 Presacral sympathectomy Female genital system 1,116,000.00 1,488,000.00 744.00
58500 Hystero-salpingostomy: anastomosis of tube(s) to uterus Female genital system 765,000.00 1,020,000.00 510.00
58520 Hysterorrhaphy: repair of ruptured uterus (non-obstetrical) Female genital system 1,009,500.00 1,346,000.00 673.00
58540 Hysteroplasty: repair of uterine anomaly Female genital system 1,387,500.00 1,850,000.00 925.00
Transection of Fallopian tube, unilateral, or bilateral, any method, or fulguration of

58600 oviduct (with or without transection) or any other methed of interruption of Fallopian Female genital system 825,000.00 1,100,000.00 550.00
tubes
SECURE &
PACKAGES PACKAGES
PACKAGES
58700 Salpingectomy, complete, unilateral or bilateral (independent procedure) Female genital system 1,104,000.00 1,472,000.00 736.00
Salping-oophorectomy, complete or partial, bilateral or unilateral (independent

procedure)
58741 Salpingoplasty, tube or tubes Female genital system 672,000.00 896,000.00 448.00
Anastomosis of tube or tubes (not applicable to the reversal of previous surgical

sterilisation procedures)
Ectopic pregnancy, tubal, requiring salpingectomy, with or without ophorectomy,

abdominal or vaginal approach
58830 Hormone implant Female genital system 42,000.00 56,000.00 28.00
58840 Norplant, insertion Female genital system 90,000.00 120,000.00 60.00
58841 - removal Female genital system 90,000.00 120,000.00 60.00
58900 Partial resection of ovary, unilateral or bilateral (independent procedure) Female genital system 849,000.00 1,132,000.00 566.00
58940 Oophorectomy, unilateral or bilateral, partial or total (independent procedure) Female genital system 1,033,500.00 1,378,000.00 689.00
58945 - with total omenectomy (for ovarian malignancy) Female genital system 645,000.00 860,000.00 430.00
58946 Excision of endometriotic nodules in the pelvis other than ovaries Female genital system 613,500.00 818,000.00 409.00
58980 Laparoscopy for visualisation of pelvic viscera Female genital system 319,500.00 426,000.00 213.00
58984 - with fulguration of ovarian or peritoneal lesions or lysis of adhesions Female genital system 387,000.00 516,000.00 258.00
58986 - with biopsy (single or multiple) Female genital system 387,000.00 516,000.00 258.00
- with transection of Fallopian tube, unilateral or bilateral, or fulguration of oviducts

(with or without transection) or ay other method of interruption of Fallopian tubes
58990 Laparoscopy with dilatation and curettage and insufflation of dye Female genital system 439,500.00 586,000.00 293.00
58993 - with fulguration of ovarian or peritoneal lesions or lysis of adhesions Female genital system 528,000.00 704,000.00 352.00
58994 - with biopsy (single or multiple) Female genital system 528,000.00 704,000.00 352.00
MATERNITY CARE AND DELIVERY SYSTEM
Amniocentesis for diagnostic purposes, abdominal approach, where certified there

59000 Maternity care and delivery 204,000.00 272,000.00 136.00
is a recognised risk
Initial and/or supervision of internal foetal monitoring during labour for established
pathology where certified there is a high risk....
Surgical induction of labour for established pathology where certified there is a high
risk
59231 Epidural, continuous anaesthesia Maternity care and delivery 150,000.00 200,000.00 100.00
SECURE &
PACKAGES PACKAGES
PACKAGES
59232 Ante-natal external foetal heart trace (high risk cases only). By report Maternity care and delivery 30,000.00 40,000.00 20.00
When the obstetrical care necessitates multiple procedures undertaken under one
59401 anaesthetic or on the same occasion, item 01030 and/or item 01031 apply to all Maternity care and delivery 27,000.00 36,000.00 18.00
listed procedures except 59050, 59230 and 59231, 59497 and 59498.
59435 Emergency fee for normal delivery (see general rules 01040 and 01061) Maternity care and delivery 70,500.00 94,000.00 47.00
59438 On call for vaginal delivery Maternity care and delivery 99,000.00 132,000.00 66.00
Vaginal delivery (certification of the practitioner's presence at the delivery or arrival

59439 within thirty minutes of the delivery is required through endorsement of the claim to Maternity care and delivery 450,000.00 600,000.00 300.00
this effect)
Vaginal delivery, with low forceps, vacuum delivery or midcavity forceps without
mal-rotation of the occiput
59441 Midcavity forceps or vacuum with mal-rotation of the occiput Maternity care and delivery 478,500.00 638,000.00 319.00
59443 Breech delivery Maternity care and delivery 478,500.00 638,000.00 319.00
Twin delivery: full appropriate fee for the major delivery and 50% (add modifier 18)
59444 Maternity care and delivery Add 50% Add 50% Add 50%
of the second appropriate delivery fee.
Triplet delivery: full appropriate fee for the two major deliveries and 50% (add
59445 Maternity care and delivery Add 50% Add 50% Add 50%
modifier 41) of the third appropriate delivery fee.
59446 Multiple delivery, quadruplets or more Maternity care and delivery BR BR BR
59455 Resuscitation of the new born, requiring intubation Maternity care and delivery 73,500.00 98,000.00 49.00
59475 Initial ante-natal consultation by specialist obstetrician at rooms. Maternity care and delivery 75,000.00 100,000.00 50.00
59476 Initial ante-natal consultation by specialist obstetrician at hospital Maternity care and delivery 45,000.00 60,000.00 30.00
Subsequent ante-natal consultation by specialist obstetrician at rooms or hospital,

per consultation to a maximum of nine consultations
59478 Initial ante-natal consultation by general practitioner Maternity care and delivery 30,000.00 40,000.00 20.00
Subsequent ante-natal consultation by general practitioner, per consultation, to a

maximum of nine consultations
Where the full obstetrical care is undertaken by a specialist obstetrician resulting in
a normal delivery without complications, post-natal care may not be charged by the
referring practitioner. Where the infant is referred to a general practitioner for a post-
natal consultation the maximum charge shall be
Post-natal assessment of infant (independent procedure) where total obstetrical
59484 care is undertaken, and the infant is not referred to another practitioner for post- Maternity care and delivery 19,500.00 26,000.00 13.00
natal consultation. Maximum charge
Post-natal consultation by specialist obstetrician at hospital or rooms, per

consultations to a maximum of five consultations
Post-natal consultation by general practitioner, per consultation, to a maximum to

five consultations
59492 Suture of cervical laceration Maternity care and delivery 45,000.00 60,000.00 30.00
59493 Second degree laceration (in consultation) Maternity care and delivery 30,000.00 40,000.00 20.00
59494 Third degree laceration Maternity care and delivery 112,500.00 150,000.00 75.00
SECURE &
PACKAGES PACKAGES
PACKAGES
59495 External version, without anaesthetic Maternity care and delivery 67,500.00 90,000.00 45.00
59496 External version, with anaesthetic Maternity care and delivery 150,000.00 200,000.00 100.00
Manual removal of placenta where a general anaesthetic is required and is

administered by another medical practitioner
59498 - by any other method Maternity care and delivery BR BR BR
59499 Dilatation and curettage for removal of retained products of conception Maternity care and delivery 319,500.00 426,000.00 213.00
59500 Low cervical (independent procedure), single or multiple births Maternity care and delivery 900,000.00 1,200,000.00 600.00
59502 Attendance at caesarean section by paediatrician and post follow-up of infant Maternity care and delivery 45,000.00 60,000.00 30.00
Post-caesarean care of infant by general practitioner (independent procedure) per

consultation, to a maximum of five consultation
Caesarean section and tubal oclusion by any method (including salpingectomy,

partial or complete)
Caesarean section with hysterectomy, sub-total (independent procedure), single or

59560 Maternity care and delivery 924,000.00 1,232,000.00 616.00
multiple births
59562 Ruptured uterus in pregnancy Maternity care and delivery 1,119,000.00 1,492,000.00 746.00
59861 Abortion, completed by dilatation and curettage Maternity care and delivery 319,500.00 426,000.00 213.00
59862 -induced by dilatation and curettage (including suction curettage) Maternity care and delivery 310,500.00 414,000.00 207.00
59865 - induced, by hysterotomy Maternity care and delivery 697,500.00 930,000.00 465.00
ENDOCRINE SYSTEM
60100 biopsy thyroid (Needle) Endocrine system 160,500.00 214,000.00 107.00
60101 Biopsy Endocrine system 151,500.00 202,000.00 101.00
60200 excision of cyst or adenoma of thyroid or transection of isthmus Endocrine system 1,203,000.00 1,604,000.00 802.00
60240 thyroidectomy total or complete Endocrine system 2,047,500.00 2,730,000.00 1,365.00
60245 - subtotal or partial Endocrine system 540,000.00 720,000.00 360.00
60280 exision of thyroglossal duct cyst or sinus Endocrine system 973,500.00 1,298,000.00 649.00
60500 exploration of parathyroid(s) Endocrine system 2,098,500.00 2,798,000.00 1,399.00
Adrenalectomy, partial or complete, or exploration of adrenal gland with or without

60540 Endocrine system 2,182,500.00 2,910,000.00 1,455.00
biopsy, transabdominal, lumbar or dorsal (independent procedure), unilateral
60600 excision of carotid body tumour witout excision of carotid artery Endocrine system 2,328,000.00 3,104,000.00 1,552.00
SECURE &
PACKAGES PACKAGES
PACKAGES
60700 Concussion, simple Endocrine system FFS FFS FFS
60701 with brain damage, per consultation, up to a maximus of eight per week Endocrine system FFS FFS FFS
NERVOUS SYSTEM
61000 Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial Nervous system 211,500.00 282,000.00 141.00
61001 subsequent taps Nervous system 193,500.00 258,000.00 129.00
Ventricular puncture through previous burr hole, fontanelle, suture, or implanted

61020 Nervous system 229,500.00 306,000.00 153.00
ventricular catheter/reservoir; without injection
61050 Cisternal or lateral cervical (Cl-C2) puncture; without injection (separate procedure) Nervous system 196,500.00 262,000.00 131.00
61070 Puncture of shunt tubing or reservoir for aspiration or injection procedure Nervous system 111,000.00 148,000.00 74.00
Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye
61120 Nervous system 1,254,000.00 1,672,000.00 836.00
or radioactive material);
61140 Burr hole(s) or trephine; with biopsy of brain or intracranial lesion Nervous system 2,332,500.00 3,110,000.00 1,555.00
61150 with drainage of brain abscess or cyst Nervous system 2,496,000.00 3,328,000.00 1,664.00
61151 with subsequent tapping (aspiration) of intracranial abscess or cyst Nervous system 1,255,500.00 1,674,000.00 837.00
61154 Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural Nervous system 2,472,000.00 3,296,000.00 1,648.00
61156 Burr hole(s); with aspiration of hematoma or cyst, intracerebral Nervous system 2,487,000.00 3,316,000.00 1,658.00
61210 for implanting ventricular catheter, reservoir, EEG electrode(s), pressure Nervous system 874,500.00 1,166,000.00 583.00
61250 Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery Nervous system 1,545,000.00 2,060,000.00 1,030.00
61304 Craniectomy or craniotomy, exploratory; supratentorial Nervous system 3,606,000.00 4,808,000.00 2,404.00
61305 infratentorial (posterior fossa) Nervous system 4,183,500.00 5,578,000.00 2,789.00
61320 Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial Nervous system 3,465,000.00 4,620,000.00 2,310.00
61321 infratentorial Nervous system 3,792,000.00 5,056,000.00 2,528.00
61330 Decompression of orbit only, transcranial approach Nervous system 2,425,500.00 3,234,000.00 1,617.00
61340 Subtemporal cranial decompression (pseudotumor cerebri, slit ventrical syndrome) Nervous system 2,251,500.00 3,002,000.00 1,501.00
61345 Other cranial decompression, posterior fossa Nervous system 3,631,500.00 4,842,000.00 2,421.00
Craniectomy, subtemporal, for section, compression, or decompression of sensory

61450 Nervous system 3,573,000.00 4,764,000.00 2,382.00
root of gasserian ganglion
SECURE &
PACKAGES PACKAGES
PACKAGES
61460 for section of one or more cranial nerves Nervous system 4,074,000.00 5,432,000.00 2,716.00
61470 for medullary tractotomy Nervous system 2,952,000.00 3,936,000.00 1,968.00
61490 Craniotomy for lobotomy, including cingulotomy Nervous system 2,520,000.00 3,360,000.00 1,680.00
61500 Craniectomy and excision of skull tumour or bone lesion Nervous system 2,872,500.00 3,830,000.00 1,915.00
Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor,

61510 Nervous system 4,063,500.00 5,418,000.00 2,709.00
supratentorial, except meningioma
61512 for excision of meningioma, supratentorial Nervous system 4,414,500.00 5,886,000.00 2,943.00
61514 for excision of brain abscess, supratentorial Nervous system 3,861,000.00 5,148,000.00 2,574.00
61516 for excision or fenestration of cyst, supratentorial Nervous system 3,853,500.00 5,138,000.00 2,569.00
Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except

61518 Nervous system 5,055,000.00 6,740,000.00 3,370.00
meningloma, cerebellopontine angle tumor, or midline tumor at base of skull
61519 meningioma Nervous system 5,320,500.00 7,094,000.00 3,547.00
61522 Craniectomy, infratentorial or posterior fossa; for excision of brain abscess Nervous system 3,885,000.00 5,180,000.00 2,590.00
61524 for excision or fenestration of cyst Nervous system 4,216,500.00 5,622,000.00 2,811.00
Craniectomy ,bone flap craniotomy,trans temporal mastoid for cerebellopontine

61526 Nervous system 5,392,500.00 7,190,000.00 3,595.00
angle tumour
61534 for excision of epileptogenic focus without electrocorticography during surgery Nervous system 2,298,000.00 3,064,000.00 1,532.00
for excision of cerebral epileptogenic focus, with electrocorticography during

61536 Nervous system 4,306,500.00 5,742,000.00 2,871.00
surgery (includes removal of electrode array)
61538 for lobectomy, temporal lobe, with electrocorticography during surgery Nervous system 4,600,500.00 6,134,000.00 3,067.00
for lobectomy, other than temporal lobe, partial or total with electrocorticography
61539 Nervous system 4,297,500.00 5,730,000.00 2,865.00
during surgery
61542 for total hemispherectomy Nervous system 3,931,500.00 5,242,000.00 2,621.00
Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial

61546 Nervous system 4,477,500.00 5,970,000.00 2,985.00
approach
Hypophysegtomy or excision of pituitary tumour transnasal or transeptal non

61548 Nervous system 3,436,500.00 4,582,000.00 2,291.00
stereotaxic
61550 Craniectomy for craniosynostosis;single cranial suture Nervous system 1,969,500.00 2,626,000.00 1,313.00
61552 multiple cranial sutures Nervous system 2,581,500.00 3,442,000.00 1,721.00
61570 Craniectomy or craniotomy; with excision of foreign body from brain Nervous system 3,228,000.00 4,304,000.00 2,152.00
61700 Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation Nervous system 5,644,500.00 7,526,000.00 3,763.00
SECURE &
PACKAGES PACKAGES
PACKAGES
61702 vertebrobasilar circulation Nervous system 6,330,000.00 8,440,000.00 4,220.00
Surgery of intracranial aneurysm, cervical approach by application of occluding

61703 Nervous system 2,328,000.00 3,104,000.00 1,552.00
clamp to cervical carotid artery (Selverstone-Crutchfield type)
Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by

61705 Nervous system 5,130,000.00 6,840,000.00 3,420.00
intracranial and cervical occlusion of carotid artery
61710 by intra-arterial embolization, injection procedure, or balloon catheter Nervous system 3,573,000.00 4,764,000.00 2,382.00
61711 Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries Nervous system 5,334,000.00 7,112,000.00 3,556.00
Creation of lesion by stereotactic method, including burr hole(s) and localizing and
61720 Nervous system 2,752,500.00 3,670,000.00 1,835.00
recording techniques, single or multiple stages; globus pallidus or thalamus
61735 subcortical structure(s) other than globus pallidus or thalamus Nervous system 2,442,000.00 3,256,000.00 1,628.00
Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg,

61790 Nervous system 1,869,000.00 2,492,000.00 1,246.00
alcohol, thermal, electrical, radiofrequency); gasserian ganglion
62000 Elevation of depressed skull fracture; simple, extradural Nervous system 1,411,500.00 1,882,000.00 941.00
62005 compound or comminuted, extradural Nervous system 2,125,500.00 2,834,000.00 1,417.00
62010 with repair of dura and/or debridement of brain Nervous system 2,983,500.00 3,978,000.00 1,989.00
Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for

62100 Nervous system 3,316,500.00 4,422,000.00 2,211.00
rhinorrhea/otorrhea
62120 Repair of encephalocele, skull vault, including cranioplasty Nervous system 3,183,000.00 4,244,000.00 2,122.00
62140 Cranioplasty for skull defect; up to 5 cm diameter Nervous system 2,065,500.00 2,754,000.00 1,377.00
62141 larger than 5 cm diameter Nervous system 2,458,500.00 3,278,000.00 1,639.00
62145 Cranioplasty for skull defect with reparative brain surgery Nervous system 2,505,000.00 3,340,000.00 1,670.00
62180 Ventriculocisternostomy (Torkildsen type operation) Nervous system 2,352,000.00 3,136,000.00 1,568.00
62190 Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular Nervous system 1,851,000.00 2,468,000.00 1,234.00
62192 subarachnoid/subdural-peritoneal, -pleural, -other terminus Nervous system 2,014,500.00 2,686,000.00 1,343.00
62194 Replacement or irrigation, subarachnoid/subdural catheter Nervous system 412,500.00 550,000.00 275.00
62200 Ventriculocisternostomy, third ventricle Nervous system 2,464,500.00 3,286,000.00 1,643.00
62220 Creation of shunt; ventriculo-atrial, -jugular, -auricular Nervous system 2,152,500.00 2,870,000.00 1,435.00
62223 ventriculo-peritoneal, -pleural, -other terminus Nervous system 2,256,000.00 3,008,000.00 1,504.00
62225 Replacement or irrigation, ventricular catheter Nervous system 795,000.00 1,060,000.00 530.00
SECURE &
PACKAGES PACKAGES
PACKAGES
Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal

62230 Nervous system 1,570,500.00 2,094,000.00 1,047.00
catheter in shunt system
62256 Removal of complete cerebrospinal fluid shunt system; without replacement Nervous system 1,008,000.00 1,344,000.00 672.00
62258 with replacement by similar or other shunt at same operation Nervous system 2,239,500.00 2,986,000.00 1,493.00
62270 Spinal puncture, lumbar, diagnostic Nervous system 174,000.00 232,000.00 116.00
Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or

62272 Nervous system 216,000.00 288,000.00 144.00
catheter)
62273 Thoraic Epidural cannula for post op pain relief Nervous system 256,500.00 342,000.00 171.00
62274 Injection Of Anaesthetic substance ,epidural Continous Nervous system 150,000.00 200,000.00 100.00
62280 Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline Nervous system 336,000.00 448,000.00 224.00
62282 epidural, lumbar, sacral (caudal) Nervous system 378,000.00 504,000.00 252.00
62284 Injection procedure for myelography and/or computed tomography, spinal Nervous system 328,500.00 438,000.00 219.00
62290 Injection procedure for diskography, each level; lumbar Nervous system 456,000.00 608,000.00 304.00
63001 laminectomy for exploration of intraspinal canal,one or 2 Nervous system 2,578,500.00 3,438,000.00 1,719.00
63003 thoracic Nervous system 2,551,500.00 3,402,000.00 1,701.00
63005 lumbar, except for spondylolisthesis Nervous system 2,418,000.00 3,224,000.00 1,612.00
63011 sacral Nervous system 1,783,500.00 2,378,000.00 1,189.00
Laminectomy with removal of abnormal facets and/or pars inter-articularis with

63012 decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill Nervous system 2,515,500.00 3,354,000.00 1,677.00
type procedure)
Laminectomy with exploration and/or decompression of spinal cord and/or cauda
63015 equina, without facetectomy, foraminotomy or diskectomy, (eg. spinal stenosis), Nervous system 2,992,500.00 3,990,000.00 1,995.00
more than 2 vertebral segments; cervical
63017 lumbar Nervous system 2,784,000.00 3,712,000.00 1,856.00
Laminotomy (hemilaminectomy), with decompression of nerve root(s), including

63020 partial facetectomy, foraminotomy and/or excision of herniated intervertebral disk; Nervous system 2,290,500.00 3,054,000.00 1,527.00
one interspace, cervical
63030 one interspace, lumbar (including open or endoscopically-assisted approach) Nervous system 2,134,500.00 2,846,000.00 1,423.00
63035 each additional interspace, cervical or lumbar Nervous system 537,000.00 716,000.00 358.00
Laminotomy (hemilaminectomy), with decompression of nerve root(s), including

63040 partial facetectomy, foraminotomy and/or excision of herniated intervertebral disk, Nervous system 3,106,500.00 4,142,000.00 2,071.00
re-exploration, single interspace; cervical

SECURE &
PACKAGES PACKAGES
PACKAGES
63043 each additional cervical interspace Nervous system 429,000.00 572,000.00 286.00
63044 each additional lumbar interspace Nervous system 447,000.00 596,000.00 298.00
63045 Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with Nervous system 2,745,000.00 3,660,000.00 1,830.00
63048 each additional segment, cervical thoracic or lumbar Nervous system 585,000.00 780,000.00 390.00
Laminoplasty, cervical, with decompression of the spinal cord, two or more

63050 Nervous system 2,032,500.00 2,710,000.00 1,355.00
vertebral segments;
with reconstruction of the posterior bony elements (including the application of

63051 bridging bone graft and non-segmental fixation devices (eg, wire, suture, mini- Nervous system 3,157,500.00 4,210,000.00 2,105.00
plates), when performed)
Transpedicular approach with decompression of spinal cord, equina and/or nerve

63055 Nervous system 3,457,500.00 4,610,000.00 2,305.00
root(s) (eg, herniated intervertebral disk), single segment; thoracic
63056 lumbar (including transfacet, or lateral extraforaminal approach) (eg, far Nervous system 3,190,500.00 4,254,000.00 2,127.00
63057 each additional segment, thoracic or lumbar Nervous system 592,500.00 790,000.00 395.00
Costovertebral approach with decompression of spinal cord or nerve root(s), (eg,

63064 Nervous system 3,688,500.00 4,918,000.00 2,459.00
herniated intervertebral disk), thoracic; single segment
63066 each additional segment Nervous system 447,000.00 596,000.00 298.00
Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s),

63075 Nervous system 2,925,000.00 3,900,000.00 1,950.00
including osteophytectomy; cervical, single interspace
63076 cervical, each additional interspace Nervous system 688,500.00 918,000.00 459.00
63077 thoracic, single interspace Nervous system 3,171,000.00 4,228,000.00 2,114.00
63078 thoracic, each additional interspace Nervous system 540,000.00 720,000.00 360.00
Vertebral corpectomy (vertebral body resection), partial or complete, anterior

63081 approach with decompression of spinal cord and/or nerve root(s); cervical, single Nervous system 3,765,000.00 5,020,000.00 2,510.00
segment
63082 cervical, each additional segment Nervous system 759,000.00 1,012,000.00 506.00
Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic

63085 approach with decompression of spinal cord and/or nerve root(s); thoracic, single Nervous system 4,066,500.00 5,422,000.00 2,711.00
segment
63086 thoracic, each additional segment Nervous system 576,000.00 768,000.00 384.00
Vertebral corpectomy (vertebral body resection), partial or complete, combined

63087 thoracolumbar approach with decompression of spinal cord, cauda equina or nerve Nervous system 4,500,000.00 6,000,000.00 3,000.00
root(s), lower thoracic or lumbar; single segment
Vertebral corpectomy (vertebral body resection), partial or complete,

63090 transperitoneal or retroperitoneal approach with decompression of spinal cord, Nervous system 4,278,000.00 5,704,000.00 2,852.00
cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; single segment
SECURE &
PACKAGES PACKAGES
PACKAGES
Vertebral corpectomy (vertebral body resection), partial or complete, lateral

