PROPOSED GUIDELINE TARIFFS FOR MEDICAL PRACTITIONERS

To be published in terms of Section 53 (3) (d) of the HEALTH PROFESSIONS ACT (56 OF
1974)
Note that this schedule is based on the 2006 NHRPL which was inflated by 46.66%.
The 2006 NHRPL is available in database format at http://www.hpcsa.co.za

10000

Version

Add CF

Units BF

Value Flag CF

11400

Units BF

Value Flag CF

In terms of section 53(1) of the Health Professions Act, 1974 (Act No. 56 of 1974) every person registered under the Act (in this section referred to as the
practitioner) shall, unless the circumstances render it impossible for him or her to do so, before rendering any professional services inform the person to whom the
services are to be rendered or any person responsible for the maintenance of such person, of the fee which he or she intends to charge for such services (a)

when so requested by the person concerned; or

(b)

when such fee exceeds the Guideline Tariffs for such services,

11000

Units BF

Value Flag
-

and shall in a case to which paragraph (b) relates, also inform the person concerned of the usual fee.

Every person registered under the Act shall, unless the circumstances render it impossible for him or her to do so, before rendering any professional services also
inform the person to whom the services are to be rendered or any person responsible for the maintenance of such person, of the fee which he or she intends to
charge for such services if such fee exceeds the medical aid rates.

A.

B.

RULES GOVERNING THE STRUCTURE

Consultations: Definitions: (a) New and established patients: A consultation/visit refers to a clinical 2004.00
situation where a medical practitioner personally obtains a patients medical history, performs an
appropriate clinical examination and, if indicated, administers treatment, prescribes or assists with
advice. These services must be face-to-face with the patient and excludes the time spent doing
special investigations which receive additional remuneration. (b) Subsequent visits: Refers to a
voluntarily scheduled visit performed within four (4) months after the first visit. It may imply taking
down a medical history and/or a clinical examination and/or prescribing or administering of treatment
and/or counseling. (c) Hospital visits: Where a procedure or operation was done, hospital visits are
regarded as part of the normal after-care and no fees may be levied (unless otherwise indicated).
Where no procedure or operation was carried out, fees may be charged for hospital visits according
to the appropriate hospital or inpatient follow-up visit code.

Normal hours and after hours: After-hours services are paid at the same rate as benefits for normal 2006.04
hours services. Bona fide emergency medical services rendered to a patient, at any time, may
attract a fee as specified in modifier 0011 and items 0146 or 0147 (which should be added to the
appropriate consultative services code selected from items 0190-0192, 0173-0175, 0161-0164,
0166-0169)

Page 1 of 84

C.

Comparable services: A service may be rendered that is not listed in this edition of the coding
2005.02
structure. The fee that may be charged in respect of the rendering of a service not listed in this
coding structure shall be based on the fee in respect of a comparable service. For these
procedure(s)/service(s), item 6999: Unlisted procedure or service code, should be used. Please
contact the SA Medical Association (SAMA) Private Practice Unit via e-mail on
coding@samedical.org to obtain a comparable code for the unlisted procedure/service which will be
based on the fee for a comparable service in the coding structure. When item 6999 is used to
indicate that an unlisted service was rendered, the use of the item must be supported by a special
report. This report must include: (1) An adequate definition or description of the nature, extent and
need for the procedure/service or medical necessity; (2) In which respect is this service unusual or
different in technique, compared to available procedures/services listed in the coding structure?
Information regarding the nature and extent of the procedure/service, time and effort,
special/dedicated equipment needed to provide this service, must be included in the report; (3) Is
this procedure/service medically appropriate under the circumstances? Explain why another
procedure/service listed in the coding structure will not be appropriate in this case; (4) A description
of the complexity of the symptoms and concurrent problems must be supplied; (5) Final diagnosis
supported by the appropriate ICD-10 code(s); (6) Pertinent physical findings (size, location and
number of lesions if applicable); (7) Mention any other diagnostic or therapeutic
procedure(s)/service(s) provided at the same session; (8) Any further diagnostic or therapeutic
procedure(s)/service(s) to be provided in the follow-up period; and (9) Description of the follow-up
care needed. Please note: This comparable service code may not be used for a period longer than
six months for a particular procedure/service after which time an application has to be made for the
addition of a specific code for this procedure

D.

Cancellation of appointments: Unless timely steps are taken to cancel an appointment for a
2004.00
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 visit at or away from doctor's rooms as the case may be

E.

Pre-operative visits: The appropriate fee may be charged for all pre-operative visits with the
exception of a routine pre-operative visit at the hospital
Administering of injections and/or infusions: Where applicable, fees for administering injections
and/or infusions may only be charged when done by the practitioner himself
Post-operative care: (a) Unless otherwise stated, the fee in respect of an operation or procedure
shall include normal after-care for a period not exceeding ONE month (after-care is excluded from
pure diagnostic procedures during which no therapeutic procedures were performed). (b) If the
normal after-care is delegated to any other registered health professional and not completed by the
surgeon, it shall be his/her own responsibility to arrange for this to be done without extra charge. (c)
When post-operative care/treatment of a prolonged or specialised nature is required, such fee as
may be agreed upon between the surgeon and the scheme or the patient (in case of a private
account) may be charged. (d) Normal after-care refers to an uncomplicated post-operative period
not requiring any further incisions

2004.00

2004.00

2004.00

H.
J.

Removal of lesions: Items involving removal of lesions include follow-up treatment for 10 days
2004.00
Disproportionately low fees: In exceptional cases where the fee is disproportionately low in relation 2004.00
to the actual services rendered by a medical practitioner, a higher fee may be negotiated. The use of
this rule is not intended merely to increase the Medical Schemes Benefits.

K.

Practice of specialists: In terms of the conditions in respect of the practice of specialists as

2004.00
published in Government Gazette No. 12958 of 11 January 1991, 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 scheme 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

2004.00
consultation/visit, the fee for the visit PLUS the fee for the procedure is charged
Procedure planned to be performed later: In cases where, during a consultation/visit, a procedure is 2004.00
planned to be performed at a later occasion, a visit may not be charged for again, at such a later
occasion

F.
G.

M.

Page 2 of 84

Per consultation: No additional fee may be charged for a service for which the fee is indicated as 2004.00
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
Costly or prolonged medical services or procedures: In the case of costly or prolonged medical
2004.00
services or procedures, the medical practitioner shall first ascertain from the medical scheme for
what amount the medical scheme will accept responsibility in respect of such treatment, should the
practitioner wish any direct payment from the scheme
Travelling fees: (a) Where, in cases of emergency, a practitioner was called out from his residence 2004.00
or rooms to a patient's home or the hospital, travelling fees can be charged according to the section
on travelling expenses (section IV) if he had to travel more than 16 kilometres in total. (b) If more
than one patient would be attended to during the course of a trip, the full travelling expenses must be
divided between the relevant patients. (c) A practitioner is not entitled to charge for any travelling
expenses or travelling time to his rooms. (d) Where a practitioner's residence would be more than 8
kilometres away from a hospital, no travelling fees may be charged for services rendered at such
hospitals, except in cases of emergency (services not voluntarily scheduled). (e) Where a
practitioner conducts an itinerant practice, he is not entitled to charge fees for travelling expenses
except in cases of emergency (services not voluntarily scheduled). (f) For voluntarily scheduled
services, fees for travelling expenses may only be charged where the patient and the practitioner
have entered into an agreement to this effect. Medical scheme benefits will not be applicable in
such instances.
Intensive care/High Care: Units in respect of items 1204 to 1210 (Categories 1 to 3) EXCLUDE the 2006.05
following: (a) Anaesthetic and/or surgical fees for any condition or procedure, as well as a first
consultation/visit, which is, regarded as the assessment of the patient, while the daily intensive
care/high care fee covers the daily care in the intensive/high care unit. (b) Cost of any drugs and/or
materials. (c) Any other cost which may be incurred before, during or after the consultation/visit
and/or the therapy. (d) Blood gases and chemistry tests, including the arterial puncture to obtain the
specimen. (e) Procedural items 1202 and 1212 to 1221. but INCLUDE the following: (f) Performing
and interpretation of a resting ECG. (g) Interpretation of chemistry tests and x-rays. (h) Intravenous
treatment (items 0206 and 0207), except intravenous infusion in patients under the age of three
years (item 0205) that does not form a part of the daily ICU/High Care fee and may be charged for
separately on a daily basis (fee includes the introduction of the cannula as well as the daily
management)
Multiple organ failure: Units for items 1208, 1209 and 1210 (Category 3: Cases with multiple organ 2004.00
failure) include resuscitation (i.e. item 1211: Cardio-respiratory resuscitation)
Ventilation: Units for items 1212, 1213 and 1214 (ventilation) include the following: (a)
2004.00
Measurement of minute volume, vital capacity, time- and vital capacity studies. (b) Testing and
connecting the machine. (c) Putting patient on machine: setting machine, synchronising patient with
machine. (d) Instruction to nursing staff. (e) All subsequent visits for 24 hours.
Ventilation (items 1212 to 1214) does not form a part of normal post-operative care, but may not be 2004.00
added to item 1204: Category 1: Cases requiring intensive monitoring
Obstetric procedures: (a) When a general practitioner treats a patient in the ante-natal period and, 2004.00
after starting the confinement, requests an obstetrician to take over the case, the general practitioner
shall be entitled to charge for all the ante-natal consultations he/she has performed. (i) If the patient
has been in labour for less than 6 hours, the general practitioner shall charge 50,00 clinical
procedure units according to item 2614: Global obstetric care. (ii) If the patient has been in labour
for more than 6 hours, the general practitioner shall charge 80,00 clinical procedure units according
to item 2614: Global obstetric care. (b) When a general practitioner calls an obstetrician to help with
a confinement, take over the management of a confinement, and treats the patient until after the postpartum visit, the obstetrician shall charge according to item 2614: Global obstetric care. (c) When a
general practitioner calls an obstetrician (specialist or general practitioner) to help with a
confinement, or take over the management of a confinement, but the general practitioner treats the
patient until after the post-partum visit, the obstetrician shall charge according to item 2616:
Intrapartum obstetric care by obstetrician in consultation, and the general practitioner according to
item 2614: Global obstetric care.

V.

(a) Electro-convulsive treatment: 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.
(b) Except where otherwise indicated, the duration of a medical psychotherapeutic session is set at
20 minutes or part thereof, provided that such a part comprises 50% or more of the time of a
session. This set duration is also applicable for psychiatric examination methods

2004.00

Y.

Except where otherwise indicated, radiologists are entitled to charge for contrast material used

2004.00

N.

O.

P.

Q.

R.
S.

T.
U.

Page 3 of 84

Z.
AA.
BB.
CC.

EE.

FF.

GG.

RR.

XX.

YY.

0002

0004

No fee is subject to more than one reduction

Procedures to exclude cost of isotope
The fees in this section (radiation oncology) do NOT include the cost of radium or isotopes
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
Ultrasound examinations: The international norm approved for use in South Africa for NORMAL
PREGNANCY is two ultrasound exams: (a) The first scan should preferably include a nuchal
thickness estimation and be performed between 10 and 14 weeks gestation. The second scan
should be performed between 20 and 24 weeks and should include a full anatomical report. All
subsequent ultrasound scans are excluded from the benefits of medical schemes unless
accompanied by proper motivation. An ultrasound scan to assess an abnormal early pregnancy may
be formed before 10 weeks but this scan may not be used to diagnose a normal uncomplicated
pregnancy. Item 3618 is a gynaecological scan and its use is not approved for use in pregnancy. (b)
In cases where the scan is performed by the attending practitioner, a clear indication for such a scan
must be entered on the account rendered, or a letter of motivation must be attached to the account
(the practitioner must elect one of the two options). (c) In case of a referral, the referring doctor must
submit a letter of motivation to the radiologist or other practitioner doing the scan. A copy of the
letter of motivation must be attached to the first account rendered to the patient (by the radiologist or
the other practitioner doing the scan) and must be attached to the first account submitted to the
medical scheme by the patient or the doctor, as the case may be. (d) In case of a referral to a
radiologist, no motivation should be required from the radiologist

2004.00
2004.00
2004.00
2004.00

2004.00

(a) When a cystoscopy precedes a related operation, Modifier 0013: Endoscopic examination done
at an operation, applies, e.g. cystoscopy followed by transurethral (TUR) prostatectomy. (b) When a
cystoscopy precedes an unrelated operation, Modifier 0005: Multiple procedures/operations under
the same anaesthetic, applies, e.g. cystoscopy for urinary tract infection followed by inguinal hernia
repair. (c) No modifier applies to item 1949: Cystoscopy, when performed together with any of items
1951 to 1973.
Capturing and recording of examinations: Images from all radiological, ultrasound and magnetic
resonance imaging procedures must be captured during every examination and a permanent record
generated by means of film, paper, or magnetic media. A report of the examination, including the
findings and diagnostic comment, must be written and stored for five years
The radiology section in this price list is not for use by registered specialist radiology practices (Pr No
"038") or nuclear medicine practices (Pr No "025"), but only for use by other specialist practices or
general practitioners.
A separate radiology schedule is for the exclusive use of registered specialist radiology practices (Pr
No "038") and nuclear medicine practices (Pr No "025").
Diagnostic services rendered to hospital inpatients: Quote Modifier 0091 on all accounts for
diagnostic services (e.g. MRI, X-rays, pathology tests) performed on patients officially admitted to
hospital or day clinic
Diagnostic services rendered to outpatients: Quote Modifier 0092 on all accounts for diagnostic
services (e.g. MRI, X-rays, pathology tests) performed on patients NOT officially admitted to hospital
or day clinic (could be within the confines of a hospital)
MODIFIERS GOVERNING THE STRUCTURE
Written report on X-rays: The lowest level code for a new patient office (consulting rooms) visit, is
applicable only where a radiologist is requested to give a written report on X-rays taken elsewhere
and submitted to him. The above mentioned item and the lowest level initial hospital visit code, as
appropriate are not to be used for routine reporting of X-rays taken elsewhere

2004.00

2004.00

2004.00

2004.00

2004.00

2004.00

Procedures performed in own procedure rooms: Procedures performed in doctors' own procedure 2006.05
rooms instead of in a hospital theatre or unattached theatre unit: as per fee for procedure + 100%
(the value of modifier 0004 equals 100% of the value of the procedure performed). See Section V
(Section G in SAMA's DBT) for a list of procedures, which are often done in rooms to which Modifier
0004 should not be applied. Please note: Only the medical practitioner who owns the facility and the
equipment may charge modifier 0004. Only one person may claim this modifier for procedures
performed in doctors' own procedure rooms

Page 4 of 84

0005

Multiple therapeutic procedures/operations under the same anaesthetic:

2004.00

Visiting specialists performing procedures: Where specialists visit smaller centres to perform
2004.00
procedures, fees for these particular procedures are exclusive of after-care. The referring
practitioner will then be entitled to subsequent hospital visits for after-care. If the referring practitioner
is not available, the specialist shall, on consultation with the patient, choose an appropriate locum
tenens. Both the surgeon and the practitioner who handled the after-care, must in such instances
quote Modifier 0006 with the particular items which they use
a) Use of own monitoring equipment in the rooms: Remuneration for the use of any type of own
2004.00
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.

139.85

a) Unless otherwise identified in the tariff when multiple therapeutic procedures/operations add
significant time and/or complexity, and when each procedure/operation is clearly identified and
defined, the following values shall prevail: 100% (full value) for the first or major
procedure/operation, 75% for the second procedure/operation, 50% for the third
procedure/operation, 25% for the fourth and subsequent procedures/operations. This modifier does
not apply to purely diagnostic procedures.
b) In the case of multiple fractures and/or dislocations the above values shall prevail.
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) Please note: 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 used in addition to another definitive procedure and is therefore not
subject to reduction according to Modifier 0005 (see also Modifier 0082)

0006

0007

0008
0009

0010

0011

b) Use of own equipment in hospital theatre or unattached theatre unit: Remuneration for the use of
any type of own equipment for procedures performed in a hospital theatre or unattached theatre unit
when appropriate equipment is not provided by the hospital - 15,00 clinical procedure units
irrespective of the number of items of equipment provided.
Specialist surgeon assistant: Where a procedure requires a registered specialist surgeon assistant,
the fee is 33,33% (1/3) of the fee for the specialist surgeon
Assistant: The fee for an assistant is 20% of the fee for the specialist surgeon, with a minimum of
36,00 clinical procedure units. The minimum fee payable may not be less than 36,00 clinical
procedures units
Local anaesthetic: (a) A fee for a local anaesthetic administered by the operator may only be
charged for (1) an operation or procedure having a value greater than 30,00 clinical procedure units
(i.e. 31,00 or more clinical procedure units allocated to a single item) or (2) where more than one
operation or procedure is done at the same time with a combined value greater than 50,00 clinical
procedure units. (b) The fee shall be calculated according to the basic anaesthetic units for the
specific operation. Anaesthetic time may not be charged for, but the minimum fee as per Modifier
0036: Anaesthetic administered by a general practitioner, shall be applicable in such a case. (c) Not
applicable to radiological procedures (such as angiography and myelography. (d) No fee may be
levied for topical application of local anaesthetic. (e) Please note: Modifier 0010: Local anaesthetic
administered by the operator, may not be added on the surgeons account for procedures that were
performed under general anaesthetic.
Emergency procedures: Any bona fide, justifiable emergency procedure (all hours) undertaken in an
operating theatre and/or in another setting in lieu of an operating theatre, will attract an additional
12,00 clinical procedure units per half-hour or part thereof of the operating time for all members of
the surgical team. Modifier 0011 does not apply in respect of patients on scheduled lists. (A medical
emergency is any condition where death or irreparable harm to the patient will result if there are
undue delays in receiving appropriate medical treatment)

20

15.000 1.0 R

139.85

20

15.000 1.0 R

2004.00

2004.00

2004.00

2006.04

Page 5 of 84

0013

0014

0015

Endoscopic examinations done at operations: Where a related endoscopic examination is done at 2004.00
an operation by the operating surgeon or the attending anaesthesiologist, only 50% of the fee for the
endoscopic examination may be charged
Operations previously performed by other surgeons: Where an operation is performed which has
2004.00
been previously performed by another surgeon, e.g. a revision or repeat operation, the fee shall be
calculated according to the tariff for the full operation plus an additional fee to be negotiated under
general Rule J: In exceptional cases where the fee is disproportionately low in relation to actual
service rendered, except where already specified in the tariff
Intravenous infusions: Where intravenous infusions (including blood and blood cellular products) are 2004.00
administered as part of the after-treatment after the operation or confinement, no extra fees shall be
charged as this is included in the global operative or maternity fees. Should the practitioner doing
the operation or attending to the maternity case prefer to ask another practitioner to perform postoperative or post-confinement intravenous infusions, then the practitioner himself (and not the
patient) shall be responsible for remunerating such practitioner for the infusions

112.91

0017

Injections administered by practitioners: When desensitisation, intravenous, intramuscular or

2005.06
subcutaneous injections are administered by the practitioner him-/herself to patients who attend the
consulting rooms, a first injection forms part of the consultation/visit and only all subsequent
injections for the same condition should be charged at 7.50 consultative services units using modifier
0017 to reflect the amount (not chargeable together with a consultation item)

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

2004.00

0019

Surgery on neonates (up to and including 28 days after birth) and low birth weight infants (less than 2004.00
2500g) under general anaesthesia (excluding circumcision): per fee for procedure + 50% for
surgeons and a 50% increase in anaesthetic time units for anaesthesiologists
Where in the treatment of a specific fracture or dislocation (compound or closed) an initial procedure 2004.00
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 assistants fee where
applicable. After one month, a full fee as for the initial treatment, is applicable

