2023 - General Practitioners and Family Medicine (014 & 015) V2

NAMIBIAN BENCHMARK TARIFFS FOR SERVICES BY GENERAL PRACTITIONERS AND
FAMILY MEDICINE WITH A PRACTICE NUMBER COMMENCING WITH "14" and "15" WITH
EFFECT FROM 1 JANUARY 2023
THIS SCHEDULE IN NO WAY CONSTITUTES AN AGREEMENT BETWEEN ANY PARTIES.
ALL BENCHMARK TARIFFS ARE INCLUSIVE OF VAT
GENERAL RULES GOVERNING THE BENCHMARK TARIFFS
A medical practitioner or specialist is a healthcare practitioner registered with the Medical and Dental Council
of Namibia as a medical practitioner or specialist in terms of the Medical and Dental Act, 2004 (Act No. 10 of
2004).
Note: Every medical practitioner must acquaint him-/herself with the provisions of the Medical and Dental Act,
2004 (Act No. 10 of 2004) and the regulations promulgated under the Acts in connection with the rendering of
accounts. Practitioners' attention is specifically drawn to Section 50 of the Medical and Dental Act which
regulates charges by registered persons.
Section 50(2) of the Act specifically requires that a detailed account relating to professional services must be
submitted to patients. This implies that single accounts must reflect the full cost of services provided and that
the cost of services may not be distributed across separate accounts regardless of the fact that different
payers might be held liable for portions of the account. In practical terms this means that member portions
must be reflected on the same account that is submitted to the medical aid fund.
Every account shall contain the following particulars:
i. The name and practice number of the consulting practitioner.

ii. The name of the member.
iii. The name of the patient.
iv. The name of the medical aid fund.
v. The membership number of the patient.
vi. The nature of the treatment.
vii. The date on which the service was rendered.
viii. The diagnosis code (ICD) of the condition being treated
ix. The code number of the procedure used in the Namibian Benchmark Tariff.
2023/01/16 © The Namibian Association of Medical Aid Funds 1

A CONSULTATIONS
(i) First consultation/visit: Refers to a situation where a medical practitioner personally takes down a
patient's medical history, performs an appropriate clinical examination and, if indicated, prescribes
or administers treatment or assists the patient with advice.
(ii) Subsequent visits: Refers to a voluntarily scheduled visit performed within four (4) months after the
first visit. It may imply taking down a medical history and/or a clinical examination and/or
prescribing or administering of treatment and/or counselling
(iii) Hospital visits: Where a procedure or operation was done, hospital visits are regarded as part of
the normal after-care and no fees may be levied (unless otherwise indicated). Where no procedure
or operation was carried out, fees may be charged for hospital visits according to the appropriate
hospital or inpatient follow-up visit code.
B Due to the multi-ethnicity within the medical profession which results in a variance of office hours, rates
for after-hours consultative services are paid at the same rate as benefits for normal hours consultative
services. Bona-fide, justifiable emergency medical services rendered to a patient, at any time, may
attract a fee as specified in items 0119 or 0104 or 0106 or 0113.
C The fee that may be charged in respect of the rendering of a service not listed in this schedule shall be
based on the fee in respect of a comparable service. Please note: Rule C may not be used for
comparable pathology services Sections 21, 22 and 23.
D Cancellation of appointments: Unless timely steps are taken to cancel an appointment for a
consultation the relevant consultation fee may be charged. In the case of a general practitioner
"timely" shall mean two hours and in the case of a specialist 24 hours prior to the appointment. Each
case shall, however, be considered on merit and, if circumstances warrant, no fee shall be charged. If
a patient has not turned up for a procedure, each member of the surgical team is entitled to charge for
a consultation at or away from doctor's rooms as the case may be.
E Pre-operative visits: The appropriate fee may be charged for all pre-operative visits with the exception
of a routine pre-operative visit at the hospital.
F Where applicable, fees for administering injections and/or infusions may only be charged when done
by the practitioner himself.
G Post-operative care: (Refer to Section VI)

(a) Unless otherwise stated, the fee in respect of an operation or procedure shall include normal after-
care for a period not exceeding ONE month (after-care is excluded from pure diagnostic
procedures during which no therapeutic procedures were performed).

(b) If the normal after-care is delegated to any other registered health professional and not completed
by the surgeon, it shall be his or her responsibility to arrange for this to be done without extra
charge.
(c) When the care of post-operative treatment of a prolonged or specialised nature is required, such
fee as may be agreed upon between the surgeon and the fund or the patient (in the case of a
private account) may be charged.
(d) Normal after-care refers to an uncomplicated post-operative period not requiring any further
incisions.
H Removal of lesions: Items involving removal of lesions include follow-up treatment for 10 days. Refer to
Section VI.
I The fee in respect of the prescribed examination of, and the prescribed report on, any person for his or
her initial admission to a medical aid fund, undertaken at the request of the fund concerned, shall be
paid by such fund. The fee for such examination and report shall be the general practitioner's
consultation fee in respect of the member, and a general practitioner's consultation fee in respect of any
dependant of such member.
J In exceptional cases where the fee is disproportionately low in relation to the actual services rendered by
a medical practitioner, a higher fee may be negotiated.
K In terms of relevant legislation applicable in Namibia, a specialist may treat any person who comes to
him direct for consultation. A specialist who is consulted by a patient or who treats a patient shall take all
reasonable steps to ensure the collaboration of the patient's general practitioner. Medical practitioners
referring cases to other medical practitioners shall indicate in the reference whether the patient is a
member of a medical aid fund or a dependant of such member. This also applies in respect of
specimens sent to pathologists.
L Procedures performed at time of visits: If a procedure is performed at the time of a consultation/visit, the
fee for the visit PLUS the fee for the procedure is charged.
M Procedure planned to be performed later: In cases where, during a consultation/visit, a procedure is

planned to be performed at a later occasion, a visit may not be charged for again, at such a later
occasion.
N Per consultation: No additional fee may be charged for a service for which the fee is indicated as "per
consultation". Such services are regarded as part of the consultation/visit performed at the time the
condition is brought to the doctor's attention.

O In the case of costly or prolonged medical services or procedures the medical practitioner shall first
ascertain from the medical aid fund for what amount the medical aid fund will accept responsibility in
respect of such treatment, should the practitioner wish any direct payment from the fund.
P Travelling fees
(a) Where, in cases of emergency, a practitioner was called out from his residence or rooms to a
patient's home or the hospital, travelling fees can be charged according to section on travelling
expenses (section IV) if he had to travel more than 16 kilometres in total.
(b) If more than one patient would be attended to during the course of a trip, the full travelling
expenses must be divided between the relevant patients.
(c) A practitioner is not entitled to charge for any travelling expenses or travelling time to his rooms
(d) Where a practitioner's residence would be more than 8 kilometres away from a hospital, no
travelling fees may be charged for services rendered at such hospitals, except in cases of
emergency (services not voluntarily scheduled)
(e) Where a practitioner conducts an itinerant practice, he is not entitled to charge fees for travelling
expenses except in cases of emergency (services not voluntarily scheduled)
(f) For voluntarily scheduled services, fees for travelling expenses may only be charged where the
patient and the practitioner have entered into an agreement to this effect. Medical aid benefits will
not be applicable in such instances
INTENSIVE CARE
RULES GOVERNING THIS SPECIFIC SECTION OF THE BENCHMARK TARIFFS
Q Intensive care: Units in respect of items 1204 to 1210 (Categories 1 to 3) EXCLUDE the following:
(a) Anaesthetic and/or surgical fees for any condition or procedure, as well as a first consultation/visit,
which is, regarded as the assessment of the patient, while the daily intensive fee covers the daily
care in the intensive care unit.
(b) Cost of any drugs and/or materials.
(c) Any other cost which may be incurred before, during or after the consultation/visit and/or the
therapy.
(d) Blood gases and chemistry tests, including the arterial puncture to obtain the specimen.
(e) Procedural items 1202 and 1212 to 1221. but INCLUDE the following:
(f) Performing and interpretation of a resting ECG.
(g) Interpretation of chemistry tests and x-rays.
(h) Intravenous treatment (items 0206 and 0207) except intravenous infusion in patients under the age
of two years (item 0205) that does not form a part of the daily ICU fee and may be charged for
separately on a daily basis (fee includes the introduction of the cannula as well as the daily
management)

R Units for items 1208, 1209 and 1210 include resuscitation (i.e. item 1211).
S Units for items 1212, 1213 and 1214 include the following
(a) Measurement of minute volume, vital capacity, time- and vital capacity studies.
(b) Testing and connecting the machine.
(c) Putting patient on machine: setting machine, synchronising patient with machine.
(d) Instruction to nursing staff.
(e) All subsequent visits for 24 hours.
T Ventilation (items 1212 to 1214) does not form a part of normal post-operative care, but may not be
added to item 1204.
RULE GOVERNING THE SECTION OBSTETRIC PROCEDURES
U ANTE NATAL CARE

(i) When a general practitioner treats a patient in the ante-natal period and, after starting the
confinement, requests an obstetrician to take over the case, the general practitioner shall be entitled
to charge for all the ante-natal consultations he has performed.
(a) If the patient has been in labour for less than 6 hours, the general practitioner shall charge
50,00 clinical procedure units according to item 2614.
(b) If the patient has been in labour for more than 6 hours, the general practitioner shall charge
80,00 clinical procedure units according to item 2614.
(ii) When a general practitioner calls an obstetrician to help with a confinement, take over the
management of a confinement, and treats the patient until after the post-partum visit, the
obstetrician shall charge according to item 2614.
(iii) When a general practitioner calls an obstetrician (specialist or general practitioner) to help with a
confinement, or take over the management of a confinement, but the general practitioner treats the
patient until after the post-partum visit, the obstetrician shall charge according to item 2616 and the
general practitioner according to item 2614.
RULES GOVERNING THE SECTION MEDICAL PSYCHOTHERAPY
Va Visits at hospital or nursing home during a course of electro-convulsive treatment are justified and may
be charged for in addition to the fees for the procedure.
Vb Except where otherwise indicated, the duration of a medical psychotherapeutic session is set at 20
minutes or part thereof provided that such apart comprises 50% or more of the time of a session. This
set duration is also applicable for psychiatric examination methods.

RULES GOVERNING THE SECTION RADIOLOGY
Y Except where otherwise indicated, practitioners performing radiology services are entitled to charge for
contrast material used.
Z No fee is subject to more than one reduction
RULES GOVERNING THE SECTION ACUPUNCTURE
AA ACUPUNCTURE
(a) When two separate acupuncture techniques are used, each treatment shall be regarded as a
separate treatment for which fees may be charged for separately.
(b) Not more than two separate techniques may be charged for at each session.
(c) The maximum number of acupuncture treatments per course to be charged for is limited to 20. If
further treatment is required at the end of this period of treatment, it should be negotiated with the
patient.
(d) Item 0380 refers to scalp acupuncture as a treatment in its own right and not to the use of
acupuncture points on the scalp.
MONETARY VALUE OF UNITS
BB The monetary values of the units are as follows:
Description N$
1 Anaesthesiologists 106.60
106.58
2 Clinical Pathology 22.50
22.48
3 Clinical Procedures 20.40
20.45
4 Consultative Services 27.20
27.21
5 Consultative Services (Paediatrics and Paediatric Cardiologists ) 27.20
27.19
6 General Practitioner Consultative Services (Item 0101) 32.00
32.03
32.26
35.82
9 Human Genetics 22.40
22.42
10 Radiology 27.50
27.52
11 Ultrasound 18.81
12 Chemotherapy 17.65

Note: Monetary values have been rounded off on the basis that values less than N$ 20 have been rounded
to the nearest single cent, and those greater than N$ 20 have been rounded to the nearest 10 cents.
EXAMPLE:
(a) Basic fee of 3,00 anaesthetic units N$ 319.90
(b) Time of 75 minutes = 11 units X N$ <<_L_Anaesthesiologist>> N$ 1,172.90
(c) Total (a + b) N$ 1,492.90
RULE GOVERNING ULTRASONIC EXAMINATIONS
CC OBSTETRIC ULTRASOUND
(a) The international norm for antenatal ultrasounds during NORMAL PREGNANCY is three ultrasound
exams. The first scan should preferably include a nuchal thickness estimation and be performed
during the first trimester. The second scan should be performed during the second trimester and
should include a full anatomical report. The third scan should be performed during the third
trimester and should include an assesment of foetal growth. All other ultrasound scans are
excluded from the benefits of medical aid funds unless accompanied by proper motivation. An
ultrasound scan to assess an abnormal early pregnancy may be formed before 10 weeks but this
scan may not be used to diagnose a normal uncomplicated pregnancy. Item 3618 is a
gynaecological scan and its use is not approved for use in pregnancy.
(b) In case of a referral, the referring doctor must submit a letter of motivation to the radiologist or
other practitioner doing the scan. A copy of the letter of motivation must be attached to the first
account rendered to the patient (by the radiologist or the other practitioner doing the scan) and
must be attached to the first account submitted to the medical aid fund by the patient or the doctor,
as the case may be.
(c) In case of a referral to a radiologist, no motivation should be required from the radiologist.
RULES GOVERNING THE SECTION URINARY SYSTEM
DD CYTOSCOPY
(a) When a cystoscopy precedes a related operation, modifier 0013: Endoscopic examination done at
an operation, applies, e.g. cystoscopy followed by transurethral (T U R) prostatectomy.
(b) When a cystoscopy precedes an unrelated operation, modifier 0005: Multiple
procedures/operations under the same anaesthetic, applies, e.g. cystoscopy for urinary tract
infection followed by inguinal hernia repair.
(c) No modifier applies to item 1949: Cystoscopy, when performed together with any of items 1951 to
1973.

RULE GOVERNING THE SECTION RADIOLOGY
EE Capturing and recording of examinations: Images from all radiological and ultrasound procedures
must be captured during every examination and a permanent record generated by means of film,
paper, or magnetic media. A report of the examination, including the findings and diagnostic
comment, must be written and stored for five years.
RULES GOVERNING DIAGNOSTIC SERVICES
AX Diagnostic services rendered to hospital inpatients: Quote modifier 0091 on all accounts for
diagnostic services (e.g. X-rays and pathology tests) performed on patients officially admitted to
hospital or day clinic.
AY Diagnostic services rendered to outpatients: Quote modifier 0092 on all accounts for diagnostic
services (e.g. X-rays and pathology tests) performed on patients NOT officially admitted to hospital
or day clinic (could be within the confines of a hospital).
RULES GOVERNING ENDOSCOPIC PROCEDURES
FF Gastro-intestinal Radiofrequency Therapy for Gastro-Oesophageal Reflux Disease (GORD) and

anal incompetence are not regarded as first line treatment options. Allocation of benefits will be
subject to the application of relevant clinical protocols and require prior authorisation by the relevant
Medical Aid Fund. Treating practitioners will be required to submit confirmation of completion of
relevant training.
RULES GOVERNING PATHOLOGY
GG Single Nucleotide Polymorphism ante-natal testing is not a routine ante-natal test and should be
reserved for high risk patients. Relevant clinical protocols will apply, and prior authorisation must
be obtained from the relevant Medical Aid Fund.

MODIFIERS GOVERNING THE BENCHMARK TARIFFS
GENERAL MODIFIERS GOVERNING THE BENCHMARK TARIFFS
0004 Procedures performed in own procedure rooms: Procedures performed in doctors' own procedure
rooms instead of in a hospital theatre or unattached theatre unit: per fee for procedure + 40 clinical
procedure units. See Section V for a list of procedures which are often done in rooms to which
modifier 0004 should not be applied. Please note: Modifier 0004 may only be charged by the
medical practitioner owning the facility and the equipment. Only one person may claim this modifier
for procedures performed in doctors' own procedure rooms.
Modifier 0004 is not applicable to the following sections:
All anaesthetic services

Section 19: Radiology
Section 20: Radiosurgery
Section 21: Clinical pathology (except for items 3719, 3720 and 3721 where modifier 0004 may be
applied)
0005 Multiple therapeutic procedures/operations under the same anaesthetic:

(a) Unless otherwise identified in the benchmark tariffs when multiple therapeutic
procedures/operations add significant time and/or complexity, and when each
procedure/operation is clearly identified and defined, the following values shall prevail: 100%
(full value) for the first or major procedure/operation, 75% for the second
procedure/operation, 50% for the third procedure/operation, 25% for the fourth and
subsequent procedures/operations. This modifier does not apply to purely diagnostic
procedures
(b) In the case of multiple fractures and/or dislocations the above values shall prevail.
(c) When purely diagnostic endoscopic procedures or diagnostic endoscopic procedures
unrelated to any therapeutic procedures performed, are performed under the same general
anaesthetic, modifier 0005 is not applicable to the fees for such diagnostic endoscopic
procedures as the fees for endoscopic procedures do not provide for after-care. Specify
unrelated endoscopic procedure and provide diagnosis to indicate diagnostic endoscopic
procedure(s) unrelated to other (therapeutic) procedures performed under the same
anaesthetic.
(d) When more than one small procedure is performed, and the tariff makes provision for items
for "subsequent" or "maximum for multiple additional procedures" (see Section 2.
Integumentary System) modifier 0005 is not applicable as the fee is already a reduced fee.

(e) '+' Means that this item is complementary to a preceding item and is therefore not subject to
reduction. (See also modifier 0082).
0006 Visiting specialists performing procedures: Where specialists visit smaller centres to perform
procedures, fees for these procedures are exclusive of after-care. The referring practitioner will
then be entitled to subsequent hospital visits for after-care. If the referring practitioner is not
available, the specialist shall, on consultation with the patient, choose an appropriate locum tenens.
Both the surgeon and the practitioner who handled the after-care, must in such instances quote
modifier 0006 with the particular items which they use.
0007 Use of own equipment

(a) Remuneration for the use of any type of own monitoring equipment in the rooms for
procedures performed under intravenous sedation 15,00 clinical procedure units irrespective
of the number of items of equipment provided.
(b) Remuneration for the use of any type of own equipment for procedures performed in a
hospital theatre or unattached theatre unit when appropriate equipment is not provided by
the hospital - 15 clinical procedure units irrespective of the number of items of equipment
provided.
0008 Specialist surgeon assistant: Where a procedure requires a registered specialist surgeon assistant,
the fee is 33,33% (1/3) of the fee for the specialist surgeon.
Modifier 0008 may only be used under the following circumstances:

• Registered specialist assistants may only be used when the principal surgeon is a registered
specialist surgeon;
• The use of a registered specialist assistant should be requested and authorised prior to the
procedure being performed;
• The procedure should be performed in a hospital theatre;
• The use of a registered specialist should not be authorised if the motivation is related to a lack of
training on the part of the primary surgeon.
It is unlikely that procedures carrying a unit value of less than 300 will require the presence of registered
specialist surgeons.
0009 The fee for an assistant is 20% of the fee for the specialist surgeon, with a minimum of 36,00
clinical procedure units.

0010 A fee for a local anaesthetic administered by the operator may only be charged for an operation or
a procedure having a value greater than 30,00 clinical procedure units (i.e. 31,00 or more units
allocated to a single item). The fee shall be calculated according to the basic anaesthetic units for
the specific operation. Anaesthetic time may not be charged for, but the minimum fee as per
modifier 0036 shall be applicable in such a case. Not applicable to radiological procedures (such
as angiography and myelography). No fee may be levied for topical application of local anaesthetic.
Please note: modifier 0010 may not be added on the surgeon's account for procedures that were
performed under general anaesthetic
0011 Emergency surgery for theatre procedures: Any bona fide, justifiable emergency procedure (all
hours) undertaken in an operating theatre, will attract an additional 12,00 clinical procedure units
per half-hour or part thereof of the operating time for all members of the surgical team. Modifier
0011 does not apply in respect of patients on scheduled lists.
0013 Endoscopic examinations done at operations: Where a related endoscopic examination is done at
an operation by the operating surgeon or the attending anaesthesiologist, only 50% of the fee for
the endoscopic examination may be charged.
0014 Where an operation is performed which has been previously performed by another surgeon, e.g. a
revision or repeat operation, the fee shall be calculated according to the benchmark tariffs for the
full operation plus an additional fee to be negotiated under General Rule J, except where already
specified in the scale of benefits.
INJECTIONS, INFUSIONS AND INHALATION SEDATION
MODIFIERS GOVERNING THIS SPECIFIC SECTION OF THE BENCHMARK TARIFFS
0015 Where intravenous infusions (including blood and blood cellular products) are administered as part
of the after-treatment after the operation or confinement, no extra fees shall be charged as this is
included in the global operative or maternity fees. Should the practitioner doing the operation or
attending to the maternity case prefer to ask another practitioner to perform post-operative or post-
confinement intravenous infusions, then the practitioner himself (and not the patient) shall be
responsible for remunerating such practitioner for the infusions.
0017 Injections administered by practitioners: When desensitization, intravenous, intramuscular or

subcutaneous injections are administered by the practitioner himself to patients who attend the
consulting rooms, a first injection forms a part of the consultation/visit and all subsequent injections
for the same condition should be charged at 50% of the appropriate visit fee for a general
practitioner.

MODIFIER GOVERNING SURGERY ON PERSONS WITH A BMI OF MORE THAN 35
0018 Surgical modifier for persons with a BMI of >35 (calculated according to kg/m2): Fee for procedure
+50% for surgeons and a 50% increase in anaesthetic time units for anaesthesiologists. Note: For
pregnant patients 1 kg per elapsed month of pregnancy should be subtracted from the total body
weight at the time of calculation of the BMI before the BMI is calculated (Not appplicable when
doagnostic procedures are performed).
MODIFIER GOVERNING SURGERY ON NEONATES OR LOW BIRTH WEIGHT INFANTS
0019 Surgery on neonates (up to and including 28 days after birth) and low birth weight infants (less than
2500g) under general anaesthesia, excluding circumcision: per fee for procedure + 50% for
surgeons and a 50% increase in anaesthetic time units for anaesthesiologists (Note: Please record
the patient's weight on the account)
MODIFIERS GOVERNING THE ADMINISTRATION OF ANAESTHETIC FOR ALL THE PROCEDURES

AND OPERATIONS INCLUDED IN THIS BENCHMARK TARIFFS
0020 Conscious Sedation: Any case which is conducted outside of a theatre hospital suite, shall be
coded with the relevant procedure code. To identify these cases, the above modifier should be
used to indicate to the medical funders that there will be no hospital/theatre account.
0021 Determination of anaesthetic fees: Anaesthetic fees are determined by obtaining the sum of the
basic anaesthetic units (allocated to each procedure that might be performed under anaesthetic
indicated in the anaesthetic column) plus the time units (calculated according to the formula in
modifier 0023) and the appropriate modifiers (see modifiers 0037-0044). In cases of operative
procedures on the musculo-skeletal system, open fractures and open reduction of fractures or
dislocations add units as laid down by modifiers 5441 to 5448.
0023 The basic anaesthetic units are laid down in the benchmark tariffs and are reflected in the
anaesthetic column. These basic anaesthetic units reflect the additional anaesthetic risk, the
technical skill required of the anaesthesiologist and the scope of the surgical procedure, but
exclude the value of the actual time spent administering the anaesthetic. The time units (indicated
by "T") will be added to the listed basic anaesthetic units in all cases on the following
basis:Anaesthetic time: The remuneration for anaesthetic time shall be per 15-minute period or part
thereof, calculated from the commencement of the anaesthetic, i.e. 2,00 anaesthetic units per 15-
minute period or part thereof, provided that should the duration of the anaesthetic be longer than
one (1) hour the number of units shall, after one (1) hour, be 3,00 anaesthetic units per 15-minute

period or part thereof
0024 Pre-operative assessments not followed by procedures: If a pre-operative assessment of a patient

by the anaesthesiologist is not followed by an operation it will be regarded as a visit at hospital or
nursing home and the appropriate hospital visit item should be charged.
0025 Calculation of anaesthetic time: Anaesthetic time is calculated from the time the anaesthesiologist
begins to prepare the patient for the induction of anaesthesia in the operating theatre or in a similar
equivalent area and ends when the anaesthesiologist is no longer required to give his/her personal
professional attention to the patient, i.e. when the patient may, with reasonable safety, be placed
under the customary post-operative supervision. Where prolonged personal professional attention
is necessary for the well-being and safety of such patient, the necessary time will be valued on the
same basis as indicated above for the anaesthetic time. The anaesthesiologist must show on
his/her account the exact anaesthetic time, including the supervision time spent with the patient.
0027 Where more than one operation is performed under the same anaesthetic, the basic anaesthetic
units will be that of the major operation with the highest number of units.
0028 Use of low flow anaesthetic technique less than 1litre/minute: Fresh gas flow of less than 1
litre/minute. Additional N$0.00 per 15 minutes of anaesthetic time. The amount reflected in this item
would be reviewed regularly.
0030 Use of low flow anaesthetic technique 1-2 litre/minute: Fresh gas flow of 1 to 2 litre/minute.
Additional N$0.00 per 15 minutes of anaesthetic time. The amount reflected in this item would be
reviewed regularly.
0029 When rendered necessary by the scope of the anaesthetic, an assistant anaesthesiologist may be
employed. The remuneration of the assistant anaesthesiologist shall be calculated on the same
basis as in the case where a general practitioner administers the anaesthetic.
0031 Treatment with intravenous drips and transfusions is considered part of the normal treatment in
administering an anaesthetic. No additional fees may be charged for such services when rendered
either prior to, or during actual theatre or operating time.
0032 Anaesthesia administered to patients in the prone position shall have a minimum of 4,00 basic
anaesthetic units. When the basic anaesthetic units for the procedure is 3,00, one extra
anaesthetic unit should be added. If the basic anaesthetic units for the procedure is 4,00 or more,
no extra units should be added.

0033 When an anaesthesiologist is required to participate in the general care of a patient during a
surgical procedure, but does not administer the anaesthetic, such services may be remunerated at
full anaesthetic rate, subject to the provisions of modifier 0035
0034 All anaesthetics administered for diagnostic, surgical or X-ray procedures on the head and neck
shall have a minimum of 4,00 basic anaesthetic units. When the basic anaesthetic units for the
procedure is 3,00, one extra anaesthetic unit should be added. If the basic anaesthetic units for the
procedure is 4,00 or more, no extra units should be added.
0035 No anaesthetic administered by a specialist anaesthesiologist shall have a total value of less than
7,00 anaesthetic units.
0036 Fees for an anaesthetic administered by a general practitioner shall be eighty-two percent (82%) of
the total number of units (basic plus time plus appropriate modifier) applicable to the specialist
anaesthesiologist provided that no anaesthetic shall have a total value of less than 6,00 anaesthetic
units. The monetary value of the unit is the same for both a specialist anaesthesiologist and a
general practitioner anaesthesiologist.
Note: Modifying units may be added to the basic anaesthetic unit value according to the following
modifiers (0037-0044, 5441-5448):
0037 Utilisation of total body hypothermia: Add 3,00 anaesthetic units
0038 Peri-operative blood salvage: Add 4,00 anaesthetic units for intra-operative blood salvage and 4,00
anaesthetic units for post-operative blood salvage.
0039 Deliberate control of the blood pressure: All cases up to one hour - add 3,00 anaesthetic units,
thereafter add 1,00 (one) additional anaesthetic unit per quarter hour or part thereof
0040 The basic anaesthetic units for procedures performed for pheochromocytoma shall be 15,00
anaesthetic units
0041 Utilisation of hyperbaric pressurisation: Add 3,00 anaesthetic units
0042 Utilisation of extracorporeal circulation: Add 3,00 anaesthetic units
0043 For all cases under one year or over 70 years of age - 3,00 anaesthetic units to be added

0044 Neonates (i.e. up to and including 28 after birth) - 3,00 anaesthetic units to be added to the basic
anaesthetic units for the particular procedure. This modifier is charged in addition to modifier 0043:
Cases under one year or over 70 years of age.
MODIFIERS GOVERNING ANAESTHETIC FEES FOR ORTHOPAEDIC OPERATIONS
Modifiers 5441 to 5448
Modification of the anaesthetic fee in cases of operative procedures on the musculo-skeletal system, open
fractures and open reduction of fractures and dislocations is governed by adding units indicated by
modifiers 5441 to 5448. (The letter "M" is annotated next to the number of units of the appropriate items, for
facilitating identification of the relevant items)
5441 Add ONE anaesthetic unit, except where the procedure refers to the bones named in modifiers
5442 to 5448
5442 Shoulder, scapula, clavicle, humerus, elbow joint, upper 1/3 tibia, knee joint, patella, mandible and
temporo-mandibular joint - Add TWO anaesthetic units
5443 Maxillary and orbital bones - Add THREE anaesthetic units
5444 Shaft of femur - Add FOUR anaesthetic units
5445 Spine (except coccyx), pelvis, hip, neck of femur - Add FIVE anaesthetic units
5448 Sternum and/or ribs and musculo-skeletal procedures which involve an intra-thoracic approach -
Add EIGHT anaesthetic units
POST-OPERATIVE ALLEVIATION OF PAIN
0045 Post-operative alleviation of pain

(a) When a regional or nerve block procedure (not local infiltration with local anaesthetic) is
performed, the appropriate hospital follow-up visit to patient in ward or nursing facility can be
charged, provided that it is not the primary anaesthetic technique.
(b) When a second medical practitioner has administered the regional or nerve block for post-
operative alleviation of pain it shall be charged according to the particular procedure for
instituting therapy. Revisits shall be charged according to the appropriate hospital follow-up
visit to patient in ward or nursing facility.

(c) None of the above is applicable for routine post-operative pain management i.e.
intramuscular, intravenous or subcutaneous administration of opiates or NSAID
(nonsteroidal anti-inflammatory drug).
MODIFIER GOVERNING FEES FOR AN ANAESTHESIOLOGIST OPERATING INTRA-AORTIC

BALLOON PUMP (CARDIOVASCULAR SYSTEM)
0100 Where an anaesthesiologist would be responsible for operating an intra-aortic balloon pump, a fee
of 75,00 clinical procedure units is applicable.
MUSCULO-SKELETAL SYSTEM
0046 Where in the treatment of a specific fracture or dislocation (compound or closed) an initial
procedure is followed within one month by an open reduction, internal fixation, external skeletal
fixation or bone grafting on the same bone, the fee for the initial treatment of that fracture or
dislocation shall be reduced by 50%. Please note: This reduction does not include the assistant's
fee or after-hours levy where applicable. After one month, a full fee as for the initial treatment, is
applicable.
0047 A fracture NOT requiring reduction shall be charged on a fee per service basis.
0048 Where in the treatment of a fracture or dislocation an initial closed reduction is followed within one
month by further closed reductions under general anaesthesia, the fee for such subsequent
reductions will be 27,00 clinical procedure units (not including after-care).
0049 Except where otherwise specified, in cases of compound fractures, 77,00 clinical procedure units
(specialists) and 51,00 clinical procedure units (general practitioners) are to be added to the units
for the fractures including debridement.
0050 In cases of a compound fracture where a debridement is followed by internal fixation (excluding
fixation with Kirschner wires), the full amount according to either modifier 0049 or 0051 may be
added to the fee for the procedure involved, plus half of the amount according to the second
modifier (either 0049 or 0051 as applicable).
0051 Fractures requiring open reduction, internal fixation, external skeletal fixation and/or bone grafting:
Specialists add 77,00 clinical procedure units. General practitioners add 51,00 clinical procedure
units.

0053 Fracture requiring percutaneous internal fixation [insertion and removal of fixatives (wires) in
respect of fingers and toes included]: Specialists add 32,00 clinical procedure units; general
practitioners add 21,00 clinical procedure units.
0055 Dislocation requiring open reduction: Units for the specific joint plus 77,00 clinical procedure units
for specialists. General practitioners add 51,00 clinical procedure units.
0057 Multiple procedures on feet: In multiple procedures on feet, fees for the first foot are calculated
according to modifier 0005: Multiple procedures/operations under the same anaesthetic. Calculate
fees for the second foot in the same way, reduce the total to 75% and add to the total for the first
foot.
0058 Revision operation for total joint replacement and immediate resubstitution (infected or non-
infected): per fee for total joint replacement + 100%.
MODIFIER GOVERNING COMBINED PROCEDURES ON THE SPINE
0061 In cases of combined procedures on the spine, both the orthopaedic surgeon and the
neurosurgeon are entitled to the full fee for the relevant part of the operation performed.
MODIFIERS GOVERNING THE SUBSECTION REPLANTATION OPERATION
0063 Where two specialists work together on a replantation procedure, each shall be entitled to two-
thirds of the fee for the procedure.
0064 Where the replantation is unsuccessful, no further surgical fee is payable for amputation of the
non-viable parts.
MODIFIER: SECTION SPINAL DEFORMITIES
0065 Additional operative procedures by same surgeon (other than the first two items listed under this
heading) within a period of 12 months: 75% of scheduled fee for the lesser procedure, except
where otherwise specified elsewhere.
MODIFIER: MICROSURGERY OF THE FALLOPIAN-TUBES AND OVARIES
0066 Where microsurgical techniques are used, with the aid of a microscope 25% may be added to the
fee.

MODIFIER GOVERNING THE SECTION LARYNX
0067 Microsurgery of the larynx: To the fee of the operation performed add 25%
MODIFIERS GOVERNING NASAL SURGERY
0069 When endoscopic instruments are used during intranasal surgery: Add 10% of the fee of the
procedure performed. Only applicable to items 1025, 1027, 1030, 1033, 1035, 1036, 1039, 1047,
1054 and 1083.
MODIFIER GOVERNING OPEN PROCEDURE(S) WHEN PERFORMED THROUGH A THORASCOPE
0070 Add 45,00 clinical procedure units to procedure(s) performed through a thorascope
MODIFIER GOVERNING NON-INVASIVE PERIPHERAL VASCULAR TESTS
0072 The number of tests in a single case is restricted to two (2) per diagnosis. Tests are not justified in
cases of uncomplicated varicose veins.
MODIFIER GOVERNING PAEDIATRIC CARDIAC CATHETERISATION BY PAEDIATRIC

CARDIOLOGISTS WITH A "33" PRACTICE NUMBER
0073 When item 1288: Paediatric cardiac catheterisation or item 1289: Paediatric cardiac catheterisation:
Infants below the age of one year, was performed by paediatric cardiologists ('33'): fee for
procedure + 100%.
MODIFIER GOVERNING GASTROENTEROLOGY PROCEDURES
0074 Endoscopic procedures performed with own equipment: The basic procedure fee plus 33.33% (1/3)
of that fee ("+" codes excluded) will apply where endoscopic procedures are performed with own
equipment. (Note: Only applicable to endoscopic procedures and cannot be claimed with Modifier
0004)
MODIFIER GOVERNING FEES FOR FIBRE OPTIC PROCEDURES
0075 Endoscopic procedures performed in own procedure room: The fee plus 21,00 clinical procedure
units will apply where endoscopic procedures are performed in rooms with own equipment. This fee
is chargeable by medical practitioners who own or rent the facility. (Note: Cannot be claimed with

modifier 0004)
MODIFIER GOVERNING THE SECTION ON PHYSICAL TREATMENT
0077 When two separate areas are treated simultaneously for totally different conditions, such treatment
shall be regarded as two treatments for which separate fees may be charged. (Only applicable if
services are provided by a specialist in physical medicine).
MODIFIER TESTIS AND EPIDIDYMIS
0078 When testis biopsy is done combined with vasogram or seminal vesiculogram or epididymogram,
add 50% of the units for the appropriate procedure.
MODIFIER GOVERNING THE SECTION MEDICAL PSYCHOTHERAPY
0079 When a first consultation/visit proceeds into, or is immediately followed by a medical

psychotherapeutic procedure, fees for the procedure are calculated according to item 2957:
Individual psychotherapy (specify type) for a 20-minute session or part thereof, provided that such
a part comprises 50% or more of the time of a session.
MODIFIERS GOVERNING THE SECTION DIAGNOSTIC RADIOLOGY
0080 Multiple examinations: Full Fee.
0081 Repeat examinations: No reduction.
0082 + Means that this item is complementary to a preceding item and is therefore not subject to
reduction.
0083 A reduction of 33,33% (1/3) in the fee will apply to radiological examinations as indicated in section
19 where hospital equipment is used.
0084 Fixed fee of N$ 113.90 will apply for the first film. The same applies to images captured on CD.
MODIFIER GOVERNING VASCULAR STUDIES
0086 Vascular groups: "Film series" and "Introduction of Contrast Media" are complementary and
together constitute a single examination: neither fee is therefore subject to increase in terms of
Modifier 0080.

0085 Where more than one view is requested by the referring clinician, 50% of the cost of modifier 0084
will apply for each additional film/CD. This excludes undesirable films.
Medical Aid Funds reserve the right to request proof of prescription
6300 If a procedure lasts less than 30 minutes only 50% of the machine fees for items 3536-3550 will be
allowed (specify time of procedure on account).
6303 When a procedure is performed entirely by a non-radiologist in a facility owned by a radiologist, the
radiologist owning the facility may charge 55% of the procedure units used.
6305 When multiple catheterisation procedures are used (items 3557, 3559, 3560, 3562) and an
angiogram investigation is performed at each level, the unit value of each such multiple procedure
will be reduced by 20,00 radiological units for each procedure after the initial catheterisation. The
first catheterisation is charged at 100% of the unit value
MODIFIER GOVERNING ULTRASONIC INVESTIGATIONS
0160 Aspiration of biopsy procedure performed under direct ultrasonic control by an ultrasonic aspiration
biopsy transducer (Static Realtime): Fee for part examined plus 30% of the units.
0165 Use of contrast during ultrasound study: add 6.00 ultrasound units
5104 Ultrasound in pregnancy, multiple gestation, after ten weeks: add 85%
MODIFIER GOVERNING INTERVENTIONAL RADIOLOGICAL PROCEDURES
6303 When a procedure is performed entirely by a non-radiologist in a facility owned by a radiologist, the
radiologist owning the facility may charge 55% of the procedure units used.
MODIFIERS GOVERNING THE SECTION PATHOLOGY
0097 Where items under Pathology and Anatomical Pathology fall within the province of other specialists

or general practitioners, the fee is to be charged at two-thirds of the pathologist's fee.
MODIFIERS GOVERNING DIAGNOSTIC SERVICES
0091 Diagnostic services rendered to hospital inpatients: Quote modifier 0091 on all accounts for
diagnostic services (e.g. X-rays and pathology tests) performed on patients officially admitted to
hospital or day clinic (Refer to Rule XX)
0092 Diagnostic services rendered to outpatients: Quote modifier 0092 on all accounts for diagnostic
services (e.g. X-rays and pathology tests) performed on patients NOT officially admitted to hospital
or day clinic (could be within the confines of a hospital) (Refer to Rule YY)
I. CONSULTATIVE SERVICES
Please note: The calculated amounts in this section are calculated according to the consultative service
values
FIRST CONSULTATIONS: NORMAL HOURS
The Namibian Benchmark Tariff unit values for general practitioners and paediatrics differ from that of
other specialists, except for items 0102, 0105, 0108, 0109, 0130, 0132 and 0133 where the unit value for
general practitioners are equal to that of the other specialists.
The unit values for general practitioners in respect of item 0101 were calculated at N$ 32.20, item 0108 at
N$ 32.40 and item 2601 at N$ 35.80.
Note: First consultations include patient care for the initial 24-hour period, excluding any procedures that
may be performed during this period, and subsequent consultations become applicable following this
period.
All consultations include the performing of all clinical observations that would normally form part of a clinical
examination.
Item Description Units N$
0101 At Doctor's rooms or home 15.00 480.40

480.44
0101 At Doctor's rooms or home (Pr. Nr. 15) 27.00 734.70
734.72
0103 Away from doctor's rooms 18.00 489.80
489.81
0103 Away from doctor's rooms (Pr. Nr. 15) 33.00 898.00
897.99

0102 Pre-anaesthetic assessment of patient in ward or Doctor’s rooms (includes 16.00 435.40
435.39
emergency cases where doctor does not travel): Includes the interpretation of an
ECG and/or lung function test
0105 Pre-anaesthetic assessment of patient inside theatre suite (includes emergency 10.00 272.10
272.12
cases where doctor does not travel): Includes the interpretation of an ECG and/or
lung function test
0107 Exclusive attendance to baby at caesarean section, normal delivery or visit in the 33.00 898.00
897.99
ward
SUBSEQUENT CONSULTATIONS OR VISITS within 4 months for the same condition (See Rule A)
The Namibian Benchmark Tariff unit values for general practitioners and paediatrics differ from that of other
specialists, except for items 0102, 01050108, 0109, 0130, 0132 and 0133 where the unit value for general
practitioners are equal to that of the other specialists.
Note: Subsequent consultations become applicable after the initial 24-hour period (during which first
consultations were applicable) and refer to patientcare per 24-hour period following the initial 24-hour
period.
0108 Subsequent consultation/visit at rooms (once per 24-hour period) 12.00 387.10
0108 Subsequent consultation/visit at rooms (once per 24-hour period) (Pr. Nr. 15) 18.00 489.80
489.81
0109 Hospital follow-up visit to patient in ward or nursing facility (once per 24-hour period) 10.00 272.10
272.12
0109 Hospital follow-up visit to patient in ward or nursing facility (once per 24-hour period) 10.00 272.10
272.12
(Pr. Nr. 15)
0112 At patient's residence: All hours (once per 24-hour period) 15.00 408.20
408.18
0114 Weekly maximum for 0112 for first 2 weeks 105.00 2 857.20
857.23
0115 Weekly maximum for 0112 after first 2 weeks 60.00 1 632.70
632.71
EMERGENCY VISIT - See General Rule B - (Not to be charged together with any first or subsequent
consultation) Where, in cases of emergency, a practitioner was called and has to travel to the
patient at all hours
Please note: Pre-anaesthetic assessment (all hours), in cases of emergency: Item 0119 may be charged by
an anaesthesiologist in cases of emergency where doctor has to travel (would replace items 0102 and
0105) irrespective of whether evaluation is followed by an anaesthetic or not.
Please note: Only one emergency visit code may be charged per occasion. That is the most appropriate

code under a specific circumstance must be selected.
specialists, except for items 0102, 0105, 0108, 0109, 0130, 0132 and 0133 where the unit value for general
0119 Doctor has to travel due to an emergency (all hours) (Note: This code applies to 26.00 707.50
707.51
reasonable travel that requires the use of a motor vehicle and includes the
emergency consultation and travelling)
0119 Doctor has to travel due to an emergency (all hours) (Note: This code applies to 41.00 1 115.70
115.69
reasonable travel that requires the use of a motor vehicle and includes the
emergency consultation and travelling) (Pr. Nr. 15)
0104 Emergency attendance where doctor does not travel (all hours) (not applicable to 20.00 544.20
544.23
General Medical Practices where a General Medical Practitioner is on duty for 24-
hours per day offering 24 hour services) - See General Rule B
0104 Emergency attendance where doctor does not travel (all hours) (not applicable to 35.00 952.40
952.42
General Medical Practices where a General Medical Practitioner is on duty for 24-
hours per day offering 24 hour services) - See General Rule B (Pr.Nr. 15)
0106 Emergency attendance at General Medical Practices where a General Medical 23.00 625.90
625.87
Practitioner is on duty for 24-hours per day offering 24 hour services (all hours) - See
General Rule B
0113 Emergency attendance to newborn at all hours - See General Rule B 30.00 816.40
816.35
WHEN MORE THAN ONE PATIENT FROM THE SAME HOUSEHOLD IS TREATED
0120 First patient: Normal hours, away from doctor's rooms 18.00 489.80
489.81
0123 Each additional patient 12.00 326.50
326.54
MISCELLANEOUS
specialists, except for items 0102, 0105, 0108, 0109, 0130, 0132 and 0133 where the unit value for general
0125 Long consultations (general practitioner), due to an emergency or the necessity for 6.70 182.30
182.32
the practitioner's prolonged attention to a patient for services for which no other fee
may be charged: After first 1/2 hour (for which the appropriate consultation item

should be charged) (excluding time used for additional procedures): Per 1/4 hour or
part thereof (duration of long consultation should be stated on the account)
0127 Prolonged post-operative care in hospital, exceeding 4 weeks: Per week -
0129 Prolonged first consultation (specialists) per 15-minutes (to be added to item 0101 or -
0103 only if service extends 10 minutes or more into the next 15-minute period
following on the first 30 minutes.
0130 Telephone or e-mail consultation (all hours) * 12.00 326.50
326.54
0132 Consulting service e.g. writing of repeat scripts or requesting routine pre-authorisation 5.00 136.10
136.06
without the physical presence of the patient (needs not be face to face contact)
0133 Writing of special motivations for procedures and treatment without the physical 9.00 244.90
244.91
presence of the patient (includes report on the clinical condition of a patient)
requested by or on behalf of a third party funder or its agent.
0134 Administration fee to be paid by the patient (or the person responsible for the -
account) per month towards the costs of statements for accounts outstanding for
over 60 days.
II. SUPPLIES, MATERIALS, SPECIAL MEDICINE AND OWN EQUIPMENT USED IN TREATMENT
Please note: Pre-anaesthetic assessment (all hours), in cases of emergency: Item 0119 may be charged by
an anaesthesiologist in cases of emergency where doctor has to travel (would replace items 0102 and
0105) irrespective of whether evaluation is followed by an anaesthetic or not.
The Namibian Benchmark Tariff unit values for general practitioners and paediatrics differ from that of
other specialists, except for items 0102, 0105, 0108, 0109, 0130, 0132 and 0133 where the unit value for
general practitioners are equal to that of the other specialists.
It is recommended that, when such benefits are granted, drugs, consumables and disposable items used
during a procedure or issued to a patient on discharge will only be reimbursed by a medical aid fund if the
correct NAPPI code is supplied on the account.
0200 Cost of prostheses and/or internal fixation apparatus: Cost price (VAT-included) plus 10% mark-
up, with a maximum mark-up of N$ 7,578.20
0201 Cost of material and medicines used in treatment: This item provides for a charge for material,
and special medicine used in treatment. Material to be charged for at cost price plus 35%,
except where the cost is N$ 3,783.90 or more (VAT included), when a mark-up of 10% to a
maximum markup of N$ 7,578.20 (VAT included) will apply. Charges for medicine used in
treatment not to exceed the retail ethical price list. Note: This item does not provide for charges
for consumables used during treatment, the cost of which are included in the relevant tariffs.
0202 Setting of sterile tray: A fee of 10,00 clinical procedure units may be charged for the setting of a
sterile tray where a sterile procedure is performed in the rooms. Cost of stitching material, if
applicable, shall be charged for according to item 0201.