63101 extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, Nervous system 4,197,000.00 5,596,000.00 2,798.00
for tumor or retropulsed bone fragments); thoracic, single segment
63102 lumbar, single segment Nervous system 4,194,000.00 5,592,000.00 2,796.00
63103 thoracic or lumbar, each additional segment Nervous system 502,500.00 670,000.00 335.00
63160 Laminectomy for implanation of dorsal column stimulator unit Nervous system 1,428,000.00 1,904,000.00 952.00
63165 revision or removal of implant or system Nervous system 765,000.00 1,020,000.00 510.00
Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic or

63170 Nervous system 2,941,500.00 3,922,000.00 1,961.00
thoracolumbar
63172 Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space Nervous system 2,899,500.00 3,866,000.00 1,933.00
63173 to peritoneal or plueral space Nervous system 2,931,000.00 3,908,000.00 1,954.00
Laminectomy and section of dentate ligaments, with or without dural graft, cervical;
63180 Nervous system 2,356,500.00 3,142,000.00 1,571.00
one or two segments
63182 more than two segments Nervous system 2,796,000.00 3,728,000.00 1,864.00
63185 Laminectomy with rhizotomy; one or two segments Nervous system 2,305,500.00 3,074,000.00 1,537.00
63190 more than two segments Nervous system 2,845,500.00 3,794,000.00 1,897.00
63191 Laminectomy with section of spinal accessory nerve Nervous system 2,368,500.00 3,158,000.00 1,579.00
Laminectomy with cordotomy, with section of one spinothalamic tract, one

63194 Nervous system 2,515,500.00 3,354,000.00 1,677.00
stage;cervical
Laminectomy with cordotomy, with section of both spinothalamic tracts, one

63196 Nervous system 2,973,000.00 3,964,000.00 1,982.00
stage;cervical
Laminectomy with cordotomy, with section of both spinothalamic tracts, two stages
63198 Nervous system BR BR BR
within 14 days; cervical
63199 thoracic Nervous system BR BR BR
63200 Laminectomy, with release of tethered spinal cord, lumbar Nervous system 2,505,000.00 3,340,000.00 1,670.00
Laminectomy for excision or occlusion of arteriovenous malformation of spinal

63250 Nervous system 5,373,000.00 7,164,000.00 3,582.00
cord;cervical
63252 thoracolumbar Nervous system 5,469,000.00 7,292,000.00 3,646.00

SECURE &
PACKAGES PACKAGES
PACKAGES
Laminectomy for excision or evacuation of intraspinal lesion other than

63265 Nervous system 3,321,000.00 4,428,000.00 2,214.00
neoplasm,extradural; cervical
Laminectomy for excision of intraspinal lesion other than neoplasm,

63270 Nervous system 3,549,000.00 4,732,000.00 2,366.00
intradural;cervical
63275 Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical Nervous system 3,867,000.00 5,156,000.00 2,578.00
63276 extradural, thoracic Nervous system 3,687,000.00 4,916,000.00 2,458.00
63277 extradural, lumbar Nervous system 3,357,000.00 4,476,000.00 2,238.00
63278 extradural, sacral Nervous system 3,304,500.00 4,406,000.00 2,203.00
63280 intradural, extramedullary, cervical Nervous system 4,308,000.00 5,744,000.00 2,872.00
63281 intradural, extramedullary, thoracic Nervous system 4,257,000.00 5,676,000.00 2,838.00
63282 intradural, extramedullary, lumbar Nervous system 3,895,500.00 5,194,000.00 2,597.00
63283 intradural, sacral Nervous system 3,435,000.00 4,580,000.00 2,290.00
63285 intradural, intramedullary, cervical Nervous system 4,762,500.00 6,350,000.00 3,175.00
63286 intradural, intramedullary, thoracic Nervous system 5,001,000.00 6,668,000.00 3,334.00
63287 intradural, intramedullary, thoracolumbar Nervous system 4,902,000.00 6,536,000.00 3,268.00
63290 combined extradural-intradural lesion, any level Nervous system 5,029,500.00 6,706,000.00 3,353.00
Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal

63295 Nervous system 621,000.00 828,000.00 414.00
procedure
Vertebral corpectomy (vertebral body resection), partial or complete for excision of

63300 Nervous system 3,247,500.00 4,330,000.00 2,165.00
intraspinal lesion, single segment; extradural, cervical
63301 extradural, thoracic by transthoracic approach Nervous system 3,579,000.00 4,772,000.00 2,386.00
63302 extradural, thoracic by thoracolumbar approach Nervous system 3,759,000.00 5,012,000.00 2,506.00
SECURE &
PACKAGES PACKAGES
PACKAGES
63303 extradural, lumbar or sacral by transperitoneal or retroperitoneal approach Nervous system 3,825,000.00 5,100,000.00 2,550.00
63304 intradural, cervical Nervous system 4,005,000.00 5,340,000.00 2,670.00
63305 intradural, thoracic by transthoracic approach Nervous system 4,213,500.00 5,618,000.00 2,809.00
63306 intradural, thoracic by thoracolumbar approach Nervous system 4,266,000.00 5,688,000.00 2,844.00
63307 intradural, lumbar or sacral by transperitoneal or retroperitoneal approach Nervous system 4,230,000.00 5,640,000.00 2,820.00
Creation of lesion of spinal cord by stereotactic method, percutaneous, any

modality (including stimulation and/or recording)
Stereotactic stimulation of spinal cord, percutaneous, separate procedure not

followed by other surgery
63615 Stereotactic biopsy, aspiration, or excision of lesion spinal cord Nervous system BR BR BR
63650 Percutaneous implantation of neurostimulator electrode array, epidural Nervous system 1,075,500.00 1,434,000.00 717.00
63655 Laminectomy for implantation of neuro-stimulator electrodes plate/paddle,epidural Nervous system 1,867,500.00 2,490,000.00 1,245.00
Revision or removal of spinal neurostimulator electrode percutaneous array(s) or

63660 Nervous system 366,000.00 488,000.00 244.00
plate/paddle(s)
Insertion or replacement of spinal neurostimulator pulse generator or receiver,

63685 Nervous system 1,069,500.00 1,426,000.00 713.00
direct or inductive coupling
Revision or removal of implanted spinal neurostimulator pulse generator or

63688 Nervous system 858,000.00 1,144,000.00 572.00
receiver
63700 Repair of meningocele; less than 5 cm diameter Nervous system 2,203,500.00 2,938,000.00 1,469.00
63704 Repair of myelomeningocele; less than 5 cm diameter Nervous system 2,760,000.00 3,680,000.00 1,840.00
63707 Repair of dural/cerebrospinal fluid leak, not requiring laminectomy Nervous system 1,831,500.00 2,442,000.00 1,221.00
63709 Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy Nervous system 2,356,500.00 3,142,000.00 1,571.00
63710 Dural graft, spinal Nervous system 1,881,000.00 2,508,000.00 1,254.00
Creation of shunt, lumbar, subarachnoid- peritoneal, -pleural, or other; including

63740 Nervous system 1,888,500.00 2,518,000.00 1,259.00
laminectomy
63741 percutaneous, not requiring laminectomy Nervous system 1,338,000.00 1,784,000.00 892.00
63744 Replacement, irrigation or revision of lumbosubarachnoid shunt Nervous system 1,213,500.00 1,618,000.00 809.00
SECURE &
PACKAGES PACKAGES
PACKAGES
63746 Removal of entire lumbosubarachnoid shunt system without replacement Nervous system 922,500.00 1,230,000.00 615.00
64400 Injection, anesthetic agent; trigeminal nerve, any division or branch Nervous system 136,500.00 182,000.00 91.00
64402 facial nerve Nervous system 165,000.00 220,000.00 110.00
64405 greater occipital nerve Nervous system 153,000.00 204,000.00 102.00
64408 vagus nerve Nervous system 184,500.00 246,000.00 123.00
64410 phrenic nerve Nervous system 183,000.00 244,000.00 122.00
64412 spinal accessory nerve Nervous system 163,500.00 218,000.00 109.00
64413 cervical plexus Nervous system 168,000.00 224,000.00 112.00
64415 brachial plexus, single Nervous system 160,500.00 214,000.00 107.00
64416 brachial plexus,continuous infusion by catheter (including catheter Nervous system 324,000.00 432,000.00 216.00
64417 axillary nerve Nervous system 180,000.00 240,000.00 120.00
64418 suprascapular nerve Nervous system 181,500.00 242,000.00 121.00
64420 intercostal nerve, single Nervous system 178,500.00 238,000.00 119.00
64421 intercostal nerves, multiple, regional block Nervous system 258,000.00 344,000.00 172.00
64425 ilioinguinal, iliohypogastric nerves Nervous system 184,500.00 246,000.00 123.00
64430 pudendal nerve Nervous system 205,500.00 274,000.00 137.00
64435 paracervical (uterine) nerve Nervous system 187,500.00 250,000.00 125.00
64445 sciatic nerve, single Nervous system 172,500.00 230,000.00 115.00
sciatic nerve, continuous infusion by catheter, (including catheter placement)

64446 Nervous system 327,000.00 436,000.00 218.00
including daily management for anesthetic agent administration
64447 femoral nerve, single Nervous system 148,500.00 198,000.00 99.00
64448 femoral nerve, continuous infusion by catheter, (including catheter Nervous system 300,000.00 400,000.00 200.00
lumbar plexus, posterior approach, continuous infusion by catheter (including

64449 Nervous system 306,000.00 408,000.00 204.00
catheter placement) including daily management for anesthetic agent administration
64450 other peripheral nerve or branch Nervous system 156,000.00 208,000.00 104.00
Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint
64470 Nervous system 225,000.00 300,000.00 150.00
nerve; cervical or thoracic, single level
SECURE &
PACKAGES PACKAGES
PACKAGES
64472 cervical or thoracic, each additional level Nervous system 108,000.00 144,000.00 72.00
64475 lumbar or sacral, single level Nervous system 225,000.00 300,000.00 150.00
64476 lumbar or sacral, each additional level Nervous system 91,500.00 122,000.00 61.00
Injection, anesthetic agent and/or steroid, transforaminal epidural; cervical or

64479 Nervous system 475,500.00 634,000.00 317.00
thoracic, single level
64483 lumbar or sacral, single level Nervous system 450,000.00 600,000.00 300.00
64505 Injection, anesthetic agent; sphenopalatine ganglion Nervous system 153,000.00 204,000.00 102.00
64508 carotid sinus (separate procedure) Nervous system 186,000.00 248,000.00 124.00
64510 stellate ganglion (cervical sympathetic) Nervous system 177,000.00 236,000.00 118.00
64517 superior hypogastric plexus Nervous system 265,500.00 354,000.00 177.00
64520 lumbar or thoracic (paravertebral sympathetic) Nervous system 210,000.00 280,000.00 140.00
64530 celiac plexus, with or without radiologic monitoring Nervous system BR BR BR
64553 Percutaneous implantation of neurostimulator electrodes;cranial nerve Nervous system 273,000.00 364,000.00 182.00
64555 peripheral nerve (excludes sacral nerve) Nervous system 240,000.00 320,000.00 160.00
64560 autonomic nerve Nervous system 322,500.00 430,000.00 215.00
64561 sacral nerve (transforaminal placement) Nervous system 1,189,500.00 1,586,000.00 793.00
64565 neuromuscular Nervous system BR BR BR
64573 Incision for implantation of neurostimulator electrodes; cranial nerve Nervous system 723,000.00 964,000.00 482.00
64575 peripheral nerve (excludes sacral nerve) Nervous system 576,000.00 768,000.00 384.00
64577 autonomic nerve Nervous system 619,500.00 826,000.00 413.00
64580 neuromuscular Nervous system 553,500.00 738,000.00 369.00
64581 sacral nerve (transforaminal placement) Nervous system BR BR BR
64585 Revision or removal of peripheral neurostimulator electrodes Nervous system 384,000.00 512,000.00 256.00
SECURE &
PACKAGES PACKAGES
PACKAGES
Insertion or replacement of peripheral or gastric neurostimulator pulse generator or

64590 Nervous system 432,000.00 576,000.00 288.00
receiver, direct or inductive coupling
Revision or removal of peripheral or gastric neurostimulator pulse generator or

64595 Nervous system 366,000.00 488,000.00 244.00
receiver
Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental,

64600 Nervous system 475,500.00 634,000.00 317.00
or inferior alveolar branch
64605 second and third division branches at foramen ovale Nervous system 651,000.00 868,000.00 434.00
64610 second and third division branches at foramen ovale under radiologic Nervous system 1,096,500.00 1,462,000.00 731.00
Chemodenervation of muscle(s); muscle(s) innervated by facial nerve (eg, for

64612 Nervous system 277,500.00 370,000.00 185.00
blepharospasm, hemifacial spasm)
64613 neck muscle(s) (eg, for spasmodic torticollis, spasmotic dysphonia) Nervous system 280,500.00 374,000.00 187.00
extremity(s) and/or trunk muscle(s) (eg, for dystonia, cerebral palsy, multiple
64614 Nervous system 265,500.00 354,000.00 177.00
sclerosis)
64620 Destruction by neurolytic agent; intercostal nerve Nervous system 334,500.00 446,000.00 223.00
Destruction by neurolytic agent, paravertebral facet joint nerve;lumbar or sacral,

64622 Nervous system 424,500.00 566,000.00 283.00
single level
64626 cervical or thoracic, single level Nervous system 573,000.00 764,000.00 382.00
64630 Destruction by neurolytic agent; pudendal nerve Nervous system 360,000.00 480,000.00 240.00
64640 other peripheral nerve or branch Nervous system 295,500.00 394,000.00 197.00
64650 Chemodenervation of eccrine glands; both axillae Nervous system 88,500.00 118,000.00 59.00
64653 other area(s) (eg, scalp, face, neck), per day Nervous system 109,500.00 146,000.00 73.00
64680 Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus Nervous system 376,500.00 502,000.00 251.00
64681 superior hypogastric plexus Nervous system 537,000.00 716,000.00 358.00
64702 Neuroplasty; digital, one or both, same digit Nervous system 703,500.00 938,000.00 469.00
64704 nerve of hand or foot Nervous system 750,000.00 1,000,000.00 500.00
64708 Neuroplasty, major peripheral nerve, arm or leg; other than specified Nervous system 1,008,000.00 1,344,000.00 672.00
64712 sciatic nerve Nervous system 1,248,000.00 1,664,000.00 832.00
64713 brachial plexus Nervous system 1,548,000.00 2,064,000.00 1,032.00

SECURE &
PACKAGES PACKAGES
PACKAGES
64714 lumbar plexus Nervous system 1,266,000.00 1,688,000.00 844.00
64716 Neuroplasty and/or transposition; cranial nerve (specify) Nervous system 886,500.00 1,182,000.00 591.00
64718 ulnar nerve at elbow Nervous system 1,002,000.00 1,336,000.00 668.00
64719 ulnar nerve at wrist Nervous system 772,500.00 1,030,000.00 515.00
64721 median nerve at carpal tunnel Nervous system 736,500.00 982,000.00 491.00
64722 Decompression; unspecified nerve(s) (specify) Nervous system 774,000.00 1,032,000.00 516.00
64726 plantar digital nerve Nervous system 417,000.00 556,000.00 278.00
64732 Transection or avulsion of; supraorbital nerve Nervous system 685,500.00 914,000.00 457.00
64734 infraorbital nerve Nervous system 751,500.00 1,002,000.00 501.00
64736 mental nerve Nervous system 703,500.00 938,000.00 469.00
64738 inferior alveolar nerve by osteotomy Nervous system 849,000.00 1,132,000.00 566.00
64740 lingual nerve Nervous system BR BR BR
64742 facial nerve, differential or complete Nervous system BR BR BR
64744 greater occipital nerve Nervous system 864,000.00 1,152,000.00 576.00
64746 phrenic nerve Nervous system 780,000.00 1,040,000.00 520.00
64752 vagus nerve (vagotomy), transthoracic Nervous system 871,500.00 1,162,000.00 581.00
vagus nerve limited to proximal stomach (selective proximal vagotomy, proximal

64755 Nervous system 1,845,000.00 2,460,000.00 1,230.00
gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy)
64760 vagus nerve (vagotomy), abdominal Nervous system 1,275,000.00 1,700,000.00 850.00
64761 pudendal nerve Nervous system BR BR BR
Transection or avulsion of obturator nerve, extrapelvic, with or without adductor

64763 Nervous system 936,000.00 1,248,000.00 624.00
tenotomy
Transection or avulsion of obturator nerve, intrapelvic, with or without adductor

64766 Nervous system 1,189,500.00 1,586,000.00 793.00
tenotomy
64771 Transection or avulsion of other cranial nerve, extradural Nervous system 1,075,500.00 1,434,000.00 717.00
64772 Transection or avulsion of other spinal nerve, extradural Nervous system 1,086,000.00 1,448,000.00 724.00
64774 Excision of neuroma; cutaneous nerve, surgically identifiable Nervous system 648,000.00 864,000.00 432.00
SECURE &
PACKAGES PACKAGES
PACKAGES
64776 digital nerve, one or both, same digit Nervous system 642,000.00 856,000.00 428.00
64778 digital nerve, each additional digit Nervous system 444,000.00 592,000.00 296.00
64782 hand or foot, except digital nerve Nervous system 840,000.00 1,120,000.00 560.00
64783 hand or foot, each additional nerve, except same digit Nervous system 528,000.00 704,000.00 352.00
64784 major peripheral nerve, except sciatic Nervous system 1,248,000.00 1,664,000.00 832.00
64786 sciatic nerve Nervous system 2,191,500.00 2,922,000.00 1,461.00
64787 Implantation of nerve end into bone or muscle Nervous system 594,000.00 792,000.00 396.00
64788 Excision of neurofibroma or neurolemmoma; cutaneous nerve Nervous system 654,000.00 872,000.00 436.00
64790 major peripheral nerve Nervous system 1,479,000.00 1,972,000.00 986.00
64792 extensive (including malignant type) Nervous system 1,905,000.00 2,540,000.00 1,270.00
64795 Biopsy of nerve Nervous system 417,000.00 556,000.00 278.00
64802 Sympathectomy, cervical Nervous system 1,113,000.00 1,484,000.00 742.00
64804 cervicothoracic Nervous system 2,053,500.00 2,738,000.00 1,369.00
64809 thoracolumbar Nervous system 1,830,000.00 2,440,000.00 1,220.00
64818 lumbar Nervous system 1,411,500.00 1,882,000.00 941.00
64820 digital arteries, each digit Nervous system 1,305,000.00 1,740,000.00 870.00
64821 radial artery Nervous system 1,213,500.00 1,618,000.00 809.00
64822 ulnar artery Nervous system 1,212,000.00 1,616,000.00 808.00
64823 superficial palmar arch Nervous system 1,392,000.00 1,856,000.00 928.00
64831 Suture of digital nerve, hand or foot; one nerve Nervous system 1,072,500.00 1,430,000.00 715.00
64832 each additional digital nerve Nervous system 589,500.00 786,000.00 393.00
64834 Suture of one nerve; hand or foot, common sensory nerve Nervous system 1,144,500.00 1,526,000.00 763.00
64835 median motor thenar Nervous system 1,369,500.00 1,826,000.00 913.00
64836 ulnar motor Nervous system 1,417,500.00 1,890,000.00 945.00

SECURE &
PACKAGES PACKAGES
PACKAGES
64837 Suture of each additional nerve, hand or foot Nervous system 835,500.00 1,114,000.00 557.00
64840 Suture of posterior tibial nerve Nervous system 1,771,500.00 2,362,000.00 1,181.00
64857 without transposition Nervous system 1,879,500.00 2,506,000.00 1,253.00
64858 Suture of sciatic nerve Nervous system 2,172,000.00 2,896,000.00 1,448.00
64859 Suture of each additional major peripheral nerve Nervous system 595,500.00 794,000.00 397.00
64861 Suture of; brachial plexus Nervous system 2,523,000.00 3,364,000.00 1,682.00
64862 lumbar plexus Nervous system 3,021,000.00 4,028,000.00 2,014.00
64864 Suture facial nerve,extracranial Nervous system 1,603,500.00 2,138,000.00 1,069.00
64865 infratemporal with or without grafting Nervous system 2,175,000.00 2,900,000.00 1,450.00
64866 Anastomosis , facial -spinal accessory Nervous system 2,146,500.00 2,862,000.00 1,431.00
64868 facial -hypoglossal Nervous system 1,969,500.00 2,626,000.00 1,313.00
64870 facial-phrenic Nervous system 2,233,500.00 2,978,000.00 1,489.00
64872 Suture of nerve; requiring secondary or delayed suture Nervous system 267,000.00 356,000.00 178.00
64874 requiring extensive mobilization, or transposition of nerve Nervous system 400,500.00 534,000.00 267.00
64876 requiring shortening of bone of extremity Nervous system BR BR BR
64885 Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length Nervous system 2,304,000.00 3,072,000.00 1,536.00
64886 more than 4 cm in length Nervous system 2,740,500.00 3,654,000.00 1,827.00
64890 Nerve graft (includes obtaining graft), single strand hand or foot; up to 4 cm length Nervous system 2,122,500.00 2,830,000.00 1,415.00
64891 more than 4 cm length Nervous system 2,049,000.00 2,732,000.00 1,366.00
64892 Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length Nervous system 1,996,500.00 2,662,000.00 1,331.00
Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4
64895 Nervous system 2,521,500.00 3,362,000.00 1,681.00
cm length
Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4
64897 Nervous system 2,415,000.00 3,220,000.00 1,610.00
cm. Length
SECURE &
PACKAGES PACKAGES
PACKAGES
64901 Nerve graft, each additional nerve; single strand Nervous system 2,293,500.00 3,058,000.00 1,529.00
64902 multiple strands (cable) Nervous system 1,554,000.00 2,072,000.00 1,036.00
64905 Nerve pedicle transfer; first stage Nervous system 1,795,500.00 2,394,000.00 1,197.00
64907 second stage Nervous system 2,470,500.00 3,294,000.00 1,647.00
64910 Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve Nervous system 1,068,000.00 1,424,000.00 712.00
64911 with autogenous vein graft (includes harvest of vein graft), each nerve Nervous system 1,375,500.00 1,834,000.00 917.00
64999 Unlisted procedure, nervous system Nervous system BR BR BR
EYE
65091 evisceration without implant Eye 1,101,000.00 1,468,000.00 734.00
65093 - with implant Eye 1,153,500.00 1,538,000.00 769.00
65101 enucleation without implant Eye 1,197,000.00 1,596,000.00 798.00
65103 - with implant, muscles not attached to implant Eye 1,284,000.00 1,712,000.00 856.00
65105 - with implant, muscles attached to implant Eye 1,419,000.00 1,892,000.00 946.00
65110 exenteration of orbit Eye 2,262,000.00 3,016,000.00 1,508.00
65205 Removal of foreign body, external eye; conjuctival superficial Eye 93,000.00 124,000.00 62.00
- conjuctival embedded (includes concretions), sub-conjuctival, or scleral non-