0046

0047
0048

0049

0050

0051

0053

0055
0057

0058

A fracture NOT requiring reduction shall be charged on a fee per service basis
Where in the treatment of a fracture or dislocation, an initial closed reduction is followed within one
month by further closed reductions under general anaesthesia, the fee for such subsequent
reductions will be 27,00 clinical procedure units (not including after-care)
Except where otherwise specified, in cases of compound fractures, 77,00 clinical procedure units
(specialists) and 77,00 clinical procedure units (general practitioners) are to be added to the units for
the fractures including debridement
In cases of a compound fracture where a debridement is followed by internal fixation (excluding
fixation with Kirschner wires, as well as fractures of hands and feet), the full amount according to
either Modifier 0049: Cases of compound fractures, or Modifier 0051: Fractures requiring open
reduction, internal fixation, external skeletal fixation and/or bone grafting, may be added to the fee
for the procedure involved, plus half of the amount according to the second modifier (either Modifier
0049: Cases of compound fractures or Modifier 0051: Fractures requiring open reduction, internal
fixation, external skeletal fixation and/or bone grafting, as applicable)

10

7.500 1.0 R

112.91

10

7.500 1.0 R

2004.00
2004.00

20

27.000 1.0 R

251.72

20

27.000 1.0 R

251.72

2004.11

20

77.000 1.0 R

717.87

20

77.000 1.0 R

717.87

2004.00

20 115.500 1.0 R 1 076.79

20 115.500 1.0 R 1 076.79

Fractures requiring open reduction, internal fixation, external skeletal fixation and/or bone grafting:
2004.11
Specialists add 77,00 clinical procedure units. General practitioners add 77,00 clinical procedure
units
Fracture requiring percutaneous internal fixation [insertion and removal of fixatives (wires) in respect 2004.00
of fingers and toes included]: Specialists and general practitioners add 32,00 clinical procedure units

20

77.000 1.0 R

717.87

20

77.000 1.0 R

717.87

20

32.000 1.0 R

298.33

20

32.000 1.0 R

298.33

Dislocation requiring open reduction: Units for the specific joint plus 77,00 clinical procedure units for 2004.11
specialists. General practitioners add 77,00 clinical procedure units
Multiple procedures on feet: In multiple procedures on feet, fees for the first foot are calculated
2004.00
according to Modifier 0005: Multiple procedures/operations under the same anaesthetic. Calculate
fees for the second foot in the same way, reduce the total to 75% and add to the total for the first
foot
Revision operation for total joint replacement and immediate re-substitution (infected or non2004.00
infected): per fee for total joint replacement + 100%

20

77.000 1.0 R

717.87

20

77.000 1.0 R

717.87

Page 6 of 84

0061

0063
0064
0065

0066
0067

0069

0070
0072
0073

0074

0075

0077

Combined procedures on the spine: In cases of combined procedures on the spine, both the
orthopaedic surgeon and the neurosurgeon are entitled to the full fee for the relevant part of the
operation performed
Where two specialists work together on a replantation procedure, each shall be entitled to two-thirds
of the fee for the procedure
Where the replantation is unsuccessful, no further surgical fee is payable for amputation of the nonviable parts
Additional operative procedures by same surgeon, under section 3.8.6: Spinal deformities, within a
period of 12 months: 75% of scheduled fee for the lesser procedure, except where otherwise
specified elsewhere
Microsurgery of the fallopian-tubes and ovaries: Where micro-surgical techniques are used, with the
aid of a microscope, 25% may be added to the fee
Microsurgery of the larynx: Add 25% to the fee of the operation performed (for other operations
requiring the use of an operation microscope, the fee include the use of the microscope, except
where otherwise specified elsewhere in the Tariff)
When endoscopic instruments are used during intranasal surgery: Add 10% of the fee of the
procedure performed. Only applicable to items 1025, 1027, 1030, 1033, 1035, 1036, 1039, 1047,
1054 and 1083
Add 45,00 clinical procedure units to procedure(s) performed through a thorascope
Non invasive peripheral vascular tests: The number of tests in a single case is restricted to two (2)
per diagnosis. Tests are not justified in cases of uncomplicated varicose veins
When item 1288 (Cardiac catheterisation for congenital heart disease: All ages above 1 year old) or
item 1289 (Paediatric cardiac catheterisation: Infants below the age of one year) is performed by
paediatric cardiologists (33): fee for procedure + 100%
Endoscopic procedures performed with own equipment: The basic procedure fee plus 33.33% (1/3)
of that fee ("+" codes excluded) will apply where endoscopic procedures are performed with own
equipment.
Endoscopic procedures performed in own procedure room: The fee plus 21,00 clinical procedure
units will apply where endoscopic procedures are performed in rooms with own equipment. This fee
is chargeable by medical practitioners who own or rent the facility. Please note: Modifier 0075 is not
applicable to any of the items for diagnostic procedures in the otorhinolaryngology sections of the
tariff.
Physical treatment: When two separate areas are treated simultaneously for totally different
conditions, such treatment shall be regarded as two treatments for which separate fees may be
charged. (Only applicable if services are provided by a specialist in physical medicine)
When a testis biopsy is done combined with vasogram or seminal vesiculogram or epididymogram,
add 50% of the units for the appropriate procedure
When a first consultation/visit proceeds into, or is immediately followed by a medical
psychotherapeutic procedure, fees for the procedure are calculated according to the appropriate
individual psychotherapy code (items 2957, 2974 or 2975)
Multiple examinations: Full Fee
Repeat examinations: No reduction
+ Means that this item is complementary to a preceding item and is therefore not subject to
reduction
A reduction of 33,33% (1/3) in the fee will apply to radiological examinations as indicated in section
19: Radiology where hospital equipment is used
Film costs: In the case of radiological items where films are used, practitioners should adjust the fee
upwards or downwards in accordance with changes in the price of films in comparison with
November 1979; the calculation must be done on the basis that film costs comprise 10% of the
monetary value of the unit (This information is obtainable from the Radiological Society of SA)

2004.00

2004.00

2004.00

2004.00

2004.00

2004.00

2004.00

419.54
-

2004.00
2004.00

20

45.000 1.0 R

419.54
-

20

45.000 1.0 R

2004.00

2004.00

195.79

2004.00

20

21.000 1.0 R

195.79

20

21.000 1.0 R

2004.00

2004.00

2004.00

2004.00
2004.00
2004.00

2004.00

2004.00

0085

Left Side' modifier to be added to when items 6500 to 6519 are used when the left side is examined. 2004.00
Please note that the absence of this modifier indicates that the right side was examined

0086

Vascular groups: Film series and Introduction of Contrast Media are complementary and together 2004.00
constitute a single examination: neither fee is therefore subject to increase in terms of Modifier 0080:
Multiple examinations
Radiologists fee for participation in a team: 30,00 radiology units per hour or part thereof for all
2004.00
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)

0078
0079

0080
0081
0082
0083
0084

0090

Page 7 of 84

Diagnostic services rendered to hospital inpatients: Quote Modifier 0091 on all accounts for
2004.00
diagnostic services (e.g. MRI, X-rays, pathology tests) performed on patients officially admitted to
hospital or day clinic (refer to Rule XX)
Diagnostic services rendered to outpatients: Quote Modifier 0092 on all accounts for diagnostic
2004.00
services (e.g. MRI, X-rays, pathology tests) performed on patients NOT officially admitted to hospital
or day clinic (could be within the confines of a hospital) (refer to Rule YY)
Radiation materials: Exclusively for use where radiation materials supplied by the practice are used 2004.00
by clinical and radiation oncologists, modifier 0095 should be used to identify these materials. A
material code list with descriptions and guideline costs for these materials, maintained and updated
on a regular basis, will be supplied by the Society of Clinical and Radiation Oncology. This modifier
is only chargeable by the practice responsible for the cost of this material and where the hospital did
not charge therefore. Please note that item 0201 should not be used for these materials

0096

Radio-isotope therapy patients who fail to keep their appointments: Fee will include cost of isotope

2004.00

0097

Pathology tests performed by non-pathologists: Where items under Clinical Pathology (section 21)
and Anatomical Pathology (section 22) fall within the province of other specialists or general
practitioners, the fee is to be charged at two-thirds of the pathologists fee
Aspiration of biopsy procedure performed under direct ultrasound control by an ultrasound aspiration
biopsy transducer (Static Realtime): Fee for part examined plus 30% of the units
Use of contrast during ultrasound study: add 6.00 ultrasound units
Ultrasound in pregnancy, multiple gestation, after twenty weeks: plus 30%
In order to charge the full fee (600,00 magnetic resonance units) for an examination of a specific
single anatomical region, it should be performed with the applicable radio frequency coil including T1
and T2 weighted images on at least two planes
Where a limited series of a specific anatomical region is performed (except bone tumour), e.g. a T2
weighted image of a bone for an occult stress fracture, not more than two-thirds (2/3) of the fee may
be charged. Also applicable to all radiotherapy planning studies, per region
All post-contrast studies (except bone tumour), including perfusion studies, to be charges at 50% of
the fee
Post-contrast study: Bone tumour: 100% of the fee
Limited examination of the hypophysis e.g. where a coronal T1 and sagittal T1 series are performed,
two-thirds (2/3) of the fee is applicable
Where, in a limited hypophysis examination, Gadolinium is administered and coronal T1 and sagittal
T1 series are repeated, a single full fee for the entire examination is applicable + cost of Gadolinium
+ disposable items
Where a magnetic resonance angiography (MRA) of large vessels is performed as primary
examination, 100% of the fee is applicable. This modifier is only applicable if the series is performed
by use of a recognised angiographic software package with reconstruction capability

2004.00

2004.00

53.31
-

Where a magnetic resonance angiography (MRA) of the vessels is performed additional to an

examination of a particular region, 50% of the fee is applicable for the angiography. This modifier is
only applicable if the series is performed by use of a recognised angiographic software package with
reconstruction capability
Where only a gradient echo series is performed with a machine without a recognised angiographic
software package with reconstruction ability, 20% of the full fee is applicable specifying that it is a
flow sensitive series
Very limited studies to be charged at 33,33% of the full fee e.g. MR urography for renal colic,
diffusion studies of the brain additional to routine brain
MRI spectroscopy: 50% of fee
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)
If a procedure is performed by a radiologist in a facility not owned by himself, the fee will be reduced
by 40% (i.e. 60% of the fee will be charged)
When the procedure is performed by a non-radiologist, the fee will be reduced by 40% (i.e. 60% of
the fee will be charged)
When a procedure is performed entirely by a non-radiologist in a facility owned by a radiologist, the
radiologist owning the facility may charge 55% of the procedure units used. Modifier 6302 applies to
the non radiologist performing the procedure
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

0091

0092

0095

0160
0165
5104
6100

6101

6102
6103
6104
6105

6106

6107

6108

6109
6110
6300
6301
6302
6303

6305

2004.00
2004.00
2004.00

60

6.000 1.0 R

53.31
-

60

6.000 1.0 R

2004.00

2004.00

2004.00
2004.00

2004.00

2004.00

2004.00

2004.00

2004.00

2004.00
2004.00

2004.00

2004.00

2004.00

2004.00

Page 8 of 84

I.
I.a
I.b
I.b.1
0161

0162

0163

0164

0166

0167

0168

0169

I.c
0190

0191

0192

0173

0174

Consultative Services
General Practitioner visits
Specialists tiered consultation structure
New and established patients: Consultations/visits by psychiatrists (22) only
Psychiatry ('22'): New and established patients: Consultation/visit of new or established patient with
problem focused history, clinical examination and straightforward decision making for minor problem.
Typically occupies the doctor personally with the patient between 10 and 20 minutes (for hospital
consultation/visit by psychiatrist - refer to items 0166-0169)
Psychiatry ('22'): New and established patients: Consultation/visit of new or established patient with
detailed history, clinical examination and straightforward decision making and counselling. Typically
occupies the doctor personally with the patient between 21 and 35 minutes (for hospital
consultation/visit by psychiatrist - refer to items 0166-0169)
Psychiatry ('22'): New and established patients: Consultation/visit of new or established patient with
detailed history, complete clinical examination and moderately complex decision making and
counselling. Typically occupies the doctor personally with the patient between 36 and 45 minutes (for
hospital consultation/visit by psychiatrist - refer to items 0166-0169)
Psychiatry ('22'): New and established patients: Consultation/visit of new or established patient with
comprehensive history and clinical examination for complex problem requiring complex decision
making and counselling. Typically occupies a doctor personally with the patient between 46 and 60
minutes (for hospital consultation/visit by psychiatrist - refer to items 0166-0169)

2006.02

2006.02

2006.02

2006.02

Psychiatry (22): First hospital consultation/visit with problem focused history, clinical examination and 2006.06
straightforward decision making for minor problem. Typically occupies the doctor personally with the
patient for between 10 and 20 minutes
Psychiatry (22): First hospital consultation/visit with detailed history, clinical examination and
2006.06
straightforward decision making and counselling. Typically occupies the doctor personally with the
patient for between 21 and 35 minutes
Psychiatry (22): First hospital consultation/visit with detailed history, complete clinical examination
2006.06
and moderately complex decision making and counselling. Typically occupies the doctor personally
with the patient for between 36 and 45 minutes
Psychiatry (22): First hospital consultation/visit with comprehensive history and clinical examination 2006.06
for complex problem requiring complex decision making and counselling. Typically occupies a doctor
personally with the patient for between 46 and 60 minutes
General practitioner and specialist services
New and established patient: Consultation/visit of new or established patient of an average duration 2006.02
and/or complexity. Includes counselling with the patient and/or family and co-ordination with other
health care providers or liaison with third parties on behalf of the patient (for hospital
consultation/visit - refer to item 0173-0175 or item 0109) - not appropriate for pre-anaesthetic
assessment followed by the appropriate anaesthetics - refer to new anaesthetic structure

130

15.000 1.0 R

253.13

10

17.000 1.0 R

255.91

New and established patient: Consultation/visit of new or established patient of a moderately above 2006.02
average duration and/or complexity. Includes counselling with the patient and/or family and coordination with other health care providers or liaison with third parties on behalf of the patient (for
hospital consultation/visit - refer to item 0173-0175 or item 0109) - not appropriate for preanaesthetic assessment followed by the appropriate anaesthetics - refer to new anaesthetic
structure
New and established patient: Consultation/visit of new or established patient of long duration and/or 2006.02
high complexity. Includes counselling with the patient and/or family and co-ordination with other
health care providers or liaison with third parties on behalf of the patient (for hospital
consultation/visit - refer to item 0173-0175 or item 0109) - not appropriate for pre-anaesthetic
assessment followed by the appropriate anaesthetics - refer to new anaesthetic structure

130

15.000 1.0 R

253.13

10

17.000 1.0 R

255.91

130

15.000 1.0 R

253.13

10

17.000 1.0 R

255.91

First hospital consultation/visit of an average duration and/or complexity. Includes counselling with
2006.02
the patient and/or family and co-ordination with other health care providers or liaison with third
parties on behalf of the patient (not appropriate for pre-anaesthetic assessment followed by the
appropriate anaesthetics - refer to new anaesthetic structure)
First hospital consultation/visit of a moderately above average duration and/or complexity. Includes 2006.02
counselling with the patient and/or family and co-ordination with other health care providers or liaison
with third parties on behalf of the patient (not appropriate for pre-anaesthetic assessment followed by
the appropriate anaesthetics - refer to new anaesthetic structure)

130

15.000 1.0 R

253.13

10

17.000 1.0 R

255.91

130

15.000 1.0 R

253.13

10

17.000 1.0 R

255.91

Page 9 of 84

0175

0109

0111

0129

0145

0146

0147

0148

0149

I.e
0151

0152

0153

I.f
0107

0113
I.g
0130
0132

0133

First hospital consultation/visit of long duration and/or high complexity. Includes counselling with the 2006.02
patient and/or family and co-ordination with other health care providers or liaison with third parties on
behalf of the patient (not appropriate for pre-anaesthetic assessment followed by the appropriate
anaesthetics - refer to new anaesthetic structure)
Hospital follow-up visit to patient in ward or nursing facility - Refer to general rule G(a) for post2006.04
operative care) (may only be charged once per day) (not to be used with items 0111, 0145, 0146,
0147 or ICU items 1204-1214)
Paediatric hospital follow-up visits (excluding neonates) by paediatricians or paediatric cardiologists 2006.04
(may only be charged once per day) (not to be used with items 0109 or ICU items 1204-1214). For a
healthy neonate please use item 0109 for a hospital follow-up visit
Prolonged face-to-face attendance to a patient: ADD to either item 0192, item 0175, item 0164 or 2006.06
item 0169 as appropriate, for each 15-minute period only if service extends 10 minutes or more into
the next 15-minute period following on the first 60 minutes
For consultation/visit away from the doctor's home or rooms (non-emergency): ADD only to the
2006.04
consultation/visit items 0190-0192, items 0173-0175, items 0161-0164 or items 0166-0169, as
appropriate. Note: Only one of items 0145, 0146 or 0147 may be charged and not combinations
thereof
For an unscheduled emergency consultation/visit at the doctors' home or rooms, all hours: ADD only 2006.05
to the consultation/visit items 0190-0192, items 0161-0164 or items 0151-0153, as appropriate (refer
to general rule B). Note: Only one of items 0145, 0146 or 0147 may be charged and not
combinations thereof
For an unscheduled emergency consultation/visit away from the doctor's home or rooms, all hours: 2006.05
ADD only to the consultation/visit items 0190-0192, items 0173-0175, items 0161-0164, items 01660169 or items 0151-0153, as appropriate. Note: Only one of items 0145, 0146 or 0147 may be
charged and not combinations thereof
For elective after-hours services on request of the patient or family (non emergency) (refer to
2006.05
general rule B): ADD 50% of the fee for the appropriate consultation/visit item (only to be used with
items 0190-0192, items 0173-0175, items 0161-0164, items 0166-0169 or items 0151-0153) and
reflect this as a separate item 0148. Usage: This item is used when, for example, a patient or the
family request the doctor for a non-emergency consultation/visit outside of the normal hours period
as reflected in general rule B.
After-hours bona fide emergency consultation/visit (21:00-6:00 daily): ADD 25% of the fee for the
2006.05
appropriate consultation/visit item (only to be used with items 0190-0192, items 0173-0175, items
0161-0164, items 0166-0169 or items 0151-0153) and reflect this as a separate item 0149. Note:
The after-hour period applicable to this item is from Monday to Sunday 21:00-6:00
Pre-anaesthetic assessment
Pre-anaesthetic assessment: Pre-anaesthetic assessment of patient (all hours). Problem focused
2006.04
history and clinical examination and straightforward decision making for minor problem. Typically
occupies the doctor face-to-face with the patient for between 10 and 20 minutes

10

15.000 1.0 R

130

15.000 1.0 R

253.13

225.85

10

15.000 1.0 R

225.85

10

17.000 1.0 R

255.91

10

15.000 1.0 R

225.85

10

15.000 1.0 R

225.85

10

6.000 1.0 R

90.34

10

6.000 1.0 R

90.34

10

8.000 1.0 R

120.40

10

8.000 1.0 R

120.40

10

14.000 1.0 R

210.74

10

14.000 1.0 R

210.74

10

- 1.0

10

- 1.0

10

- 1.0

10

- 1.0

10

16.000 1.0 R

240.81

10

16.000 1.0 R

240.81

10

16.000 1.0 R

240.81

10

16.000 1.0 R

240.81

10

16.000 1.0 R

240.81

10

16.000 1.0 R

240.81

Pre-anaesthetic assessment: Pre-anaesthetic assessment of patient (all hours). Detailed history and 2006.04
clinical examination and straightforward decision making and counselling. Typically occupies the
doctor face-to-face with the patient for between 20 and 35 minutes
Pre-anaesthetic assessment: Pre-anaesthetic assessment of patient or other consultative service. 2006.04
Consultation with detailed history, complete examination and moderate complex decision making
and counselling. Typically occupies the doctor face-to-face for between 30 and 45 minutes
Prenatal visits and new born attendance
New born attendance: Exclusive attendance to baby at Caesarean section, normal delivery or visit in
the ward (once per patient) (items 0109, 0111, 0113, 0145, 0146 and/or 0147 may not be added to
item 0107)
Item 0107 can be used once only for given confinement
New born attendance: Emergency attendance to newborn at all hours (once per patient) (items
0107, 0109, 0111, 0145, 0146 and/or 0147 may not be added to item 0113)
Consultative services: Miscellaneous
Telephone consultation (all hours)
Consulting service e.g. writing of repeat scripts or requesting routine pre-authorisation without the
physical presence of the patient (needs not be face-to-face contact) (Consultation via SMS or
electronic media included)
Writing of special motivations for procedures and treatment without the physical presence of a
patient (includes report on the clinical condition of a patient) requested by or on behalf of a third party
funder or its agent

2006.02

12

33.000 1.0 R

496.72

12

33.000 1.0 R

496.72

2004.00
2006.02

12

45.000 1.0 R

677.40

12

45.000 1.0 R

677.40

10
10

12.000 1.0 R
5.000 1.0 R

180.68
75.23

10

9.000 1.0 R

135.51

2004.00
2004.00

10

5.000 1.0 R

75.23

2004.00

10

9.000 1.0 R

135.51

Page 10 of 84

10

12.000 1.0 R

180.68
-

0199
II.
II.a
II.a.1
0197

II.a.2
0198

Completion of chronic medication forms by medical practitioners with or without the physical
2004.00
presence of the patient requested by or on behalf of a third party funder or its agent
Medicine, material, supplies and use of own equipment
Medicine codes
Dispensing of medicine by licensed dispensing medical practitioners
Licensed dispensing medical practitioners: Dispensing cost - R16.00 for medicine with a cost of
2006.02
R100,00 or more (VAT inclusive), or 16% for medicine costing less than R100,00 (VAT inclusive).
Add to each Nappi code to provide for the dispensing cost.
Once-off administration of medicine used during a consultation
Once-off administration of medicines: This item provides for medicines used at a consultation, viz,
2006.02
once off administration of medicine, special medicine used in treatment, or emergency dispensing.
Charge for medicine used according to the Single Exit Price (SEP) PLUS R16,00 for medicine with a
cost of R100,00 or more, or 16% for medicine costing less than R100,00 PLUS VAT on the
16%/R16,00. (Where applicable, VAT should be added to the 16%/R 16,00 only and not to the
SEP, since the SEP is VAT inclusive). [According to Section 18(8) of the Medicines and Related
Substances Act (Act 101 of 1965) compounding and dispensing does not refer to a medicine
requiring preparation for a once-off administration to a patient during a consultation]. The appropriate
Ethical Medicine Nappi code(s), selected from those codes commencing with 7, 8 or 9 (provided that
it is not a reference code), should be added applicable to the medicine used. Please note: Refer to
item 0201 for cost of material used in treatment.