0212 Cost of chemotherapy drugs: This item provides for a charge at cost price plus 35% for
chemotherapy drugs used in chemotherapy, except where the cost is N$ 3,783.90 or more (VAT
included), when a mark-up of 10% to a maximum mark-up of N$ 7,578.20 (VAT included) will
apply. Please note: Where a condition necessitates the administration of a drug by any route of
administration on a routine/continuous/schedules basis, the price of such drug must be
calculated and billed per course/cycle of treatment for a given condition, and not per individual
unit (tablet/capsule/ampoule/vial) of such drug.
OWN EQUIPMENT USED IN TREATMENT 0084
Please note: Only the owner of the equipment may charge hire fees for equipment used and not the person
using the equipment
LASER EQUIPMENT
(a) Ophthalmic laser equipment
See section 16.14: General (items 3190, 3198 and 3201) for ophthalmic laser equipment
(b) Surgical laser equipment
Item Description Specialist Specialist Anaesthetic Anaesthetic

Units N$ Units N$
5930 Surgical laser apparatus: Hire fee for own 109.00 2 228.60
228.62
equipment
5932 Candella laser apparatus: (Rates by -
arrangement with the fund concerned): Hire fee
for own equipment
III. PROCEDURES
GENERAL MODIFIERS GOVERNING THIS SECTION OF THE BENCHMARK TARIFFS
0011 Emergency surgery for theatre procedures: Any bona fide, justifiable emergency procedure (all
hours) undertaken in an operating theatre, will attract an additional 12,00 clinical procedure units

per half-hour or part thereof of the operating time for all members of the surgical team. Modifier
0011 does not apply in respect of patients on scheduled lists.
0013 Endoscopic examinations done at operations: Where a related endoscopic examination is done
at an operation by the operating surgeon or the attending anaesthesiologist, only 50% of the fee
for the endoscopic examination may be charged.
0014 Where an operation is performed which has been previously performed by another surgeon, e.g.
a revision or repeat operation, the fee shall be calculated according to the benchmark tariffs for
the full operation plus an additional fee to be negotiated under General Rule J, except where
already specified in the benchmark tariffs.
0015 Where intravenous infusions (including blood and blood cellular products) are administered as
part of the after-treatment after the operation or confinement, no extra fees shall be charged as
this is included in the global operative or maternity fees. Should the practitioner doing the
operation or attending to the maternity case prefer to ask another practitioner to perform post-
operative or post-confinement intravenous infusions, then the practitioner himself (and not the
patient) shall be responsible for remunerating such practitioner for the infusions.
0017 Injections administered by practitioners: When desensitization, intravenous, intramuscular or

subcutaneous injections are administered by the practitioner himself to patients who attend the
consulting rooms, a first injection forms a part of the consultation/visit and all subsequent
injections for the same condition should be charged at 50% of the appropriate visit fee for a
general practitioner.
1 INJECTIONS, INFUSIONS AND SEDATION TREATMENT

Units N$ Units N$
- -
INHALATION SEDATION - -
0203 Use of analgesic nitrous oxide for alcohol and 6.00 122.68
122.70 -
other withdrawal states: First quarter-hour or part
thereof
0204 Per additional quarter-hour or part thereof 3.00 61.34
61.30 -
INTRAVENOUS TREATMENT (See note: How to - -
charge for intravenous infusions)
0205 Intravenous infusions (cutdown or push-in) 12.00 245.35
245.40 -

Units N$ Units N$
(patients under two years): Cutdown and/or

insertion of cannula - chargeable once per 24 hours
0206 Intravenous infusions (push-in) (patients over two 6.00 122.68
122.70 -
years): Insertion of cannula - chargeable once per
24 hours
0207 Intravenous infusions (cutdown) (patients over two 8.00 163.57
163.60 -
years): Cutdown and insertion of cannula -
chargeable once per 24 hours
VENESECTION - -
0208 Therapeutic venesection (Not to be used when 6.00 122.68
122.70 -
blood is drawn for the purpose of laboratory
investigations)
0209 Umbilical artery cannulation at birth 18.00 368.03
368.00 -
0210 Collection of blood specimen(s) for pathology 3.25 66.45
66.40 -
examination, per venesection
0211 Exchange transfusion: First and subsequent 53.00 1 083.60
083.64 -
(including after-care)
INTRAVENOUS TREATMENT WITH - -
CYTOSTATIC AGENTS
0213 Chemotherapy prescribed by a specialist 5.00 102.23
102.20 -
oncologist: Intramuscular or subcutaneous: per
injection: Maximum 3 injections
184.00 -
oncologist: Intravenous bolus technique: per
286.20 -
oncologist: Intravenous infusion technique: per
5790 Non Infusional Chemotherapy Fee - Global Fee for 28.63 505.39
505.40 -
the management of and for related services
delivered in the treatment of cancer with oral
chemotherapy, intramuscular (IMI) or
subcutaneous (SC), intrathecal or bolus
chemotherapy or oncology specific drugs per
treatment day under circumstances where the
treating doctor is taking full responsibility for the
patient's care and a specialist oncologist is not
involved (consultations to be charged separately)
(not applicable to oral hormonal therapy).
5793 Infusional Chemotherapy - Global fee for the 109.23 1 928.20
928.19 -
management of and for services delivered during
infusional chemotherapy per treatment day under
circumstances where the treating doctor is taking
full responsibility for the patient's care and a
specialist oncologist is not involved
Note: HOW TO CHARGE FOR INTRAVENOUS INFUSIONS:
Practitioners are entitled to charge according to the appropriate item whenever they personally insert the
cannula (but may only charge for this service once every 24 hours). For managing the infusion as such,
e.g. checking it when visiting the patient or prescribing the substance, no fee may be charged since this

service is regarded as part of the services the doctor renders during consultations (not applicable to item
0205)
MODIFIERS GOVERNING THE ADMINISTRATION OF ANAESTHETIC FOR ALL THE PROCEDURES

AND OPERATIONS INCLUDED IN THIS BENCHMARK TARIFFS
0021 Determination of anaesthetic fees: Anaesthetic fees are determined by obtaining the sum of the
basic anaesthetic units (allocated to each procedure that might be performed under anaesthetic
indicated in the anaesthetic column) plus the time units (calculated according to the formula in
modifier 0023) and the appropriate modifiers (see modifiers 0037-0044). In cases of operative
procedures on the musculo-skeletal system, open fractures and open reduction of fractures or
dislocations add units as laid down by modifiers 5441 to 5448.
0023 The basic anaesthetic units are laid down in the benchmark tariffs and are reflected in the
anaesthetic column. These basic anaesthetic units reflect the additional anaesthetic risk, the
technical skill required of the anaesthesiologist and the scope of the surgical procedure, but
exclude the value of the actual time spent administering the anaesthetic. The time units
(indicated by "T") will be added to the listed basic anaesthetic units in all cases on the following
basis:
Anaesthetic time: The remuneration for anaesthetic time shall be per 15 minute period or part
thereof, calculated from the commencement of the anaesthetic, i.e. 2,00 anaesthetic units per 15
minute period or part thereof, provided that should the duration of the anaesthetic be longer than
one (1) hour the number of units shall, after one (1) hour, be 3,00 anaesthetic units per 15
minute period or part thereof
0024 Pre-operative assessments not followed by procedures: If a pre-operative assessment of a

patient by the anaesthesiologist is not followed by an operation it will be regarded as a visit at
hospital or nursing home and the appropriate hospital visit item should be charged.
0025 Calculation of anaesthetic time: Anaesthetic time is calculated from the time the
anaesthesiologist begins to prepare the patient for the induction of anaesthesia in the operating
theatre or in a similar equivalent area and ends when the anaesthesiologist is no longer required
to give his/her personal professional attention to the patient, i.e. when the patient may, with
reasonable safety, be placed under the customary post-operative supervision. Where prolonged
personal professional attention is necessary for the well-being and safety of such patient, the
necessary time will be valued on the same basis as indicated above for the anaesthetic time. The
anaesthesiologist must show on his/her account the exact anaesthetic time, including the
supervision time spent with the patient.

0027 Where more than one operation is performed under the same anaesthetic, the basic anaesthetic
units will be that of the major operation with the highest number of units.
0029 When rendered necessary by the scope of the anaesthetic, an assistant anaesthesiologist may
be employed. The remuneration of the assistant anaesthesiologist shall be calculated on the
same basis as in the case where a general practitioner administers the anaesthetic.
0031 Treatment with intravenous drips and transfusions is considered part of the normal treatment in
administering an anaesthetic. No additional fees may be charged for such services when
rendered either prior to, or during actual theatre or operating time.
0032 Anaesthesia administered to patients in the prone position shall have a minimum of 4,00 basic
anaesthetic units. When the basic anaesthetic units for the procedure is 3,00, one extra
anaesthetic unit should be added. If the basic anaesthetic units for the procedure is 4,00 or
more, no extra units should be added.
0033 When an anaesthesiologist is required to participate in the general care of a patient during a
surgical procedure, but does not administer the anaesthetic, such services may be remunerated
at full anaesthetic rate, subject to the provisions of modifier 0035
0034 All anaesthetics administered for diagnostic, surgical or X-ray procedures on the head and neck
shall have a minimum of 4,00 basic anaesthetic units. When the basic anaesthetic units for the
procedure is 3,00, one extra anaesthetic unit should be added. If the basic anaesthetic units for
the procedure is 4,00 or more, no extra units should be added.
0035 No anaesthetic administered by a specialist anaesthesiologist shall have a total value of less
than 7,00 anaesthetic units.
0036 Fees for an anaesthetic administered by a general practitioner shall be eighty-two percent (82%)
of the total number of units (basic plus time plus appropriate modifier) applicable to the specialist
anaesthesiologist provided that no anaesthetic shall have a total value of less than 6,00
anaesthetic units. The monetary value of the unit is the same for both a specialist
anaesthesiologist and a general practitioner anaesthesiologist.
Note: Modifying units may be added to the basic anaesthetic unit value according to the following
modifiers (0037-0044, 5441-5448):
0037 Utilisation of total body hypothermia: Add 3,00 anaesthetic units

0038 Peri-operative blood salvage: Add 4,00 anaesthetic units for intra-operative blood salvage and
4,00 anaesthetic units for post-operative blood salvage.
0039 Deliberate control of the blood pressure: All cases up to one hour - add 3,00 anaesthetic units,
thereafter add 1,00 (one) additional anaesthetic unit per quarter hour or part thereof
0040 The basic anaesthetic units for procedures performed for phaeochromocytoma shall be 15,00
anaesthetic units
0041 Utilisation of hyperbaric pressurisation: Add 3,00 anaesthetic units
0042 Utilisation of extracorporeal circulation: Add 3,00 anaesthetic units
0043 For all cases under one year or over 70 years of age - 3,00 anaesthetic units to be added
0044 Neonates (i.e. up to and including 28 after birth) - 3,00 anaesthetic units to be added to the basic
anaesthetic units for the particular procedure. This modifier is charged in addition to modifier
0043: Cases under one year or over 70 years of age.

Modification of the anaesthetic fee in cases of operative procedures on the musculo-skeletal
system, open fractures and open reduction of fractures and dislocations is governed by adding
units indicated by modifiers 5441 to 5448. (The letter "M" is annotated next to the number of
units of the appropriate items, for facilitating identification of the relevant items)
5442 to 5448
5442 Shoulder, scapula, clavicle, humerus, elbow joint, upper 1/3 tibia, knee joint, patella, mandible
and temporo-mandibular joint - Add TWO anaesthetic units
5448 Sternum and/or ribs and musculo-skeletal procedures which involve an intra-thoracic approach -
Add EIGHT anaesthetic units

POST-OPERATIVE ALLEVIATION OF PAIN
0045 Post-operative alleviation of pain

(a) When a regional or nerve block procedure is performed, the appropriate hospital follow-up
visit to patient in ward or nursing facility can be charged, provided that it is not the primary
anaesthetic technique.
(b) When a second medical practitioner has administered the regional or nerve block for post-
operative alleviation of pain it shall be charged according to the particular procedure for
instituting therapy. Revisits shall be charged according to the appropriate hospital follow-
up visit to patient in ward or nursing facility.
(c) None of the above is applicable for routine post-operative pain management i.e.
intramuscular, intravenous or subcutaneous administration of opiates or NSAID
(nonsteroidal anti-inflammatory drug).
2 INTEGUMENTARY SYSTEM
NOTES APPLICABLE TO THIS SPECIFIC SECTION OF THE BENCHMARK TARIFFS
T Time Units
2.1 Allergy

Units N$ Units N$
PATCH TESTS - -
0217 First patch 4.00 81.78
81.80 -
0219 Each additional patch 2.00 40.89
40.90 -
Fees for reading of test as per subsequent - -
consultation
SKIN PRICK TESTS - -
0218 Skin-prick testing: Insect vemon, latex and 2.80 57.25
57.20 -
drugs
0220 Immediate hypersensitivity testing (Type I 1.90 38.85
38.80 -
reaction): per antigen: Inhalant and food
allergens
0221 Delayed hypersensitivity testing (Type IV 2.80 57.25
57.20 -
reaction): per antigen

2.2 Skin (general)

Units N$ Units N$
INTRALESIONAL INJECTION INTO AREAS - -

OF PATHOLOGY e.g. KELOIDS
0222 Single 4.00 81.78
81.80 -
0223 Multiple 8.00 163.57
163.60 -
0225 Epilation: per session 8.00 163.57
163.60 -
0227 Special treatment of severe acne cases, 8.00 163.57
163.60 4.00 T 426.31
426.30
including draining of cysts, expressing of
comedones and/or steaming, abrasive cleaning
of skin and UVR per session
0228 PUVA Treatment: Maximum of 21 treatments 13.00 265.80 -

0229 PUVA: Follow-up or maintenance once a week. 13.00 265.80 -
0230 UVR-Treatment 13.00 265.80 -
0231 UVR-Follow-up - for use of ultraviolet lamp 5.50 112.45
112.50 -
(applied personally by the dermatologist) No
charge to be levied if a nurse or
physiotherapist applies the ultraviolet lamp
BIOPSY WITHOUT SUTURING - -
0233 First lesion 6.00 122.68
122.70 3.00 T 319.73
319.70
0234 Subsequent lesions, each 3.00 61.34
61.30 3.00 T 319.73
319.70
0235 Maximum for multiple additional lesions. 18.00 368.03
368.00 3.00 T 319.73
319.70
0237 Deep skin biopsy by surgical incision with 12.00 245.35
245.40 3.00 T 319.73
319.70
local anaesthetic and suturing.
TREATMENT OF BENIGN SKIN LESION BY - -
CHEMO-CRYOTHERAPY
0241 First Lesion. 6.00 122.68
122.70 3.00 T 319.73
319.70
0242 Subsequent lesions, each. 3.00 61.34
61.30 3.00 T 319.73
319.70
0243 Maximum for code 0242. 42.00 858.74
858.70 3.00 T 319.73
319.70
0244 Repair of nail bed. 30.00 613.38
613.40 3.00 T 319.73
319.70
REMOVAL OF BENIGN LESION BY - -
CURETTING UNDER LOCAL OR GENERAL
ANAESTHESIA FOLLOWED BY DIATHERMY
AND CURETTING OR ELECTROCAUTERY
0245 First Lesion. 14.00 286.25
286.20 3.00 T 319.73
319.70
0246 Subsequent lesions, each 7.00 143.12
143.10 3.00 T 319.73
319.70
0247 Maximum for code 0246. 49.00 1 001.90
001.86 3.00 T 319.73
319.70
REMOVAL OF MALIGNANT LESIONS BY - -

CURETTING UNDER LOCAL OR GENERAL
ANAESTHESIA FOLLOWED BY
ELECTROCAUTERY
0251 First Lesion. 30.00 613.38
613.40 3.00 T 319.73
319.70
0252 Subsequent lesions, each. 15.00 306.69
306.70 3.00 T 319.73
319.70
0255 Drainage of subcutaneous abscess onychia, 20.00 408.92
408.90 3.00 T 319.73
319.70
Units N$ Units N$
paronychia, pulp space or avulsion of nail.

0257 Drainage of major hand or foot infection: 60.00 1 226.80
226.77 3.00 T 319.73
319.70
drainage of major abscess with necrosis of
tissue, involving deep fascia or requiring
debridement, complete excision of pilonidal
cyst or sinus. (Note: The application of
specialised wound treatment such as Vac
therapy is included)
0259 Removal of foreign body superficial to deep 20.00 408.92
408.90 3.00 T 319.73
319.70
deep fascia (except hands).
0261 Removal of foreign body deep to deep fascia 31.00 633.83
633.80 3.00 T 319.73
319.70
(except hands).
Note: See items 0922 and 0923 for removal of - -
foreign bodies in hands
KURTIN PLANING FOR ACNE SCARRING - -
0271 Whole face 137.00 2 801.10
801.12 4.00 T 426.31
426.30
0273 Extensive. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
0275 Limited 30.00 613.38
613.40 4.00 T 426.31
426.30
0277 Subsequent planing of whole face within 12 69.00 1 410.80
410.78 4.00 T 426.31
426.30
months
0279 Surgical treatment for axillary hyperhidrosis. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
LASER TREATMENT FOR SMALL SKIN - -

LESIONS
0280 First Lesion. 14.00 286.25
286.20 3.00 T 319.73
319.70
0281 Subsequent lesions (each). 7.00 143.12
143.10 3.00 T 319.73
319.70
0282 Maximum for multiple additional lesions. 56.00 1 145.00
144.98 3.00 T 319.73
319.70
LASER TREATMENT FOR LARGE SKIN - -

LESIONS
0283 Limited area. 30.00 613.38
613.40 4.00 T 426.31
426.30
0284 Extensive area. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
0285 Whole face or other areas of equivalent size or 137.00 2 801.10
801.12 4.00 T 426.31
426.30
larger
0286 Photo-dynamic therapy for malignant skin 56.63 Ne 1 158.00
157.99 0.00 Ne -
lesions: Equipment fee for PDT lamp Text Text
0287 Scanning of pigmented skin lesions: 43.44 888.18

888.20 -
Equipment Fee for Molemax or similar device.

2.3 Major plastic repair

Units N$ Units N$
0289 Large skin grafts, composite skin grafts, large 156.00 3 189.60
189.59 4.00 T 426.31
426.30
full thickness free skin grafts.
0290 Reconstructive procedures (including all 273.00 5 581.80
581.79 4.00 T 426.31
426.30
stages) and skingraft by myocutaneous or
fasciocutaneous flap
0291 Reconstructive procedures (including all 533.00 10 897.80
897.77 4.00 T 426.31
426.30
stages) grafting by microvascular
reanastomosis.
0292 Distant flaps: First stage. 137.00 2 801.10
801.12 4.00 T 426.31
426.30
0293 Contour grafts (excluding cost of material) 137.00 2 801.10
801.12 4.00 T 426.31
426.30
0294 Vascularised bone graft with or without soft 800.00 16 356.90
356.88 6.00 T 639.46
639.50
tissue with one or more sets microvascular
anastomoses
0295 Local skin flaps (large, complicated). 137.00 2 801.10
801.12 4.00 T 426.31
426.30
0296 Other reconstructive procedures of major 137.00 2 801.10
801.12 4.00 T 426.31
426.30
technical nature.
0297 Subsequent major procedures for repair of 69.00 1 410.80
410.78 4.00 T 426.31
426.30
same lesion.
0298 Lower abdominal dermo lipectomy. 113.00 2 310.40
310.41 5.00 T 532.89
532.90
0299 Major abdominal lipectomy with repositioning 183.00 3 741.60
741.64 5.00 T 532.89
532.90
of umbilicus.
2.4 Lacerations, scars, tumours, cysts and other skin lesions

Units N$ Units N$
STITCHING OF SOFT-TISSUE INJURIES - -

0300 Stitching of wound (with or without local 14.00 286.25
286.20 3.00 T 319.73
319.70
anaesthesia): Including normal after-care
0301 Additional wounds stitched at same session 7.00 143.12
143.10 3.00 T 319.73
319.70
(each)
0302 Deep laceration involving limited muscle 60.00 1 226.80
226.77 4.00 T 426.31
426.30
damage
0303 Deep laceration involving extensive muscle 85.00 1 737.90
737.92 4.00 T 426.31
426.30
damage
0304 Major debridement of wound, sloughectomy or 50.00 1 022.30 3.00 T 319.73
319.70
secondary suture. (Note: The application of
specialised wound treatment such as Vac
therapy is included)
0305 Needle biopsy - soft tissue 16.00 327.14
327.10 3.00 T 319.73
319.70
0307 Excision and repair by direct suture; excision 27.00 552.04
552.00 3.00 T 319.73
319.70
Units N$ Units N$
nail fold or other minor procedures of similar

magnitude
0308 Each additional small procedure done at the 14.00 286.25
286.20 3.00 T 319.73
319.70
same time (may only be added to item 0307)
0309 Maximum for additional small procedures 112 112.00 2 290.00
289.96 -
units
0310 Radical excision of nailbed 38.00 776.95
777.00 3.00 T 319.73
319.70
0311 Excision of large benign tumour (more than 5 55.00 1 124.50
124.54 3.00 T 319.73
319.70
cm).
0313 Extensive resection for malignant soft tissue 80.00 1 635.70
635.69 4.00 T 426.31
426.30
tumour including muscle
0314 Requiring repair by large skin graft or large 69.00 1 410.80
410.78 4.00 T 426.31
426.30
local flap or other procedures of similar
magnitude
0315 Requiring repair by small skin graft or small 55.00 1 124.50
124.54 3.00 T 319.73
319.70
local flap or other procedures of similar
magnitude
2.5 Breasts

Units N$ Units N$
0316 Fine needle aspiration for soft tissue (all areas). 15.00 306.69
306.70 -
0317 Aspiration of cyst or tumour. 9.00 184.01
184.00 3.00 T 319.73
319.70
0319 Mastotomy with exploration, drainage of 42.00 858.74
858.70 3.00 T 319.73
319.70
abscess or removal of mammary implant.
0321 Biopsy or excision of cyst, benign tumour, 60.00 1 226.80
226.77 3.00 T 319.73
319.70
aberrant breast tissue, duct papilloma.
0323 Subareola cone excision of ducts or wedge 60.00 1 226.80
226.77 3.00 T 319.73
319.70
excision of breast
0324 Wedge excision of breast and axillary 150.00 3 066.90
066.91 5.00 T 532.89
532.90
dissection.
0325 Total mastectomy. 103.00 2 105.90
105.95 5.00 T 532.89
532.90
0327 Total mastectomy with axillary gland biopsy. 123.00 2 514.90
514.87 5.00 T 532.89
532.90
0329 Total mastectomy with axillary gland 183.00 3 741.60
741.64 5.00 T 532.89
532.90
dissection.
0330 Nipple and areola reconstruction 63.00 1 288.10 4.00 T 426.31
426.30
SUBCUTANEOUS MASTECTOMY FOR - -
DISEASE OF BREAST; INCLUDING
RECONSTRUCTION BUT EXCLUDING COST
OF PROSTHESIS
0331 Unilateral. 156.00 3 189.60
189.59 4.00 T 426.31
426.30
0333 Bilateral. 273.00 5 581.80
581.79 4.00 T 426.31
426.30

Units N$ Units N$
0334 Removal of breast implant by means of 156.00 3 189.60

189.59 4.00 T 426.31
426.30
capsulectomy: Per breast
0335 Implantation of internal subpectoral mammary 100.00 2 044.60
044.61 4.00 T 426.31
426.30
prosthesis in post mastectomy patients.
REDUCTION: MAMMOPLASTY FOR - -
PATHOLOGICAL
HYPERTROPHY
0337 Unilateral. 156.00 3 189.60
189.59 5.00 T 532.89
532.90
0339 Bilateral. 273.00 5 581.80
581.79 5.00 T 532.89
532.90
GYNAECOMASTIA - -
0341 Unilateral. 61.00 1 247.20
247.21 3.00 T 319.73
319.70
0343 Bilateral. 107.00 2 187.70
187.73 3.00 T 319.73
319.70
2.6 Burns

Units N$ Units N$
0351 Major Burns: Resuscitation (including 184.00 3 762.10

762.08 5.00 T 532.89
532.90
supervision and intravenous therapy - first 48
hours).
0353 Tangential excision and grafting: Small. 67.00 1 369.90
369.89 5.00 T 532.89
532.90
0354 Tangential excision and grafting: Large. 133.00 2 719.30
719.33 5.00 T 532.89
532.90
2.7 Hands (skin)

Units N$ Units N$
0355 Skin flap in acute hand injuries where a flap is 60.00 1 226.80
226.77 4.00 T 426.31
426.30
taken from a site remote from the injured finger
or in cases of advancement flap e.g. Cutler
0357 Small skin graft in acute hand injury. 45.00 920.07
920.10 3.00 T 319.73
319.70
0359 Release of extensive skin contracture and or 128.00 2 617.10 3.00 T 319.73
319.70
excision of scar tissue with major skin graft
resurfacing
0361 Z-plasty. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
0363 Local flap and skin graft. 100.00 2 044.60
044.61 3.00 T 319.73
319.70
0365 Cross finger flap (all stages). 128.00 2 617.10 3.00 T 319.73
319.70
0367 Palmar flap (all stages). 128.00 2 617.10 3.00 T 319.73
319.70
Units N$ Units N$
0369 Distant flap: First stage. 105.00 2 146.80

146.84 3.00 T 319.73
319.70
0371 Distant flap: Subsequent stage (not subject to 60.00 1 226.80
226.77 3.00 T 319.73
319.70
general modifier 0007)
0373 Transfer neurovascular island flap. 128.00 2 617.10 3.00 T 319.73
319.70
0374 Syndactyly: Separation of, including skin graft 137.00 2 801.10
801.12 3.00 T 319.73
319.70
for one web.
DUPUYTREN'S CONTRACTURE - -
0375 Fasciotomy. 51.00 1 042.80
042.75 3.00 T 319.73
319.70
0376 Fasciectomy. 137.00 2 801.10
801.12 3.00 T 319.73
319.70
2.8 Acupuncture
Please note: General Rule M not applicable to section 2.8 of the benchmark tariffs

AA ACUPUNCTURE
further treatment is required at the end of this period of treatment, it should be negotiated with
the patient.

Units N$ Units N$
0377 Standard acupuncture. 10.00 204.46

204.50 -
0378 Laser acupuncture using more than 6 points. 14.00 286.25
286.20 -
0379 Electro-acupuncture. 14.00 286.25
286.20 -
0380 Scalp acupuncture. 10.00 204.46
204.50 -
0381 Micro-acupuncture (ear, hand) 10.00 204.46
204.50 -

AA ACUPUNCTURE
further treatment is required at the end of this period of treatment, it should be negotiated with the
patient.
3 MUSCULO-SKELETAL SYSTEM
MODIFIERS GOVERNING ANAESTHETIC FEES FOR ORTHOPAEDIC OPERATIONS
Modification of the anaesthetic fee in cases of operative procedures on the musculo-skeletal system, open
fractures and open reduction of fractures and dislocations is governed by adding units indicated by
modifiers 5441 to 5448. (The letter "M" is annotated next to the number of units of the appropriate items, for
facilitating identification of the relevant items) units
5442 to 5448
5442 Shoulder, scapula, clavicle, humerus, elbow joint, upper 1/3 tibia, knee joint, patella, mandible
and temporo-mandibular joint - Add TWO anaesthetic units
5448 Sternum and/or ribs and musculo-skeletal procedures which involve an intra-thoracic approach
- Add EIGHT anaesthetic units

0046 Where in the treatment of a specific fracture or dislocation (compound or closed) an initial
procedure is followed within one month by an open reduction, internal fixation, external skeletal
fixation or bone grafting on the same bone, the fee for the initial treatment of that fracture or
dislocation shall be reduced by 50%. Please note: This reduction does not include the
assistant's fee or after-hours levy where applicable. After one month, a full fee as for the initial
treatment, is applicable.
0047 A fracture NOT requiring reduction shall be charged on a fee per service basis.
0048 Where in the treatment of a fracture or dislocation an initial closed reduction is followed within
one month by further closed reductions under general anaesthesia, the fee for such subsequent
reductions will be 27,00 clinical procedure units (not including after-care).
0049 Except where otherwise specified, in cases of compound fractures, 77,00 clinical procedure
units (specialists) and 51,00 clinical procedure units (general practitioners) are to be added to
the units for the fractures including debridement.
0050 In cases of a compound fracture where a debridement is followed by internal fixation (excluding
fixation with Kirschner wires), the full amount according to either modifier 0049 or 0051 may be
added to the fee for the procedure involved, plus half of the amount according to the second
modifier (either 0049 or 0051 as applicable).
0051 Fractures requiring open reduction, internal fixation, external skeletal fixation and/or bone
grafting: Specialists add 77,00 clinical procedure units. General practitioners add 51,00 clinical
procedure units.
0053 Fracture requiring percutaneous internal fixation [insertion and removal of fixatives (wires) in
respect of fingers and toes included]: Specialists add 32,00 clinical procedure units, general
practitioners add 21,00 clinical procedure units.
0055 Dislocation requiring open reduction: Units for the specific joint plus 77,00 clinical procedure
units for specialists. General practitioners add 51,00 clinical procedure units.
0057 Multiple procedures on feet: In multiple procedures on feet, fees for the first foot are calculated
according to modifier 0005: Multiple procedures/operations under the same anaesthetic.
Calculate fees for the second foot in the same way, reduce the total to 75% and add to the total
for the first foot.

0058 Revision operation for total joint replacement and immediate resubstitution (infected or non-
infected): per fee for total joint replacement + 100%.
iii Per Service (specify)

iv Per Service
v Per Consultation
vi If required
x By arrangement
T Time Units
M Musculo-skeletal modifier applies
3.1 Bones
3.1.1 Fractures (reduction under general anaesthetic)

Units N$ Units N$
0383 Scapula. iii - 3.00 TM 319.70

319.73
0387 Clavicle. iii - 3.00 TM 319.70
319.73
0389 Humerus. 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
0391 Radius and/or Ulna. 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
0392 Open reduction of both radius and ulna 140.00 2 862.50
862.45 3.00 TM 319.73
319.70
(Modifier 0051 not applicable)
0402 Carpal bone. 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
0403 Bennett's fracture-dislocation 51.00 1 042.80
042.75 3.00 TM 319.73
319.70
0405 Metacarpal: Simple. 40.00 817.84
817.80 3.00 TM 319.73
319.70
FINGER PHALANX: DISTAL - -
0409 Simple. iv - 3.00 TMx 319.70
319.73
0411 Compound. 52.00 1 063.20 3.00 TM 319.73
319.70
PROXIMAL OR MIDDLE - -
0413 Simple. 48.00 981.41
981.40 3.00 T 319.73
319.70
0415 Compound. 68.00 1 390.30
390.33 3.00 TM 319.73
319.70
- -
PELVIS - -
0417 Closed. iv - 3.00 T 319.70
319.73
0419 Operative reduction and fixation. 213.00 4 355.00
355.02 3.00 TM 319.73
319.70
0421 Femur: Neck or Shaft. 128.00 2 617.10 3.00 TM 319.73
319.70
0425 Patella. 51.00 1 042.80
042.75 3.00 TM 319.73
319.70
Units N$ Units N$
0429 Tibia with or without fibula. 85.00 1 737.90

737.92 3.00 TM 319.73
319.70
0433 Fibula shaft. iv - 3.00 TM 319.70
319.73
0435 Malleolus of ankle. 58.00 1 185.90
185.87 3.00 TM 319.73
319.70
0437 Fracture-dislocation of ankle. 85.00 1 737.90
737.92 3.00 TM 319.73
319.70
0438 Open reduction Talus fracture (Modifier 0051 111.00 2 269.50
269.52 3.00 TM 319.73
319.70
not applicable)
0440 Calcanius reduction (Modifier 0051 not 111.00 2 269.50
269.52 3.00 TM 319.73
319.70
applicable)
- -
TOE PHALANX - -
0443 Distal: Simple. iv - 3.00 T 319.70
319.73
0445 Compound. 32.00 654.28
654.30 3.00 TM 319.73
319.70
- -
OTHER - -
0447 Simple. 26.00 531.60 3.00 T 319.73
319.70
0449 Compound. 52.00 1 063.20 3.00 TM 319.73
319.70
- -
STERNUM and/or RIBS - -
0451 Closed. iii - 3.00 T 319.70
319.73
0452 Open reduction and fixation of multiple 153.00 3 128.30
128.25 3.00 TM 319.73
319.70
fractured ribs for flail chest
- -
SPINE: WITH OR WITHOUT PARALYSIS - -
0455 Cervical. iii - 3.00 TM 319.70
319.73
0456 Rest. iii - 3.00 TM 319.70
319.73
- -
COMPRESSION FRACTURE - -
0461 Cervical. iv - 3.00 TM 319.70
319.73
0462 Rest iv - 3.00 TM 319.70
319.73
- -
SPINOUS OR TRANSVERSE PROCESSES - -
0463 Cervical. iv - 3.00 TM 319.70
319.73
0464 Rest. iv - 3.00 TM 319.70
319.73

3.1.1.1 Operations for fractures

Units N$ Units N$
0465 Fractures involving large joints (includes the 192.00 3 925.70

925.65 3.00 M 319.73
319.70
item for the relative bone) (this item may not
be used as a modifier)
0473 Percutaneous insertion plus subsequent 32.00 654.28
654.30 3.00 T 319.73
319.70
removal of Kirschner wires or Steinmann pins
(no after-care), modifier 0005 not applicable
- -
BONEGRAFTING OR INTERNAL FIXATION - -
FOR MAL- OR NONUNION
0475 Femur, Tibia, Humerus, Radius and Ulna. 188.00 3 843.90
843.87 3.00 TM 319.73
319.70
0479 Other bones. 103.00 2 105.90
105.95 3.00 TM 319.73
319.70
3.1.2 Bony operations
3.1.2.1 Bone grafting

Units N$ Units N$
0497 Resection of bone or tumour with or without 188.00 3 843.90

843.87 3.00 TM 319.73
319.70
grafting.
GRAFTS TO CYSTS - -
0499 Large bones. 128.00 2 617.10 3.00 TM 319.73
319.70
0501 Small bones. 85.00 1 737.90
737.92 3.00 TM 319.73
319.70
0503 Cartilage graft. 137.00 2 801.10
801.12 3.00 TM 319.73
319.70
0505 Inter-metacarpal bone graft 98.00 2 003.70
003.72 3.00 TM 319.73
319.70
0507 Removal of autogenous bone for grafting (not 50.00 1 022.30 3.00 TM 319.73
319.70
subject to general modifier 0005)

3.1.2.2 Acute or chronic osteomyelitis

Units N$ Units N$
0509 Conservative treatment. iv - -

0511 Operation: Fee which would be applicable for - -
compound fracture of the bone involved,
including six weeks postoperative care
0512 Sternum sequestrectomy and drainage: 85.00 1 737.90
737.92 3.00 TM 319.73
319.70
Including six weeks after-care
3.1.2.3 Osteotomy

Units N$ Units N$
0514 Sternum: Repair of pectus excavatum. 220.00 4 498.10

498.14 3.00 TM 319.73
319.70
0515 Sternum: Repair of pectus carinatum. 220.00 4 498.10
498.14 3.00 TM 319.73
319.70
0516 Pelvic. 213.00 4 355.00
355.02 3.00 TM 319.73
319.70
0521 Femoral: Proximal. 213.00 4 355.00
355.02 3.00 TM 319.73
319.70
- -
KNEE REGION - -
0523 Children. 77.00 1 574.30
574.35 3.00 TM 319.73
319.70
0527 Adults. 213.00 4 355.00
355.02 3.00 TM 319.73
319.70
0528 Os Calcis (Dwyer operation). 77.00 1 574.30
574.35 3.00 TM 319.73
319.70
0530 Metacarpal and phalanx: Corrective for mal- 80.00 1 635.70
635.69 3.00 TM 319.73
319.70
union or rotation
0532 Rotation osteotomies of the Radius, Ulna or 107.00 2 187.70
187.73 3.00 TM 319.73
319.70
Humerus
0533 Osteotomy, single metatarsal 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
0534 Multiple metatarsal osteotomies. 100.00 2 044.60
044.61 3.00 TM 319.73
319.70
3.1.2.4 Exostosis

Units N$ Units N$
0535 Exostosis: Excision: Readily accessible sites. 60.00 1 226.80

226.77 3.00 TM 319.73
319.70
0537 Exostosis: Excision: Less accessible sites. 64.00 1 308.60
308.55 3.00 TM 319.73
319.70

3.1.2.5 Biopsy
Item Description Specialist Mo Specialist Anaesthetic Mo Anaesthetic

Units N$ Units N$
0539 Needle Biopsy: Spine (no after-care), modifier 50.00 1 022.30 4.00 T 426.31
426.30
0005 not applicable.
0541 Needle Biopsy: Other sites (no after-care), 32.00 654.28
654.30 4.00 T 426.31
426.30
modifier 0005 not applicable.
- -
OPEN (MODIFIER 0005 NOT APPLICABLE) - -
0543 Readily accessible site. 60.00 1 226.80
226.77 -
0545 Less accessible site. 64.00 1 308.60
308.55 -
3.2 Joints
3.2.1 Dislocations

Units N$ Units N$
0547 Clavicle: either end. 38.00 776.95

777.00 3.00 TM 319.73
319.70
0549 Shoulder. 51.00 1 042.80
042.75 3.00 TM 319.73
319.70
0551 Elbow. 51.00 1 042.80
042.75 3.00 TM 319.73
319.70
0552 Wrist. 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
0553 Perilunar trans-scaphoid fracture dislocation 87.00 1 778.80
778.81 3.00 TM 319.73
319.70
0555 Lunate. 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
0556 Carpo-metacarpo dislocation 51.00 1 042.80
042.75 3.00 TM 319.73
319.70
0557 Metacarpo-phalangeal or interphalangeal joints 26.00 531.60 3.00 TM 319.73
319.70
(hand)
0559 Hip. 73.00 1 492.60
492.57 3.00 TM 319.73
319.70
0561 Knee. 64.00 1 308.60
308.55 3.00 TM 319.73
319.70
0563 Patella. 32.00 654.28
654.30 3.00 TM 319.73
319.70
0565 Ankle. 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
0567 Sub-Talar dislocation. 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
0569 Intertarsal or Tarsometatarsal or Midtarsal. 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
0571 Metatarsophalangeal or interphalangeal joints 14.00 286.25
286.20 3.00 TM 319.73
319.70
(foot)
0573 Spine: with or without paralysis. iii - -

3.2.2 Operations for dislocations myelitis

Units N$ Units N$
0578 Recurrent dislocation of shoulder 133.00 2 719.30

719.33 3.00 TM 319.73
319.70
0579 Recurrent dislocation of all other joints. 107.00 2 187.70
187.73 3.00 TM 319.73
319.70
3.2.3 Capsular operations

Units N$ Units N$
0582 Capsulotomy or arthrotomy or biopsy or 51.00 1 042.80

042.75 3.00 TM 319.73
319.70
drainage of joint: Small joint (including three
weeks after-care)
0583 Capsulotomy or arthrotomy or biopsy or 64.00 1 308.60
308.55 3.00 TM 319.73
319.70
drainage of joint: Large joint (including three
weeks after-care).
0585 Capsulectomy digital joint. 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
0586 Multiple percutaneous capsulotomies of 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
metacarpophalangeal joints.
0587 Release of digital joint contracture. 85.00 1 737.90
737.92 3.00 TM 319.73
319.70
3.2.4 Synovectomy

Units N$ Units N$
0589 Digital joint. 60.00 1 226.80

226.77 3.00 TM 319.73
319.70
0592 Large joint. 107.00 2 187.70
187.73 3.00 TM 319.73
319.70
0593 Tendon synovectomy. 85.00 1 737.90
737.92 3.00 TM 319.73
319.70
3.2.5 Arthrodesis

Units N$ Units N$
0597 Shoulder. 149.00 3 046.50

046.47 3.00 TM 319.73
319.70
Units N$ Units N$
0598 Elbow. 120.00 2 453.50

453.53 3.00 TM 319.73
319.70
0599 Wrist. 120.00 2 453.50
453.53 3.00 TM 319.73
319.70
0600 Digital joint. 85.00 1 737.90
737.92 3.00 TM 319.73
319.70
0601 Hip. 213.00 4 355.00
355.02 3.00 TM 319.73
319.70
0602 Knee. 120.00 2 453.50
453.53 3.00 TM 319.73
319.70
0603 Ankle. 120.00 2 453.50
453.53 3.00 TM 319.73
319.70
0604 Sub-talar. 87.00 1 778.80
778.81 3.00 TM 319.73
319.70
0605 Stabilization of foot (triple-arthrodesis). 120.00 2 453.50
453.53 3.00 TM 319.73
319.70
0607 Mid-tarsal wedge resection 120.00 2 453.50
453.53 3.00 TM 319.73
319.70
3.2.6 Arthroplasty

Units N$ Units N$
0614 Debridement large joints 107.00 2 187.70

187.73 3.00 TM 319.73
319.70
0615 Excision medial or lateral end of clavicle. 77.00 1 574.30
574.35 3.00 TM 319.73
319.70
0617 Shoulder: Acromioplasty. 128.00 2 617.10 3.00 TM 319.73
319.70
0619 Shoulder: Partial replacement 185.00 3 782.50
782.53 5.00 TM 532.89
532.90
0620 Shoulder: Total replacement. 277.00 5 663.60
663.57 5.00 TM 532.89
532.90
0621 Elbow: Excision head of radius. 64.00 1 308.60
308.55 3.00 TM 319.73
319.70
0622 Elbow: Excision. 128.00 2 617.10 3.00 TM 319.73
319.70
0623 Elbow: Partial replacement 125.00 2 555.80
555.76 3.00 TM 319.73
319.70
0624 Elbow: Total replacement. 188.00 3 843.90
843.87 3.00 TM 319.73
319.70
0625 Wrist: Excision distal end of ulna. 64.00 1 308.60
308.55 3.00 TM 319.73
319.70
0626 Wrist: Excision single bone 73.00 1 492.60
492.57 3.00 TM 319.73
319.70
0627 Wrist: Excision proximal row 111.00 2 269.50
269.52 3.00 TM 319.73
319.70
0631 Wrist: Total replacement. 166.00 3 394.10
394.05 3.00 TM 319.73
319.70
0635 Digital Joint: Total replacement. 128.00 2 617.10 3.00 TM 319.73
319.70
0637 Hip: Total replacement 277.00 5 663.60
663.57 3.00 TM 319.73
319.70
0639 Hip: Cup. 277.00 5 663.60
663.57 3.00 TM 319.73
319.70
0641 Hip: Prosthetic replacement of femoral head. 192.00 3 925.70
925.65 3.00 TM 319.73
319.70
0643 Hip: Girdlestone. 213.00 4 355.00
355.02 3.00 TM 319.73
319.70
0645 Knee: Partial replacement 185.00 3 782.50
782.53 3.00 TM 319.73
319.70
0646 Knee: Total replacement. 277.00 5 663.60
663.57 3.00 TM 319.73
319.70
0649 Ankle: Total replacement 166.00 3 394.10
394.05 3.00 TM 319.73
319.70
0650 Ankle: Astragalectomy. 103.00 2 105.90
105.95 3.00 TM 319.73
319.70

3.2.7 Miscellaneous (joints)

Units N$ Units N$
0661 Aspiration of joint or intra-articular injection 9.00 184.01

184.00 3.00 T 319.73
319.70
(not including after-care), modifier 0005 not
applicable.
MULTIPLE INTRA-ARTICULAR INJECTIONS - -

FOR RHEUMATOID ARTHRITIS (EXCLUDING
AFTER-CARE), MODIFIER 0005 NOT
APPLICABLE)
0663 First joint. 7.50 153.35
153.30 3.00 T 319.73
319.70
0665 Additional (each). 4.00 81.78
81.80 3.00 T 319.73
319.70
0667 Arthroscopy (excluding after-care), modifiers 60.00 1 226.80
226.77 3.00 T 319.73
319.70
0005 and 0013 not applicable.
0669 Manipulation large joint under general 14.00 286.25
286.20 4.00 T 426.31
426.30
anaesthetic (not including after-care), modifier
0005 not applicable: Hip
0670 The consultation fee only should be charged iii - 4.00 426.30
426.31
when manipulation of a large joint is performed
with or without local anaesthetic: Hip
0673 Meniscectomy or operation for other internal 73.00 1 492.60
492.57 3.00 TM 319.73
319.70
derangement of knee.
3.2.8 Joint ligament reconstruction or suture

Units N$ Units N$
0675 Ankle: Collateral. 107.00 2 187.70

187.73 3.00 TM 319.73
319.70
0677 Knee: Collateral. 107.00 2 187.70
187.73 3.00 TM 319.73
319.70
0678 Knee: Cruciate. 107.00 2 187.70
187.73 3.00 TM 319.73
319.70
0679 Ligament augmentation procedure of knee. 187.00 3 823.40
823.42 3.00 TM 319.73
319.70
0680 Digital joint ligament. 93.00 1 901.50
901.49 3.00 TM 319.73
319.70

3.3 Amputations
3.3.1 Specific Amputations

Units N$ Units N$
0682 Fore-quarter amputation. 196.00 4 007.40

007.44 9.00 TM 959.19
959.20
0683 Through shoulder. 99.00 2 024.20
024.16 5.00 TM 532.89
532.90
0685 Upper arm or fore-arm. 77.00 1 574.30
574.35 3.00 TM 319.73
319.70
0687 Partial amputation of the hand: One ray. 68.00 1 390.30
390.33 3.00 TM 319.73
319.70
0691 Part of or whole of finger. 51.00 1 042.80
042.75 3.00 TM 319.73
319.70
0693 Hindquarter amputation. 280.00 5 724.90
724.91 6.00 TM 639.46
639.50
0695 Through hip joint region. 128.00 2 617.10 6.00 TM 639.46
639.50
0697 Through thigh 137.00 2 801.10
801.12 6.00 TM 639.46
639.50
0699 Below knee, through knee or Syme. 129.00 2 637.50
637.55 6.00 TM 639.46
639.50
0701 Trans metatarsal or trans tarsal. 95.00 1 942.40
942.38 3.00 TM 319.73
319.70
0703 Foot: One ray. 65.00 1 329.00 3.00 TM 319.73
319.70
0705 Toe. 44.00 899.63
899.60 3.00 TM 319.73
319.70
3.3.2 Post-amputation reconstruction

Units N$ Units N$
0706 Skin flap taken from a site remote from the 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
injured finger or in cases of an advanced flap
e.g. Cutler
0707 Krukenberg reconstruction 137.00 2 801.10
801.12 3.00 TM 319.73
319.70
0709 Metacarpal transfer. 128.00 2 617.10 3.00 TM 319.73
319.70
0711 Pollicization of the finger (to include all stages). 188.00 3 843.90
843.87 3.00 TM 319.73
319.70
0712 Toe to thumb transfer. 533.00 10 897.80
897.77 3.00 TM 319.73
319.70

3.4 Muscles, tendons and fasciae :
3.4.1 Investigations :

Units N$ Units N$
0713 Electromyography. 50.00 1 022.30 3.00 Tvi 319.73

319.70
0714 Electromyographic neuromuscular junctional 38.00 776.95
777.00 3.00 Tiii 319.73
319.70
study, including edrophonium response.
0715 Strength duration curve per session. 7.00 143.12
143.10 3.00 Tiii 319.73
319.70
0717 Electrical examination of single nerve or 6.00 122.68
122.70 3.00 Tiii 319.73
319.70
muscle.
0718 Oxidative study for mitochondrial function. 43.00 879.18
879.20 -
0721 Voltage integration during isometric contraction 8.00 163.57
163.60 3.00 Tiii 319.73
319.70
0723 Tonometry with edrophonium 5.00 102.23
102.20 3.00 Tiii 319.73
319.70
0725 Isometric tension studies with edrophonium. 7.00 143.12
143.10 3.00 Tiii 319.73
319.70
- -
CRANIAL REFLEX STUDY (BOTH EARLY - -
AND LATE RESPONSES) SUPRA
OCCULOFACIAL OR CORNEO-FACIAL OR
FLABELLOFACIAL
0727 Unilateral. 5.00 102.23
102.20 3.00 Tiii 319.73
319.70
0728 Bilateral. 9.00 184.01
184.00 3.00 Tiii 319.73
319.70
0729 Tendon reflex time. 5.00 102.23
102.20 3.00 Tiii 319.73
319.70
0730 Limb-brain somatosensory studies (per limb). 32.00 654.28
654.30 -
0731 Visio and audio-sensory studies. 32.00 654.28
654.30 -
0733 Motor nerve conduction studies (single nerve). 17.00 347.58
347.60 -
0735 Examinations of sensory nerve conduction by 21.00 429.37
429.40 3.00 Tiii 319.73
319.70
sweep averages (single nerve).
0737 Biopsy for motor nerve terminals and end 20.00 408.92
408.90 3.00 Tiii 319.73
319.70
plates.
0739 Combined muscle biopsy with end plates and 34.00 695.17
695.20 8.00 Tiii 852.62
852.60
nerve terminal biopsy.
0740 Muscle fatigue studies. 20.00 408.92
408.90 3.00 Tiii 319.73
319.70
0741 Muscle biopsy. 20.00 408.92
408.90 8.00 Tiii 852.62
852.60
0742 Global fee for all muscle studies, including - -
histochemical studies
- -
BIOCHEMICAL ESTIMATIONS ON MUSCLE - -
BIOPSY SPECIMENS
4701 Creatine kinase. - -
4703 Adenylate kinase. - -
4705 Pyruvate kinase. - -
4707 Lactate dehydrogenase. - -
4709 Adenylate deaminase - -
Units N$ Units N$
4711 Phosphoglycerate kinase. - -

4713 Phosphoglycerate mutase. - -
4715 Enolase. - -
4717 Phosphofructokinase - -
4719 Aldolase. - -
4721 Glyceraldehyde 3 phosphate dehydrogenase. - -
4723 Phosphorylase. - -
4725 Phosphoglucomutase. - -
4727 Phosphohexose Isomerase. - -
4729 Muscle biopsy for muscle tension study - -
4731 H-response study (per nerve) - -
4733 Late response study (per nerve). - -
4735 Single fibre studies - -
4737 Somatosensory study (limb-spine). - -
4739 Dystrophin estimation. - -
4744 Tension/caffeine/halothane procedure in - -
malignant hyperthermia.
4745 Electron microscopy - -
3.4.2 Decompression Operations

Units N$ Units N$
0743 Major compartmental decompression. 88.00 1 799.30

799.26 3.00 T 319.73
319.70
0744 Fasciotomy only. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
3.4.3 Muscle and tendon repair

Units N$ Units N$
0745 Biceps humeri. 73.00 1 492.60

492.57 3.00 T 319.73
319.70
0746 Removal of calcification in Rotator cuff. 64.00 1 308.60
308.55 3.00 TM 319.73
319.70
0747 Rotator cuff. 89.00 1 819.70 4.00 T 426.31
426.30
0755 Infrapatellar or quadriceps tendon 85.00 1 737.90
737.92 3.00 T 319.73
319.70
0757 Achilles tendon. 85.00 1 737.90
737.92 4.00 T 426.31
426.30
Units N$ Units N$
0759 Other single tendon. 60.00 1 226.80

226.77 3.00 T 319.73
319.70
0763 Tendon or ligament injection 9.00 184.01
184.00 3.00 T 319.73
319.70
HAND - -
FLEXOR TENDON SUTURE

0767 Primary (per tendon). 85.00 1 737.90
737.92 3.00 T 319.73
319.70
0769 Secondary (per tendon) 107.00 2 187.70
187.73 3.00 T 319.73
319.70
- -
EXTENSOR TENDON SUTURE - -
0771 Primary (per tendon). 60.00 1 226.80
226.77 3.00 T 319.73
319.70
0773 Secondary (per tendon). 60.00 1 226.80
226.77 3.00 T 319.73
319.70
0774 Repair of Boutonniere deformity or Mallet finger. 81.00 1 656.10
656.13 3.00 T 319.73
319.70
3.4.4 Tendon graft

Units N$ Units N$
0775 Free tendon graft. 107.00 2 187.70

187.73 3.00 T 319.73
319.70
0776 Reconstruction of pulley for flexor tendon. 50.00 1 022.30 3.00 T 319.73
319.70
- -
FINGER - -
0777 Flexor. 128.00 2 617.10 3.00 T 319.73
319.70
0779 Extensor. 81.00 1 656.10
656.13 3.00 T 319.73
319.70
0780 Two stage flexor tendon graft using silastic rod. 160.00 3 271.40
271.38 3.00 T 319.73
319.70
3.4.5 Tenolysis

Units N$ Units N$
0781 Tendon freeing operation, except where 60.00 1 226.80

226.77 3.00 T 319.73
319.70
specified elsewhere
0782 Carpal tunnel syndrome. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
0783 De Quervain. 38.00 776.95
777.00 3.00 T 319.73
319.70
0784 Trigger finger. 38.00 776.95
777.00 3.00 T 319.73
319.70
0785 Flexor tendon freeing operation following free 100.00 2 044.60
044.61 3.00 T 319.73
319.70
Units N$ Units N$
tendon graft or suture.