65210 Eye 108,000.00 144,000.00 72.00
perforating
65220 - corneal, without slit lamp Eye 90,000.00 120,000.00 60.00
65222 - corneal, with slit lamp Eye 121,500.00 162,000.00 81.00
65223 Removal of foreign body eye with slit lamp under general anaesthesia Eye 103,500.00 138,000.00 69.00
65235 Removal of foreign body, intraocular; from anterior chamber or lens Eye 1,045,500.00 1,394,000.00 697.00
65260 - from posterior segment, magnetic extraction, anterior or posterior route Eye 1,528,500.00 2,038,000.00 1,019.00
65265 - from posterior segment, non-magnetic extraction Eye 1,761,000.00 2,348,000.00 1,174.00
65272 - conjuctiva, by mobilization and re-arrangement, without hospitalisation Eye 526,500.00 702,000.00 351.00
SECURE &
PACKAGES PACKAGES
PACKAGES
65273 - conjuctiva, by mobilization and re-arrangement, with hospitalisation Eye 580,500.00 774,000.00 387.00
65275 - cornea, non-perforating, with or without removal of foreign body Eye 573,000.00 764,000.00 382.00
65280 - cornea and/or sclera, perforating, not involving uveal tissue Eye 1,237,500.00 1,650,000.00 825.00
65285 - cornea and/or sclera, perforating, with re-position or resection of uveal tissue Eye 1,875,000.00 2,500,000.00 1,250.00
65286 - application of tissue glue, wounds of cornea and/or sclera Eye 898,500.00 1,198,000.00 599.00
65290 Repair of wound, extraocular muscle, tendon and/or Tenon's capsule Eye 873,000.00 1,164,000.00 582.00
65400 Excision of lesion, cornea (keratectomy, lamellar partial), except pterygium Eye 999,000.00 1,332,000.00 666.00
65410 Biopsy of cornea Eye 246,000.00 328,000.00 164.00
65420 Excision or transposition of pterygium; without graft Eye 718,500.00 958,000.00 479.00
65426 - with graft Eye 967,500.00 1,290,000.00 645.00
65710 Keratoplasty (corneal transplant); lamellar Eye 1,941,000.00 2,588,000.00 1,294.00
65730 - penetrating (except in aphakia) Eye 2,301,000.00 3,068,000.00 1,534.00
65750 - penetrating (in aphakia) Eye 2,397,000.00 3,196,000.00 1,598.00
65755 - penetrating (in pseudophakia) Eye 2,425,500.00 3,234,000.00 1,617.00
Paracentesis of anterior chamber of eye (seperate procedure); with diagnostic

65800 Eye 282,000.00 376,000.00 188.00
aspiration of aqueous
65805 - with therapeutic release of aqueous Eye 294,000.00 392,000.00 196.00
- with removal of vitreous and/or discission of anterior hyaloid membrane, with or

65810 Eye 787,500.00 1,050,000.00 525.00
without air injection
65815 - with removal of blood, with or without irrigation and/or air injection Eye 826,500.00 1,102,000.00 551.00
65820 Gonotomy Eye 1,335,000.00 1,780,000.00 890.00
65850 Trabeculotomy ab externo Eye 1,734,000.00 2,312,000.00 1,156.00
65855 Trabeculoplasty by laser surgery, one or more sessions (defined treatment series) Eye 958,500.00 1,278,000.00 639.00
65860 Severing adhesions of anterior segment, laser technique (seperate procedure) Eye 667,500.00 890,000.00 445.00
Severing adhesions of anterior segment, incessional technique (with or without

65865 Eye 937,500.00 1,250,000.00 625.00
injection of air or liquid) (seperate procedure); goniosynechiae
65870 - anterior synechiae Eye 946,500.00 1,262,000.00 631.00

SECURE &
PACKAGES PACKAGES
PACKAGES
65875 - posterior synechiae Eye 999,000.00 1,332,000.00 666.00
65880 - corneovitreal adhesions Eye 1,080,000.00 1,440,000.00 720.00
65900 Removal of epithelial downgrowth , anterior chamber Eye 1,510,500.00 2,014,000.00 1,007.00
65920 Removal of implanted material, anterior segment Eye 1,291,500.00 1,722,000.00 861.00
65930 Removal of blood clot, anterior segment Eye 1,144,500.00 1,526,000.00 763.00
66020 Injection, anterior chamber (seperate procedure); air or liquid Eye 295,500.00 394,000.00 197.00
66030 - medication Eye 177,000.00 236,000.00 118.00
66150 Fistulization of sclera for glaucoma; trephination with iridectomy Eye 1,387,500.00 1,850,000.00 925.00
66155 - thermocauterization with iridectomy Eye 1,368,000.00 1,824,000.00 912.00
66160 - sclerectomy with punch or scissors, with iridectomy Eye 1,606,500.00 2,142,000.00 1,071.00
66165 - iridencleisis or iridotasis Eye 1,341,000.00 1,788,000.00 894.00
66170 - trabeculectomy ab externo Eye 1,882,500.00 2,510,000.00 1,255.00
66180 Aqueous shunt to extraocular reservoir (e.g. Molteno, Schocket, Denver - Krupin) Eye 2,199,000.00 2,932,000.00 1,466.00
66185 Revision of aqueous shunt to extraocular reservoir Eye 1,350,000.00 1,800,000.00 900.00
66220 Repair of scleral staphyloma; without graft Eye 1,242,000.00 1,656,000.00 828.00
66225 - with graft Eye 2,053,500.00 2,738,000.00 1,369.00
66500 Iridectomy by stab incision (seperate procedure); except transfixion Eye 636,000.00 848,000.00 424.00
66505 - with transfixion as for iris bombe Eye 594,000.00 792,000.00 396.00
66600 Iridectomy, with corneoscleral or corneal section, for removal of lesion Eye 1,383,000.00 1,844,000.00 922.00
66605 - with cyclectomy Eye 1,884,000.00 2,512,000.00 1,256.00
66625 - peripheral for glaucoma (seperate procedure) Eye 900,000.00 1,200,000.00 600.00
66630 - sector for glaucoma (seperate procedure) Eye 1,021,500.00 1,362,000.00 681.00
66680 Repair of iris, ciliary body (as for iridodialysis) Eye 898,500.00 1,198,000.00 599.00
Suture of iris, ciliary body (seperate procedure) with retrieval of suture through
66682 Eye 1,039,500.00 1,386,000.00 693.00
small incision (e.g. McCannel suture)
SECURE &
PACKAGES PACKAGES
PACKAGES
66700 Ciliary body destruction; diathermy Eye 805,500.00 1,074,000.00 537.00
66710 - cyclophotocoagulation Eye 819,000.00 1,092,000.00 546.00
66720 - cryotherapy Eye 814,500.00 1,086,000.00 543.00
66740 - cyclodialysis Eye 813,000.00 1,084,000.00 542.00
66761 Iridotomy/iridectomy by laser surgery (e.g. for glaucoma) (one or more sessions) Eye 799,500.00 1,066,000.00 533.00
Iridoplastry by photocoagulation (one or more sessions) e.g for improvement of

66762 Eye 906,000.00 1,208,000.00 604.00
vision, for widening of anterior chamber angle)
66770 Destruction of cyst or lesion, iris or ciliary body (non-excisional procedure) Eye 1,050,000.00 1,400,000.00 700.00
Laser surgery (e.g. YAG) (one or more stages). Not applicable during follow-up
66821 Eye 589,500.00 786,000.00 393.00
period or within six months after cataract surgery
Repositioning of intraocular lens prosthesis, requiring an incision (separate

66825 Eye 1,216,500.00 1,622,000.00 811.00
procedure)
66826 Pachymetry, both eyes, two examinations per year Eye 120,000.00 160,000.00 80.00
66827 Optical Coherent Tomography (OCT) Eye 412,500.00 550,000.00 275.00
66828 Corneal Topography, two examinations per year Eye 180,000.00 240,000.00 120.00
66829 Retinal Topography, per eye Eye 180,000.00 240,000.00 120.00
Removal of secondary membranous cataract (opacified posterior lens capsule

66830 and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy Eye 1,213,500.00 1,618,000.00 809.00
(iridocapsulotomy, iridocapsulectomy)
66840 Removal of lens material; aspiration technique, one or more stages Eye 1,306,500.00 1,742,000.00 871.00
- phacofragmentation technique (mechanical or ultrasonic) (e.g.

66850 Eye 1,503,000.00 2,004,000.00 1,002.00
phacoemulsification), with aspiration
66852 - pars plana approach, with or without vitrectomy Eye 1,707,000.00 2,276,000.00 1,138.00
66920 - intracapsular Eye 1,459,500.00 1,946,000.00 973.00
66930 - intracapsular, for dislocated lens Eye 1,557,000.00 2,076,000.00 1,038.00
66940 - extracapsular (other than 66840, 66850, 66852) Eye 1,471,500.00 1,962,000.00 981.00
Intracpsular cataract extraction with insertion of intraocular lens prosthesis (one

66973 Eye 789,000.00 1,052,000.00 526.00
stage procedure)
Extracapsular cataract removal with insertion of intraocular lens prosthesis (one

66974 stage procedure), manual or mechanical technique (e.g. irrigation and aspiration or Eye 1,012,500.00 1,350,000.00 675.00
phacoemulsification)
Insertion of intraocular lens prosthesis (secondary implant) not associated with

66985 Eye 1,384,500.00 1,846,000.00 923.00
concurrent cataract removal
66986 Exchange of intraocular lens Eye 1,815,000.00 2,420,000.00 1,210.00

SECURE &
PACKAGES PACKAGES
PACKAGES
Axial length measurement and calculation of intraocular power by ultra-sonography

66987 Eye 87,000.00 116,000.00 58.00
"A" mode
66990 Removal of corneo scleral sutures under slit lamp or operating microscope Eye 163,500.00 218,000.00 109.00
66996 Viscoelastic Eye FFS FFS FFS
66998 Lenticulus Eye 258,000.00 344,000.00 172.00
Unlisted procedure, anterior segment of eye-Collagen cross-linking of cornea

66999 (including removal of the corneal epithelium and intraoperative pachymetry when Eye 1,099,500.00 1,466,000.00 733.00
performed)
Removal of vitreous, anterior approach (open sky technique or limbal incision);

67005 Eye 1,584,000.00 2,112,000.00 1,056.00
partial removal
67010 - subtotal removal with mechanical vitrectomy Eye 1,546,500.00 2,062,000.00 1,031.00
Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach

67015 Eye 1,026,000.00 1,368,000.00 684.00
(posterior sclerotomy)
Injection of vitreous substitute, pars plana or limbal approach, (fluid-gas exchange),

67025 Eye 1,090,500.00 1,454,000.00 727.00
with or without aspiration (separate procedure)
67028 Intravitreal injection of a pharmacologic agent (Separate procedure) Eye 501,000.00 668,000.00 334.00
67030 Discission of vitreous strands (without removal ), pars plana approach Eye 1,036,500.00 1,382,000.00 691.00
Severing of vitreous strands, vitreous face adhesions, sheets, membranes or

67031 Eye 1,084,500.00 1,446,000.00 723.00
opacities, laser surgery (one or more stages)
67036 Vitrectomy, mechanical, pars plana approcah Eye 2,271,000.00 3,028,000.00 1,514.00
67038 - with epiretinal membrane stripping Eye 1,419,000.00 1,892,000.00 946.00
67039 - with focal endolaser photo-coagulation Eye 2,689,500.00 3,586,000.00 1,793.00
67040 - with endolaser panretinal photo-coagulation Eye 3,046,500.00 4,062,000.00 2,031.00
Repair of retinal detachment, one or more sessions; cryotherapy or diathermy, with

67102 Eye 588,000.00 784,000.00 392.00
or without drainage of subretinal fluid
- photocoagulation (laser or xenon arc, one or more sessions), with or without

67105 Eye 1,389,000.00 1,852,000.00 926.00
drainage of sub-retinal fluid
- scleral buckling (such as lamellar excision, imbrication or encircling procedure),

67107 Eye 2,403,000.00 3,204,000.00 1,602.00
with or without implant, may include procedures 67101, 67105
- with vitrectomy, any method, with or without air or gas tamponade, with or without
67108 focal endolaser photocoagulation, may include procedures 67101 - 67107 and/or Eye 3,447,000.00 4,596,000.00 2,298.00
removal of lens by same technique
67109 - by technique other than 67101 - 67108 and 67110 Eye 976,500.00 1,302,000.00 651.00
67110 - by injection of air or other gas (e.g. pneumoretinopexy) Eye 1,629,000.00 2,172,000.00 1,086.00
67112 - previously operated upon, any technique Eye 2,493,000.00 3,324,000.00 1,662.00
67115 Release of encircling material Eye 858,000.00 1,144,000.00 572.00

SECURE &
PACKAGES PACKAGES
PACKAGES
67120 Removal of implanted material, posterior segment extraocular Eye 1,036,500.00 1,382,000.00 691.00
67121 - intraocular Eye 1,540,500.00 2,054,000.00 1,027.00
67130 Flurescein angiography (excluding materials) Eye 88,500.00 118,000.00 59.00
Prophylaxis of retinal detachment (e.g. retinall break, lattice degeneration) without

67141 Eye 1,035,000.00 1,380,000.00 690.00
drainage, one or more sessions; cryotherapy, diathermy
67145 - photocoagulation (laser or xenon arc) Eye 951,000.00 1,268,000.00 634.00
Destruction of localised lesion of retina (e.g. maculopathy, choroidopathy, small

67208 Eye 1,122,000.00 1,496,000.00 748.00
tumours), one or more sessions; cryotherapy, diathermy
67210 - photocoagulation (laser or xenon arc) Eye 1,390,500.00 1,854,000.00 927.00
67218 - radiation by implantation of source (includes removal of source) Eye 2,125,500.00 2,834,000.00 1,417.00
Destruction of extensive or progressive retinopathy (e.g. diabetic retinopathy), one

67227 Eye 1,111,500.00 1,482,000.00 741.00
or more sessions; cryotherapy, diathermy
67228 - photocoagulation (laser or xenon arc) Eye 1,785,000.00 2,380,000.00 1,190.00
67250 Scleral reinforcement (seperate procedure; without graft Eye 1,248,000.00 1,664,000.00 832.00
67255 - with graft Eye 1,608,000.00 2,144,000.00 1,072.00
67313 Strabismus surgery, one, two or three muscle procedure Eye 457,500.00 610,000.00 305.00
Transposition of eye muscles, such as for paretic muscle (one or more stages, one
67320 Eye 1,353,000.00 1,804,000.00 902.00
or more muscles, necessitating displacement of plane of action more than 5mm)
67331 Strabismus surgery, on patient previously operated on Eye 1,246,500.00 1,662,000.00 831.00
67400 orbitotomy without bone flap with or without biopsy Eye 1,593,000.00 2,124,000.00 1,062.00
67420 orbitotomy with bone flap or window , lateral approach with removal of lesion Eye 895,500.00 1,194,000.00 597.00
67500 Injection, retrobulbar, local anaesthesia Eye 127,500.00 170,000.00 85.00
67501 - general anaesthesia Eye 103,500.00 138,000.00 69.00
67502 Regional anaethesia/Block Eye 225,000.00 300,000.00 150.00
67510 Air or contrast medium for radiography Eye 31,500.00 42,000.00 21.00
67800 Excision, chalazion, meibomian cyst, single or multiple, local anaesthesia Eye 190,500.00 254,000.00 127.00
67808 - single or multiple, general anaesthesia Eye 489,000.00 652,000.00 326.00
67825 Correction, trichiasis by eletrolysis (independent procedure) local anaesthesia Eye 213,000.00 284,000.00 142.00
SECURE &
PACKAGES PACKAGES
PACKAGES
Excision of lesion (except chalazion), involving lid margin, tarsus or palpebral

67840 Eye 319,500.00 426,000.00 213.00
conjunctiva, with or without simple direct closure
67841 - wide excision of malignant or other complicated lesion Eye 184,500.00 246,000.00 123.00
67842 Excision of lesion of bulbar conjunctiva without entering orbit Eye 184,500.00 246,000.00 123.00
67845 Removal of lesion of bulbar conjunctiva infiltrating into orbit Eye 384,000.00 512,000.00 256.00
Destruction of lesion of lid margin or conjunctiva (such as electro-surgery or

67850 Eye 223,500.00 298,000.00 149.00
cryotherapy), local anaesthesia
67880 Tarsorrhaphy, intermarginal lid adhesion (Blepharorrhaphy, canthorrhaphy) Eye 642,000.00 856,000.00 428.00
67881 Severing tarsorrhapy Eye 142,500.00 190,000.00 95.00
67901 Repair of blepharoptosis, suture only Eye 1,206,000.00 1,608,000.00 804.00
67902 - with fascial sling, including obtaining fascia Eye 1,227,000.00 1,636,000.00 818.00
67903 - levator resection, internal approach Eye 1,201,500.00 1,602,000.00 801.00
67911 Correction of lid retraction Eye 1,015,500.00 1,354,000.00 677.00
67912 Lagophthalmos - implant of magnets Eye 1,057,500.00 1,410,000.00 705.00
67915 Repair of ectropian or entropion by cautery Eye 417,000.00 556,000.00 278.00
67917 Repair of ectropion or entropion by operation Eye 1,051,500.00 1,402,000.00 701.00
67918 Ectropion or intropion by cautery - general anaesthesia Eye 142,500.00 190,000.00 95.00
67950 Canthoplasty (reconstruction of canthus) Eye 1,021,500.00 1,362,000.00 681.00
Excision and repair, eyelid, full thickness, or involving lid margins by advancement
67961 Eye 1,003,500.00 1,338,000.00 669.00
flap such as wedge resection or halving procedures), up to quarter lid margin
67966 - over quarter lid margin Eye 1,204,500.00 1,606,000.00 803.00
Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from

67971 Eye 1,515,000.00 2,020,000.00 1,010.00
opposing eyelid, one or first stage, up to two-thirds lid
67973 - total eyelid, lower Eye 1,960,500.00 2,614,000.00 1,307.00
67974 - upper Eye 1,987,500.00 2,650,000.00 1,325.00
67975 - second or subsequent stage Eye 1,072,500.00 1,430,000.00 715.00

SECURE &
PACKAGES PACKAGES
PACKAGES
68200 Subconjunctival injection Eye 78,000.00 104,000.00 52.00
68440 Incision, snip of lacrimal punctum, local anaesthesia Eye 148,500.00 198,000.00 99.00
68500 Excision of lacrimal gland (dacryoadenectomy) [except for tumour] total Eye 1,495,500.00 1,994,000.00 997.00
68520 Excision, lacrimal sac (dacryocystectomy) Eye 1,251,000.00 1,668,000.00 834.00
68700 Plastic repair, canaliculi Eye 778,500.00 1,038,000.00 519.00
68720 dacryocystorhinostomy Eye 1,384,500.00 1,846,000.00 923.00
68745 Conjunctiva-rhinostomy (fistulization of conjuctiva to nasal cavity), without tube Eye 1,201,500.00 1,602,000.00 801.00
Probing of nasolacrimal duct, with or without irrigation and insertion of polythene

68820 Eye 97,500.00 130,000.00 65.00
tubes, unilateral
68825 - requiring general anaesthesia, unilateral, with or without insertion of tube or stent Eye 103,500.00 138,000.00 69.00
68826 Pterygium Eye 195,000.00 260,000.00 130.00
68827 Consultation and Education by Registered Ophthalmic Nurse Eye 21,000.00 28,000.00 14.00
68828 Fundus camera Eye 45,000.00 60,000.00 30.00
68829 Consumables Eye 15,000.00 20,000.00 10.00
EAR
69000 drainage of external ear , abscess or haematoma (simple) Ear 187,500.00 250,000.00 125.00
69005 complicated Ear 291,000.00 388,000.00 194.00
69140 excision exostosis (es) external auditory canal Ear 1,350,000.00 1,800,000.00 900.00
69141 - multiple Ear 1,635,000.00 2,180,000.00 1,090.00
69200 removal foreign body external auditory canal wihout general anaesthesia Ear FFS FFS FFS
69201 - requiring local anaesthesia Ear 109,500.00 146,000.00 73.00
69205 with general anaesthesia Ear 181,500.00 242,000.00 121.00
69206 - with general anaesthesia, proceeding to post auricular incision Ear 424,500.00 566,000.00 283.00
69209 Removal of impacted cerumen, one or both ears Ear 18,000.00 24,000.00 12.00
SECURE &
PACKAGES PACKAGES
PACKAGES
69210 Removal of impacted keratotic debris, under general anaesthesia Ear 295,500.00 394,000.00 197.00
69300 otoplasty protruding ear with or without size reduction Ear 966,000.00 1,288,000.00 644.00
69301 Otoplastry, post trauma, unilateral, part of ear (e.g. "cauliflower" ear) Ear 613,500.00 818,000.00 409.00
69302 - whole ear Ear 699,000.00 932,000.00 466.00
69320 reconstruction of external auditory canal (congenital) single stage Ear 2,605,500.00 3,474,000.00 1,737.00
69321 - acquired Ear 1,392,000.00 1,856,000.00 928.00
69325 Construction of external ear from patient's own tissue, all stages, within six months Ear 478,500.00 638,000.00 319.00
69326 Minor adjustment (of 69325) after six months period Ear 369,000.00 492,000.00 246.00
69330 cochlear device implantation with or without mastoidectomy Ear BR BR BR
69350 microotoscopy under general anaesthesia Ear 114,000.00 152,000.00 76.00
69351 micro-otoscopy with microsuctioning under local anaesthesia Ear 114,000.00 152,000.00 76.00
69400 Eustachian tube inflation, with local anaesthesia Ear 139,500.00 186,000.00 93.00
69401 - with general anaesthesia Ear 165,000.00 220,000.00 110.00
69418 Paracentesis of ear - one ear Ear 277,500.00 370,000.00 185.00
69420 myringotomy without general anaesthesia Ear 205,500.00 274,000.00 137.00
Tympanostomy (requires insertion of ventilating tube) in surgical suite with or

69435 Ear 169,500.00 226,000.00 113.00
without operating microscope (one ear)
69440 middle ear exploration (post auricular or permeatal ) Ear 549,000.00 732,000.00 366.00
69502 mastoidectomy (cortical) Ear 1,975,500.00 2,634,000.00 1,317.00
69505 modified radical Ear 2,293,500.00 3,058,000.00 1,529.00
69511 radical Ear 2,379,000.00 3,172,000.00 1,586.00
69535 resection temporal bone , externa approach Ear 6,000,000.00 8,000,000.00 4,000.00
69536 - per oral excision styloid process Ear 624,000.00 832,000.00 416.00
69539 Aural polypectomy, with general anaesthesia Ear 232,500.00 310,000.00 155.00
69540 excision aural polyp Ear 241,500.00 322,000.00 161.00

SECURE &
PACKAGES PACKAGES
PACKAGES
69555 Excission, surgical for neoplasm Ear 2,623,500.00 3,498,000.00 1,749.00
69620 myringoplasty Ear 1,440,000.00 1,920,000.00 960.00
69633 with ossicular reconstruction & synthetic prosthesis ( porp, torp) Ear 2,104,500.00 2,806,000.00 1,403.00
69635 tympanoplasty with mastoidotomy(with canalplasty ,no ossiculoplasty) Ear 2,359,500.00 3,146,000.00 1,573.00
69650 stapes mobilisation Ear 1,662,000.00 2,216,000.00 1,108.00
69660 stapedectomy or stapedotomy with or without use of prosthesis Ear 2,037,000.00 2,716,000.00 1,358.00
69661 with foot plate drill out Ear 2,599,500.00 3,466,000.00 1,733.00
69666 repair oval window fistula Ear 1,714,500.00 2,286,000.00 1,143.00
69668 Repair perforation of round window Ear 1,261,500.00 1,682,000.00 841.00
69720 decopression facial nerve, intratemporal lateral to geniculate ganglion Ear 2,452,500.00 3,270,000.00 1,635.00
69722 Microsuction Ear 64,500.00 86,000.00 43.00
69740 suture facial nerve,intratemporal with or without graft or lateral decompression Ear 2,191,500.00 2,922,000.00 1,461.00
69801 labyrinthotomy with or without cryo or other destructive procedures or perfusion Ear 1,597,500.00 2,130,000.00 1,065.00
69805 endolymphatic sac operation without shunt Ear 1,990,500.00 2,654,000.00 1,327.00
69806 with shunt Ear 2,221,500.00 2,962,000.00 1,481.00
69820 fenestration semicircular canal Ear 1,548,000.00 2,064,000.00 1,032.00
69900 Ultrasound to labyrinth, excluding mastoidectomy fee Ear 1,261,500.00 1,682,000.00 841.00
69930 Unilateral Cochlear implant device implantation with or without masteidectomy Ear 2,851,500.00 3,802,000.00 1,901.00
RADIOLOGY - DIAGNOSTIC
70008 Hyperinflation practice expense surcharge, per attendance Diagnostic Radiology
70009 Cash co-payment, per attendance Diagnostic Radiology
Diagnostic Radiology Head