10

21.430 1.0 R

322.64

10

21.430 1.0 R

322.64

II.a.3
0212

Cost of chemotherapy drugs

Cost of chemotherapy drugs: This item provides for a charge for chemotherapy drugs used in
2006.02
treatment. Charge for chemotherapy drugs used in treatment at cost price PLUS 16% (with a
maximum of R16,00). (Where applicable, VAT should be added to the above). The appropriate
Ethical Medicine Nappi code(s), selected from those codes commencing with 7, 8 or 9 (provided that
it is not a reference code), should be added applicable to the chemotherapy drugs used.

II.b
II.b.1
0200

Material codes
Prosthesis and/or internal fixation
Prosthesis and/or internal fixation: This item provides for a charge for prosthesis and/or internal
fixation. Charge for prosthesis and/or internal fixation at cost price PLUS 26% (up to a maximum of
R 26,00). (Where applicable, VAT should be added to the above). The appropriate Nappi code(s),
where applicable, for the prosthesis and/or internal fixation used, must be provided.

2006.02

II.b.2
0201

Material used during a consultation

Cost of material in treatment: This item provides for a charge for material used in treatment. Charge
for material at cost price PLUS 26% (up to a maximum of R26,00). (Where applicable, VAT should
be added to the above). The appropriate Surgical and Material Nappi code(s), selected from those
codes commencing with 4, 5, 6, where applicable, for the material used, must be provided. Please
note: Refer to item 0198 for once off administration of medicine.
Setting of sterile tray
Setting of sterile tray: A fee of 10,00 clinical procedure units may be charged for the setting of a
sterile tray where a sterile procedure is performed in the rooms. Cost of stitching material, if
applicable, shall be charged for according to item 0201, as appropriate
Own equipment used in treatment
Surgical laser apparatus: Hire fee for own equipment
Candella laser apparatus: Hire fee for own equipment (Rates by arrangement with the scheme
concerned)
PROCEDURES
Unlisted procedure/service: A procedure/service may be provided that is not listed in this edition of
the coding structure. Refer to General Rule C for the criteria to use item 6999
GENERAL MODIFIERS GOVERNING THIS SECTION
Emergency procedures: Any bona fide, justifiable emergency procedure (all hours) undertaken in an
operating theatre and/or in another setting in lieu of an operating theatre, will attract an additional
12,00 clinical procedure units per half-hour or part thereof of the operating time for all members of
the surgical team. Modifier 0011 does not apply in respect of patients on scheduled lists. (A medical
emergency is any condition where death or irreparable harm to the patient will result if there are
undue delays in receiving appropriate medical treatment)
Endoscopic examinations done at operations: Where a related endoscopic examination is done at
an operation by the operating surgeon or the attending anaesthesiologist, only 50% of the fee for the
endoscopic examination may be charged

2006.02

93.27

II.c
0202

II.d
5930
5932
III.
6999

0011

0013

20

2004.00
2004.00

20 109.000 1.0 R 1 016.18

-

20 109.000 1.0 R 1 016.18

-

2005.03

2006.04

2004.00

Page 11 of 84

10.000 1.0 R

93.27

2005.06

20

10.000 1.0 R

0014

0015

Operations previously performed by other surgeons: Where an operation is performed which has
2004.00
been previously performed by another surgeon, e.g. a revision or repeat operation, the fee shall be
calculated according to the tariff for the full operation plus an additional fee to be negotiated under
general Rule J: In exceptional cases where the fee is disproportionately low in relation to actual
service rendered, except where already specified in the tariff
MODIFIERS GOVERNING SECTION 1
Intravenous infusions: Where intravenous infusions (including blood and blood cellular products) are 2004.00
administered as part of the after-treatment after the operation or confinement, no extra fees shall be
charged as this is included in the global operative or maternity fees. Should the practitioner doing
the operation or attending to the maternity case prefer to ask another practitioner to perform postoperative or post-confinement intravenous infusions, then the practitioner himself (and not the
patient) shall be responsible for remunerating such practitioner for the infusions

0017

Injections administered by practitioners: When desensitisation, intravenous, intramuscular or

2005.06
subcutaneous injections are administered by the practitioner him-/herself to patients who attend the
consulting rooms, a first injection forms part of the consultation/visit and only all subsequent
injections for the same condition should be charged at 7.50 consultative services units using modifier
0017 to reflect the amount (not chargeable together with a consultation item)

1
1.1
0203

General
Injections, Infusions and Inhalation Sedation Treatment
Inhalation sedation: Use of analgesic nitrous oxide for alcohol and other withdrawal states: First
quarter-hour or part thereof
Inhalation sedation: Per additional quarter-hour or part thereof
Intravenous treatment: Intravenous infusions (cut-down or push-in) (patients under three years): Cutdown and/or insertion of cannula - chargeable once per 24 hours
Intravenous treatment: Intravenous infusions (push-in) (patients over three years): Insertion of
cannula - chargeable once per 24 hours
Intravenous treatment: Intravenous infusions (cut-down) (patients over three years): Cut-down and
insertion of cannula - chargeable once per 24 hours
Venesection: Therapeutic venesection (Not to be used when blood is drawn for the purpose of
laboratory investigations)
Umbilical artery cannulation at birth
Collection of blood specimen(s) by medical practitioner for pathology examination, per venesection
(not to be used by pathologists)
Exchange transfusion: First and subsequent (including after-care)
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)
Chemotherapy treatment (not in chemotherapy facilities)
Treatment with cytostatic agents: Administering of Chemotherapy: Intramuscular or subcutaneous:
Per injection. For use by providers who do not make use of recognised chemotherapy facilities
and/or who are not primarily responsible for managing the chemotherapy treatment

0204
0205
0206
0207
0208
0209
0210
0211

1.2
0213

10

7.500 1.0 R

112.91

7.500 1.0 R

112.91

10

20

6.000 1.0 R

55.88

2004.00

20

6.000 1.0 R

55.88

2004.00
2004.00

20
20

3.000 1.0 R
12.000 1.0 R

28.01
111.90

20
20

3.000 1.0 R
12.000 1.0 R

28.01
111.90

2004.00

20

6.000 1.0 R

55.88

20

6.000 1.0 R

55.88

2004.00

20

8.000 1.0 R

74.65

20

8.000 1.0 R

74.65

2004.00

20

6.000 1.0 R

55.88

20

6.000 1.0 R

55.88

2004.00
2004.00

20
20

18.000 1.0 R
3.250 1.0 R

167.77
30.36

20
20

18.000 1.0 R
3.250 1.0 R

167.77
30.36

2004.00
2004.00

20

80.000 1.0 R

745.89
-

20

80.000 1.0 R

745.89
-

2004.00

20

5.000 1.0 R

46.64

20

5.000 1.0 R

46.64

0214

Intravenous treatment with cytostatic agents: Administering of Chemotherapy: Intravenous bolus

technique: Per injection. For use by providers who do not make use of recognised chemotherapy
facilities and/or who are not primarily responsible for managing the chemotherapy treatment

2004.00

20

9.000 1.0 R

83.89

20

9.000 1.0 R

83.89

0215

Intravenous treatment with cytostatic agents: Administering of Chemotherapy: Intravenous infusion

technique: Per injection. For use by providers who do not make use of recognised chemotherapy
facilities and/or who are not primarily responsible for managing the chemotherapy treatment

2004.00

20

14.000 1.0 R

130.52

20

14.000 1.0 R

130.52

1.3
5780

Oncology related services in non-oncology facilities

Interstitial implants: Placing of guide tubes for interstitial implants under local or general anaesthetic. 2006.06
The cost of materials is not included
Intracavitary applications: Placing of guide tubes under local or general anaesthetic for manual or
2006.02
remote afterloading brachytherapy. The cost of materials is not included
Isotope Therapy: Administration of low dose surface applicators, up to five applications. Typically an 2006.02
out patient procedure. The cost of materials is not included

5781
5782

20 394.860 1.0 R 3 681.21

20 315.890 1.0 R 2 945.00

20 262.410 1.0 R 2 446.37

20 209.930 1.0 R 1 957.12

20

20

Page 12 of 84

77.810 1.0 R

725.36

77.810 1.0 R

725.36

Infusional pharmacotherapy: Fee for the treatment of non cancerous conditions with bolus or
infusional pharmacotherapy per treatment day (consultations to be charged separately)
MODIFIERS GOVERNING THE ADMINISTRATION OF ANAESTHETICS FOR ALL
PROCEDURES AND OPERATIONS
Conscious sedation: Any case that is conducted outside of a hospital theatre shall be coded with the
relevant procedure code. To identify these cases, the above modifier should be used to indicate to
the medical scheme that there will be no hospital/theatre account.
Determination of anaesthetic fees: Anaesthetic fees are determined by obtaining the sum of the
basic anaesthetic units (allocated to each procedure that might be performed under anaesthetic as
indicated in the "Anaesthetic Performed" column) plus the time units (calculated according to the
formula in Modifier 0023) and the appropriate modifiers (see Modifiers 0037-0044). In cases of
operative procedures on the musculoskeletal system, open fractures and open reduction of fractures
or dislocations add units as laid down by Modifiers 5441 to 5448
The basic anaesthetic units are laid down in the tariff and are reflected in the anaesthetic column.
These basic anaesthetic units reflect the additional anaesthetic risk, the technical skill required of the
anaesthesiologist/anaesthetist and the scope of the surgical procedure, but exclude the value of the
actual time spent administering the anaesthetic. The time units (indicated by T) will be added to the
listed basic anaesthetic units in all cases on the following basis: Anaesthetic time: The remuneration
for anaesthetic time shall be per 15 minute period or part thereof, calculated from the
commencement of the anaesthetic, i.e. 2,00 anaesthetic units per 15 minute period or part thereof,
provided that should the duration of the anaesthetic be longer than one (1) hour the number of units
shall, after one (1) hour, be 3,00 anaesthetic units per 15 minute period or part thereof.

2006.02

0024

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

by the anaesthesiologist/anaesthetist is not followed by an operation, it will be regarded as a visit at
hospital or nursing home and the appropriate hospital visit item should be charged.

5783

20

42.650 1.0 R

397.58

20

42.650 1.0 R

397.58

2006.06

2006.04

2006.05

2006.05

0025

Calculation of anaesthetic time: Anaesthetic time is calculated from the time the
2006.05
anaesthesiologist/anaesthetist begins to prepare the patient for the induction of anaesthesia in the
operating theatre or in a similar equivalent area and ends when the anaesthesiologist/anaesthetist is
no longer required to give his/her personal professional attention to the patient, i.e. when the patient
may, with reasonable safety, be placed under the customary post-operative supervision. Where
prolonged personal professional attention is necessary for the well-being and safety of such patient,
the necessary time will be valued on the same basis as indicated above for the anaesthetic time.
The anaesthesiologist/anaesthetist must show on his/her account the exact anaesthetic time,
including the supervision time spent with the patient.

0027

More than one procedure under the same anaesthetic: Where more than one operation is performed 2006.04
under the same anaesthetic, the basic anaesthetic units will be that of the major operation with the
highest number of units
Indicator for use of low flow anaesthetic technique less than 1litre/minute: Fresh gas flow of less than 2006.06
1 litre/minute
Assistant anaesthesiologists: When rendered necessary by the scope of the anaesthetic, an
2006.04
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
Indicator for use of low flow anaesthetic technique 1-2 litre/minute: Fresh gas flow of 1 to 2
2006.06
litre/minute
Intravenous drips and transfusions: Treatment with intravenous drips and transfusions is considered 2006.04
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

Patients in prone position: Anaesthesia administered to patients in the prone position shall have a
2006.04
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
Participating in general care of patients: When an anaesthesiologist/anaesthetist is required to
2006.05
participate in the general care of a patient during a surgical procedure, but does not administer the
anaesthetic, such services may be remunerated at full anaesthetic rate, subject to the provisos of
modifier 0035: Anaesthetic administered by an anaesthesiologist/anaesthetist. and modifier 0036:
Anaesthetic administered by general practitioners.

0020

0021

0023

0028
0029

0030
0031

0032

0033

Page 13 of 84

0034

Head and neck procedures: All anaesthetics administered for diagnostic, surgical or X-ray
procedures on the head and neck shall have a minimum of 4,00 basic anaesthetic units. When the
basic anaesthetic units for the procedure is 3,00, one extra anaesthetic unit should be added. If the
basic anaesthetic units for the procedure is 4,00 or more, no extra units should be added

2006.04

0035

Anaesthetic administered by an anaesthesiologist/anaesthetist: No anaesthetic administered shall

2006.05
have a total value of less than 7,00 anaesthetic units (basic units, time units plus appropriate
modifiers).
Anaesthetic administered by general practitioners: The units (basic units plus time plus the
2006.05
appropriate modifiers) used to calculate the fee for an anaesthetic administered by a general
practitioner lasting one hour or less, shall be the same as that for an anaesthesiologist. For
anaesthetic lasting more than one hour, the units used to calculate the fee for an anaesthetic
administered by a general practitioner will be 4/5 (80%) of the total number of units (basic units plus
time [refer to modifier 0023] plus the appropriate modifiers) applicable to an anaesthesiologist.
Please note that the 4/5 (80%) principle will be applied to all anaesthetics administered by general
practitioners with the proviso that no anaesthetic with a total number of units higher than 11.00 will be
reduced to less than 11,00 units in total. The monetary value of the unit is the same for both an
anaesthesiologist/anaesthetist.
Body hypothermia: Utilisation of total body hypothermia: Add 3,00 anaesthetic units
2006.04
Peri-operative blood salvage: Add 4,00 anaesthetic units for intra-operative blood salvage and 4,00 2006.04
anaesthetic units for post-operative blood salvage
Control of blood pressure: Deliberate control of the blood pressure: All cases up to one hour: Add
2006.04
3,00 anaesthetic units, thereafter add 1,00 (one) additional anaesthetic unit per quarter hour or part
thereof
Phaeochromocytoma: The basic anaesthetic units for procedures performed for
2006.04
phaeochromocytoma shall be 15,00 anaesthetic units
Hyperbaric pressurisation: Utilisation of hyperbaric pressurisation: Add 3,00 anaesthetic units
2006.04
Extracorporeal circulation: Utilisation of extracorporeal circulation: Add 3,00 anaesthetic units
2006.04
Patients under one year of age: For all cases where the patient is under one year of age 3,00
2006.04
anaesthetic units to be added
Neonates (i.e. up to and including 28 days after birth): 3,00 anaesthetic units to be added to the
2006.04
basic anaesthetic units for the particular procedure. This modifier is charged in addition to Modifier
0043: Cases under one year of age
Intra-aortic balloon pump: Where an anaesthesiologist would be responsible for operating an intra- 2006.06
aortic balloon pump, a fee of 75,00 clinical procedure units is applicable.
Modifiers 5441 to 5448
2006.04

30
30
30

3.000 1.0 R
3.000 1.0 R
3.000 1.0 R

175.53
175.53
175.53

30

3.000 1.0 R

175.53

30

1.000 1.0 R

58.52

30

2.000 1.0 R

117.02

30
30
30
30

3.000
4.000
5.000
8.000

175.53
234.03
292.55
468.07

0036

0037
0038
0039

0040
0041
0042
0043
0044

0100

5441
5442
5443
5444
5445
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)
Add one (1,00) anaesthetic unit, except where the procedure refers to the bones named in Modifiers 2006.04
5442 to 5448
Shoulder, scapula, clavicle, humerus, elbow joint, upper 1/3 tibia, knee joint, patella, mandible and
2006.04
tempero-mandibular joint: Add two (2,00) anaesthetic units
Maxillary and orbital bones: Add three (3,00) anaesthetic units
2006.04
Shaft of femur: Add four (4,00) anaesthetic units
2006.04
Spine (except coccyx), pelvis, hip, neck of femur: Add five (5,00) anaesthetic units
2006.04
Sternum and/or ribs and musculo-skeletal procedures which involve an intra-thoracic approach: Add 2006.04
eight (8,00) anaesthetic units
POST-OPERATIVE ALLEVIATION OF PAIN

Page 14 of 84

30

3.000 1.0 R

1.0
1.0
1.0
1.0

R
R
R
R

175.53
-

0045

Post-operative alleviation of pain:

2006.04

2004.00
2004.00
2004.00
2004.00

20
20
20
20

4.000
2.800
2.000
1.900

37.25
26.10
18.63
17.75

37.25
26.10
18.63
17.75

2004.00

20

2.800 1.0 R

2004.00
2004.00
2004.00
2004.00

20
20
20
20

4.000
8.000
8.000
8.000

1.0
1.0
1.0
1.0

234.06

2004.00
2004.00
2004.00
2004.00

20
20
20
20

20.000
20.000
20.000
5.500

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20

6.000
3.000
18.000
12.000
6.000
3.000
42.000
30.000
14.000

2004.00

(a) When a regional or nerve block procedure is performed, the appropriate procedure item to
patient in ward or nursing facility, can be charged, provided that it is not the primary anaesthetic
technique
(b) When a second medical practitioner has administered the regional or nerve block for postoperative 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.