0787 Extensor tendon freeing operation following 77.00 1 574.30
574.35 3.00 T 319.73
319.70
graft or suture
0788 Intrinsic tendon release per finger 60.00 1 226.80
226.77 3.00 T 319.73
319.70
0789 Central tendon tenotomy for Boutonniere 60.00 1 226.80
226.77 3.00 T 319.73
319.70
deformity
3.4.6 Tenodesis

Units N$ Units N$
0790 Digital joint. 60.00 1 226.80

226.77 3.00 T 319.73
319.70
3.4.7 Muscle tendon and fascia transfer

Units N$ Units N$
0791 Single tendon transfer. 64.00 1 308.60

308.55 3.00 T 319.73
319.70
0792 Multiple tendon transfer. 85.00 1 737.90
737.92 3.00 T 319.73
319.70
0793 Hamstring to quadriceps transfer. 94.00 1 921.90
921.93 3.00 T 319.73
319.70
0794 Pectoralis major or Latissimus dorsi transfer to 213.00 4 355.00
355.02 5.00 T 532.89
532.90
biceps tendon
0795 Tendon transfer at elbow 77.00 1 574.30
574.35 3.00 T 319.73
319.70
0796 Iliopsoas at hip. 149.00 3 046.50
046.47 5.00 T 532.89
532.90
0797 Knee (Eggers). 94.00 1 921.90
921.93 3.00 T 319.73
319.70
HAND TENDONS - -
0803 Single tendon transfer (first) 64.00 1 308.60
308.55 3.00 T 319.73
319.70
0809 Substitution for intrinsic paralysis of hand. 149.00 3 046.50
046.47 3.00 T 319.73
319.70
0811 Opponens transfers. 85.00 1 737.90
737.92 3.00 T 319.73
319.70

3.4.8 Muscle slide operations and tendon lengthening

Units N$ Units N$
0812 Percutaneous Tenotomy: All sites. 38.00 776.95

777.00 3.00 T 319.73
319.70
0813 Torticollis. 64.00 1 308.60
308.55 5.00 T 532.89
532.90
0815 Scalenotomy. 88.00 1 799.30
799.26 5.00 T 532.89
532.90
0817 Scalenotomy with excision of first rib. 127.00 2 596.70
596.65 3.00 TM 319.73
319.70
0821 Tennis elbow. 64.00 1 308.60
308.55 3.00 T 319.73
319.70
0823 Excision or slide for Volkmann's Contracture. 128.00 2 617.10 3.00 T 319.73
319.70
0825 Hip: Open muscle release. 77.00 1 574.30
574.35 7.00 T 746.04
746.00
0829 Knee: Quadricepsplasty. 107.00 2 187.70
187.73 3.00 T 319.73
319.70
0831 Knee: Open tenotomy. 94.00 1 921.90
921.93 3.00 T 319.73
319.70
0835 Calf. 64.00 1 308.60
308.55 4.00 T 426.31
426.30
0837 Open elongation tendon Achilles. 64.00 1 308.60
308.55 4.00 T 426.31
426.30
0845 Foot: Plantar fasciotomy. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
0846 Foot: Postero-medial release for club-foot. 128.00 2 617.10 3.00 T 319.73
319.70
3.5 Bursae and ganglia

Units N$ Units N$
- -
EXCISION - -
0847 Semimembranosus. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
0849 Prepatellar. 45.00 920.07
920.10 3.00 T 319.73
319.70
0851 Olecranon. 45.00 920.07
920.10 3.00 T 319.73
319.70
0853 Small bursa or ganglion. 51.00 1 042.80
042.75 3.00 T 319.73
319.70
0855 Compound palmar ganglion or synovectomy. 85.00 1 737.90
737.92 3.00 T 319.73
319.70
0857 Aspiration or injection (no after-care), modifier 9.00 184.01
184.00 3.00 T 319.73
319.70
0005 not applicable

3.6 Miscellaneous
3.6.1 Leg equalisation and congenital hips and feet

Units N$ Units N$
0859 Leg shortening. 188.00 3 843.90

843.87 3.00 TM 319.73
319.70
0861 Leg lengthening. 277.00 5 663.60
663.57 3.00 TM 319.73
319.70
0863 Epiphysiodesis at one level. 77.00 1 574.30
574.35 3.00 TM 319.73
319.70
CONGENITAL DISLOCATION OF HIP - -
INITIAL NON-OPERATIVE REDUCTION AND

APPLICATION OF PLASTERCAST
0865 One hip. 73.00 1 492.60
492.57 3.00 TM 319.73
319.70
0867 Two hips. 107.00 2 187.70
187.73 3.00 TM 319.73
319.70
0868 Open reduction of congenital dislocation of the 124.00 2 535.30
535.32 3.00 TM 319.73
319.70
hip
0869 Subsequent plaster 32.00 654.28
654.30 -
- -
CONGENITAL CLUB FOOT - -
MANIPULATION AND PLASTER

0873 One foot. 26.00 531.60 3.00 T 319.73
319.70
3.6.2 Removal of internal fixatives or prosthesis

Units N$ Units N$
0883 Removal of internal fixatives or prosthesis: 32.00 654.28

654.30 -
Readily accessible. As per bone (specify)
0884 Removal of internal fixatives or prosthesis: 60.00 1 226.80
226.77 -
Less accessible. As per bone (specify)
0885 Removal of prosthesis for infection soon after 85.00 1 737.90
737.92 -
operation. As per bone (specify)
0886 Late removal of infected total joint replacement - 6.00 TM 639.50
639.46
prosthesis (including six weeks after-care).
Fee for total joint replacement of the specific
joint plus 64,00 units (general practitioner
42,00 units)

3.7 Plasters (exclusive of after-care)
Note: The initial application of a plaster cast is included in the scheduled fee for the particular procedure,
except for scoliosis

Units N$ Units N$
0887 Limb cast (excluding after-care) (modifier 0005 13.00 265.80 3.00 T 319.73
319.70
not applicable).
0889 Spica, plaster jacket or hinged cast brace 32.00 654.28
654.30 4.00 T 426.31
426.30
(excluding after-care).
0891 Turnbuckle cast (excluding after-care). 51.00 1 042.80
042.75 5.00 T 532.89
532.90
0893 Adjustment or repair of turnbuckle cast 19.00 388.48
388.50 5.00 T 532.89
532.90
3.8 Special areas
3.8.1 Foot and Ankle

Units N$ Units N$
0897 One foot. 93.00 1 901.50

901.49 3.00 TM 319.73
319.70
0901 Tenotomy, single tendon 38.00 776.95
777.00 3.00 TM 319.73
319.70
0903 Hammer toe: one toe 51.00 1 042.80
042.75 3.00 TM 319.73
319.70
0905 Fillet of Toe or Ruiz-Mora procedure 51.00 1 042.80
042.75 3.00 TM 319.73
319.70
0906 Arthrodesis Hallux. 85.00 1 737.90
737.92 3.00 TM 319.73
319.70
0907 Silver bunionectomy or similar for Hallux Valgus 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
0909 Excision arthroplasty. 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
0910 Cheilectomy or metatarsophangeal implant 128.00 2 617.10 3.00 TM 319.73
319.70
Hallux
0911 Metatarsal osteotomy or Lapidus or similar or 68.00 1 390.30
390.33 3.00 TM 319.73
319.70
Chevron
5730 Hallux Valgus double osteotomy, etc 146.08 2 986.80
986.77 3.00 TM 319.73
319.70
5731 Distal soft tissue procedure for Hallux Valgus 138.88 2 839.60
839.55 3.00 TM 319.73
319.70
5732 Aitkin procedure or similar 133.44 2 728.30
728.33 3.00 TM 319.73
319.70
5734 Removal bony prominance foot e.g. bunionette 91.00 1 860.60 3.00 TM 319.73
319.70
5735 Repair angular deformity toe (lesses toes) 97.20 1 987.40
987.36 3.00 TM 319.73
319.70
5736 Sesamoidectomy 97.80 1 999.60
999.63 3.00 TM 319.73
319.70

Units N$ Units N$
5737 Repair major foot tendons e.g. Tib Post 120.00 2 453.50
453.53 3.00 TM 319.73
319.70
5738 Repair of dislocating peroneal tendons 138.56 2 833.00
833.01 3.00 TM 319.73
319.70
5739 Forefoot reconstruction for rheumatoid arthritis: 161.84 3 309.00 3.00 TM 319.73
319.70
Clayton or similar - one foot
5740 Steindler strip - plantar fascia 97.20 1 987.40
987.36 3.00 TM 319.73
319.70
5741 Kelikian syndactilly (one web space) 97.20 1 987.40
987.36 3.00 TM 319.73
319.70
5742 Tendon transfer foot 137.60 2 813.40
813.38 3.00 TM 319.73
319.70
5743 Capsulotomy metatarsophalangeal joints - foot 86.80 1 774.70
774.72 3.00 TM 319.73
319.70
3.8.2 Reimplantations
MODIFIERS
0063 Where two specialists work together on a replantation procedure, each shall be entitled to two-
thirds of the fee for the procedure.
0064 Where the replantation is unsuccessful, no further surgical fee is payable for amputation of the
non-viable parts.

Units N$ Units N$
0912 Replant of amputated upper limb proximal to 487.00 9 957.20

957.25 3.00 TM 319.73
319.70
wrist joint
0913 Replantation of thumb. 447.00 9 139.40
139.41 3.00 TM 319.73
319.70
0914 Replantation of a single digit (to be motivated), 387.00 7 912.60
912.64 3.00 TM 319.73
319.70
for multiple digits, modifier 0005 applicable.
0915 Replantation operation through the palm. 847.00 17 317.80
317.85 3.00 TM 319.73
319.70
3.8.3 Hands: (Note: Skin: See Integumentary System)

Units N$ Units N$
TUMOURS - -
0919 Epidermoid cysts. 35.00 715.61
715.60 3.00 TM 319.73
319.70
0920 Ganglion or fibroma. 51.00 1 042.80
042.75 3.00 TM 319.73
319.70
0921 Nodular synovitis (Giant cell tumour of tendon 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
sheath)

Units N$ Units N$
REMOVAL OF FOREIGN BODIES - -

REQUIRING INCISION
0922 Under local anaesthetic. 19.00 388.48
388.50 3.00 TM 319.73
319.70
0923 Under general or regional anaesthetic. 32.00 654.28
654.30 3.00 TM 319.73
319.70
- -
CRUSHED HAND INJURIES - -
0924 Initial extensive soft tissue toilet under general 37.00 756.51
756.50 3.00 TM 319.73
319.70
anaesthetic (sliding scale).
Item 0924: The number of units chargeable - -

under this item ranges from 37.00 to 110.00 for
Specialists, and from 37.00 to 73.00 for
General Practitioners.
0925 Subsequent dressing changes under general 16.00 327.14
327.10 3.00 TM 319.73
319.70
anaesthetic
3.8.4 Spine
Please note the following with regard to section 3.8.5: Spine
(a) Modifier 0005 (multiple procedures/operations under the same anaesthetic) is not applicable if the
following procedures are performed together:
1 Bone graft procedures and instrumentation are to be charged in addition to arthrodesis.
2 When vertebral procedures are performed by arthrodesis, bone grafts and instrumentation
may be charged for in addition.
(b) Modifier 0005 (multiple procedures/operations under the same anaesthetic) would be applicable
when arthrodesis is performed in addition to another procedure, e.g. Osteotomy, laminectomy
MODIFIER
0061 In cases of combined procedures on the spine, both the orthopaedic surgeon and the
neurosurgeon are entitled to the full fee for the relevant part of the operation performed.

Units N$ Units N$
0927 Excision of one vertebral body, for a lesion 138.00 2 821.60

821.56 3.00 TM 319.73
319.70
within the body (no decompression)
0928 Excision of each additional vertebral segment 42.00 858.74
858.70 3.00 TM 319.73
319.70
Units N$ Units N$
for a lesion within the body (no decompression)

0930 Posterior osteotomy of spine: One vertebral 226.00 4 620.80
620.82 3.00 TM 319.73
319.70
segment
0932 Posterior osteotomy of spine: Each additional 69.00 1 410.80
410.78 3.00 TM 319.73
319.70
vertebral segment
0933 Anterior spinal osteotomy with disc removal: 210.00 4 293.70
293.68 3.00 TM 319.73
319.70
One vertebral segment
0936 Anterior spinal osteotomy with disc removal: 69.00 1 410.80
410.78 3.00 TM 319.73
319.70
Each additional vertebral segment
0938 Anterior fusion base of skull to C2 299.00 6 113.40
113.38 4.00 TM 426.31
426.30
0941 Anterior interbody fusion: One level 240.00 4 907.10
907.06 3.00 TM 319.73
319.70
0942 Anterior interbody fusion: Each additional level 68.00 1 390.30
390.33 3.00 TM 319.73
319.70
0944 Posterior fusion: Occiput to C2 260.00 5 316.00
315.99 4.00 TM 426.31
426.30
0931 Posterior spinal fusion: One level. 257.00 5 254.60
254.65 3.00 TM 319.73
319.70
0946 Posterior spinal fusion: Each additional level 74.00 1 513.00
513.01 3.00 TM 319.73
319.70
0948 Posterior interbody lumbar fusion: One level 243.00 4 968.40 3.00 TM 319.73
319.70
0950 Posterior interbody lumbar fusion: Each 63.00 1 288.10 3.00 TM 319.73
319.70
additional interspace
0929 Manupilation of spine under general 14.00 286.25
286.20 5.00 T 532.89
532.90
anaesthetic: (no after-care), modifier 0005 not
applicable.
0939 Trans-abdominal anterior exposure of the spine 107.00 2 187.70
187.73 3.00 TM 319.73
319.70
for spinal fusion only if done by a second
surgeon
0940 Trans-thoracic anterior exposure of the spine if 107.00 2 187.70
187.73 3.00 TM 319.73
319.70
done by a second surgeon
0959 Excision of coccyx. 64.00 1 308.60
308.55 3.00 TM 319.73
319.70
0961 Costo-transversectomy. 132.00 2 698.90
698.89 3.00 TM 319.73
319.70
0963 Antero-lateral decompression of spinal cord or 217.00 4 436.80 3.00 TM 319.73
319.70
anterior debridement

3.8.5 Spinal deformities
Please note: Posterior fusion for spinal deformity (to be used for scoliosis more than 30 degrees or thoracic
kyphosis more than 45 degrees)
MODIFIER
0065 Additional operative procedures by same surgeon (other than the first two items listed under this
heading) within a period of 12 months: 75% of scheduled fee for the lesser procedure, except
where otherwise specified elsewhere.

Units N$ Units N$
0952 Posterior fusion for spinal deformity: Up to 6 239.00 4 886.60

886.62 3.00 TM 319.73
319.70
levels
0954 Posterior fusion for spinal deformity: 7 to 12 365.00 7 462.80
462.83 3.00 TM 319.73
319.70
levels
0955 Posterior fusion for spinal deformity: 13 or 395.00 8 076.20
076.21 3.00 TM 319.73
319.70
more levels
0956 Anterior fusion for spinal deformity 2 or 3 levels 273.00 5 581.80
581.79 3.00 TM 319.73
319.70
0957 Anterior fusion for spinal deformity: 4 to 7 levels 296.00 6 052.00
052.05 3.00 TM 319.73
319.70
0958 Anterior fusion for spinal deformity: 8 or more 359.00 7 340.10
340.15 3.00 TM 319.73
319.70
levels
3.8.6 All spinal problems

Units N$ Units N$
0960 Posterior non-segmental instrumentation 111.00 2 269.50

269.52 5.00 TM 532.89
532.90
0962 Posterior segmental instrumentation: 2 to 6 117.00 2 392.20
392.19 5.00 TM 532.89
532.90
vertebrae
0964 Posterior segmental instrumentation: 7 to 12 134.00 2 739.80
739.78 5.00 TM 532.89
532.90
vertebrae
0966 Posterior segmental instrumentation: 13 or 163.00 3 332.70
332.71 5.00 TM 532.89
532.90
more vertebrae
0968 Anterior instrumentation: 2 to 3 vertebrae 106.00 2 167.30
167.29 5.00 TM 532.89
532.90
0970 Anterior instrumentation: 4 to 7 vertebrae 123.00 2 514.90
514.87 5.00 TM 532.89
532.90
0972 Anterior instrumentation: 8 or more vertebrae 137.00 2 801.10
801.12 5.00 TM 532.89
532.90
0974 Additional pelvic fixation of instrumentation 72.00 1 472.10

472.12 5.00 TM 532.89
532.90
Units N$ Units N$
other than sacrum

5750 Reinsertion of instrumentation 184.00 3 762.10
762.08 6.00 TM 639.46
639.50
5751 Removal of posterior non-segmental 115.00 2 351.30 6.00 TM 639.46
639.50
instrumentation
5752 Removal of posterior segmental instrumentation 117.00 2 392.20
392.19 6.00 TM 639.46
639.50
5753 Removal of anterior instrumentation 136.00 2 780.70
780.67 6.00 TM 639.46
639.50
5755 Laminectomy for spinal stenosis (exclude 197.00 4 027.90
027.88 3.00 TM 319.73
319.70
diskectomy, foraminotomy and
spondylolisthesis): One or two levels
5756 Laminectomy with full decompression for 203.00 4 150.60
150.56 3.00 TM 319.73
319.70
spondylolisthesis (Gill procedure)
5757 Laminectomy for decompression without 214.00 4 375.50
375.47 3.00 TM 319.73
319.70
foraminotomy or diskectomy more than two
levels
0943 Laminectomy with decompression of nerve 160.00 3 271.40
271.38 3.00 TM 319.73
319.70
roots and disc removal: One level.
5758 Laminectomy with decompression of nerve 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
roots and disc removal: Each additional level
5759 Laminectomy for decompression diskectomy 235.00 4 804.80
804.83 4.00 TM 426.31
426.30
etc., revision opertation
5760 Laminectomy, facetectomy, decompression for 201.00 4 109.70
109.67 3.00 TM 319.73
319.70
lateral recess stenosis plus spinal stenosis:
One level
5761 Laminectomy, facetectomy, decompression for 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
lateral recess stenosis plus spinal stenosis:
Each additional level
5763 Anterior disc removal and spinal 229.00 4 682.20
682.16 3.00 TM 319.73
319.70
decompression cervical: One level
5764 Anterior disc removal and spinal 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
decompression cervical: Each additional level
5765 Vertebral corpectomy for spinal 311.00 6 358.70
358.74 3.00 TM 319.73
319.70
decompression: One level
5766 Vertebral corpectomy for spinal 60.00 1 226.80
226.77 3.00 TM 319.73
319.70
decompression: Each additional level
5770 Use of microscope in spinal of intracranial 60.00 1 226.80
226.77 -
procedures (modifier 0005 not applicable)
0969 Skull or skull-femoral traction including two 60.00 1 226.80
226.77 -
weeks after-care
0971 Halo-splint and POP jacket including two 77.00 1 574.30
574.35 -
weeks after-care

3.9 Facial bone procedures
Please note: Modifiers 0046 to 0058 are not applicable to section 3.9 of the benchmark tariffs

Units N$ Units N$
0987 Repair of orbital floor (blowout fracture). 121.00 2 474.00

473.98 4.00 TM 426.31
426.30
0988 Genioplasty. 175.00 3 578.10
578.07 4.00 TM 426.31
426.30
- -
OPEN REDUCTION AND FIXATION OF - -
CENTRAL MID-THIRD FACIAL FRACTURE
WITH DISPLACEMENT
0989 Le Fort I. 123.00 2 514.90
514.87 4.00 TM 426.31
426.30
0990 Le Fort II. 201.00 4 109.70
109.67 4.00 TM 426.31
426.30
0991 Le Fort III. 289.00 5 908.90
908.92 4.00 TM 426.31
426.30
0992 Le Fort I Osteotomy. 647.00 13 228.60
228.63 4.00 TM 426.31
426.30
0993 Palatal Osteotomy. 201.00 4 109.70
109.67 4.00 TM 426.31
426.30
0994 Le Fort II Osteotomy (team fee). 735.00 15 027.90
027.88 4.00 TM 426.31
426.30
0995 Le Fort III Osteotomy (team fee). 1103.00 22 552.00
552.05 4.00 TM 426.31
426.30
0996 Fracture of maxilla without displacement. iii - -
- -
MANDIBLE: FRACTURED NOSE AND - -
ZYGOMA
0997 Open reduction and fixation. 201.00 4 109.70
109.67 3.00 TM 319.73
319.70
0999 Closed reduction by inter-maxillary fixation. 123.00 2 514.90
514.87 3.00 TM 319.73
319.70
1001 Temporo-mandibular joint: Reconstruction for 137.00 2 801.10
801.12 4.00 TM 426.31
426.30
dysfunction
1003 Manipulation: Immobilisation and follow-up of 35.00 715.61
715.60 3.00 TM 319.73
319.70
fractured nose.
1005 Nasal fracture without manipulation. iii - -
1007 Mandibulectomy. 213.00 4 355.00
355.02 5.00 TM 532.89
532.90
1009 Maxillectomy 224.00 4 579.90
579.93 4.00 TM 426.31
426.30
1011 Bone graft to mandible. 137.00 2 801.10
801.12 4.00 TM 426.31
426.30
1012 Adjustment of occlusion by ramisection. 151.00 3 087.40
087.36 4.00 TM 426.31
426.30
1013 Fracture of arch of zygoma without iii - -
displacement.
1015 Fracture of arch of zygoma with displacement 87.00 1 778.80
778.81 3.00 TM 319.73
319.70
requiring operative manipulation but not
including associated fractures, recent fractures
(within four weeks)
1017 Fracture of arch of zygoma with displacement 175.00 3 578.10
578.07 3.00 TM 319.73
319.70
requiring operative manipulation but not
including associated fractures; (after four
weeks)

4 RESPIRATORY SYSTEM
ii Clinical Units
T Time Units
4.1 Nose and sinuses
MODIFIERS GOVERNING NASAL OPERATIONS
0069 When endoscopic instruments are used during intranasal surgery: Add 10% of the fee of the
procedure performed. Only applicable to items 1025, 1027, 1030, 1033, 1035, 1036, 1039, 1047,
1054 and 1083.

Units N$ Units N$
1018 Flexible nasopharyngolaryngoscope 51.94 1 062.00

061.97 -
1019 ENT endoscopy in rooms with rigid endoscope. - -
1020 Septum perforation repair, by any method. 83.00 1 697.00
697.03 4.00 T 426.31
426.30
1022 Functional reconstruction of nasal septum. 77.00 1 574.30
574.35 5.00 T 532.89
532.90
1024 Insertion of silastic obturator into nasal septum 30.00 613.38
613.40 4.00 T 426.31
426.30
perforation (excluding material)
1025 Intranasal antrostomy (modifier 0005 to applyto 60.00 1 226.80
226.77 4.00 T 426.31
426.30
opposite side)
1027 Dacrocystorhinostomy. 140.00 2 862.50
862.45 5.00 T 532.89
532.90
1029 Turbinectomy, uni- or bilateral 45.00 920.07
920.10 4.00 T 426.31
426.30
1030 Endoscopic turbinectomy: laser or 60.00 1 226.80
226.77 5.00 T 532.89
532.90
microdebrider
1031 Removal of single nasal polyp at rooms (at 15.00 306.69
306.70 -
initial consultation only)
1033 Removal of multiple polyps in hospital under 50.00 1 022.30 4.00 T 426.31
426.30
general anaesthetic
1034 Autogenous nasal bone transplant: Bone 67.00 1 369.90
369.89 4.00 T 426.31
426.30
removal included
1035 Functional endoscopic sinus surgery: Unilateral 93.00 1 901.50
901.49 4.00 T 426.31
426.30
1036 Bilateral functional endoscopic sinus surgery. 163.00 3 332.70
332.71 4.00 T 426.31
426.30
- -
DIATHERMY TO NOSE OR PHARYNX - -
EXCLUSIVE OF CONSULTATION FEE, UNI-
OR BILATERAL
1037 Under local anaesthetic. 8.00 163.57
163.60 -
Units N$ Units N$
1039 Under general anaesthetic 35.00 715.61

715.60 4.00 T 426.31
426.30
- -
SEVERE EPISTAXIS, REQUIRING - -
HOSPITALISATION
1041 Control severe epistaxis requiring 40.00 817.84
817.80 6.00 T 639.46
639.50
hospitalisation: Anterior plugging
1043 Control severe epistaxis requiring 60.00 1 226.80
226.77 6.00 T 639.46
639.50
hospitalisation: Anterior and posterior plugging
1045 Ligation anterior ethmoidal artery. 59.00 1 206.30
206.32 6.00 T 639.46
639.50
1047 Caldwell-Luc operation (unilateral). 61.00 1 247.20
247.21 4.00 T 426.31
426.30
1049 Ligation internal maxillary artery. 87.00 1 778.80
778.81 6.00 T 639.46
639.50
1050 Vidian neurectomy (transantral or transnasal). 75.00 1 533.50
533.46 4.00 T 426.31
426.30
1051 Removal nasopharyngeal fibroma. 190.00 3 884.80
884.76 6.00 T 639.46
639.50
1052 Instrumental examination of the nasopharynx 50.00 1 022.30 4.00 T 426.31
426.30
including biopsy under general anaesthetic.
1053 Frontal sinus drainage, trephin operation 60.00 1 226.80
226.77 4.00 T 426.31
426.30
1054 Antroscopy through the canine fossa (uni- or - -
bilateral)
1055 External frontal ethmoidectomy 129.00 2 637.50
637.55 4.00 T 426.31
426.30
1057 External ethmoidectomy and/or 109.00 2 228.60
228.62 4.00 T 426.31
426.30
sphenoidectomy
1058 Sublabial transseptal sphenoidotomy. 91.00 1 860.60 4.00 T 426.31
426.30
1059 Frontal osteomyelitis. 129.00 2 637.50
637.55 4.00 T 426.31
426.30
1060 Obliteration of frontal sinus. 147.00 3 005.60
005.58 4.00 T 426.31
426.30
1061 Lateral rhinotomy. 109.00 2 228.60
228.62 4.00 T 426.31
426.30
1062 Excision nasolabial cyst 223.32 4 566.00
566.02 4.00 T 426.31
426.30
1063 Removal of foreign bodies from nose at rooms. 10.00 204.46
204.50 -
1065 Removal of foreign body from nose under 35.00 715.61
715.60 4.00 T 426.31
426.30
general anaesthetic
1067 Proof puncture at rooms (unilatetal). 10.00 204.46
204.50 4.00 T 426.31
426.30
1069 Proof puncture, uni- or bilateral under general 35.00 715.61
715.60 4.00 T 426.31
426.30
anaesthetic
1071 Proetz treatment (consultation fee only to be 4.00 81.78
81.80 -
charged for first treatment)
1077 Septum abscess, at rooms, including after- 8.00 163.57
163.60 -
care.
1079 Septum abscess, under general anaesthetic. 35.00 715.61
715.60 4.00 T 426.31
426.30
1081 Oro-antral fistula (without Caldwell-Luc). 60.00 1 226.80
226.77 4.00 T 426.31
426.30
1083 Choanal atresia: Intranasal approach. 75.00 1 533.50
533.46 5.00 T 532.89
532.90
1084 Choanal atresia: Transpalatal approach. 129.00 2 637.50
637.55 7.00 T 746.04
746.00
1085 Total reconstruction of the nose: including 233.00 4 763.90
763.94 5.00 T 532.89
532.90
reconstruction of nasal septum (septumplasty)
nasal pyramid (osteotomies) and nose tip
1087 Sub-total reconstruction consisting of any two 140.00 2 862.50
862.45 5.00 T 532.89
532.90
of the following: septumplasty, osteotomies,
Units N$ Units N$
nasal tip reconstruction
FOREHEAD RHINOPLASTY (ALL STAGES) - -

1089 Total. 368.00 7 524.20
524.16 5.00 T 532.89
532.90
1091 Partial. 276.00 5 643.10
643.12 5.00 T 532.89
532.90
1093 Rhinophyma without skin graft 92.00 1 881.00
881.04 5.00 T 532.89
532.90
1095 Full nasal reconstruction for secondary cleft lip 185.00 3 782.50
782.53 5.00 T 532.89
532.90
deformity
1097 Partial nasal reconstruction for cleft lip 117.00 2 392.20
392.19 5.00 T 532.89
532.90
deformity
1099 Columella reconstruction or lengthening. 92.00 1 881.00
881.04 5.00 T 532.89
532.90
4.2 Throat

Units N$ Units N$
1101 Tonsillectomy (dissection of tonsils) 60.00 1 226.80

226.77 4.00 T 426.31
426.30
1102 Laser tonsillectomy 60.00 1 226.80
226.77 6.00 T 639.46
639.50
1105 Removal of adenoids 40.00 817.84
817.80 4.00 T 426.31
426.30
1106 Laser assisted functional reconstruction of 75.00 1 533.50
533.46 5.00 T 532.89
532.90
palate and uvula: In the rooms (+ item 5930 for
hire of laser)
1108 Laser assisted functional reconstruction of 60.00 1 226.80
226.77 5.00 T 532.89
532.90
palate and uvula: In rooms (+ item 5930 for hire
of laser): Follow-up operation performed by the
same surgeon
1107 Opening of quinsy - at rooms. 12.00 245.35
245.40 6.00 T 639.46
639.50
1109 Opening of quinsy under general anaesthetic 35.00 715.61
715.60 6.00 T 639.46
639.50
1110 Ludwig's Angina: Drainage. 42.00 858.74
858.70 9.00 T 959.19
959.20
1111 Post tonsillectomy or adenoidectomy 46.00 940.52
940.50 6.00 T 639.46
639.50
haemorrhage
1112 Pharyngeal pouch operation. 140.00 2 862.50
862.45 5.00 T 532.89
532.90
1113 Retropharyngeal abscess internal approach. 35.00 715.61
715.60 6.00 T 639.46
639.50
1115 Retropharyngeal abscess external approach. 60.00 1 226.80
226.77 6.00 T 639.46
639.50
1116 Functional reconstruction of palate and uvula 75.00 1 533.50
533.46 5.00 T 532.89
532.90

4.3 Larynx
SPECIFIC MODIFIER GOVERNING THIS SECTION OF THE BENCHMARK TARIFFS
0067 Micro-surgery of the larynx; to the fee of the operation performed add 25%.

Units N$ Units N$
1117 Laryngeal intubation (Cannot be claimed 10.00 204.46

204.50 -
together with a general anaesthetic. All
intubations are included in the anaesthetic fee)
1118 Laryngeal stroboscopy with video capture 39.00 797.40 6.00 T 639.46
639.50
- -
LARYNGECTOMY - -
1119 Laryngectomy without block dissection of the 287.00 5 868.00
868.03 7.00 T 746.04
746.00
neck.
1123 Botulinum toxin injection for adductor - -
dysphonia (+ item 0201 + item 0202).
1125 Operative laryngoscopy with excision of 120.00 2 453.50
453.53 6.00 T 639.46
639.50
tumour and/or stripping of vocal cords
(excluding aftercare)
1126 Post laryngectomy for voice restoration. 60.00 1 226.80
226.77 9.00 T 959.19
959.20
1127 Tracheotomy. 60.00 1 226.80
226.77 9.00 T 959.19
959.20
1128 Endolaryngeal operations using a laser. 50.00 1 022.30 8.00 T 852.62
852.60
1129 External laryngeal operation e.g. laryngeal 131.00 2 678.40
678.44 8.00 T 852.62
852.60
stenosis, laryngocele, abductor paralysis,
laryngo- fissure.
DIRECT LARYNGOSCOPY - -
1130 Diagnostic laryngoscopy including biopsy (also 35.00 715.61
715.60 6.00 T 639.46
639.50
to be applied when a flexible fibre-optic
laryngoscope was used)
1131 Plus foreign body removal 46.00 940.52
940.50 6.00 T 639.46
639.50
4.4 Bronchial procedures

Units N$ Units N$
BRONCHOSCOPY - -
Note: Please specify on account if a biopsy

was performed together with the bronchoscopy
1132 Diagnostic bronchoscopy 43.00 879.18
879.20 6.00 T 639.46
639.50
1133 With removal of foreign body. 53.00 1 083.60
083.64 8.00 T 852.62
852.60
Units N$ Units N$
1134 Bronchoscopy with use of laser. - 8.00 T 852.60

852.62
1135 With bronchography. 53.00 1 083.60
083.64 8.00 T 852.62
852.60
1136 Nebulisation (in rooms) 12.00 245.35
245.40 -
1137 Bronchial lavage. - 8.00 T 852.60
852.62
1138 Thoracotomy: for broncho-pleural 233.00 4 763.90
763.94 12.00 T 1 278.90
278.92
fistula(including ruptured bronchus, any cause)
4.5 Pleura

Units N$ Units N$
1139 Pleural needle biopsy: (no after-care), modifier 50.00 1 022.30 3.00 T 319.73
319.70
0005 not applicable
1141 Insertion of intercostal catheter (under water 50.00 1 022.30 6.00 T 639.46
639.50
drainage)
1142 Intra-pleural block. 36.00 736.06
736.10 -
1143 Paracentesis chest: Diagnostic. 8.00 163.57
163.60 3.00 T 319.73
319.70
1145 Paracentesis chest: Therapeutic. 13.00 265.80 3.00 T 319.73
319.70
1147 Pneumothorax: Induction (diagnostic). 25.00 511.15
511.20 -
1149 Pleurectomy. 167.00 3 414.50 11.00 T 1 172.30
172.35
1151 Decortication of lung. 233.00 4 763.90
763.94 11.00 T 1 172.30
172.35
1153 Chemical pleurodesis (instillation silver nitrate, 55.00 1 124.50
124.54 3.00 T 319.73
319.70
tetracycline, talc, etc)
4.6 Pulmonary procedures
4.6.1 Surgical

Units N$ Units N$
1155 Needle biopsy lung: (no after-care) modifier 32.00 654.28

654.30 5.00 T 532.89
532.90
0005 not applicable
1157 Pneumonectomy. 233.00 4 763.90
763.94 11.00 T 1 172.30
172.35
1159 Pulmonary lobectomy. 233.00 4 763.90
763.94 11.00 T 1 172.30
172.35
1161 Segmental lobectomy. 243.00 4 968.40 11.00 T 1 172.30
172.35
- -
Units N$ Units N$
EXCISION TRACHEAL STENOSIS - -

1163 Cervical. 250.00 5 111.50
111.52 8.00 T 852.62
852.60
1164 Intra thoracic. 233.00 4 763.90
763.94 12.00 T 1 278.90
278.92
1167 Thoracoplasty associated with lung resection 143.00 2 923.80
923.79 12.00 T 1 278.90
278.92
or done by the same surgeon within 6 weeks.
1168 Thoracoplasty: Complete. 167.00 3 414.50 11.00 T 1 172.30
172.35
1169 Thoracoplasty: Limited/osteoplastic. 133.00 2 719.30
719.33 11.00 T 1 172.30
172.35
1171 Drainage empyema (including six weeks after 113.00 2 310.40
310.41 11.00 T 1 172.30
172.35
treatment)
1173 Drainage of lung abscess (including six weeks 113.00 2 310.40
310.41 11.00 T 1 172.30
172.35
after treatment)
1175 Thoracotomy (limited): For lung or pleural 77.00 1 574.30
574.35 11.00 T 1 172.30
172.35
biopsy.
1177 Major: Diagnostic, as for inoperable carcinoma 143.00 2 923.80
923.79 11.00 T 1 172.30
172.35
1179 Thoracoscopy. 60.00 1 226.80
226.77 11.00 T 1 172.30
172.35
1181 Unilateral lung transplant. 400.00 8 178.40
178.44 15.00 T 1 598.70
598.66
1182 Harvesting donor lung: Unilateral. 80.00 1 635.70
635.69 5.00 T 532.89
532.90
- -
EXCISION OR PLICATION OF - -
EMPHYSEMATOUS CYST
1183 Unilateral. 167.00 3 414.50 11.00 T 1 172.30
172.35
1184 Bilateral synchronous (Median sternotomy). 292.00 5 970.30
970.26 11.00 T 1 172.30
172.35
1185 Re-exploration following sternal dehiscence. 67.00 1 369.90
369.89 11.00 T 1 172.30
172.35
4.6.2 Pulmonary function tests

Units N$ Units N$
1186 Flow volume test: Inspiration/expiration. 20.00 408.92

408.90 -
1188 Flow volume test: Inspiration/expiration pre- 33.00 674.72
674.70 -
and post bronchodilator (to be charged for only
with first consultation - thereafter item 1186
applies)
1189 Forced expirogram only 10.00 204.46
204.50 -
1191 N_2 single breath distribution 10.00 204.46
204.50 -
1192 Peak expiratory flow only. 5.00 102.23
102.20 -
1197 Compliance and resistance, using 24.00 490.71
490.70 -
oesophageal balloon
1201 Maximum inspiratory/expiratory pressure. 5.00 102.23
102.20 -
1193 Functional residual capacity or residual - -
volume: helium, nitrogen open circuit, or other
Units N$ Units N$
method
1195 Thoracic gas volume - -
1196 Determination of resistance to airflow, - -
oscillatory or plethysmographic methods
1198 Prolonged postexposure evaluation of 55.89 1 142.70
142.73 -
bronchospasm with multiple spirometric
determinations after antigen, cold air,
methacholine or other chemical agent, with
subsequent spirometrics
1199 Pulmonary stress testing; simple (eg. 96.50 1 973.00
973.05 -
prolonged exercise test for bronchospasm with
pre- and post-spirometry)
1200 Carbon monoxide diffusing capacity, any - -
method
4.7 Intensive care: (in intensive care or high care unit) Respiratory, cardiac, general
RULES GOVERNING THIS SPECIFIC SECTION OF THE BENCHMARK TARIFFS
Q Intensive care: Units in respect of items 1204 to 1210 (Categories 1 to 3) EXCLUDE the following:
(a) Anaesthetic and/or surgical fees for any condition or procedure, as well as a first
consultation/visit, which is, regarded as the assessment of the patient, while the daily intensive
fee covers the daily care in the intensive care unit.
(b) Cost of any drugs and/or materials.
(c) Any other cost which may be incurred before, during or after the consultation/visit and/or the
therapy.
(d) Blood gases and chemistry tests, including the arterial puncture to obtain the specimen.
(e) Procedural items 1202 and 1212 to 1221.
but INCLUDE the following:
(f) Performing and interpretation of a resting ECG.

(g) Interpretation of chemistry tests and x-rays.
(h) Intravenous treatment (items 0206 and 0207) except intravenous infusion in patients under the
age of two years (item 0205) that does not form a part of the daily ICU fee and may be charged
for separately on a daily basis (fee includes the introduction of the cannula as well as the daily
management)
R Units for items 1208, 1209 and 1210 include resuscitation (i.e. item 1211).