70030 Orbital foreign body, without localisation 22,500.00 30,000.00 15.00
and Neck

70040 with localisation 45,000.00 60,000.00 30.00
and Neck

70100 Mandible 37,500.00 50,000.00 25.00
and Neck
SECURE &
PACKAGES PACKAGES
PACKAGES

70130 Mastoids 45,000.00 60,000.00 30.00
and Neck

70134 Internal auditory meati 45,000.00 60,000.00 30.00
and Neck

70150 Facial bones and/or orbits 22,500.00 30,000.00 15.00
and Neck

70160 Nose 22,500.00 30,000.00 15.00
and Neck

70210 Post nasal space 15,000.00 20,000.00 10.00
and Neck

70220 Para-nasal sinus 30,000.00 40,000.00 20.00
and Neck

70240 Pituitary fossa (sella turcia), localised views only) 22,500.00 30,000.00 15.00
and Neck

70260 Routine skull 22,500.00 30,000.00 15.00
and Neck

70300 Teeth: one quadrant 22,500.00 30,000.00 15.00
and Neck

70310 Teeth: two quadrant 22,500.00 30,000.00 15.00
and Neck

70320 Teeth: Full mouth 150,000.00 200,000.00 100.00
and Neck

70330 Tempro-mandibular joints 22,500.00 30,000.00 15.00
and Neck

70332 Tempro-mandibular joints with tomography 22,500.00 30,000.00 15.00
and Neck

70360 Throat or soft tissue, neck 22,500.00 30,000.00 15.00
and Neck
Sialography (plus two-thirds for each additional gland) Diagnostic Radiology Head
70390 BR BR BR
…………………………………………. and Neck

71019 Thoratic inlet 22,500.00 30,000.00 15.00
and Neck
71020 Chest, routine Diagnostic Radiology 52,500.00 70,000.00 35.00
71100 Ribs Diagnostic Radiology 22,500.00 30,000.00 15.00
71120 Sternum or sterno-clavicular joints Diagnostic Radiology 22,500.00 30,000.00 15.00
72050 Spine per region, e.g. cervical, sacral, coccygeal, thoracic, Diagnostic Radiology 22,500.00 30,000.00 15.00
72090 Scoliosis studies Diagnostic Radiology 30,000.00 40,000.00 20.00
72111 Lumbar spine and pelvis Diagnostic Radiology 97,500.00 130,000.00 65.00
72114 Stress studies Diagnostic Radiology 22,500.00 30,000.00 15.00
72115 Whole spine and pelvis Diagnostic Radiology 67,500.00 90,000.00 45.00
SECURE &
PACKAGES PACKAGES
PACKAGES
72250 Myelography per region Diagnostic Radiology 180,000.00 240,000.00 120.00
72270 Myelography full Diagnostic Radiology 540,000.00 720,000.00 360.00
72290 Discography Diagnostic Radiology 450,000.00 600,000.00 300.00
73000 Per region of limp, eg Shoulder, elbow, forearm Diagnostic Radiology 30,000.00 40,000.00 20.00
73040 Orthography, per joint Diagnostic Radiology 37,500.00 50,000.00 25.00
73050 Acromio-clavicular joints, plain, per pair Diagnostic Radiology 22,500.00 30,000.00 15.00
73051 with weight bearing, per pair Diagnostic Radiology 30,000.00 40,000.00 20.00
73140 Finger Diagnostic Radiology 22,500.00 30,000.00 15.00
73520 Hip joints or pelvis with sacro-iliac Diagnostic Radiology 30,000.00 40,000.00 20.00
73530 Smith-Petersen or equivalent control, in theatre Diagnostic Radiology 15,000.00 20,000.00 10.00
73592 Stress studies, eg joint Diagnostic Radiology 22,500.00 30,000.00 15.00
73660 Toe Diagnostic Radiology 15,000.00 20,000.00 10.00
74000 Straight abdomen Diagnostic Radiology 60,000.00 80,000.00 40.00
74020 Acute abdomen studies Diagnostic Radiology 90,000.00 120,000.00 60.00
74210 Pharynx and oesophagus: plain or barium swallow Diagnostic Radiology 67,500.00 90,000.00 45.00
74242 Upper gastro-intestinal tract Diagnostic Radiology 97,500.00 130,000.00 65.00
74245 Gastro-intestinal tract, with follow through Diagnostic Radiology 81,000.00 108,000.00 54.00
74250 Small bowel meal Diagnostic Radiology 66,000.00 88,000.00 44.00
74251 Small bowel meal and follow through Diagnostic Radiology 81,000.00 108,000.00 54.00
74255 Appendix meal, without screening Diagnostic Radiology 45,000.00 60,000.00 30.00
74260 Duodenography, hypotonic Diagnostic Radiology 75,000.00 100,000.00 50.00
74261 insertion of tube add Diagnostic Radiology 22,500.00 30,000.00 15.00
74270 Barium enema Diagnostic Radiology 75,000.00 100,000.00 50.00
74272 with air contrast study add Diagnostic Radiology 7,500.00 10,000.00 5.00
SECURE &
PACKAGES PACKAGES
PACKAGES
74273 Barium meal and enema (single session) Diagnostic Radiology 105,000.00 140,000.00 70.00
74300 Cholangiography and/or pancreatography; intraoperative, radiological supervision Diagnostic Radiology 165,000.00 220,000.00 110.00
74305 post-operative Diagnostic Radiology 120,000.00 160,000.00 80.00
Percutaneous, trashepatic (For injection procedures for trnshepatic

74320 Diagnostic Radiology 120,000.00 160,000.00 80.00
cholangiography or percutaneous see 47500)
74321 Tomography of biliary tract Diagnostic Radiology BR BR BR
74325 Pneumoperitoneography (for injection see 49400) Diagnostic Radiology - - -
74340 Gastric/oesophageal/duodenal intubation control Diagnostic Radiology 45,000.00 60,000.00 30.00
74341 insertion of tube Diagnostic Radiology 22,500.00 30,000.00 15.00
74346 Bowel washout Diagnostic Radiology 7,500.00 10,000.00 5.00
74400 Urography, intravenous Diagnostic Radiology 105,000.00 140,000.00 70.00
74402 time sequence add Diagnostic Radiology 15,000.00 20,000.00 10.00
74405 voiding cysto-urethrography, without additional contrast medium add Diagnostic Radiology 15,000.00 20,000.00 10.00
74420 Retrograde pyelography Diagnostic Radiology 135,000.00 180,000.00 90.00
74430 Cystography or urethrography (retrograde) Diagnostic Radiology 135,000.00 180,000.00 90.00
74450 Cysto - urethrography (retrograde) Diagnostic Radiology 135,000.00 180,000.00 90.00
74455 Urethrocystography (retrograde) voiding Diagnostic Radiology 135,000.00 180,000.00 90.00
74472 Renal cyst puncture Diagnostic Radiology 135,000.00 180,000.00 90.00
74710 Pelvimetry Diagnostic Radiology 120,000.00 160,000.00 80.00
74740 Hystero-salpingoraphy Diagnostic Radiology 105,000.00 140,000.00 70.00
75505 Angiocardiography: first series Diagnostic Radiology 114,000.00 152,000.00 76.00
75605 Aortography: first series (For injection procedure, see 36200) Diagnostic Radiology 82,500.00 110,000.00 55.00
75616 Other arteriogra Diagnostic Radiology 82,500.00 110,000.00 55.00
75635 Cerebral angiography first two series Diagnostic Radiology 78,000.00 104,000.00 52.00
Per additional series for 74720, 75505, 75605,75616, 75785, 75905, and 75970,
add 50% to the fee - add (For injectioprocedure, see 36210, 36220)
SECURE &
PACKAGES PACKAGES
PACKAGES
Peripheral andiography, per limb: first series (For injection procedure, see 36210,
36200)
75905 Vena-cavography: first series (for injection procedure, see 36011) Diagnostic Radiology 72,000.00 96,000.00 48.00
75965 Splenoportography (For injection, see 38200) Diagnostic Radiology 82,500.00 110,000.00 55.00
75970 Venography, per field or limb Diagnostic Radiology 105,000.00 140,000.00 70.00
75985 Lymphangiography (For injection procedure, see 38790,38791) Diagnostic Radiology 450,000.00 600,000.00 300.00
76000 Fluoroscopy: per half-hour Diagnostic Radiology 22,500.00 30,000.00 15.00
76020 Bone age assessment Diagnostic Radiology 15,000.00 20,000.00 10.00
76040 Long bones length studies, per right and left pair Diagnostic Radiology 22,500.00 30,000.00 15.00
76060 Skeletal survey, over five years Diagnostic Radiology 210,000.00 280,000.00 140.00
76065 Skeletal survey, under five years Diagnostic Radiology 112,500.00 150,000.00 75.00
Radiological guidance for percutaneous drainage of abscess or specimen

76070 collection, with or without placement of indwelling catheter, radiological supervision Diagnostic Radiology 75,000.00 100,000.00 50.00
and interpretation
76082 Sinography (includes fee for injection) Diagnostic Radiology 120,000.00 160,000.00 80.00
76086 Dexa central skeletal bone mineral density study Diagnostic Radiology 75,000.00 100,000.00 50.00
76087 Dexa peripheral skeletal bone mineral density study Diagnostic Radiology 90,000.00 120,000.00 60.00
76088 QCT measurement of bone mineral density Diagnostic Radiology 90,000.00 120,000.00 60.00
76090 Mammography per side Diagnostic Radiology 37,500.00 50,000.00 25.00
76101 Tomography (pluridirectional) per projection - add 150% Diagnostic Radiology 3,000.00 4,000.00 2.00
Tomography (conventional) per projection (except where otherwise specified) add

76105 Diagnostic Radiology Add 100% Add 100% Add 100%
100%
76120 Cinematrography for first series, add 100% Diagnostic Radiology Add 100% Add 100% Add 100%
76125 Cinematrography: for subsequent series charge each 80% of primary fee for the Diagnostic Radiology Add 80% Add 80% Add 80%
76130 Foreign body localisation: fee for part, add two-thirds for each additional series, Diagnostic Radiology 22,500.00 30,000.00 15.00
76131 Foreign body localisation introduction of sterile needle markers Diagnostic Radiology 45,000.00 60,000.00 30.00
76140 Consultation in rooms, hospital or nursing home Diagnostic Radiology 22,500.00 30,000.00 15.00
Stereoscopic breast biopsy (This is a composite fee to cover the entire procedure
and there
76141 Diagnostic Radiology 1,402,500.00 1,870,000.00 935.00
will be no additional fees or tariffs charged together with the tariff
code 76141).
SECURE &
PACKAGES PACKAGES
PACKAGES
Attendance at operations except 73530 and 74300, per half-hour (plus fee for
region examined)
Where a radiography service is provided on a "call-out" basis, outside normal
working hours (weekdays 5pm to 7am, weekends Saturday 1pm to Monday 7am
and public holidays add....(Note: Where provided in conjunction with a “call-out”
radiologist service, this fee to be independent of the procedure fee. By report)
76180 Where portable X-ray unit has to be transported Diagnostic Radiology 7,500.00 10,000.00 5.00
76182 Where portable X-ray unit is kept and used in a hospital Diagnostic Radiology 7,500.00 10,000.00 5.00
76201 Surcharge per procedure requiring the use of consumables Diagnostic Radiology 7,500.00 10,000.00 5.00
76210 Conray 280, per 20ml Diagnostic Radiology 30,000.00 40,000.00 20.00
76220 Biloptin, per 6 capsules Diagnostic Radiology At cost At cost At cost
76231 Lidpiodol, per ampule Diagnostic Radiology At cost At cost At cost
76232 Urografin 30% per 250ml Diagnostic Radiology 187,500.00 250,000.00 125.00
76233 Urografin 30% per 20ml Diagnostic Radiology 15,000.00 20,000.00 10.00
76235 Biliscopin, per ampule Diagnostic Radiology At cost At cost At cost
76237 Jopamiron (Iorpamidol), per ampule Diagnostic Radiology 30,000.00 40,000.00 20.00
76240 Iohexol 240mg per 1ml, 20ml Diagnostic Radiology 30,000.00 40,000.00 20.00
76241 Iohexol 300mg per 1ml, 20ml Diagnostic Radiology 30,000.00 40,000.00 20.00
76242 Iohexol 350mg per 1ml, 1 x 20ml Diagnostic Radiology 30,000.00 40,000.00 20.00
76243 Iohexol 240mg per 1ml, 1 x 50ml Diagnostic Radiology 75,000.00 100,000.00 50.00
76244 EZHD, per 300 gms Diagnostic Radiology 75,000.00 100,000.00 50.00
76245 EZHD, 340mg Diagnostic Radiology 75,000.00 100,000.00 50.00
76247 Bariopaque, per examination Diagnostic Radiology 75,000.00 100,000.00 50.00

SECURE &
PACKAGES PACKAGES
PACKAGES
76248 Omnipaque 300mg, per 50ml Diagnostic Radiology 75,000.00 100,000.00 50.00
76249 Omnipaque 350mg, per 50ml Diagnostic Radiology 75,000.00 100,000.00 50.00
76250 Ultravist 350, per 20ml Diagnostic Radiology 30,000.00 40,000.00 20.00
76254 Magnevist 300, per 20ml Diagnostic Radiology 30,000.00 40,000.00 20.00
76256 Gastrogafin, per 100ml Diagnostic Radiology 75,000.00 100,000.00 50.00
76258 EZ Paque, per bottle Diagnostic Radiology 75,000.00 100,000.00 50.00
76259 EX Cat, per 225ml Diagnostic Radiology 337,500.00 450,000.00 225.00
76260 EZ Gas 24g Diagnostic Radiology 1,500.00 2,000.00 1.00
76262 Polibar ACB 397g Diagnostic Radiology 595,500.00 794,000.00 397.00
76264 Optiray 240, per 50ml Diagnostic Radiology 75,000.00 100,000.00 50.00
76269 Contrast media not otherwise listed Diagnostic Radiology BR BR BR
Surcharge per procedure requiring the use of Standard film, single 76269
……………
76281 each, to a maximum of two films Diagnostic Radiology 7,500.00 10,000.00 5.00
76282 each, to a maximum of three films …………………………………………………… X-Ray Film Standard Film 7,500.00 10,000.00 5.00
76283 each to a maximum of four films …………………………………………………… X-Ray Film Standard Film 7,500.00 10,000.00 5.00
76284 each, to a maximum of five films (Applicable only to procedure items 73040,76065) X-Ray Film Standard Film 7,500.00 10,000.00 5.00
each, to a maximum of six films (Applicable only to procedure codes

76285 X-Ray Film Standard Film 7,500.00 10,000.00 5.00
74455,75505,75635,75985)
each, to a maximum of eight films (Applicable only to procedure

items,72115,74270,74400,76060)
each, to a maximum of twelve films (Apllicable only to procedure items

72270,74273)
SECURE &
PACKAGES PACKAGES
PACKAGES
76290 Surcharge per procedure requiring the use of laser film, single X-Ray Film Standard Film 30,000.00 40,000.00 20.00
76291 each to a maximum ot two films X-Ray Film Standard Film 30,000.00 40,000.00 20.00
76292 each to a maximum of three films X-Ray Film Laser Film 30,000.00 40,000.00 20.00
each to maximum of four films (Applicable to procedure items

76293 X-Ray Film Laser Film 30,000.00 40,000.00 20.00
76430,76434,77017,77037,77511,77512,77514,77515,77517,77519,
76295 each to a maximum of six films X-Ray Film Laser Film 30,000.00 40,000.00 20.00
76296 each to a maximum of seven films X-Ray Film Laser Film 30,000.00 40,000.00 20.00
76297 each to a maximum of eight films X-Ray Film Laser Film 30,000.00 40,000.00 20.00
76301 Hyperinflation practice expense surcharge, per attendance X-Ray Film Laser Film - - -
76302 Cash co-payment per attendance X-Ray Film Laser Film - - -
76310 Thyroid imaging; only Nuclear Medicine- 202,500.00 270,000.00 135.00
76311 with vascular flow Nuclear Medicine- 235,500.00 314,000.00 157.00
Nuclear MedicineDiagnostic
76312 Thyroid carcinoma metastates imaging: limited area (e.g neck and chest only) 328,500.00 438,000.00 219.00
Endocrine
76314 Multiple areas, whole body - - -
Endocrine
76315 Multiple areas, whole body - - -
Endocrine
76320 Bone marrow imaging; limited area 189,000.00 252,000.00 126.00
Endocrine
76321 multiple areas 280,500.00 374,000.00 187.00
Endocrine
76322 whole body Nuclear Medicine- 345,000.00 460,000.00 230.00
Spleen imaging only, with or without vascular flow (If combined with liver study, use
76326 Nuclear Medicine- 193,500.00 258,000.00 129.00
procedures 76334 and 76335)
76329 Lymphatics and lymph glands imaging Nuclear Medicine- 334,500.00 446,000.00 223.00
76331 Liver imaging; static only Nuclear Medicine- 196,500.00 262,000.00 131.00
76333 Liver imaging (SPECT) Nuclear Medicine- 456,000.00 608,000.00 304.00
76334 Liver imaging: static only Nuclear Medicine- 240,000.00 320,000.00 160.00

SECURE &
PACKAGES PACKAGES
PACKAGES
76336 Liver function study with hepatobiliary agents, with serial images. Nuclear Medicine- 291,000.00 388,000.00 194.00
Hepato-biliary ductal system imaging, including gallbladder, with or without

76337 pharmacologic intervention, with or without quantitative measurement of gallbladder Nuclear Medicine- 321,000.00 428,000.00 214.00
function
76345 Acute gastro-intestinal blood loss imaging Nuclear Medicine- 415,500.00 554,000.00 277.00
76346 Gastro-intestinal blood loss study (e.g Stool counting) Nuclear Medicine- 243,000.00 324,000.00 162.00
76348 Bowel imaging (e.g Ectopic gastric mucosa, Meckel's Localisation, volvulus Nuclear Medicine- 258,000.00 344,000.00 172.00
76410 Bone and/or joint imaging; limited area Nuclear Medicine- 219,000.00 292,000.00 146.00
76411 multiple areas Nuclear Medicine- 312,000.00 416,000.00 208.00
76412 whole body Nuclear Medicine- 354,000.00 472,000.00 236.00
76413 vascular flow only Nuclear Medicine- 127,500.00 170,000.00 85.00
76414 three phase study Nuclear Medicine- 400,500.00 534,000.00 267.00
76415 tomographic (SPECT) Nuclear Medicine- 474,000.00 632,000.00 316.00
76420 Vascular flow imaging (e.g angiography, venography) Nuclear Medicine- 166,500.00 222,000.00 111.00
Myocardial perfusion imaging; single study, resting or stress (exercise and/or

pharmacologic), quantitative or qualitative
multiple studies, resting and/or stress (exercise and/or pharmacologic), and

redistribution and/or rest injection, qualitative or quantitative
Tomographic (SPECT), single study at rest or stress (exercise and/or

pharmacologic, with or without quantification
76426 Myocardial imaging; infarct, avid, planar; qualitative or quantitative Nuclear Medicine- 234,000.00 312,000.00 156.00
76427 with ejection fraction by first pass technique Nuclear Medicine- 309,000.00 412,000.00 206.00
tomographic (SPECT) with or without

quantification………………………………………………………..
Cardiac blood pool imaging, gated equilibrium; single study at rest wall motion
study plus ejection fraction, with or without additional quantitative processing
multiple studies, wall motion study plus ejection fraction, resting and stress (with
exercise and/or pharmacologic), with or without additional quantification
Myocardial perfusion imaging with wall motion, qualitative or quantitative study (list
76431 separately in addition to code for primary Nuclear Medicine- 162,000.00 216,000.00 108.00
procedure) (Use only for codes 76422, 76423, 76424)
Myocardial perfusion study with ejection fraction (list separately in addition to code
for primary procedure) (use only for codes 76422, 76423, 76424)
Cardiac blood pool imaging, first pass technique; single study, at rest, wall motion
study, with ejection fraction
multiple studies, resting and with stress (exercise and/or pharmacologic), with or
without additional quantification
SECURE &
PACKAGES PACKAGES
PACKAGES
76440 Pulmonary perfusion imaging; articulate Nuclear Medicine- 298,500.00 398,000.00 199.00
76441 gaseous Nuclear Medicine- 225,000.00 300,000.00 150.00
76442 gaseous, with ventilation, re-breathing and washout 336,000.00 448,000.00 224.00
Respiratory
Pulmonary perfusion imaging; particulate, with ventilation; single breath Nuclear MedicineDiagnostic
76443 307,500.00 410,000.00 205.00
……………….. Respiratory
re-breathing and washout, with or without single Nuclear MedicineDiagnostic

76444 475,500.00 634,000.00 317.00
breath……………………………………….. Respiratory
76445 Pulmonary ventilation imaging, aerosol; single projection 208,500.00 278,000.00 139.00
Respiratory
76446 multiple projections (e.g anterior, posterior, lateral views) 232,500.00 310,000.00 155.00
Respiratory
76447 Pulmonary ventilation imaging, gaseous, single breath, single projection 226,500.00 302,000.00 151.00
Respiratory
Pulmonary ventilation imaging, gaseous, with rebreathing and washout, with or Nuclear MedicineDiagnostic
76448 273,000.00 364,000.00 182.00
without single breath; single projection Respiratory
76449 multiple projections (e.g anterior, posterior, lateral views) 379,500.00 506,000.00 253.00
Respiratory
76450 Pulmonary quantitative differential function (Ventilation/perfusion) study 588,000.00 784,000.00 392.00
Respiratory
76452 Brain, imaging, limited procedure; static 232,500.00 310,000.00 155.00
Nervous
76453 with vascular flow 274,500.00 366,000.00 183.00
Nervous
76454 Brain, imaging, complete study; static 276,000.00 368,000.00 184.00
Nervous
Nervous
76456 tomographic (SPECT) 549,000.00 732,000.00 366.00
Nervous
76457 Brain Imaging, vascular flow only 132,000.00 176,000.00 88.00
Nervous
76458 Cerebral blood flow 298,500.00 398,000.00 199.00
Nervous
76460 cerebrospinal fluid flow, imaging (not including introduction of material); 396,000.00 528,000.00 264.00
Nervous
76461 ventriculography 226,500.00 302,000.00 151.00
Nervous
76462 shunt evaluation 282,000.00 376,000.00 188.00
Nervous
76463 SF leakage detection and localisation 364,500.00 486,000.00 243.00
Nervous
76464 tomographic (SPECT) 474,000.00 632,000.00 316.00
Nervous
76465 Radio nuclide identification of eye tumour 382,500.00 510,000.00 255.00
Nervous
SECURE &
PACKAGES PACKAGES
PACKAGES
76470 Kidney imaging; static only 243,000.00 324,000.00 162.00
Nervous
Nervous
76472 with function study (ie imaging renogram) Nuclear Medicine- 331,500.00 442,000.00 221.00
76473 with vascular flow and function study Nuclear Medicine- 385,500.00 514,000.00 257.00
76474 Kidney imaging (SPECT) Nuclear Medicine- 451,500.00 602,000.00 301.00
76475 Kidney vascular flow only Nuclear Medicine- 132,000.00 176,000.00 88.00
76476 Kidney function study without pharmacologic intervention Nuclear Medicine- 117,000.00 156,000.00 78.00
76477 Kidney function study including pharmacologic intervention Nuclear Medicine- 279,000.00 372,000.00 186.00
76480 Urinary blooder residual study Nuclear Medicine- 130,500.00 174,000.00 87.00
76481 Ureteral reflex study (radionuclide voiding cystogram) Nuclear Medicine- 195,000.00 260,000.00 130.00
76483 Testicular imaging Nuclear Medicine- 279,000.00 372,000.00 186.00
Generation of automated data: interactive process involving nuclear physician

76490 and/or allied professional personnel; simple manipulations and interpretation. Nuclear Medicine- 90,000.00 120,000.00 60.00
Exceeding 30minutes
76491 complex manipulations and interpretation, exceeding 30 minutes. Nuclear Medicine- 181,500.00 242,000.00 121.00
100% UP TO 100% UP TO 100% UP TO