2
2.1
0217
0218
0219
0220
0221
2.2
0222
0223
0225
0227
0228
0229
0230
0231
0233
0234
0235
0237
0241
0242
0243
0244
0245
0246
0251
0252
0255
0257
0259
0261
0271
0273
0275
0277
0279
0280
0281
0282
0283

(c) None of the above is applicable for routine post-operative pain management i.e. intramuscular,
intravenous or subcutaneous administration of opiates or NSAID (non-steroidal anti-inflammatory
drug)
Integumentary System
Allergy
Allergy: Patch tests: First patch
Allergy: Skin-prick tests: Skin-prick testing: Insect venom, latex and drugs
Allergy: Patch tests: Each additional patch
Allergy: Skin-prick tests: Immediate hypersensitivity testing (Type I reaction): Per antigen: Inhalant
and food allergens
Allergy: Skin-prick tests: Delayed hypersensitivity testing (Type IV reaction): Per antigen
Skin (general)
Intralesional injection into areas of pathology e.g. Keloid: Single
Intralesional injection into areas of pathology e.g. Keloids: Multiple
Epilation: Per session
Special treatment of severe acne cases, including draining of cysts, expressing of cleaning of
Comedones and/or steaming, abrasive cleaning of skin and UVR per session
PUVA Treatment: Maximum of 21 treatments
PUVA: Follow-up or maintenance therapy once a week
UVR-Treatment
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
Biopsy without suturing: First lesion
Biopsy without suturing: Subsequent lesions (each)
Biopsy without suturing: Maximum for multiple additional lesions
Deep skin biopsy by surgical incision with local anaesthetic and suturing
Treatment of benign skin lesion by chemo-cryotherapy: First Lesion
Treatment of benign skin lesion by chemo-cryotherapy: Subsequent lesions (each)
Treatment of benign skin lesion by chemo-cryotherapy: Maximum for multiple additional lesions
Repair of nail bed
Removal of benign lesion by curretting under local or general anaesthesia followed by diathermy and
curretting or electrocautery: First lesion
Removal of benign lesion by curretting under local or general anaesthesia followed by diathermy and
curretting or electrocautery: Subsequent lesions (each)
Removal of malignant lesions by curretting under local or general anaesthesia followed by
electrocautery: First lesion
Removal of malignant lesions by curretting under local or general anaesthesia followed by
electrocautery: Subsequent lesions (each)
Drainage of subcutaneous abscess onychia, paronychia, pulp space or avulsion of nail
Drainage of major hand or foot infection: Drainage of major abscess with necrosis of tissue,
involving deep fascia or requiring debridement; complete excision of pilonidal cyst or sinus
Removal of foreign body superficial to deep fascia (except hands)
Removal of foreign body deep to deep fascia (except hands)
Kurtin planing for acne scarring: Whole face
Kurtin planing for acne scarring: Extensive
Kurtin planing for acne scarring: Limited
Kurtin planing for acne scarring: Subsequent planing of whole face within 12 months
Surgical treatment for axillary hyperhidrosis
Laser treatment for small skin lesions: First lesion
Laser treatment for small skin lesions: Subsequent lesions (each)
Laser treatment for small skin lesions: Maximum for multiple additional lesions
Laser treatment for large skin lesions: Limited area

20
20
20
20

4.000
2.800
2.000
1.900

20

2.800 1.0 R

R
R
R
R

26.10
37.25
74.65
74.65
74.65

20
20
20
20

4.000
8.000
8.000
8.000

1.0
1.0
1.0
1.0

R
R
R
R

26.10
37.25
74.65
74.65
74.65

1.0
1.0
1.0
1.0

R
R
R
R

186.40
186.40
186.40
51.33

20
20
20
20

20.000
20.000
20.000
5.500

1.0
1.0
1.0
1.0

R
R
R
R

186.40
186.40
186.40
51.33

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

55.88
28.01
167.77
111.90
55.88
28.01
391.57
279.67
130.52

20
20
20
20
20
20
20
20
20

6.000
3.000
18.000
12.000
6.000
3.000
42.000
30.000
14.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

55.88
28.01
167.77
111.90
55.88
28.01
391.57
279.67
130.52

30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000

R
R
R
R
R
R
R
R
R

175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55

T
T
T
T
T
T
T
T
T

20

7.000 1.0 R

65.26

20

7.000 1.0 R

65.26

30

3.000 1.0 R

175.55

2004.00

20

30.000 1.0 R

279.67

20

30.000 1.0 R

279.67

30

3.000 1.0 R

175.55

2004.00

20

15.000 1.0 R

139.91

20

15.000 1.0 R

139.91

30

3.000 1.0 R

175.55

2004.00
2004.00

20
20

20.000 1.0 R
87.000 1.0 R

186.40
811.15

20
20

20.000 1.0 R
87.000 1.0 R

186.40
811.15

30
30

3.000 1.0 R
3.000 1.0 R

175.55
175.55

T
T

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 20.000 1.0 R
186.40
20 31.000 1.0 R
289.06
20 206.000 1.0 R 1 920.46
20 70.000 1.0 R
652.62
20 30.000 1.0 R
279.67
20 103.000 1.0 R
960.30
20 64.000 1.0 R
596.60
20 14.000 1.0 R
130.52
20
7.000 1.0 R
65.26
20 56.000 1.0 R
522.09
20 30.000 1.0 R
279.67

20 20.000 1.0 R
186.40
20 31.000 1.0 R
289.06
20 164.800 1.0 R 1 536.37
20 70.000 1.0 R
652.62
20 30.000 1.0 R
279.67
20 103.000 1.0 R
960.30
20 64.000 1.0 R
596.60
20 14.000 1.0 R
130.52
20
7.000 1.0 R
65.26
20 56.000 1.0 R
522.09
20 30.000 1.0 R
279.67

30
30
30
30
30
30
30
30
30
30
30

3.000
3.000
4.000
4.000
4.000
4.000
4.000
3.000
3.000
3.000
4.000

175.55
175.55
234.06
234.06
234.06
234.06
234.06
175.55
175.55
175.55
234.06

T
T
T
T
T
T
T
T
T
T
T

Page 15 of 84

1.0
1.0
1.0
1.0

R
R
R
R

1.0
1.0
1.0
1.0

R
R
R
R

30

4.000 1.0 R

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R

0284
0285
0286
0287
2.3
0289
0290
0291
0292
0293
0294
0295
0296
0297
0298
0299
2.4
0300
0301
0302
0303
0304
0305
0307
0308
0310
0311
0313
0314
0315
2.5
0316
0317
0319
0321
0323
0324
0325
0327
0329
0330
0331
0333
0334
0335
0337
0339
0341
0343
2.6
0351
0353
0354
2.7
0355
0357

Laser treatment for large skin lesions: Extensive area

Laser treatment for large skin lesions: Whole face or other areas of equivalent size or larger
Photo-dynamic therapy for malignant skin lesions: Equipment fee for PDT lamp
Scanning of pigmented skin lesions: Equipment fee for Molemax or similar device
Major plastic repair
Large skin grafts, composite skin grafts, large full thickness free skin grafts
Reconstructive procedures (including all stages) and skin graft by myo-cutaneous or fasciocutaneous flap
Reconstructive procedures (including all stages) grafting by micro-vascular re-anastomosis
Distant flaps: First stage
Contour grafts (excluding cost of material)
Vascularised bone graft with or without soft tissue with one or more sets of micro-vascular
anastomoses
Local skin flaps (large, complicated)
Other procedures of major technical nature
Subsequent major procedures for repair of same lesion
Lower abdominal dermo-lipectomy
Major abdominal lipectomy with repositioning of umbilicus
Lacerations, scars, tumours, cysts and other skin lesions
Stitching of soft-tissue injuries: Stitching of wound (with or without local anaesthesia): Including
normal after-care)
Stitching of soft-tissue injuries: Additional wounds stitched at same session (each)
Stitching of soft-tissue injuries: Deep laceration involving limited muscle damage
Stitching of soft-tissue injuries: Deep laceration involving extensive muscle damage
Major debridement of wound, sloughectomy or secondary suture
Needle biopsy - soft tissue
Excision and repair by direct suture; excision nail fold or other minor procedures of similar magnitude

2004.00
2004.00
2004.00
2004.00

Each additional small procedure done at the same time

Radical excision of nailbed
Excision of large benign tumour (more than 5 cm)
Extensive resection for malignant soft tissue tumour including muscle
Requiring repair by large skin graft or large local flap or other procedures of similar magnitude
Requiring repair by small skin graft or small local flap or other procedures of similar magnitude
Breasts
Fine needle aspiration for soft tissue (all areas)
Aspiration of cyst or tumour
Mastotomy with exploration, drainage of abscess or removal of mammary implant
Biopsy or excision of cyst, benign tumour, aberrant breast tissue, duct papilloma
Subareolar cone excision of ducts of wedge excision of breast
Wedge excision of breast and axillary dissection
Total mastectomy
Total mastectomy with axillary gland biopsy
Total mastectomy with axillary gland dissection
Nipple and areola reconstruction
Subcutaneous mastectomy for disease of breast; including reconstruction but excluding cost of
prosthesis: Unilateral
Subcutaneous mastectomy for disease of breast; including reconstruction but excluding cost of
prosthesis: Bilateral
Removal of breast implant by means of capsulectomy: Per breast
Implantation of internal subpectoral mammary prosthesis in post mastectomy patients
Reduction: Mammoplasty for pathological hypertrophy: Unilateral
Reduction: Mammoplasty for pathological hypertrophy: Bilateral
Gynaecomastia: Unilateral
Gynaecomastia: Bilateral
Burns
Major Burns: Resuscitation (including supervision and intravenous therapy - first 48 hours)
Tangential excision and grafting: Small
Tangential excision and grafting: Large
Hands (skin)
Skin flap in acute hand injuries where a flap is taken from a site remote from the injured finger or in
cases of advancement flag e.g. Cutler
Small skin graft in acute hand injury

2004.00
2004.00

20 70.000 1.0 R
652.62
20 206.000 1.0 R 1 920.46
20 56.630 1.0 R
527.96
20 43.440 1.0 R
404.92
20 234.000 1.0 R 2 181.51
20 410.000 1.0 R 3 822.44

2004.00
2004.00
2004.00
2004.11

20
20
20
20

800.000
206.000
206.000
#######

1.0
1.0
1.0
1.0

R 7 458.33
R 1 920.46
R 1 920.46
R 11 187.49

20
20
20
20

640.000
164.800
164.800
960.000

1.0
1.0
1.0
1.0

R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

206.000
206.000
104.000
170.000
275.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

20
20
20
20
20

164.800
164.800
104.000
136.000
220.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

2004.00

20

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
7.000 1.0 R
65.26
20 64.000 1.0 R
596.60
20 128.000 1.0 R 1 193.34
20 50.000 1.0 R
466.22
20 25.000 1.0 R
233.04
20 27.000 1.0 R
251.66

20
7.000 1.0 R
65.26
20 64.000 1.0 R
596.60
20 120.000 1.0 R 1 118.69
20 50.000 1.0 R
466.22
20 25.000 1.0 R
233.04
20 27.000 1.0 R
251.66

30
30
30
30
30
30

3.000
4.000
4.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

175.55
234.06
234.06
175.55
175.55
175.55

T
T
T
T
T
T

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 14.000 1.0 R
130.52
20 38.000 1.0 R
354.32
20 55.000 1.0 R
512.71
20 227.120 1.0 R 2 117.42
20 104.000 1.0 R
969.54
20 55.000 1.0 R
512.71
20 15.000 1.0 R
139.91
20
9.000 1.0 R
83.89
20 42.000 1.0 R
391.57
20 94.200 1.0 R
878.18
20 90.000 1.0 R
839.02
20 180.000 1.0 R 1 678.18
20 124.000 1.0 R 1 156.09
20 148.000 1.0 R 1 379.74
20 220.000 1.0 R 2 050.98
20 95.000 1.0 R
885.65
20 187.200 1.0 R 1 745.20

30
30
30
30
30
30

3.000
3.000
3.000
4.000
4.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

30
30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
5.000
5.000
5.000
5.000
4.000
4.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

175.55
175.55
175.55
234.06
234.06
175.55
175.55
175.55
175.55
175.55
292.58
292.58
292.58
292.58
234.06
234.06

T
T
T
T
T
T

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 14.000 1.0 R
130.52
20 38.000 1.0 R
354.32
20 55.000 1.0 R
512.71
20 283.900 1.0 R 2 646.84
20 104.000 1.0 R
969.54
20 55.000 1.0 R
512.71
20 15.000 1.0 R
139.91
20
9.000 1.0 R
83.89
20 42.000 1.0 R
391.57
20 94.200 1.0 R
878.18
20 90.000 1.0 R
839.02
20 225.000 1.0 R 2 097.62
20 155.000 1.0 R 1 445.00
20 185.000 1.0 R 1 724.67
20 275.000 1.0 R 2 563.84
20 95.000 1.0 R
885.65
20 234.000 1.0 R 2 181.51

2004.00

20 410.000 1.0 R 3 822.44

20 328.000 1.0 R 3 057.92

30

4.000 1.0 R

234.06

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20

20
20
20
20
20
20

4.000
4.000
5.000
5.000
3.000
3.000

30
30
30

5.000 1.0 R
5.000 1.0 R
5.000 1.0 R

2004.00

20 147.400 1.0 R

30

4.000 1.0 R

234.06
234.06
292.58
292.58
175.55
175.55
292.58
292.58
292.58
234.06

T
T
T
T
T
T

20 276.000 1.0 R
20 100.000 1.0 R
20 200.000 1.0 R

1 745.20
1 118.69
1 745.20
3 057.92
857.64
1 200.82
2 058.46
932.29
1 491.64
1 118.69

30
30
30
30
30
30

2004.00
2004.00
2004.00

2 181.51
1 398.51
2 181.51
3 822.44
857.64
1 501.02
2 573.08
932.29
1 864.58
1 374.17

2004.00

20

419.58

20

419.58

30

3.000 1.0 R

175.55

Page 16 of 84

1 920.46
1 920.46
969.54
1 584.91
2 563.84
14.000 1.0 R
130.52

234.000
150.000
234.000
410.000
92.000
161.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

45.000 1.0 R

Z
Z

20 70.000 1.0 R
652.62
20 164.800 1.0 R 1 536.37
20 56.630 1.0 R
527.96
20 43.440 1.0 R
404.92
20 187.200 1.0 R 1 745.20
20 328.000 1.0 R 3 057.92

20

T
T

4.000 1.0 R
4.000 1.0 R

234.06
234.06
234.06
234.06

30
30
30
30

4.000
4.000
4.000
6.000

1.0
1.0
1.0
1.0

R
R
R
R

234.06
234.06
234.06
351.09

T
T
T
T

1 536.37
1 536.37
969.54
1 267.99
2 050.98
14.000 1.0 R
130.52

30
30
30
30
30

4.000
4.000
4.000
5.000
5.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

T
T
T
T
T

30

3.000 1.0 R

234.06
234.06
234.06
292.58
292.58
175.55

187.200
120.000
187.200
328.000
92.000
128.800

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

20 220.800 1.0 R
20 100.000 1.0 R
20 160.000 1.0 R
20 120.000 1.0 R
45.000 1.0 R

30
30

4.000 1.0 R
4.000 1.0 R

30
30

5 966.69
1 536.37
1 536.37
8 949.97

Z
Z

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

T
T

T
T
T
T
T
T
T
T
T
T

T
T
T
T

0359

Release of extensive skin contracture and/or excision of scar tissue with major skin graft resurfacing 2004.00

20 192.000 1.0 R 1 789.93

20 153.600 1.0 R 1 431.95

30

3.000 1.0 R

175.55

0361
0363
0365
0367
0369
0371
0373
0374
0375
0376
2.8

Z-plasty
Local flap and skin graft
Cross finger flap (all stages)
Palmar flap (all stages)
Distant flap: First stage
Distant flap: Subsequent stage (not subject to general modifier 0007)
Transfer neurovascular island flap
Syndactyly: Separation of, including skin graft for one web (with skin flap and graft)
Dupuytren's contracture: Fasciotomy
Dupuytren's contracture: Fasciectomy
Acupuncture
Please note: General Rule M not applicable to section 2.8 of this price list
Standard acupuncture
Laser acupuncture using more than 6 points
Electro-acupuncture
Scalp acupuncture
Micro-acupuncture (ear, hand)
RULES GOVERNING THE SECTION ACUPUNCTURE
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
Musculo-skeletal System
MODIFIERS GOVERNING ORTHOPAEDIC OPERATIONS AND ANAESTHETIC FEES FOR
ORTHOPAEDIC OPERATIONS
A fracture NOT requiring reduction shall be charged on a fee per service basis
Where in the treatment of a fracture or dislocation, an initial closed reduction is followed within one
month by further closed reductions under general anaesthesia, the fee for such subsequent
reductions will be 27,00 clinical procedure units (not including after-care)
Except where otherwise specified, in cases of compound fractures, 77,00 clinical procedure units
(specialists) and 77,00 clinical procedure units (general practitioners) are to be added to the units for
the fractures including debridement
In cases of a compound fracture where a debridement is followed by internal fixation (excluding
fixation with Kirschner wires, as well as fractures of hands and feet), the full amount according to
either Modifier 0049: Cases of compound fractures, or Modifier 0051: Fractures requiring open
reduction, internal fixation, external skeletal fixation and/or bone grafting, may be added to the fee
for the procedure involved, plus half of the amount according to the second modifier (either Modifier
0049: Cases of compound fractures or Modifier 0051: Fractures requiring open reduction, internal
fixation, external skeletal fixation and/or bone grafting, as applicable)

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20

220.100
150.000
192.000
192.000
158.000
77.000
230.500
242.400
51.000
218.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

20
20
20
20
20
20
20
20
20
20

176.080
120.000
153.600
153.600
126.400
77.000
184.400
193.920
51.000
174.400

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

30
30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000

T
T
T
T
T
T
T
T
T
T

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

10.000
14.000
14.000
10.000
10.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

20
20
20
20
20

10.000
14.000
14.000
10.000
10.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
-

0377
0378
0379
0380
0381
CC.