S Units for items 1212, 1213 and 1214 include the following
(a) Measurement of minute volume, vital capacity, time- and vital capacity studies.
(b) Testing and connecting the machine.
(c) Putting patient on machine: setting machine, synchronising patient with machine.
(d) Instruction to nursing staff.
(e) All subsequent visits for 24 hours.
T Ventilation (items 1212 to 1214) does not form a part of normal postoperative care, but may not be
added to item 1204.
4.7.1 Neonatal procedures

Units N$ Units N$
1202 Insertion of central veneous catheter via 40.00 817.84

817.80 -
peripheral vein in neonates.
4.7.2 Benchmark tariff items for intensive care

Units N$ Units N$
Category 1: Cases requiring intensive - -

monitoring (to include cases where
physiological instability is anticipated, e.g.
diabetic pre-coma, asthma, gastro-intestinal
haemorrhage, etc). Please note that item 1204
may not be charged by the responsible
surgeon for monitoring a patient post-
operatively in ICU or in the high-care unit since
postoperative monitoring is included in the fee
for the procedure
1204 Per Day 30.00 613.38
613.40 -
Category 2: Cases requiring active system - -

support (where active specialised intervention
is required in cases such as acute myocardial
infarction; diabetic coma, head injury, severe
asthma, acute pancreatius, eclampsia, flail
chest, etc.) Ventilation may or may not be part
of the active system support
1205 First day 67.00 1 369.90
369.89 -
1206 Subsequent days, per day. 50.00 1 022.30 -

Units N$ Units N$
1207 After two weeks, per day. 30.00 613.38

613.40 -
Please Note: The principal practitioner may - -

charge items 1205 - 1207, other participating
practitioners must charge the consultation
item, e.g. item 0109
Category 3: Cases with multiple organ failure

or Category 2 patients that may require
multidisciplinary intervention
1208 First day (principal practitioner). 91.00 1 860.60 -
1209 First day (per involved practitioner) 58.00 1 185.90
185.87 -
1210 Subsequent days (per involved practitioner). 50.00 1 022.30 -
4.7.3 Procedures

Units N$ Units N$
1211 Cardio-respiratory resuscitation: Prolonged - -

attendance in cases of emergency (not
necessarily in ICU) - 50,00 clinical procedure
units per half hour or part thereof for the first
hour per practitioner, thereafter 25,00 clinical
procedure units per half hour up to a maximum
of 150,00 clinical procedure units per
practitioner. Resuscitation fee includes all
necessary additional procedures e.g. infusion,
intubation, etc.
VENTILATION - -
1212 First day. 50.00 1 022.30 -
1213 Subsequent days, per day. 50.00 1 022.30 -
1214 After two weeks, per day 25.00 511.15
511.20 -
1215 Insertion of arterial pressure cannula. 25.00 511.15
511.20 -
1216 Insertion of Swan Ganz catheter for 50.00 1 022.30 -
haemodynamic monitoring
1217 Insertion of central venous line via peripheral 10.00 204.46
204.50 -
vein
1218 Insertion of central venous line via subclavian 25.00 511.15
511.20 -
or jugular veins.
1219 Hyperalimentation (daily rate). 15.00 306.69
306.70 -
1220 Patient-controlled analgesic pump: Hire fee: 30.00 613.38
613.40 -
Per 24 hours (Casette to be charged for
according to item 0201 per patient)
1221 Professional fee for managing a patient- 30.00 613.38
613.40 -
controlled analgesic pump: Once off charge
Units N$ Units N$
per patient
4.8 Hyperbaric Oxygen Therapy
Internationally recognized scientific indications for Hyperbaric Oxygen Therapy:

(a) Arterial gas embolism (traumatic or iatrogenic).
(b) Decompression sickness ('the bends')
(c) Carbon monoxide poisoning
(d) Gas gangrene
(e) Crush injuries, compartment syndromes or acute traumatic ischaemias.
(f) Problem wounds (selected diabetic wounds, complicated pressure sores, arterial and refractory
venous stasis ulcers and non-union)
(g) Necrotising soft tissue infections (e.g. necrotising fasciitis)
(h) Refractory osteomyelitis/ Refraktêre osteomiëlitis.
(i) Bone and soft tissue radiation necrosis.
(j) Compromised skin grafts and flaps.
(k) Acute thermal burns.
(l) Acute bloodloss anaemia (transfusion is contraindicated - e.g. Jehovah's Witnesses or haemolytic
anaemia).
(m) Cerebral abscesses

Units N$ Units N$
4800 Pre-hyperbaric assessment of a patient away - -

from the hyperbaric unit (all hours) (includes
interpretation of ECG and/or lung function test)
4801 Pre-hyperbaric assessment of a patient in the - -
hyperbaric unit (all hours) (includes
interpretation of ECG and/or lung function test)
4804 Monitoring of a patient at the hyperbaric 30.00 613.38
613.40 -
chamber during hyperbaric treatment (includes
pre-hyperbaric assessment and consultation
regarding the indication for hyperbaric
treatment provided in the hyperbaric unit): Low
pressure table (1,5-1,8 ATA x 45-60 min)
4805 Monitoring of a patient at the hyperbaric 60.00 1 226.80
226.77 -
treatment provided in the hyperbaric unit):
Routine HBO table (2-2,5 ATA x 90-120 min)

Units N$ Units N$

635.69 -
treatment provided in the hyperbaric unit):
Emergency HBO table (2,5-3 ATA x 90-120
min)
840.15 -
treatment provided in the hyperbaric unit): USN
TT5 (2,8 ATA x 135 min)
884.76 -
TT6 (2,8 ATA x 285 min)
685.87 -
TT6ext/6A or Cx 30 (2,8-6 ATA x 305-490 min)
4815 Prolonged attendance inside a hyperbaric - -
chamber: 50,00 clinical units per half hour or
part thereof for the first hour, thereafter 25,00
clinical procedure units per half hour; minimum
50,00 clinical procedure units; maximum
400,00 clinical procedure units
5 MEDIASTINAL PROCEDURES
T Time Units

Units N$ Units N$
1222 Mediastinal tumours. 190.00 3 884.80

884.76 11.00 T 1 172.30
172.35
1223 Mediastinoscopy. 63.00 1 288.10 5.00 T 532.89
532.90
1224 Mediastinotomy. 77.00 1 574.30
574.35 11.00 T 1 172.30
172.35
1225 Excision of malignant chest wall tumours 233.00 4 763.90
763.94 11.00 T 1 172.30
172.35
involving sternum and multiple ribs.
1226 Removal of single rib with a lesion. 188.00 3 843.90
843.87 11.00 T 1 172.30
172.35

6 CARDIOVASCULAR SYSTEM
MODIFIER GOVERNING FEES FOR AN ANAESTHESIOLOGIST OPERATING INTRA-AORTIC

BALLOON PUMP (CARDIOVASCULAR SYSTEM)
0100 Where an anaesthesiologist would be responsible for operating an intra-aortic balloon pump, a
fee of 75,00 clinical procedure units is applicable.
ii Clinical Units
T Time Units
6.1 General

Units N$ Units N$
1227 Prolonged neonatal resuscitation. 20.00 408.92

408.90 -
PHYSICIAN'S FEE FOR INTERPRETING AN - -

ECG
A specialist physician is entitled to the

following fees for interpretation of an ECG
tracing referred for interpretation. This applies
also to a paediatrician when an ECG of a child
is referred to him for interpretation
1230 Without effort. - -
1231 Without and with effort. - -
- -
ELECTROCARDIOGRAM - -
1232 Without effort. 9.00 184.01
184.00 -
1233 Without and with effort 13.00 265.80 -
1234 Effort electrocardiogram with the aid of a 40.00 817.84
817.80 -
special bicycle ergometer, monitoring
apparatus and availability of associated
apparatus
1235 Multi-stage treadmill test. 60.00 1 226.80
226.77 -
1236 ECG without effort: Under 4 years. 18.00 368.03
368.00 -
1237 24 Hour ambulatory blood pressure: Hire fee. 30.00 613.38
613.40 -

Units N$ Units N$
1238 24 Hour ambulatory ECG monitoring (holter): 55.00 1 124.50

124.54 -
Hire fee.
1239 24 Hour ambulatory ECG monitoring (holter): 27.00 552.04
552.00 -
Interpretation
1240 Signal averaged electrocardiogram. 53.00 1 083.60
083.64 -
1271 Cardiological supervision of Dobutamine 51.00 1 042.80
042.75 -
magnetic resonance stress testing
1241 X-ray Screening: Chest. 4.00 81.78
81.80 -
1242 X-ray screening: Prosthetic valves. 10.00 204.46
204.50 -
1243 Two week event triggered ambulatory ECG 55.00 1 124.50
124.54 -
monitoring: Hire fee.
1244 Two week event triggered ambulatory ECG 25.00 511.15
511.20 -
monitoring: Interpretation.
1245 Angiography cerebral: First two series. 34.30 701.30 4.00 T 426.31
426.30
1246 Angiography peripheral: Per limb. 25.00 511.15
511.20 4.00 T 426.31
426.30
1247 Cardioversion for arrhythmias (any method) 60.00 1 226.80
226.77 6.00 T 639.46
639.50
with doctor in attendance
1248 Paracentesis of pericardium. 50.00 1 022.30 9.00 T 959.19
959.20
6.2 Invasive cardiology
6.2.1 Cardiac catheterisation

Units N$ Units N$
1249 Right and left cardiac catheterisation without - 9.00 T 959.20

959.19
coronary angio-graphy (with or without biopsy).
1250 Endomyocardial biopsy. 60.00 1 226.80
226.77 9.00 T 959.19
959.20
1251 Transseptal puncture. 60.00 1 226.80
226.77 9.00 T 959.19
959.20
1252 Left heart catheterisation with coronary - 9.00 T 959.20
959.19
angiography (with or without biopsy).
1253 Right heart catheterisation (with or without - 9.00 T 959.20
959.19
biopsy)
1254 Catheterisation of coronary artery bypass 40.00 817.84
817.80 9.00 T 959.19
959.20
grafts and/or internal mammary grafts.
1255 Tilt test. 31.00 633.83
633.80 -

6.2.2 Electrophysiological study

Units N$ Units N$
1256 Ventricular stimulation study. - 9.00 T 959.20

959.19
1257 Full electrophysiological study - 9.00 T 959.20
959.19
6.2.3 Pacemakers

Units N$ Units N$
1258 Permanent - single chamber. 103.00 2 105.90

105.95 9.00 T 959.19
959.20
1259 Permanent - dual chamber. 153.00 3 128.30
128.25 9.00 T 959.19
959.20
1260 AV nodal ablation. 200.00 4 089.20
089.22 9.00 T 959.19
959.20
1261 Accessory pathway ablation. 400.00 8 178.40
178.44 9.00 T 959.19
959.20
1262 Electrophysiological mapping. 333.00 6 808.60
808.55 -
1263 Insertion transvenous implantable defibrillator. 141.00 2 882.90 15.00 T 1 598.70
598.66
1264 Test for implantable transvenous defibrillator 80.00 1 635.70
635.69 15.00 T 1 598.70
598.66
1265 Renewal of pacemaker unit only, team fee. 83.00 1 697.00
697.03 9.00 T 959.19
959.20
1266 Resiting pacemaker generator. 60.00 1 226.80
226.77 -
1267 Repositioning of catheter electrode. 50.00 1 022.30 9.00 T 959.19
959.20
1268 Threshold testing: Own equipment. - -
1269 Threshold testing: Hospital equipment. - -
1270 Programming of atrio-ventricular sequential 50.00 1 022.30 -
pacemaker
1273 Insertion of temporary pacemaker (modifier 80.00 1 635.70
635.69 9.00 T 959.19
959.20
0005 not applicable).
1275 Termination of arrhythmia - programmed 133.00 2 719.30
719.33 9.00 T 959.19
959.20
stimulation and lead insertion of temporary
pacer.
1272 Coronary Sinus Lead implantation for Cardiac 120.00 2 453.50
453.53 4.00 T 426.31
426.30
Resynchronisation (CRT) - add to code 1258 or
1259
1274 Percutaneous Transluminal Thrombectomy 208.00 4 252.80
252.79 -
1296 Fractional Flow Reserve (FFR) Study - first 28.00 572.49
572.50 -
vessel
1298 Fractional Flow Reserve (FFR) Study - per 22.40 457.99
458.00 -
additional vessel
1300 Renal Denervation, per treated vessel 178.40 3 647.60
647.58 -

6.2.4 Percutaneous transluminal angioplasty

Units N$ Units N$
1276 First cardiologist: single lesion 173.00 3 537.20

537.18 13.00 T 1 385.50
1277 Second cardiologist: single lesion. 93.00 1 901.50
901.49 13.00 T 1 385.50
1278 First cardiologist: second lesion. 60.00 1 226.80
226.77 13.00 T 1 385.50
1279 Second cardiologist: second lesion. 40.00 817.84
817.80 13.00 T 1 385.50
1280 First cardiologist: third or subsequent lesions 60.00 1 226.80
226.77 13.00 T 1 385.50
(each)
1281 Second cardiologist: third or subsequent 40.00 817.84
817.80 13.00 T 1 385.50
lesions (each)
1282 Use of balloon procedures including - first 173.00 3 537.20
537.18 15.00 T 1 598.70
598.66
cardiologist
- Atrial septostomy
- Pulmonary valve valvuloplasty
- Aortic valve valvuloplasty
- Coarctation dilation
- Mitral valve valvuloplasty
1283 Use of balloon procedure as in item 1282 - 93.00 1 901.50
901.49 15.00 T 1 598.70
598.66
second cardiologist
1290 Use of balloon procedures including - first - -
paediatric cardiologist ('33')
- Arterial septostomy
- Pulmonary valve valvuloplasty
- Aortic valve valvuloplasty
- Coarctation dilation
- Mitral valve valvuloplasty
- Closure Atrial septal defect
- Closure of patent ductus arteriosus
1291 Use of balloon procedure as in item 1290 - - -
second paediatric cardiologist ('33')
1284 Atherectomy: single lesion: first cardiologist. 200.00 4 089.20
089.22 -
1285 Atherectomy: single lesion: second 120.00 2 453.50
453.53 -
cardiologist.
1286 Insertion of intravascular stent: first cardiologist. 67.00 1 369.90
369.89 -
1287 Insertion of intravascular stent: second 50.00 1 022.30 -
cardiologist

6.2.5 Paediatric cardiac catheterisation
MODIFIER GOVERNING PAEDIATRIC CARDIAC CATHETERISATION BY PAEDIATRIC

CARDIOLOGISTS WITH A "33" PRACTICE NUMBER 0073
When item 1288: Paediatric cardiac catheterisation or item 1289: Paediatric cardiac catheterisation: Infants
below the age of one year, was performed by paediatric cardiologists ('33'): fee for procedure + 100%.

Units N$ Units N$
1288 Paediatric cardiac catheterisation 140.00 2 862.50

862.45 12.00 T 1 278.90
278.92
1289 Paediatric cardiac catheterisation: Infants 175.00 3 578.10
578.07 12.00 T 1 278.90
278.92
below the age of one year.
6. 3 Cardiac surgery

Units N$ Units N$
1294 Patent ductus arteriosus. 213.00 4 355.00

355.02 13.00 T 1 385.50
1295 Pericardiectomy for constrictive pericarditis. 267.00 5 459.10
459.11 15.00 T 1 598.70
598.66
1297 Coarctation of aorta. 283.00 5 786.20
786.25 15.00 T 1 598.70
598.66
1299 Systemo-pulmonary anastomosis. 283.00 5 786.20
786.25 15.00 T 1 598.70
598.66
1301 Mitral valvotomy: Closed heart technique. 233.00 4 763.90
763.94 15.00 T 1 598.70
598.66
1302 Heart transplant. 583.00 11 920.10
920.08 15.00 T 1 598.70
598.66
1303 Harvesting donor heart. 60.00 1 226.80
226.77 5.00 T 532.89
532.90
1305 Operative implantation of cardiac pacemaker 147.00 3 005.60
005.58 15.00 T 1 598.70
598.66
by thoracotomy
1307 Re-exploration after cardiac-surgery. 143.00 2 923.80
923.79 15.00 T 1 598.70
598.66
1308 Heart and lung transplant. 667.00 13 637.50
637.55 15.00 T 1 598.70
598.66
1309 Harvesting donor heart and lungs. 80.00 1 635.70
635.69 5.00 T 532.89
532.90
1311 Pericardial drainage. 93.00 1 901.50
901.49 13.00 T 1 385.50

6.3.1 Open heart surgery

Units N$ Units N$
1312 Evaluation of coronary angiogram by cardio- - -

thoracic surgeon
1320 Repeat open heart surgery (additional fee 167.00 3 414.50 15.00 T 1 598.70
598.66
above procedure fee)
1321 Stand-by fee for coronary angioplasty. 30.00 613.38
613.40 -
1322 Attendance at other operations or monitoring - -
at bedside, by physician e.g. heart block etc.:
Per hour.
6.3.1.1 Congenital conditions

Units N$ Units N$
- -
ATRIAL SEPTAL DEFECT - -
1323 Osteum secundum. 333.00 6 808.60
808.55 15.00 T 1 598.70
598.66
1325 Sinus venosus or osteum primum. 375.00 7 667.30
667.29 15.00 T 1 598.70
598.66
1327 Ventricular septal defect. 375.00 7 667.30
667.29 15.00 T 1 598.70
598.66
1329 Fallot's tetralogy. 375.00 7 667.30
667.29 15.00 T 1 598.70
598.66
1330 Pulmonary stenosis. 333.00 6 808.60
808.55 15.00 T 1 598.70
598.66
1331 Transposition of large vessels (venous repair). 375.00 7 667.30
667.29 15.00 T 1 598.70
598.66
1332 Transposition of great arteries (arterial repair). 500.00 10 223.00
223.05 15.00 T 1 598.70
598.66
1333 Ebstein's Anomaly. 375.00 7 667.30
667.29 15.00 T 1 598.70
598.66
1334 Aorta-coronary bypass operation as a MidCab 439.04 8 976.70
976.66 -
procedure (thorocotomy with coronary grafting
without bypass or hypothermia
1335 Total anomalous venous drainage. 375.00 7 667.30
667.29 15.00 T 1 598.70
598.66
1336 Aorta-coronary bypass operation as an OpCab 527.12 10 777.50
777.55 -
procedure (sternotomy with coronary grafting
without bypass or hypothermia
1337 Creation of atrial septal defect by thoracotomy 333.00 6 808.60
808.55 15.00 T 1 598.70
598.66
with or without cardiac bypass.
1338 Fontan type repair 500.00 10 223.00
223.05 15.00 T 1 598.70
598.66

6.3.1.2 Acquired conditions

Units N$ Units N$
1339 Mitral valve replacement. 375.00 7 667.30

667.29 15.00 T 1 598.70
598.66
1340 Mitral valvuloplasty 459.00 9 384.80
384.76 15.00 T 1 598.70
598.66
1341 Aortic valve replacement. 375.00 7 667.30
667.29 15.00 T 1 598.70
598.66
1342 Tricuspid annulo plasty. 125.00 2 555.80
555.76 15.00 T 1 598.70
598.66
1343 Double valve replacement. 500.00 10 223.00
223.05 15.00 T 1 598.70
598.66
1344 Acute dissecting aneurysm repair. 500.00 10 223.00
223.05 15.00 T 1 598.70
598.66
1345 Aortic arch aneurysm repair utilising deep 667.00 13 637.50
637.55 15.00 T 1 598.70
598.66
hypothermal and circulatory arrest.
AORTA-CORONARY BYPASS OPERATION - -

(INCLUDING INTERPRETATION OF
ANGIOGRAM)
1346 Harvesting of saphenous veins: Unilateral 67.00 1 369.90
369.89 -
(modifier 0005 not applicable).
1347 Harvesting of saphenous veins: Bilateral 117.00 2 392.20
392.19 -
(modifier 0005 not applicable).
1358 Harvesting of radial artery 117.00 2 392.20
392.19 -
1348 Utilizing saphenous veins. 500.00 10 223.00
223.05 15.00 T 1 598.70
598.66
1349 Additional arterial implant: any artery. 521.00 10 652.40
652.42 15.00 T 1 598.70
598.66
1350 Additional double arterial implant: any artery. 542.00 11 081.80
081.79 15.00 T 1 598.70
598.66
1351 Aorta-coronary bypass operation with valve 583.00 11 920.10
920.08 15.00 T 1 598.70
598.66
replacement or excision of cardiac aneurysm
1352 Cardiac aneurysm. 375.00 7 667.30
667.29 15.00 T 1 598.70
598.66
1353 Ascending/descending thoracic aortic 417.00 8 526.00
526.02 15.00 T 1 598.70
598.66
aneurysm repair
1354 Arrhythmia surgery. 459.00 9 384.80
384.76 15.00 T 1 598.70
598.66
1355 Cardiac tumour. 417.00 8 526.00
526.02 15.00 T 1 598.70
598.66
1356 Insertion and removal of intra-aortic balloon 125.00 2 555.80
555.76 15.00 T 1 598.70
598.66
pump (modifier 0005 not applicable).

6.4 Peripheral vascular system
6.4.1 Investigations
MODIFIER GOVERNING THIS SPECIFIC SECTION OF THE BENCHMARK TARIFFS
0072 The number of tests in a single case is restricted to two (2) per diagnosis. Tests are not justified in
cases of uncomplicated varicose veins.

Units N$ Units N$
- -
SKIN TEMPERATURE TEST - -
1357 Response to reflex heating. 15.00 306.69
306.70 -
1359 Response to reflex cooling 15.00 306.69
306.70 -
1361 Cold sensitivity test. 17.00 347.58
347.60 -
1363 Oscillometry test. 5.00 102.23
102.20 -
1365 Sweat test. 17.00 347.58
347.60 -
1367 Doppler blood tests. 6.00 122.68
122.70 -
5369 Doppler arterial pressures 6.00 122.68
122.70 -
5371 Doppler arterial pressures with exercise 10.00 204.46
204.50 -
5373 Doppler segmental pressures and wave forms 12.00 245.35
245.40 -
5375 Venous doppler examination (both limbs) 9.00 184.01
184.00 -
5377 Venous plethysmography 16.00 327.14
327.10 -
5379 Supra-orbital doppler test 5.00 102.23
102.20 -
5381 Carotid non-invasive complex tests 39.00 797.40 -
TRANSCUTANEOUS OXIMETRY - -
1366 Transcutaneous oximetry - single site 26.30 537.73
537.70 -
6.4.2 Arterio-venous abnormalities :

Units N$ Units N$
1369 Fistula or aneurysm (as for grafting of various - -

arteries)

6.4.3 Arteries :
6.4.3.1 Aorta-iliac and major branches

Units N$ Units N$
- -
ABDOMINAL AORTA AND ILIAC ARTERY - -
1372 Unruptured 360.00 7 360.60 15.00 T 1 598.70
598.66
1373 Ruptured. 400.00 8 178.40
178.44 15.00 T 1 598.70
598.66
1375 Grafting and/or thrombo-endarteriectomy for 296.00 6 052.00
052.05 15.00 T 1 598.70
598.66
thrombosis
1376 Aorta bifemoral graft, including proximal and 396.00 8 096.70
096.66 15.00 T 1 598.70
598.66
distal endarteriectomy and preparation for
anastomosis
6.4.3.2 Iliac artery

Units N$ Units N$
1379 Prosthetic grafting and/or Thrombo- 200.00 4 089.20

089.22 13.00 T 1 385.50
endarteriectomy
6.4.3.3 Peripheral

Units N$ Units N$
1385 Prosthetic grafting, including the establishment 170.00 3 475.80

475.84 5.00 T 532.89
532.90
of arterio-venous fistula.
1396 Suture major blood vessel (artery or vein) - 176.00 3 598.50
598.51 15.00 T 1 598.70
598.66
trauma (major blood vessel are definde as
aorta, innominate artery, carotid artery and
vetebral artery, subclavian artery, axillary
artery, illiac artery, common femoral and
popliteal artery. The vertebral and popliteal
arteries are included because of the relevant
inaccessibility of the arteries and difficult
surgical exposure.)

Units N$ Units N$
- -
GRAFTING VEIN - -
1387 Vein grafting proximal to knee joint. 200.00 4 089.20
089.22 5.00 T 532.89
532.90
1388 Distal to knee joint 296.00 6 052.00
052.05 5.00 T 532.89
532.90
1389 Endarterectomy when not part of another 176.00 3 598.50
598.51 5.00 T 532.89
532.90
specified procedure
1390 Carotid endarterectomy. 214.00 4 375.50
375.47 15.00 T 1 598.70
598.66
- -
EMBOLECTOMY - -
1393 Peripheral embolectomy transfemoral 112.00 2 290.00
289.96 5.00 T 532.89
532.90
MISCELLANEOUS ARTERIAL PROCEDURES - -

1395 Arterial suture: trauma. 83.00 1 697.00
697.03 5.00 T 532.89
532.90
1397 Profundoplasty. 140.00 2 862.50
862.45 5.00 T 532.89
532.90
1399 Distal tibial (Ankle region). 304.00 6 215.60
215.61 5.00 T 532.89
532.90
1401 Femoro-femoral. 169.00 3 455.40
455.39 5.00 T 532.89
532.90
1402 Carotid-subclavian. 192.00 3 925.70
925.65 8.00 T 852.62
852.60
1403 Axillo-femoral: (Bifemoral + 50%). 192.00 3 925.70
925.65 8.00 T 852.62
852.60
6.4.4 Veins

Units N$ Units N$
1407 Ligation of saphenous vein. 50.00 1 022.30 3.00 T 319.73

319.70
1408 Placement of Hickman catheter or similar. 61.00 1 247.20
247.21 4.00 T 426.31
426.30
- -
LIGATION OF INFERIOR VENA CAVA : - -
1410 Abdominal. 120.00 2 453.50
453.53 8.00 T 852.62
852.60
UMBRELLA OPERATION ON INFERIOR - -

VENA CAVA :
1412 Abdominal. 67.00 1 369.90
369.89 8.00 T 852.62
852.60
COMBINED PROCEDURE FOR VARICOSE - -

VEINS: LIGATION OF SAPHENOUS VEIN,
STRIPPING, MULTIPLE LIGATION
INCLUDING OF PERFORATING VEINS AS
INDICATED :
1413 Unilateral. 94.00 1 921.90
921.93 3.00 T 319.73
319.70
1415 Bilateral. 165.00 3 373.60
373.61 3.00 T 319.73
319.70

Units N$ Units N$
1417 Extensive sub-fascial ligation of perforating 83.00 1 697.00

697.03 3.00 T 319.73
319.70
veins.
1419 Lesser varicose vein procedures 31.00 633.83
633.80 3.00 T 319.73
319.70
- -
COMPRESSION SCLEROTHERAPY OF - -
VARICOSE VEINS
1421 Per injection to a maximum of nine injections 9.00 184.01
184.00 -
per leg (excluding cost of material)
THROMBECTOMY - -
1425 Inferior vena cava (Trans abdominal). 160.00 3 271.40
271.38 11.00 T 1 172.30
172.35
1427 Ilio-femoral. 117.00 2 392.20
392.19 6.00 T 639.46
639.50
6.4.5 Portal hypertension

Units N$ Units N$
1429 Porto-caval shunt. 333.00 6 808.60

808.55 11.00 T 1 172.30
172.35
6.5 Cardiac rehabilitation

Units N$ Units N$
Phase I: Consultations to be charged - -

according to the consultative
services section of the benchmark tariffs
1431 Phase II: Exercise rehabilitation: Per patient 12.00 245.35
245.40 -
per 60 min session with a maximum of 5
patients per group
1432 Phase III: Exercise rehabilitation: Per patient 6.00 122.68
122.70 -
per 60 min session with a maximum of 10
patients per group
Please note:
(a) A practitioner is only allowed to instruct one group at a time.
(b) Benefits are limited to 3 times per week for a period of 60 minutes with a maximum of 3 months.

7 LYMPHO-RETICULAR SYSTEM
T Time Units
7.1 Spleen

Units N$ Units N$
- -
SPLENECTOMY - -
1435 Splenectomy (In all cases) 117.00 2 392.20
392.19 9.00 T 959.19
959.20
1436 Splenorrhaphy. 117.00 2 392.20
392.19 9.00 T 959.19
959.20
7.2 Lymph nodes and lymphatic channels

Units N$ Units N$
- -
EXCISION OF LYMPH NODE FOR BIOPSY - -
1439 Neck or axilla. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
1441 Groin. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
1443 Simple excision of lymph nodes for 61.00 1 247.20
247.21 3.00 T 319.73
319.70
tuberculosis
RADICAL EXCISION OF LYMPH NODES OF - -

NECK: TOTAL
1445 Unilateral. 210.00 4 293.70
293.68 5.00 T 532.89
532.90
1447 Suprahyoid unilateral. 157.00 3 210.00
210.04 5.00 T 532.89
532.90
1449 Radical excision of lymph nodes of axilla. 107.00 2 187.70
187.73 4.00 T 426.31
426.30
RADICAL EXCISION OF LYMPH NODES OF - -

GROIN
1451 Ilio-inguinal. 117.00 2 392.20
392.19 4.00 T 426.31
426.30
1453 Inguinal. 100.00 2 044.60
044.61 4.00 T 426.31
426.30
1455 Retroperitioneal lymphadenectomy including 183.00 3 741.60
741.64 6.00 T 639.46
639.50
pelvic, aortic and renal nodes.

Units N$ Units N$
BONE MARROW BIOPSY - -

1457 By trephine. 13.00 265.80 3.00 T 319.73
319.70
1458 Simple aspiration of marrow by means of 8.00 163.57
163.60 -
trocar or cannula
1459 Staging laparotomy for lymphoma (including 163.00 3 332.70
332.71 7.00 T 746.04
746.00
splenectomy)
BONE MARROW TRANSPLANTATION - -

1450 Cryopreservation of bone marrow or peripheral 58.00 1 185.90
185.87 5.00 T 532.89
532.90
blood stem cells
1454 Plasma/cell separation using designated cell 39.00 797.40 5.00 T 532.89
532.90
separator equipment (per hour) (specify time
used)
1456 Preparation of extra-corporeal equipment by 42.00 858.74
858.70 5.00 T 532.89
532.90
the medical practitioner for plasma, platelet
and leucocyte pheresis
8 DIGESTIVE SYSTEM
0074 Endoscopic procedures performed with own equipment: The basic procedure fee plus 33.33%
(1/3) of that fee ("+" codes excluded) will apply where endoscopic procedures are performed with
own equipment. (Note: Only applicable to endoscopic procedures and cannot be claimed with
Modifier 0004)
0075 Endoscopic procedures performed in own procedure room: The fee plus 21,00 clinical procedure
units will apply where endoscopic procedures are performed in rooms with own equipment. This
fee is chargeable by medical practitioners who own or rent the facility. (Note: Cannot be claimed
with Modifier 0004)
Ii Clinical Units
vii By arrangement between medical practitioner/patient/Medical Aid Fund
xii By arrangement with Medical Aid Fund
T Time Units

8.1 Oral cavity

Units N$ Units N$
1461 All dental procedures. - 4.00 T 426.30

426.31
1463 Surgical biopsy of tongue or palate: Under 35.00 715.61
715.60 4.00 T 426.31
426.30
general anaesthetic.
1465 Surgical biopsy of tongue or palate: Under 15.00 306.69
306.70 4.00 T 426.31
426.30
local anaesthetic
1467 Drainage of intra-oral abscess. 31.00 633.83
633.80 4.00 T 426.31
426.30
1469 Local excision of mucosal lesion of oral cavity. 23.00 470.26
470.30 4.00 T 426.31
426.30
1471 Resection of malignant lesion of buccal 366.00 7 483.30
483.27 7.00 T 746.04
746.00
mucosa including radical neck dissection
(Commando operation), but not including
reconstructive plastic procedure
1473 Complicated reconstruction following major ii - 7.00 T 746.00
746.04
ablative procedure for head and neck cancer.
1475 Cleft palate: Repair primary deformity with or 185.00 3 782.50
782.53 6.00 T 639.46
639.50
without pharyngoplasty
1477 Cleft palate: Secondary repair. 137.00 2 801.10
801.12 6.00 T 639.46
639.50
1478 Velopharyngeal reconstruction with 160.00 3 271.40
271.38 6.00 T 639.46
639.50
myoneurovascular transfer (dynamic repair)
1479 Velopharyngeal reconstruction with or without 151.00 3 087.40

087.36 6.00 T 639.46
639.50
pharyngeal flap (static repair).
1481 Repair of oronasal fistula (small) e.g. trapdoor: 92.00 1 881.00
881.04 5.00 T 532.89
532.90
One stage or first stage
1480 Repair of oronasal fistula (large) e.g. distant flap 151.00 3 087.40
087.36 6.00 T 639.46
639.50
1482 Repair of oronasal fistula (large): Second stage 92.00 1 881.00
881.04 5.00 T 532.89
532.90
1483 Alveolar periosteal or other flaps for arch 92.00 1 881.00
881.04 4.00 T 426.31
426.30
closure
1486 Closure of anterior nasal floor 92.00 1 881.00
881.04 5.00 T 532.89
532.90
8.2 Lips

Units N$ Units N$
1485 Local excision of benign lesion of lip. 27.00 552.04

552.00 4.00 T 426.31
426.30
1487 Resection for lip malignancy. 61.00 1 247.20
247.21 4.00 T 426.31
426.30
- -
CLEFT LIP - -
1484 Lip adhesion (cleft lip) 63.00 1 288.10 5.00 T 532.89
532.90
1489 Repair unilateral cleft lip (with muscle 151.00 3 087.40
087.36 5.00 T 532.89
532.90

Units N$ Units N$
reconstruction).
1491 Repair bilateral cleft lip (with muscle 241.00 4 927.50
927.51 5.00 T 532.89
532.90
reconstruction) (one stage).
1490 Repair bilateral cleft lip (with muscle 151.00 3 087.40
087.36 5.00 T 532.89
532.90
reconstruction) (one of two stages)
1492 Repair bilateral cleft lip (second stage) 151.00 3 087.40
087.36 5.00 T 532.89
532.90
1493 Total revision of secondary cleft lip deformities. 137.00 2 801.10
801.12 5.00 T 532.89
532.90
1494 Partial revision of secondary cleft lip deformity 61.00 1 247.20
247.21 5.00 T 532.89
532.90
1495 Abbé or Estlander type flap (all stages 155.00 3 169.10
169.15 5.00 T 532.89
532.90
included).
1497 Vermilionectomy. 69.00 1 410.80
410.78 4.00 T 426.31
426.30
1499 Lip reconstruction following an injury: Direct 61.00 1 247.20
247.21 4.00 T 426.31
426.30
repair
- -
LIP RECONSTRUCTION FOLLOWING AN - -
INJURY OR TUMOUR REMOVAL
1501 Flap repair. 137.00 2 801.10
801.12 4.00 T 426.31
426.30
1503 Total reconstruction (first stage). 137.00 2 801.10
801.12 4.00 T 426.31
426.30
1504 Subsequent stages (see item 0299). 69.00 1 410.80
410.78 4.00 T 426.31
426.30
8.3 Tongue

Units N$ Units N$
1505 Partial glossectomy. 150.00 3 066.90

066.91 6.00 T 639.46
639.50
1507 Local excision of lesion of tongue. 27.00 552.04
552.00 4.00 T 426.31
426.30
8.4 Palate, uvula and salivary glands

Units N$ Units N$
1509 Wide excision of lesion of palate. 67.00 1 369.90

369.89 5.00 T 532.89
532.90
1511 Radical resection of palate (including skin 167.00 3 414.50 7.00 T 746.04
746.00
graft).
1513 Excision of ranula. 41.00 838.29
838.30 5.00 T 532.89
532.90
1515 Excision of sublingual salivary gland. 80.00 1 635.70
635.69 4.00 T 426.31
426.30

Units N$ Units N$
1517 Excision of submandibular salivary gland. 97.00 1 983.30

983.27 4.00 T 426.31
426.30
1519 Excision of submandibular salivary gland with 100.00 2 044.60
044.61 5.00 T 532.89
532.90
suprahyoid dissection
1521 Excision of submandibular salivary gland with 235.00 4 804.80
804.83 6.00 T 639.46
639.50
radical neck dissection.
1523 Local resection of parotid tumour. 83.00 1 697.00
697.03 5.00 T 532.89
532.90
1525 Partial parotidectomy. 153.00 3 128.30
128.25 5.00 T 532.89
532.90
1526 Total parotidectomy with preservation of facial 430.20 8 795.90
795.91 5.00 T 532.89
532.90
nerve
1527 Total parotidectomy. 167.00 3 414.50 5.00 T 532.89
532.90
1529 Extracapsular Parotidectomy 200.00 4 089.20
089.22 5.00 T 532.89
532.90
1531 Drainage of parotid abscess. 25.00 511.15
511.20 4.00 T 426.31
426.30
1533 Closure of salivary fistula. 61.00 1 247.20
247.21 4.00 T 426.31
426.30
1535 Dilatation of salivary duct. 10.00 204.46
204.50 4.00 T 426.31
426.30
1537 Operative removal of salivary calculus. 55.00 1 124.50
124.54 4.00 T 426.31
426.30
1539 Meatotomy: Salivary duct. 20.00 408.92
408.90 4.00 T 426.31
426.30
1541 Branchial cyst and/or fistula: Excision. 93.00 1 901.50
901.49 5.00 T 532.89
532.90
1543 Excision of cystic hygroma 93.00 1 901.50
901.49 5.00 T 532.89
532.90
1544 Ludwig's Angina: Drainage 42.00 858.74
858.70 9.00 T 959.19
959.20
8.5 Oesophagus

Units N$ Units N$
1545 Oesophagoscopy with rigid instrument: First 47.00 960.97

961.00 4.00 T 426.31
426.30
and subsequent
1547 Oesophageal acid perfusion test 15.00 306.69
306.70 -
1549 Oesophagoscopy with dilatation of stricture. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
1550 With removal of foreign body. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
1551 With insertion of indwelling oesophageal tube. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
1552 Injection of oesophageal varices (endoscopy 60.00 1 226.80
226.77 4.00 T 426.31
426.30
inclusive)
1553 Subsequent injection of oesophageal varices 60.00 1 226.80
226.77 4.00 T 426.31
426.30
(endoscopy inclusive).
1554 Per-oral small bowel biopsy. 25.00 511.15
511.20 4.00 T 426.31
426.30
1555 Repair of tracheal oesophageal fistula and 267.00 5 459.10
459.11 15.00 T 1 598.70
598.66
oesophageal atresia.
1557 Oesophageal dilatation. 40.00 817.84
817.80 4.00 T 426.31
426.30
- -
OESOPHAGECTOMY - -
Units N$ Units N$
1559 Two stage. 333.00 6 808.60

808.55 11.00 T 1 172.30
172.35
1560 Three stage. 367.00 7 503.70
503.72 11.00 T 1 172.30
172.35
1561 Thoraco-abdominal oesophagogastrectomy 333.00 6 808.60
808.55 11.00 T 1 172.30
172.35
HIATUS HERNIA AND DIAPHRAGMATIC - -

HERNIA REPAIR
1563 With anti-reflux procedure. 200.00 4 089.20
089.22 11.00 T 1 172.30
172.35
1565 With Collis Nissen oesophageal lengthening 233.00 4 763.90
763.94 11.00 T 1 172.30
172.35
procedure
1566 Private fee: Gastroplasty. 217.00 4 436.80 8.00 T 852.62
852.60
1567 Bochdalek hernia repair in newborn. 167.00 3 414.50 14.00 T 1 492.10
492.08
1568 Hiatus hernia and diaphragmatic repair: 250.00 5 111.50
111.52 11.00 T 1 172.30
172.35
Revision after previous repair.
1569 Heller's operation. 167.00 3 414.50 14.00 T 1 492.10
492.08
1575 Insertion of indwelling oesophageal tube - 95.00 1 942.40
942.38 6.00 T 639.46
639.50
laparotomy
1578 Oesophageal motility (4 channel + 67.00 1 369.90
369.89 4.00 T 426.31
426.30
pneumograph)
1579 Oesophageal substitution (without 267.00 5 459.10
459.11 11.00 T 1 172.30
172.35
oesophagectomy) using colon, small bowel or
stomach
1580 Oesophageal motility (6 Channel + 73.00 1 492.60
492.57 4.00 T 426.31
426.30
pneumograph + pH pull-through)
1581 Removal of benign oesophageal tumours. 190.00 3 884.80
884.76 11.00 T 1 172.30
172.35
1582 Oesophageal motility (4 or 6 channel + 100.00 2 044.60
044.61 4.00 T 426.31
426.30
pneumograph - ECG + provocative tests for
oesophageal spasm vs. myocardial ischaemia)
1583 Excision of intrathoracic oesophageal 167.00 3 414.50 11.00 T 1 172.30
172.35
diverticulum.
1584 24 Hour oesophageal pH studies: Hire fee 55.00 1 124.50
124.54 -
(Item 0201 applicable for pro-rata of probe: 50
examinations per glass electrode pH probe
and 10 examinations per antimone pH probe).
1585 24 Hour oesophageal pH studies: Interpretation 27.00 552.04
552.00 -
8.6 Stomach

Units N$ Units N$
1587 Upper gastro-intestinal fibre-optic endoscopy - 48.75 996.75

996.70 4.00 T 426.31
426.30
Hospital equipment
1588 Plus polypectomy: ADD to Upper gastro- 25.00 + 511.15
511.20 4.00 T 426.31
426.30
intestinal fiber-optic endoscopy (Item1587)

Units N$ Units N$
1589 Endoscopic control of gatrointestinal 34.00 + 695.17

695.20 6.00 T 639.46
639.50
haemorrhage from upper gastrointestinal tact,
intestines or large bowel by injection of
vasoconstrictors and/or schleroses
(endoscopic haemostasis) to be added to
gastroscopy (item 1587) or colonoscopy (item
1653)
1591 Plus removal of foreign bodies (stomach) 25.00 + 511.15
511.20 4.00 T 426.31
426.30
1593 Augmented histamine test: Gastric intubation 5.00 102.23
102.20 -
with x-ray screening.
1597 Gastrostomy or Gastrotomy 77.00 1 574.30
574.35 6.00 T 639.46
639.50
1598 Gastrotomy with suture repair of bleeding ulcer - 8.00 T 852.60
852.62
1599 Pyloromyotomy (Rammstedt). 77.00 1 574.30
574.35 6.00 T 639.46
639.50
1601 Local excision of ulcer or benign neoplasm 94.00 1 921.90
921.93 6.00 T 639.46
639.50
VAGOTOMY - -
1603 Abdominal. 100.00 2 044.60
044.61 6.00 T 639.46
639.50
1604 Thoracic. 100.00 2 044.60
044.61 11.00 T 1 172.30
172.35
1605 Truncal or selective with drainage procedures. 167.00 3 414.50 6.00 T 639.46
639.50
1607 Vagotomy and antrectomy 213.00 4 355.00
355.02 6.00 T 639.46
639.50
1609 Highly selective vagotomy. 167.00 3 414.50 6.00 T 639.46
639.50
1611 Pyloroplasty. 94.00 1 921.90
921.93 6.00 T 639.46
639.50
1613 Gastroenterostomy 94.00 1 921.90
921.93 6.00 T 639.46
639.50
1615 Suture of perforated gastric or duodenal ulcer 133.00 2 719.30
719.33 7.00 T 746.04
746.00
or wound or injury
1617 Partial gastrectomy. 200.00 4 089.20
089.22 7.00 T 746.04
746.00
1619 Total gastrectomy 250.00 5 111.50
111.52 7.00 T 746.04
746.00
1621 Revision of gastrectomy or gastro-enterostomy. 250.00 5 111.50
111.52 7.00 T 746.04
746.00
1625 Gastro-oesophageal operation for portal 250.00 5 111.50
111.52 11.00 T 1 172.30
172.35
hypertension (Tanner)
8.7 Duodenum

Units N$ Units N$
1626 Endoscopic examination of the small bowel 80.00 1 635.70

635.69 6.00 T 639.46
639.50
beyond the duodenojejunal flexure with biopsy
with or without polypectomy with or without
arrest of haemorrhage (enteroscopy)
1627 Duodenal intubation (under X-ray screening) - -
1629 Duodenal intubation with biliary drainage after - -
gall bladder stimulation

Units N$ Units N$
1631 Duodenal intubation: Under three years - -
8.8 Intestines

Units N$ Units N$
1632 H2 breath test (intestines) 9.00 184.01

184.00 -
1633 Complete test using lactose or lactulose. 27.00 552.04
552.00 -
1634 Enterotomy or Enterostomy. 77.00 1 574.30
574.35 6.00 T 639.46
639.50
1635 Intestinal obstruction of the newborn. 160.00 3 271.40
271.38 7.00 T 746.04
746.00
1637 Operation for relief of intestinal obstruction 153.00 3 128.30
128.25 7.00 T 746.04
746.00
1639 Resection of small bowel with enterostomy or 153.00 3 128.30
128.25 6.00 T 639.46
639.50
anastomosis
1641 Entero-enterostomy or entero-colostomy for 94.00 1 921.90
921.93 6.00 T 639.46
639.50
bypass
1645 Suture of intestine (small or large): Perforated 77.00 1 574.30
574.35 6.00 T 639.46
639.50
ulcer, wound or injury
1647 Closure of intestinal fistula 172.00 3 516.70
516.73 6.00 T 639.46
639.50
1649 Excision of Meckel's diverticulum 74.00 1 513.00
513.01 6.00 T 639.46
639.50
1651 Excision of lesion of mesentery. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
1652 Laparotomy for mesenteric thrombosis 200.00 4 089.20
089.22 8.00 T 852.62
852.60
- -
TOTAL FIBRE-OPTIC COLONOSCOPY - -
1653 Total colonoscopy: With hospital equipment 80.00 1 635.70
635.69 4.00 T 426.31
426.30
1654 Plus removal of polyps: ADD to colonoscopy 30.00 + 613.38
613.40 4.00 T 426.31
426.30
(Item 1653)
1656 Left sided fibre-optic colonoscopy. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
1657 Right or left hemicolectomy or segmental 217.00 4 436.80 6.00 T 639.46
639.50
colectomy.
1658 Reconstruction of colon after Hartman's 161.00 3 291.80
291.82 6.00 T 639.46
639.50
procedure
1661 Colotomy: Including removal of tumour or 90.00 1 840.10
840.15 6.00 T 639.46
639.50
foreign body.
1663 Total colectomy. 260.00 5 316.00
315.99 6.00 T 639.46
639.50
1665 Colostomy or ileostomy isolated procedure. 131.00 2 678.40
678.44 6.00 T 639.46
639.50
1666 Continent ileostomy pouch (all types). 200.00 4 089.20
089.22 6.00 T 639.46
639.50
1667 Colostomy Closure 100.00 2 044.60
044.61 5.00 T 532.89
532.90
1668 Revision of ileostomy pouch 250.00 5 111.50
111.52 6.00 T 639.46
639.50
1669 Total proctocolectomy and ileostomy. 320.00 6 542.80
542.75 7.00 T 746.04
746.00
1670 Proctocolectomy, ileostomy and ileostomy 360.00 7 360.60 7.00 T 746.04
746.00
Units N$ Units N$
pouch
1671 Colomyotomy (Reilly operation) 123.00 2 514.90
514.87 6.00 T 639.46
639.50
8.9 Appendix

Units N$ Units N$
1673 Drainage of appendix abscess 100.00 2 044.60

044.61 5.00 T 532.89
532.90
1675 Appendicectomy. 67.00 1 369.90
369.89 4.00 T 426.31
426.30
8.10 Rectum and anus

Units N$ Units N$
1676 Fibre-optic sigmoidoscopy including rectum 48.75 996.75

996.70 3.00 T 319.73
319.70
and anus: Hospital equipment
1677 Sigmoidoscopy: First and subsequent, with or 13.00 265.80 3.00 T 319.73
319.70
without biopsy
1678 Plus polypectomy: ADD to sigmoidoscopy 25.00 + 511.15

511.20 3.00 T 319.73
319.70
(Item 1676).
1679 Sigmoidoscopy with removal of polyps, first 30.00 613.38
613.40 3.00 T 319.73
319.70
and subsequent
- -
PROCTOSCOPY WITH REMOVAL OF - -
POLYPS
1681 First time. 21.00 429.37
429.40 3.00 T 319.73
319.70
1683 Subsequent times. 15.00 306.69
306.70 3.00 T 319.73
319.70
1685 Endoscopic fulguration of tumour. 50.00 1 022.30 4.00 T 426.31
426.30
1687 Anterior resection of rectum performed for 217.00 4 436.80 6.00 T 639.46
639.50
carcinoma of rectum including excision of any
part of proximal colon necessary
1688 Total mesarectal excision with colo-anal 297.00 6 072.50
072.49 8.00 T 852.62
852.60
anastomosis and defunctioning enterostomy or
colostomy
1689 Perineal resection of rectum 94.00 1 921.90
921.93 5.00 T 532.89
532.90
- -
ABDOMINO-PERINEAL RESECTION OF - -
Units N$ Units N$
RECTUM
Please note: Items1691 and 1692: Abdominal

and/or perineal assistant's fee to be charged
additionally.
1691 Abdominal surgeon. 233.00 4 763.90
763.94 7.00 T 746.04
746.00
1692 Perineal surgeon. 67.00 1 369.90
369.89 -
1693 Local excision of rectal tumour (posterior 133.00 2 719.30
719.33 4.00 T 426.31
426.30
approach)
1695 Combined abdomino-anal pull-through 267.00 5 459.10
459.11 7.00 T 746.04
746.00
procedure for Hirschsprung's disease, rectal
agenesis or tumour.
- -
REPAIR OF PROLAPSED RECTUM: - -
ABDOMINAL
1697 Roscoe Graham Moskovitz 200.00 4 089.20
089.22 6.00 T 639.46
639.50
1699 Ivalon sponge. 133.00 2 719.30
719.33 6.00 T 639.46
639.50
1701 Perineal. 100.00 2 044.60
044.61 4.00 T 426.31
426.30
1703 Thierisch suture. 35.00 715.61
715.60 4.00 T 426.31
426.30
1705 Incision and drainage of peri-anal abscess. 40.00 817.84
817.80 3.00 T 319.73
319.70
1707 Drainage of submucous abscess. 40.00 817.84
817.80 3.00 T 319.73
319.70
1709 Drainage of ischio-rectal abscess. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
1711 Excision of pelvi-rectal fistula 133.00 2 719.30
719.33 5.00 T 532.89
532.90
1713 Excision of fistula-in-ano 70.00 1 431.20
431.23 3.00 T 319.73
319.70
1715 Operation for fissure-in-ano 45.00 920.07
920.10 3.00 T 319.73
319.70
1719 Rubber band ligation of haemorrhoids: per 10.00 204.46
204.50 3.00 T 319.73
319.70
haemorrhoid
1721 Sclerosing injection for haemorroids: per 5.00 102.23
102.20 -
injection
1723 Haemorrhoidectomy. (Any technique) 60.00 1 226.80
226.77 3.00 T 319.73
319.70
1725 Drainage of external thrombosed pile. 12.50 255.58
255.60 3.00 T 319.73
319.70
1727 Multiple procedures (haemorrhoids, fissure, 60.00 1 226.80
226.77 3.00 T 319.73
319.70
etc.). (Note: This code cannot be combined
with any other anal procedures)
1728 Biopsy of ano-rectal wall - 5.00 T 532.90
532.89
1729 Excision of anal skin tags 25.00 511.15
511.20 3.00 T 319.73
319.70
1731 Operation for low imperforate anus. 70.00 1 431.20
431.23 6.00 T 639.46
639.50
1733 Anoplasty: Y-V-plasty. 41.00 838.29
838.30 3.00 T 319.73
319.70
1735 Anal sphincteroplasty for incontinence. 80.00 1 635.70
635.69 3.00 T 319.73
319.70
1737 Dilation of ano-rectal stricture. 12.50 255.58
255.60 3.00 T 319.73
319.70
1739 Closure of recto-vesical fistula 161.00 3 291.80
291.82 5.00 T 532.89
532.90
1741 Closure of recto-urethral fistula 161.00 3 291.80
291.82 5.00 T 532.89
532.90
1742 Bio-feedback training for faecal incontinence 27.00 552.04
552.00 -
during anorectal manometry performed by
doctor

8.11 Liver

Units N$ Units N$
1743 Needle biopsy of liver. 25.00 511.15

511.20 3.00 T 319.73
319.70
1745 Biopsy of liver by laparotomy. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
1747 Drainage of liver abscess or cyst. 94.00 1 921.90
921.93 7.00 T 746.04
746.00
1748 Body composition measured by bio- electrical ii - -
impedance
- -
HEMI-HEPATECTOMY - -
1749 Right. 293.00 5 990.70
990.71 9.00 T 959.19
959.20
1751 Left. 200.00 4 089.20
089.22 9.00 T 959.19
959.20
1752 Extended hemi-hepatectomy 456.72 9 338.10
338.14 9.00 T 959.19
959.20
1753 Partial or segmental hepatectomy. 233.00 4 763.90
763.94 9.00 T 959.19
959.20
1754 Hepatico-jejunostomy 295.36 6 039.00
038.96 9.00 T 959.19
959.20
1755 Liver transplant. 880.00 17 992.60
992.57 15.00 T 1 598.70
598.66
1756 Harvesting donor hepatectomy. 100.00 2 044.60
044.61 5.00 T 532.89
532.90
1757 Suture of liver wound or injury. 120.00 2 453.50
453.53 9.00 T 959.19
959.20
8.12 Biliary tract

Units N$ Units N$
1759 Cholecystostomy. 109.00 2 228.60

228.62 6.00 T 639.46
639.50
1761 Cholecystectomy. 150.00 3 066.90
066.91 6.00 T 639.46
639.50
1762 Cholecystectomy and operative cholangiogram. 170.00 3 475.80
475.84 6.00 T 639.46
639.50
1763 With exploration of common bile duct. 183.00 3 741.60
741.64 6.00 T 639.46
639.50
1765 Exploration of common bile duct: Secondary 194.00 3 966.50
966.54 6.00 T 639.46
639.50
operation
1767 Reconstruction of common bile duct. 267.00 5 459.10
459.11 6.00 T 639.46
639.50
1768 Resection of bile duct tumor with reconstuction 262.16 5 360.10
360.15 6.00 T 639.46
639.50
1769 Cholecysto-enterostomy or gastrostomy. 117.00 2 392.20
392.19 6.00 T 639.46
639.50
1770 Endoscopic placement of biliduodenal 100.00 2 044.60
044.61 6.00 T 639.46
639.50
endoprosthesis (125,00 units for
sphincterectomy + 25,00 units for insertion of
endoprosthesis)
1772 Endoscopic placement of a nasobiliary stent. 83.00 1 697.00
697.03 6.00 T 639.46
639.50
1773 Transduodenal sphincteroplasty. 150.00 3 066.90
066.91 6.00 T 639.46
639.50
Units N$ Units N$
1774 Balloon dilatation of common bile duct 83.00 1 697.00

697.03 6.00 T 639.46
639.50
strictures.
1775 Excision choledochal cyst with reconstruction. 267.00 5 459.10
459.11 6.00 T 639.46
639.50
1777 Porto-enterostomy for biliary atresia. 267.00 5 459.10
459.11 11.00 T 1 172.30
172.35
8.13 Pancreas

Units N$ Units N$
1778 Pancreas: ERCP: Endoscopy + 65.00 1 329.00 4.00 T 426.31

426.30
catheterisation of pancreas duct or
choledochus.
1779 Endoscopic exploration of the common vile 10.00 204.46
204.50 4.00 T 426.31
426.30
duct performed following endoscopic retrograde
choangiography to be added to ERCP (item
1778): Add
1780 Gastric and duodenal intubation. 8.00 163.57
163.60 -
1781 Procedure (excluding laboratory tests) 21.00 429.37
429.40 -
1782 Endoscopic sphincterotomy. 83.00 1 697.00
697.03 4.00 T 426.31
426.30
1783 Drainage of pancreatic abscess 120.00 2 453.50
453.53 6.00 T 639.46
639.50
1784 Debridement pancreas necrosis 200.00 4 089.20
089.22 6.00 T 639.46
639.50
1785 Internal drainage of pancreatic cyst. 167.00 3 414.50 6.00 T 639.46
639.50
1787 Operative pancreatogram: Add. 10.00 204.46
204.50 -
1789 Pancreatico-duodenectomy 333.00 6 808.60
808.55 8.00 T 852.62
852.60
1791 Local, partial or subtotal pancreatectomy. 167.00 3 414.50 8.00 T 852.62
852.60
1793 Distal pancreatectomy with internal drainage. 200.00 4 089.20
089.22 8.00 T 852.62
852.60
1795 Triple anastomosis for carcinoma of pancreas. 161.00 3 291.80
291.82 8.00 T 852.62
852.60
8.14 Peritoneal cavity

Units N$ Units N$
1800 Peritoneal lavage. 20.00 408.92

408.90 -
1801 Diagnostic paracentesis: Abdomen. 8.00 163.57
163.60 -
1803 Therapeutic paracentesis: Abdomen. 13.00 265.80 -
1807 Add to open procedure where procedure was 45.00 920.07
920.10 5.00 T 532.89
532.90
performed through a laparoscope (for
Units N$ Units N$
anaesthetic refer to modifier 0027).