76494 Provision for radio-pharmacetical (s) Nuclear Medicine-
BENEFIT LIMIT BENEFIT LIMIT BENEFIT LIMIT
100% UP TO 100% UP TO 100% UP TO

76495 Provision for diagonstic radionuclide (s) Nuclear Medicine-
BENEFIT LIMIT BENEFIT LIMIT BENEFIT LIMIT
76496 Handling charge, add Nuclear Medicine- Add 10% Add 10% Add 10%
76499 Unlisted miscellaneous procedure, diagnostic nuclear medicine Nuclear Medicine- BR BR BR
76501 Hyperinflation practice expense surcharge, per attendance Nuclear Medicine- - - -
76502 Ultrasound Co-payment per attendance Nuclear Medicine- - - -
Thyroid examination (high resolution B-mode) including assessment for neck

76535 Diagnostic Ultrasound 52,500.00 70,000.00 35.00
nodes, with or without color Doppler
76540 Two dimensional ultrasonography of the paediatric brain. Diagnostic Ultrasound 37,500.00 50,000.00 25.00
Two-dimensional high resolution ultrasonography of one or both breasts including

axillae, with or withour color Doppler assessment
76660 Eye and orbit, unilateral or bilateral assessment Diagnostic Ultrasound 37,500.00 50,000.00 25.00
SECURE &
PACKAGES PACKAGES
PACKAGES
76662 Cutaneous lesions such as lumps, ganglia, etc Diagnostic Ultrasound 37,500.00 50,000.00 25.00
76665 Musculoskeletal - tendons, muscles, rotator cuff, etc Diagnostic Ultrasound 37,500.00 50,000.00 25.00
76710 Liver sonogram (B-scan) Diagnostic Ultrasound 37,500.00 50,000.00 25.00
76720 Gallbladder sonogram (B-scan) Diagnostic Ultrasound 37,500.00 50,000.00 25.00
76730 Kidney sonogram, one or both kidnesy (B-scan) Diagnostic Ultrasound 37,500.00 50,000.00 25.00
76740 Pancreas sonogram (B-scan) Diagnostic Ultrasound 37,500.00 50,000.00 25.00
76750 Spleen sonogram (B-scan) Diagnostic Ultrasound 37,500.00 50,000.00 25.00
76765 Aorta sonogram (B-scan) Diagnostic Ultrasound 37,500.00 50,000.00 25.00
76770 Retroperitoneal space sonogram (B-scan) Diagnostic Ultrasound 37,500.00 50,000.00 25.00
76780 Urinary bladder (B-scan) Diagnostic Ultrasound 37,500.00 50,000.00 25.00
76790 Parts not covered by an of the above. By Report (B.R.) Diagnostic Ultrasound 37,500.00 50,000.00 25.00
Pregnancy and foetal age determination, placental localisation, foetal well being),
initial
76815 subsequent/repeat Diagnostic Ultrasound 45,000.00 60,000.00 30.00
76816 Where two or more scans are performed for follicle maturation, an all-inclusive fee Diagnostic Ultrasound 45,000.00 60,000.00 30.00
76830 Uterus and adnexae, trans-vaginal assessment Diagnostic Ultrasound 60,000.00 80,000.00 40.00
Uterus and adnexae, trans-abdominal assessment including the bladder and female
pelvic mass examination
Testes/Scrotum, search for undescended testes (high resolution B-mode), with or

without color doppler assessment
Prostate assessment , trans-abdominal assessment including pre and post

micturition assessment of bladder, with or without color Doppler assessment
76872 Prostate and seminal vesicles, transrectal assessment Diagnostic Ultrasound 52,500.00 70,000.00 35.00
Doppler echocardiography, pulsed wave and/or continuous wave with spectral

display;
Echocardiography, including real-time with image documentation

(2D)………………………
Echocardiography, during rest and cardiovascular stress treadmill or bicycle

exercise,
Duplex scan of extra cranial arteries; complete bilateral study including 2D

imaging…..
76941 follow up or limited study Diagnostic Ultrasound 22,500.00 30,000.00 15.00

SECURE &
PACKAGES PACKAGES
PACKAGES
76945 Transcranial doppler study of the intracranial arteries; complete study including 2D Diagnostic Ultrasound 22,500.00 30,000.00 15.00
76946 follow up or limited study Diagnostic Ultrasound 15,000.00 20,000.00 10.00
Duplex scan of lower extremity arteies or arterial bypass grafts; complete bilateral
study
76951 Follow-up or limited study including 2D imaging Diagnostic Ultrasound 52,500.00 70,000.00 35.00
76955 Duplex scan of b-pass grafts; complete bilateral study inc 2D imaging. Diagnostic Ultrasound 60,000.00 80,000.00 40.00
Duplex scan of extremity veins inc responses to compression and other

manoeuveres; complete bilateral study including 2D imaging
Duplex scanof arterial inflow and venous outflow of abdominal, pelvic and/or
retroperitoneal organs; complete study including 2D imaging
Duplex scanning of aorta, inferior vena cava, liac vasculatre, or by-pass grafts,
complete study including 2D imaging
76970 Duplex scan of arterial inflow and venous outflow of penile vessels;complete study Diagnostic Ultrasound 37,500.00 50,000.00 25.00
Radiological guidence for pertaneous drainage of abscess or specimen collection,

76980 with or without placement of indwelling catheter, radiological supervision and Diagnostic Ultrasound 120,000.00 160,000.00 80.00
interpretation
76990 Colour Flow mapping add Diagnostic Ultrasound 60,000.00 80,000.00 40.00
76996 Mileage Radiologist per km Diagnostic Ultrasound - - -
76997 Mileage Radiologist per km Diagnostic Ultrasound - - -
RADIOLOGY-CT
77001 CT Brain Computed Tomography 225,000.00 300,000.00 150.00
77002 - without contrast, followed by contrast and further sections Computed Tomography 262,500.00 350,000.00 175.00
77005 CT Brain with add computer reconstructions (sagg, coro,oblique) Computed Tomography 225,000.00 300,000.00 150.00
77007 CT Angiography Brain Computed Tomography 240,000.00 320,000.00 160.00

SECURE &
PACKAGES PACKAGES
PACKAGES
77009 Orbit/Sella/Post Fossa/outer or inner or mid ear Computed Tomography 270,000.00 360,000.00 180.00
77012 CT Neck larynx soft tissue Computed Tomography 315,000.00 420,000.00 210.00
77015 CT Angiography Neck Computed Tomography 240,000.00 320,000.00 160.00
77016 Thorax/mediastinum from apex of lungs to below diapragm Computed Tomography 202,500.00 270,000.00 135.00
77019 CT Angiography - Thorax Computed Tomography 240,000.00 320,000.00 160.00
Abdomen including base of lungs down to bifurcation of the aorta, with or without
77022 Computed Tomography 240,000.00 320,000.00 160.00
oral contrast.
77025 CT angiography - abdomen Computed Tomography 240,000.00 320,000.00 160.00
77028 Pelvis with or without rectal contrast Computed Tomography 240,000.00 320,000.00 160.00
Spine, one region (eg Cervical, upper or lower thoracic, lumber) wth or without
additional
77036 Spine with additonal computer reconstructon(sagg,obl,coron) Computed Tomography 480,000.00 640,000.00 320.00
77044 Limbs and other limited exams Computed Tomography 240,000.00 320,000.00 160.00
77045 Hip,shoulder etc Computed Tomography 210,000.00 280,000.00 140.00
77047 CT Angiography Legs Computed Tomography 240,000.00 320,000.00 160.00
77070 CT Cash copayment Computed Tomography - - -
77071 CT cash copayment Computed Tomography - - -
Head or body limited for known tumour or other lesin for radiotherapy planning or
biopsy
Radiological guidence for pertaneous drainage of abscess or specimen collection,

with or
77085 Repeat examination within 6 weeks of 1st Computed Tomography BR BR BR

SECURE &
PACKAGES PACKAGES
PACKAGES
UP TO BENEFIT UP TO BENEFIT UP TO BENEFIT

77090 IV Contrast materials Computed Tomography
LIMIT LIMIT LIMIT
77091 Cardiac Calcium Scoring Computed Tomography 360,000.00 480,000.00 240.00
77092 Cardiac and Coronary CT Angiography Computed Tomography 1,044,000.00 1,392,000.00 696.00
77093 Cardiac Functional Analysis Computed Tomography 270,000.00 360,000.00 180.00
77294 Typical -2D Dimensional Course of care Computed Tomography 6,654,000.00 8,872,000.00 4,436.00
77295 Typical- 3D Typical Course Dimension Course of care Radiation Oncology 15,750,000.00 21,000,000.00 10,500.00
77371 Stereotactic radio surgery (SRS) -1 Fraction Radiation Oncology 6,390,000.00 8,520,000.00 4,260.00
77387 IMRT with CT scan for therapy guide (IGRT)-29 Fractions (Package/Benefit based) Radiation Oncology 35,925,000.00 47,900,000.00 23,950.00
RADIOLOGY - MRI
77450 MRI hyperinflation Magnetic Resonance - - -
77451 MRI copayment Magnetic Resonance - - -
77500 Temperomandibular joints Magnetic Resonance 528,000.00 704,000.00 352.00
77510 Orbit, face, neck Magnetic Resonance 630,000.00 840,000.00 420.00
77511 Brain including brain stem Magnetic Resonance 630,000.00 840,000.00 420.00
77512 Brain including brain stem with contrast material Magnetic Resonance 630,000.00 840,000.00 420.00
Brain including brain stem without contrast material, followed by contrast material
77513 Magnetic Resonance 1,275,000.00 1,700,000.00 850.00
and further sequences
77514 Chest ( eg for evaluation of hilr and mediastinum lymphadenoplasty) Magnetic Resonance 607,500.00 810,000.00 405.00
77515 Cervical spine canal and contents, without contrast material. Magnetic Resonance 592,500.00 790,000.00 395.00
77516 Cervical spine canal and contents, with contrast material. Magnetic Resonance 652,500.00 870,000.00 435.00
77517 Thoracic spine canal and contents, without contrast material. Magnetic Resonance 592,500.00 790,000.00 395.00
77518 Thoracic spine canal and contents, with contrast material. Magnetic Resonance 652,500.00 870,000.00 435.00
77519 Lumbar spine canal and contents, without contrast material. Magnetic Resonance 592,500.00 790,000.00 395.00
77520 Lumbar spine canal and contents, with contrast material. Magnetic Resonance 652,500.00 870,000.00 435.00
Cervical spine canal and contents, without contrast material followed by contrast
material
SECURE &
PACKAGES PACKAGES
PACKAGES
Thoracic spine canal and contents, without contrast material followed by contrast
material
Lumbar spine canal and contents, without contrast material followed by contrast
material
77524 Pelvis Magnetic Resonance 532,500.00 710,000.00 355.00
77525 Upper extremity not joint Magnetic Resonance 532,500.00 710,000.00 355.00
77526 Any joint of upper extremity eg shoulder, elbow Magnetic Resonance 652,500.00 870,000.00 435.00
77527 Lower extremity not joint Magnetic Resonance 532,500.00 710,000.00 355.00
77528 an joint of lower extremities, ankle etc Magnetic Resonance 682,500.00 910,000.00 455.00
77529 Abdomen Magnetic Resonance 592,500.00 790,000.00 395.00
77530 Myocardium Magnetic Resonance 592,500.00 790,000.00 395.00
77531 Bone marrow supply Magnetic Resonance 592,500.00 790,000.00 395.00
77532 Brain Magnetic Resonance 660,000.00 880,000.00 440.00
77533 Large vessels neck Magnetic Resonance 652,500.00 870,000.00 435.00
77534 Large vessels chest Magnetic Resonance 652,500.00 870,000.00 435.00
77535 Large vessels abdomen Magnetic Resonance 652,500.00 870,000.00 435.00
77536 Large vessels legs Magnetic Resonance 652,500.00 870,000.00 435.00
77537 Heart Magnetic Resonance 652,500.00 870,000.00 435.00
Contrast Medium (not applicable to codes

77550 Magnetic Resonance 225,000.00 300,000.00 150.00
77512,77513,77516,77516,77518,77520,77520,77521,77522 and 77523)
RADIOTHERAPY
78001 Stimulator film per procedure Radiotherapy 19,500.00 26,000.00 13.00
78005 Making an outline or contour Radiotherapy 75,000.00 100,000.00 50.00
78007 Simulation of treatment field, per field, simple Radiotherapy 15,000.00 20,000.00 10.00
78008 Complex Radiotherapy 124,500.00 166,000.00 83.00
Contact and superficial theraphy, malignant and benign lesions, per treatment day,
78010 Radiotherapy 30,000.00 40,000.00 20.00
1 or 2 fields
78011 each additional field Radiotherapy 13,500.00 18,000.00 9.00

SECURE &
PACKAGES PACKAGES
PACKAGES
78015 Deep X - Ray theraphy and 60 cobalt therapy, per treatment day, 1 or 2 fields Radiotherapy 58,500.00 78,000.00 39.00
78020 Linear accelerator, 1 or 2 fields Radiotherapy 75,000.00 100,000.00 50.00
78025 Planning of field treatment, simple Radiotherapy 24,000.00 32,000.00 16.00
78026 complex ( computerised ) Radiotherapy 150,000.00 200,000.00 100.00
78028 Cobalt Radiotherapy 112,500.00 150,000.00 75.00
78030 Radioactive eye application, per application Radiotherapy 30,000.00 40,000.00 20.00
78035 Caesium implant up to 6 needles or grains Radiotherapy 142,500.00 190,000.00 95.00
78036 up to 10 needles or grains Radiotherapy 268,500.00 358,000.00 179.00
78040 Caesium insertion - uterine and/ or vaginal for artificial menopause or menorrhagia Radiotherapy 112,500.00 150,000.00 75.00
Caesium insertion - uterine and/ or vaginal, rectal, oral, etc. for malignant disease,
78041 Radiotherapy 223,500.00 298,000.00 149.00
first insertion
78042 subsequent insertions Radiotherapy 150,000.00 200,000.00 100.00
78045 H. D. R ( High Dose Rate) intra cavity insertion, first insertion Radiotherapy 375,000.00 500,000.00 250.00
78046 each subsequent insertion Radiotherapy 300,000.00 400,000.00 200.00
78050 Simulator film, per film Radiotherapy 19,500.00 26,000.00 13.00
78052 Making an outline or contour Radiotherapy 75,000.00 100,000.00 50.00
78055 Simulation of treatment field, simple Radiotherapy 15,000.00 20,000.00 10.00
78056 Complex Radiotherapy 124,500.00 166,000.00 83.00
Contact and superficial therapy, malignant and benign lesions, per treatment day, 1
78058 Radiotherapy 30,000.00 40,000.00 20.00
or 2 fields
78062 Deep X - ray therapy and 60 cobalt thaerapy, per treatment day , 1 or 2 fields Radiotherapy 58,500.00 78,000.00 39.00

SECURE &
PACKAGES PACKAGES
PACKAGES
78065 Linear accelerator, 1 or 2 fields Radiotherapy 75,000.00 100,000.00 50.00
78068 Planning of treatment field, field Radiotherapy 24,000.00 32,000.00 16.00
78069 Complex ( computerised ) Radiotherapy 150,000.00 200,000.00 100.00
78070 Cobalt Radiotherapy 223,500.00 298,000.00 149.00
78072 Radioactive eye application, per application Radiotherapy 60,000.00 80,000.00 40.00
78075 Caesium implant - up to 6 needles or grains Radiotherapy 283,500.00 378,000.00 189.00
78080 Caesium insertion - uterine and/ or vaginal for artificial menopause or menorrhagia Radiotherapy 225,000.00 300,000.00 150.00
Caesium insertion - uterine and/ or vaginal, rectal, oral, etc, for malignant disease,
78081 Radiotherapy 450,000.00 600,000.00 300.00
first insertion
78085 H. D. R ( High Dose Rate ) intra cavity insertion, first insertion Radiotherapy 750,000.00 1,000,000.00 500.00
78090 Admission for chemotherapy administration per day Radiotherapy 199,500.00 266,000.00 133.00
78111 131 Iodine, per 50 mCl Radiotherapy 375,000.00 500,000.00 250.00
PHYSIOTHERAPY
79010 Initial assessment at rooms, hospital, nursing home or patient's residence Physiotherapy 27,000.00 36,000.00 18.00
79012 Subsequent assessment at rooms, hospital, nursing home, up to 15 miutes Physiotherapy 21,000.00 28,000.00 14.00
79014 Pre/Post operative assessment of patient not requiring further therapy Physiotherapy 18,000.00 24,000.00 12.00
79016 Individual therapy at rooms, hospital, nursing home, up to 15 minutes Physiotherapy 18,000.00 24,000.00 12.00
79017 15 to 30 minutes Physiotherapy 30,000.00 40,000.00 20.00

SECURE &
PACKAGES PACKAGES
PACKAGES
emergency or other essential therapy carried out during a weekend or public

79022 Physiotherapy 52,500.00 70,000.00 35.00
holiday or out of normal working hours
Individual routine therapy at hospital or nursing home when only one patient to be
79024 Physiotherapy 42,000.00 56,000.00 28.00
treated
Individual therapy at patients residence where condition of the patient precludes

79025 Physiotherapy 57,000.00 76,000.00 38.00
treatment at the physiotherapists rooms
79031 Group therapy, at rooms, hospital, or nursing home, per person per session Physiotherapy 7,500.00 10,000.00 5.00
Mileage. Per kilometre travelled. Applicable to all domicilary visits and to

79040 emergency and other essential visits to rooms, hospital or nursing home during Physiotherapy 465.00 620.00 0.31
weekends and public holidays or outside normal working hours.
NURSING
79220 Initaial ante-natal consultation Nursing 21,000.00 28,000.00 14.00
Subsequent ante-natal consultation- per consultation- to a maximum of nine

79221 Nursing 15,000.00 20,000.00 10.00
consultations
Vaginal delivery (certificate of the midwife's presence at the delivery or arrival within
79222 ten minutes of the delivery is required through endorsement of the claim to this Nursing 127,500.00 170,000.00 85.00
effect)
79223 Breech delivery Nursing 216,000.00 288,000.00 144.00
Twin delivery (uncomplicated): full appropriate fee for the major delivery and 50%
79224 Nursing 216,000.00 288,000.00 144.00
(add modifier 18) of the second appropriate delivery fee.
79225 Post-natal consultation- per consultation- to a maximum of five consultations Nursing 15,000.00 20,000.00 10.00
Maternity (vaginal delivery), per day, up to a maximum of seven days less the
79235 number of days the patient was in hospital. To include care and supervision of the Nursing 30,000.00 40,000.00 20.00
mother and baby
79236 Acute medical and post-surgical care, per visit, to a maximum of ten visits Nursing 30,000.00 40,000.00 20.00
79237 - thereafter, per visit to a maximum of twenty visits Nursing 18,000.00 24,000.00 12.00
79238 Terminal care, per visit, to a maximum of ninety days Nursing 30,000.00 40,000.00 20.00
Routine care for chronic disabling illness, per visit, to a maximum of two visits per
79242 Nursing 18,000.00 24,000.00 12.00
week
Basic chronic care by an auxiliary nurse (eg. Red Cross Nurse) under the
79245 Nursing 15,000.00 20,000.00 10.00
supervision of a registered general nurse, per twelve hours or part thereof
Basic nursing care of an acutely ill patient by an auxiliary nurse (eg. Red Cross
Nurse) under the supervision of a registered general nurse per hour up to a
79246 Nursing 21,000.00 28,000.00 14.00
maximum per day….. Limited to a total of 180 days, with a report required after any
thirty day period of continuous care.
79281 Consultation and therapy at rooms (independent procedure) Nursing 18,000.00 24,000.00 12.00
Consultation and therapy at patient's residence- hospital or nursing home

79282 Nursing 30,000.00 40,000.00 20.00
79283 Individual consultation, counseling, planning and/or assessment at rooms Nursing 57,000.00 76,000.00 38.00
Individual consultation, counseling, planning and/or assessment at home, nursing

79284 Nursing 37,500.00 50,000.00 25.00
home or residence.
79285 Individual consultation, counseling, planning and/or assessment in Hospital. Nursing 30,000.00 40,000.00 20.00
SECURE &
PACKAGES PACKAGES
PACKAGES
79286 MLD, IncludesManual Lympatic Drainage, soft tissue mobilisation Nursing 48,000.00 64,000.00 32.00
Application of multilayyered compression system of leg (below knee) inc ankle @

79287 Nursing 18,000.00 24,000.00 12.00
leg
Application of Multilayered compression system of thigh and leg inc ankle & foot
79288 Nursing 18,000.00 24,000.00 12.00
entire leg
79289 Application of multi layered compression system of upper arm and forearm Nursing 18,000.00 24,000.00 12.00
Mileage: per km travelled to a maximum of 10 km per visit from practitioner’s base

79290 Nursing 465.00 620.00 0.31
(or maximum of 20km including return journey)
79291 Application of multilayered comp entire arm Nursing 18,000.00 24,000.00 12.00
79292 Treatment of simple burns dressing only Nursing 4,500.00 6,000.00 3.00
79293 Treatment of simple burns requiring dres Nursing 12,000.00 16,000.00 8.00
79294 Simple dressing (Conventional Dressing)-Current fees Nursing 19,500.00 26,000.00 13.00
Advanced Wound Care Dressing -Wound Irrigation -Weekly Dressings -(Not limited
79295 to the following Advance Dressing Groups- Hydro gels/Silicon Nursing 54,000.00 72,000.00 36.00
gels/Foam/Transparent film collagens/Hydro-fibre)
79300 Stoma irrigation 60 minutes. Nursing 6,000.00 8,000.00 4.00
Simple stoma - a well constructed, sited stoma which is easy to pouch. Very little or
79301 Nursing 75,000.00 100,000.00 50.00
no peristomal skin excoriation.
79302 Moderate stoma,-fairly well constructed Nursing 12,000.00 16,000.00 8.00
79303 Complex stoma -a poorly constucted, non Nursing 15,000.00 20,000.00 10.00
79304 Initial Consultation Nursing 27,000.00 36,000.00 18.00
79305 Subsequent consultation….............................................................. Nursing 15,000.00 20,000.00 10.00
79306 Observation of up to 8 hours…............................................... Nursing 15,000.00 20,000.00 10.00
Dressing- complex, requiring probing, irrigation, pluggingor debridement.Per day to

79307 Nursing 7,500.00 10,000.00 5.00
a maximum of seven days.
Injection given by Registered General, Enrolled or Certified Nurse ( if not
immediately subsequent to a consultation). Where a consultation was not
79308 Nursing 3,000.00 4,000.00 2.00
performed and the nurse attended to the patient with the sole purpose of
adminstering intramuscular or intraveneous medication to be stated, as well as the
Any urinary tract procedure including catheterisation bladder stimulation and
79309 Nursing 30,000.00 40,000.00 20.00
emptying…............................
Condom catheter aplication, penile dressing,catheter care including bag change or

79310 Nursing 4,500.00 6,000.00 3.00
catheter removal…..................
79311 Suturing and Removal…................... Nursing 7,500.00 10,000.00 5.00
Incision and Drainage of infected or non infected sebaceous cyst, one

79312 Nursing 30,000.00 40,000.00 20.00
lesion…..............................................................................................................
79313 Puncture aspiration of abscess or haematoma…................................... Nursing 22,500.00 30,000.00 15.00