0047
0048

0049

0050

0051

0053

0055
0057

0058
3.1
3.1.1
0383
0387

2004.00

2 052.01
1 398.51
1 789.93
1 789.93
1 473.01
717.88
2 148.95
2 259.82
475.46
2 032.36
93.27
130.52
130.52
93.27
93.27
-

1 641.52
1 118.69
1 431.95
1 431.95
1 178.38
717.88
1 719.10
1 807.83
475.46
1 625.97
93.27
130.52
130.52
93.27
93.27
-

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

2004.00
2004.00

20

27.000 1.0 R

251.72

20

27.000 1.0 R

251.72

2004.11

20

77.000 1.0 R

717.87

20

77.000 1.0 R

717.87

2004.00

20 115.500 1.0 R 1 076.79

20 115.500 1.0 R 1 076.79

Fractures requiring open reduction, internal fixation, external skeletal fixation and/or bone grafting:
2004.11
Specialists add 77,00 clinical procedure units. General practitioners add 77,00 clinical procedure
units
Fracture requiring percutaneous internal fixation [insertion and removal of fixatives (wires) in respect 2004.00
of fingers and toes included]: Specialists and general practitioners add 32,00 clinical procedure units

20

77.000 1.0 R

717.87

20

77.000 1.0 R

717.87

20

32.000 1.0 R

298.33

20

32.000 1.0 R

298.33

Dislocation requiring open reduction: Units for the specific joint plus 77,00 clinical procedure units for
specialists. General practitioners add 77,00 clinical procedure units
Multiple procedures on feet: In multiple procedures on feet, fees for the first foot are calculated
according to Modifier 0005: Multiple procedures/operations under the same anaesthetic. Calculate
fees for the second foot in the same way, reduce the total to 75% and add to the total for the first
foot
Revision operation for total joint replacement and immediate re-substitution (infected or noninfected): per fee for total joint replacement + 100%
Bones
Bones: Fractures (reduction under general anaesthetic - refer to modifier 0047)
Fracture (reduction under general anaesthetic): Scapula
Fracture (reduction under general anaesthetic): Clavicle

20

77.000 1.0 R

717.87

20

77.000 1.0 R

717.87

2004.11
2004.00

2004.00

2004.00
2004.00

717.88

717.88

175.55
175.55

20
20

Page 17 of 84

- 1.0
77.000 1.0 R

20
20

- 1.0
77.000 1.0 R

30
30

3.000 1.0 R
3.000 1.0 R

TM
TM

Percutaneous pinning of supracondylar fracture: Elbow - stand alone procedure

Fracture (reduction under general anaesthetic): Humerus
Fracture (reduction under general anaesthetic): Radius and/or Ulna
Fracture (reduction under general anaesthetic): Open reduction of both radius and ulna (modifier
0051 not applicable)
0402 Fracture (reduction under general anaesthetic): Carpal bone
0403 Fracture (reduction under general anaesthetic): Bennett fracture-dislocation
0405 Fracture (reduction under general anaesthetic): Open treatment of metacarpal: Simple
0409 Fracture (reduction under general anaesthetic): Finger phalanx: Distal: Simple
0411 Fracture (reduction under general anaesthetic): Finger phalanx: Distal: Compound
0413 Fracture (reduction under general anaesthetic): Proximal or middle: Simple
0415 Fracture (reduction under general anaesthetic): Proximal or middle: Compound
0417 Fracture (reduction under general anaesthetic): Pelvis fracture: Closed
0419 Fracture (reduction under general anaesthetic): Pelvis: Operative reduction and fixation
0421 Fracture (reduction under general anaesthetic): Femur: Neck or Shaft
0425 Fracture (reduction under general anaesthetic): Patella
0429 Fracture (reduction under general anaesthetic): Tibia with or without fibula
0433 Fracture (reduction under general anaesthetic): Fibula shaft
0435 Fracture (reduction under general anaesthetic): Malleolus of ankle
0437 Fracture (reduction under general anaesthetic): Fracture-dislocation of ankle
0438 Fracture (reduction under general anaesthetic): Open reduction Talus fracture (modifier 0051 not
applicable)
0439 Fracture (reduction under general anaesthetic): Tarsal bones (excluding talus and calcaneus)
0440 Fracture (reduction under general anaesthetic): Open reduction Calcaneus fracture (modifier 0051
not applicable)
0441 Fracture (reduction under general anaesthetic): Metatarsal
0443 Fracture (reduction under general anaesthetic): Toe phalanx: Distal Simple
0445 Fracture (reduction under general anaesthetic): Toe phalanx: Compound
0447 Fracture (reduction under general anaesthetic): Other: Simple
0449 Fracture (reduction under general anaesthetic): Other: Compound
0451 Fracture (reduction under general anaesthetic): Sternum and/or ribs: Closed
0452 Fracture (reduction under general anaesthetic): Sternum and/or ribs: Open reduction and fixation of
multiple fractured ribs for flail chest
0455 Fracture (reduction under general anaesthetic): Spine: With or without paralysis: Cervical
0456 Fracture (reduction under general anaesthetic): Spine: With or without paralysis: Rest
0461 Fracture (reduction under general anaesthetic): Compression fracture: Cervical
0462 Fracture (reduction under general anaesthetic): Compression fracture: Rest
0463 Fracture (reduction under general anaesthetic): Spinous or transverse processes: Cervical
0464 Fracture (reduction under general anaesthetic): Spinous or transverse processes: Rest
3.1.1.1 Bones: Fractures (reduction under general anaesthetic - refer to modifier 0047): Operations for
fractures
0465 Fractures involving large joints (includes the item for the relative bone) (this item may not be used as
a modifier)
0473 Percutaneous insertion plus subsequent removal of Kirschner wires or Steinmann pins (no aftercare) (modifier 0005 not applicable)
0475 Bonegrafting or internal fixation for malunion or non-union: Femur, Tibia, Humerus, Radius and Ulna

2004.00
2004.00
2004.00
2004.00

20 175.700 1.0 R 1 638.00

20 111.600 1.0 R 1 040.38
20 77.000 1.0 R
717.88
20 210.000 1.0 R 1 957.86

20 140.560 1.0 R 1 310.37

20 111.600 1.0 R 1 040.38
20 77.000 1.0 R
717.88
20 168.000 1.0 R 1 566.28

30
30
30
30

3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0

R
R
R
R

175.55
175.55
175.55
175.55

TM
TM
TM
TM

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55

TM
TM
TM
TM
TM
T
TM
T
TM
TM
TM
TM
TM
TM
TM
TM

2004.00
2004.00

20 64.000 1.0 R
596.60
20 403.500 1.0 R 3 761.72

30
30

3.000 1.0 R
3.000 1.0 R

175.55
175.55

TM
TM

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 41.800
20
20 32.000
20 26.000
20 52.000
20
20 230.000

1.0
0.0
1.0
1.0
1.0
0.0
1.0

30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

175.55
175.55
175.55
175.55
175.55
175.55
175.55

TM
T
TM
T
TM
T
TM

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20

0.0
0.0
0.0
0.0
0.0
0.0

30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

175.55
175.55
175.55
175.55
175.55
175.55
-

TM
TM
TM
TM
TM
TM

2004.00

20 288.000 1.0 R 2 684.98

20 230.400 1.0 R 2 148.07

30

3.000 1.0 R

175.55

TM

2004.00

20

20

400.96

30

3.000 1.0 R

175.55

2004.00

20 282.000 1.0 R 2 629.10

20 225.600 1.0 R 2 103.19

30

3.000 1.0 R

175.55

TM

0479 Bonegrafting or internal fixation for malunion or non-union: Other bones

3.1.2 Bony operations
3.1.2.1 Bony operations: Bone grafting
0497 Resection of bone or tumour with or without grafting (benign)
0498 Resection of bone or tumour with or without grafting (malignant) - does not include digits
0499 Grafts to cysts: Large bones
0501 Grafts to cysts: Small bones
0503 Grafts to cysts: Cartilage graft
0505 Grafts to cysts: Inter-metacarpal bone graft
0507 Removal of autogenous bone for grafting (not subject to general modifier 0005)
3.1.2.2 Bony operations: Acute or chronic osteomyelitis
0509 Acute or chronic osteomyelitis: Conservative treatment
0511 Acute or chronic osteomyelitis: Operation: Tariff which would be applicable for compound fracture of
the bone involved, including six weeks post-operative care
0512 Acute or chronic osteomyelitis: Sternum sequestrectomy and drainage: Including six weeks aftercare

2004.00

20 123.200 1.0 R 1 148.61

20 225.600 1.0 R 2 103.19
20 272.000 1.0 R 2 535.83
20 153.600 1.0 R 1 431.95
20 120.000 1.0 R 1 118.69
20 164.800 1.0 R 1 536.37
20 120.000 1.0 R 1 118.69
20 50.000 1.0 R
466.22
20
- 1.0
-

30

3.000 1.0 R

30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000
3.000

R
R
R
R
R
R
R

175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
-

TM

2004.00
2004.00

20 154.000 1.0 R 1 435.76

20 282.000 1.0 R 2 629.10
20 340.000 1.0 R 3 169.82
20 192.000 1.0 R 1 789.93
20 128.000 1.0 R 1 193.34
20 206.000 1.0 R 1 920.46
20 147.000 1.0 R 1 370.50
20 50.000 1.0 R
466.22
20
- 1.0
-

2004.00

20 128.000 1.0 R 1 193.34

30

3.000 1.0 R

175.55

TM

0388
0389
0391
0392

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

Page 18 of 84

64.000
51.000
118.300
52.000
48.000
102.000
320.000
237.000
51.000
128.000
58.000
128.000
198.700

1.0
1.0
1.0
1.0
1.0
1.0
1.0
0.0
1.0
1.0
1.0
1.0
0.0
1.0
1.0
1.0

R
596.60
R
475.46
R 1 102.85
R
484.84
R
447.45
R
950.92
R 2 983.27
R 2 209.52
R
475.46
R 1 193.34
R
540.72
R 1 193.34
R 1 852.41

R
R
R
R
R

43.000 1.0 R

389.66
298.30
242.42
484.84
2 144.25
-

64.000
51.000
118.300
52.000
48.000
102.000
256.000
189.600
51.000
120.000
58.000
120.000
158.960

1.0
1.0
1.0
1.0
1.0
1.0
1.0
0.0
1.0
1.0
1.0
1.0
0.0
1.0
1.0
1.0

R
596.60
R
475.46
R 1 102.85
R
484.84
R
447.45
R
950.92
R 2 386.68
R 1 767.64
R
475.46
R 1 118.69
R
540.72
R 1 118.69
R 1 481.96

20 64.000 1.0 R
596.60
20 322.500 1.0 R 3 006.59

v
v
v
v

400.96

20 41.800
20
20 32.000
20 26.000
20 52.000
20
20 184.000

1.0
0.0
1.0
1.0
1.0
0.0
1.0

20
20
20
20
20
20

0.0
0.0
0.0
0.0
0.0
0.0

R
R
R
R
R

43.000 1.0 R

389.66
298.30
242.42
484.84
1 715.43
-

20 120.000 1.0 R 1 118.69

v
v
v
v

1.0
1.0
1.0
1.0
1.0
1.0
1.0

TM
TM
TM
TM
TM
TM
TM

3.1.2.3 Bony operations: Osteotomy

0514 Osteotomy: Sternum: Repair of pectus excavatum
0515 Osteotomy: Sternum: Repair of pectus carinatum
0516 Osteotomy: Pelvic
0521 Osteotomy: Femoral: Proximal
0527 Osteotomy: Knee region
0528 Osteotomy: Os Calcis (Dwyer operation)
0530 Osteotomy: Metacarpal and phalanx: Corrective for malunion or rotation
0531 Rotational osteotomy of tibia and fibula - stand alone procedure
0532 Osteotomy: Rotation osteotomy of the Radius, Ulna or Humerus
0533 Osteotomy: Single metatarsal
0534 Osteotomy: Multiple metatarsal osteotomies
3.1.2.4 Bony operations: Exostosis
0535 Exostosis: Excision: Readily accessible sites
0537 Exostosis: Excision: Less accessible sites
3.1.2.5 Bony operations: Biopsy
0539 Needle Biopsy: Spine (no after-care) (modifier 0005 not applicable)
0541 Needle Biopsy: Other sites (no after-care) (modifier 0005 not applicable)
0543 Biopsy: Open (modifier 0005 not applicable): Readily accessible site
0545 Biopsy: Open (modifier 0005 not applicable): Less accessible site
Joints
3.2
3.2.1 Joints: Dislocations
0547 Joint: Dislocation: Clavicle either end
0549 Joint: Dislocation: Shoulder
0551 Joint: Dislocation: Elbow
0552 Joint: Dislocation: Wrist
0553 Joint: Dislocation: Perilunar trans-scaphoid fracture dislocation
0555 Joint: Dislocation: Lunate
0556 Joint: Dislocation: Carpo-metacarpo dislocation
0557 Joint: Dislocation: Metacarpo-phalangeal or interphalangeal (hand)
0559 Joint: Dislocation: Hip
0561 Joint: Dislocation: Knee
0563 Joint: Dislocation: Patella
0565 Joint: Dislocation: Ankle
0567 Joint: Dislocation: Sub-Talar dislocation
0569 Joint: Dislocation: Intertarsal or Tarsometatarsal or Mid-tarsal
0571 Joint: Dislocation: Meta-tarsophalangeal or interphalangeal joints (foot)
0573 Joint: Dislocation: Spine with or without paralysis
3.2.2 Joints: Operations for dislocations
0578 Operations for dislocations: Recurrent dislocation of shoulder
0579 Operations for dislocations: Recurrent dislocation of all other joints
3.2.3 Joints: Capsular operations
0582 Capsulotomy or arthrotomy or biopsy or drainage of joint: Small joint (including three weeks aftercare)
0583 Capsulotomy or arthrotomy or biopsy or drainage of joint: Large joint (including three weeks aftercare)
0585 Capsulectomy digital joint
0586 Multiple percutaneous capsulotomies of metacarpophalangeal joints
0587 Release of digital joint contracture
3.2.4 Joints: Synovectomy
0589 Synovectomy: Digital joint
0592 Synovectomy: Large joint
0593 Tendon synovectomy
3.2.5 Joints: Arthrodesis
0597 Arthrodesis: Shoulder
0598 Arthrodesis: Elbow
0599 Arthrodesis: Wrist
0600 Arthrodesis: Digital joint
0601 Arthrodesis: Hip
0602 Arthrodesis: Knee
0603 Arthrodesis: Ankle
0604 Arthrodesis: Sub-talar
0605 Arthrodesis: Stabilisation of foot (triple-arthrodesis)

2004.00
2004.00
2004.00
2004.00
2004.11
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20

2004.00
2004.00

20
20

60.000 1.0 R
96.000 1.0 R

2004.00
2004.00
2004.00
2004.00

20
20
20
20

50.000
32.000
64.000
96.000

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 38.000 1.0 R
20 51.000 1.0 R
20 51.000 1.0 R
20 77.000 1.0 R
20 130.000 1.0 R
20 77.000 1.0 R
20 51.000 1.0 R
20 26.000 1.0 R
20 109.000 1.0 R
20 96.000 1.0 R
20 32.000 1.0 R
20 90.000 1.0 R
20 90.000 1.0 R
20 77.000 1.0 R
20 14.000 1.0 R
20
- 0.0

2004.00
2004.00

20 200.000 1.0 R
20 161.000 1.0 R

2004.00

20

51.000 1.0 R

3 076.55
3 076.55
2 983.27
2 983.27
2 983.27
1 072.20
1 118.69
2 600.21
1 491.64
559.35
1 398.51
559.35
895.04
466.22
298.30
596.60
895.04
354.32
475.46
475.46
717.88
1 211.96
717.88
475.46
242.42
1 016.18
895.04
298.30
839.02
839.02
717.88
130.52
1 864.58
1 501.02
475.46

2004.00

20

96.000 1.0 R

895.04

2004.00
2004.00
2004.00

20 64.000 1.0 R
596.60
20 90.000 1.0 R
839.02
20 128.000 1.0 R 1 193.34
20 77.000 1.0 R
717.88
20 160.000 1.0 R 1 491.64
20 203.700 1.0 R 1 899.05
20 224.000 1.0 R 2 088.38
20 180.000 1.0 R 1 678.18
20 180.000 1.0 R 1 678.18
20 128.000 1.0 R 1 193.34
20 320.000 1.0 R 2 983.27
20 180.000 1.0 R 1 678.18
20 180.000 1.0 R 1 678.18
20 130.000 1.0 R 1 211.96
20 180.000 1.0 R 1 678.18

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

Page 19 of 84

330.000
330.000
320.000
320.000
320.000
115.000
120.000
278.900
160.000
60.000
150.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R

R
R
R
R

20

51.000 1.0 R

2 461.18
2 461.18
2 386.68
2 386.68
2 386.68
1 072.20
1 118.69
2 080.17
1 193.34
559.35
1 118.69
559.35
895.04
466.22
298.30
596.60
895.04
354.32
475.46
475.46
717.88
1 118.69
717.88
475.46
242.42
1 016.18
895.04
298.30
839.02
839.02
717.88
130.52
1 491.64
1 200.82
475.46

20

96.000 1.0 R

895.04

30

3.000 1.0 R

175.55

TM

20 64.000 1.0 R
596.60
20 90.000 1.0 R
839.02
20 120.000 1.0 R 1 118.69
20 77.000 1.0 R
717.88
20 128.000 1.0 R 1 193.34
20 162.960 1.0 R 1 519.21
20 179.200 1.0 R 1 670.70
20 144.000 1.0 R 1 342.49
20 144.000 1.0 R 1 342.49
20 120.000 1.0 R 1 118.69
20 256.000 1.0 R 2 386.68
20 144.000 1.0 R 1 342.49
20 144.000 1.0 R 1 342.49
20 120.000 1.0 R 1 118.69
20 144.000 1.0 R 1 342.49

30
30
30

3.000 1.0 R
3.000 1.0 R
3.000 1.0 R

TM
TM
TM

30
30
30

3.000 1.0 R
3.000 1.0 R
3.000 1.0 R

30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000

175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55

20
20
20
20
20
20
20
20
20
20
20

264.000
264.000
256.000
256.000
256.000
115.000
120.000
223.120
128.000
60.000
120.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R

20
20

60.000 1.0 R
96.000 1.0 R

20
20
20
20

50.000
32.000
64.000
96.000

1.0
1.0
1.0
1.0

R
R
R
R

20 38.000 1.0 R
20 51.000 1.0 R
20 51.000 1.0 R
20 77.000 1.0 R
20 120.000 1.0 R
20 77.000 1.0 R
20 51.000 1.0 R
20 26.000 1.0 R
20 109.000 1.0 R
20 96.000 1.0 R
20 32.000 1.0 R
20 90.000 1.0 R
20 90.000 1.0 R
20 77.000 1.0 R
20 14.000 1.0 R
20
- 0.0
20 160.000 1.0 R
20 128.800 1.0 R

30
30
30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000

30
30

3.000 1.0 R
3.000 1.0 R

30
30

4.000 1.0 R
4.000 1.0 R

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000

30
30

3.000 1.0 R
3.000 1.0 R

30

3.000 1.0 R

175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
234.06
234.06
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
T
T

TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM

TM
TM
TM

TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM

0607
3.2.6
0614
0615
0617
0619
0620
0621
0622
0623
0624
0625
0626
0627
0631
0635
0637
0641
0643
0645
0646
0649
0650
3.2.7
0661

Arthrodesis: Mid-tarsal wedge resection

Joints: Arthroplasty
Arthroplasty: Debridement large joints
Arthroplasty: Excision medial or lateral end of clavicle
Shoulder: Acromioplasty
Shoulder: Partial replacement
Shoulder: Total replacement
Elbow: Excision head of radius
Elbow: Excision
Elbow: Partial replacement
Elbow: Total replacement
Wrist: Excision distal end of ulna
Wrist: Excision single bone
Wrist: Excision proximal row
Wrist: Total replacement
Digital Joint: Total replacement
Hip: Total replacement
Hip: Prosthetic replacement of femoral head
Hip: Girdlestone
Knee: Partial replacement
Knee: Total replacement
Ankle: Total replacement
Ankle: Astragalectomy
Joints: Miscellaneous (joints)
Aspiration of joint or intra-articular injection (not including after-care) (modifier 0005 not applicable)

Multiple intra-articular injections for rheumatoid arthritis (excluding after-care) (modifier 0005 not
applicable): First joint
0665 Multiple intra-articular injections for rheumatoid arthritis (excluding after-care) (modifier 0005 not
applicable): Additional (each)
0667 Arthroscopy (excluding after-care) (modifiers 0005 and 0013 not applicable)
0669 Manipulation large joint under general anaesthetic (not including after-care) (modifier 0005 not
applicable)
0669a Manipulation large joint under general anaesthetic (not including after-care) (modifier 0005 not
applicable)
0670 Only the consultation fee should be charged when manipulation of a large joint is performed with or
without local anaesthetic
0670a The consultation fee only should be charged when manipulation of a large joint is performed with or
without local anaesthetic
0673 Meniscectomy or operation for other internal derangement of knee
3.2.8 Joints: Joint ligament reconstruction or suture
0675 Joint ligament reconstruction or suture: Ankle: Collateral
0677 Joint ligament reconstruction or suture: Knee: Collateral
0678 Joint ligament reconstruction or suture: Knee: Cruciate
0679 Joint ligament reconstruction or suture: Ligament augmentation procedure of knee
0680 Joint ligament reconstruction or suture: Digital joint ligament
Amputations
3.3
3.3.1 Amputations: Specific Amputations
0682 Amputation: Fore-quarter amputation
0683 Amputation: Through shoulder
0685 Amputation: Upper arm or fore-arm
0687 Partial amputation of the hand: One ray
0691 Amputation: Whole or part of finger
0693 Hindquarter amputation
0695 Amputation: Through hip joint region
0697 Amputation: Through thigh
0699 Amputation: Below knee, through knee or Syme
0701 Amputation: Trans-metatarsal or trans-tarsal
0703 Amputation: Foot: One ray
0705 Amputation: Toe
3.3.2 Amputations: Post-amputation reconstruction
0706 Post-amputation reconstruction: Skin flap taken from a site remote from the injured finger or in cases
of an advanced flap e.g. Cutler
0663