1809 Laparotomy. 113.00 2 310.40
310.41 4.00 T 426.31
426.30
1810 Radical removal of retro-peritoneal malignant 233.00 4 763.90
763.94 7.00 T 746.04
746.00
tumours: including sacro-coccygeal and pre-
sacral.
1811 Suture of burst abdomen 67.00 1 369.90
369.89 7.00 T 746.04
746.00
1812 Laparotomy for control of surgical haemorrhage. 70.00 1 431.20
431.23 9.00 T 959.19
959.20
1813 Drainage of subphrenic abscess. 120.00 2 453.50
453.53 7.00 T 746.04
746.00
DRAINAGE OF OTHER INTRAPERITONEAL - -

ABSCESS (EXCLUDING APPENDIX
ABSCESS)
1815 Drainage of other intraperitoneal abscess 120.00 2 453.50
453.53 5.00 T 532.89
532.90
(excluding appendix abscess): Transabdominal
1817 Transrectal drainage of pelvic abscess. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
9 HERNIAE
T Time Units

Units N$ Units N$
- -
INGUINAL OR FEMORAL HERNIA : - -
1819 Adult. (Any technique, including the 83.00 1 697.00
697.03 4.00 T 426.31
426.30
application of a mesh patch)
1821 Child, under 14 years. (Any technique, 60.00 1 226.80
226.77 4.00 T 426.31
426.30
including the application of a mesh patch)
1823 Inguinal hernia: Infant under one year. 67.00 1 369.90
369.89 4.00 T 426.31
426.30
1825 Recurrent inguinal or femoral hernia. (Any 103.00 2 105.90
105.95 4.00 T 426.31
426.30
technique, including the application of a mesh
patch)
1827 Strangulated hernia requiring resection of 159.00 3 250.90
250.93 7.00 T 746.04
746.00
bowel.
1829 Epigastric hernia. (Any technique, including 60.00 1 226.80
226.77 4.00 T 426.31
426.30
the application of a mesh patch)
- -
UMBILICAL HERNIA - -
1831 Adult. (Any technique, including the 93.00 1 901.50
901.49 4.00 T 426.31
426.30
application of a mesh patch)
Units N$ Units N$
1833 Child under 14 years. 60.00 1 226.80

226.77 4.00 T 426.31
426.30
1835 Incisional hernia. 107.00 2 187.70
187.73 4.00 T 426.31
426.30
1836 Implantation of mesh or other prosthesis for 77.00 1 574.30
574.35 4.00 T 426.31
426.30
incisional hernia (List separately in addition to
item for the incisional or ventral hernia repair)
1837 Repair of omphalocele in new-born (one or 183.00 3 741.60
741.64 7.00 T 746.04
746.00
more procedures).
10 URINARY SYSTEM
RULES GOVERNING THE SECTION URINARY SYSTEM
DD CYTOSCOPY
(a) When a cystoscopy precedes a related operation, modifier 0013: Endoscopic examination done at
an operation, applies, e.g. cystoscopy followed by transurethral (T U R) prostatectomy.
(b) When a cystoscopy precedes an unrelated operation, modifier 0005: Multiple
procedures/operations under the same anaesthetic, applies, e.g. cystoscopy for urinary tract
infection followed by inguinal hernia repair.
(c) No modifier applies to item 1949: Cystoscopy, when performed together with any of items 1951 to
1973.
+ Means that this item is complementary to a preceding item and is therefore not subject to reduction.
(See also modifier 0082).
T Time Units
10.1 Kidney

Units N$ Units N$
1839 Renal biopsy, per kidney, open. 60.00 1 226.80

226.77 5.00 T 532.89
532.90
1841 Renal biopsy (needle). 30.00 613.38
613.40 3.00 T 319.73
319.70
- -
PERITONEAL DIALYSIS - -

Units N$ Units N$
1843 Peritoneal Dialysis: First day (Can only be 33.00 674.72

674.70 -
claimed if the dialysis is performed by the
treating practitioner hom-/herself)
1845 Peritoneal Dialysis: Every subsequent day 33.00 674.72
674.70 -
(Can only be claimed if the dialysis is
performed by the treating practitioner hom-
/herself)
- -
HAEMODIALYSIS: - -
1847 Haemodialyis: Per hour or part thereof (Can 21.00 429.37
429.40 -
only be claimed if the dialysis is performed by
the treating practitioner hom-/herself)
1849 Haemodialysis: Maximum: Eight hours (Can 112.00 2 290.00
289.96 -
only be claimed if the dialysis is performed by
the treating practitioner hom-/herself)
1851 Haemodialysis: Thereafter per week (Can only 55.00 1 124.50
124.54 -
be claimed if the dialysis is performed by the
1852 Haemodialysis: Continuous hemodiafiltration 33.00 674.72
674.70 -
per day in intensive or high care unit (Can only
be claimed if the dialysis is performed by the
- -
NEPHRECTOMY: - -
1853 Primary nephrectomy. 150.00 3 066.90
066.91 5.00 T 532.89
532.90
1855 Secondary nephrectomy. 178.00 3 639.40
639.41 5.00 T 532.89
532.90
1857 Radical nephrectomy with regional 187.00 3 823.40
823.42 6.00 T 639.46
639.50
lymphadenectomy for tumour.
1859 Partial 178.00 3 639.40
639.41 5.00 T 532.89
532.90
1861 Symphysiotomy for horse-shoe kidney. 191.00 3 905.20
905.21 6.00 T 639.46
639.50
1863 Nephro-ureterectomy. 203.00 4 150.60
150.56 5.00 T 532.89
532.90
1865 Nephrotomy with drainage nephrostomy. 126.00 2 576.20
576.21 6.00 T 639.46
639.50
1869 Nephrolithotomy. 151.00 3 087.40
087.36 5.00 T 532.89
532.90
1870 Nephrolithotomy: Multiple calculi: repeat open 189.00 3 864.30
864.31 -
operation + 25%
1871 Staghorn stone - surgical. 227.00 4 641.30
641.26 6.00 T 639.46
639.50
1873 Suture renal laceration (renorraphy). 129.00 2 637.50
637.55 6.00 T 639.46
639.50
1875 Percutaneous aspiration cyst: Nephrostomy, 34.00 695.17
695.20 3.00 T 319.73
319.70
pyelostomy
1877 Operation for renal cyst: Marsupialisation or 126.00 2 576.20
576.21 5.00 T 532.89
532.90
excision
1879 Closure renal fistula. 126.00 2 576.20
576.21 5.00 T 532.89
532.90
1881 Pyeloplasty. 168.00 3 434.90
434.94 5.00 T 532.89
532.90
1883 Pyelostomy. 126.00 2 576.20
576.21 5.00 T 532.89
532.90
1885 Pyelolithotomy 126.00 2 576.20
576.21 5.00 T 532.89
532.90
1887 Complicated pyelolithotomy (e.g. solitary, 149.00 3 046.50
046.47 5.00 T 532.89
532.90
ectopic, horse-shoe kidney or secondary

Units N$ Units N$
operation).
1889 Nephrectomy for Allograft: Living or dead 170.00 3 475.80
475.84 5.00 T 532.89
532.90
1891 Perinephric abscess or renal abscess: 133.00 2 719.30
719.33 7.00 T 746.04
746.00
Drainage.
1893 Aberrant renal vessels: Repositioning with 140.00 2 862.50
862.45 5.00 T 532.89
532.90
pyeloplasty
1894 Auto transplantation of kidney. 280.00 5 724.90
724.91 10.00 T 1 065.80
065.77
1895 Allo transplantation of kidney. 280.00 5 724.90
724.91 10.00 T 1 065.80
065.77
10.2 Ureter

Units N$ Units N$
1897 Ureterorrhaphy: Suture of ureter 98.00 2 003.70

003.72 5.00 T 532.89
532.90
1898 Lumbar approach. 126.00 2 576.20
576.21 5.00 T 532.89
532.90
1899 Ureteroplasty. 121.00 2 474.00
473.98 5.00 T 532.89
532.90
1901 Ureterolysis. 79.00 1 615.20
615.24 5.00 T 532.89
532.90
1902 Lumbar approach. 126.00 2 576.20
576.21 5.00 T 532.89
532.90
1903 Ureterectomy only. 91.00 1 860.60 5.00 T 532.89
532.90
1905 Ureterolithotomy. 91.00 1 860.60 5.00 T 532.89
532.90
CUTANEOUS URETEROSTOMY : - -
1907 Unilateral. 72.00 1 472.10
472.12 5.00 T 532.89
532.90
1909 Bilateral 126.00 2 576.20
576.21 5.00 T 532.89
532.90
- -
URETERO-ENTEROSTOMY : - -
1911 Unilateral. 91.00 1 860.60 5.00 T 532.89
532.90
1913 Bilateral. 160.00 3 271.40
271.38 5.00 T 532.89
532.90
1915 Uretero-ureterostomy. 91.00 1 860.60 5.00 T 532.89
532.90
1917 Transuretero-ureterostomy. 103.00 2 105.90
105.95 5.00 T 532.89
532.90
1919 Closure of ureteric fistula. 98.00 2 003.70
003.72 5.00 T 532.89
532.90
1921 Immediate deligation of ureter. 98.00 2 003.70
003.72 5.00 T 532.89
532.90
1923 Ureterolysis for retrocaval ureter with 112.00 2 290.00
289.96 5.00 T 532.89
532.90
anastomosis.
1925 Uretero-pyelostomy. 168.00 3 434.90
434.94 5.00 T 532.89
532.90
- -
URETERO-NEO-CYSTOSTOMY : - -
1927 Unilateral. 112.00 2 290.00
289.96 5.00 T 532.89
532.90
1929 Bilateral. 196.00 4 007.40
007.44 5.00 T 532.89
532.90
Units N$ Units N$
1931 With Boariplasty. 131.00 2 678.40

678.44 5.00 T 532.89
532.90
1933 Uretero-sigmoidostomy with rectal bladder and 168.00 3 434.90
434.94 5.00 T 532.89
532.90
colostomy
1935 Uretero-ileal conduit. 259.00 5 295.50
295.54 5.00 T 532.89
532.90
REPLACEMENT OF URETER BY BOWEL - -

SEGMENT:
1937 Unilateral 185.00 3 782.50
782.53 5.00 T 532.89
532.90
1939 Bilateral 323.00 6 604.10
604.09 5.00 T 532.89
532.90
- -
URETEROSTOMY-IN-SITU: - -
1941 Unilateral 67.00 1 369.90
369.89 5.00 T 532.89
532.90
1943 Bilateral 117.00 2 392.20
392.19 5.00 T 532.89
532.90
10.3 Bladder

Units N$ Units N$
1945 Instillation of radio-opaque material for 5.00 102.23

102.20 3.00 T 319.73
319.70
cystography or urethrocystography.
1947 Instillation of anti-carcinogenic agent including 10.00 204.46
204.50 3.00 T 319.73
319.70
retention time, but not cost of material or
hydrodilatation of bladder
1949 Cystoscopy: Hospital equipment. 44.00 899.63
899.60 3.00 T 319.73
319.70
1951 And retrograde pyelography or retrograde 10.00 + 204.46
204.50 3.00 T 319.73
319.70
ureteral catheterisation: Unilateral or bilateral
1952 J J Stent catheter. 44.00 + 899.63
899.60 3.00 T 319.73
319.70
1953 With hydrodilatation of the bladder for 5.00 + 102.23

102.20 3.00 T 319.73
319.70
interstitial cystitis
1954 Urethroscopy. - 3.00 T 319.70
319.73
1955 And bilateral ureteric catheterisation with 35.00 + 715.61
715.60 3.00 T 319.73
319.70
differential function studies requiring additional
attention time.
1957 With dilatation of the ureter or ureters. 25.00 + 511.15
511.20 3.00 T 319.73
319.70
1959 With manipulation of ureteral calculus. 20.00 + 408.92
408.90 3.00 T 319.73
319.70
1961 With removal of foreign body or calculus from 20.00 + 408.92
408.90 3.00 T 319.73
319.70
urethra or bladder
1963 With fulguration or treatment of minor lesions, 15.00 + 306.69
306.70 3.00 T 319.73
319.70
with or without biopsy.
1964 And control of haemorrhage and blood clot 15.00 + 306.69
306.70 3.00 T 319.73
319.70
evacuation

Units N$ Units N$
1965 And catheterisation of the ejaculatory duct. 10.00 + 204.46

204.50 3.00 T 319.73
319.70
1967 With ureteric meatotomy: Unilateral or bilateral 15.00 + 306.69
306.70 3.00 T 319.73
319.70
1969 And cold biopsy. 15.00 + 306.69
306.70 3.00 T 319.73
319.70
1971 With cryosurgery for bladder or prostatic 55.00 + 1 124.50
124.54 3.00 T 319.73
319.70
disease
1973 With incision fulguration, or resection of 35.00 + 715.61
715.60 3.00 T 319.73
319.70
bladderneck and/or posterior urethra for
congenital valves or obstructive hypertrophic
bladderneck in a child
1975 Ultraviolet cystoscopy for bladder tumour. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
1976 Optic urethrotomy. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
1977 Transuretheral resection of ejaculatory duct. 50.00 1 022.30 3.00 T 319.73
319.70
INTERNAL URETHROTOMY : - -
1979 Female. 50.00 1 022.30 3.00 T 319.73
319.70
1981 Male. 50.00 1 022.30 3.00 T 319.73
319.70
1983 Transuretheral resection of bladder tumour. 67.00 1 369.90
369.89 5.00 T 532.89
532.90
1984 Transuretheral resection of bladder tumours: 77.00 1 574.30
574.35 5.00 T 532.89
532.90
Large multiple tumours.
- -
TRANSURETHERAL RESECTION OF - -
BLADDERNECK :
1985 Female or child. 70.00 1 431.20
431.23 5.00 T 532.89
532.90
1986 Male. 83.00 1 697.00
697.03 5.00 T 532.89
532.90
1987 Litholapaxy. 60.00 1 226.80
226.77 5.00 T 532.89
532.90
1989 Cystometrogram. 25.00 511.15
511.20 3.00 T 319.73
319.70
1991 Flowmetric bladder, studies with 40.00 817.84
817.80 3.00 T 319.73
319.70
videocystograph
1992 Without videocystograph. 25.00 511.15
511.20 3.00 T 319.73
319.70
1993 Voiding cysto-urethrogram. 21.00 429.37
429.40 3.00 T 319.73
319.70
1994 Rigiscan examination. 60.00 1 226.80
226.77 -
1995 Percutaneous aspiration of bladder. 10.00 204.46
204.50 3.00 T 319.73
319.70
1996 Bladder catheterisation - male (not at operation) 6.00 122.68
122.70 3.00 T 319.73
319.70
1997 Bladder catheterisation - female (not at 3.00 61.34
61.30 -
operation)
1999 Percutaneous cystostomy. 24.00 490.71
490.70 3.00 T 319.73
319.70
- -
TOTAL CYSTECTOMY : - -
2001 After previous urinary diversion. 196.00 4 007.40
007.44 8.00 T 852.62
852.60
2003 With conduit construction and ureteric 280.00 5 724.90
724.91 8.00 T 852.62
852.60
anastomosis
2005 Cystectomy with substitute bowel bladder 433.00 8 853.20
853.16 8.00 T 852.62
852.60
construction with anastomosis to urethra or
trigone

Units N$ Units N$
2006 Cystectomy with continent urinary diversion 467.00 9 548.30

548.33 8.00 T 852.62
852.60
(e.g. Kocks Pouch).
2007 Partial cystectomy. 98.00 2 003.70
003.72 6.00 T 639.46
639.50
2008 Continent urinary diversion without cystectomy 400.00 8 178.40
178.44 8.00 T 852.62
852.60
(e.g. Kocks Pouch).
2009 Radical total cystectomy with block 308.00 6 297.40 8.00 T 852.62
852.60
dissection, ileal conduit and transplantation of
ureters.
2010 Reversion of temporary conduit. 240.00 4 907.10
907.06 8.00 T 852.62
852.60
2011 Partial cystectomy with uretero-neo- 135.00 2 760.20
760.22 6.00 T 639.46
639.50
cystostomy
2012 Reversion of conduit with major urinary tract 400.00 8 178.40
178.44 8.00 T 852.62
852.60
reconstruction
2013 Diverticulectomy (independent procedure): 91.00 1 860.60 5.00 T 532.89
532.90
Multiple or single
2015 Suprapubic cystostomy. 60.00 1 226.80
226.77 5.00 T 532.89
532.90
2016 Abdomino-neo-urethrostomy. 168.00 3 434.90
434.94 5.00 T 532.89
532.90
2017 Open loop fulguration or excision of bladder 67.00 1 369.90
369.89 5.00 T 532.89
532.90
tumour
2019 Operation for vesico-vaginal or urethra- vaginal 103.00 2 105.90
105.95 5.00 T 532.89
532.90
fistula
2020 Repair of vesico vaginal fistula: Abdominal 170.00 3 475.80
475.84 5.00 T 532.89
532.90
approach.
2021 Vesico-plication (Hamilton Stewart). 79.00 1 615.20
615.24 5.00 T 532.89
532.90
2023 Vesico-urethrapexy for correction or urinary 100.00 2 044.60
044.61 5.00 T 532.89
532.90
incontinence: Abdominal approach.
2025 Vesico-urethrapexy with rectus sling. 111.00 2 269.50
269.52 5.00 T 532.89
532.90
OPEN OPERATION FOR URETEROCELE: - -

2027 Unilateral. 79.00 1 615.20
615.24 5.00 T 532.89
532.90
2029 Bilateral. 138.00 2 821.60
821.56 5.00 T 532.89
532.90
- -
RECONSTRUCTION OF ECTOPIC BLADDER - -
EXCLUSIVE OF ORTHOPAEDIC OPERATION
(IF REQUIRED) :
2031 Initial 176.00 3 598.50
598.51 8.00 T 852.62
852.60
2033 Subsequent. 53.00 1 083.60
083.64 8.00 T 852.62
852.60
2035 Cutaneous vesicostomy. 79.00 1 615.20
615.24 5.00 T 532.89
532.90
2037 Cystoplasty, cysto-urethraplasty, vesicolysis. 84.00 1 717.50
717.47 5.00 T 532.89
532.90
2039 Operation for ruptured bladder. 91.00 1 860.60 6.00 T 639.46
639.50
2041 Enterocystoplasty. 126.00 2 576.20
576.21 5.00 T 532.89
532.90
2043 Cysto-lithotomy. 60.00 1 226.80
226.77 5.00 T 532.89
532.90
2045 Excision of patent-urachus or urachal cyst. 75.00 1 533.50
533.46 5.00 T 532.89
532.90
2047 Drainage of perivesical or prevesical abscess 60.00 1 226.80
226.77 5.00 T 532.89
532.90

Units N$ Units N$
EVACUATION OF CLOTS FROM BLADDER : - -

2049 Other than post-operative. 40.00 817.84
817.80 3.00 T 319.73
319.70
2050 Post-operative. - 4.00 T 426.30
426.31
2051 Simple bladder lavage: Including 12.00 245.35
245.40 3.00 T 319.73
319.70
catheterisation.
BLADDER NECK PLASTY : - -

2053 Male. 91.00 1 860.60 5.00 T 532.89
532.90
2057 Female. 91.00 1 860.60 5.00 T 532.89
532.90
10.4 Urethra

Units N$ Units N$
- -
OPEN BIOPSY OF URETHRA: - -
2059 Male. 45.00 920.07
920.10 3.00 T 319.73
319.70
2061 Female. 45.00 920.07
920.10 3.00 T 319.73
319.70
- -
DILATATION OF URETHRAL STRICTURE: BY - -
PASSAGE SOUND:
2063 Initial (male). 20.00 408.92
408.90 3.00 T 319.73
319.70
2065 Subsequent (male). 10.00 204.46
204.50 3.00 T 319.73
319.70
2067 By passage of filiform and follower (male). 20.00 408.92
408.90 3.00 T 319.73
319.70
2069 Dilatation of female urethra 5.00 102.23
102.20 3.00 T 319.73
319.70
2071 Urethrorraphy: Suture of urethral wound or 93.00 1 901.50
901.49 4.00 T 426.31
426.30
injury
2073 External urethrotomy: Pendulous urethra 60.00 1 226.80
226.77 3.00 T 319.73
319.70
(anterior).
- -
URETHRAPLASTY: PENDULOUS URETHRA - -
2075 First stage. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
2077 Second stage. 97.00 1 983.30
983.27 4.00 T 426.31
426.30
2079 Reconstruction of female urethra. 98.00 2 003.70
003.72 4.00 T 426.31
426.30
2081 Reconstruction or repair of male anterior 107.00 2 187.70
187.73 4.00 T 426.31
426.30
urethra (one stage).
- -
RECONSTRUCTION OR REPAIR OF - -
PROSTATIC OR MEMBRANOUS URETHRA
2083 First stage. 112.00 2 290.00
289.96 6.00 T 639.46
639.50
Units N$ Units N$
2085 Second stage 112.00 2 290.00

289.96 6.00 T 639.46
639.50
2086 If done in one stage. 196.00 4 007.40
007.44 6.00 T 639.46
639.50
2087 Urethral diverticulectomy: Male or female 98.00 2 003.70
003.72 4.00 T 426.31
426.30
2088 Peri-urethral teflon injection: Male or female - 60.00 1 226.80
226.77 -
fee as for cystoscopy (item 1949) plus 42,00
units.
2089 Marsupialisation of urethral diverticula: Male or 34.00 695.17
695.20 4.00 T 426.31
426.30
female
- -
TOTAL URETHRECTOMY - -
2091 Female. 98.00 2 003.70
003.72 5.00 T 532.89
532.90
2093 Male 126.00 2 576.20
576.21 5.00 T 532.89
532.90
2095 Drainage of simple localised perineal urinary 42.00 858.74
858.70 5.00 T 532.89
532.90
extravasation
2097 Drainage of extensive perineal urinary 91.00 1 860.60 5.00 T 532.89
532.90
extravasation.
2099 Fulguration for urethral caruncle or polyp. 15.00 306.69
306.70 3.00 T 319.73
319.70
2101 Excision of urethral caruncle. 26.00 531.60 3.00 T 319.73
319.70
2103 Simple urethral meatotomy. 15.00 306.69
306.70 3.00 T 319.73
319.70
INCISION OF DEEP PERI-URETHRAL - -

ABSCESS
2105 Female. 42.00 858.74
858.70 3.00 T 319.73
319.70
2107 Male 25.00 511.15
511.20 3.00 T 319.73
319.70
2109 Badenoch pull-through for intractable stricture 121.00 2 474.00
473.98 5.00 T 532.89
532.90
or incontinence
2111 External sphincterotomy. 72.00 1 472.10
472.12 5.00 T 532.89
532.90
2113 Drainage of Skenegland abscess or cyst. 25.00 511.15
511.20 3.00 T 319.73
319.70
2115 Operation for correction of male urinary 112.00 2 290.00

289.96 5.00 T 532.89
532.90
incontinence with or without introduction of
prostheses (excluding cost of prostheses)
2116 Urethral meatoplasty. 44.00 899.63
899.60 3.00 T 319.73
319.70
2117 Closure of urethrostomy or urethro-cutaneous 29.00 592.94
592.90 3.00 T 319.73
319.70
fistula (independent procedure).
2121 Closure of urethrovaginal fistula: Including 126.00 2 576.20
576.21 5.00 T 532.89
532.90
diversionary procedures.

11 MALE GENITAL SYSTEM
T Time Units
11.1 Penis

Units N$ Units N$
2123 Biopsy of penis (independent procedure). 12.00 245.35

245.40 3.00 T 319.73
319.70
DESTRUCTION OF CONDYLOMATA : - -
CHEMO- OR CRYOTHERAPY:
2125 Limited number (see item 2317). 10.00 204.46
204.50 3.00 T 319.73
319.70
2127 Multiple extensive. 20.00 408.92
408.90 3.00 T 319.73
319.70
- -
ELECTRODESICCATION OF GENITAL - -
LESIONS:
2129 Limited number. 20.00 408.92
408.90 3.00 T 319.73
319.70
2131 Multiple extensive. 40.00 817.84
817.80 3.00 T 319.73
319.70
- -
VARICOCOELE - -
2132 Ligation of abnormal venous drainage. 50.00 1 022.30 3.00 T 319.73
319.70
CIRCUMCISION - -
2133 Circumcision: Clamp procedure (all ages). 25.00 511.15
511.20 3.00 T 319.73
319.70
2136 Circumcision: Global Fee for circumcisions 146.57 2 996.80
996.78 -
performed in doctors' rooms (includes all
associated costs and consumables)
Note: Code 2136 applies to the AidsFree - -
project and is not applicable to members of
medical aid funds.
2137 Circumcision: Surgical excision other than by 60.00 1 226.80
226.77 3.00 T 319.73
319.70
clamp or dorsal slit, any age.
2139 Dorsal slit of prepuce (independent procedure). 17.00 347.58
347.60 3.00 T 319.73
319.70
PLASTIC OPERATION ON PENIS - -

2141 Plastic operation for insertion of prostheses. 67.00 1 369.90
369.89 3.00 T 319.73
319.70
2143 For straightening of chordee e.g. hypospadias 60.00 1 226.80
226.77 3.00 T 319.73
319.70
with or without mobilisation of urethra.
2145 For straightening of chordee with 60.00 1 226.80
226.77 3.00 T 319.73
319.70

Units N$ Units N$
transplantation of prepuce
2147 For injury: Including fracture of penis and 112.00 2 290.00
289.96 3.00 T 319.73
319.70
skingraft if required.
2149 For epispadias distal to the external sphincter 112.00 2 290.00
289.96 3.00 T 319.73
319.70
2153 Plastic operation for epispadias with 112.00 2 290.00
289.96 3.00 T 319.73
319.70
incontinence.
2154 Induction of artificial erection 16.00 327.14
327.10 3.00 T 319.73
319.70
HYPOSPADIAS - -
2155 Urethral reconstruction. 125.00 2 555.80
555.76 3.00 T 319.73
319.70
2157 Subsequent procedures for repair of urethra: 60.00 1 226.80
226.77 3.00 T 319.73
319.70
Total
2159 Urethraplasty: Complete, one stage for 200.00 4 089.20
089.22 3.00 T 319.73
319.70
hypospadias
TOTAL AMPUTATION OF PENIS - -

2161 Without gland dissection. 140.00 2 862.50
862.45 4.00 T 426.31
426.30
2163 With gland dissection. 224.00 4 579.90
579.93 6.00 T 639.46
639.50
- -
PARTIAL AMPUTATION OF PENIS - -
2165 With gland-dissection. 140.00 2 862.50
862.45 6.00 T 639.46
639.50
2167 Without gland-dissection. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
2169 Injection procedure for Peyronies disease 13.00 265.80 3.00 T 319.73
319.70
PRIAPISM OPERATION - -
2171 Irrigation of corpora cavernosa for priapism. 42.00 858.74
858.70 3.00 T 319.73
319.70
2173 Shunt procedure: Any type 168.00 3 434.90
434.94 4.00 T 426.31
426.30
2174 Stab shunt. 42.00 858.74
858.70 4.00 T 426.31
426.30
11.2 Testis and epididymis
SPECIFIC MODIFIER
0078 When testis biopsy is done combined with vasogram or seminal vesiculogram or epididymogram,
add 50% of the units for the appropriate procedure

Units N$ Units N$
2175 Testis biopsy, needle (independent procedure). 10.00 204.46

204.50 3.00 T 319.73
319.70

Units N$ Units N$
TESTIS BIOPSY, INCISIONAL: - -

INDEPENDENT PROCEDURE
2177 Unilateral. 27.00 552.04
552.00 3.00 T 319.73
319.70
2179 Bilateral. 47.00 960.97
961.00 3.00 T 319.73
319.70
2181 Biopsy of epididymis, needle. 15.00 306.69
306.70 3.00 T 319.73
319.70
2183 Puncture aspiration hydrocoele with or without 10.00 204.46
204.50 3.00 T 319.73
319.70
injection of medication
2185 Operation for maldescended testicle: Including 79.00 1 615.20
615.24 4.00 T 426.31
426.30
herniotomy
2187 Operation for torsion appendix testis. 53.00 1 083.60
083.64 4.00 T 426.31
426.30
2189 Operation for torsion testis with fixation of 60.00 1 226.80
226.77 4.00 T 426.31
426.30
contralateral testis
ORCHIDECTOMY (TOTAL OR - -
SUBCAPSULAR):
2191 Unilateral. 65.00 1 329.00 3.00 T 319.73
319.70
2193 Bilateral. 98.00 2 003.70
003.72 3.00 T 319.73
319.70
2195 Radical operation for malignant testis: 87.00 1 778.80
778.81 6.00 T 639.46
639.50
Excluding gland dissection.
2197 Operation for hydrocoele or spermatocoele. 55.00 1 124.50
124.54 4.00 T 426.31
426.30
2199 Varicocelectomy. 38.00 776.95
777.00 4.00 T 426.31
426.30
2201 Abdominal ligation of spermatic vein for 50.00 1 022.30 4.00 T 426.31
426.30
varicocoele
- -
EPIDIDYMECTOMY: - -
2203 Unilateral. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
2205 Bilateral. 89.00 1 819.70 3.00 T 319.73
319.70
2207 Vasectomy: Unilateral or bilateral (no extra fee 55.00 1 124.50
124.54 3.00 T 319.73
319.70
to be charged if done in combination with
prostatectomy
2209 Vasotomy: Unilateral or bilateral. 7.00 143.12
143.10 3.00 T 319.73
319.70
- -
VASOGRAM, SEMINAL VESICULOGRAM: - -
2210 Unilateral 17.00 347.58
347.60 3.00 T 319.73
319.70
2211 Bilateral. 30.00 613.38
613.40 3.00 T 319.73
319.70
2212 Insertion of testicular prosthesis: Independent 34.00 695.17
695.20 4.00 T 426.31
426.30
procedure (exclusive of cost of material).
2213 Suture or repair of testicular injury. 34.00 695.17
695.20 4.00 T 426.31
426.30
2215 Incision and drainage of testis or epididymis 60.00 1 226.80
226.77 4.00 T 426.31
426.30
e.g. abscess or haematoma.
2217 Excision of local lesion of testis or epididymis. 34.00 695.17
695.20 4.00 T 426.31
426.30
- -

Units N$ Units N$
VASO-VASOSTOMY: - -
2219 Unilateral. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
2221 Bilateral. 78.00 1 594.80 3.00 T 319.73
319.70
- -
EPIDIDYMO-VASOSTOMY: - -
2223 Unilateral. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
2225 Bilateral. 78.00 1 594.80 3.00 T 319.73
319.70
2227 Incision and drainage of scrotal wall abscess. 17.00 347.58
347.60 3.00 T 319.73
319.70
2229 Excision of Mullerian duct cyst. 126.00 2 576.20
576.21 4.00 T 426.31
426.30
2231 Excision of lesion of spermatic cord. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
2233 Seminal Vesiculectomy. 147.00 3 005.60
005.58 5.00 T 532.89
532.90
11.3 Prostate

Units N$ Units N$
2235 Biopsy prostate: Needle or punch, single or 8.00 163.57

163.60 3.00 T 319.73
319.70
multiple, any approach.
2237 Biopsy, prostate, incisional, any approach. 70.00 1 431.20
431.23 4.00 T 426.31
426.30
2239 Transurethral drainage of prostatic abscess. 46.00 940.52
940.50 4.00 T 426.31
426.30
2241 Perineal drainage of prostatic abscess. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
2243 Trans-urethral cryo-surgical removal of prostate. 84.00 1 717.50
717.47 6.00 T 639.46
639.50
2245 Trans-urethral resection of prostate. 168.00 3 434.90
434.94 6.00 T 639.46
639.50
2247 Trans-urethral resection of residual prostatic 60.00 1 226.80
226.77 6.00 T 639.46
639.50
tissue 90 days post-operative or longer.
2249 Trans-urethral resection of post-operative 84.00 1 717.50
717.47 5.00 T 532.89
532.90
bladder neck contracture.
- -
PROSTATECTOMY: PERINEAL: - -
2251 Sub-total. 168.00 3 434.90
434.94 6.00 T 639.46
639.50
2253 Radical. 224.00 4 579.90
579.93 8.00 T 852.62
852.60
2254 Pelvic lymphadenectomy. 117.00 2 392.20
392.19 8.00 T 852.62
852.60
2255 Supra-pelvic, transvesical. 168.00 3 434.90
434.94 6.00 T 639.46
639.50
- -
RETROPUBIC: - -
2257 Sub-total. 168.00 3 434.90
434.94 6.00 T 639.46
639.50
2259 Radical. 224.00 4 579.90
579.93 8.00 T 852.62
852.60
2260 Prostate brachytherapy 153.00 3 128.30
128.25 8.00 T 852.62
852.60

12 FEMALE GENITAL SYSTEM
T Time Units
12.1 Vulva and introitus

Units N$ Units N$
2271 Removal of tag or polyp. 6.00 122.68

122.70 3.00 T 319.73
319.70
2272 Removal of small superficial benign lesions. 23.00 470.26
470.30 3.00 T 319.73
319.70
2273 Biopsy with suture in theatre (excluding after- 27.00 552.04
552.00 3.00 T 319.73
319.70
care).
2274 Laser therapy of vulva and/or vagina 60.00 1 226.80
226.77 3.00 T 319.73
319.70
(colposcopically directed)
2275 Reduction labial hypertrophy. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
2277 Removal of extensive benign vulva tumour. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
- -
SECONDARY PERINEAL REPAIR - -
2279 Repair second degree tear 45.00 920.07
920.10 6.00 T 639.46
639.50
2280 Repair third degree tear. 64.00 1 308.60
308.55 6.00 T 639.46
639.50
2281 Excision of inclusion cyst 43.00 879.18
879.20 4.00 T 426.31
426.30
2283 Hymenectomy. 43.00 879.18
879.20 4.00 T 426.31
426.30
2285 Drainage haematocolpos. 54.00 1 104.10
104.09 4.00 T 426.31
426.30
2287 Clitoris repair for injury: Including skin graft if 60.00 1 226.80
226.77 4.00 T 426.31
426.30
required
2288 Clitoral reduction 107.00 2 187.70
187.73 4.00 T 426.31
426.30
2289 Denervation or alcohol infiltration vulva 54.00 1 104.10
104.09 4.00 T 426.31
426.30
(Woodruff)
2291 Vulva: Undercutting skin (ball). 58.00 1 185.90
185.87 4.00 T 426.31
426.30
2293 Vulva and introitus: Drainage of abscess. 27.00 552.04
552.00 3.00 T 319.73
319.70
- -
BARTHOLIN GLAND - -
2295 Bartholin abscess marsupialisation. 36.00 736.06
736.10 3.00 T 319.73
319.70
2297 Bartholin gland excision. 45.00 920.07
920.10 3.00 T 319.73
319.70
2299 Bartholin radical excision for malignant lesion. 238.00 4 866.20
866.17 6.00 T 639.46
639.50
OPERATION FOR ENLARGING INTROITUS - -

Units N$ Units N$
2301 Fenton plasty 50.00 1 022.30 4.00 T 426.31

426.30
2303 Bilateral Z-plasty. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
- -
VULVECTOMY - -
2305 Partial vulvectomy 107.00 2 187.70
187.73 4.00 T 426.31
426.30
2307 Vulvectomy. 150.00 3 066.90
066.91 6.00 T 639.46
639.50
2309 Radical vulvectomy with bilateral 238.00 4 866.20
866.17 6.00 T 639.46
639.50
lymphadenectomy
2311 Radical vulvectomy with bilateral 268.00 5 479.60
479.55 6.00 T 639.46
639.50
lymphadenectomy, plus deep lymph gland
dissection.
12.2 Vaginal procedures and operations

Units N$ Units N$
2312 Artificial insemination. 13.00 265.80 -

2313 Examination under anaesthetic when no other 20.00 408.92
408.90 3.00 T 319.73
319.70
procedures are performed.
2314 Intra uterine insemination. 18.00 368.03
368.00 -
2315 Simms Huhner test plus wet smear. 5.00 102.23
102.20 -
- -
DESTRUCTION OF CONDYLOMATA BY - -
CHEMO-, CRYO- OR ELECTROTHERAPY,
OR HARMONIC SCALPEL:
2316 First Lesion. 14.00 286.25
286.20 3.00 T 319.73
319.70
2317 Limited repeat. 7.00 143.12
143.10 3.00 T 319.73
319.70
2318 Widespread. 56.00 1 145.00
144.98 3.00 T 319.73
319.70
2319 Excision of cysts or tumours. 54.00 1 104.10
104.09 3.00 T 319.73
319.70
2321 Drainage of vaginal abscess 54.00 1 104.10
104.09 3.00 T 319.73
319.70
2322 Pudendal nerve block. 15.00 306.69
306.70 -
2323 Reconstruction of vagina after atresia. 71.00 1 451.70
451.67 5.00 T 532.89
532.90
CONSTRUCTION OF ARTIFICIAL VAGINA: - -

2325 Construction of artificial vagina: Labial fusion. 119.00 2 433.10
433.09 4.00 T 426.31
426.30
2327 Construction of artificial vagina: Macindoe type 131.00 2 678.40
678.44 5.00 T 532.89
532.90

Units N$ Units N$
2329 Construction of vagina: Bowel pull-through 161.00 3 291.80

291.82 6.00 T 639.46
639.50
operation: Two surgeons: Each.
2331 Vaginal septum removal 71.00 1 451.70
451.67 4.00 T 426.31
426.30
- -
COLPOTOMY - -
2339 Colpotomy: Diagnostic (excluding after-care). 20.00 408.92
408.90 4.00 T 426.31
426.30
2341 Colpotomy: Therapeutic, with or without 69.00 1 410.80
410.78 4.00 T 426.31
426.30
sterilisation
- -
VAGINAL HYSTERECTOMY - -
2343 Vaginal hysterectomy. Without repair. 170.00 3 475.80
475.84 6.00 T 639.46
639.50
2345 Vaginal hysterectomy. With repair. 200.00 4 089.20
089.22 6.00 T 639.46
639.50
2357 Vaginal hysterectomy and repair with unilateral 213.00 4 355.00
355.02 6.00 T 639.46
639.50
or bilateral salpingo-oopherectomy.
2361 Vaginal hysterectomy and repair for total 213.00 4 355.00
355.02 6.00 T 639.46
639.50
prolapse
2363 Fothergill or Manchester repair operation 131.00 2 678.40
678.44 5.00 T 532.89
532.90
2365 Repair of recurrent enterocele or vault prolapse 155.00 3 169.10
169.15 5.00 T 532.89
532.90
(except at the time of hysterectomy).
2366 Posterior repair alone. 71.00 1 451.70
451.67 5.00 T 532.89
532.90
2367 Other operations for prolapse: Anterior repair - 107.00 2 187.70
187.73 5.00 T 532.89
532.90
with or without posterior repair.
2368 Uterovesical fistula. 140.00 2 862.50
862.45 5.00 T 532.89
532.90
2369 Repair of Vesico- or urethro-vaginal fistula. 119.00 2 433.10
433.09 5.00 T 532.89
532.90
2370 Repair of V.V.F. - Obstetric or radiation. 155.00 3 169.10
169.15 5.00 T 532.89
532.90
2371 Closure of uretero-vaginal fistula. 167.00 3 414.50 5.00 T 532.89
532.90
2372 Closure of uretero-vaginal fistula: Obstetric or 167.00 3 414.50 5.00 T 532.89
532.90
radiation
2373 Closure of recto-vaginal fistula 89.00 1 819.70 5.00 T 532.89
532.90
2374 Closure of recto-vaginal fistula: Obstetric or 101.00 2 065.10
065.06 5.00 T 532.89
532.90
radiation
2375 Colpocleisis. 86.00 1 758.40
758.36 4.00 T 426.31
426.30
2377 Le Fort operation. 86.00 1 758.40
758.36 4.00 T 426.31
426.30
2379 Schauta operation. 238.00 4 866.20
866.17 8.00 T 852.62
852.60
2381 Vaginectomy. 179.00 3 659.90
659.85 8.00 T 852.62
852.60
2383 Synchronous combined hysterocolpectomy: 286.00 5 847.60
847.58 8.00 T 852.62
852.60
(one or two surgeons - total fee).
2385 Vaginal laceration or trauma: Repair. 50.00 1 022.30 4.00 T 426.31
426.30

12.3 Cervix

Units N$ Units N$
2389 Paracervical nerve block. 20.00 408.92

408.90 -
2391 Cervix: Canal reconstruction. 98.00 2 003.70
003.72 3.00 T 319.73
319.70
2392 Cryo- or electro-cauterisation, or Lletz of cervix 14.00 286.25
286.20 -
(excluding cost of disposable loop electrode):
In consulting room
2395 Cryo- or electro-cauterisation, or Lletz of cervix 22.00 449.81
449.80 3.00 T 319.73
319.70
(excluding cost of disposable loop electrode):
Under anaesthetic
2396 Laser or harmonic scalpel treatment of the 60.00 1 226.80
226.77 3.00 T 319.73
319.70
cervix
2397 Dilation of cervix for stenosis and insertion 31.00 633.83
633.80 3.00 T 319.73
319.70
prosthesis and Budge suture.
- -
BIOPSY - -
2399 Punch biopsy (excluding after-care). 9.00 184.01
184.00 3.00 T 319.73
319.70
2400 Biopsy during pregnancy (excluding after-care). 13.00 265.80 3.00 T 319.73
319.70
2403 Wedge biopsy: Cervix (excluding after-care). 18.00 368.03
368.00 3.00 T 319.73
319.70
2404 Biopsy: Wedge during pregnancy: Cervix 24.00 490.71
490.70 3.00 T 319.73
319.70
(excluding after-care)
2405 Cone biopsy: Cervix (excluding after-care). 54.00 1 104.10
104.09 3.00 T 319.73
319.70
2407 Amputation: Cervix. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
2409 Cervix encirclage: McDonald stitch. 35.00 715.61
715.60 3.00 T 319.73
319.70
2411 Cervix encirclage: Shirodkar suture. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
2413 Cervix encirclage: Lash. 49.00 1 001.90
001.86 3.00 T 319.73
319.70
2415 Cervix encirclage: Removal items 2409 and 5.00 102.23
102.20 -
2411 without anaesthetic.
2416 Cervix: Removal items 2409 and 2411 with 30.00 613.38
613.40 3.00 T 319.73
319.70
anaesthetic in theatre.
REPAIR OF TEARS - -
2417 Emmet repair of tears. 45.00 920.07
920.10 3.00 T 319.73
319.70
2418 Sturmdorff repair of tears. 54.00 1 104.10
104.09 3.00 T 319.73
319.70
- -
EXTIRPATION OF CERVICAL STUMP - -
2421 Extirpation of cervical stump: Vaginal. 89.00 1 819.70 5.00 T 532.89
532.90
2423 Extirpation of cervical stump: Abdominal. 89.00 1 819.70 5.00 T 532.89
532.90
2425 Removal of cervical polyps (excluding after- 13.00 265.80 3.00 T 319.73
319.70
care).
2427 Removal of cervical myomata. 54.00 1 104.10
104.09 3.00 T 319.73
319.70
- -
COLPOSCOPY - -
Units N$ Units N$
2429 Colposcopy (excluding after-care). 27.00 552.04

552.00 3.00 T 319.73
319.70
12.4 Uterus

Units N$ Units N$
2433 Embryo transfer. 45.00 920.07

920.10 4.00 T 426.31
426.30
2434 Endometrial biopsy (excluding after-care). 18.00 368.03
368.00 3.00 T 319.73
319.70
- -
HYSTEROSCOPY - -
2435 Hysterosalpingogram (excluding after-care). 22.00 449.81
449.80 3.00 T 319.73
319.70
2436 Hysteroscopy (excluding after-care). 40.00 817.84
817.80 3.00 T 319.73
319.70
2437 Hysteroscopy and D&C (excluding after- care). 58.00 1 185.90
185.87 3.00 T 319.73
319.70
2438 Hysteroscopy and removal of uterine septum 60.00 1 226.80
226.77 3.00 T 319.73
319.70
2439 Hysteroscopy and division of endometrial and 60.00 1 226.80
226.77 3.00 T 319.73
319.70
endocervical bands (excluding after- care).
2440 Hysteroscopy and polypectomy (excluding 60.00 1 226.80
226.77 3.00 T 319.73
319.70
after-care)
2441 Hysteroscopy and myomectomy (excluding 87.00 1 778.80
778.81 3.00 T 319.73
319.70
after-care)
2442 Insertion of I.U.C.D. (excluding after-care). 18.00 368.03
368.00 3.00 T 319.73
319.70
- -
EVACUATION OF UTERUS - -
2443 D&C: (excluding after-care). 35.00 715.61
715.60 3.00 T 319.73
319.70
2444 Fractional D&C (excluding after-care). 45.00 920.07
920.10 3.00 T 319.73
319.70
2445 Evacuation of uterus: Incomplete abortion: 50.00 1 022.30 4.00 T 426.31
426.30
Before 12 weeks gestation
2447 Evacuation of uterus, incomplete abortion: 60.00 1 226.80
226.77 4.00 T 426.31
426.30
After 12 weeks gestation.
2448 Termination of pregnancy before 12 weeks. 50.00 1 022.30 4.00 T 426.31
426.30
2449 Evacuation: Missed abortion: Before 12 weeks 50.00 1 022.30 4.00 T 426.31
426.30
gestation
2451 Evacuation: Missed abortion: After 12 weeks 60.00 1 226.80
226.77 4.00 T 426.31
426.30
gestation
2452 Termination of pregnancy after 12 weeks - 54.00 1 104.10
104.09 4.00 T 426.31
426.30
administration of intra/extra amniotic
prostaglandin.
2453 Evacuation hydatidiform mole. 60.00 1 226.80
226.77 5.00 T 532.89
532.90
2455 Evacuation uterus post-partum. 54.00 1 104.10
104.09 6.00 T 639.46
639.50
2461 Ventrosuspension. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
Units N$ Units N$
2463 Uteroplasty: Strassman. 95.00 1 942.40

942.38 6.00 T 639.46
639.50
2465 Uteroplasty: Tompkins. 95.00 1 942.40
942.38 6.00 T 639.46
639.50
2467 Myomectomy. 95.00 1 942.40
942.38 6.00 T 639.46
639.50
2469 Subtotal hysterectomy with or without 83.00 1 697.00
697.03 6.00 T 639.46
639.50
unilateral or bilateral salpingo-oopherectomy.
2471 Total abdominal hysterectomy: With or without 150.00 3 066.90
066.91 6.00 T 639.46
639.50
unilateral/ bilateral salpingo-oophorectomy -
uncomplicated
2473 Total abdominal hysterectomy plus vaginal cuff 164.00 3 353.20
353.16 6.00 T 639.46
639.50
with or without unilateral or bilateral salpingo-
oophorectomy
2475 Radical abdominal hysterectomy with bilateral 238.00 4 866.20
866.17 8.00 T 852.62
852.60
lymphadenectomy (Wertheim).
2477 Abdominal hysterotomy with or without 125.00 2 555.80
555.76 6.00 T 639.46
639.50
sterilisation
2478 Non-surgical endometrial destruction, any 133.00 2 719.30
719.33 6.00 T 639.46
639.50
method, not utilising hysteroscopic
instrumentation or assistance.
2479 Surgical endometrial destruction: Any method, 150.00 3 066.90
066.91 6.00 T 639.46
639.50
utilising hysteroscopic instrumentation or
assistance.
2480 Laparoscopy by second gynaecologist during - -
hysteroscopy and endometrial ablation (Item
2478 and item 2479)
12.5 Fallopian tubes
MODIFIER: MICROSURGERY
fee.