SECURE &
PACKAGES PACKAGES
PACKAGES
79314 Nasogastric tube insertion, feeding and removal…................................. Nursing 7,500.00 10,000.00 5.00
79315 Gastric lavage, therapeutic-detention time plus…....................................... Nursing 7,500.00 10,000.00 5.00
79316 Nebulisation 15-30 minutes…....................... Nursing 7,500.00 10,000.00 5.00
79317 Nebulisation 30-45 minutes…............... Nursing 15,000.00 20,000.00 10.00
79318 Nebulisation 45-60 minutes…................. Nursing 22,500.00 30,000.00 15.00
79319 Nasal and/ or post nasal pack for severe epistaxis…......... Nursing 7,500.00 10,000.00 5.00
79320 Routine care of Chronic patient maximum 2 weeks…....... Nursing 15,000.00 20,000.00 10.00
79321 Venepunture or heel prick for pathological investigation…… Nursing 7,500.00 10,000.00 5.00
79322 Glucometer checks…............... Nursing 4,500.00 6,000.00 3.00
79324 Rapid HIV Testing…....................... Nursing 7,500.00 10,000.00 5.00
79325 Mlaria para check test…................. Nursing 4,500.00 6,000.00 3.00
79326 Urine, pregnancy test…..................... Nursing 1,500.00 2,000.00 1.00
79327 Prostrate Specific Antigen (PSA) point of care test by nurse Nursing 5,400.00 7,200.00 3.60
79330 Global fees, simple stoma -permanant inc Nursing 150,000.00 200,000.00 100.00
79331 global fee moderate stoma Nursing 165,000.00 220,000.00 110.00
79332 Global fee comlex stoma-permanant Nursing 180,000.00 240,000.00 120.00
All-inclusive global fee for the setting up of an IV line and adminstration of

79334 Nursing 7,500.00 10,000.00 5.00
intraveneous therapy by a registered nurse…
79335 Intraveneous Infusion (paediatric)…................. Nursing 15,000.00 20,000.00 10.00
79336 Intraveneous Infusion (adult)….......................... Nursing 12,000.00 16,000.00 8.00
79401 Family planning Consultation Nursing 10,500.00 14,000.00 7.00
79402 Jadelle/ Implanon insertion…................. Nursing 22,500.00 30,000.00 15.00
79403 Jadelle/ Implanon removal…................. Nursing 22,500.00 30,000.00 15.00
79404 IUD Insertion…....................... Nursing 22,500.00 30,000.00 15.00
79405 IUD Removal….................... Nursing 12,000.00 16,000.00 8.00

SECURE &
PACKAGES PACKAGES
PACKAGES
79406 Post- Abortal care…............. Nursing 75,000.00 100,000.00 50.00
79407 Vaginal Inspection with Acetic acid…........... Nursing 22,500.00 30,000.00 15.00
IMMUNOLOGY
86003 Allergen specific IgE antibodies against inhaled allergen sources (M). Immunology 15,000.00 20,000.00 10.00
86004 Allergen specific IgE antibodies against food allergen sources (M) …….. Immunology 15,000.00 20,000.00 10.00
Allergen specific IgE antibodies against inhalation and food allergens

86005 Immunology 15,000.00 20,000.00 10.00
sources…(O)……………………
86146 Beta 2 glycoprotein I antibody each IgG class…………………………. Immunology 57,000.00 76,000.00 38.00
86147 Cardiolipin (phospholipid) antibody each IgG class……………………. Immunology 67,500.00 90,000.00 45.00
86153 Physician interpretation and report when required……………………. Immunology - - -
86160 Complement antigen each component … (I)………………………. Immunology 4,500.00 6,000.00 3.00
86162 Total haemolytic complement (CH50)………………………………….. Immunology 67,500.00 90,000.00 45.00
86226 Allergen microarray for molecular diagnosis of allergy ………………. Immunology 4,500.00 6,000.00 3.00
Immunoglobulin subclasses (IgG1, IgG2, IgG3, IgG4 and IgA1 and IgA2
86228 Immunology 4,500.00 6,000.00 3.00
(F)…..............
86234 IgG antibodies against nuclear antigens …..(L) Immunology 15,000.00 20,000.00 10.00
Extractable Nuclear antigen, antibody to any method (eg nrnp, SS-A, SS- B, RNP,
86235 Immunology 40,500.00 54,000.00 27.00
Scl-70, Jo-1, dsdna, PCNA etc.)… (L)………………………..
86237 IgG antibodies against nucleoli in systemic sclerosis… (L)………… Immunology 40,500.00 54,000.00 27.00
86238 IgG antibodies in autoimmune liver diseases (IgG)…. (K)…………… Immunology 40,500.00 54,000.00 27.00
86304 IgG antibodies in Paraneoplastic Neurologic Syndromes… (J)………… Immunology 40,500.00 54,000.00 27.00
86326 Igg antibodies in Autoimmune inflammatory myopathies … (L)…….. Immunology 40,500.00 54,000.00 27.00
86337 Insulin antibodies … (T*1)……………..…………………….. Immunology 1,500.00 2,000.00 1.00
Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blast

86353 Immunology 40,500.00 54,000.00 27.00
genesis …... (T*1)……………………………………………
86355 B cell, total count (CD19, CD20)…. (T*1)……………………………… Immunology 67,500.00 90,000.00 45.00
86359 T cells total count (CD3)…. (T*1)………………………………… Immunology 67,500.00 90,000.00 45.00
86367 Stem cells (i.e. CD34) total count…. (T*1)……………………. Immunology 67,500.00 90,000.00 45.00
SECURE &
PACKAGES PACKAGES
PACKAGES
Tuberculosis test, cell mediated immunity antigen response measurement gamma

86480 Immunology 18,000.00 24,000.00 12.00
interferon…. (T*1)………………………………………..
86485 Skin test candida … (T*1)……………………………………………. Immunology 15,000.00 20,000.00 10.00
Tuberculosis, intradermal (for tuberculosis test, cell mediated immunity

86580 Immunology 18,000.00 24,000.00 12.00
measurement of gamma interferon antigen response…. (T*1)……
86612 HLA typing A, B or C….. (F) Immunology 4,500.00 6,000.00 3.00
86677 Helicobacter pylori IgG………………………………………………… Immunology 22,500.00 30,000.00 15.00
86678 Helicobacter pylori IgA ELISA………………………………………… Immunology 31,500.00 42,000.00 21.00
86813 HLA A, B, C multi antigens…………………………………………… Immunology 4,500.00 6,000.00 3.00
86816 HLA DR/DQ single antigens…………………………………………... Immunology 4,500.00 6,000.00 3.00
PATHOLOGY
89003 Transport Pathology 7,500.00 10,000.00 5.00
89011 Venepunture Pathology 12,000.00 16,000.00 8.00
89051 Full Blood Count Pathology 42,000.00 56,000.00 28.00
89052 Blood Group & Rhesus Pathology 22,500.00 30,000.00 15.00
89053 Blood Group & Rhesus Antibodies Pathology 46,500.00 62,000.00 31.00
89056 INR (Prothrombin Index) Pathology 28,500.00 38,000.00 19.00
89057 Bleeding and Clotting Time Pathology 12,000.00 16,000.00 8.00
89058 Partial Thromoplastin Time Pathology 22,500.00 30,000.00 15.00
89099 Coombes Direct Pathology 12,000.00 16,000.00 8.00
89100 Hypercoagulation/Thrombophilia Pathology 52,500.00 70,000.00 35.00
89101 Miscellaneous Microscopy Pathology 15,000.00 20,000.00 10.00
89102 Semen Culture Pathology 22,500.00 30,000.00 15.00
89103 PCR Chlamydia Pathology 67,500.00 90,000.00 45.00
89104 PCR Gonorrhoea Pathology 67,500.00 90,000.00 45.00
89105 PCR AAFB Pathology 58,500.00 78,000.00 39.00

SECURE &
PACKAGES PACKAGES
PACKAGES
89107 TPHA Pathology 139,500.00 186,000.00 93.00
89151 Glycosylated Hb Pathology 37,500.00 50,000.00 25.00
89152 VDRL/TPHA/FTA Pathology 45,000.00 60,000.00 30.00
89153 BFAT Pathology 37,500.00 50,000.00 25.00
89154 Pregnancy Test-Urine Latex Pathology 10,500.00 14,000.00 7.00
89155 ELISA (ONE ELISA - IgG or IgM) Pathology 31,500.00 42,000.00 21.00
89156 Western Blot Pathology 34,500.00 46,000.00 23.00
89157 HIV 1 RNA Viral Load Pathology 142,500.00 190,000.00 95.00
89158 T-Cell Profile (CD4/CD8) Pathology 90,000.00 120,000.00 60.00
89159 HIV Pathology 93,000.00 124,000.00 62.00
89160 CD4 Only Pathology 90,000.00 120,000.00 60.00
89162 Cryptococcal Antigen Pathology 37,500.00 50,000.00 25.00
89163 Lipoprotein HDL Pathology 33,000.00 44,000.00 22.00
89199 ASOT Screen Only Pathology 4,500.00 6,000.00 3.00
89200 Drugs Therapeutic Assay Pathology 31,500.00 42,000.00 21.00
89201 Cancer Markers & Hormones* Pathology 34,500.00 46,000.00 23.00
89247 Category 1 - Histology Pathology 48,000.00 64,000.00 32.00
89252 Cytology - One Slide Pathology 30,000.00 40,000.00 20.00
89253 Liquid based cytology- cervical cancer screening Pathology 43,500.00 58,000.00 29.00
89301 Liver Function Test* Pathology 75,000.00 100,000.00 50.00
89302 Urea & Electrolytes U's & E's* Pathology 34,500.00 46,000.00 23.00
89303 Amylase Pathology 21,000.00 28,000.00 14.00

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PACKAGES PACKAGES
PACKAGES
89304 Glucose Pathology 21,000.00 28,000.00 14.00
89305 Creatinine Pathology 19,500.00 26,000.00 13.00
89350 Astrup Blood Gases Pathology 19,500.00 26,000.00 13.00
89352 Triglycerides Pathology 21,000.00 28,000.00 14.00
89357 Cholesterol Pathology 21,000.00 28,000.00 14.00
89359 Calcium Pathology 21,000.00 28,000.00 14.00
89401 Reducing Substances Pathology 7,500.00 10,000.00 5.00
89402 Occult Blood Pathology 10,500.00 14,000.00 7.00
89404 CSF Chem Pathology 30,000.00 40,000.00 20.00
89491 Hb Electrophoresis Pathology 22,500.00 30,000.00 15.00
89492 Rapid Antigen Tests Pathology 37,500.00 50,000.00 25.00
89499 ICT - Malaria Pathology 22,500.00 30,000.00 15.00
89529 Kappa free light chains Pathology 75,000.00 100,000.00 50.00
89532 Lambga free light Pathology 75,000.00 100,000.00 50.00
89534 Lipid electropharesis Pathology 10,500.00 14,000.00 7.00
Helicobacter pylori breath test analysis for urease activity, non –radioactive
89555 Pathology 105,000.00 140,000.00 70.00
isotope…………………………………………………….
89592 Gene xpert Pathology 78,000.00 104,000.00 52.00
89621 PCR-RESP Virus (Respiratory Viral Screen) Pathology 45,000.00 60,000.00 30.00
89622 Clostridium dificile Pathology 57,000.00 76,000.00 38.00
89747 Procalcitonin Pathology 66,000.00 88,000.00 44.00
MEDICINE
90000 Initial consultation at rooms Medicine 120,000.00 160,000.00 80.00
90001 Subsequent consultation at rooms for same illness Medicine 67,500.00 90,000.00 45.00
90002 Initial consultation at hospital, nursing home or residence Medicine 165,000.00 220,000.00 110.00
SECURE &
PACKAGES PACKAGES
PACKAGES
90003 Subsequent consultation at hospital per day Medicine 90,000.00 120,000.00 60.00
90004 Subsequent consultation at hospital or nursing home - maximum per week Medicine 375,000.00 500,000.00 250.00
90011 Initial consultation at rooms (specialist family practitioner) Medicine 46,500.00 62,000.00 31.00
90012 Subsequent consultation at rooms for same illness (specialist family practitioner) Medicine 34,500.00 46,000.00 23.00
Subsequent consultation at hospital or nursing home, per day (specialist family

90013 Medicine 34,500.00 46,000.00 23.00
practitioner)
Subsequent consultation at hospital or nursing home - maximum per week

90014 Medicine 114,000.00 152,000.00 76.00
(specialist family practitioner)
90015 Initial consultations at rooms Medicine 90,000.00 120,000.00 60.00
90016 Subsequent consultations at rooms for same illness Medicine 49,500.00 66,000.00 33.00
90017 Initial consultation at hospital or nursing home Medicine 90,000.00 120,000.00 60.00
90018 Subsequent consultation at hospital per day Medicine 61,500.00 82,000.00 41.00
90020 Consultation by specialist pathologist at rooms, hospital, nursing home or residence Medicine 37,500.00 50,000.00 25.00
90021 Home visit Medicine 49,500.00 66,000.00 33.00
Consultation by specialist pathologist registered in the sub-speciality haematology,

90023 Medicine 120,000.00 160,000.00 80.00
on referral by a specialist physician, rooms, initial
90024 subsequent consultation for same illness Medicine 67,500.00 90,000.00 45.00
Consultation by specialist pathologist registered in the sub-speciality haematology,

90025 Medicine 135,000.00 180,000.00 90.00
on referral by a specialist physician, at hospital, nursing home or residence, initial
90026 subsequent consultation Medicine 82,500.00 110,000.00 55.00
90027 - maximum per week Medicine 375,000.00 500,000.00 250.00
90032 Initial consultation at hospital or nursing home, per day Medicine 90,000.00 120,000.00 60.00
90033 Subsequent consultation at hospital or nursing home, per day Medicine 52,500.00 70,000.00 35.00
90035 subsequent consultation at hospital or nursing home-maximum per week Medicine 259,500.00 346,000.00 173.00
90036 Initial consultation by Audiologist Medicine 22,500.00 30,000.00 15.00

SECURE &
PACKAGES PACKAGES
PACKAGES
90037 Subsequent Review by Audiologist Medicine 15,000.00 20,000.00 10.00
90042 Initial consultation at hospital or nursing home Medicine 105,000.00 140,000.00 70.00
90054 Routine visit to nursing home for the aged - maximum of 1 per week - first patient Medicine 45,000.00 60,000.00 30.00
90055 - each additional patient Medicine 22,500.00 30,000.00 15.00
Emergency visit to hospital - as per the appropriate home visiting fee for the first
90056 Medicine 27,000.00 36,000.00 18.00
patient, plus appropriate consultation room fee for each additional patient
Where a practitioner has to especially open his rooms outside of his normal
consulting hours to consult with a specific patient on an emergency basis, then
90058 Medicine 60,000.00 80,000.00 40.00
such consultation fee is chargeable in accordance with the appropriate home visit
fee.
If having opened his rooms in accordance with the provisions under tariff 90058, he
consults with other patients (on an emergency or routine basis), then consultation
90059 Medicine 27,000.00 36,000.00 18.00
fees in respect of such other patients are only chargeable in accordance with tariff
90050
90060 Weekday visit (between 7 am and 5 pm) Medicine 60,000.00 80,000.00 40.00
Weekend or holiday visit - weekend: a call received and a visit made on Saturday
90061 between 1 pm and 5 pm and Sunday between 7 am and 5 pm - holiday: a call Medicine 69,000.00 92,000.00 46.00
received and a visit made between 7 am and 6 pm.
90062 Night visit. Medicine 78,000.00 104,000.00 52.00
In the case of a home visit - where more than one patient is treated in the same
90064 household, the fee shall be as listed in 90060, 90061, and 90062 for the first patient Medicine 16,500.00 22,000.00 11.00
plus appropriate consultation room fee for each additional patient.
90065 Subsequent visits - maximum per week. Medicine 91,500.00 122,000.00 61.00
90067 Routine visits for chronic disabling illness - first three months - maximum per week. Medicine 315,000.00 420,000.00 210.00
90068 - thereafter, two routine visits per week - maximum per week. Medicine 189,000.00 252,000.00 126.00
90070 Injection (independent procedure) not requiring consultation Medicine 7,500.00 10,000.00 5.00
90071 Injection given during consultation Medicine

SECURE &
PACKAGES PACKAGES
PACKAGES
Injection given by Registered General, Enrolled or Certified Nurse (if not

90072 Medicine 4,500.00 6,000.00 3.00
immediately subsequent to a consultation)
Dressing - complex, requiring probing, irrigation, plugging or debridement or a
combination thereof and necessitating the medical practitioner's personal skill. Per
90073 Medicine 7,500.00 10,000.00 5.00
day to a maximum of seven days. (For materials used see 96932). (For General
Rules see 01073)
90075 Dressing - simple Medicine
90076 Mantoux or Heaf test - to be included in consultation fee Medicine
Urine chemical - by reagent stick, strip, tablet or similar. For use in ante-natal care
90077 Medicine 4,500.00 6,000.00 3.00
only, to a maximum of 7 tests in any one ante-natal period.
90078 Venepuncture or heel prick for pathological investigations Medicine 4,500.00 6,000.00 3.00
90080 Urine culture, microstix Medicine 4,500.00 6,000.00 3.00
90081 Urine, pregnancy test Medicine 4,500.00 6,000.00 3.00
90082 Glucometer-by glucostix Medicine 7,500.00 10,000.00 5.00
90083 Blood glucose test Medicine 7,500.00 10,000.00 5.00
90084 Venepuncture, barrier conditions Medicine 4,500.00 6,000.00 3.00
90085 GP point of care - Cholera antigen Medicine 15,000.00 20,000.00 10.00
90086 GP point of care - H.Pylori Medicine 10,500.00 14,000.00 7.00
90087 GP point of care - HAV lgGM Medicine 18,000.00 24,000.00 12.00
90088 GP point of care - HCV Medicine 10,500.00 14,000.00 7.00
90089 GP point of care - HIV Medicine 18,000.00 24,000.00 12.00
90090 GP point of care - Syphilis Medicine 10,500.00 14,000.00 7.00
90091 GP point of care - Alpha-Feto protein test Medicine 12,000.00 16,000.00 8.00
90092 GP point of care - Prostate specific Antigen test Medicine 9,000.00 12,000.00 6.00
90093 GP point of care - Latex Cryptococcal Ag Medicine 10,500.00 14,000.00 7.00
90094 GP point of care - Malaria paracheck / test Medicine 10,500.00 14,000.00 7.00
90095 GP point of care - Hb A1c Medicine 22,500.00 30,000.00 15.00
90096 Cholesterol-room procedure Medicine 15,000.00 20,000.00 10.00
90097 HDL- room procedure Medicine 7,500.00 10,000.00 5.00

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PACKAGES PACKAGES
PACKAGES
90098 TRIG- room procedure Medicine 7,500.00 10,000.00 5.00
90099 GP point of care - Urea Breath Test Medicine 82,500.00 110,000.00 55.00
90790 Initial consultation at rooms - Psychiatrist Medicine 97,500.00 130,000.00 65.00
90792 Initial consultation at hospital, nursing home or residence Medicine 112,500.00 150,000.00 75.00
90793 Subsequent consultation at hospital, per day Medicine 57,000.00 76,000.00 38.00
90803 Individual therapy, 25 to a maximum of 50 minutes, office Medicine 67,500.00 90,000.00 45.00
90804 - hospital or other facility Medicine 73,500.00 98,000.00 49.00
90806 Individual therapy, 15 - 25 minutes, office Medicine 46,500.00 62,000.00 31.00
90811 Individual therapy, up to 15 minutes, office Medicine 31,500.00 42,000.00 21.00
90812 Individual therapy, hospital or other facility Medicine 36,000.00 48,000.00 24.00
Group therapy (maximum 8 persons per group), per person per session, 45 - 50
90815 Medicine 19,500.00 26,000.00 13.00
minutes, office
Group therapy (maximum 8 persons per group) per person per session, 90 minutes,
90817 Medicine 31,500.00 42,000.00 21.00
office
90836 Convulsive therapy - up to 35 treatments in one year, in-patient Medicine 67,500.00 90,000.00 45.00
90838 - outpatient - up to 35 treatments in one year Medicine 67,500.00 90,000.00 45.00
Psychologic testing, with written report given by or under supervision of

90841 Medicine 88,500.00 118,000.00 59.00
psychiatrist, per hour; psychometric test [identify test(s) used]
90842 - projective tests [identify test(s) used] Medicine 88,500.00 118,000.00 59.00
90875 Hypnotherapy 25 - 50 minutes Medicine 76,500.00 102,000.00 51.00
90876 - 15 - 25 minutes Medicine 46,500.00 62,000.00 31.00
90877 - up to 15 minutes Medicine 46,500.00 62,000.00 31.00

SECURE &
PACKAGES PACKAGES
PACKAGES
90955 Cannula insertion for peritoneal dialysis, including removal Medicine 13,500.00 18,000.00 9.00
90958 - with limited omentectomy Medicine 39,000.00 52,000.00 26.00
90961 Tenchkoff shunt Medicine 49,500.00 66,000.00 33.00
90962 Peritoneal dialysis (Removal of cannula or shunt, simple) Medicine 330,000.00 440,000.00 220.00
90963 Renal failure, institution of treatment programme, per dialysis Medicine 108,000.00 144,000.00 72.00
90964 Removal of cannula or shunt in an operating theatre and G.A. Medicine 25,500.00 34,000.00 17.00
90970 Acute renal failure and/or intoxication, initial haemodialysis Medicine 198,000.00 264,000.00 132.00
90971 - second haemodialysis Medicine 121,500.00 162,000.00 81.00
90972 - third haemodialysis Medicine 121,500.00 162,000.00 81.00
90973 - fourth haemodialysis through end of second week, per treatment Medicine 60,000.00 80,000.00 40.00
90974 third week through end of sixth week, per treatmeant Medicine 30,000.00 40,000.00 20.00
90980 Chronic renal failure, initial stabilisation through sixth treatment, per treatment Medicine 121,500.00 162,000.00 81.00
- seventh stabilisation through end of first month of chronic haemodialysis therapy,

90981 Medicine 45,000.00 60,000.00 30.00
per treatment
90982 Haemodialysis in hospital by trained nursing staff under supervision of a physician Medicine 27,000.00 36,000.00 18.00
Gastric intubation by physician, washings, and preparing slides for cytology

91055 (independent procedure). (Naso-gatric intubation during an anaesthetic is Medicine 10,500.00 14,000.00 7.00
considered an incidental procedure and an additional charge is not to be made)
91056 Gastric snip ring biopsy Medicine 3,000.00 4,000.00 2.00
91100 Insertion of Sengstaken tube for intestinal bleeding Medicine 18,000.00 24,000.00 12.00
91110 Rectal biopsy with suction biopsy capsule Medicine 13,500.00 18,000.00 9.00
91112 Anus, snip ring biopsy Medicine 3,000.00 4,000.00 2.00
Determination of refractive state of eyes by general practitioner. Comprehensive

92015 Medicine 30,000.00 40,000.00 20.00
including consultion
Determination of refractive state of eyes by general practitioner. Comprehensive

92015 Medicine 30,000.00 40,000.00 20.00
including consultion
92020 Gonioscopy, in select cases only Medicine 15,000.00 20,000.00 10.00
Peripheral fundus examination with indirect opthalmoscope. Only applicable to

92021 Medicine 15,000.00 20,000.00 10.00
initial consultation
Tonometry, per test to a maximum of two tests in any one year. Only applicable to
92022 Medicine 15,000.00 20,000.00 10.00
initial consultation and glaucoma follow-up.
SECURE &
PACKAGES PACKAGES
PACKAGES
92023 Keratometry, per test to a maximum of two tests per year Medicine 15,000.00 20,000.00 10.00
Charting of visual field, Bjerum Screen or automatic recording perimeter, per test to
92024 Medicine 15,000.00 20,000.00 10.00
a maximum of two tests per year
92531 Electronystagmorgraph with caloric test Medicine 90,000.00 120,000.00 60.00
92532 Otoscopy Medicine 22,500.00 30,000.00 15.00
92533 Labyrinthine caloric test Medicine 15,000.00 20,000.00 10.00
92535 Brain stem auditory evoked response, single bilateral run Medicine 30,000.00 40,000.00 20.00
92536 each additional run to a maximum of three, add Medicine 15,000.00 20,000.00 10.00
92551 Screening test, pure tone ,air only Medicine 30,000.00 40,000.00 20.00
92552 Pure tone audiometry (threshold), air only Medicine 30,000.00 40,000.00 20.00
92553 air & bone Medicine 39,000.00 52,000.00 26.00
92555 Speech audiometry, threshold only Medicine 22,500.00 30,000.00 15.00
92556 threshold and discrimination Medicine 39,000.00 52,000.00 26.00
Basic comprehensive audiometry (92553 and 92556 combined), (pure tone, air and
92557 Medicine 78,000.00 104,000.00 52.00
bone, and speech, threshold and discrimination)
92560 Bekesey audiometry, screening Medicine 30,000.00 40,000.00 20.00
92561 Electronystamograph with caloric test/diagnostic Medicine 60,000.00 80,000.00 40.00
92562 Loudness balance test,alternate binaural or monoaural Medicine 10,500.00 14,000.00 7.00
92563 Tone decay test Medicine 10,500.00 14,000.00 7.00
92564 Short increment sensitivity index (SISI) Medicine 10,500.00 14,000.00 7.00
92565 Stengers test, pure tone Medicine 16,500.00 22,000.00 11.00
92567 Tympanometry (impedance testing) Medicine 34,500.00 46,000.00 23.00
92568 Acoustic Reflex testing Medicine 24,000.00 32,000.00 16.00
92569 Acoustic Reflex delay test Medicine 24,000.00 32,000.00 16.00
92577 Stengers test ,speech Medicine 34,500.00 46,000.00 23.00
92582 Conditioning play audiometry Medicine 16,500.00 22,000.00 11.00