2004.00

20 144.000 1.0 R 1 342.49

20 128.000 1.0 R 1 193.34
20 116.000 1.0 R 1 081.44
20 153.600 1.0 R 1 431.95
20 221.600 1.0 R 2 065.94
20 332.800 1.0 R 3 102.65
20 96.000 1.0 R
895.04
20 153.600 1.0 R 1 431.95
20 150.400 1.0 R 1 402.18
20 225.600 1.0 R 2 103.19
20 96.000 1.0 R
895.04
20 110.000 1.0 R 1 025.56
20 132.800 1.0 R 1 238.07
20 199.200 1.0 R 1 857.10
20 153.600 1.0 R 1 431.95
20 332.800 1.0 R 3 102.65
20 230.400 1.0 R 2 148.07
20 256.000 1.0 R 2 386.68
20 221.600 1.0 R 2 065.94
20 332.800 1.0 R 3 102.65
20 232.320 1.0 R 2 165.96
20 123.200 1.0 R 1 148.61
20
9.000 1.0 R
83.89

30

3.000 1.0 R

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
5.000
5.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000

2004.00

20 180.000 1.0 R 1 678.18

20 160.000 1.0 R 1 491.64
20 116.000 1.0 R 1 081.44
20 192.000 1.0 R 1 789.93
20 277.000 1.0 R 2 582.46
20 416.000 1.0 R 3 878.31
20 96.000 1.0 R
895.04
20 192.000 1.0 R 1 789.93
20 188.000 1.0 R 1 752.68
20 282.000 1.0 R 2 629.10
20 96.000 1.0 R
895.04
20 110.000 1.0 R 1 025.56
20 166.000 1.0 R 1 547.66
20 249.000 1.0 R 2 321.42
20 192.000 1.0 R 1 789.93
20 416.000 1.0 R 3 878.31
20 288.000 1.0 R 2 684.98
20 320.000 1.0 R 2 983.27
20 277.000 1.0 R 2 582.46
20 416.000 1.0 R 3 878.31
20 290.400 1.0 R 2 707.41
20 154.000 1.0 R 1 435.76
20
9.000 1.0 R
83.89

30

2004.00

20

7.500 1.0 R

69.95

20

7.500 1.0 R

69.95

2004.00

20

4.000 1.0 R

37.25

20

4.000 1.0 R

2004.00
2004.00

20
20

60.000 1.0 R
14.000 1.0 R

559.35
130.52

20
20

2005.01

20

14.000 1.0 R

130.52

20

2006.04

20

- 0.0

20

- 0.0

2005.01

20

- 0.0

20

- 0.0

2004.00

20 109.000 1.0 R 1 016.18

20 160.000 1.0 R 1 491.64
20 160.000 1.0 R 1 491.64
20 160.000 1.0 R 1 491.64
20 280.000 1.0 R 2 610.47
20 165.000 1.0 R 1 538.27
20 294.000 1.0 R 2 741.00
20 148.000 1.0 R 1 379.74
20 116.000 1.0 R 1 081.44
20 102.000 1.0 R
950.92
20 116.800 1.0 R 1 088.92
20 420.000 1.0 R 3 915.56
20 192.000 1.0 R 1 789.93
20 205.000 1.0 R 1 911.22
20 194.000 1.0 R 1 808.71
20 142.000 1.0 R 1 323.86
20 97.000 1.0 R
904.28
20 66.000 1.0 R
615.37
20 75.000 1.0 R
699.26

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

2004.00
2004.00
2004.00
2004.00
2004.00

2004.00
2004.00
2004.00
2004.00
2006.04
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

Page 20 of 84

TM

3.000 1.0 R

175.55
175.55
175.55
175.55
292.58
292.58
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55

30

3.000 1.0 R

175.55

37.25

30

3.000 1.0 R

175.55

60.000 1.0 R
14.000 1.0 R

559.35
130.52

30
30

3.000 1.0 R
3.000 1.0 R

175.55
175.55

T
T

14.000 1.0 R

130.52

30

4.000 1.0 R

234.06

30

3.000 1.0 R

175.55

30

4.000 1.0 R

234.06

30

3.000 1.0 R

TM

30
30
30
30
30

3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

30
30
30
30
30
30
30
30
30
30
30
30

9.000
5.000
3.000
3.000
3.000
6.000
6.000
6.000
5.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R

30

3.000 1.0 R

175.55
175.55
175.55
175.55
175.55
175.55
526.64
292.58
175.55
175.55
175.55
351.09
351.09
351.09
292.58
175.55
175.55
175.55
175.55

20 109.000 1.0 R 1 016.18

20 128.000 1.0 R 1 193.34
20 128.000 1.0 R 1 193.34
20 128.000 1.0 R 1 193.34
20 224.000 1.0 R 2 088.38
20 132.000 1.0 R 1 230.59
20 235.200 1.0 R 2 192.80
20 120.000 1.0 R 1 118.69
20 116.000 1.0 R 1 081.44
20 102.000 1.0 R
950.92
20 116.800 1.0 R 1 088.92
20 336.000 1.0 R 3 132.57
20 153.600 1.0 R 1 431.95
20 164.000 1.0 R 1 528.89
20 155.200 1.0 R 1 446.91
20 120.000 1.0 R 1 118.69
20 97.000 1.0 R
904.28
20 66.000 1.0 R
615.37
20 75.000 1.0 R
699.26

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
T

TM
TM
TM
TM
TM

TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM

0707
0709
0711
0712
3.4
3.4.1
0713
0714
0715
0717
0718
0721
0723
0725
0727
0728
0729
0730
0731
0733
0735
0737
0739
0740
0741
0742
4701
4703
4705
4707
4709
4711
4713
4715
4717
4719
4721
4723
4725
4727
4729
4731
4733
4735
4737
4739
4744
4745
3.4.2
0743
0744
3.4.3
0745
0746
0747
0748
0749
0755

Post-amputation reconstruction: Krukenberg reconstruction

Post-amputation reconstruction: Metacarpal transfer
Post-amputation reconstruction: Pollicisation of the finger (to include all stages)
Post-amputation reconstruction: Toe to thumb transfer
Muscles, tendons and fasciae
Muscles, tendons and fasciae: Investigations
Electromyography
Electro-myographic neuromuscular junctional study, including edrophonium response (not to be used
with item 2730)
Strength duration curve per session
Electrical examination of single nerve or muscle
Oxidative study for mitochondrial function
Voltage integration during isometric contraction
Tonometry with edrophonium
Isometric tension studies with edrophonium
Cranial reflex study (both early and late responses) supra occulofacial or corneofacial or
flabellofacial: Unilateral
Cranial reflex study (both early and late responses) supra occulofacial or corneofacial or
flabellofacial: Bilateral
Tendon reflex time
Limb brain somatosensory studies (per limb)
Vision and audio-sensory studies
Motor nerve conduction studies (single nerve)
Examinations of sensory nerve conduction by sweep averages (single nerve)
Biopsy for motor nerve terminals and end plates
Combined muscle biopsy with end plates and nerve terminal biopsy
Muscle fatigue studies
Muscle biopsy
Global fee for all muscle studies, including histochemical studies
Biochemical estimations on muscle biopsy specimens: Creatine kinase
Biochemical estimations on muscle biopsy specimens: Adenylate kinase
Biochemical estimations on muscle biopsy specimens: Pyruvate kinase
Biochemical estimations on muscle biopsy specimens: Lactate dehydrogenase
Biochemical estimations on muscle biopsy specimens: Adenylate deaminase
Biochemical estimations on muscle biopsy specimens: Phosphoglycerate kinase
Biochemical estimations on muscle biopsy specimens: Phosphoglycerate mutase
Biochemical estimations on muscle biopsy specimens: Enolase
Biochemical estimations on muscle biopsy specimens: Phosphofructokinase
Biochemical estimations on muscle biopsy specimens: Aldolase
Biochemical estimations on muscle biopsy specimens: Glyceraldehyde 3 phosphate dehydrogenase

2004.00
2004.00
2004.00
2004.00

20
20
20
20

2004.00
2006.04

Biochemical estimations on muscle biopsy specimens: Phosphorylase

Biochemical estimations on muscle biopsy specimens: Phosphoglucomutase
Biochemical estimations on muscle biopsy specimens: Phosphohexose Isomerase
Biochemical estimations on muscle biopsy specimens: Muscle biopsy for muscle tension study
Biochemical estimations on muscle biopsy specimens: H-response study (per nerve)
Biochemical estimations on muscle biopsy specimens: Late response study (per nerve)
Biochemical estimations on muscle biopsy specimens: Single fibre studies
Biochemical estimations on muscle biopsy specimens: Somatosensory study (limb-spine)
Biochemical estimations on muscle biopsy specimens: Dystrophin estimation
Biochemical estimations on muscle biopsy specimens: Tension/caffeine/halothane procedure in
malignant hyperthermia
Biochemical estimations on muscle biopsy specimens: Electron microscopy
Muscles, tendons and fasciae: Decompression Operations
Major compartmental decompression
Decompression operation: Fasciotomy only
Muscles, tendons and fasciae: Muscle and tendon repair
Muscle and tendon repair: Biceps humeri
Muscle and tendon repair: Removal of calcification in Rotator cuff
Muscle and tendon repair: Rotator cuff
Muscle and tendon repair: Debridement rotator cuff
Muscle and tendon repair: Scapulopexy - stand alone procedure
Muscle and tendon repair: Infrapatellar of quadriceps tendon

20
20
20
20

20
20

1 920.46
1 789.93
2 629.10
7 458.33
75.000 1.0 R
699.26
57.000 1.0 R
531.33

30
30
30
30

3.000
3.000
3.000
3.000

20
20

1 536.37
1 431.95
2 103.19
5 966.69
75.000 1.0 R
699.26
57.000 1.0 R
531.33

30
30

3.000 1.0 R
3.000 1.0 R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20

10.500
9.000
64.000
12.000
8.000
10.000
8.000

R
R
R
R
R
R
R

97.82
83.89
596.60
111.90
74.65
93.27
74.65

20
20
20
20
20
20
20

10.500
9.000
64.000
12.000
8.000
10.000
8.000

R
R
R
R
R
R
R

97.82
83.89
596.60
111.90
74.65
93.27
74.65

30
30

3.000 1.0 R
3.000 1.0 R

30
30
30
30

3.000
3.000
3.000
3.000

2004.00

20

14.000 1.0 R

130.52

20

14.000 1.0 R

130.52

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
7.000 1.0 R
65.26
20 49.000 1.0 R
456.83
20 49.000 1.0 R
456.83
20 26.000 1.0 R
242.42
20 31.000 1.0 R
289.06
20 20.000 1.0 R
186.40
20 34.000 1.0 R
316.92
20 20.000 1.0 R
186.40
20 20.000 1.0 R
186.40
20 262.000 1.0 R 2 442.55
20 20.250 1.0 R
188.75
20 33.300 1.0 R
310.47
20
5.700 1.0 R
53.09
20
1.600 1.0 R
14.96
20
9.900 1.0 R
92.25
20 13.700 1.0 R
127.74
20 25.900 1.0 R
241.40
20 32.700 1.0 R
304.90
20 37.700 1.0 R
351.53
20 15.750 1.0 R
146.80
20 11.060 1.0 R
103.10

20
20
20
20
20
20
20
20
20

7.000
49.000
49.000
26.000
31.000
20.000
34.000
20.000
20.000

65.26
456.83
456.83
242.42
289.06
186.40
316.92
186.40
186.40
-

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 34.700
20 40.300
20 28.800
20 43.000
20 14.000
20 20.000
20 71.000
20 69.000
20 82.000
20 143.000

2004.00

20

2004.00
2004.00

20 132.000 1.0 R
20 60.000 1.0 R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20

Page 21 of 84

206.000
192.000
282.000
800.000

1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R

1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R

R
R
R
R
R
R
R
R
R

R
323.52
R
375.73
R
268.53
R
400.96
R
130.52
R
186.40
R
661.86
R
643.23
R
764.52
R 1 333.25

75.000 1.0 R

109.000
96.000
134.000
139.700
271.900
128.000

164.800
153.600
225.600
640.000

R
R
R
R
R
R

699.26
1 230.59
559.35
1 016.18
895.04
1 249.21
1 302.45
2 534.95
1 193.34

20 120.000 1.0 R
20 60.000 1.0 R
20
20
20
20
20
20

109.000
96.000
120.000
120.000
217.520
120.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

1.0
1.0
1.0
1.0

175.55
175.55
175.55
175.55
175.55
175.55

TM
TM
TM
TM

T
T

R
R
R
R

175.55
175.55
175.55
175.55
175.55
175.55

30

3.000 1.0 R

175.55

30

3.000 1.0 R

30
30
30
30
30

3.000
3.000
8.000
3.000
8.000

175.55
175.55
175.55
468.13
175.55
468.13
-

1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0

R
R
R
R

R
R
R
R
R

1 118.69
559.35
1 016.18
895.04
1 118.69
1 118.69
2 027.96
1 118.69

175.55
175.55
175.55
175.55
234.06
234.06
234.06
175.55

30
30

3.000 1.0 R
3.000 1.0 R

30
30
30
30
30
30

3.000
3.000
4.000
4.000
4.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

T
T

T
T
T
T

T
T
T
T
T

T
T
T
TM
T
T
T
T

0757
0759
0763
0767
0769
0771
0773
0774
3.4.4
0775
0776
0777
0779
0780
3.4.5
0781
0782
0783
0784
0785
0787

Muscle and tendon repair: Achilles tendon repair

Muscle and tendon repair: Other single tendon
Muscle and tendon repair: Tendon or ligament injection
Hand: Flexor tendon suture: Primary (per tendon)
Hand: Flexor tendon suture: Secondary (per tendon)
Extensor tendon suture: Primary (per tendon)
Extensor tendon suture: Secondary (per tendon)
Repair of Boutonniere deformity or Mallet finger with graft
Muscles, tendons and fasciae: Tendon graft
Free tendon graft
Reconstruction of pulley for flexor tendon
Tendon graft: Finger: Flexor
Tendon graft: Finger: Extensor
Two stage flexor tendon graft using silastic rod
Muscles, tendons and fasciae: Tendolysis
Tendon freeing operation, except where specified elsewhere
Carpal tunnel syndrome
Tenolysis: De Quervain
Trigger finger
Flexor tendon freeing operation following free tendon graft or suture
Extensor tendon freeing operation following graft or suture in finger, hand or forearm, each tendon

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20

197.600
77.000
9.000
128.000
160.000
129.700
80.000
183.700

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

160.000
50.000
192.000
122.000
240.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 64.000 1.0
20 98.700 1.0
20 38.000 1.0
20 38.000 1.0
20 186.800 1.0
20 180.900 1.0

R
R
R
R
R
R

0788
0789
3.4.6
0790
3.4.7
0791
0792
0793
0794
0795
0802
0803
0809
0811
3.4.8
0812
0813
0815
0817
0821
0822
0823
0825
0829
0831
0835
0837
0838
0845
0846
3.5
0847
0849
0851
0853
0855
0857
3.6
3.6.1
0859
0861

Intrinsic tendon release per finger

Central tendon tenotomy for Boutonniere deformity
Muscles, tendons and fasciae: Tenodesis
Tenodesis: Digital joint
Muscles, tendons and fasciae: Muscle tendon and facia transfer
Single tendon transfer
Multiple tendon transfer
Hamstring to quadriceps transfer
Pectoralis major or Latissimus dorsi transfer to biceps tendon
Tendon transfer at elbow
Radial club hand repair - stand alone procedure
Hand tendons: Single tendon transfer (first)
Hand tendons: Substitution for intrinsic paralysis of hand
Hand tendons: Opponens tendon transfer (including obtaining of graft)
Muscles, tendons and fasciae: Muscle slide operations and tendon lengthening
Percutaneous Tenotomy: All sites
Torticollis
Scalenotomy
Scalenotomy with excision of first rib
Tennis elbow
Open release elbow (Mitals) - stand alone procedure
Excision or slide for Volkmann's Contracture
Hip: Open muscle release
Knee: Quadriceps plasty
Knee: Open tenotomy
Calf
Open elongation tendon Achilles
Percutaneous "Hoke" elongation tendo Achilles
Foot: Plantar fasciotomy
Foot: Postero-medial release for club-foot
Bursae and ganglia
Excision: Semimembranosus
Excision: Prepatellar
Excision: Olecranon
Excision: Small bursa or ganglion
Excision: Compound palmar ganglion or synovectomy
Bursae and ganglia: Aspiration or injection (no after-care) (modifier 0005 not applicable)
Musculo-skeletal system: Miscellaneous
Musculo-skeletal system: Miscellaneous: Leg equalisation and congenital hips and feet
Leg equalisation and congenital hips and feet: Leg shortening
Leg equalisation and congenital hips and feet: Leg lengthening

2004.00
2004.00

20
20

64.000 1.0 R
64.000 1.0 R

2004.00

20

90.000 1.0 R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20

96.000
128.000
141.000
320.000
116.000
360.300
96.000
224.000
220.600

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

38.000
96.000
132.000
190.000
96.000
278.200
192.000
116.000
160.000
141.000
96.000
96.000
79.300
70.000
192.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 90.000 1.0
20 45.000 1.0
20 81.800 1.0
20 80.900 1.0
20 128.000 1.0
20
9.000 1.0

R
R
R
R
R
R

2004.00
2004.00

20 282.000 1.0 R
20 416.000 1.0 R

Page 22 of 84

1 842.14
717.88
83.89
1 193.34
1 491.64
1 209.18
745.89
1 712.65
1 491.64
466.22
1 789.93
1 137.46
2 237.53
596.60
920.12
354.32
354.32
1 741.54
1 686.54

20
20
20
20
20
20
20
20

158.080
77.000
9.000
120.000
128.000
120.000
80.000
146.960

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

20
20
20
20
20

128.000
50.000
153.600
120.000
192.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

20 64.000 1.0
20 98.700 1.0
20 38.000 1.0
20 38.000 1.0
20 149.440 1.0
20 144.720 1.0

R
R
R
R
R
R

596.60
596.60
839.02
895.04
1 193.34
1 314.48
2 983.27
1 081.44
3 359.01
895.04
2 088.38
2 056.70
354.32
895.04
1 230.59
1 771.31
895.04
2 593.61
1 789.93
1 081.44
1 491.64
1 314.48
895.04
895.04
739.29
652.62
1 789.93
839.02
419.58
762.61
754.25
1 193.34
83.89
2 629.10
3 878.31

20
20

64.000 1.0 R
64.000 1.0 R

20

90.000 1.0 R

20
20
20
20
20
20
20
20
20

96.000
120.000
120.000
256.000
116.000
288.240
96.000
179.200
176.480

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

38.000
96.000
120.000
152.000
96.000
222.560
153.600
116.000
128.000
120.000
96.000
96.000
79.300
70.000
153.600

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

20 90.000 1.0
20 45.000 1.0
20 81.800 1.0
20 80.900 1.0
20 128.000 1.0
20
9.000 1.0

R
R
R
R
R
R

20 225.600 1.0 R
20 332.800 1.0 R

1 473.74
717.88
83.89
1 118.69
1 193.34
1 118.69
745.89
1 370.06
1 193.34
466.22
1 431.95
1 118.69
1 789.93
596.60
920.12
354.32
354.32
1 393.23
1 349.23

30
30
30
30
30
30
30
30

4.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

30
30
30
30
30

3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

596.60
596.60
839.02
895.04
1 118.69
1 118.69
2 386.68
1 081.44
2 687.17
895.04
1 670.70
1 645.33
354.32
895.04
1 118.69
1 417.14
895.04
2 074.89
1 431.95
1 081.44
1 193.34
1 118.69
895.04
895.04
739.29
652.62
1 431.95
839.02
419.58
762.61
754.25
1 193.34
83.89
2 103.19
3 102.65