Units N$ Units N$
2481 Insufflation Fallopian tubes (excluding after- 16.00 327.14

327.10 3.00 T 319.73
319.70
care).
2483 Salpingolysis. 83.00 1 697.00
697.03 4.00 T 426.31
426.30
2485 Salpingostomy. 107.00 2 187.70
187.73 4.00 T 426.31
426.30
2487 Tuboplasty tubal anastamosis or re- 131.00 2 678.40
678.44 4.00 T 426.31
426.30
implantation.
2489 Ectopic pregnancy under 12 weeks 83.00 1 697.00
697.03 6.00 T 639.46
639.50
(salpingectomy)
2490 Ectopic pregnancy under 12 weeks 107.00 2 187.70
187.73 6.00 T 639.46
639.50

Units N$ Units N$
(salpingostomy)
2491 Ectopic pregnancy - after 12 weeks. 150.00 3 066.90
066.91 6.00 T 639.46
639.50
2492 Salpingectomy: Uni- or bilateral or sterilisation 63.00 1 288.10 5.00 T 532.89
532.90
for accepted medical reasons
- -
LAPAROSCOPY - -
Note: Use item 1807 for open procedures

performed with a laparoscope instead of item
2493. Item 1807 may only be added once, and
may not be charged together with item 2493
for more than one procedure performed
laparoscopically
Item 2493 may be used for male patients when

clinically indicated, noting that the add-on
codes in this sub-section pertain to the
treatment of female infertility. Where further
procedures are performed on male patients the
appropriate item plus item 1807 must be used.
2493 Diagnostic laparoscopy (excluding after-care). 59.00 1 206.30
206.32 5.00 T 532.89
532.90
Please note that the units of item 1807 that is
used when open procedures are performed
laparoscopically should not be amended.
2496 Plus aspiration of a cyst (excluding after-care). 12.00 + 245.35
245.40 5.00 T 532.89
532.90
2497 Plus sterilisation. 27.00 + 552.04
552.00 5.00 T 532.89
532.90
2499 Plus biopsy (excluding after-care). 12.00 + 245.35
245.40 5.00 T 532.89
532.90
2500 Plus ablation of endometriosis by laser, 34.00 + 695.17
695.20 5.00 T 532.89
532.90
harmonic scalpel or cautery
2501 Plus cauterisation and/or lysis of adhesions. 12.00 + 245.35
245.40 5.00 T 532.89
532.90
2502 Plus aspiration of follicles (IVF) (excluding after- 35.00 + 715.61
715.60 5.00 T 532.89
532.90
care)
2503 Plus ovarian drilling: add 27.00 + 552.04
552.00 5.00 T 532.89
532.90
2504 Plus Gamete intra fallopian tube transfer 71.00 + 1 451.70
451.67 5.00 T 532.89
532.90
(includes follicle aspiration) (GIFT).
2505 Plus laparoscopic uterosacral nerve ablation: 35.00 715.61
715.60 5.00 T 532.89
532.90
add
2506 Transcervical gamete/embryo intra-fallopian 58.00 1 185.90
185.87 -
tube transfer (TET/TEST)

12.6 Ovaries
MODIFIER: MICROSURGERY
fee.

Units N$ Units N$
2525 Wedge resection of ovaries, unilateral or 70.00 1 431.20

431.23 4.00 T 426.31
426.30
bilateral.
2527 Removal of ovarian tumour or cyst. 89.00 1 819.70 4.00 T 426.31
426.30
2529 Oophorectomy: Uni- or bilateral 89.00 1 819.70 4.00 T 426.31
426.30
2531 Ovarian carcinoma debulking and 238.00 4 866.20
866.17 6.00 T 639.46
639.50
omentectomy.
2532 Ovarian carcinoma - Abdominal hysterectomy, 313.00 6 399.60
399.63 6.00 T 639.46
639.50
bilateral salpingo-oophorectomy. debulking and
omentectomy.
12.7 Miscellaneous procedures

Units N$ Units N$
- -
EXENTERATION - -
2535 Exenteration: Anterior. 268.00 5 479.60
479.55 8.00 T 852.62
852.60
2537 Posterior exenteration. 268.00 5 479.60
479.55 8.00 T 852.62
852.60
2539 Exenteration total. 417.00 8 526.00
526.02 8.00 T 852.62
852.60
2541 Presacral neurectomy. 65.00 1 329.00 5.00 T 532.89
532.90
2543 Moschowitz operation. 80.00 1 635.70
635.69 5.00 T 532.89
532.90
2545 Marshall-Marchetti-Kranz: Operation. 100.00 2 044.60
044.61 5.00 T 532.89
532.90
2546 Urethro-vesicopexy (Abdominal approach). 99.00 2 024.20
024.16 6.00 T 639.46
639.50
2547 Burch colposuspension. 107.00 2 187.70
187.73 5.00 T 532.89
532.90
2549 Sacro-colposuspension with or without mesh 160.00 3 271.40
271.38 5.00 T 532.89
532.90
2550 Urethro-vesicopexy (combined abdominal and 131.00 2 678.40
678.44 5.00 T 532.89
532.90
vaginal approach).
2551 Laparotomy. 113.00 2 310.40
310.41 4.00 T 426.31
426.30
Note: If a laparotomy is followed by a listed - -

intra-abdominal procedure, the fee would be for
the greater of the procedures and not for the
Units N$ Units N$
laparotomy plus the relevant intra-abdominal

procedure
2552 Removal benign retroperitoneal tumour. 149.00 3 046.50

046.47 6.00 T 639.46
639.50
2553 Radical removal of malignant retro-peritoneal 233.00 4 763.90
763.94 8.00 T 852.62
852.60
tumour
2554 Drainage of pelvic abcess per abdomen 120.00 2 453.50
453.53 6.00 T 639.46
639.50
2556 Drainage of pelvic abcess per vagina(refer item 60.00 1 226.80
226.77 5.00 T 532.89
532.90
2341)
2558 Drainage intra-abdominal abscess - delayed 179.00 3 659.90
659.85 6.00 T 639.46
639.50
closure.
2560 Surgery for moderate endometriosis (AFS 100.00 2 044.60
044.61 6.00 T 639.46
639.50
stages 2 + 3) any method.
2561 Surgery for severe endometriosis (AFS stage 4 140.00 2 862.50
862.45 6.00 T 639.46
639.50
- rectovaginal septum), any method (may not
be used with another procedure or as a
modifier)
2562 Treatment of endometriosis (any method) 51.00 1 042.80
042.75 -
found as an incidental finding during surgery for
unrelated condition (histology required)
2565 Implantation hormone pellets (excluding after- 3.00 61.34
61.30 -
care).
2570 Ligation of internal iliac vessels (when not part 150.00 3 066.90
066.91 8.00 T 852.62
852.60
of another procedure)
13 OBSTETRIC PROCEDURES
RULES GOVERNING THIS SECTION OF THE BENCHMARK TARIFFS
U ANTE NATAL CARE

1 When a general practitioner treats a patient in the ante-natal period and, after starting the
confinement, requests an obstetrician to take over the case, the general practitioner shall be
entitled to charge for all the ante-natal consultations he has performed.
(a) If the patient has been in labour for less than 6 hours, the general practitioner shall
charge 50,00 clinical procedure units according to item 2614.
(b) If the patient has been in labour for more than 6 hours, the general practitioner shall
charge 80,00 clinical procedure units according to item 2614.
2 When a general practitioner calls an obstetrician to help with a confinement, take over the
management of a confinement, and treats the patient until after the post-partum visit, the
obstetrician shall charge according to item 2614.
3 When a general practitioner calls an obstetrician (specialist or general practitioner) to help with

a confinement, or take over the management of a confinement, but the general practitioner
treats the patient until after the post-partum visit, the obstetrician shall charge according to
item 2616 and the general practitioner according to item 2614.
4 Non-Invasive Pre-Natal Testing (NIPT) is a method of determining the risk that the foetus will
be born with genetic abnormalities. NIPT is not considered a routine ante-natal screening test
and must be reserved for high-risk patients only. Consequently, funds will only consider
reimbursement if prior authorisation has been obtained, proof of pre-test genetic counselling
provided, and available benefits confirmed before the test is requested. NIPT comes in the
form of a test kit, meaning that claims must be reported by quoting the relevant NAPPI code.
ix Consultative units
T Time Units
13.1 Pre-natal care and procedures

Units N$ Units N$
2601 First pre-natal visit. 15.00 xvii 537.36

537.40 -
2602 Repeat pre-natal visit. 12.00 ix 326.54
326.50 -
2603 External cephalic version (excluding after-care). 22.00 449.81
449.80 -
2605 Amniocentesis (excluding after-care). 36.00 736.06
736.10 -
Ultrasound for amniocentesis (5026) and
amniocentesis (2605) may be done by both
radiologists and obstetricians, individually or
working as a team where each person would
use the appropriate code for the work
performed.
2607 Amnioscopy (excluding after-care). 18.00 368.03
368.00 -
2609 Intra-uterine transfusion of foetus or 89.00 1 819.70 -
cordocentesis
2610 Tococardiography pre-natal and intrapartum 16.00 327.14
327.10 -
(including stress and non-stress test; Own
machine) (excluding after-care)
2611 Chorion villus sampling (excluding after-care). 54.00 1 104.10
104.09 -

13.2 Confinements
Global obstetric care includes

• All modes of delivery (including Caesarean)
• All inductions of labour (medical or surgical)
• Intrapartum paracervical and prudential blocks
• Intrapartum amnioscopy
• Foetal blood sampling
• Application of scalp leads
• Symphysiotomy
• Manual removal of placenta
• Repair cervical tears
• Correction of uterine inversion
• Drainage of vulval haematoma
• Repair third degree tear
• Repair second degree tear
• Repair episiotomy
• Resuscitation of newborn by obstetrician
• Tracheal intubation
• Missed confinement
Global obstetric care excludes

• Prenatal consultations
• Prenatal procedures (Items 2603 - 2611)
• Emergency hysterectomy for obstetrical reasons
• Abdominal operation for repair of ruptured gravid uterus
• Intensive care for obstetrical emergencies
• Tubal ligation performed as a post-partum procedure
• Post-partum complications occurring after discharge from the
• Hospital

Units N$ Units N$
2614 Global obstetric care: All inclusive fee that 221.99 4 538.80
538.83 6.00 T 639.46
639.50
includes all modes of vaginal delivery
(excluding Caeserean Section) and obstetric

care from the commencement of labour until
after the post-partum visit (6 weeks visit)
2615 Global obstetric care: All inclusive fee for 195.16 3 990.30
990.26 6.00 T 639.46
639.50
Caesarean section and obstetric care from the
commencement of labour until after the post-
partum visit (6 weeks visit). See modifier 0011
for emergency caesarean section (all hours).
2616 Intrapartum obstetric care by obstetrician in 127.00 2 596.70
596.65 -
consultation (excluding after-care).
13.3 Operative procedures (excluding antenatal care)

Units N$ Units N$
2653 Caesarean - hysterectomy. 223.00 4 559.50

559.48 9.00 T 959.19
959.20
2657 Post-partum hysterectomy. 200.00 4 089.20
089.22 8.00 T 852.62
852.60
2669 Abdominal operation for ruptured gravid uterus: 167.00 3 414.50 9.00 T 959.19
959.20
Repair.
14 NERVOUS SYSTEM
ii Clinical Units
iii Per Service (specify)
T Time Units
14.1 Diagnostic procedures

Units N$ Units N$
2681 Visual evoked potentials (V.E.P.): Unilateral. - -

2682 Bilateral. - -
2683 Electro-retinography (Ganzfeld method): - -
Unilateral.
2684 Bilateral. - -
2685 Electro-oculography: Unilateral - -
2686 Bilateral. - -

Units N$ Units N$
2687 V.E.P. stable condition: (photic drive) Unilateral - -

2689 Bilateral. - -
2690 Total fee for full evaluation of visual tracts, - -
including bilateral electroretinography and
V.E.P.
Note: See items 2691 to 2702 under section - -

17.5.1: Audiometry
2703 Somatosensory evoked potentials (S.E.P.) - -

single nerve examination to brachial- or
lumbosacral plexus, spinal cord and cortex
2705 Transcutaneous nerve stimulation in the 6.00 122.68
122.70 -
treatment of post-operative and chronic
intractable pain, per treatment
2707 Full fee for complete neurological evoked - -
potential evaluation including neurological
A.E.P., bilateral V.E.P., and bilateral median
and/or posterior tibial stimulation
2708 Evaluation of cognitive evoked potential with - -
visual or audiology stimulus.
2709 Full spinogram including bilateral median and - -
posterior-tibial studies
2710 Morphia saturation testing in rooms - -

(consultation x2 plus item 0206) (excluding
injection material)
2711 Electro-encephalography - Taking of record 36.10 738.10 -
2712 Electro-encephalography - Interpretation. 12.00 245.35
245.40 -
2733 Cortical Stimulation 58.90 1 204.30
204.28 -
2734 Sodium Amytal Testing (WADA test) 88.70 1 813.60
813.57 -
- -
SLEEP ELECTRO-ENCEPHALOGRAPHY - -
6001 Sleep electro-encephalography - infants that fit 36.10 738.10 -
into a perambulator - taking of record.
6002 Sleep electro-encephalography - infants that fit 12.00 245.35
245.40 -
into a perambulator - interpretation.
6003 Sleep electro-encephalography - adults and 36.10 738.10 -
children over infant age - taking of record.
6004 Sleep electro-encephalography - adults and 12.00 245.35
245.40 -
children over infant age - interpretation.
6010 24 Hour scalp EEG video monitoring per 24 235.68 4 818.70
818.74 -
hour: Equipment
6011 24 Hour scalp EEG video monitoring per 24 120.00 2 453.50
453.53 -
hour: Interpretation and supervision
2713 Lumbar puncture and/or intrathecal injections. 15.00 306.69
306.70 -
2714 Cisternal puncture and/or intrathecal injections. 15.00 306.69
306.70 -
2715 8 Hour ambulatory EEG monitoring (Holter): - -
Hire
Units N$ Units N$
2716 8 Hour ambulatory EEG monitoring (Holter): - -

Interpretation
- -
ELECTROMYOGRAPHY. - -
2717 First 50.00 1 022.30 -
2718 Subsequent 50.00 1 022.30 -
2719 Overnight polysomnogram and sleep staging: - -
Hire
2720 Overnight polysomnogram and sleep staging: - -
Interpretation
2721 Daytime polysomnogram: Hire. - -
2722 Daytime polysomnogram: Interpetation. - -
2723 Multiple sleep latency test - interpretation. - -
2724 Overnight continuous positive airways pressure 103.00 2 105.90
105.95 -
(CPAP) titration
- -
ANGIOGRAPHY CAROTIS - -
2725 Unilateral. 25.00 511.15
511.20 4.00 T 426.31
426.30
2726 Bilateral. 44.00 899.63
899.60 4.00 T 426.31
426.30
2727 Vertebral artery: Direct needling. 50.00 1 022.30 4.00 T 426.31
426.30
2729 Vertebral catheterisation. 50.00 1 022.30 4.00 T 426.31
426.30
- -
AIR ENCEPHALOGRAPHY AND POSTERIOR - -
FOSSA TOMOGRAPHY
2731 Injection of air (independent procedure). - 4.00 T 426.30
426.31
2735 Posterior fossa tomography attendance by iii - -
clinician
2737 Visual field charting on Bjerrum Screen. 7.00 143.12
143.10 -
VENTRICULAR NEEDLING WITHOUT - -

BURRING
2739 Tapping only. 16.00 327.14
327.10 4.00 T 426.31
426.30
2741 Plus introduction of air and/or contrast dye for 43.00 879.18
879.20 4.00 T 426.31
426.30
ventriculography.
- -
SUBDURAL TAPPING: - -
2743 First sitting. 15.00 306.69
306.70 4.00 T 426.31
426.30
2745 Subsequent 10.00 204.46
204.50 4.00 T 426.31
426.30

14.2 Introduction of burr holes for:

Units N$ Units N$
2747 Ventriculography. 100.00 2 044.60

044.61 8.00 T 852.62
852.60
2749 Catheterisation for ventriculography and/or 100.00 2 044.60
044.61 8.00 T 852.62
852.60
drainage
2751 Biopsy of brain tumor. 100.00 2 044.60
044.61 8.00 T 852.62
852.60
2753 Subdural haematoma or hygroma. 100.00 2 044.60
044.61 8.00 T 852.62
852.60
2755 Subdural empyema. 100.00 2 044.60
044.61 8.00 T 852.62
852.60
2757 Brain abscess. 100.00 2 044.60
044.61 8.00 T 852.62
852.60
14.3 Nerve procedures :

Units N$ Units N$
2759 Peripheral. 37.00 756.51

756.50 4.00 T 426.31
426.30
2763 Cranial nerves: Extra-cranial 20.00 408.92
408.90 4.00 T 426.31
426.30
2765 Nerve conduction studies (see item 0733 and 17.00 347.58
347.60 4.00 T 426.31
426.30
3285)
6005 For blepharospasm (+ item 0201+ item 0202) - -
6006 For hemifacial spasm (+ item 0201 + item - -
0202)
6007 For adductor dysphonia (+ item 0201 + - -
item0202)
6008 In extra-ocular muscles (+ item 0201 + - -
item0202)
6009 For spasmodic torticollis and/or cranial - -
dystonia (+ item 0201 + item 0202).
14.3.1 Nerve repair or suture :

Units N$ Units N$
2767 Suture brachial plexus (see also items 2837 200.00 4 089.20
089.22 6.00 T 639.46
639.50
and 2839)
SUTURE: LARGE NERVE: - -

2769 Primary. 89.00 1 819.70 5.00 T 532.89
532.90
Units N$ Units N$
2771 Secondary. 135.00 2 760.20

760.22 5.00 T 532.89
532.90
- -
DIGITAL NERVE: - -
2773 Primary. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
2775 Secondary 64.00 1 308.60
308.55 3.00 T 319.73
319.70
- -
NERVE GRAFT: - -
2777 Simple. 135.00 2 760.20
760.22 4.00 T 426.31
426.30
FASCICULAR : - -
2779 First fasciculus. 135.00 2 760.20
760.22 4.00 T 426.31
426.30
2781 Each additional fasciculus. 50.00 1 022.30 4.00 T 426.31
426.30
2783 Nerve flap: To include all stages. 149.00 3 046.50
046.47 4.00 T 426.31
426.30
2785 Facio-accessory or facio-hypoglossal 83.00 1 697.00
697.03 6.00 T 639.46
639.50
anastomosis
2787 Grafting of facial nerve. 143.00 2 923.80
923.79 5.00 T 532.89
532.90
14.3.2 Neurectomy :

Units N$ Units N$
- -
TRIGEMINAL GANGLION : - -
2789 Injection of alcohol. 100.00 2 044.60
044.61 4.00 T 426.31
426.30
2791 Injection of cortisone. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
2793 Coagulation through high frequency. 113.00 2 310.40
310.41 3.00 T 319.73
319.70
PROCEDURES FOR PAIN RELIEF : - -

2799 Intrathecal injections for pain (Not applicable to 36.00 736.06
736.10 4.00 T 426.31
426.30
spinal anaesthesia)
2800 Plexus nerve block. 36.00 736.06
736.10 -
2801 Epidural injection for pain. (See modifier 0045 36.00 736.06
736.10 -
for post-operative pain relief) (refer to modifier
0021 for epidural anaestheric).
2802 Peripheral nerve block for pain relief (See 25.00 511.15
511.20 25.00 ix 511.15
511.20
Modifier 0045 for post-operative pain relief)
(See Modifier 0010 for the administration of
local anaesthesia). (Note: A peripheral nerve
block applies to the infiltration of an identified

Units N$ Units N$
peripheral nerve and excludes local infiltration

with local anaesthesia)
- -
ALCOHOL INJECTION IN PERIPHERAL - -
NERVES FOR PAIN:
2803 Unilateral. 20.00 408.92
408.90 3.00 T 319.73
319.70
2805 Bilateral. 35.00 715.61
715.60 3.00 T 319.73
319.70
2809 Peripheral nerve section for pain. 45.00 920.07
920.10 3.00 T 319.73
319.70
2811 Pudendal neurectomy: Bilateral. 77.00 1 574.30
574.35 3.00 T 319.73
319.70
2813 Obturator or Stoffels. 64.00 1 308.60
308.55 3.00 T 319.73
319.70
2815 Interdigital. 51.00 1 042.80
042.75 3.00 T 319.73
319.70
2825 Excision: Neuroma: Peripheral. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
14.3.3 Other nerve procedures :

Units N$ Units N$
2827 Transposition of ulnar nerve. 67.00 1 369.90

369.89 3.00 T 319.73
319.70
NEUROLYSIS: - -
2829 Minor. 51.00 1 042.80
042.75 3.00 T 319.73
319.70
2831 Major. 88.00 1 799.30
799.26 3.00 T 319.73
319.70
2833 Digital. 64.00 1 308.60
308.55 3.00 T 319.73
319.70
2835 Scalenotomy. 88.00 1 799.30
799.26 6.00 T 639.46
639.50
2837 Brachial plexus, suture or neurolysis (item 200.00 4 089.20
089.22 6.00 T 639.46
639.50
2767)
2839 Total brachial plexus exposure with graft, 300.00 6 133.80
133.83 6.00 T 639.46
639.50
neurolysis and transplantation
2841 Carpal Tunnel. 60.00 1 226.80
226.77 3.00 T 319.73
319.70
LUMBAR SYMPATHECTOMY: - -
2843 Unilateral. 102.00 2 085.50 4.00 T 426.31
426.30
2845 Bilateral. 179.00 3 659.90
659.85 6.00 T 639.46
639.50
- -
CERVICAL SYMPATHECTOMY : - -
2846 Trans-thoracic approach (use item 2847 or - 11.00 T 1 172.30
172.35
item 2848 as appropriate)
2847 Unilateral. 102.00 2 085.50 4.00 T 426.31
426.30
2848 Bilateral 179.00 3 659.90
659.85 6.00 T 639.46
639.50

Units N$ Units N$
SYMPATHETIC BLOCK: OTHER LEVELS: - -

2849 Unilateral. 20.00 408.92
408.90 3.00 T 319.73
319.70
2851 Bilateral 35.00 715.61
715.60 3.00 T 319.73
319.70
2853 Diagnostic/Therapeutic nerve block 20.00 408.92
408.90 4.00 T 426.31
426.30
(unassociated with surgery) - either intercostal,
or brachial, or peripheral, or stellate ganglion
14.4 Skull procedures :

Units N$ Units N$
- -
REMOVAL OF SKULL TUMOUR: WITH OR - -
WITHOUT PLASTIC REPAIR:
2855 Small. 113.00 2 310.40
310.41 5.00 T 532.89
532.90
2857 Major. 133.00 2 719.30
719.33 8.00 T 852.62
852.60
- -
REPAIR OF DEPRESSED FRACTURE OF - -
SKULL: WITHOUT
BRAIN LACERATION:
2859 Major. 133.00 2 719.30
719.33 8.00 T 852.62
852.60
2860 Small 113.00 2 310.40
310.41 8.00 T 852.62
852.60
- -
WITH BRAIN LACERATIONS: - -
2861 Small. 133.00 2 719.30
719.33 8.00 T 852.62
852.60
2862 Major. 250.00 5 111.50
111.52 8.00 T 852.62
852.60
2863 Cranioplasty. 187.00 3 823.40
823.42 8.00 T 852.62
852.60
2864 Encephalocoele (excluding frontal). 133.00 2 719.30
719.33 8.00 T 852.62
852.60
- -
CRANIOSTENOSIS: - -
2865 Few sutures. 142.00 2 903.30
903.35 9.00 T 959.19
959.20
2867 Multiple sutures 187.00 3 823.40
823.42 9.00 T 959.19
959.20

14.5 Shunt procedures :

Units N$ Units N$
2869 Ventriculo-cisternostomy. 187.00 3 823.40

823.42 8.00 T 852.62
852.60
2871 Ventriculo-caval shunt. 187.00 3 823.40
823.42 11.00 T 1 172.30
172.35
2873 Ventriculo-peritoneal shunt. 187.00 3 823.40
823.42 8.00 T 852.62
852.60
2875 Theco-peritoneal C.S.F. shunt. 187.00 3 823.40
823.42 8.00 T 852.62
852.60
14.6 Aneurysm repair :

Units N$ Units N$
2876 Repair of aneurysms or arteriovenous 467.00 9 548.30

548.33 15.00 T 1 598.70
598.66
anomalies (Intracranial)
2877 Extracranial to intracranial vessel. 467.00 9 548.30
548.33 15.00 T 1 598.70
598.66
2878 Posterior fossa arteriovenous anomalies. 467.00 9 548.30
548.33 15.00 T 1 598.70
598.66
14.7 Posterior fossa surgery :

Units N$ Units N$
- -
NEURECTOMY : - -
2879 Glossopharyngeal nerve. 320.00 6 542.80
542.75 6.00 T 639.46
639.50
EIGHTH NERVE: - -
2881 Intracranial. 320.00 6 542.80
542.75 8.00 T 852.62
852.60
2883 Extracranial. 320.00 6 542.80
542.75 4.00 T 426.31
426.30
2884 Subtemporal section of the trigeminal nerve. 250.00 5 111.50
111.52 9.00 T 959.19
959.20
2885 Trigeminal tractotomy. 320.00 6 542.80
542.75 9.00 T 959.19
959.20
2886 Posterior fossa decompression with or without 300.00 6 133.80
133.83 9.00 T 959.19
959.20
laminectomy with or without dural insertion for
Arnold Chiari malformation or obstructive cysts
e.g. Dandy Walker or parasites
2887 Vestibular nerve. 320.00 6 542.80
542.75 9.00 T 959.19
959.20
Units N$ Units N$
- -
POSTERIOR FOSSA TUMOUR REMOVAL : - -
2889 Acoustic neuroma, benign cerebello-pontine 467.00 9 548.30
548.33 11.00 T 1 172.30
172.35
tumours, meningioma, clivus meningioma,
chordoma, clivus chordoma, cholesteatoma
2891 Glioma, secondary deposits. 300.00 6 133.80
133.83 11.00 T 1 172.30
172.35
2893 Abscess. 300.00 6 133.80
133.83 11.00 T 1 172.30
172.35
EXCISION OF TUMOUR OF GLOMUS - -

JUGULARE:
2895 Intracranial. 280.00 5 724.90
724.91 11.00 T 1 172.30
172.35
2897 Extracranial. 280.00 5 724.90
724.91 9.00 T 959.19
959.20
2898 Hemispherectomy 333.00 6 808.60
808.55 15.00 T 1 598.70
598.66
14.7.1 Supratentorial procedures :

Units N$ Units N$
2899 Craniectomy for extra-dural haematoma or 250.00 5 111.50

111.52 11.00 T 1 172.30
172.35
empyema
14.8 Craniotomy for :

Units N$ Units N$
2900 Extra-dural orbital decompression or excision 467.00 9 548.30

548.33 11.00 T 1 172.30
172.35
of orbital tumour.
2901 Osteoplastic Flap for removal of: Meningioma, 467.00 9 548.30
548.33 11.00 T 1 172.30
172.35
basal extracerebral mass, intra ventricular
tumours, Pineal tumours, pituitary adenoma,
total excision cranio-pharyngioma/
pharyngioma
2903 Abscess, Glioma. 300.00 6 133.80
133.83 11.00 T 1 172.30
172.35
2904 Haematoma, foreign body: Cerebral or 300.00 6 133.80
133.83 11.00 T 1 172.30
172.35
cerebellar.
2905 Focal epilepsy: Excision of cortical scar. 300.00 6 133.80
133.83 11.00 T 1 172.30
172.35
2906 With anterior fossa meningocoele and repair of 250.00 5 111.50
111.52 11.00 T 1 172.30
172.35
bony skull defect.
2907 Temporal lobectomy. 300.00 6 133.80
133.83 11.00 T 1 172.30
172.35
Units N$ Units N$
2908 Torkildsen anastomosis. 250.00 5 111.50

111.52 11.00 T 1 172.30
172.35
2909 CSF-leaks. 300.00 6 133.80
133.83 11.00 T 1 172.30
172.35
2910 Removal of arteriovenous malformation. 467.00 9 548.30
548.33 11.00 T 1 172.30
172.35
14.8.1 Stereo-tactic cerebral and spinal cord procedures:

Units N$ Units N$
2911 First sitting. 187.00 3 823.40

823.42 4.00 T 426.31
426.30
2913 Repeat. 131.00 2 678.40
678.44 4.00 T 426.31
426.30
2915 Transnasal hypophysectomy 200.00 4 089.20
089.22 11.00 T 1 172.30
172.35
2916 Transfrontal hypophysectomy. 320.00 6 542.80
542.75 11.00 T 1 172.30
172.35
2917 Transnasal hypophyseal implants 115.00 2 351.30 11.00 T 1 172.30
172.35
2918 Non-operative supervision of paraplegics for all ix - -
disciplines except urologists
14.9 Spinal operations :

Units N$ Units N$
- -
LAMINECTOMY : - -
See section 3.8.7 for laminectomy procedures.
CHORDOTOMY:
2923 Unilateral 119.00 2 433.10
433.09 3.00 TM 319.73
319.70
2925 Open 233.00 4 763.90
763.94 3.00 TM 319.73
319.70
- -
RHIZOTOMY: - -
2927 Extradural, but intraspinal 213.00 4 355.00
355.02 3.00 TM 319.73
319.70
2928 Intradural: 233.00 4 763.90
763.94 3.00 TM 319.73
319.70
- -
REMOVAL OF SPINAL CORD TUMOUR: - -
INTRAMEDULLAR :
2929 Posterior approach 467.00 9 548.30
548.33 8.00 T 852.62
852.60

Units N$ Units N$
2930 Anterio-lateral approach 467.00 9 548.30

548.33 8.00 T 852.62
852.60
- -
EXTRAMEDULLARY, BUT INTRADURAL: - -
2931 Posterior approach 233.00 4 763.90
763.94 3.00 TM 319.73
319.70
2932 Anterio-lateral approach 233.00 4 763.90
763.94 8.00 T 852.62
852.60
2933 Intraspinal, but extradural: Posterior approach. 213.00 4 355.00
355.02 7.00 T 746.04
746.00
2935 Transcutaneous chordotomy 150.00 3 066.90
066.91 3.00 T 319.73
319.70
2937 Repair of meningocele, involving nerve tissue 167.00 3 414.50 9.00 T 959.19
959.20
2938 Simple 100.00 2 044.60
044.61 9.00 T 959.19
959.20
2939 Excision of arterial vascular malformations and 467.00 9 548.30
548.33 9.00 T 959.19
959.20
cysts of the spinal cord
2940 Lumbar osteophyte removal 125.00 2 555.80
555.76 3.00 TM 319.73
319.70
2941 Cervical or thoracic osteophyte removal 190.00 3 884.80
884.76 3.00 TM 319.73
319.70
14.10 Arterial ligations :

Units N$ Units N$
- -
CAROTIS : - -
2951 Trauma 80.00 1 635.70
635.69 8.00 T 852.62
852.60
2953 For aneurysm (A.V. anomaly) 100.00 2 044.60
044.61 8.00 T 852.62
852.60
2955 Removal of carotid body tumour (without 167.00 3 414.50 8.00 T 852.62
852.60
vascular reconstruction).
14.11 Medical psychotherapy.
Please note: The item numbers in this section do not follow in numerical order since new items have been
added.
RULES GOVERNING THE SECTION MEDICAL PSYCHOTHERAPY
Va Visits at hospital or nursing home during a course of electroconvulsive treatment are justified and
may be charged for in addition to the fees for the procedure.
Vb Except where otherwise indicated, the duration of a medical psychotherapeutic session is set at

20 minutes or part thereof provided that such a part comprises 50% or more of the time of a
session. This set duration is also applicable for psychiatric examination methods.
MODIFIER GOVERNING THE SECTION MEDICAL PSYCHOTHERAPY
0079 When a first consultation/visit proceeds into, or is immediately followed by a medical

psychotherapeutic procedure, fees for the procedure are calculated according to item 2957:
Individual psychotherapy (specify type) for a 20-minute session or part thereof, provided that
such a part comprises 50% or more of the time of a session.

Units N$ Units N$
2957 Individual psychotherapy (specific type): 16.00 327.14

327.10 -
Including play therapy for children: Per short
session (20 minutes)
654.30 -
Including play therapy for children: Per
intermediate session (40 minutes)
981.40 -
Including play therapy for children: Per
extended session (60 minutes or longer)
2958 Psychoanalytic therapy: Per 60-minute session 48.00 981.41
981.40 -
2962 Directive therapy to family, parent(s), spouse: 16.00 327.14
327.10 -
Per 20-minute session.
2963 Pairs, marraige or sex therapy: Per 20-minute 16.00 327.14
327.10 -
session
2976 Intermediate treatment where either items 32.00 654.28
654.30 -
2962 or 2963 are used: Per 40-minute session.
2977 Extended treatment where either items 2962 or 48.00 981.41
981.40 -
2963 are used: Per 60-minute session
2968 Group therapy: Adults (specify number): Fee 8.00 163.57
163.60 -
per person per 80-minute session. Group
therapy: Children (specify number): Fee per
person per 80-minute session
14.12 Physical treatment methods :

Units N$ Units N$
2970 Electro-convulsive treatment (ECT): Each time 17.00 347.58

347.60 3.00 T 319.73
319.70
(See rule Va.).
2971 Intravenous anti-depressive medication through 4.00 81.78
81.80 -
infusion: Per push in (Maximum 1 push in per
24 hours)

14.13 Psychiatric examination methods :

Units N$ Units N$
2972 Narco-analysis (Maximum of 3 sessions per 16.00 327.14

327.10 -
treatment): Per session
2973 Psychometry (specify examination): Per 16.00 327.14
327.10 -
session (Maximum of 3 sessions per
examination)
15 ENDOCRINE SYSTEM
T Time Units
15.1 Thyroid :

Units N$ Units N$
2983 Partial lobectomy. 100.00 2 044.60

044.61 5.00 T 532.89
532.90
2985 Total lobectomy. 133.00 2 719.30
719.33 5.00 T 532.89
532.90
2987 Subtotal thyroidectomy. 133.00 2 719.30
719.33 5.00 T 532.89
532.90
2989 Total thyroidectomy. 161.00 3 291.80
291.82 5.00 T 532.89
532.90
2991 Thyroglossal cyst or fistula excision. 60.00 1 226.80
226.77 5.00 T 532.89
532.90
15.2 Parathyroid :

Units N$ Units N$
2993 Exploration of parathyroid glands for 183.00 3 741.60

741.64 5.00 T 532.89
532.90
hyperparathyroidism including removal.

15.3 Adrenals :

Units N$ Units N$
2995 Adrenalectomy: Unilateral. 150.00 3 066.90

066.91 9.00 T 959.19
959.20
2997 Bilateral exploration of adrenal glands: 263.00 5 377.30
377.32 11.00 T 1 172.30
172.35
Including removal
15.4 Hypophysis :

Units N$ Units N$
2999 Transethmoidal hypophysectomy. 200.00 4 089.20

089.22 11.00 T 1 172.30
172.35
3000 Transnasal hypophysectomy (see item 2915). 200.00 4 089.20
089.22 11.00 T 1 172.30
172.35
15.5 General :

Units N$ Units N$
3001 Implantation of pellets (excluding cost of 3.00 61.34

61.30 -
material) (excluding after-care).
16 EYE

v Per Consultation
T Time Units

16.1 Procedures performed in rooms :
(a) Eye investigations and photography refer to both eyes except where otherwise indicated. No extra
fee may be charged where each eye is examined separately on two different occasions
(b) Material used is excluded
(c) The fee for photography is not related to the number of photographs taken

Units N$ Units N$
3002 Gonioscopy. 7.00 143.12

143.10 -
3003 Fundus contact lens or 90 D lens examination 7.00 143.12
143.10 -
3004 Peripheral fundus examination with indirect 7.00 143.12
143.10 -
ophthalmoscope
3005 Endothelial cell count. 7.00 143.12
143.10 -
3006 Keratometry. 7.00 143.12
143.10 -
3007 Potential acuity measurement 7.00 143.12
143.10 -
3008 Contrast sensitivity test. 7.00 143.12
143.10 -
3009 Basic capital equipment used in own rooms by - -
Ophthalmologists. Only to be charged at first
and follow-up consultations. Not to be charged
for post-operative follow-up consultations. BY
ARRANGEMENT
3010 Orthoptic consultation. 10.00 204.46
204.50 -
3011 Orthoptic subsequent sessions. 5.00 102.23
102.20 -
3012 Pre-surgical retinal examination before retinal 32.00 654.28
654.30 -
surgery
3013 Ocular motility assessment comprehensive 12.00 245.35
245.40 -
examination
3014 Tonometry per test with maximum of 2 tests 7.00 143.12
143.10 -
for provocative tonometry (one or both eyes)
3015 Charting of visual field with manual perimeter. 28.00 572.49
572.50 -
3016 Retinal threshold test without storage facilities 30.00 613.38
613.40 -
3017 Retinal threshold test inclusive of computer 60.00 1 226.80
226.77 -
disc storage for Delta or Statpak programs.
3018 Retinal threshold trend evaluation (additional to 16.00 327.14
327.10 -
item 3017)
3019 Ocular muscle function with Hess screen or 16.00 327.14
327.10 -
perimeter
3024 Infusion of dye used during Fluorescein 12.00 245.35
245.40 -
Angiography, Indocyanine Green Video
Angiography and Photodynamic therapy.
Linked to codes 3022, 3023, 3031, 3039
3026 Digital Tomography of optic nerve with 19.00 388.48
388.50 -
Scanning Laser Ophthalmoscopy (SLO)
3028 Optical Coherent Tomography (OCT) of optic 40.00 817.84
817.80 -
Units N$ Units N$
nerve and macula limited to two investigations

per annum
3020 Pachymetry: Only when own instrument is 46.00 940.52
940.50 -
used, per eye. Only in addition to corneal
surgery.
3021 Retinal function assessment including 9.00 184.01
184.00 -
refraction after ocular surgery (within four
months), maximum two examinations
3022 Digital fluorescein video angiography 60.00 1 226.80
226.77 9.00 T 959.19
959.20
3023 Digital indocyanine video angiography 73.00 1 492.60
492.57 9.00 T 959.19
959.20
3025 Electronic tonography. 19.00 388.48
388.50 -
3027 Fundus photography. 21.00 429.37
429.40 -
3029 Anterior segment microphotography. 21.00 429.37
429.40 -
3031 Fluorescein angiography, for one or both eyes 45.00 920.07
920.10 -
in one sitting (excluding colour photography).
3032 Eyelid and orbit photography. 9.00 184.01
184.00 -
3033 Interpretation of items 3022, 3023 and 3031 16.00 327.14
327.10 -
referred by other clinician
3034 Determination of lens implant power per eye. 15.00 306.69
306.70 -
3035 Where a minor procedure usually done in the 22.00 449.81
449.80 -
consulting rooms requires a general
anaesthetic or use of an operating theatre, an
additional fee may be charged
3036 Corneal topography: For pathological corneas 36.00 736.06

736.10 -
only on special motivation. For refractive
surgery - may be charged once pre-operative
and once post-operative per sitting (for one or
both eyes)
16.2 Retina:

Units N$ Units N$
3037 Surgical treatment of retinal detachment 187.00 3 823.40

823.42 6.00 T 639.46
639.50
including vitreous replacement but excluding
vitrectomy.
3039 Prophylaxis and treatment of retina and 70.00 1 431.20
431.23 6.00 T 639.46
639.50
choroid by cryotherapy and/or diathermy
and/or photocoagulation and/or laser per eye
3041 Pan retinal photocoagulation (per eye): done in 100.00 2 044.60
044.61 6.00 T 639.46
639.50
one sitting.