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PACKAGES PACKAGES
PACKAGES
92584 Electrocochleography Medicine 90,000.00 120,000.00 60.00
92585 Brainstem auditory evoked response (evoked response EEG audiometry ) Medicine 90,000.00 120,000.00 60.00
92588 Comprehensive diagnostic evaluation cochlear mapping Medicine 84,000.00 112,000.00 56.00
92599 Unlisted ENT Service or procedure Medicine BR BR BR
92611 Electronystagmorgraph with caloric test Medicine 57,000.00 76,000.00 38.00
93000 Electrocardiogram with interpretation and report (resting) Medicine 90,000.00 120,000.00 60.00
93005 - tracing only, without interpretation and report Medicine 36,000.00 48,000.00 24.00
93010 - interpretation and report only Medicine 45,000.00 60,000.00 30.00
Electrocardiogram with multi-stage treadmill test, including monitoring,

93015 Medicine 240,000.00 320,000.00 160.00
interpretation and report
93017 - monitoring and tracing only, without interpretation and report Medicine 165,000.00 220,000.00 110.00
- monitoring, tracing, interpretation and report by physician with use of hospital

93019 Medicine 105,000.00 140,000.00 70.00
equipment
93021 Electrocardiogram with resting and limited exercise test, such as step test Medicine 111,000.00 148,000.00 74.00
93022 - tracing only without interpretation and report Medicine 52,500.00 70,000.00 35.00
Electrocardiogram, tracing and interpretation of report by physician with used of

93024 Medicine 63,000.00 84,000.00 42.00
hospital equipment
Provision of electrocardiogram equipment and material by hospital (only) where

93025 Medicine 18,000.00 24,000.00 12.00
tracing is undertaken by physician personally
Phonocardiogram with ECG lead, with supervision during recording with

93201 Medicine 94,500.00 126,000.00 63.00
interpretation and report (when equipment is supplied by the physician)
Electrocardiogram monitoring utilising a sytem such as magnetic tape, for up to 12

93270 Medicine 279,000.00 372,000.00 186.00
hours, includes recording, scanning analysis, interpretation and report
93274 12 through 24 hours recording Medicine 388,500.00 518,000.00 259.00
93278 - 24 through 72 hours recording Medicine 570,000.00 760,000.00 380.00
93501 Right heart catherization only Medicine 76,500.00 102,000.00 51.00
93502 - His bundle recording only Medicine 51,000.00 68,000.00 34.00
- placement of flow directed catheter (with or without balloon tip) only, when placed
93503 Medicine 40,500.00 54,000.00 27.00
for monitoring purposes or angiography
SECURE &
PACKAGES PACKAGES
PACKAGES
93505 Endocardial biopsy Medicine 70,500.00 94,000.00 47.00
Left heart catheterization, retrograde, from the brachial artery, axillary artery or
93510 Medicine 70,500.00 94,000.00 47.00
femoral artery percutaneous
93511 - by cutdown Medicine 81,000.00 108,000.00 54.00
93514 - by left ventricular puncture Medicine 81,000.00 108,000.00 54.00
93515 - by trans-septal venous catheterization Medicine 81,000.00 108,000.00 54.00
93524 Combined trans-septal and retrograde left heart cathererization Medicine 102,000.00 136,000.00 68.00
93526 Combined right heart catheterization and retrograde left heart catheterization Medicine 142,500.00 190,000.00 95.00
Combined right heart catheterization and trans-septal left heart catheterization (with
93527 Medicine 153,000.00 204,000.00 102.00
or without retrograde left heart catheterization)
Combined right heart catheterization with left ventricular puncture (with or without
93528 Medicine 153,000.00 204,000.00 102.00
retrograde left heart catheterization)
93541 Injection procedure during cardiac catheterization for pulmonary angiography Medicine 30,000.00 40,000.00 20.00
93542 - for selective right ventricular or right atrial angiography Medicine 30,000.00 40,000.00 20.00
93543 - for selective left ventricular or left atrial angiography Medicine 40,500.00 54,000.00 27.00
93544 - for aortography Medicine 51,000.00 68,000.00 34.00
- for selective coronary angiography (injection of radio-opaque material may be by

93545 Medicine 60,000.00 80,000.00 40.00
hand)
93546 Combined left heart catheterization and left ventricular angiography Medicine 91,500.00 122,000.00 61.00
Combined left heart catheterization, selective coronary angiography, and selective

93547 left ventricular angiography (this code number is to be used when procedure 93510 Medicine 142,500.00 190,000.00 95.00
is combined with procedures 93543 and 93545)
Combined left heart catheterization, selective coronary angiography, selective left

93548 Medicine 162,000.00 216,000.00 108.00
ventriculography and aortic root aotography
Combined right and left heart catheterization selective coronary angiography and
93549 selective left ventricular angiography (this code number is to be used when Medicine 204,000.00 272,000.00 136.00
procedure 93547 is combined with right heart catheterization)
Indicator dilution studies such as dye or thermal dilution, including arterial and
93561 Medicine 60,000.00 80,000.00 40.00
venous catheterization, with cardiac output measurement (independent procedure)
93562 - subsequent measurement of cardiac output Medicine 15,000.00 20,000.00 10.00
First day - for each total 15 minutes actual Intensive Care attendance with the
93570 Medicine 300,000.00 400,000.00 200.00
patient to maximum of one hour.
- for each total 15 minutes actual attendance with the patient to a maximum of two
93571 Medicine 30,000.00 40,000.00 20.00
hours
Second and third days - for each total 15 minutes actual attendance with the patient
93572 Medicine 225,000.00 300,000.00 150.00
to a maximum of three hours per day
Fourth to seventh days - for each total 15 minutes actual attendance with the
93573 Medicine 30,000.00 40,000.00 20.00
patient to a maximum of two hours per day, add (BR)
SECURE &
PACKAGES PACKAGES
PACKAGES
93574 Over seven days. Medicine BR BR BR
Re-admission to Unit - for each total 15 minutes actual attendance with the patient
93575 Medicine 30,000.00 40,000.00 20.00
to a maximum of two hours per day for five days
93576 - over five days. Medicine BR BR BR
93580 Consultation, initial three days, per visit to a maximum of two visits per day Medicine 30,000.00 40,000.00 20.00
- subsequent, per day to a maximum of one visit per day for seven days where no
93581 Medicine 30,000.00 40,000.00 20.00
surgery is undertaken
93582 - subsequent, pre-operative, per day to a maximum one visit per day for four days Medicine 30,000.00 40,000.00 20.00
- subsequent, post-operative in the absence of irreversible disease, per day to a

93583 Medicine 30,000.00 40,000.00 20.00
maximum of one visit per day for seven days
93590 - for the first forty-eight hours thereafter, per quarter of an hour Medicine 28,500.00 38,000.00 19.00
93591 - fee for service basis thereafter. Medicine FFS FFS FFS
94000 Peak flow - maximum per day Medicine 1,500.00 2,000.00 1.00
Vital capacity, with expiratory flow determinations and/or flow volume loop with
94001 Medicine 7,500.00 10,000.00 5.00
interpretation and report (Spirogram)
94002 - tracing only, without interpretation and report Medicine 4,500.00 6,000.00 3.00
94010 Pulmonary function test with vitallometer Medicine 42,000.00 56,000.00 28.00
94011 Forced expiratory volumes (F.E.V.O.5.F.E.V.I.O, etc) Medicine 9,000.00 12,000.00 6.00
Gas distribution. Closed circuit method (lung clearance method or single breath
94012 Medicine 19,500.00 26,000.00 13.00
oxygen curve)
94013 Lung volumes. Closed circuit method or body plythyssograph Medicine 42,000.00 56,000.00 28.00
94014 Air-way resistance and conductance using body plythyssograph Medicine 42,000.00 56,000.00 28.00
94015 Compliance and resistance using oesophageal balloon Medicine 42,000.00 56,000.00 28.00
Exercise testing with a combination of the following measurements; pulse, oxygen

94016 Medicine 42,000.00 56,000.00 28.00
uptake, ventilation, respiratory quotient, blood gases, compliance and resistance
94017 For complete pulmonary function battery, including the above Medicine 78,000.00 104,000.00 52.00
94019 Diffusion tests or equivalents Medicine 42,000.00 56,000.00 28.00
When using hospital equipment a 25% reduction will be granted on the above
94020 Medicine - - -
pulmonary function test
95005 Scratch or puncture test, unit charge per test Medicine - - -

SECURE &
PACKAGES PACKAGES
PACKAGES
95006 - minimum unit charge Medicine 21,000.00 28,000.00 14.00
95019 Intradermal test, unit charge per test Medicine 42,000.00 56,000.00 28.00
95039 Patch test, unit charge per test Medicine 30,000.00 40,000.00 20.00
95045 Prick test, unit charge per test Medicine - - -
95047 Punch biopsy Medicine 43,500.00 58,000.00 29.00
95050 Bilharzia skin test Medicine 1,500.00 2,000.00 1.00
95819 Electro-encephalogram (EEG), standard or portable same facility Medicine 150,000.00 200,000.00 100.00
95821 - portable, to an alternate facility Medicine 225,000.00 300,000.00 150.00
95822 - sleep Medicine 225,000.00 300,000.00 150.00
95823 - physical or pharmacological, activation Medicine 225,000.00 300,000.00 150.00
95824 - celebral death evaluation recording Medicine 225,000.00 300,000.00 150.00
95826 - intra-cerebral (depth) EEG Medicine
95828 - extended monitoring, greater than 1 hour Medicine 426,000.00 568,000.00 284.00
95829 - extended monitoring, 8 hours continous Medicine 657,000.00 876,000.00 438.00
95831 - sphenoidal recording, including insertion of electrode Medicine 225,000.00 300,000.00 150.00
95833 - interpretation of record Medicine 150,000.00 200,000.00 100.00
95836 Polysomnography; overnight sleep staging (digital) including interpretation of record Medicine 717,000.00 956,000.00 478.00
Multiple sleep latency testing, including recording, analysis and interpretation of

95837 Medicine 600,000.00 800,000.00 400.00
record
95842 Nerve conduction studies Medicine 126,000.00 168,000.00 84.00
95845 Somatosensory evoked potentials Medicine 232,500.00 310,000.00 155.00
95848 Visual evoked potentials; unilateral Medicine 246,000.00 328,000.00 164.00

SECURE &
PACKAGES PACKAGES
PACKAGES
95849 - bilateral Medicine 426,000.00 568,000.00 284.00
95851 Auditory evoked potentials and/or testing of the central nervous system Medicine 193,500.00 258,000.00 129.00
95860 Electromyography, one extremity and related paraspinal areas Medicine 150,000.00 200,000.00 100.00
95861 - two extremities and related paraspinal areas Medicine 270,000.00 360,000.00 180.00
95863 - three extremities and related paraspinal areas Medicine 330,000.00 440,000.00 220.00
95864 - four extrimites and related paraspinal areas Medicine 390,000.00 520,000.00 260.00
95867 Cranial nerve supplied muscles, unilateral. Medicine BR BR BR
95868 - bilateral. Medicine BR BR BR
- limited study of specific muscles, eg. external anal sphincter, thoracic spinal
95869 Medicine BR BR BR
muscles, etc.
95870 - interpretation of record Medicine 150,000.00 200,000.00 100.00
95880 Tensilon test for Myasthenia Gravis Medicine 37,500.00 50,000.00 25.00
96000 Cardio-pulmonary resuscitation, e.g. cardiac arrest Medicine 300,000.00 400,000.00 200.00
96010 Nebulisation 15-30 minutes Medicine 7,500.00 10,000.00 5.00
Electrical conversion of arrhythmia, external (independent, elective or semi-elective

96020 Medicine 30,000.00 40,000.00 20.00
procedure)
Chemical conversion of arrhythmia requiring intravenous bolus of anti-arrhythmia

96021 Medicine 6,000.00 8,000.00 4.00
agent (to a maximum of three) per bolus
Therapy prepared and administered parenterally by the medical practitioner. Per

96030 day to a maximum of six days per week. Including venepuncture and not Medicine 4,500.00 6,000.00 3.00
applicable to an intensive care situation. Appropriate consultation fee plus
96055 Injection of intrathecal chemotherapeutic agent, administered by physician Medicine 10,500.00 14,000.00 7.00
96090 Gastric lavage, therapeutic - detention time plus Medicine FFS FFS FFS
96100 Desensitisation injection Medicine 4,500.00 6,000.00 3.00
96250 Hypothermia, regional Medicine 36,000.00 48,000.00 24.00
96450 Phlebotomy, therapeutic (independent procedure) Medicine 4,500.00 6,000.00 3.00
96451 Bone marrow - aspiration Medicine 9,000.00 12,000.00 6.00

SECURE &
PACKAGES PACKAGES
PACKAGES
96452 Radioscopy of chest Medicine 6,000.00 8,000.00 4.00
Morphine saturation test - morphine injection (plus intravenous infusion as per item
96460 Medicine 4,500.00 6,000.00 3.00
36410)
96461 For each 15 minutes in attendance up to a maximum of 45 minutes Medicine 4,500.00 6,000.00 3.00
Pentothal saturation test - pentothal injection (plus intravenous infusion as per item
96462 Medicine 4,500.00 6,000.00 3.00
36410)
96463 For each 15 minutes in attendance up to a maximum of 30 minutes Medicine 4,500.00 6,000.00 3.00
Cost of material, excluding local anaesthetic (see 96470), for minor procedure
96465 Medicine At cost At cost At cost
under local anaesthetic undertaken in rooms. Invoices to be attached.
96470 Local anaesthetic, including anaesthetic agent Medicine 4,500.00 6,000.00 3.00
96475 Venesection pack for therapeutic phlebotomy Medicine At cost At cost At cost
Abstract from clinical records or report supplied at the request of a medical aid
96480 Medicine 7,500.00 10,000.00 5.00
society and with the patient's prior agreement. Not applicable to BR items.
96900 Actinotherapy (Ultraviolet light), local Medicine 3,000.00 4,000.00 2.00
96905 - general Medicine 7,500.00 10,000.00 5.00
96906 - to part or whole of body, administrated by trained nurse Medicine 3,000.00 4,000.00 2.00
Dressing materials used, or a combination thereof, including therapeutic bandages,

etc
Dressing materials used, or a combination thereof, including therapeutic bandages,

etc to a maximum of seven dressings per lesion
Superficial or orthovoltage (under 600 KVP) dermatoses, 3 fields or less, per

96940 Medicine 7,500.00 10,000.00 5.00
treatment
96941 - more than 3 fields, per treatment Medicine 9,000.00 12,000.00 6.00
96942 - other benign lesions, 3 fields or less, per treatment Medicine 9,000.00 12,000.00 6.00
96944 - super voltage (600 KVP - 2MeV) malignant lesion per course of treatment Medicine 48,000.00 64,000.00 32.00
General Practitioners. Per km travelled. Applicable to all domiciliary visits and

96991 emergency visits to hospitals and nursing homes. Emergency visits to consulting Medicine 465.00 620.00 0.31
rooms, by report. If second visit made en route, no additional charge may be raised
Specialists. Per km travelled. Applicable to all emergency hospital visits outside
normal working hours (weekdays 5pm - 7am, weekends Saturday 1pm - Monday
96993 Medicine 465.00 620.00 0.31
7am, public holidays 7am - 5pm). Time to be specified. If second patient seen, no
additional
97600 Initial Consultation. Medicine 37,500.00 50,000.00 25.00
Initial Consultation: Simple wound -This assessment code to be used only with first
97601 Medicine 7,500.00 10,000.00 5.00
consultation in healthy patients with minimal factors which may influence healing
97602 Subsequent Consultation Medicine 27,000.00 36,000.00 18.00
Wound Treatment for complicated wound or potentially complicated wounds in

patient with metabolic conditions. -Patients requiring compression bandaging,
97603 Medicine 22,500.00 30,000.00 15.00
debridement , off loading .Ongoing wound re-assessment and education with every
visit
SECURE &
PACKAGES PACKAGES
PACKAGES
Per specimen. This included correct collection of material, swab or tissue,

97604 Medicine 4,500.00 6,000.00 3.00
completion of documentation
97605 Simple dressing (Conventional Dressing) Medicine 7,500.00 10,000.00 5.00
97606 Advanced Wound Care Dressing Medicine 22,500.00 30,000.00 15.00
97607 Short Compression (2-3 bandages layers) Medicine 22,500.00 30,000.00 15.00
97608 Full Compression (4-6 bandages layers) Medicine 27,000.00 36,000.00 18.00
97609 Compression with drainage Medicine 33,000.00 44,000.00 22.00
Negative pressure wound therapy (e.g., vacuum assisted drainage collection),

utilizing durable medical equipment (DME), including topical application(s), wound
97610 Medicine 22,500.00 30,000.00 15.00
assessment, and instruction(s) for ongoing care, per session; total wound(s)
surface area less than or equal to 50 square centimeters
97611 total wound(s) surface area greater than 50 square centimeters Medicine 34,500.00 46,000.00 23.00
Negative pressure wound therapy, (e.g., vacuum assisted drainage collection),

utilizing disposable, non-durable medical equipment including provision of exudates
97612 Medicine 34,500.00 46,000.00 23.00
management collection system, topical application(s), wound assessment, and
instructions for ongoing care, per session; total wounds(s) surface area less than or
97613 total wounds(s) surface area greater than 50 square centimeters Medicine 34,500.00 46,000.00 23.00
ANAESTHETICS - COMPOSITE TARIFF
97009 Initial consultation in HDU 225,000.00 300,000.00 150.00
97010 Consultation - Subsequent in HDU 150,000.00 200,000.00 100.00
99501 Amputation, digits Orthopaedics 474,000.00 632,000.00 316.00
99502 Depo medrol injection Orthopaedics 474,000.00 632,000.00 316.00
99503 Excision ganglion Orthopaedics 474,000.00 632,000.00 316.00
99504 Foreign body removal Orthopaedics 474,000.00 632,000.00 316.00
99505 Incision and drainage, digits Orthopaedics 474,000.00 632,000.00 316.00
99506 In-growing toe nails Orthopaedics 474,000.00 632,000.00 316.00
99507 K-wire removal Orthopaedics 474,000.00 632,000.00 316.00
99508 Manipulation under anaesthetic and plaster of Paris Orthopaedics 474,000.00 632,000.00 316.00
99509 Planter warts Orthopaedics 474,000.00 632,000.00 316.00
99515 Carpal tunnel release Orthopaedics 718,500.00 958,000.00 479.00
99516 Excision of bursae Orthopaedics 718,500.00 958,000.00 479.00

SECURE &
PACKAGES PACKAGES
PACKAGES
99517 Excision of lipoma Orthopaedics 718,500.00 958,000.00 479.00
99518 Arthroscopy Orthopaedics 946,500.00 1,262,000.00 631.00
99519 Arthrotomy Orthopaedics 916,500.00 1,222,000.00 611.00
99520 Incision and drainage myositic abscess Orthopaedics 916,500.00 1,222,000.00 611.00
99521 K-nail removal Orthopaedics 916,500.00 1,222,000.00 611.00
99522 Removal of plate and screws Orthopaedics 916,500.00 1,222,000.00 611.00
99523 Sequestrectomy Orthopaedics 916,500.00 1,222,000.00 611.00
99524 Split-skin graft/debridement Orthopaedics 916,500.00 1,222,000.00 611.00
99525 Tendon repairs Orthopaedics 916,500.00 1,222,000.00 611.00
99531 Amputation of limbs Orthopaedics 1,375,500.00 1,834,000.00 917.00
99532 Dynamic condylar screw removal Orthopaedics 1,375,500.00 1,834,000.00 917.00
99533 Dynamic hip screw removal Orthopaedics 1,375,500.00 1,834,000.00 917.00
99534 K-nail insertion Orthopaedics 1,375,500.00 1,834,000.00 917.00
99535 Medical soft tissue release Orthopaedics 1,375,500.00 1,834,000.00 917.00
99536 Open reduction and internal fixation, arm/leg Orthopaedics 1,375,500.00 1,834,000.00 917.00
99537 Open rediction and internal fixation clavicle Orthopaedics 1,375,500.00 1,834,000.00 917.00
99538 Open reduction and internal fixation, femur Orthopaedics 1,375,500.00 1,834,000.00 917.00
99545 G-K nail insertion Orthopaedics 2,139,000.00 2,852,000.00 1,426.00
99546 Dynamic condylar screw insertion Orthopaedics 2,139,000.00 2,852,000.00 1,426.00
99547 Dynamic hip screw insertion Orthopaedics 2,139,000.00 2,852,000.00 1,426.00
99548 Hemiarthroplasty Orthopaedics 2,139,000.00 2,852,000.00 1,426.00
99549 Multiple trauma Orthopaedics 2,139,000.00 2,852,000.00 1,426.00
99550 Total hip replacement Orthopaedics 2,445,000.00 3,260,000.00 1,630.00
99551 Total knee replacement Orthopaedics 2,445,000.00 3,260,000.00 1,630.00

SECURE &
PACKAGES PACKAGES
PACKAGES
99561 Chalazion Ophthamology 546,000.00 728,000.00 364.00
99562 Conjunctival mass excision Ophthamology 546,000.00 728,000.00 364.00
99563 Examination under anaesthetic/fundoscopy Ophthamology 546,000.00 728,000.00 364.00
99564 Pterygectomy Ophthamology 546,000.00 728,000.00 364.00
99565 Syringing and probing Ophthamology 232,500.00 310,000.00 155.00
99571 Foreign body removal Ophthamology 345,000.00 460,000.00 230.00
99572 Gundason flap Ophthamology 345,000.00 460,000.00 230.00
99573 Keratectomy Ophthamology 345,000.00 460,000.00 230.00
99574 Anterior vitrectomy Ophthamology 465,000.00 620,000.00 310.00
99575 Cataract Ophthamology 465,000.00 620,000.00 310.00
99576 Corneal repair Ophthamology 465,000.00 620,000.00 310.00
99577 Cryotherapy Ophthamology 450,000.00 600,000.00 300.00
99578 Ectropion/entropion Ophthamology 450,000.00 600,000.00 300.00
99579 Enucleation Ophthamology 465,000.00 620,000.00 310.00
99580 Ptosis Ophthamology 465,000.00 620,000.00 310.00
99581 Squint Ophthamology 465,000.00 620,000.00 310.00
99582 Tarsorrhaphy Ophthamology 450,000.00 600,000.00 300.00
99583 Trabeculectomy Ophthamology 450,000.00 600,000.00 300.00
99591 Cornael grafting Ophthamology 675,000.00 900,000.00 450.00
99592 Exenteration Ophthamology 675,000.00 900,000.00 450.00
99593 Dacryocystorhinostomy Ophthamology 600,000.00 800,000.00 400.00
99594 Pars plana vitrectomy Ophthamology 600,000.00 800,000.00 400.00
99595 Retinal detachment Ophthamology 600,000.00 800,000.00 400.00
99596 Silicon oil removal Ophthamology 600,000.00 800,000.00 400.00