30
30

3.000 1.0 R
3.000 1.0 R

30

3.000 1.0 R

30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
5.000
3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

3.000
5.000
5.000
3.000
3.000
3.000
3.000
7.000
3.000
3.000
4.000
4.000
4.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

30
30
30
30
30
30

4.000
3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

30
30

3.000 1.0 R
3.000 1.0 R

234.06
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55

T
T
T
T
T
T
T
T

175.55
175.55
175.55
175.55
175.55
175.55
292.58
175.55
175.55
175.55
175.55
175.55
175.55
292.58
292.58
175.55
175.55
175.55
175.55
409.61
175.55
175.55
234.06
234.06
234.06
175.55
175.55
234.06
175.55
175.55
175.55
175.55
175.55
175.55
175.55

T
T

T
T
T
T
T
T
T
T
T
T
T

T
T
T
T
T
T
T
T
T
T
T
T
T
TM
T
TM
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

TM
TM

0863
0865

Leg equalisation and congenital hips and feet: Epiphysiodesis at one level
Congenital dislocation of hip: Initial non-operative reduction and application of plaster cast: One hip

2004.00
2004.00

20 116.000 1.0 R 1 081.44

20 109.000 1.0 R 1 016.18

20 116.000 1.0 R 1 081.44

20 109.000 1.0 R 1 016.18

30
30

3.000 1.0 R
3.000 1.0 R

175.55
175.55

TM
TM

0867

Congenital dislocation of hip: Initial non-operative reduction and application of plaster cast: Both hips 2006.04

20 160.000 1.0 R 1 491.64

20 128.000 1.0 R 1 193.34

30

3.000 1.0 R

175.55

TM

0868
0869
0873
0874
3.6.2
0883
0884
0885
0886

Open reduction of congenital dislocation of the hip

Subsequent plasters
Congenital club foot: Manipulation and plaster: One foot
Ponseti technique assistant (medical practitioner)
Musculo-skeletal system: Miscellaneous: Removal of internal fixatives of prosthesis
Removal of internal fixatives or prosthesis: Readily accessible
Removal of internal fixatives: Less accessible
Removal of prosthesis for infection soon after operation
Late removal of infected or not infected total joint replacement prosthesis (including six weeks aftercare): ADD to the item for total joint replacement of the specific joint
Plasters (exclusive of after-care)
Limb cast (excluding after-care) (modifier 0005 not applicable)
Spica, plaster jacket or hinged cast brace (excluding after-care)
Turnbuckle cast for scoliosis (excluding after-care)
Adjustment or repair of turnbuckle cast for scoliosis (excluding after-care)
Musculo-skeletal system: Special areas
Special areas: Foot and Ankle
Club foot: Revision club foot release - stand alone procedure
Club foot: Posterior release only - stand alone procedure
Excision tarsal coalition - stand alone procedure
Tenotomy: Single tendon
Hammer toe: One toe
Filleting of toe or Ruiz-Mora procedure
Arthrodesis Hallux
Silver bunionectomy or similar for Hallux Valgus
Excision arthroplasty
Cheilectomy or metatarsophangeal implant Hallux
Metatarsal osteotomy or Lapidus or similar or Chevron - stand alone procedure
Hallux Valgus double osteotomy etc.
Distal soft tissue procedure for Hallux Valgus
Aitkin procedure or similar
Removal bony prominence foot e.g. bunionette ( Bunionette not applicable to COID)
Repair angular deformity toe (lesser toes)
Sesamoidectomy
Repair major foot tendons e.g. Tib Post
Repair of dislocating peroneal tendons
Forefoot reconstruction for rheumatoid arthritis: Clayton or similar: One foot
Steindler strip - plantar fascia
Kelikian syndactilly (one web space)
Tendon transfer foot
Capsulotomy metatarsophalangeal joints: Foot
Big toe (refer to section 3.8.1 for procedures on big toe)
Special areas: Reimplantations
Replantation of amputated upper limb proximal to wrist joint
Replantation of thumb
Replantation of a single digit (to be motivated), for multiple digits (modifier 0005 applicable)
Replantation operation through the palm
Special areas: Hands: (Note: Skin: See Integumentary System)
Tumours: Epidermoid cysts
Tumours: Ganglion or fibroma
Tumours: Nodular synovitis (Giant cell tumour of tendon sheath)
Removal of foreign bodies requiring incision: Under local anaesthetic
Removal of foreign bodies requiring incision: Under general or regional anaesthetic
Crushed hand injuries: Initial extensive soft tissue toilet under general anaesthetic (sliding scale) Minimum
Item 0924: The number of units chargeable under this item ranges from 37.00 to 110.00 for
Specialists and General Practitioners.
Crushed hand injuries: Subsequent dressing changes under general anaesthetic

20 186.000 1.0 R 1 734.06

20 32.000 1.0 R
298.30
20 26.000 1.0 R
242.42
20 13.000 1.0 R
121.14
20 36.600 1.0 R
341.27
20 75.500 1.0 R
703.95
20 128.000 1.0 R 1 193.34
20 64.000 1.0 R
596.60

20 148.800 1.0 R 1 387.22

20 32.000 1.0 R
298.30
20 26.000 1.0 R
242.42
20 13.000 1.0 R
121.14
20 36.600 1.0 R
341.27
20 75.500 1.0 R
703.95
20 120.000 1.0 R 1 118.69
20 64.000 1.0 R
596.60

30

3.000 1.0 R

TM

30

3.000 1.0 R

30

6.000 1.0 R

175.55
175.55
351.09

30
30
30
30

3.000
4.000
5.000
5.000

1.0
1.0
1.0
1.0

R
R
R
R

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

30
30
30
30

3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0

R
R
R
R

30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

3.7
0887
0889
0891
0893
3.8
3.8.1
0895
0896
0900
0901
0903
0905
0906
0907
0909
0910
0911
5730
5731
5732
5734
5735
5736
5737
5738
5739
5740
5741
5742
5743
3.8.2
3.8.3
0912
0913
0914
0915
3.8.4
0919
0920
0921
0922
0923
0924

0925

2004.00
2004.00
2004.00
2005.03
2004.00
2004.00
2004.00
2004.00

2004.00
2004.00
2004.00
2004.00

20
20
20
20

13.000
32.000
51.000
19.000

1.0
1.0
1.0
1.0

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

302.700
159.300
141.500
63.300
99.500
99.500
148.000
126.200
145.200
183.000
189.200
182.600
173.600
166.800
91.000
97.200
97.800
147.300
173.200
202.300
97.200
97.200
172.000
86.800

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

2004.00
2004.00
2004.00
2004.00

20
20
20
20

730.000
670.000
580.000
#######

1.0
1.0
1.0
1.0

2004.00
2004.00
2004.00
2004.00
2004.00
2005.01

20
20
20
20
20
20

35.000
77.500
86.000
19.000
32.000
37.000

1.0
1.0
1.0
1.0
1.0
1.0

121.14
298.30
475.46
177.16
R 2 822.10
R 1 485.18
R 1 319.17
R
590.14
R
927.60
R
927.60
R 1 379.74
R 1 176.62
R 1 353.63
R 1 706.05
R 1 763.83
R 1 702.38
R 1 618.49
R 1 554.99
R
848.40
R
906.19
R
911.76
R 1 373.29
R 1 614.68
R 1 885.99
R
906.19
R
906.19
R 1 603.53
R
809.25
R 6 805.71
R 6 246.37
R 5 407.35
R 11 840.11
R
326.31
R
722.57
R
801.77
R
177.16
R
298.30
R
344.93
R
R
R
R

2004.00
2004.00

20
20
20
20

13.000
32.000
51.000
19.000

1.0
1.0
1.0
1.0

R
R
R
R

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

242.160
127.440
120.000
63.300
99.500
99.500
120.000
120.000
120.000
146.400
151.360
146.080
138.880
133.440
91.000
97.200
97.800
120.000
138.560
161.840
97.200
97.200
137.600
86.800

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

20
20
20
20

584.000
536.000
464.000
#######

1.0
1.0
1.0
1.0

R
R
R
R

20
20
20
20
20
20

35.000
77.500
86.000
19.000
32.000
37.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

20

Page 23 of 84

16.000 1.0 R

149.15

121.14
298.30
475.46
177.16
2 257.62
1 188.06
1 118.69
590.14
927.60
927.60
1 118.69
1 118.69
1 118.69
1 364.93
1 411.12
1 361.85
1 294.82
1 244.08
848.40
906.19
911.76
1 118.69
1 291.74
1 508.80
906.19
906.19
1 282.80
809.25
5 444.60
4 997.15
4 325.76
9 472.06
326.31
722.57
801.77
177.16
298.30
344.93

20

16.000 1.0 R

149.15

175.55
234.06
292.58
292.58
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55

TM

T
T
T
T

TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
TM
T
TM
TM
TM
TM
T
TM
T
T
T
T

TM
TM
TM
TM
TM
TM
TM
TM
TM
TM

30

3.000 1.0 R

175.55

TM

3.8.5

Special areas: Spine

Please note the following with regard to section 3.8.5: Spine

2004.00

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.
0927
0928
0929
0930
0931
0932
0933
0936
0938
0939

Excision of one vertebral body, for a lesion within the body (no decompression)
Excision of each additional vertebral segment for a lesion within the body (no decompression)
Manipulation of spine under general anaesthetic: (no after-care) (modifier 0005 not applicable)
Posterior osteotomy of spine: One vertebral segment
Posterior spinal fusion: One level
Posterior osteotomy of spine: Each additional vertebral segment
Anterior spinal osteotomy with disc removal: One vertebral segment
Anterior spinal osteotomy with disc removal: Each additional vertebral segment
Anterior fusion base of skull to C2
Trans-abdominal anterior exposure of the spine for spinal fusion only if done by a second surgeon

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

0940
0941
0942
0944
0946
0948
0950
0959
0961
0963

Trans-thoracic anterior exposure of the spine if done by a second surgeon

Anterior interbody fusion: One level
Anterior interbody fusion: Each additional level
Posterior fusion: Occiput to C2
Posterior spinal fusion: Each additional level
Posterior interbody lumbar fusion: One level
Posterior interbody lumbar fusion: Each additional interspace
Excision of coccyx
Costo-transversectomy
Antero-lateral decompression of spinal cord or anterior debridement
MODIFIER
Combined procedures on the spine: In cases of combined procedures on the spine, both the
orthopaedic surgeon and the neurosurgeon are entitled to the full fee for the relevant part of the
operation performed
Special areas: Spinal deformities
Please note : Posterior fusion for spinal deformity (to be used for scoliosis more than 30 degrees or
thoracic kyphosis more than 45 degrees).
Posterior fusion for spinal deformity: Up to 6 levels
Posterior fusion for spinal deformity: 7 to 12 levels
Posterior fusion for spinal deformity: 13 or more levels
Anterior fusion for spinal deformity: 2 or 3 levels
Anterior fusion for spinal deformity: 4 to 7 levels
Anterior fusion for spinal deformity: 8 or more levels
MODIFIER
Additional operative procedures by same surgeon, under section 3.8.6: Spinal deformities, within a
period of 12 months: 75% of scheduled fee for the lesser procedure, except where otherwise
specified elsewhere
Special areas: All spinal problems
Laminectomy with decompression of nerve roots and disc removal: One level
Posterior non-segmental instrumentation
Posterior segmental instrumentation: 2 to 6 vertebrae
Posterior segmental instrumentation: 7 to 12 vertebrae
Posterior segmental instrumentation:13 or more vertebrae
Anterior instrumentation: 2 to 3 vertebrae
Skull or skull-femoral traction including two weeks after-care
Anterior instrumentation: 4 to 7 vertebrae
Halo-splint and POP jacket including two weeks after-care
Anterior instrumentation: 8 or more vertebrae

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

0061

3.8.6

0952
0954
0955
0956
0957
0958
0065

3.8.7
0943
0960
0962
0964
0966
0968
0969
0970
0971
0972

20
20
20
20
20
20
20
20
20
20

207.000
42.000
14.000
339.000
385.000
103.000
315.000
103.000
449.000
160.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

1 929.84
391.57
130.52
3 160.43
3 589.25
960.30
2 936.78
960.30
4 186.00
1 491.64

20
20
20
20
20
20
20
20
20
20

165.600
42.000
14.000
271.200
308.000
103.000
252.000
103.000
359.200
128.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

1 543.85
391.57
130.52
2 528.35
2 871.52
960.30
2 349.43
960.30
3 348.74
1 193.34

30
30
30
30
30
30
30
30
30
30

3.000
3.000
5.000
3.000
3.000
3.000
3.000
3.000
4.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

175.55
175.55
292.58
175.55
175.55
175.55
175.55
175.55
234.06
175.55

TM
TM
TM
TM
TM
TM
TM
TM
TM
TM

20
20
20
20
20
20
20
20
20
20

160.000
360.000
102.000
390.000
111.000
364.000
95.000
96.000
198.000
326.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

20
20
20
20
20
20
20
20
20
20

128.000
288.000
102.000
312.000
111.000
291.200
95.000
96.000
158.400
260.800

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

1 193.34
2 684.98
950.92
2 908.77
1 034.80
2 714.89
885.65
895.04
1 476.68
2 431.41
-

30
30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
4.000
3.000
3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

175.55
175.55
175.55
234.06
175.55
175.55
175.55
175.55
175.55
175.55
-

TM
TM
TM
TM
TM
TM
TM
TM
TM
T

2004.00

1 491.64
3 356.22
950.92
3 635.89
1 034.80
3 393.47
885.65
895.04
1 845.96
3 039.30
-

2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

+
+

+
+
+

20
20
20
20
20
20

359.000
547.000
593.000
410.000
444.000
539.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

20
20
20
20
20
20
20
20
20
20

240.000
167.000
176.000
201.000
245.000
159.000
64.000
185.000
116.000
206.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

Page 24 of 84

3 346.98
5 099.66
5 528.49
3 822.44
4 139.36
5 025.02
-

2 237.53
1 556.90
1 640.79
1 873.97
2 284.16
1 482.40
596.60
1 724.67
1 081.44
1 920.46

20
20
20
20
20
20

287.200
437.600
474.400
328.000
355.200
431.200

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

20
20
20
20
20
20
20
20
20
20

192.000
133.600
140.800
160.800
196.000
127.200
64.000
148.000
116.000
164.800

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

2 677.50
4 079.67
4 422.85
3 057.92
3 311.49
4 019.98
-

1 789.93
1 245.55
1 312.72
1 499.12
1 827.33
1 185.86
596.60
1 379.74
1 081.44
1 536.37

30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

30
30
30
30
30
30

3.000
5.000
5.000
5.000
5.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

30

5.000 1.0 R

30

5.000 1.0 R

175.55
175.55
175.55
175.55
175.55
175.55
-

175.55
292.58
292.58
292.58
292.58
292.58
292.58
292.58

TM
TM
TM
TM
TM
TM

TM
TM
TM
TM
TM
TM
TM
TM

0974
5750
5751
5752
5753
5755
5756
5757
5758
5759
5760
5761
5763
5764
5765
5766
5770
3.9
0987
0988
0989
0990
0991
0992
0993
0994
0995
0996
0997
0999
1001
1003
1005
1007
1009
1011
1012
1013
1015
1017
4
4.1
1018
1019
1020
1022
1024
1025
1027
1029
1030
1031

Additional pelvic fixation of instrumentation other than sacrum

Reinsertion of instrumentation
Removal of posterior non-segmental instrumentation
Removal of posterior segmental instrumentation
Removal of anterior instrumentation
Laminectomy for spinal stenosis (exclude diskectomy, foraminotomy and spondylolisthesis): One or
two levels
Laminectomy with full decompression for spondylolisthesis (Gill procedure)
Laminectomy for decompression without foraminotomy or diskectory more than two levels
Laminectomy with decompression of nerve roots and disc removal: Each additional level
Laminectomy for decompression diskectomy, etc. revision operation
Laminectomy, facetectomy, decompression for lateral recess stenosis plus spinal stenosis: One
level
Laminectomy, facetectomy, decompression for lateral recess stenosis plus spinal stenosis: Each
additional level
Anterior disc removal and spinal decompression cervical: One level
Anterior disc removal and spinal decompression cervical: Each additional level
Vertebral corpectomy for spinal decompression: One level
Vertebral corpectomy for spinal decompression: Each additional level
Use of microscope in spinal or intracranial procedures (modifier 0005 not applicable)
Facial bone procedures
Please note: Modifiers 0046 to 0058 are not applicable to section 3.9
Repair of orbital floor (blowout fracture)
Genioplasty
Open reduction and fixation of central mid-third facial fracture with displacement: Le Fort I
Open reduction and fixation of central mid-third facial fracture with displacement: Le Fort II
Open reduction and fixation of central mid-third facial fracture with displacement: Le Fort III
Open reduction and fixation of central mid-third facial fracture with displacement: Le Fort I
Osteotomy
Open reduction and fixation of central mid-third facial fracture with displacement: Palatal Osteotomy

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20

108.000
276.000
173.000
175.000
204.000
295.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

1 006.94
2 573.08
1 612.92
1 631.55
1 901.83
2 750.24

20
20
20
20
20
20

108.000
220.800
138.400
140.000
163.200
236.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

1 006.94
2 058.46
1 290.28
1 305.24
1 521.55
2 200.28

30
30
30
30
30
30

5.000
6.000
6.000
6.000
6.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

292.58
351.09
351.09
351.09
351.09
175.55

TM
TM
TM
TM
TM
TM

2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

304.000
321.000
63.000
352.000
301.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

2 834.12
2 992.66
587.36
3 281.72
2 806.26

20
20
20
20
20

243.200
256.800
63.000
281.600
240.800

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

2 267.30
2 394.16
587.36
2 625.29
2 245.01

30
30
30
30
30

3.000
3.000
3.000
4.000
3.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

175.55
175.55
175.55
234.06
175.55

TM
TM
TM
TM
TM

2004.00

20

68.000 1.0 R

633.99

20

68.000 1.0 R

633.99

30

3.000 1.0 R

175.55

TM

20 275.200 1.0 R 2 565.60

20 81.000 1.0 R
755.13
20 372.800 1.0 R 3 475.60
20 88.000 1.0 R
820.39
20 71.000 1.0 R
661.86
20 147.680 1.0 R 1 376.80
20 210.400 1.0 R 1 961.52
20 161.760 1.0 R 1 508.06
20 241.600 1.0 R 2 252.49
20 346.400 1.0 R 3 229.51
20 776.000 1.0 R 7 234.53

30
30
30
30

3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0

R
R
R
R

30
30
30
30
30
30

4.000
4.000
4.000
4.000
4.000
4.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

175.55
175.55
175.55
175.55
234.06
234.06
234.06
234.06
234.06
234.06

TM
TM
TM
TM

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 344.000 1.0 R 3 207.07

20 81.000 1.0 R
755.13
20 466.000 1.0 R 4 344.53
20 88.000 1.0 R
820.39
20 71.000 1.0 R
661.86
20 184.600 1.0 R 1 721.01
20 263.000 1.0 R 2 451.94
20 202.200 1.0 R 1 885.11
20 302.000 1.0 R 2 815.50
20 433.000 1.0 R 4 036.85
20 970.000 1.0 R 9 043.24