Units N$ Units N$
3044 Removal of encircling band and/or buckling 70.00 1 431.20

431.23 6.00 T 639.46
639.50
material
16.3 Cataract:

Units N$ Units N$
3045 Intra-capsular. 140.00 2 862.50

862.45 7.00 T 746.04
746.00
3047 Extra-capsular (including capsulotomy). 140.00 2 862.50
862.45 7.00 T 746.04
746.00
3049 Insertion of lenticulus in addition to item 3045 57.00 1 165.40
165.43 7.00 T 746.04
746.00
or item 3047 (cost of lens excluded) (modifier
0005 not applicable)
3050 Repositioning of intra ocular lens 114.10 2 332.90 -
3051 Needling or capsulotomy. 87.00 1 778.80
778.81 4.00 T 426.31
426.30
3052 Laser capsulotomy. 70.00 1 431.20
431.23 4.00 T 426.31
426.30
3057 Removal of lenticulus. 140.00 2 862.50
862.45 7.00 T 746.04
746.00
3058 Exchange of intra ocular lens 157.30 3 216.20
216.17 -
3059 Insertion of lenticulus when item 3045 or item 140.00 2 862.50
862.45 7.00 T 746.04
746.00
3047 was not executed (cost of lens excluded).
3060 Use of own surgical microscope for surgery or - -

examination (not for slitlamp microscope) (for
use by ophthalmologists only)
16.4 Glaucoma:

Units N$ Units N$
3061 Drainage operation. 140.00 2 862.50

862.45 6.00 T 639.46
639.50
3062 Implantation of aqueous shunt device/seton in 60.00 1 226.80
226.77 6.00 T 639.46
639.50
glaucoma, e.g. Ahmed or Molteno valve or
Collagen implants. Additional to item 3061
3063 Cyclocryotherapy or cyclodiathermy. 70.00 1 431.20
431.23 6.00 T 639.46
639.50
3064 Laser trabeculoplasty. 70.00 1 431.20
431.23 6.00 T 639.46
639.50
3065 Removal of blood from anterior chamber. 70.00 1 431.20
431.23 4.00 T 426.31
426.30
3067 Goniotomy. 140.00 2 862.50
862.45 7.00 T 746.04
746.00

16.5 Intra-ocular foreign body:

Units N$ Units N$
3071 Anterior to Iris. 85.00 1 737.90

737.92 4.00 T 426.31
426.30
3073 Posterior to Iris (including prophylactic thermal 140.00 2 862.50
862.45 6.00 T 639.46
639.50
treatment to retina)
16.6 Strabismus:
(WHETHER OPERATION PERFORMED ON ONE EYE OR BOTH)

Units N$ Units N$
3074 Adjustment of sutures if not done at the time of 20.00 408.92

408.90 -
the operation. Additional fee for sterile tray
(see item 0202)
3075 Operation on one or two muscles. 107.00 2 187.70
187.73 5.00 T 532.89
532.90
3076 Operation on three or four muscles. 133.00 2 719.30
719.33 5.00 T 532.89
532.90
3077 Subsequent operation one or two muscles. 80.00 1 635.70
635.69 5.00 T 532.89
532.90
3078 Subsequent operation on three or four muscles 100.00 2 044.60
044.61 5.00 T 532.89
532.90
16.7 Globe:

Units N$ Units N$
3079 Transcleral biopsy. 88.00 1 799.30

799.26 4.00 T 426.31
426.30
3080 Examination of eyes under general anaesthetic 60.00 1 226.80
226.77 4.00 T 426.31
426.30
where no surgery is done
3081 Treatment of minor perforating injury 68.00 1 390.30
390.33 6.00 T 639.46
639.50
3083 Treatment of major perforating injury 151.00 3 087.40
087.36 6.00 T 639.46
639.50
3085 Enucleation or Evisceration 70.00 1 431.20
431.23 5.00 T 532.89
532.90
3087 Enucleation or Evisceration with mobile 107.00 2 187.70
187.73 5.00 T 532.89
532.90
implant: Excluding cost of implant and
prosthesis
3088 Hydroxyapetite insertion (additional to item 40.00 817.84
817.80 5.00 T 532.89
532.90
3087):
3089 Subconjunctival injection if not done at time of 10.00 204.46
204.50 5.00 T 532.89
532.90
Units N$ Units N$
operation
3090 Intra vitrael injection drug 47.60 973.23
973.20 -
3091 Retrobulbar injection (if not done at time of 16.00 327.14
327.10 4.00 T 426.31
426.30
operation)
3092 External laser treatment for superficial lesions 53.00 1 083.60
083.64 -
3093 Treatment of tumors of retina or choroid by 139.00 2 842.00
842.01 6.00 T 639.46
639.50
radioactive plaque and/or diathermy and/or
cryotherapy and/or laser therapy and/or
photocoagulation
3094 Implantation of intra vitreal durg delivery system 165.10 3 375.70
375.65 -
3095 Biopsy of vitreous body or anterior chamber 70.00 1 431.20
431.23 6.00 T 639.46
639.50
contents
3096 Adding of air or gas in vitreous as a post- 87.00 1 778.80
778.81 7.00 T 746.04
746.00
operative procedure or pneumoretinopexy
3097 Anterior vitrectomy 187.00 3 823.40
823.42 6.00 T 639.46
639.50
3098 Removal of silicon from globe 187.00 3 823.40
823.42 6.00 T 639.46
639.50
3099 Posterior vitrectomy including anterior 279.00 5 704.50
704.46 6.00 T 639.46
639.50
vitrectomy, encircling of globe and vitreous
replacement
3100 Lensectomy done at time of posterior 30.00 613.38
613.40 7.00 T 746.04
746.00
vitrectomy
16.8 Orbit:

Units N$ Units N$
3101 Drainage of orbital abscess 70.00 1 431.20

431.23 5.00 T 532.89
532.90
3103 Removal of tumour 160.00 3 271.40
271.38 5.00 T 532.89
532.90
3104 Removal orbital prostese 141.80 2 899.30
899.26 -
3105 Exenteration 183.00 3 741.60
741.64 5.00 T 532.89
532.90
3107 Orbitotomy requiring bone flap 160.00 3 271.40
271.38 5.00 T 532.89
532.90
3108 Eye socket reconstruction 137.00 2 801.10
801.12 5.00 T 532.89
532.90
3109 Hydroxyapetite implantation in eye cavity when 200.00 4 089.20
089.22 5.00 T 532.89
532.90
evisceration or enucleation was done previously
3110 Second stage hydroxyapetite implantation 73.00 1 492.60
492.57 5.00 T 532.89
532.90

16.9 Cornea:

Units N$ Units N$
3111 Contact lenses: Assessment involving ix - -

preliminary fittings and tolerance visits (costs
of lenses borne by patient)
3112 Fitting of contact lens for treatment of disease 12.20 249.44
249.40 -
including supply of lens
3113 Fitting of contact lenses and instuctions to 133.00 2 719.30
719.33 -
patient: Includes eye examination, first fitting
of the contact lenses and further post-fitting
visits for 1 year
3114 Wavefront analysist (Aberometry) for - -
customised ablation of pathological coreas
prior to LASIK surgery - Equipment component
only
3115 Fitting of only one contact lens and 111.00 2 269.50
269.52 -
instructions to the patient: eye examination,
first fitting of the contact lens and further post-
fitting visits for one year included
3116 Astigmatic correction with T cuts or wedge 162.24 3 317.20
317.18 6.00 T 639.46
639.50
resection following intra ocular surgery,
penetrating keratoplasty or trauma
3117 Removal of foreign body: On the basis of fee ix - 4.00 T 426.30
426.31
per consultation
3118 Curettage of cornea after removal of foreign 10.00 204.46
204.50 -
body
3119 Tattooing. 26.00 531.60 4.00 T 426.31
426.30
3120 Excimer laser (per eye) for refractive 100.00 2 044.60
044.61 6.00 T 639.46
639.50
keratectomy or Holmium laser thermo
keratoplasty (LTK). For machine hire fee for
LTK used item 3201: ADD
3121 Graft (Lamellar of fullthickness) 193.00 3 946.10 6.00 T 639.46
639.50
3122 Epikeratophakia. 193.00 3 946.10 -
3123 Insertion of intra-corneal or intrascleral 169.00 3 455.40
455.39 6.00 T 639.46
639.50
prosthesis for refractive surgery.
3124 Removal of corneal stitches under microscope 9.00 184.01
184.00 -
(maximum of 2 procedures) Additional fee for
sterile tray (see item 0202)
3125 Keratectomy or conjuctival flap. 85.00 1 737.90
737.92 6.00 T 639.46
639.50
3127 Cauterization of cornea (by chemical, thermal 10.00 204.46
204.50 4.00 T 426.31
426.30
or cryotherapy methods).
3128 Radial keratotomy or keratoplasty for 100.00 2 044.60
044.61 6.00 T 639.46
639.50
astigmatism (cosmetic unless medical
reasons can be proved).
3132 Lamellar keratectomy (per eye) for refractive 100.00 2 044.60
044.61 6.00 T 639.46
639.50
surgery (LK, ALK, MLK)
3129 Additional to item 3128 for the use of own 40.00 + 817.84
817.80 -
diamond knives
Units N$ Units N$
3126 Additional to item 3128 for the use of own - -

microkeratome used with an excimer laser:
Add
3130 Pterygium or conjunctival cyst or conjunctival 53.00 1 083.60
083.64 4.00 T 426.31
426.30
tumor
3131 Paracentesis 53.00 1 083.60
083.64 4.00 T 426.31
426.30
3134 Pterygium or conjunctival cyst or conjunctival 77.50 1 584.60
584.57 4.00 T 426.31
426.30
tumour. Conjunctival flap or graft used - stand
alone procedure.
3136 Conjunctival flap or graft 63.80 1 304.50
304.46 6.00 T 639.46
639.50
3138 Removal corneal epithelium and chelating 60.00 1 226.80
226.77 4.00 T 426.31
426.30
agent for band keratopathy
16.10 Ducts:

Units N$ Units N$
3133 Probing and/or syringing, per duct 10.00 204.46

204.50 4.00 T 426.31
426.30
3135 Insertion of polythene tubes (additional): 13.00 265.80 4.00 T 426.31
426.30
Unilateral
3137 Excision of lacrimal sac: Unilateral 88.00 1 799.30
799.26 4.00 T 426.31
426.30
3139 Dacryocystorhinostomy (Single) with or 140.00 2 862.50
862.45 5.00 T 532.89
532.90
without polythene tube
3141 Sealing of punctum. 20.00 408.92
408.90 4.00 T 426.31
426.30
3143 Three-snip operation. 10.00 204.46
204.50 4.00 T 426.31
426.30
3142 Sealing Punctum with plugs: Per eye 20.00 408.92
408.90 4.00 T 426.31
426.30
REPAIR OF CANALICULUS: - -
3145 Primary procedure. 88.00 1 799.30
799.26 4.00 T 426.31
426.30
3147 Secondary procedure. 117.00 2 392.20
392.19 4.00 T 426.31
426.30
16.11 Iris:

Units N$ Units N$
3149 Iridectomy or iridotomy by open operation as 88.00 1 799.30

799.26 4.00 T 426.31
426.30
isolated procedure.
3151 Excision of iris tumour. 123.00 2 514.90
514.87 6.00 T 639.46
639.50
Units N$ Units N$
3153 Iridectomy or iridotomy by laser or photo- 70.00 1 431.20

431.23 4.00 T 426.31
426.30
coagulation as isolated procedure (maximum
one procedure)
3155 Iridocyclectomy for tumour. 177.00 3 619.00
618.96 6.00 T 639.46
639.50
3157 Division of anterior synechiae as isolated 88.00 1 799.30
799.26 4.00 T 426.31
426.30
procedure
3158 Repair iris as in dialysis: Anterior chamber 94.90 1 940.30
940.33 4.00 T 426.31
426.30
reconstruction
16.12 Lids:

Units N$ Units N$
3161 Tarsorrhaphy. 47.00 960.97

961.00 4.00 T 426.31
426.30
3163 Excision of superficial lid tumour. 47.00 960.97
961.00 4.00 T 426.31
426.30
3165 Repair of skin lacerations of the lid. 47.00 960.97
961.00 4.00 T 426.31
426.30
3167 Diathermy to wart on lid margin. 12.00 245.35
245.40 4.00 T 426.31
426.30
3169 Electrolysis of any number of eyelashes (per 15.00 306.69
306.70 -
eye)
3171 Excision of Meibomian cyst. Addisional fee for 10.00 204.46
204.50 4.00 T 426.31
426.30
sterile tray (see item 0202).
3173 Epicanthal folds. 88.00 1 799.30
799.26 4.00 T 426.31
426.30
3174 Botulinum toxin injection for blepharospasm (+ - -
item 0201 + item 0202)
3175 Botulinum toxin injection in extra-ocular - -
muscles (+ item 0201+ item 0202)
3176 Lid operation for facial nerve paralysis including 125.00 2 555.80
555.76 4.00 T 426.31
426.30
tarsorrhaphy but excluding cost of material.
16.12.1 Entropion or ectropion by:

Units N$ Units N$
3177 Cautery. 10.00 204.46

204.50 4.00 T 426.31
426.30
3179 Suture. 47.00 960.97
961.00 4.00 T 426.31
426.30
3181 Open operation. 70.00 1 431.20
431.23 4.00 T 426.31
426.30
3183 Free skin, mucosal grafting or flap 137.00 2 801.10
801.12 4.00 T 426.31
426.30

16.12.2 Reconstruction of eyelid:

Units N$ Units N$
- -
STAGED PROCEDURES FOR PARTIAL OR - -
TOTAL LOSS OF EYELID
3185 First stage. 137.00 2 801.10
801.12 4.00 T 426.31
426.30
3187 Subsequent stage. 137.00 2 801.10
801.12 4.00 T 426.31
426.30
3189 Full thickness eyelid laceration for tumour or 88.00 1 799.30
799.26 4.00 T 426.31
426.30
injury: Direct repair
3191 Blepharoplasty: upper lid for improvement in 88.00 1 799.30
799.26 4.00 T 426.31
426.30
function
3172 Blepharoplasty lower eyelid plus fat pad 83.90 1 715.40
715.43 4.00 T 426.31
426.30
16.12.3 Ptosis:

Units N$ Units N$
3193 Repair by superior rectus, levator or frontalis 127.00 2 596.70

596.65 4.00 T 426.31
426.30
muscle operation
PTOSIS: BY LESSER PROCEDURE e.g. - -

SLING OPERATION:
3195 Unilateral. 63.00 1 288.10 4.00 T 426.31
426.30
3197 Bilateral. 111.00 2 269.50
269.52 4.00 T 426.31
426.30
16.13 Conjunctiva:

Units N$ Units N$
3199 Repair of conjunctiva by grafting. 88.00 1 799.30

799.26 4.00 T 426.31
426.30
3200 Repair of lacerated conjunctiva. 47.00 960.97
961.00 4.00 T 426.31
426.30

16.14 General:
OWN EQUIPMENT USED IN TREATMENT:
Only the owner of the equipment may charge hire fees for equipment used and not the person using the
equipment.

Units N$ Units N$
3196 Diamond knife: Use of own diamond knife - -

during intraocular surgery: Add
3198 Excimer laser: Hire fee (per eye). - -

3192 If a practitioner performs the procedure in his - -
own facility an excimer laser theatre fee of N$
<<3192>> per minute
44.70 per minute may may be charged
be charged
3190 Holmium laser apparatus (ophthalmic): Hire fee - -
for one or both eyes done in one sitting
3201 Ophthalmic laser apparatus: Hire fee for one or - -

both eyes done in one sitting (refer to item
5930 for surgical laser apparatus)
3202 Phako emulcification apparatus: Hire fee - -
3203 Vitrectomy apparatus: Hire fee - -
17 EAR
Please note: The items of this section are placed in a more logical order but due to a problem to renumber
existing items, the item numbers will notfollow in numerical order. A new range of numbers are added for
section 17.6 Microsurgery of the skull base, namely items 5221 to 5252.
v Per Consultation
x By arrangement
T Time Units

17.1 External ear (Pinna):

Units N$ Units N$
- -
MAJOR CONGENITAL DEFORMITY - -
RECONSTRUCTION OF EXTERNAL EAR:
3267 Unilateral 92.00 1 881.00
881.04 5.00 T 532.89
532.90
3269 Bilateral 161.00 3 291.80
291.82 5.00 T 532.89
532.90
3271 Partial or total reconstruction for congenital or ix - -
traumatic absence or following tumour excision
of external ear
3270 Excision of superficial pre-auricular fistula 55.00 1 124.50
124.54 4.00 T 426.31
426.30
3272 Excision of complicated pre-auricular fistula. 93.00 1 901.50
901.49 4.00 T 426.31
426.30
17.2 External ear canal:

Units N$ Units N$
3204 Removal of foreign body at rooms. - -

3205 Removal of foreign body under general 21.00 429.37
429.40 4.00 T 426.31
426.30
anaesthetic
- -
MEATUS ATRESIA: - -
3215 Repair of stenosis of cartilaginous portion 109.00 2 228.60
228.62 4.00 T 426.31
426.30
3217 Congenital 185.00 3 782.50
782.53 4.00 T 426.31
426.30
3219 Removal of osteoma from meatus: Solitary. 60.00 1 226.80
226.77 4.00 T 426.31
426.30
3221 Removal of osteoma from meatus: Multiple. 143.00 2 923.80
923.79 4.00 T 426.31
426.30
17.3 Middle ear:

Units N$ Units N$
3206 Microscopic examination of tympanic 5.00 102.23

102.20 -
membrane including microsuction
3210 Microscope instrument fee used in consulting - -
Units N$ Units N$
rooms
3207 Unilateral myringotomy. 28.00 572.49
572.50 4.00 T 426.31
426.30
3209 Bilateral myringotomy. 34.00 695.17
695.20 4.00 T 426.31
426.30
3211 Unilateral myringotomy with insertion of 34.00 695.17
695.20 4.00 T 426.31
426.30
ventilation tube
3212 Bilateral myringotomy with insertion of 42.00 858.74
858.70 4.00 T 426.31
426.30
unilateral ventilation tube.
3213 Bilateral myringotomy with insertion of bilateral 60.00 1 226.80
226.77 4.00 T 426.31
426.30
ventilation tubes.
3214 Reconstruction of middle ear ossicles 204.00 4 171.00 -
(ossiculoplasty)
3237 Exploratory tympanotomy 59.00 1 206.30
206.32 5.00 T 532.89
532.90
3243 Myringoplasty 92.00 1 881.00
881.04 5.00 T 532.89
532.90
3245 Functional reconstruction of tympanic 185.00 3 782.50
782.53 5.00 T 532.89
532.90
membrane
3249 Stapedotomy and stapedectomy. 185.00 3 782.50
782.53 5.00 T 532.89
532.90
3257 Cortical mastoidectomy. 87.00 1 778.80
778.81 5.00 T 532.89
532.90
3259 Radical mastoidectomy (excluding minor 130.00 2 658.00
657.99 5.00 T 532.89
532.90
procedures)
3260 Computerized static posturography consists of 71.48 1 461.50
461.49 -
standing a patient on a Piezo-electric platform
which tests the vestibular and proprioceptive
systems
3261 Muscle grafting to mastoid cavity without 120.00 2 453.50

453.53 5.00 T 532.89
532.90
tympanoplasty
3263 Autogenous bone graft to mastoid cavity 120.00 2 453.50
453.53 5.00 T 532.89
532.90
3265 Reconstruction of posterior canal wall, 213.00 4 355.00
355.02 5.00 T 532.89
532.90
following radical mastoid
3264 Tympanomastoidectomy. 250.00 5 111.50
111.52 5.00 T 532.89
532.90
3266 Gentamycin instillation into the middle ear for 30.00 613.38
613.40 5.00 T 532.89
532.90
Méniére's disease (myringotomy and cost of
material excluded)
17.4 Facial nerve:
17.4.1 Facial nerve tests:

Units N$ Units N$
3223 Percutaneous stimulation of the facial nerve. 9.00 184.01

184.00 4.00 T 426.31
426.30
3224 Electroneurography (ENOG). 50.00 1 022.30 4.00 T 426.31
426.30
17.4.2 Facial nerve surgery:

Units N$ Units N$
- -
EXPLORATION OF FACIAL NERVE: - -
3227 Exploration of tympanomastiod segment. 185.00 3 782.50
782.53 5.00 T 532.89
532.90
3228 Grafting of the tympanomastoid segment 291.00 5 949.80
949.81 5.00 T 532.89
532.90
(including item 3227)
3230 Extratemporal grafting of the facial nerve. 291.00 5 949.80
949.81 5.00 T 532.89
532.90
3232 Facio-accessory or facio-hypoglossal 83.00 1 697.00
697.03 6.00 T 639.46
639.50
anastomosis
17.5 Inner ear:
17.5.1 Audiometry:

Units N$ Units N$
3273 Pure tone audiometry (air conduction) 4.30 87.92

87.90 -
3274 Pure tone audiometry (bone conduction with 4.30 87.92
87.90 -
masking).
3275 Impedance audiometry (tympanometry). 4.30 87.92
87.90 -
3276 Impedance audiometry (stapedial reflex) - no 4.30 87.92
87.90 -
charge for volume, compliance etc.
3277 Speech audiometry: Inclusive fee (speech 6.70 136.99
137.00 -
audiogram, speech reception threshold,
discrimination score).
3278 Recruitment tests: Inclusive fee (Bekesy, 4.30 87.92
87.90 -
Fowler, etc.)
2691 Short latency brainstem evoked potentials - -
(A.E.P.) neurological examination, single
decibel unilateral
2692 Bilateral. - -
2693 A.E.P. Audiological examination: unilateral at - -
a minimum of 4 decibels
2694 Bilateral - -
2695 Audiology 40Hz response: unilateral. - -
2696 Bilateral. - -
2697 Mid- and long latency auditory evoked - -

Units N$ Units N$
potentials: unilateral
2698 Bilateral. - -
2699 Electro-cochleography: unilateral - -
2700 Bilateral - -
2702 Total fee for audiological evaluation including - 4.00 T 426.30
426.31
bilateral A.E.P. and bilateral electro-
cochleography
3250 Otoacoustic emission (high risk patients only) 66.48 1 359.30
359.26 -
17.5.2 Balance tests:

Units N$ Units N$
3251 Minimal caloric test (excluding consultation 10.00 204.46

204.50 -
fee).
3252 Bithermal Halpike caloric test (excluding 20.00 408.92
408.90 -
consultation fee)
3253 Electro-nystagmography for spontaneous and 25.00 511.15
511.20 -
positional nystagmus.
3255 Caloric test done with electronystagmography 60.00 1 226.80
226.77 -
3254 Video nystagmoscopy (monocular). 25.00 511.15
511.20 -
3256 Video nystagmoscopy (binocular) 50.00 1 022.30 -
3258 Otolith repositioning manoevre 14.00 286.25
286.20 4.00 T 426.31
426.30
17.5.3 Inner ear surgery:

Units N$ Units N$
3233 Labyrinthectomy via the middle ear or mastoid. 185.00 3 782.50

782.53 5.00 T 532.89
532.90
3240 Endolymphatic sac surgery 185.00 3 782.50
782.53 4.00 T 426.31
426.30
3246 Cochlear implant surgery 185.00 3 782.50
782.53 5.00 T 532.89
532.90
3244 Fenestration and occlusion of the posterior 207.00 4 232.30
232.34 5.00 T 532.89
532.90
semicircular canal (F.O.S.) for benign
paroxysmal positioning vertigo (BPPV)

17.6 Microsurgery of the skull base:
17.6.1 Middle fossa approach (i.e. trans temporal or supralabyrinthine):

Units N$ Units N$
3229 Facial nerve: Exploration of the labyrinthine 280.00 5 724.90

724.91 5.00 T 532.89
532.90
segment
5221 Facial nerve: Grafting of labyrinthine segment 340.00 6 951.70
951.67 11.00 T 1 172.30
172.35
(graft removal and exploration of labyrinthine
segment included)
5222 Facial nerve surgery inside the internal 413.00 8 444.20

444.24 11.00 T 1 172.30
172.35
auditory canal (if grafting required and
harvesting of graft included)
5223 Vestibular neurectomy, removal of 353.00 7 217.50
217.47 11.00 T 1 172.30
172.35
supralabyrinthine tumours, or similar
procedures
5224 Removal of acoustic neuroma via the middle 440.00 8 996.30
996.28 11.00 T 1 172.30
172.35
fossa approach
17.6.2 Trans labyrinthine approach:

Units N$ Units N$
5227 Cochleo-vestibular neurectomy 353.00 7 217.50

217.47 11.00 T 1 172.30
172.35
3239 Acoustic neuroma removal translabyrinthine 440.00 8 996.30
996.28 5.00 T 532.89
532.90
5229 Facial nerve surgery in the internal auditory 440.00 8 996.30
996.28 11.00 T 1 172.30
172.35
canal, translabyrinthine (if grafting and graft
removal included)
17.6.3 Transotic approach to the cerebellopontine angle:

Units N$ Units N$
5232 Removal of acoustic neuroma or cyst of the 440.00 8 996.30

996.28 11.00 T 1 172.30
172.35
internal auditory canal

17.6.4 Infratemporal fossa approach type A:

Units N$ Units N$
5235 Removal of tumour for the jugular foramen, 473.00 9 671.00 11.00 T 1 172.30
172.35
internal carotid artery, petrous apex and large
intratemporal tumours
17.6.5 Infratemporal fossa approach type B:

Units N$ Units N$
5238 Removal of tumour of the petrous apex 413.00 8 444.20

444.24 11.00 T 1 172.30
172.35
5239 Removal of tumour of the clivus 413.00 8 444.20
444.24 11.00 T 1 172.30
172.35
17.6.6 Infratemporal approach type C:

Units N$ Units N$
5242 Removal of nasopharyngeal angiofibroma or 347.00 7 094.80 8.00 T 852.62

852.60
carcinoma
5243 Removal of tumour from the infratemporal 347.00 7 094.80 11.00 T 1 172.30
172.35
fossa, pterygopalatine fossa, parasellar region
or nasopharynx
17.6.7 Subtotal petrosectomy:

Units N$ Units N$
5246 Subtotal petrosectomy for removal of temporal 400.00 8 178.40

178.44 11.00 T 1 172.30
172.35
bone tumour
5247 Subtotal petrosectomy for CSF leak and/or for 320.00 6 542.80
542.75 11.00 T 1 172.30
172.35
total obliteration of the mastoid cavity

17.6.8 Petrosectomy and radical dissection of petromandibular fossa:

Units N$ Units N$
5250 Partial mastoido-tympanectomy for 347.00 7 094.80 11.00 T 1 172.30

172.35
malignancy of the deep lobe of the parotid
gland.
5251 Total mastoido-tympanectomy for more 400.00 8 178.40

178.44 8.00 T 852.62
852.60
extensive malignancy of the deep lobe of the
parotid gland
5252 Extended petrosectomy for extensive 440.00 8 996.30
996.28 8.00 T 852.62
852.60
malignancy of the deep lobe of the parotid
gland
18 PHYSICAL TREATMENT:
SPECIAL MODIFIER: SECTION ON PHYSICAL TREATMENT:
0077 When two separate areas are treated simultaneously for totally different conditions, such
treatment shall be regarded as two treatments for which separate fees may be charged. (Only
applicable if services are provided by a specialist in physical medicine)
xi Consultation fee only
T Time Units

Units N$ Units N$
3279 Domiciliary or nursing home treatment (only - -

applicable where a patient is physically
incapable of attending the rooms, and the
equipment has to be transported to the patient)
3280 Consultation units for specialists in physical - -
medicine when treatment is given (per
treatment)
3281 Ultrasonic therapy. - -
3282 Shortwave diathermy. - -
3284 Sensory nerve conduction studies - -
3285 Motor nerve conduction studies - -
Units N$ Units N$
3287 Spinal joint and ligament injection. 13.00 265.80 -

3288 Epidural injection. - -
3289 Multiple injections - First joint. - -
3290 Each additional joint. - -
3291 Tendon or ligament injection. - -
3292 Aspiration of joint or intra-articular injection. - -
3293 Aspiration or injection of bursa or ganglion - -
3294 Paracervical nerve block. - -
3295 Paravertebral root block - unilateral. - -
3296 Paravertebral root block - bilateral. - -
3297 Manipulation of spine performed by a specialist - -
in Physical Medicine.
3298 Spinal traction. - -
3299 Manipulation of large joints under general - 4.00 T 426.30
426.31
anaesthesia: Hip
3300 Manipulation of large joints without anaesthetic ix - -
3301 Muscle fatigue studies - -
3302 Strength duration curve per session - -
3303 Electromyography - -
3304 All other physical treatments carried out: 10.00 204.46
204.50 -
Complete physical treatment: Specify
treatment (For subsequent treatments by a
general practitioner, for the same condition
within 4 months after initial treatment: A fee for
the treatment only, is applicable: See general
rules L and M)

19 RADIOLOGY
Please note: Specialist Radiologists and Nuclear Medicine Specialists must use the 5-digit coding system
for radiology. All other providers of radiology services must continue the 4-digit coding system as outlined in
this section.
DIAGNOSTIC PROCEDURES
Please note: The calculated amounts in this section (except for section 19.10) are calculated according to
the radiology unit values
RULES GOVERNING THIS SECTION RADIOLOGY
Y Except where otherwise indicated, practitioners performing radiology services are entitled to charge
for contrast material used.
Z No fee is subject to more than one reduction
EE Capturing and recording of examinations: Images from all radiological and ultrasound procedures
must be captured during every examination and a permanent record generated by means of film,
paper, or magnetic media. A report of the examination, including the findings and diagnostic
comment, must be written and stored for five years
MODIFIERS GOVERNING THE SECTION OF THE BENCHMARK TARIFF
0080 Multiple examinations: Full Fee.
0081 Repeat examinations: No reduction.
0082 + Means that this item is complementary to a preceding item and is therefore not subject to
reduction.
0083 A reduction of 33,33% (1/3) in the fee will apply to radiological examinations as indicated in section
19 where hospital equipment is used.
0084 Fixed fee of N$ 113.90 will apply for the first film. The same applies to images captured on CD

T Time Units
19.1 Skeleton:
19.1.1 Limbs:

Units N$ Units N$
3305 Finger, toe. 6.30 173.34

173.30 -
6500 Hand 7.70 211.86
211.90 -
6501 Wrist (specify region) 7.70 211.86
211.90 -
6504 Radius and Ulna 7.70 211.86
211.90 -
6505 Elbow 7.70 211.86
211.90 -
6506 Humerus 7.70 211.86
211.90 -
6507 Shoulder 7.70 211.86
211.90 -
6508 Acromio-Clavicula joint 7.70 211.86
211.90 -
6509 Clavicle 7.70 211.86
211.90 -
6510 Scapula 7.70 211.86
211.90 -
6511 Foot 7.70 211.86
211.90 -
6512 Ankle 7.70 211.86
211.90 -
6513 Calcaneus 7.70 211.86
211.90 -
6514 Tibia and fibula 7.70 211.86
211.90 -
6515 Knee 7.70 211.86
211.90 -
6517 Femur 7.70 211.86
211.90 -
6518 Hip 7.70 211.86
211.90 -
3309 Smith-Petersen or equivalent control, in theatre. 38.70 1 064.80 -
3319 Arthrography per joint 15.40 423.72
423.70 -
3320 Introduction of contrast medium or air: Add 13.80 + 379.70 -
19.1.2 Spinal column:

Units N$ Units N$
3321 Per region, e.g. cervical, sacral, coccygeal, 11.00 302.66

302.70 -
one region thoracic
3331 Pelvis (Sacro-iliac or hip joints only to be 11.00 302.66
302.70 -
added where an extra set of views is required).
3333 Lumbar 28.90 795.16
795.20 4.00 T 426.31
426.30
3344 Introduction of contrast medium: Add 18.70 + 514.52
514.50 -
3345 Discography. 34.60 951.99
952.00 4.00 T 426.31
426.30
19.1.3 Skull:

Units N$ Units N$
3349 Skull studies 15.70 431.97

432.00 -
3351 Paranasal sinuses 11.00 302.66
302.70 -
3355 Mandible 9.40 258.63
258.60 -
3367 Temporo-mandibular joints: Per side. 11.00 302.66
302.70 -
3371 Localisation of foreign body in the eye. 15.70 431.97
432.00 -
19.2 Alimentary tract:

Units N$ Units N$
3415 Biliary Tract: E.R.C.P. own equipment: 23.30 641.08

641.10 4.00 T 426.31
426.30
Choledogram and/or pancreatography
screening included.
3417 Gastric/oesophageal/duodenal intubation 5.90 162.33
162.30 -
control
3419 Gastric/oesophageal intubation insertion of 5.60 + 154.08
154.10 -
tube Add
19.3 Biliary tract:

Units N$ Units N$
3427 Intravenous 22.00 605.31

605.30 -

19.4 Chest:

Units N$ Units N$
3445 Chest (item 3601 included). 9.40 258.63

258.60 -
3447 Chest and cardiac studies (item 3601 included) 12.60 346.68
346.70 -
3457 Introduction of contrast medium included 35.70 982.26
982.30 -
3461 Pleurography 12.60 346.68
346.70 3.00 T 319.73
319.70
19.5 Abdomen:

Units N$ Units N$
3477 Control films of the Abdomen (not being part of 9.40 258.63
258.60 -
examination for barium meal, barium enema,
pyelogram, cholecystogram, cholangiogram
etc.)
3479 Acute abdomen or equivalent studies 15.70 431.97
432.00 -
19.6 Urinary tract:

Units N$ Units N$
3487 Control film included and bladder views before 25.10 690.61
690.60 -
and after mictrurition (intraveneus pyelogram)
(item 0206 not applicable)
3493 Waterload test: Add. 12.20 + 335.67
335.70 -
3497 Cystography only or urethrography only 19.30 531.02
531.00 -
(retrograde).
3499 Retrograde 31.90 877.70 -

3503 Introduction of contrast medium: Add 3.70 + 101.80 -
3505 Retrograde-prograde pyelography 18.30 503.51
503.50 3.00 T 319.73
319.70

19.7 Gynaecology and obstetrics:

Units N$ Units N$
3515 Pregnancy 9.40 258.63

258.60 -
3517 Pelvimetry 17.40 478.75
478.70 -
3519 Hystero-salpingography 12.50 343.93
343.90 3.00 T 319.73
319.70
3521 Introduction of contrast medium: Add 15.30 + 420.97
421.00 -
19.8 Vascular studies:
The following rules are applicable to Section 19.8 (Vascular studies) and Section 19.11 (Interventional
Radiological Procedures):
a. The machine fee (items 3536 to 3550 includes the cost of the following:
i. All runs (runs may not be billed for separately).
ii. All film costs (modifier 0084 is not applicable).
iii All fluoroscopy (item 3601 does not apply).
iv All minor consumables (defined as any item other than catheters, guidewires, introducer sets,
specialised catheters, balloon catheters, stents, embolic agents, drugs and contrast media).
b. The machine fee (items 3536 to 3550) may only be billed for as a once off fee per case per day by
the owner of the equipment and is only applicable to radiology practices.
c. If a procedure is performed by a non-radiologist together with a radiologist as a team, in a facility
owned by the radiologist, each member of the team will fee at their respective full rates as per
modifiers and the applicable items.
d. If a procedure is performed by a non-radiologists and a radiologist as a team, in a facility not owned
by the radiologist, modifier 6301 applies.
Please note : Modifier 0083 is not applicable to section 19.8 (Vascular Studies) and section 19.11
(Interventional Radiological Procedures)
MODIFIER GOVERNING VASCULAR STUDIES
6300 If a procedure lasts less than 30 minutes only 50% of the machine fees for items 3536 - 3550 will
be allowed (specify time of procedure on account)
6303 When a procedure is performed entirely by a non-radiologist in a facility owned by a radiologist,

the radiologist owning the facility may charge 55% of the procedure units used.

will be reduced by 20.00 radiological units for each procedure after the initial catheterisation. The
first catheterisation is charged at 100% of the unit value.
0086 Vascular groups: "Film series" and "Introduction of Contrast Media" are complementary and
together constitute a single examination: neither fee is therefore subject to increase in terms of
Modifier 0080.
19.8.1 Film Series
Note: In the case of selective catheterisation of a branch of the aorta, the fee for catheterisation of the aorta
is not added.

Units N$ Units N$
3545 Venography: Per limb 16.50 453.98

454.00 -
3551 Lymphangiogram per limb (global fee) including 166.80 + 4 589.40
589.37 -
lymphatic catheterisation (no machine fee
applicable)
3557 Catheterisation aorta or vena cava, any level, 48.60 + 1 337.20
337.19 4.00 T 426.31
426.30
any route, with aortogram/cavogram
3559 Selective first order catheterisation, arterial or 57.00 1 568.30
568.31 4.00 T 426.31
426.30
venous with angiogram/venogram
3560 Selective second order catheterisation, arterial 65.40 1 799.40
799.43 4.00 T 426.31
426.30
or venous, with angiogram/venogram
3562 Selective third order catheterisation, arterial or 73.20 2 014.00
014.04 4.00 T 426.31
426.30
venous, with angiogram/venogram
3564 Direct femoral arterial or venous or jugular 37.20 1 023.50
023.53 -
venous puncture
3566 Guiding catheter placement, any site arterial or 85.80 2 360.70
360.72 5.00 T 532.89
532.90
venous, for any intracranial procedure or
anteriovenous malformation (AVM)
3569 Intravascular pressure studies, arterial or 19.80 + 544.78
544.80 -
venous, once off per case
3570 Microcatheter insertion, any cranial vessel 130.80 3 598.90
598.86 5.00 T 532.89
532.90
and/or pulmonary vessel, arterial or venous
(including guiding catheter placement)
3572 Transcatheter selective blood sampling, arterial 32.40 891.46
891.50 -
or venous
3574 Spinal angiogram (global fee) including all 480.00 13 206.80
206.81 5.00 T 532.89
532.90
selective catheterisations

19.8.2 Introduction of contrast medium:

Units N$ Units N$
3563 Direct intravenous for limb: Add 7.40 + 203.61

203.60 -
3575 'Cut-downs' for venography: Add 11.00 302.66
302.70 -
19.9 Miscellaneous:

Units N$ Units N$
3604 Bone densitometry (to be charged once only 51.00 1 403.20

403.22 -
for one or more levels done at the same
session)
3605 Mammography: Unilateral or bilateral, including 33.00 907.97
908.00 -
ultrasound and doppler ultrasound
examination, where necessary. This item may
not be used together with a item from the
ultrasound section. Note that when an
ultrasound of the breast is requested without
mammography, item 3629 is used.
3606 Repeat mammography, unilateral or bilateral, 30.00 825.43
825.40 -
for localisation of tumour
3608 Repeat mammography procedure with 40.00 1 100.60
100.57 3.00 T 319.73
319.70
minimally invasive breast biopsy, core biopsy
or fine needle aspiration biopsy utilising
dedicated stereotactic equipmen, with patient
in erect or prone position.
3609 Foreign body localisation: Fee for part - -
examined plus two-thirds for every additional
series plus fluoroscopy fee if this is done.
3611 Foreign body localisation: Introduction of 11.00 + 302.66
302.70 -
sterile needle markers: Add
3613 Setting of sterile trays 3.30 90.80 -
5034 Fine needle aspiration or biopsy or core biopsy 25.00 687.85
687.90 6.00 T 639.46
639.50
of mamma.
6600 General anaesthetic for CT and MRI - 5.00 532.90
532.89
investigations (subject to pre-authorisation)

19.10 Ultrasonic investigations:
Please note: The calculated amounts in this section are calculated according to the ultrasound unit values
Note: See rule EE for requirements for reports and the keeping of records which are also applicable to
ultrasonic investigations.
MODIFIER GOVERNING ULTRASONIC INVESTIGATIONS:
0160 Aspiration of biopsy procedure performed under direct ultrasonic control by an ultrasonic
aspiration biopsy transducer (Static Realtime): Fee for part examined plus 30% of the units.
GENERAL RULE GOVERNING ULTRASONIC EXAMINATIONS DURING PREGNANCY
CC The international norm for antenatal untrasounds during a NORMAL PREGNANCY is three
ultrasound exams
a) The first scan should preferably include a nuchal thickness estimation and be performed during the
first trimester.
b) In case of a referral, the referring doctor must submit a letter of motivation to the radiologist or other
practitioner doing the scan.
c) In case of a referral to a radiologist, no motivation should be required from the radiologist.

Units N$ Units N$
3610 Transrectal ultrasonographic prostate volume 73.00 1 373.00

372.97 5.00 T 532.89
532.90
study for prostate brachytherapy (own
equipment).
3612 Ultrasonic bone densitometry 13.00 244.50 -
3616 Contrast media: General Rule Y applies. - -
3614 Transvaginal aspiration of ova 73.00 1 373.00
372.97 -
5104 Ultrasound in pregnancy, multiple gestation, - -
after ten weeks: add 85%
5026 Ultrasound for amniocentesis 36.00 677.08
677.10 6.00 T 639.46
639.50
5106 Obstetric ultrasound before 10 weeks 17.00 319.73
319.70 -
gestational age for complicated pregnancy i.e.
suspected ectopic pregnancy abortion or
discrepancy between gestational age and
dates. Not to be used for routine diagnosis of
pregnancy. (Note: This code is also referred to

Units N$ Units N$
as a dating scan and is a stand-alone code

that may not be combined with other codes)
3615 Routine obstetric ultrasound at 10 to 20 weeks 59.00 1 109.70
109.66 -
gestational age preferable at 10 to 14 weeks
gestational age to include nuchal translucency
assessment. (Note: This code is also referred
to as a first trimester scan and is a stand-
alone code that may not be combined with any
other codes. The code specifically includes
Doppler studies)
3617 Routine obstetric ultrasound at 20 to 24 weeks 59.00 1 109.70
109.66 -
to include detailed anatomical assessment.
(Note: This code is also referred to as a
second trimester scan and is a stand-alone
code that may not be combined with any other
codes. The code specifically includes Doppler
studies)
5107 Ultrasound after 24 weeks. (Note: This code is 51.00 959.20 -

also referred to as a second trimester scan
and is a stand-alone code that may not be
combined with any other codes. The code
specifically includes Doppler studies)
3618 Pelvic organs ultrasound transabdominal 45.90 863.36
863.40 -
probe, , including Doppler (this is a
gynaecological ultrasound examination and
may not be used in pregnancy)
5108 Second opinion obstetric ultrasound may be 50.00 940.39
940.40 -
charged by practitioners accepted by SASOG
(list of names available from SASOG)
5100 Pelvic organs ultrasound: transvaginal or trans 33.00 620.66
620.70 -
rectal probe
3619 Intravascular ultrasound imaging assesses the 20.00 376.16
376.20 9.00 T 959.19
959.20
atheroschlerotic process to guide the
placement of an intracoronary stent. This item
may be applied once per vessel (left anterior
descending territory, circumflex territory and/or
right coronary territory) in which a stent or
multiple stents are deployed.
3596 Intravascular ultrasound per case, arterial or 20.00 376.16
376.20 -
venous, for intervention
5117 Diagnostic intravascular ultrasound (IVUS) 88.00 1 655.10
655.08 -
imaging or wavewire mapping (without
accompaning angioplasty). May be used only
once per angiographic procedure
5118 Diagnostic intravascular ultrasound imaging or 44.00 899.63
899.60 -
wavewire imaging (with accompanying
angioplasty or accompanying intravascular
ultrasound imaging or wavewire mapping in a
different coronary artery [LAD, Circumflex or
Right coronoary artery]). May be used a
maximum of twice per angiographic procedure
5110 Carotid ultrasound vascular study; B mode, 85.00 1 598.70
598.66 -
pulsed and colour doppler; bilateral study,
internal, external and common carotid flow and
anatomy

Units N$ Units N$
5111 Full ultrasonic and colour Doppler evaluation of 137.00 2 576.70

576.66 -
entire extracranial vascular tree; carotids,
vertebral and subclavian vessels (not to used
together with items 5110, 5112, 5113, 5114)
5112 Peripheral arterial ultrasound vascular study; B 78.00 1 467.00
467.01 -
mode, pulsed and colour doppler; per limb; to
include waveforms at minimum of three levels,
pressure studies at two levels and full
interpretation of results
5113 Peripheral venous ultrasound vascular study; B 78.00 1 467.00
467.01 -
mode, pulsed and colour doppler; to evaluate
deep vein thrombosis
5114 Peripheral venous ultrasound vascular study; B 119.00 2 238.10
238.12 -
mode, pulsed and colour Doppler in erect and
supine position including compression
manoeuvres and reflux in superficial and deep
systems, bilaterally
3634 Peripheral vascular study, B mode only. 26.00 489.00 -

3620 Cardiac examination plus Doppler colour 33.00 620.66
620.70 -
mapping
3621 Cardiac examination (M.Mode) 17.00 319.73
319.70 -
3622 Cardiac examination: 2 Dimensional 33.00 620.66
620.70 -
3623 Cardiac examination + effort: Add 6.70 + 126.01
126.00 -
3624 Cardiac examinations + contrast: Add 6.70 + 126.01
126.00 -
3625 Cardiac examinations + doppler: Add 33.00 + 620.66
620.70 -
3626 Cardiac examination + phonocardiography: Add 6.70 + 126.01
126.00 -
3627 Ultrasound examination includes whole 68.00 1 279.10
279.05 -
abdomen and pelvic organs, where pelvic
organs are clinically indicated (including liver,
gall bladder, spleen, pancreas, abdominal
vascular anatomy, para-aortic area, renal tract,
pelvic organs). Includes a Doppler
examination.
3628 Renal tract 33.00 620.66
620.70 -
5101 Pleural space ultrasound 33.00 620.66
620.70 -
5102 Ultrasound of joints (eg shoulder hip knee), per 33.00 620.66
620.70 -
joint
5103 Ultrasound soft tissue, any region 33.00 620.66
620.70 -
3629 High definition (small parts) scan: thyroid, 33.00 620.66
620.70 -
breast lump, scrotum, etc.
3631 Ophthalmic examination 33.00 620.66
620.70 -
3632 Axial length measurement and calculation of 33.00 620.66
620.70 -
intraocular lens power: per eye
3633 Neonatal head scan 33.00 620.66
620.70 -
3635 + Doppler 26.00 489.00 -
3636 Trans-oesophageal echocardiography including 67.00 1 260.10
260.12 -
passing the device
3637 + Colour Doppler (may be added onto any 52.00 978.00 -

Units N$ Units N$
other regional exam, but not to be added to

items 3605, 3618, 3627, 5110, 5111, 5112,
5113 or 5114.)
5115 Intra-operative ultrasound study 33.00 620.66
620.70 3.00 T 319.73
319.70
MODIFIER GOVERNING ULTRASONIC INVESTIGATIONS:
0160 Aspiration of biopsy procedure performed under direct ultrasonic control by an ultrasonic
aspiration biopsy transducer (Static Realtime): Fee for part examined plus 30% of the units.
GENERAL RULE GOVERNING ULTRASONIC EXAMINATIONS DURING PREGNANCY
CC The international norm for antenatal untrasounds during a NORMAL PREGNANCY is three
ultrasound exams
a) The first scan should preferably include a nuchal thickness estimation and be performed during
the first trimester.
b) In case of a referral, the referring doctor must submit a letter of motivation to the radiologist or
other practitioner doing the scan.
c) In case of a referral to a radiologist, no motivation should be required from the radiologist.
19.11 Interventional radiological procedures:
The following rules are applicable to Section 19.8 (Vascular studies) and Section 19.11 (Interventional
Radiological Procedures):
(a) The machine fee (items 3536 to 3550 includes the cost of the following:
i. All runs (runs may not be billed for separately).
ii. All film costs (modifier 0084 is not applicable).
iii All fluoroscopy (item 3601 does not apply).
iv All minor consumables (defined as any item other than catheters, guidewires, introducer sets,
specialised catheters, balloon catheters, stents, embolic agents, drugs and contrast media).
(b) The machine fee (items 3536 to 3550) may only be billed for as a once off fee per case per day by
the owner of the equipment and is only applicable to radiology practices.
(c) If a procedure is performed by a non-radiologist together with a radiologist as a team, in a facility
owned by the radiologist, each member of the team will fee at their respective full rates as per

modifiers and the applicable items.
(d) If a procedure is performed by a non-radiologists and a radiologist as a team, in a facility not owned
by the radiologist, modifier 6301 applies.
Please note : Modifier 0083 is not applicable to section 19.8 (Vascular Studies) and section 19.11
(Interventional Radiological Procedures)
Note: In regard to multiple examinations see modifier 0080
MODIFIER GOVERNING VASCULAR STUDIES AND INTERVENTIONAL RADIOLOGICAL

PROCEDURES
6300 If a procedure lasts less than 30 minutes only 50% of the machine fees for items 3536-3550 will

0090 Radiologist's fee for participation in a team: 30,00 radiology units per 1/2 hour or part thereof for
all interventional radiological procedures, excluding any pre- or post-operative angiography,
catheterisation, CT-scanning, ultrasound-scanning or x-ray procedures. (Only to be charged if
radiologist is hands-on, and not for interpretation of images only).

Units N$ Units N$
5002 Percutaneous transluminal angioplasty: 102.60 2 823.00

822.96 13.00 T 1 385.50
Aortic/IVC
5004 Percutaneous transluminal angioplasty, arterial 102.60 2 823.00
822.96 13.00 T 1 385.50
or venous, Illiac vessel/subclavian vessel/AV
Fistula
822.96 13.00 T 1 385.50
Femoral to popliteal bifurcation, axilliary and
brachial
5008 Percutaneous transluminal angioplasty: sub- 139.20 3 830.00
829.98 13.00 T 1 385.50

Units N$ Units N$
popliteal sub brachial

829.98 13.00 T 1 385.50
Renal/Visceral/Brachiocephalic
5014 Atherectomy (per vessel) 204.60 5 629.40 -
5016 Aspiration thrombectomy (per vessel) 131.40 3 615.40
615.37 -
5018 On-table thrombolysis/Transcatheter infusion 106.80 2 938.50
938.52 5.00 T 532.89
532.90
performed in angiography suite
5022 Embolisation non-intercranial, per vessel 106.80 2 938.50
938.52 9.00 T 959.19
959.20
5030 Percutaneous nephrostomy for further 73.80 2 030.50
030.55 6.00 T 639.46
639.50
procedure or drainage.
5036 Percutaneous abdominal/pelvis/other drain 34.20 940.99
941.00 -
insertion, any modality.
5038 Intracranial/Spinal AVM embolisation (per 335.40 9 228.30
228.26 13.00 T 1 385.50
session).
5040 Intracranial aneurysm occlusion. 286.80 7 891.10
891.07 13.00 T 1 385.50
5045 Hepatic arterial infusion catheter insertion 156.00 4 292.20
292.21 6.00 T 639.46
639.50
5046 Percutaneous biliary drainage (external). 102.60 2 823.00
822.96 9.00 T 959.19
959.20
5047 Combined internal/external biliary drainage 102.60 2 823.00
822.96 9.00 T 959.19
959.20
5048 Biliary stent insertion. 139.20 3 830.00
829.98 9.00 T 959.19
959.20
5058 Stent insertion: Aortic/IVC - including 139.20 3 830.00
829.98 13.00 T 1 385.50
percutaneous transluminal angioplasty (PTA)
5060 Stent insertion: Illiac/subclavian/AV fistula - 139.20 3 830.00
829.98 13.00 T 1 385.50
including percutaneous transluminal
angioplasty (PTA)
5062 Stent insertion: Femoral popliteal bifurcation, 139.20 3 830.00
829.98 13.00 T 1 385.50
axcilliary and brachial - including percutaneous
transluminal angioplasty (PTA)
5066 Stent insertion: Renal/Visceral/Brachiocephali - 204.60 5 629.40 13.00 T 1 385.50
angioplasty (PTA)
5068 Stent insertion: extracranial Carotid/Vertebral - 204.60 5 629.40 -
angioplasty (PTA)
5070 Stent insertion: Aorto-illiac stent graft - 311.40 8 567.90
567.92 13.00 T 1 385.50
angioplasty (PTA)
5072 Tunnelled/Subcutaneous arteria/venous line. 82.20 2 261.70
261.67 5.00 T 532.89
532.90
5074 IVC filter insertion jugular or femoral route 156.00 4 292.20
292.21 9.00 T 959.19
959.20
5076 Intravascular foreign body removal, arterial or 204.60 5 629.40 9.00 T 959.19
959.20
venous, any route
5078 Percutaneous sclerotherapy of an 70.20 1 931.50 5.00 T 532.89
532.90
arteriovenous malformation (AVM) per session
5082 Transjugular liver biopsy 69.60 1 915.00
914.99 9.00 T 959.19
959.20
5090 Tracheal stent insertion 102.60 2 823.00
822.96 6.00 T 639.46
639.50
5091 GIT Balloon dilatation under fluoroscopy 66.60 1 832.40
832.45 6.00 T 639.46
639.50
5093 Percutaneous gastrostomy in radiology suite 85.80 2 360.70
360.72 -
5094 Cutting needle biopsy with image guidance 22.80 627.32
627.30 -
Units N$ Units N$
5097 Vertebroplasty - Introduction of stabilising - -

material under screening or CT control - per
level
MODIFIER GOVERNING VASCULAR STUDIES AND INTERVENTIONAL RADIOLOGICAL

PROCEDURES
6300 If a procedure lasts less than 30 minutes only 50% of the machine fees for items 3536-3550 will

angiogram investigation is performed at each level, the unit value of each such multiple
procedure will be reduced by 20,00 radiological units for each procedure after the initial
catheterisation. The first catheterisation is charged at 100% of the unit value
0090 Radiologist's fee for participation in a team: 30,00 radiology units per 1/2 hour or part thereof for
all interventional radiological procedures, excluding any pre- or post-operative angiography,
catheterisation, CT-scanning, ultrasound-scanning or x-ray procedures. (Only to be charged if
radiologist is hands-on, and not for interpretation of images only).