SECURE &
PACKAGES PACKAGES
PACKAGES
99601 Dental wire removal Dental/Maxiollofacial 438,000.00 584,000.00 292.00
99602 Biopsy lesion in mouth Dental/Maxiollofacial 643,500.00 858,000.00 429.00
99603 Cyst enucleation Dental/Maxiollofacial 643,500.00 858,000.00 429.00
99605 Fillings extraction Dental/Maxiollofacial 877,500.00 1,170,000.00 585.00
99606 Orbit Dental/Maxiollofacial 1,170,000.00 1,560,000.00 780.00
99607 Parotid tumour Dental/Maxiollofacial 1,170,000.00 1,560,000.00 780.00
99608 Cleft lip/palate Dental/Maxiollofacial 1,170,000.00 1,560,000.00 780.00
99609 Palatal tumour Dental/Maxiollofacial 1,170,000.00 1,560,000.00 780.00
99615 Excision of maxillary/mandibular tumuors Dental/Maxiollofacial 1,753,500.00 2,338,000.00 1,169.00
99616 Fractures, facial bones Dental/Maxiollofacial 1,753,500.00 2,338,000.00 1,169.00
99621 Anal dilatation General Surgery 502,500.00 670,000.00 335.00
99622 Cautery of warts General Surgery 502,500.00 670,000.00 335.00
99623 Circumcision General Surgery 520,500.00 694,000.00 347.00
99624 Colonoscopy General Surgery 502,500.00 670,000.00 335.00
99625 Fissure-in-ano General Surgery 502,500.00 670,000.00 335.00
99626 Ganglion excision General Surgery 502,500.00 670,000.00 335.00
99627 Haemorroids General Surgery 502,500.00 670,000.00 335.00
99628 Proctoscopy General Surgery 502,500.00 670,000.00 335.00
99629 Sigmoidoscopy General Surgery 502,500.00 670,000.00 335.00
99630 Breast biopsy General Surgery 520,500.00 694,000.00 347.00
99631 Bursae General Surgery 520,500.00 694,000.00 347.00
99632 Incision and drainage of abscess General Surgery 502,500.00 670,000.00 335.00
99633 Lipoma General Surgery 520,500.00 694,000.00 347.00
99641 Appendicectomy General Surgery 771,000.00 1,028,000.00 514.00

SECURE &
PACKAGES PACKAGES
PACKAGES
99642 Incisional hernia General Surgery 771,000.00 1,028,000.00 514.00
99643 Inguinal hernia General Surgery 771,000.00 1,028,000.00 514.00
99644 Split-skin graft/debridement General Surgery 771,000.00 1,028,000.00 514.00
99645 Umbilical hernia General Surgery 771,000.00 1,028,000.00 514.00
99651 Colostomy General Surgery 1,039,500.00 1,386,000.00 693.00
99652 Exploratory laparotomy General Surgery 1,039,500.00 1,386,000.00 693.00
99653 Mastectomy (radical) General Surgery 1,039,500.00 1,386,000.00 693.00
99654 Mastectomy (simple) General Surgery 1,039,500.00 1,386,000.00 693.00
99655 Parotidectomy and nerve dissection General Surgery 1,039,500.00 1,386,000.00 693.00
99656 Parotidectomy (superficial) General Surgery 1,039,500.00 1,386,000.00 693.00
99657 Thyroid surgery General Surgery 1,509,000.00 2,012,000.00 1,006.00
99658 Bowel obstruction General Surgery 1,509,000.00 2,012,000.00 1,006.00
99659 Cholecystectomy General Surgery 1,509,000.00 2,012,000.00 1,006.00
99660 Gastrectomy General Surgery 1,509,000.00 2,012,000.00 1,006.00
99661 Hemicolectomy General Surgery 1,509,000.00 2,012,000.00 1,006.00
99665 Liver surgery General Surgery 3,187,500.00 4,250,000.00 2,125.00
99666 Abdominoperineal resection General Surgery 3,187,500.00 4,250,000.00 2,125.00
99667 Oesophagectomy General Surgery 3,690,000.00 4,920,000.00 2,460.00
99668 Phaeochromocytoma General Surgery 4,026,000.00 5,368,000.00 2,684.00
99681 Cautery of warts Urology 232,500.00 310,000.00 155.00
99682 Circumcision Urology 232,500.00 310,000.00 155.00
99683 Cystoscopy Urology 232,500.00 310,000.00 155.00
99684 Examination under anaethetic Urology 232,500.00 310,000.00 155.00
99685 J J stent insertion Urology 232,500.00 310,000.00 155.00

SECURE &
PACKAGES PACKAGES
PACKAGES
99686 J J stent removal Urology 232,500.00 310,000.00 155.00
99687 Optical internal urethrotomy Urology 232,500.00 310,000.00 155.00
99688 Testicular biopsy Urology 232,500.00 310,000.00 155.00
99695 Orchidectomy Urology 352,500.00 470,000.00 235.00
99696 Orchidopexy Urology 352,500.00 470,000.00 235.00
99697 Retrograde urogram Urology 352,500.00 470,000.00 235.00
99698 Vasectomy Urology 352,500.00 470,000.00 235.00
99705 Bladder neck dissection/resection Urology 352,500.00 470,000.00 235.00
99706 Hypospadias repair Urology 352,500.00 470,000.00 235.00
99707 Transuretheral resection of prostate Urology 982,500.00 1,310,000.00 655.00
99708 Transvesical prostatectomy Urology 352,500.00 470,000.00 235.00
99715 Nephrectomy Urology 750,000.00 1,000,000.00 500.00
99716 Pyeloplasty Urology 750,000.00 1,000,000.00 500.00
99717 Reimplantation of ureters Urology 750,000.00 1,000,000.00 500.00
99718 Cystectomy Urology 1,500,000.00 2,000,000.00 1,000.00
99719 Urinary diversion Urology 1,500,000.00 2,000,000.00 1,000.00
99720 Radical prostatectomy Urology 1,500,000.00 2,000,000.00 1,000.00
99731 Circumcision, under 6 months Paediatric Surgery 268,500.00 358,000.00 179.00
99732 Circumcision, over 6 months Paediatric Surgery 268,500.00 358,000.00 179.00
99733 Examination under anaesthetic Paediatric Surgery 268,500.00 358,000.00 179.00
99734 Incision and drainage of abscess Paediatric Surgery 268,500.00 358,000.00 179.00
99735 Lumps and bumps Paediatric Surgery 268,500.00 358,000.00 179.00
99736 Rectal biopsy Paediatric Surgery 268,500.00 358,000.00 179.00
99737 Tongue tie Paediatric Surgery 268,500.00 358,000.00 179.00

SECURE &
PACKAGES PACKAGES
PACKAGES
99741 Hernia repair, under 6 months Paediatric Surgery 459,000.00 612,000.00 306.00
99742 Hernia repair, over 6 months Paediatric Surgery 459,000.00 612,000.00 306.00
99743 Orchidopexy Paediatric Surgery 459,000.00 612,000.00 306.00
99751 Bowel obstruction Paediatric Surgery 711,000.00 948,000.00 474.00
99752 Colostomy Paediatric Surgery 711,000.00 948,000.00 474.00
99753 Intussusception Paediatric Surgery 711,000.00 948,000.00 474.00
99754 Pyloroplasty Paediatric Surgery 711,000.00 948,000.00 474.00
99761 Bowel atresia Paediatric Surgery 1,581,000.00 2,108,000.00 1,054.00
99762 Gastroschisis Paediatric Surgery 1,581,000.00 2,108,000.00 1,054.00
99763 Anal pull through (PENA pull through) Paediatric Surgery 1,581,000.00 2,108,000.00 1,054.00
99764 Tracheoesophageal fistula Paediatric Surgery 2,292,000.00 3,056,000.00 1,528.00
99765 Repair of cloaca Paediatric Surgery 2,292,000.00 3,056,000.00 1,528.00
99771 Peripheral nerves Neurosurgery 420,000.00 560,000.00 280.00
99775 Burr holes, epidural, subdural. Biopsy Neurosurgery 913,500.00 1,218,000.00 609.00
99776 Elevation of depressed fracture Neurosurgery 913,500.00 1,218,000.00 609.00
99777 Ventriculo-peritoneal shunt, adult Neurosurgery 913,500.00 1,218,000.00 609.00
99778 Ventriculo-peritoneal shunt, infant under 6 months Neurosurgery 913,500.00 1,218,000.00 609.00
99779 Ventriculo-peritoneal shunt, infant over 6 months Neurosurgery 913,500.00 1,218,000.00 609.00
99785 Laminectomy Neurosurgery 1,279,500.00 1,706,000.00 853.00
99786 Cervical fusion Neurosurgery 1,425,000.00 1,900,000.00 950.00
99791 Craniotomy for tumour Neurosurgery 2,010,000.00 2,680,000.00 1,340.00
99792 Posterior fossa surgery Neurosurgery 2,010,000.00 2,680,000.00 1,340.00
99793 Transphenoidal procedures Neurosurgery 2,010,000.00 2,680,000.00 1,340.00
99801 A-port insertion Cardiothoracic/Vascular 348,000.00 464,000.00 232.00

SECURE &
PACKAGES PACKAGES
PACKAGES
99802 Bronchoscopy and biopsy Cardiothoracic/Vascular 532,500.00 710,000.00 355.00
99803 Bronchoscopy and lavage Cardiothoracic/Vascular 532,500.00 710,000.00 355.00
99804 Oesophagoscopy Cardiothoracic/Vascular 532,500.00 710,000.00 355.00
99805 Thoracoscopy Cardiothoracic/Vascular 532,500.00 710,000.00 355.00
99811 Lobectomy Cardiothoracic/Vascular 1,159,500.00 1,546,000.00 773.00
99812 Pulmonary segmentectomy Cardiothoracic/Vascular 1,159,500.00 1,546,000.00 773.00
99815 Pneumonectomy Cardiothoracic/Vascular 2,550,000.00 3,400,000.00 1,700.00
99816 Mediastinal surgery, other Cardiothoracic/Vascular 2,202,000.00 2,936,000.00 1,468.00
99817 Valvotomy Cardiothoracic/Vascular 2,550,000.00 3,400,000.00 1,700.00
99818 Pericardectomy Cardiothoracic/Vascular 1,623,000.00 2,164,000.00 1,082.00
99819 Pericardial window Cardiothoracic/Vascular 1,623,000.00 2,164,000.00 1,082.00
99820 Oesophagectomy Cardiothoracic/Vascular 2,550,000.00 3,400,000.00 1,700.00
99825 Peripheral endarterectomy Cardiothoracic/Vascular 1,344,000.00 1,792,000.00 896.00
99826 Aortofemoral graft Cardiothoracic/Vascular 1,807,500.00 2,410,000.00 1,205.00
99827 Aortoiliac graft Cardiothoracic/Vascular 1,807,500.00 2,410,000.00 1,205.00
99828 Carotid endarterectomy Cardiothoracic/Vascular 1,807,500.00 2,410,000.00 1,205.00
99829 Coarctation of aorta Cardiothoracic/Vascular 1,807,500.00 2,410,000.00 1,205.00
99830 Femorofemoral Cardiothoracic/Vascular 1,807,500.00 2,410,000.00 1,205.00
99831 Femoropopliteal Cardiothoracic/Vascular 1,807,500.00 2,410,000.00 1,205.00
99832 Iliofemoral Cardiothoracic/Vascular 1,807,500.00 2,410,000.00 1,205.00
99833 Patent ductus arteriosus ligation Cardiothoracic/Vascular 2,248,500.00 2,998,000.00 1,499.00
99834 Aortic aneurysm Cardiothoracic/Vascular 2,550,000.00 3,400,000.00 1,700.00
99841 Open heart surgery Cardiothoracic/Vascular 4,056,000.00 5,408,000.00 2,704.00
99851 Bartholins abscess Obstetrics and Gynaecology 430,500.00 574,000.00 287.00

SECURE &
PACKAGES PACKAGES
PACKAGES
99852 Cautery of warts Obstetrics and Gynaecology 430,500.00 574,000.00 287.00
99853 Cervical surgery Obstetrics and Gynaecology 430,500.00 574,000.00 287.00
99854 Dilatation and curettage Obstetrics and Gynaecology 430,500.00 574,000.00 287.00
99855 Evacuation of uterus Obstetrics and Gynaecology 430,500.00 574,000.00 287.00
99856 Intra-uterine contraceptive device, insertion Obstetrics and Gynaecology 430,500.00 574,000.00 287.00
99857 Intra-uterine contraceptive device, removal Obstetrics and Gynaecology 430,500.00 574,000.00 287.00
99861 Laparoscopy and dye studies Obstetrics and Gynaecology 660,000.00 880,000.00 440.00
99862 Laparoscopy Obstetrics and Gynaecology 660,000.00 880,000.00 440.00
99863 Mini-laparotomy Obstetrics and Gynaecology 660,000.00 880,000.00 440.00
99864 Perineal repair Obstetrics and Gynaecology 660,000.00 880,000.00 440.00
99865 Tubal ligation Obstetrics and Gynaecology 660,000.00 880,000.00 440.00
99871 Caesarian section Obstetrics and Gynaecology 889,500.00 1,186,000.00 593.00
99872 Ectopic (not ruptured) Obstetrics and Gynaecology 889,500.00 1,186,000.00 593.00
99873 Laparotomy Obstetrics and Gynaecology 889,500.00 1,186,000.00 593.00
99874 Myomectomy Obstetrics and Gynaecology 889,500.00 1,186,000.00 593.00
99875 Ovarian cystectomy Obstetrics and Gynaecology 889,500.00 1,186,000.00 593.00
99881 Ectopic (ruptured) Obstetrics and Gynaecology 1,291,500.00 1,722,000.00 861.00
99882 Eclampsia Obstetrics and Gynaecology 1,291,500.00 1,722,000.00 861.00
99883 Ruptured uterus Obstetrics and Gynaecology 1,291,500.00 1,722,000.00 861.00
99884 Total abdominal hysterectomy Obstetrics and Gynaecology 1,291,500.00 1,722,000.00 861.00
Reconstructive and Cosmetic

99891 Excision polydactaly/syndactaly 225,000.00 300,000.00 150.00
surgery

99892 Excision of benign/malignant skin lesions 225,000.00 300,000.00 150.00
surgery

99893 Excision small keloid scar 225,000.00 300,000.00 150.00
surgery

99894 Repair small wound 225,000.00 300,000.00 150.00
surgery
SECURE &
PACKAGES PACKAGES
PACKAGES

99895 Excision extensive keloid scar 345,000.00 460,000.00 230.00
surgery

99901 Release ectropion 450,000.00 600,000.00 300.00
surgery

99902 Release of contracture/split-skin graft 465,000.00 620,000.00 310.00
surgery

99903 Rotation flaps (minor) 465,000.00 620,000.00 310.00
surgery

99904 Complex skin repairs 465,000.00 620,000.00 310.00
surgery

99911 Cleft lip and/palate 825,000.00 1,100,000.00 550.00
surgery

99912 Rotation flaps (major) 825,000.00 1,100,000.00 550.00
surgery

99915 Chin/neck lift only 825,000.00 1,100,000.00 550.00
surgery

99916 Eye lids only 825,000.00 1,100,000.00 550.00
surgery

99917 Mastectomy for gynaecomastia 825,000.00 1,100,000.00 550.00
surgery

99918 Face lift 1,200,000.00 1,600,000.00 800.00
surgery

99919 Liposuction 1,200,000.00 1,600,000.00 800.00
surgery

99920 Abdominoplasty 1,350,000.00 1,800,000.00 900.00
surgery

99921 Reduction mammoplasty 1,350,000.00 1,800,000.00 900.00
surgery
99931 Antrum washout Ear-Nose and Throat 621,000.00 828,000.00 414.00
99932 Excision of nasal polyps Ear-Nose and Throat 621,000.00 828,000.00 414.00
99933 Foreign body removal in nose/ear Ear-Nose and Throat 621,000.00 828,000.00 414.00
99934 Grommets/tympanotomy Ear-Nose and Throat 621,000.00 828,000.00 414.00
99935 Lymph node biopsy Ear-Nose and Throat 621,000.00 828,000.00 414.00
99936 Myringotomy Ear-Nose and Throat 621,000.00 828,000.00 414.00
99937 Otoscopy Ear-Nose and Throat 621,000.00 828,000.00 414.00
99941 Adenoidectomy Ear-Nose and Throat 993,000.00 1,324,000.00 662.00
99942 Laryngoscopy Ear-Nose and Throat 1,240,500.00 1,654,000.00 827.00
99943 Parotidectomy Ear-Nose and Throat 1,240,500.00 1,654,000.00 827.00

SECURE &
PACKAGES PACKAGES
PACKAGES
99944 Sinusotomy Ear-Nose and Throat 1,240,500.00 1,654,000.00 827.00
99945 Tonsillectomy Ear-Nose and Throat 1,240,500.00 1,654,000.00 827.00
99946 Turbinectomy Ear-Nose and Throat 1,240,500.00 1,654,000.00 827.00
99947 Tympanoplasty Ear-Nose and Throat 1,240,500.00 1,654,000.00 827.00
99948 Cochlear implant surgery Ear-Nose and Throat 8,688,000.00 11,584,000.00 5,792.00
99951 Epistaxis control Ear-Nose and Throat 993,000.00 1,324,000.00 662.00
99952 Ethmoidectomy Ear-Nose and Throat 993,000.00 1,324,000.00 662.00
99953 Functional endoscopic sinus surgery Ear-Nose and Throat 1,654,500.00 2,206,000.00 1,103.00
99954 Mastoidectomy Ear-Nose and Throat 993,000.00 1,324,000.00 662.00
99955 Maxillectomy Ear-Nose and Throat 993,000.00 1,324,000.00 662.00
99956 Rhinoplasty Ear-Nose and Throat 993,000.00 1,324,000.00 662.00
99957 Tracheostomy Ear-Nose and Throat 993,000.00 1,324,000.00 662.00
99961 Excision of laryngeal papillomata Ear-Nose and Throat 2,068,500.00 2,758,000.00 1,379.00
99962 Laryngectomy Ear-Nose and Throat 2,068,500.00 2,758,000.00 1,379.00
99963 Neck dissection Ear-Nose and Throat 2,068,500.00 2,758,000.00 1,379.00
99964 Pharyngoplasty Ear-Nose and Throat 993,000.00 1,324,000.00 662.00

Cimas ZRVS - Effective 1 June 2023

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Cimas ZRVS - Effective 1 June 2023

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CIMAS TARIFFS FOR ZIMBABWE RELATIVE VALUE SCHEDULE - EFFECTIVE 1 JUNE 2023

ZWL ZWL USD

10001 second lesion Integumentary system 19,500.00 26,000.00 13.00

Incision and drainage of infected or non-infected epithelial inclusion cyst

Acne surgery (eg. marsupialization, opening or removal of multiple milia,

Acne surgery (eg. marsupialization, opening or removal of multiple milia,

10061 - under general anaesthetic Integumentary system 436,500.00 582,000.00 291.00

10101 - multiple or complicated Integumentary system 19,500.00 26,000.00 13.00

10121 - complicated Integumentary system 546,000.00 728,000.00 364.00

10140 Drainage of haematoma: simple Integumentary system 300,000.00 400,000.00 200.00

10141 - under general anaesthetic Integumentary system 72,000.00 96,000.00 48.00

Biopsy of skin or subcutaneous tissue (including simple closure), unless otherwise

11101 - each additional lesion Integumentary system 91,500.00 122,000.00 61.00

11102 Biopsy, punch Integumentary system 19,500.00 26,000.00 13.00

11201 - each additional 10 lesions Integumentary system 84,000.00 112,000.00 56.00

11400 - lesion diameter up to 0.5 cm Integumentary system 220,500.00 294,000.00 147.00

11420 - lesion diameter up to 0.5 cm Integumentary system 234,000.00 312,000.00 156.00

11431 Lesions up to 0.5 cm in diameter Integumentary system 193,500.00 258,000.00 129.00

11440 - lesion diameter up to 0.5 cm Integumentary system 268,500.00 358,000.00 179.00

11451 - with complex repair Integumentary system 991,500.00 1,322,000.00 661.00

11463 - with coplex repair Integumentary system 909,000.00 1,212,000.00 606.00

Excision of skin and subcutaneous tissue for hydradentis, perianal, perineal, or

11471 - with complex repair Integumentary system 1,015,500.00 1,354,000.00 677.00

11600 - lesion diameter up to 0.15 cm Integumentary system 370,500.00 494,000.00 247.00

11620 - lesion diameter up to 0.5 cm Integumentary system 384,000.00 512,000.00 256.00

11640 - lesion diameter up to 0.5 cm Integumentary system 439,500.00 586,000.00 293.00

11731 - second nail plate Integumentary system 24,000.00 32,000.00 16.00

11900 Injection, intralesional Integumentary system 114,000.00 152,000.00 76.00

11901 - more than 7 lesions Integumentary system 165,000.00 220,000.00 110.00

Tattooing, intradermal, introduction of insoluble opaque pigments to correct colour

11921 - 6 to 20 sq cm Integumentary system 493,500.00 658,000.00 329.00

11922 - over 20 sq cm Integumentary system 114,000.00 152,000.00 76.00

11951 1 to 5 ml Integumentary system 303,000.00 404,000.00 202.00

11952 - 6 to 10 ml Integumentary system 384,000.00 512,000.00 256.00

11953 - over 10 ml Integumentary system 84,000.00 112,000.00 56.00

12001 Up to 2.5 cm Integumentary system 297,000.00 396,000.00 198.00

12002 2.5 to 7.5 cm Integumentary system 336,000.00 448,000.00 224.00

12004 7.5 to 12.5 cm Integumentary system 418,500.00 558,000.00 279.00

12005 12.5 to 20 cm Integumentary system 532,500.00 710,000.00 355.00

12006 20 to 30 cm Integumentary system 670,500.00 894,000.00 447.00

12011 Up to 2.5 cm Integumentary system 324,000.00 432,000.00 216.00

12013 2.5 to 5.0 cm Integumentary system 379,500.00 506,000.00 253.00

12014 5.0 to 7.5 cm Integumentary system 454,500.00 606,000.00 303.00

12015 7.5 to 12.5 cm Integumentary system 592,500.00 790,000.00 395.00

12016 12.5 to 20 cm Integumentary system 744,000.00 992,000.00 496.00

12061 - first hour Integumentary system 169,500.00 226,000.00 113.00

13003 - first hour Integumentary system 241,500.00 322,000.00 161.00

13008 - first hour Integumentary system 580,500.00 774,000.00 387.00

13101 -2.5 to 7.5 cm Integumentary system 856,500.00 1,142,000.00 571.00

13102 - each additional 7.5 cm Integumentary system 253,500.00 338,000.00 169.00

13121 -2.5 to 7.5 cm Integumentary system 981,000.00 1,308,000.00 654.00

13122 - each additional 7.5 cm Integumentary system 295,500.00 394,000.00 197.00

13141 -2.5 to 7.5 cm Integumentary system 241,500.00 322,000.00 161.00

13142 - each additional 7.5 cm Integumentary system 84,000.00 112,000.00 56.00

13161 -2.5 to 7.5 cm Integumentary system 313,500.00 418,000.00 209.00

13162 - each additional 7.5 cm Integumentary system 121,500.00 162,000.00 81.00

14020 For defects up to 10 sq cm Integumentary system 1,581,000.00 2,108,000.00 1,054.00

14021 - 10 sq cm to 30 sq cm Integumentary system 2,200,500.00 2,934,000.00 1,467.00

14040 For defects up to 10 sq cm Integumentary system 1,894,500.00 2,526,000.00 1,263.00

14041 - 10 sq cm to 30 sq cm Integumentary system 2,556,000.00 3,408,000.00 1,704.00

14060 For defects up to 10 sq cm Integumentary system 2,097,000.00 2,796,000.00 1,398.00

14061 - 10 sq cm to 30 sq cm Integumentary system 2,938,500.00 3,918,000.00 1,959.00

15201 - each addition 20 sq cm Integumentary system 453,000.00 604,000.00 302.00