20 RADIOSURGERY

Units N$ Units N$
5146 Insertion of afterloading intra-cavitary apparatus - -

under general anaesthetic
5147 Insertion of interstitial guides under general - -
anaesthetic
5926 Stereotactic radiosurgery: Global fee for - -
stereotactic radiosurgery - PROFESSIONAL
COMPONENT (Fee same as recommended
medical aid funds benefits for hospitals with the
proviso that the same rules regarding inclusion
and exclusion should apply)
21 PATHOLOGY
Please note: The calculated amounts in this section are calculated according to the clinical pathology unit
values
0097 Where items under Pathology and Anatomical Pathology fall within the province of other
specialists or general practitioners, the fee is to be charged at two-thirds of the pathologist's fee.
21.1 Haematology:
Item Description Specialist Specialist

Units N$
3713 Bleeding time (does not include the cost of the simplate device) 4.63 104.10
3719 Bone marrow: Aspiration 5.60 125.90
125.91
3720 Bone marrow trephine biopsy. 21.70 487.90
487.89
3721 Bone marrow aspiration and trephine biopsy (excluding histology) 24.50 550.80
550.85
3727 Coagulation time. 2.11 47.40
47.44
3743 Erythrocyte sedimentation rate. 1.67 37.50
37.55
3755 Full blood count (including items 3739, 3762, 3783, 3785, 3791) 7.00 157.40
157.38
3762 Haemoglobin estimation 1.20 27.00
26.98
3785 Leucocytes: total count 1.20 27.00
26.98

Units N$
3786 QBC malaria concentration and fluorescent staining 16.70 375.50

375.47
3791 Packed cell volume: Haematocrit 1.20 27.00
26.98
3797 Platelet count. 1.50 33.70
33.73
3803 Prothrombin determination (two stages) 3.90 87.70
87.69
3805 Prothrombin index. 4.00 89.90
89.93
3837 Partial thromboplastin time. 3.90 87.70
87.69
21.2 Microscopic and miscellaneous tests:

Units N$
3865 Parasites in blood smear 3.73 83.90

83.86
3868 Fungus identification 5.50 123.70
123.66
3869 Faeces (including parasites). 3.27 73.50
73.52
21.3 Serology

Units N$
3932 Antibodies to human immunodeficiency virus (HIV): ELISA. 13.30 299.00

299.03
3942 Hepatitis Viral Ab, Rapid 8.23 185.00
185.04
3947 C-reactive protein. 2.40 54.00
53.96
4614 HIV Ab - Rapid Test 8.00 179.90
179.87
7001 SARS-CoV-2 Ab Rapid Test 8.00 179.90
179.87

21.4 Skin tests:
For skin-prick allergy tests, please refer to items 0218, 0220 and 0221 in Section 2: Integumentary Section
21.5 Biochemical tests: Blood

Units N$
3999 Albumin 3.20 71.90

71.95
4001 Alkaline phosphatase. 3.45 77.60
77.57
4006 Amylase 3.45 77.60
77.57
4009 Bilirubin: total. 3.18 71.50
4010 Bilirubin: conjugated. 2.41 54.20
54.19
4023 Chloride 1.73 38.90
4025 Chol/HDL/LDL/Trig 18.05 405.80
405.83
4026 LDL cholesterol (chemical determination) 4.60 103.40
103.42
4027 Cholesterol total. 3.56 80.00
80.04
4028 HDL cholesterol. 4.60 103.40
103.42
4031 Total CO2 3.45 77.60
77.57
4032 Creatinine. 2.41 54.20
54.19
4049 Glucose tolerance test (2 specimens) 5.98 134.50
134.45
4050 Glucose strip-test with photometric reading 1.20 27.00
26.98
4057 Glucose: Quantitative. 2.41 54.20
54.19
323.09
4064 HbA1c (HPL method) 8.52 191.60
191.56
4075 Blood gases: Panel 1: Astrup/pO2. This panel includes items 4077, 4078 and 4121. 14.70 330.50
330.51
4076 Blood gases: Panel 2: Panel 1 (4075) & ancillary tests. This item also includes items 22.70 510.40
510.38
4077, 4078, 4121, calcium: ionized, Na, K, Glucose, Hb.
4109 Phosphate 2.41 54.20
54.19
4113 Potassium 2.41 54.20
54.19
4114 Sodium. 2.41 54.20
54.19
4117 Protein: total. 2.07 46.50
46.54
4121 pH, pCO2 or pO2: each. 4.50 101.20
101.18
4130 Aspartate aminotransferase (AST). 3.60 80.90
80.94
4131 Alanine aminotransferase (ALT). 3.60 80.90
80.94
4132 Creatine kinase (CK) 3.60 80.90
80.94
4133 Lactate dehydrogenase (LD) 3.60 80.90
80.94
4134 Gamma glutamyl transferase (GGT). 3.60 80.90
80.94
4147 Triglyceride 5.29 118.90
118.94

Units N$
4151 Urea. 2.41 54.20

54.19
4155 Uric acid. 2.52 56.70
56.66
4171 Sodium + potassium + chloride + CO2 + urea 10.56 237.40
237.43
4172 ELISA/EMIT technique 8.28 186.20
186.16
21.6 Biochemical tests: Urine

Units N$
4188 Urine dipstick, per stick (irrespective of the number of tests on stick) 1.00 22.50
22.48
4211 Bile pigments: Qualitative. 1.50 33.70
33.73
4213 Protein: Quantitative. 1.50 33.70
33.73
4218 Glucose: Quantitative. 1.50 33.70
33.73
4221 Creatinine. 2.41 54.20
54.19
4262 Micro Albumin-Qual 3.00 67.50
67.45
4287 Identification of drug: Qualitative 3.00 67.50
67.45
4321 Uric acid. 2.41 54.20
54.19
21.7 Cerebrospinal fluid:

Units N$
4421 Glucose. 2.41 54.20

54.19
21.8 Immunology:

Units N$
4448 HCG: Latex agglutination: Qualitative (side room) 2.67 60.00

60.03
4449 HCG: Latex agglutination: Semi-quantitative (side room) 6.21 139.60
139.62
4450 HCG: Monoclonal immunological: Qualitative 6.67 150.00
149.96

Units N$
4484 Thyrotropin (TSH)/Free Thyroxine (FT4). This item includes items 4507 and 4482. 24.72 555.80
555.79
22 ANATOMICAL PATHOLOGY
Please note: The calculated amounts in this section are calculated according to the anatomical pathology
unit values
22.1 Exfoliative cytology:

Units N$
4559 Cytology preparation using approved liquid bases cytology method: First unit 11.49 234.90
234.93
4560 Cytology preparation using approved liquid bases cytology method: Each additional 4.46 91.20
91.19
unit
4564 Perfomance of fine-needle aspiration for cytology -
23 HUMAN GENETICS
Please note: The calculated amounts in this section are calculated according to the human genetics unit
values
23.1 Cytogenetics:

Units N$
4758 Single Nucleotide Polymorphism ante-natal testing -

4770 Fetal chromosomal aneuploidy (e.g. trsomy21, monosomy X) genomic sequence -
analysis panel, circulating cell-free foetal DNA in maternal blood, must include
analysis of chromosomes 13, 18 and 21.
Comments:
- Item 4770 should be subject to submission of a quotation, pre-authorisation, and
prior determination of available benefits
- Item 4770 should be preceded by pre-test genetic counselling by a suitably
qualified practitioner

IV TRAVELLING EXPENSES
RULE GOVERNING THIS SECTION OF THE BENCHMARK TARIFFS
P Travelling fees
(a) Where, in cases of emergency, a practitioner was called out from his residence or rooms to a
patient's home or the hospital, travelling fees can be charged according to section on travelling
expenses (section IV) if he had to travel more than 16 kilometres in total.
(b) If more than one patient would be attended to during the course of a trip, the full travelling
expenses must be divided between the relevant patients.
(c) A practitioner is not entitled to charge for any travelling expenses or travelling time to his
rooms
(d) Where a practitioner's residence would be more than 8 kilometres away from a hospital, no
travelling fees may be charged for services rendered at such hospitals, except in cases of
emergency (services not voluntarily scheduled)
(e) (Where a practitioner conducts an itinerant practice, he is not entitled to charge fees for
travelling expenses except in cases of emergency services not voluntarily scheduled
(f) For voluntarily scheduled services, fees for travelling expenses may only be charged where the
patient and the practitioner have entered into an agreement to this effect. Medical aid benefits
will not be applicable in such instances
Travelling costs and/or travelling time
When in cases of emergency (refer to general rule P), a doctor has to travel more than 16 kilometres in total
to visit a patient , travelling costs and/ortravelling time can be charged and shall be calculated as follows :
5003 N$ 17.89 for each kilometer in excess of 16 kilometers travelled in own car e.g. where a
practitioner has to travel 19 kilometers in total to visit a patient, the fee shall be calculated as
follows: 19 - 16 = 3 X N$ 17.89 = N$ 53.70
5005 Specialist: 18 clinical procedure units per hour or part thereof
5007 General practitioner: 12 clinical procedure units per hour of part thereof
5013 Travelling fees are not payable to practitioners who assisted at operations on cases referred to
surgeons by them

V LIST OF PROCEDURES WHICH ARE OFTEN DONE IN THE DOCTORS' ROOMS TO WHICH
MODIFIER 0004 SHOULD NOT BE APPLIED
Modifier 0004 is not applicable to the following sections:
All anaesthetic services
Section 19: Radiology

Section 20: Radiosurgery
Section 21: Clinical Pathology (except for items 3719, 3720 and 3721 where
modifier 0004 may be applied)
Please note: This is not a conclusive list and practitioners should not be penalised when patients need to be
admitted to hospital for these procedures.
II REMUNERATION FOR SUPPLIES, MATERIALS AND SPECIAL MEDICINE USED IN

TREATMENT
Setting of sterile tray
1 INJECTIONS, INFUSIONS AND INHALATION SEDATION
0203 Inhalation sedation: Use of analgesic nitrous oxide for alcohol and other withdrawal
states: First quarter-hour or part thereof 0204 Inhalation sedation: Per additional
quarter-hour or part thereof
0206 Intravenous infusions (push-in), patients over two years: Insertion of cannula.
Chargeable once per 24 hours
0208 Therapeutic venesection (not to be used when blood is drawn for the purpose of
laboratory investigations)
0213 Chemotherapy: Intramuscular or subcutaneous: Per injection
0214 Chemotherapy: Intravenous bolus technique: Per injection
0215 Chemotherapy: Intravenous infusion technique: Per injection
2 INTEGUMENTARY SYSTEM
0217 Allergy: First patch

0219 Allergy: Each additional patch
0222 Skin: Intralesional Injection: Single
0223 Skin: Intralesional Injection: Multiple

0225 Skin: Epilation: per session
0227 Skin: Special treatment of severe acne cases, including draining of cysts, expressing of come
domes and/or steaming, abrasive cleaning of skin and UVR per session
0228 Skin: PUVA treatment: Maximum of 21 treatments
0229 Skin: PUVA: Follow-up or maintenance once a week 0230 Skin: UVR treatment
0231 Skin: UVR follow-up: For use of ultraviolet lamp (applied personally by the dermatologist). No
charge to be levied if a nurse or physiotherapist applies the ultraviolet lamp
0233 Skin: Biopsy without suturing: First lesion
0234 Skin: Biopsy without suturing: Subsequent lesions
0235 Skin: Biopsy without suturing: Maximum for multiple additional lesions
0237 Skin: Deep skin biopsy by surgical incision with local anaesthetic and suturing
0241 Skin: Treatment of benign skin lesion by chemo-cryotherapy: First lesion
0242 Skin: Treatment of benign skin lesion by chemo-cryotherapy: Subsequent lesion
0243 Skin: Treatment of benign skin lesion by chemo-cryotherapy: Maximum for multiple additional
lesions
0244 Skin: Repair of nail bed
0245 Skin: Removal of benign lesion by curetting under local or general anaesthesia followed by
diathermy and curetting or electrocautery: First lesion
0246 Skin: Removal of benign lesion by curetting under local or general anaesthesia followed by
diathermy and curetting or electrocautery: Subsequent lesion
0251 Skin: Removal of malignant lesions by curetting under local or general anaesthesia followed by
electrocautery: First lesion
0252 Skin: Removal of malignant lesions by curetting under local or general followed by
electrocautery: Subsequent lesion
0255 Skin: Drainage of subcutaneous abscess onychia, paronychia, pulp space or avulsion of nail
0259 Skin: Removal of foreign body superficial to deep fascia (except hands)
0280 Skin: Laser treatment for small skin lesions: First lesion
0281 Skin: Laser treatment for small skin lesions: Second lesion
0282 Skin: Laser treatment for small skin lesions: Maximum for multiple additional lesions
0283 Skin: Laser treatment for large skin lesions: Limited area
0300 Lacerations, Scars, Tumours, Cysts & other Skin Lesions: Stitching of a wound (with or without
local anaesthesia): Including normal aftercare
0301 Lacerations, Scars, Tumours, Cysts & other Skin Lesions: Additional wounds stitched at same
session (each)
0305 Lacerations, Scars, Tumours, Cysts & other Skin Lesions: Needle Biopsy: soft tissue
0307 Lacerations, Scars, Tumours, Cysts & other Skin Lesions: Excision and repair by direct suture;
excision nail fold or other minor procedures of similar magnitude

0308 Each additional small procedure done at the same time
0316 Breasts: Fine needle aspiration for soft tissue (all areas)
0317 Breasts: Aspiration of cyst or tumour
0377 Standard acupuncture
0378 Laser acupuncture using more than 6 points
0379 Electro-acupuncture
0380 Scalp acupuncture
0381 Micro-acupuncture (ear, hand)
3 MUSCULO-SKELETAL SYSTEM
0547 Dislocation: Clavicle: either end

0549 Dislocation: Shoulder
0551 Dislocation: Elbow
0713 Electromyography
0715 Strength duration curve per session
0717 Electrical examination of single nerve or muscle 0721
0721 Voltage integration during isometric contraction
0727 Cranial reflex study (both early and late responses) supra oculofacial or corneofacial or
flabellofacial: Unilateral
0728 Cranial reflex study (both early and late responses) supra oculofacial or corneofacial or
flabellofacial: Bilateral
0729 Tendon reflex time
0730 Limb-brain somatosensory studies (per limb)
0731 Visio and audio-sensory studies
0733 Motor nerve conduction studies (single nerve)
0735 Examinations of sensory nerve conduction by sweep averages (single nerve)
0740 Muscle fatigue studies
0759 Other single tendon
0887 Limb cast (modifier 0005 not applicable)
0922 Removal of foreign bodies requiring incision: Under local anaesthetic
4 RESPIRATORY SYSTEM
1019 Nasendoscopy in rooms with either rigid or flexible endoscopy (may only be charged for together
with a first consultation)
1031 Removal of single nasal polyp at rooms (at initial consultation only)
1037 Diathermy to nose or pharynx, exclusive of consultation fee, uni-or bilateral: Under local
anaesthetic

1063 Removal of foreign body from nose at rooms
1067 Proof puncture at rooms (unilateral)
1071 Proetz treatment (consultation fee only to be charged for first treatment)
1077 Septum abscess, at rooms, including after-care
1107 Opening of quinsy, at rooms
1117 Laryngeal intubation
1123 Botulinum toxin injection for adductor dysphonia (+ item 0201 + item 0202)
1136 Nebulisation (in rooms)
1143 Paracentesis chest: Diagnostic
1145 Paracentesis chest: Therapeutic
1186 Pulmonary Function Tests: Flow volume test: Inspiration/expiration
1188 Pulmonary Function Tests: Flow volume test: Inspiration/expiration, pre and post bronchodilator,
(to be charged for only with first consultation
- thereafter item 1186 applies)
1189 Forced expirogram only
1191 N2 single breath distribution
1192 Peak expiratory flow only
1193 Functional residual capacity or residual volume: helium, nitrogen open circuit, or other method
1195 Thoracic gas volume
1196 Determination of resistance to airflow, oscillatory or plethysnographic methods
1197 Compliance and resistance using oesophageal balloon
1198 Prolonged post exposure evaluation of bronchospasm with multiple sirometric determinations
after antigen, cold air, methacholine or other chemical agents with subsequent spirometrics
1199 Pulmonary stress testing; simple (e.g.. prolonged exercise test for bronchospasm with pre- and
post-spirometry)
1200 Carbon monoxide diffusing capacity, any method
1201 Maximum inspiratory/expiratory pressure
6 CARDIOVASCULAR SYSTEM
1228 General practitioner's fee for the taking of an ECG only: without effort (1/2 of item 1232)
1229 General practitioner's fee for the taking of an ECG only: without and with effort (1/2 of item
1233)
1230 Physician's fee for interpreting an ECG: without effort
1231 Physician's fee for interpreting an ECG: without and with effort
1232 Electrocardiogram: without effort
1233 Electrocardiogram: without and with effort
1234 Effort electrocardiogram with the aid of a special bicycle ergometer, monitoring apparatus and
availability of associated apparatus

1235 Multi-stage treadmill test
1236 Electrocardiogram: without effort: Under 4 years
1237 24 hour ambulatory blood pressure: Hire fee
1238 24 hour ambulatory ECG monitoring (holter): Hire fee
1239 24 hour ambulatory ECG monitoring (holter): Interpretation
1240 Signal averaged electrocardiogram
1241 X-ray screening: Chest
1242 X-ray screening: Prosthetic valves
1243 2 week event triggered ambulatory ECG monitoring: Hire fee
1244 2 week event triggered ambulatory ECG monitoring: Interpretation
1268 Threshold testing: Own equipment
1312 Evaluation of coronary angiogram by cardiothoracic surgeon
1357 Response to reflex heating
1359 Response to reflex cooling
1361 Cold sensitivity test
1363 Oscillometry test
1365 Sweat test
1367 Doppler blood tests
5369 Doppler arterial pressures
5371 Doppler arterial pressures with exercise
5373 Doppler segmental pressures and wave forms
5375 Venous doppler examination (both limbs)
5377 Venous plethysmography
5379 Supra-orbital doppler test
5381 Carotid non-invasive complex tests
1421 Compression sclerotherapy of varicose veins: Per injection to a maximum of nine injections per
leg (excluding cost of material)
1431 Phase II: Exercise rehabilitation: Per patient per 60 min session with a maximum of 5 patients
per group
1432 Phase III: Exercise rehabilitation: Per patient per 60 min session with a maximum of 10 patients
per group
8 DIGESTIVE SYSTEM
1469 Local excision of mucosal lesion of oral cavity

1485 Local excision of benign lesion of lip
1499 Lip reconstruction following an injury: Direct repair
1507 Local excision of lesion of tongue
1547 Oesophageal acid perfusion test

1580 Oesophageal motility (6 channel + pneumograph + pH pull-through)
1582 Oesophageal motility (4 or 6 channel + pneumograph - ECG + provocative tests for
oesophageal spasm vs. myocardial ischaemia)
1587 Upper gastro-intestinal fibre-optic endoscopy: Hospital equipment
1593 Augmented histamine test: Gastric intubation with x-ray screening
1632 H2 breath test (intestines)
1633 Complete test using lactose or lactulose
1678 Fibre-optic sigmoidoscopy, plus polypectomy
1681 Proctoscopy with removal of polyps: First time
1683 Proctoscopy with removal of polyps: Subsequent times
1719 Rubber band ligation of haemorrhoids: Per haemorrhoid
1721 Sclerosing injection for haemorrhoids: Per injection
1725 Drainage of external thrombosed pile
1729 Excision of anal skin tags
1748 Body composition measured by bio-electrical impedance
1780 Gastric and duodenal intubation
1801 Diagnostic paracentesis: Abdomen
1803 Therapeutic paracentesis: Abdomen
10 URINARY SYSTEM
1841 Renal biopsy (needle)

1847 Haemodialysis: Per hour or part thereof
1849 Haemodialysis: Maximum: Eight hours
1851 Haemodialysis: Thereafter per week
1875 Percutaneous aspiration cyst: Nephrostomy, pyelostomy
1945 Instillation of radio-opaque material for cystography or urethrocystography
1947 Instillation of anti-carcinogenic agent including retention time, but not cost of material or hydro
dilatation of bladder
1949 Cystoscopy
1989 Cystometrogram
1991 Flowmetric bladder studies with videocystograph
1992 Flowmetric bladder studies without videocystograph
1993 Bladder catheterisation: Male (not during operation)
1994 Bladder catheterisation: Female (not during operation)
11 MALE GENITAL SYSTEM
2154 Induction of artificial erection

12 FEMALE GENITAL SYSTEM
2271 Removal of tag or polyp

2272 Removal of small superficial benign lesions
2312 Artificial insemination
2314 Intra-uterine insemination
2315 Simms Huhner test plus wet smear
2339 Colpotomy: diagnostic
2389 Paracervical nerve block
2392 Cryo- or electro- cauterisation, or Lletz of cervix (excluding cost of disposable loop electrode): In
consulting rooms
2399 Punch biopsy
2400 Biopsy during pregnancy
2415 Cervix encirclage: Removal items 2409 and 2411 without anaesthetic
2425 Removal of cervical polyps
2429 Colpomicroscopy
2434 Endometrial biopsy
2435 Hysterosalpingogram
2442 Insertion of IUCD
2506 Trans cervical gamete/embryo intrafallopian tube transfer (TET/TEST)
2565 Implantation hormone pellets (excluding after-care)
13 OBSTETRIC PROCEDURES
2603 External cephalic version 2605 Amniocentesis

2605 Amniocentesis
2610 Tococardiography pre-natal and intrapartum: Including stress and non-stress test (own machine)
2611 Chorion villus biopsy
14 NERVOUS SYSTEM
2681 Visual evoked potentials (VEP): Unilateral

2682 Visual evoked potentials (VEP): Bilateral
2683 Electroretinography (Ganzfeld method): Unilateral
2684 Electroretinography (Ganzfeld method): Bilateral
2685 Electro-oculography: Unilateral

2686 Electro-oculography: Bilateral
2687 VEP stable condition (photic drive): Unilateral
2689 VEP stable condition (photic drive): Bilateral
2690 Total fee for full evaluation of visual tracts including bilateral electroretinography and V.E.P.
2703 Somatosensory evoked potentials (SEP) single nerve examination to brachial - or Lumbosacral
plexus, spinal cord and cortex.
2705 Transcutaneous nerve stimulation in the treatment of post-operative and chronic intractable
pain: Per treatment
2707 Full fee for complete neurological evoked potential evaluation, including neurological AEP,
bilateral VEP and bilateral median and/or posterior tibial stimulation.
2708 Evaluation of cognitive evoked potential with visual or audiology stimulus
2709 Full spinogram including bilateral median and posterior-tibial studies
2710 Morphia saturation testing in rooms (consultation x2 plus item 0206: intravenous infusion)
(excluding injection material) 2711 Electro-encephalography: Taking of record
2712 Electro-encephalography: Interpretation
6001 Sleep electro-encephalography: infants that fit into a perambulator: taking of record
6002 Sleep electro-encephalography: infants that fit into a perambulator: interpretation
6003 Sleep electro-encephalography: adults and children over infant age: taking of record
6004 Sleep electro-encephalography: adults and children over infant age: interpretation 2717
Electromyography: First
2718 Electromyography: Subsequent
2725 Angiography carotids: Unilateral
2726 Angiography carotids: Bilateral
2727 Vertebral artery: Direct needling
2729 Vertebral catheterisation
2731 Air encephalography and posterior fossa tomography: injection of air (independent procedure)
2735 Posterior fossa tomography attendance by clinician
2737 Visual field charting on Bjerrum Screen
2739 Ventricular needling without burring: Tapping only
2741 Ventricular needling without burring: Plus introduction of air and/or contrast dye for
ventriculography
2743 Subdural tapping: First sitting
2745 Subdural tapping: Subsequent
2765 Nerve conduction studies (see item 0733 and 3285)
6005 Botulinum toxin injections: For blepharospasm (+ item 0201+ item 0202)
6006 Botulinum toxin injections: For hemifacial spasm (+ item 0201 + item 0202)
6007 Botulinum toxin injections: For adductor dysphonia (+ item 0201 + item 0202)
6008 Botulinum toxin injections: In extra-ocular muscles (+ item 0201 + item 0202)
6009 Botulinum toxin injections: For spasmodic torticollis and/or cranial dystonia (+ item 0201 + item

0202)
2789 Trigeminal: Injection of alcohol
2791 Trigeminal: Injection of cortisone
2793 Trigeminal: Coagulation through high frequency
2800 Procedures for pain relief: Plexus nerve block
2802 Procedures for pain relief: Peripheral nerve block
2803 Alcohol injection in peripheral nerves for pain: Unilateral
2805 Alcohol injection in peripheral nerves for pain: Bilateral
2815 Interdigital
2849 Sympathetic block: Other levels: Unilateral
2851 Sympathetic block: Other levels: Bilateral
2853 Sympathetic block: Other levels: Diagnostic
2957 Individual psychotherapy (specific type): Including play therapy for children: Per short session
(20 minutes)
2974 Individual psychotherapy (specific type): Including play therapy for children: Per intermediate
session (40 minutes) 2975 Individual psychotherapy (specific type): Including play therapy for
children: Per extended session (60 minutes)
2958 Psychoanalytic therapy: Per 60-minute session
2962 Directive therapy to family, parent(s), spouse: Per 20 minute session
2963 Pairs, marriage or sex therapy: Per 20 minute session
2976 Intermediate treatment where either items 2962 or 2963 are used: Per 40 minute session 2977
Extended treatment where either items 2962 or 2963 are used: Per 60 minute session 2968
2968 Group therapy
2973 Psychometry (specify examination): Per session (Maximum of 3 sessions per examination)
2970 Electro-convulsive treatment (ECT): Each time (See rule Va)
2971 Intravenous anti-depressive medication through infusion: Per push in (Maximum 1 push in per
24 hours)
2972 Narco-analysis (Maximum of 3 sessions per treatment): Per session
15 ENDOCRINE SYSTEM
3001 Implantation of pellets (excluding cost of material)
16 EYE
3002 Gonioscopy
3003 Fundus contact lens or 90 D lens examination

3004 Peripheral fundus examination with indirect ophthalmoscope
3005 Endothelial cell count
3006 Keratometry
3007 Potential acuity measurement
3008 Contrast sensitivity test
3009 Orthoptic consultation
3010 Orthoptic subsequent sessions
3011 Pre-surgical retinal examination before retinal surgery
3012 Ocular motility assessment: Comprehensive examination
3013 Tonometry: Per test with maximum of 2 tests for provocative tonometry(one or both eyes)
3014 Charting of visual field with manual perimeter
3015 Retinal threshold test without storage facilities
3016 Retinal threshold test inclusive of computer disc storage for Delta or Statpak programs
3017 Retinal threshold trend evaluation (additional to item 3017)
3018 Ocular muscle function with Hess screen or perimeter
3021 Retinal function assessment including refraction after ocular surgery (within four months),
maximum two examinations 3022 Digital fluorescein video angiography
3023 Digital indocyanine video angiography
3025 Electronic tonography
3027 Fundus photography
3029 Anterior segment microphotography
3032 Eyelid and orbit photography
3033 Interpretation of item 3031 referred by other clinician
3034 Determination of lens implant power per eye
3036 Corneal topography: For pathological corneas only on special motivation. For refractive surgery
- may be charged once pre-operative and once post-operative per sitting (for one or both eyes)
3060 Use of own surgical microscope for surgery or examination (not for slit lamp microscope)(for use
by ophthalmologists only)
3074 Adjustment of sutures if not done at the time of operation (additional fee for sterile tray - see
item 0202)
3089 Subconjunctival injection if not done at time of operation
3091 Retrobulbar injection if not done at time of operation 3092 External laser treatment for superficial
3111 Contact lenses: Assessment involving preliminary fittings and tolerance visits (costs of lenses
borne by patient)
3113 Fitting of contact lenses and instructions to patient: Includes eye examination, first fitting of the
contact lenses and further post-fitting visits for 1 year
3115 Fitting of only one contact lens and instructions to the patient: Eye examination, first fitting of the
contact lens and further post-fitting visits for one year included
3117 Cornea: Removal of foreign body: On the basis of fee per consultation

3118 Curettage of cornea after removal of foreign body
3119 Cornea: Tattooing
3124 Removal of corneal stitches under microscope (maximum of 2 procedures) Additional fee for
sterile tray (see item 0202)
3127 Cauterization of cornea (by chemical, thermal or cryotherapy methods)
3141 Sealing of punctum
3143 Three-snip operation
3163 Excision of superficial lid tumour
3167 Diathermy to wart on lid margin
3169 Electrolysis of any number of eyelashes
3171 Excision of Meibomian cyst
3174 Botulinum toxin injection for blepharospasm
3177 Entropion or ectropion by: Cautery
3192 If a practitioner performs the procedure in his own facility an excimer laser theatre fee of N$
44.70 per minute may be charged
3198 Excimer laser: Hire fee
3201 Laser apparatus: Hire fee for one or both eyes done in one sitting
3202 Phako emulsification apparatus: Hire fee
3203 Vitrectomy apparatus: Hire fee
17 EAR
3204 External ear canal: Removal of foreign body at rooms

3206 Microscopic examination of tympanic membrane including microsuction
3210 Microscope instrument fee used in consulting rooms
3260 Computerized static posturography consists of standing a patient on a Piezo-electric platform
which tests the vestibular and proprioceptive systems
3223 Percutaneous stimulation of the facial nerve
3224 Electroneurography (ENOG)
2693 A.E.P. Audiological examination: unilateral at a minimum of 4 decibels: Unilateral
2694 A.E.P. Audiological examination: unilateral at a minimum of 4 decibels: Bilateral
2695 Audiology 40Hz response: unilateralsystems
2696 Audiology 40Hz response: Bilateral
2697 Mid- and long latency auditory evoked potentials: unilateral
2698 Mid- and long latency auditory evoked potentials: Bilateral
2699 Otoacoustic emission (high risk patients only)
2700 Minimal caloric test (excluding consultation fee)
2701 Bithermal Halpike caloric test (excluding consultation fee)
2702 Electro-nystagmography for spontaneous and positional nystagmus

2703 Video nystagmoscopy (monocular)
2704 Caloric test done with electro-nystagmography
2705 Video nystagmoscopy (binocular)
2706 Pure tone audiometry (air conduction)
2707 Pure tone audiometry (bone conduction)
2708 Impedance audiometry (tympanometry)
2709 Impedance audiometry (stapedial reflex) - no charge for volume, compliance etc.
2710 Speech audiometry: Inclusive fee (speech audiogram, speech reception threshold,
discrimination score) 3278 Recruitment tests: Inclusive fee (Bekesy, Fowler, etc.)
2691 Short latency brainstem evoked potentials (A.E.P.) neurological examination, single decibel
unilateral 2692 Bilateral.
18 PHYSICAL TREATMENT
3279 Domiciliary or nursing/home treatment (only applicable where a patient is physically incapable of
attending rooms, and equipment has to be transported to patient
3280 Consultation units for specialists in physical medicine when treatment is given (per treatment)
3281 Ultrasonic therapy
3282 Shortwave diathermy
3284 Sensory nerve conduction studies
3285 Motor nerve conduction studies
3287 Spinal joint and ligament injection
3289 Multiple injections: First joint
3290 Multiple injections: Each additional joint
3291 Tendon or ligament injection
3292 Aspiration of joint or inter-articular injection
3293 Aspiration or injection of bursa or ganglion
3294 Paracervical nerve block
3295 Paravertebral root block: Unilateral
3296 Paravertebral root block: Bilateral
3297 Manipulation of spine performed by a specialist in Physical Medicine
3298 Spinal traction
3299 Manipulation of large joints without anaesthetic
3300 Muscle fatigue studies
3301 Strength duration curve per session
3302 Electromyography
3303 All other physical treatment: specify treatment
19 RADIOLOGY

3610 Transrectal ultra sonographic prostate volume study for prostate brachytherapy (own
equipment) 3612 Ultrasonic bone densitometry
3615 Ultrasonic investigations: Fetal maturity
3617 Ultrasonic investigations: Fetal maturity follow up (same pregnancy)
3619 Intravascular ultrasound imaging assesses the atherosclerotic process to guide therapeutic
interventions. The composition and distribution of the plaque can be visualised by a cross-
sectional "slice" of the artery (per vessel)
3618 Ultrasonic investigations: Pelvic organs (vaginal or abdominal probe)
3620 Ultrasonic investigations: Cardiac examination plus Doppler colour mapping
3621 Ultrasonic investigations: Cardiac examination (M.Mode)
3622 Ultrasonic investigations: Cardiac examination: 2 Dimensional
3623 Ultrasonic investigations: Cardiac examination + effort
3624 Ultrasonic investigations: Cardiac examinations + contrast
3625 Ultrasonic investigations: Cardiac examinations + doppler
3626 Ultrasonic investigations: Cardiac examination + phonocardiography
3627 Ultrasonic investigations: Ultrasound examination must include whole abdomen (including liver,
gall bladder, spleen, pancreas, abdominal vascular anatomy, para-aortic area, renal tract, pelvic
organs)
3628 Ultrasonic investigations: Renal tract
3629 Ultrasonic investigations: High definition scan (small parts): Thyroid, breast lump, scrotum, etc.
3630 Ultrasonic investigations: Ophthalmic examination
3631 Ultrasonic investigations: Axial length measurement and calculation of intraocular lens power
3632 Ultrasonic investigations: Peripheral vascular scan
3633 Ultrasonic investigations: + Doppler
3634 Ultrasonic investigations: Trans-oesophageal echocardiography including passing the device.
3635 Ultrasonic investigations: + Colour Duplex (may be added onto any other regional exam, but not
to be added to items 3605, 5110, 5111, 5112, 5113 or 5114)
VI AFTER-CARE
a 0 Days
CODE
0209 1179 1676 2088 3117

0222 1202 1677 2103 3118
0223 1211 1678 2111 3127
0233 1215 1681 2123 3204
0243 1216 1685 2154 3287
0304 1218 1743 2171 3288
0317 1247 1770 2175 3295
0353 1248 1772 2181 3296
0539 1249 1774 2183 3297
0541 1250 1778 2235
0661 1251 1782 2273
0665 1252 1841 2285
0670 1253 1843 2312
0737 1254 1845 2313
0741 1255 1847 2314
0763 1256 1849 2322
0869 1257 1852 2389
0873 1260 1875 2397
0891 1261 1945 2399
0893 1262 1947 2409
0925 1264 1949 2429
0969 1273 1951 2433
1005 1276 1952 2434
1019 1284 1953 2436
1025 1286 1954 2437
1035 1289 1959 2438
1037 1356 1961 2439
1039 1439 1963 2441
1043 1535 1965 2478
1054 1539 1967 2504
1079 1545 1969 2605
1117 1547 1971 2609
1118 1549 1976 2610
1123 1550 1979 2611
1125 1551 1981 2669
1130 1552 1983 2705
1131 1554 1984 2713
1132 1557 1987 2714
1133 1578 1989 2739
1134 1582 1991 2741

1135 1584 1992 2743
1137 1587 1994 2745
1139 1588 1995 2799
1141 1589 1996 2800
1142 1591 2049 2802
1143 1593 2059 2849
1145 1626 2063 2970
1147 1627 2065 3089
1153 1633 2067 3091
1155 1654 2069 3095
b 10 Days
CODE
0227 1531 3135

0241 1537 3141
0244 1705 3143
0251 1719 3163
0255 1721 3165
0257 1725 3169
0259 1729 3171
0261 1737 3174
0300 2073 3175
0302 2099 3205
0307 2113 3207
0310 2125 3211
0311 2127 3212
0313 2129
0473 2133
0543 2137
0545 2139
0571 2169
0669 2177
0865 2215
0883 2227
0919 2237
0922 2271

0923 2275
0924 2279
0929 2281
1003 2283
1013 2289
1015 2293
1024 2295
1027 2297
1031 2318
1052 2331
1063 2339
1065 2392
1067 2396
1077 2443
1099 2448
1107 2455
1113 2480
1223 2481
1429 2496
1463 2497
1465 2499
1467 2500
1469 2789
1473 2801
1485 2803
1499 3008
1509 3133
c 90 Days
CODE
0271 0435 0583 0701 0847 0993 1159 1667 1819 1999 2155
2367 2779 2927 3105 0273 0437 0585 0703 0849 0995 1161

1668 1821 2001 2157 2368 2785 2928 3107 0275 0439 0586
0705 0851 0996 1163 1669 1823 2003 2159 2369 2811 2929
3109 0279 0441 0589 0707 0853 0997 1164 1670 1825 2005
2161 2373 2815 2930 3110 0283 0443 0592 0709 0859 0999
1167 1671 1827 2007 2163 2377 2825 2931 3121 0284 0445
0593 0711 0861 1001 1169 1673 1829 2008 2165 2379 2827
2933 3123 0285 0449 0597 0712 0863 1007 1171 1675 1831
2009 2173 2381 2829 2935 3125 0289 0451 0598 0743 0868
1009 1175 1687 1833 2010 2174 2383 2831 2937 3130 0290
0452 0599 0744 0884 1011 1181 1689 1835 2011 2185 2391
2833 2939 3132 0291 0455 0600 0745 0885 1017 1183 1691
1837 2012 2187 2405 2839 2940 3137 0292 0456 0601 0746
0886 1020 1184 1695 1839 2013 2189 2407 2843 2951 3139
0293 0464 0602 0747 0897 1022 1185 1697 1853 2017 2191
2411 2846 2953 3145 0294 0465 0603 0755 0901 1029 1222
1701 1855 2019 2195 2421 2855 2955 3149 0295 0475 0604
0757 0903 1030 1224 1703 1857 2020 2197 2423 2859 2983
3151 0315 0479 0605 0759 0905 1033 1225 1707 1859 2021
2199 2427 2860 2985 3153 0319 0497 0607 0767 0906 1034
1226 1709 1861 2023 2201 2445 2861 2987 3155 0321 0499
0614 0769 0907 1045 1258 1711 1863 2025 2203 2449 2863
2989 3157 0323 0501 0615 0771 0910 1047 1259 1713 1865
2027 2205 2451 2864 2991 3161 0324 0503 0617 0773 0911
1049 1263 1715 1869 2031 2207 2452 2865 2993 3173 0325
0505 0619 0774 0912 1051 1265 1723 1870 2033 2209 2453
2867 2995 3177 0329 0507 0620 0775 0913 1053 1266 1727
1871 2035 2212 2461 2869 3037 3179 0330 0511 0621 0776
0914 1055 1267 1731 1873 2039 2213 2467 2871 3039 3181
0331 0512 0622 0777 0915 1057 1282 1733 1877 2041 2219
2469 2873 3041 3183 0334 0514 0623 0780 0921 1058 1290
1735 1879 2043 2223 2471 2875 3044 3185 0335 0516 0624
0781 0927 1059 1294 1739 1881 2045 2225 2473 2876 3045
3187 0337 0521 0625 0782 0930 1060 1295 1741 1883 2047
2229 2475 2877 3047 3191 0341 0523 0626 0783 0931 1061
1297 1745 1885 2071 2231 2477 2878 3049 3193 0355 0527
0627 0784 0933 1069 1299 1747 1887 2075 2233 2483 2879
3051 3195 0359 0528 0631 0785 0935 1081 1301 1749 1889
2077 2239 2485 2883 3057 3197 0361 0530 0635 0787 0937
1083 1302 1751 1891 2079 2241 2487 2884 3059 3199 0363

0532 0637 0789 0939 1084 1305 1753 1893 2081 2243 2489
2885 3061 3200 0369 0533 0639 0790 0940 1085 1307 1755
1894 2083 2247 2490 2886 3062 3215 0371 0534 0643 0791
0941 1087 1308 1757 1895 2085 2249 2492 2889 3063 3217
0373 0535 0645 0792 0943 1089 1311 1759 1897 2086 2251
2501 2891 3064 3219 0374 0537 0646 0793 0947 1093 1323
1761 1899 2087 2253 2525 2893 3065 3227 0375 0547 0649
0794 0948 1095 1325 1762 1901 2089 2254 2527 2895 3067
3228 0376 0549 0650 0796 0952 1097 1327 1763 1903 2091
2255 2529 2897 3071 3229 0383 0551 0667 0803 0954 1101
1329 1767 1905 2093 2257 2531 2898 3073 3230 0387 0552
0673 0809 0956 1102 1330 1769 1907 2095 2259 2532 2899
3075 3232 0389 0553 0675 0811 0957 1105 1331 1773 1911
2097 2277 2535 2900 3076 3233 0391 0555 0677 0812 0958
1106 1332 1775 1915 2105 2280 2541 2901 3081 3237 0392
0556 0678 0813 0959 1110 1333 1777 1917 2109 2307 2546
2903 3083 3239 0402 0557 0679 0815 0961 1111 1335 1783
1919 2115 2309 2550 2904 3085 3240 0403 0559 0680 0817
0963 1112 1337 1785 1921 2116 2311 2553 2905 3087 3243
0405 0561 0682 0821 0971 1115 1338 1789 1923 2117 2321
2570 2907 3088 3244 0409 0563 0683 0823 0983 1119 1339
1791 1925 2121 2323 2747 2909 3092 3245 0413 0565 0685
0825 0985 1126 1340 1793 1927 2132 2327 2751 2910 3093
0417 0567 0687 0829 0987 1127 1341 1810 1931 2141 2343
2753 2911 3096 0419 0569 0691 0831 0988 1129 1342 1811
1933 2143 2345 2755 2913 3097 0421 0571 0693 0835 0989
1138 1344 1812 1937 2145 2357 2767 2916 3098 0425 0573
0695 0837 0990 1149 1345 1813 1964 2147 2361 2769 2919
3099 0429 0578 0697 0845 0991 1151 1348 1815 1973 2149
2365 2773 2923 3100 0433 0582 0699 0846 0992 1157 1666
1817 1985 2153 2366 2777 2925 3101
Long consultations (general practitioner), due to an emergency or the necessity for the practitioner's
prolonged attention to a patient for services for which no other fee may be charged: After first 1/2 hour (for
which the appropriate consultation item should be charged) (excluding time used for additional procedures):
Per 1/4 hour or part thereof (duration of long consultation should be stated on the account)

2023 - General Practitioners and Family Medicine (014 & 015) V2

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NAMIBIAN BENCHMARK TARIFFS FOR SERVICES BY GENERAL PRACTITIONERS AND

THIS SCHEDULE IN NO WAY CONSTITUTES AN AGREEMENT BETWEEN ANY PARTIES.

ALL BENCHMARK TARIFFS ARE INCLUSIVE OF VAT

GENERAL RULES GOVERNING THE BENCHMARK TARIFFS

Every account shall contain the following particulars:

i. The name and practice number of the consulting practitioner.

2023/01/16 © The Namibian Association of Medical Aid Funds 1

G Post-operative care: (Refer to Section VI)

2023/01/16 © The Namibian Association of Medical Aid Funds 2

M Procedure planned to be performed later: In cases where, during a consultation/visit, a procedure is

2023/01/16 © The Namibian Association of Medical Aid Funds 3

RULES GOVERNING THIS SPECIFIC SECTION OF THE BENCHMARK TARIFFS

2023/01/16 © The Namibian Association of Medical Aid Funds 4

RULE GOVERNING THE SECTION OBSTETRIC PROCEDURES

U ANTE NATAL CARE

RULES GOVERNING THE SECTION MEDICAL PSYCHOTHERAPY

2023/01/16 © The Namibian Association of Medical Aid Funds 5

Z No fee is subject to more than one reduction

RULES GOVERNING THE SECTION ACUPUNCTURE

MONETARY VALUE OF UNITS

BB The monetary values of the units are as follows:

2023/01/16 © The Namibian Association of Medical Aid Funds 6

RULE GOVERNING ULTRASONIC EXAMINATIONS

RULES GOVERNING THE SECTION URINARY SYSTEM

2023/01/16 © The Namibian Association of Medical Aid Funds 7

RULES GOVERNING DIAGNOSTIC SERVICES

RULES GOVERNING ENDOSCOPIC PROCEDURES

FF Gastro-intestinal Radiofrequency Therapy for Gastro-Oesophageal Reflux Disease (GORD) and

RULES GOVERNING PATHOLOGY

2023/01/16 © The Namibian Association of Medical Aid Funds 8

GENERAL MODIFIERS GOVERNING THE BENCHMARK TARIFFS

Modifier 0004 is not applicable to the following sections:

All anaesthetic services

0005 Multiple therapeutic procedures/operations under the same anaesthetic:

2023/01/16 © The Namibian Association of Medical Aid Funds 9

0007 Use of own equipment

Modifier 0008 may only be used under the following circumstances:

2023/01/16 © The Namibian Association of Medical Aid Funds 10

INJECTIONS, INFUSIONS AND INHALATION SEDATION

MODIFIERS GOVERNING THIS SPECIFIC SECTION OF THE BENCHMARK TARIFFS

0017 Injections administered by practitioners: When desensitization, intravenous, intramuscular or

2023/01/16 © The Namibian Association of Medical Aid Funds 11

MODIFIER GOVERNING SURGERY ON NEONATES OR LOW BIRTH WEIGHT INFANTS

MODIFIERS GOVERNING THE ADMINISTRATION OF ANAESTHETIC FOR ALL THE PROCEDURES

2023/01/16 © The Namibian Association of Medical Aid Funds 12

0024 Pre-operative assessments not followed by procedures: If a pre-operative assessment of a patient

2023/01/16 © The Namibian Association of Medical Aid Funds 13

0037 Utilisation of total body hypothermia: Add 3,00 anaesthetic units

0041 Utilisation of hyperbaric pressurisation: Add 3,00 anaesthetic units

0042 Utilisation of extracorporeal circulation: Add 3,00 anaesthetic units

2023/01/16 © The Namibian Association of Medical Aid Funds 14

MODIFIERS GOVERNING ANAESTHETIC FEES FOR ORTHOPAEDIC OPERATIONS

Modifiers 5441 to 5448

5443 Maxillary and orbital bones - Add THREE anaesthetic units

5444 Shaft of femur - Add FOUR anaesthetic units

POST-OPERATIVE ALLEVIATION OF PAIN

0045 Post-operative alleviation of pain

2023/01/16 © The Namibian Association of Medical Aid Funds 15

MODIFIER GOVERNING FEES FOR AN ANAESTHESIOLOGIST OPERATING INTRA-AORTIC

MODIFIERS GOVERNING THIS SPECIFIC SECTION OF THE BENCHMARK TARIFFS

2023/01/16 © The Namibian Association of Medical Aid Funds 16

MODIFIER GOVERNING COMBINED PROCEDURES ON THE SPINE

MODIFIERS GOVERNING THE SUBSECTION REPLANTATION OPERATION