2004.00

20 302.000 1.0 R 2 815.50

20 241.600 1.0 R 2 252.49

30

4.000 1.0 R

234.06

TM

Open reduction and fixation of central mid-third facial fracture with displacement: Le Fort II
Osteotomy (team fee)
Open reduction and fixation of central mid-third facial fracture with displacement: Le Fort III
Osteotomy (team fee)
Open reduction and fixation of central mid-third facial fracture with displacement: Fracture of maxilla
without displacement
Mandible: Fractured nose and zygoma: Open reduction and fixation
Mandible: Fractured nose and zygoma: Closed reduction by inter-maxillary fixation
Temporo-mandibular joint: Reconstruction for dysfunction
Manipulation: Immobilisation and follow-up of fractured nose
Nasal fracture without manipulation
Mandibulectomy
Maxillectomy
Bone graft to mandible
Adjustment of occlusion by ramisection
Fracture of arch of zygoma without displacement
Fracture of arch of zygoma with displacement requiring operative manipulation (not including
associated fractures), recent fracture (within four weeks)
Fracture of arch of zygoma with displacement requiring operative manipulation but not including
associated fractures (after four weeks)
Respiratory System
Nose and sinuses
Flexible nasopharyngolaryngoscope examination
ENT endoscopy in rooms with rigid endoscope
Repair of perforated septum: Any method
Functional reconstruction of nasal septum
Insertion of silastic obturator into nasal septum perforation (excluding material)
Intranasal antrostomy (modifier 0005 to apply to opposite side of nose)
Dacrocystorhinostomy
Turbinectomy (modifier 0005 to apply to opposite side of nose)
Endoscopic turbinectomy: Laser or microdebrider
Removal of single nasal polyp at rooms (at initial consultation only)

2004.00

20 ####### 1.0 R 10 283.21

20 882.400 1.0 R 8 226.51

30

4.000 1.0 R

234.06

TM

2004.00

20 ####### 1.0 R 15 420.13

20 ####### 1.0 R 12 336.10

30

4.000 1.0 R

234.06

TM

2004.00

20

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20

2004.00

20 262.000 1.0 R 2 442.55

20 209.600 1.0 R 1 954.04

2004.00
2004.00
2006.04
2004.00
2004.00
2006.04
2004.00
2006.04
2004.00
2004.00

484.26
111.90
1 322.98
1 129.98
279.67
602.32
1 957.86
583.54
839.02
236.85

484.26
1 118.69
1 118.69
279.67
602.32
1 566.28
583.54
839.02
236.85

2004.00
2004.00
2004.00
2004.00
2004.00

- 1.0
302.000
184.000
206.000
35.000
320.000
382.500
206.000
227.000
131.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R 2 815.50
R 1 715.43
R 1 920.46
R
326.31
R 2 983.27
R 3 566.08
R 1 920.46
R 2 116.24
R 1 221.35

20 51.940 1.0 R
20 12.000 1.0 R
20 141.900 1.0 R
20 121.200 1.0 R
20 30.000 1.0 R
20 64.600 1.0 R
20 210.000 1.0 R
20 62.600 1.0 R
20 90.000 1.0 R
20 25.400 1.0 R

Page 25 of 84

20
20
20
20
20
20
20
20
20
20
20
20

20

- 1.0
241.600
147.200
164.800
35.000
256.000
306.000
164.800
181.600
120.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R 2 252.49
R 1 372.41
R 1 536.37
R
326.31
R 2 386.68
R 2 852.75
R 1 536.37
R 1 692.99
R 1 118.69

51.940 1.0 R

20 120.000 1.0 R
20 120.000 1.0 R
20 30.000 1.0 R
20 64.600 1.0 R
20 168.000 1.0 R
20 62.600 1.0 R
20 90.000 1.0 R
20 25.400 1.0 R

TM
TM
TM
TM
TM
TM

30
30
30
30

3.000
3.000
4.000
3.000

1.0
1.0
1.0
1.0

R
R
R
R

TM
TM
TM
TM

3.000 1.0 R

175.55
175.55
234.06
175.55
292.58
234.06
234.06
234.06
175.55

30
30
30
30

5.000
4.000
4.000
4.000

1.0
1.0
1.0
1.0

R
R
R
R

30
30

3.000 1.0 R

175.55

TM

30
30
30
30
30
30
30

4.000
4.000
4.000
4.000
5.000
4.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

234.06
234.06
234.06
234.06
292.58
234.06
292.58
-

TM
TM
TM
TM
TM

T
T
T
T
T
T
T

1033
1034
1035
1036
1037

Removal of multiple polyps in hospital under general anaesthetic

Autogenous nasal bone transplant: Bone removal included
Functional endoscopic sinus surgery: Unilateral
Functional endoscopic sinus surgery: Bilateral
Diathermy to nose or pharynx exclusive of consultation fee, uni- or bilateral: Under local anaesthetic

2004.00
2004.00
2004.00
2004.00
2004.00

20 81.800 1.0 R
762.61
20 100.000 1.0 R
932.29
20 140.000 1.0 R 1 305.24
20 245.000 1.0 R 2 284.16
20
8.000 1.0 R
74.65

20 81.800 1.0 R
762.61
20 100.000 1.0 R
932.29
20 120.000 1.0 R 1 118.69
20 196.000 1.0 R 1 827.33
20
8.000 1.0 R
74.65

30
30
30
30

4.000
4.000
4.000
4.000

R
R
R
R

234.06
234.06
234.06
234.06
-

T
T
T
T

1039

Diathermy to nose or pharynx exclusive of consultation fee, uni- or bilateral: Under general
anaesthetic
Control severe epistaxis requiring hospitalisation: Anterior plugging
Control severe epistaxis requiring hospitalisation: Anterior and posterior plugging
Ligation anterior ethmoidal artery
Caldwell-Luc operation: Unilateral
Ligation internal maxillary artery
Vidian neurectomy (transantral or transnasal)
Removal nasopharyngeal fibroma
Instrumental examination of the nasopharynx including biopsy under general anaesthetic
Frontal sinus drainage, trephine operation
Antroscopy through the canine fossa (modifier 0005 to apply to opposite side of nose)
External frontal ethmoidectomy
External ethmoidectomy and/or sphenoidectomy
Sublabial transseptal sphenoidotomy
Frontal osteomyelitis
Obliteration of frontal sinus
Lateral rhinotomy
Excision nasolabial cyst
Removal of foreign bodies from nose: At rooms
Removal of foreign body from nose: Under general anaesthetic
Proof puncture at rooms: Unilateral
Proof puncture, uni- or bilateral under general anaesthetic
Proetz treatment (consultation fee only to be charged for first treatment)
Septum abscess: At rooms, including after-care
Septum abscess: Under general anaesthetic
Oro-antral fistula (without Caldwell-Luc)
Choanal atresia: Intranasal approach
Choanal atresia: Transpalatal approach
Total reconstruction of the nose: Including reconstruction of nasal septum (septum plasty), nasal
pyramid (osteotomy) and nasal tip
Sub-total reconstruction consisting of any two of the following: Septum plasty, osteotomy, nasal tip
reconstruction
Forehead rhinoplasty (all stages): Total
Forehead rhinoplasty (all stages): Partial
Forehead rhinoplasty (all stages): Rhinophyma without skin graft
Full nasal reconstruction for secondary cleft lip deformity
Partial nasal reconstruction for cleft lip deformity
Columella reconstruction or lengthening
MODIFIERS GOVERNING NASAL OPERATIONS
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
Throat
Tonsillectomy (dissection of the tonsils)
Laser tonsillectomy
Removal of adenoids
Laser assisted functional reconstruction of palate uvula: In the rooms (+ item 5930 for hire of laser)

2004.00

20

326.31

20

326.31

30

4.000 1.0 R

234.06

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2006.04
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

372.95
559.35
1 262.27
1 280.01
1 827.33
1 053.43
2 656.96
466.22
867.91
347.72
1 777.91
1 859.01
1 277.23
1 808.71
2 713.87
1 528.89
1 734.94
93.27
359.89
93.27
326.31
37.25
74.65
326.31
1 042.28
1 053.43
1 808.71
3 263.09

20
20
20
20
20
20
20
20
20

40.000
60.000
120.000
120.000
156.800
113.000
228.000
50.000
93.100

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

30
30
30
30
30
30
30
30
30

6.000
6.000
6.000
4.000
6.000
4.000
6.000
4.000
4.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

152.560
159.520
120.000
155.200
232.880
131.200
148.880
10.000
38.600
10.000
35.000
4.000
8.000
35.000
111.800
113.000
155.200
280.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

30
30
30
30
30
30
30

4.000
4.000
4.000
4.000
4.000
4.000
4.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

30
30
30

4.000 1.0 R
4.000 1.0 R
4.000 1.0 R

30
30
30
30
30

4.000
4.000
5.000
7.000
5.000

R
R
R
R
R

351.09
351.09
351.09
234.06
351.09
234.06
351.09
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
292.58
409.61
292.58

T
T
T
T
T
T
T
T
T

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

372.95
559.35
1 118.69
1 118.69
1 461.87
1 053.43
2 125.63
466.22
867.91
1 422.27
1 487.24
1 118.69
1 446.91
2 171.09
1 223.11
1 387.95
93.27
359.89
93.27
326.31
37.25
74.65
326.31
1 042.28
1 053.43
1 446.91
2 610.47

2004.00

20 210.000 1.0 R 1 957.86

20 168.000 1.0 R 1 566.28

30

5.000 1.0 R

292.58

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20

20
20
20
20
20
20

30
30
30
30
30
30

5.000
5.000
5.000
5.000
5.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

292.58
292.58
292.58
292.58
292.58
292.58
-

T
T
T
T
T
T

30
30
30
30

4.000
6.000
4.000
5.000

1.0
1.0
1.0
1.0

R
R
R
R

234.06
351.09
234.06
292.58

T
T
T
T

Opening of quinsy: At rooms

Laser assisted functional reconstruction of palate uvula: In the rooms (+ item 5930 for hire of laser):
Follow-up operation performed by the same surgeon
Opening of quinsy: Under general anaesthetic
Ludwig's Angina: Drainage
Post tonsillectomy or adenoidectomy haemorrhage
Pharyngeal pouch operation
Retropharyngeal abscess: Internal approach

111.90
792.38

30
30

6.000 1.0 R
5.000 1.0 R

351.09
292.58

T
T

R
326.31
R
391.57
R
428.82
R 1 728.78
R
326.31

30
30
30
30
30

6.000
9.000
6.000
5.000
6.000

351.09
526.64
351.09
292.58
351.09

T
T
T
T
T

1041
1043
1045
1047
1049
1050
1051
1052
1053
1054
1055
1057
1058
1059
1060
1061
1062
1063
1065
1067
1069
1071
1077
1079
1081
1083
1084
1085
1087
1089
1091
1093
1095
1097
1099
0069

4.2
1101
1102
1105
1106
1107
1108
1109
1110
1111
1112
1113

35.000 1.0 R
40.000
60.000
135.400
137.300
196.000
113.000
285.000
50.000
93.100
37.300
190.700
199.400
137.000
194.000
291.100
164.000
186.100
10.000
38.600
10.000
35.000
4.000
8.000
35.000
111.800
113.000
194.000
350.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

552.000
414.000
138.000
357.900
199.700
138.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

2004.00
2004.00
2004.11
2004.00

20 75.000
20 75.000
20 40.000
20 168.300

1.0
1.0
1.0
1.0

R
699.26
R
699.26
R
372.95
R 1 569.07

2004.00
2004.00

20
20

2004.00
2004.00
2004.00
2004.11
2004.00

20 35.000 1.0
20 42.000 1.0
20 46.000 1.0
20 231.800 1.0
20 35.000 1.0

2004.00

Page 26 of 84

12.000 1.0 R
85.000 1.0 R

5 146.30
3 859.69
1 286.61
3 336.71
1 861.80
1 286.61
-

111.90
792.38

R
326.31
R
391.57
R
428.82
R 2 161.12
R
326.31

35.000 1.0 R

441.600
331.200
120.000
286.320
159.760
120.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

20 75.000
20 75.000
20 40.000
20 134.640

1.0
1.0
1.0
1.0

R
699.26
R
699.26
R
372.95
R 1 255.23

20
20

12.000 1.0 R
85.000 1.0 R

20 35.000 1.0
20 42.000 1.0
20 46.000 1.0
20 185.440 1.0
20 35.000 1.0

4 117.07
3 087.69
1 118.69
2 669.28
1 489.44
1 118.69
-

1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

T
T
T
T
T
T
T
T
T
T

T
T
T
T
T

1115
1116
4.3
1117
1118
1119
1123
1125

Retropharyngeal abscess: External approach

Functional reconstruction of palate and uvula
Larynx
Laryngeal intubation
Laryngeal stroboscopy with video capture
Laryngectomy without block dissection of the neck
Botulinus toxin injection for adductor disphonia (+ item 0198 + item 0201 + item 0202)
Operative laryngoscopy with excision of tumour and/or stripping of vocal cords (excluding after-care)

2004.00
2004.00

1126
1127
1128
1129

Post laryngectomy for voice restoration

Tracheotomy
Endolaryngeal operations
External laryngeal operation e.g. laryngeal stenosis, laryngocele, abductor, paralysis, laryngocelefissure
Direct laryngoscopy: Diagnostic laryngoscopy including biopsy (also to be applied when a flexible
fibre-optic laryngoscope was used)
Direct laryngoscopy plus foreign body removal
MODIFIERS
Microsurgery of the larynx: Add 25% to the fee of the operation performed (for other operations
requiring the use of an operation microscope, the fee include the use of the microscope, except
where otherwise specified elsewhere in the Tariff)
Bronchial procedures
Note: Please specify on account if a biopsy was performed together with the bronchoscopy
Bronchoscopy: Diagnostic bronchoscopy
Bronchoscopy: Diagnostic bronchoscopy with removal of foreign body
Bronchoscopy: Bronchoscopy with laser
Nebulisation (in rooms)
Bronchial lavage
Thoracotomy: For broncho-pleural fistula (including ruptured bronchus, any cause)
Pleura
Pleural needle biopsy (no after-care) (modifier 0005 not applicable)
Insertion of intercostal catheter (under water drainage)
Intra-pleural block
Paracentesis chest: Diagnostic
Paracentesis chest: Therapeutic
Pneumothorax: Induction (diagnostic)
Pleurectomy
Decortication of lung
Chemical pleurodesis (instillation of silver nitrate, tetracycline, talc, etc.)
Pulmonary procedures
Pulmonary procedures: Surgical
Needle biopsy lung: (no after-care) (modifier 0005 not applicable)
Pneumonectomy
Pulmonary lobectomy
Segmental lobectomy
Excision tracheal stenosis: Cervical
Excision tracheal stenosis: Intra thoracic
Thoracoplasty associated with lung resection or done by the same surgeon within 6 weeks
Thoracoplasty: Complete
Thoracoplasty: Limited (osteoplastic)
Drainage empyema (including six weeks after treatment)
Drainage of lung abscess (including six weeks after treatment)
Thoracotomy (limited): For lung or pleural biopsy
Major: Diagnostic, as for inoperable carcinoma
Thoracoscopy
Lung transplant: Unilateral
Harvesting donor lung: Unilateral
Excision or plication of emphysematous cyst: Unilateral
Excision or plication of emphysematous cyst: Bilateral synchronous (Median sternotomy)
Excision or plication of emphysematous cyst: Re-exploration following sternal dehiscence
Pulmonary function tests
Flow volume test: Inspiration/expiration

1130
1131
0067

4.4
1132
1133
1134
1136
1137
1138
4.5
1139
1141
1142
1143
1145
1147
1149
1151
1153
4.6
4.6.1
1155
1157
1159
1161
1163
1164
1167
1168
1169
1171
1173
1175
1177
1179
1181
1182
1183
1184
1185
4.6.2
1186

20 85.000 1.0 R
792.38
20 134.640 1.0 R 1 255.23
20 10.000 1.0 R
93.27
20 39.000 1.0 R
363.56
20 344.000 1.0 R 3 207.07
20 81.100 1.0 R
756.16

30
30

6.000 1.0 R
5.000 1.0 R

2004.00
2004.00
2004.00
2004.00
2004.00

20 85.000 1.0 R
792.38
20 168.300 1.0 R 1 569.07
20 10.000 1.0 R
93.27
20 39.000 1.0 R
363.56
20 430.000 1.0 R 4 008.84
20 35.000 1.0 R
326.31
20 81.100 1.0 R
756.16

30
30

6.000 1.0 R
7.000 1.0 R

30

2004.00
2004.00
2004.00
2004.00

20 139.500 1.0 R 1 300.54

20 90.000 1.0 R
839.02
20 75.000 1.0 R
699.26
20 294.400 1.0 R 2 744.66

20 120.000 1.0 R 1 118.69

20 90.000 1.0 R
839.02
20 75.000 1.0 R
699.26
20 235.520 1.0 R 2 195.73

2004.00

20

41.400 1.0 R

386.00

20

41.400 1.0 R

2004.00

20

64.600 1.0 R

602.32
-

20

64.600 1.0 R

2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20

65.000
80.000
75.000
12.000

1.0
1.0
1.0
1.0

R
R
R
R

20 350.000 1.0 R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 50.000 1.0 R
20 50.000 1.0 R
20 36.000 1.0 R
20
8.000 1.0 R
20 13.000 1.0 R
20 25.000 1.0 R
20 250.000 1.0 R
20 350.000 1.0 R
20 55.000 1.0 R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

2004.00

20

Page 27 of 84

32.000
350.000
389.500
365.000
375.000
350.000
215.000
250.000
200.000
170.000
170.000
115.000
215.000
89.000
600.000
120.000
250.000
438.000
100.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

30.000 1.0 R

605.98
745.89
699.26
111.90
3 263.09
466.22
466.22
335.70
74.65
121.14
233.04
2 330.80
3 263.09
512.71
298.30
3 263.09
3 631.35
3 402.86
3 496.13
3 263.09
2 004.49
2 330.80
1 864.58
1 584.91
1 584.91
1 072.20
2 004.49
829.78
5 593.75
1 118.69
2 330.80
4 083.49
932.29
279.67

20
20

65.000 1.0 R
80.000 1.0 R

20

12.000 1.0 R

20 280.000 1.0 R
20 50.000 1.0 R
20 50.000 1.0 R
20 36.000 1.0 R
20
8.000 1.0 R
20 13.000 1.0 R
20 25.000 1.0 R
20 200.000 1.0 R
20 280.000 1.0 R
20 55.000 1.0 R

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

32.000
280.000
311.600
292.000
300.000
280.000
172.000
200.000
160.000
136.000
136.000
115.000
172.000
89.000
480.000
120.000
200.000
350.400
100.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

30.000 1.0 R

T
T

6.000 1.0 R

351.09
292.58
351.09
409.61
351.09

30
30
30
30

9.000
9.000
8.000
8.000

R
R
R
R

526.64
526.64
468.13
468.13

T
T
T
T

386.00

30

6.000 1.0 R

351.09

602.32
-

30

6.000 1.0 R

351.09
-

605.98
745.89
111.90
2 610.47
466.22
466.22
335.70
74.65
121.14
233.04
1 864.58
2 610.47
512.71
298.30
2 610.47
2 904.96
2 722.23
2 796.87
2 610.47
1 603.53
1 864.58
1 491.64
1 267.99
1 267.99
1 072.20
1 603.53
829.78
4 475.06
1 118.69
1 864.58
3 266.76
932.29
279.67

1.0
1.0
1.0
1.0

30
30
30
20
30
30

6.000
8.000
8.000
12.000
8.000
12.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

30
30
20
30
30

3.000
6.000
36.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

30
30
30

11.000 1.0 R
11.000 1.0 R
3.000 1.0 R

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

5.000
11.000
11.000
11.000
8.000
12.000
12.000
11.000
11.000
11.000
11.000
11.000
11.000
11.000
15.000
5.000
11.000
11.000
11.000

20

30.000 1.0 R

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

351.09
468.13
468.13
111.90
468.13
702.04
175.55
351.09
335.70
175.55
175.55
643.53
643.53
175.55
292.58
643.53
643.53
643.53
468.13
702.04
702.04
643.53
643.53
643.53
643.53
643.53
643.53
643.53
877.59
292.58
643.53
643.53
643.53
279.67

T
T
T

T
T
T

T
T
T
T

T
T
T
T
T

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

1188
1189
1190
1191
1192
1193
1195
1196
1197
1198

1199
1200
1201
4.7
Q.

R.
S.

T.
4.7.1
1202
4.7.2
1204

1205

1206

1207

1208

Flow volume test: Inspiration/expiration/pre- and post bronchodilator (to be charged for only with first
consultation - thereafter item 1186 applies)
Forced expirogram only
Determination of resistance to airflow in paediatric patients, impulse oscilimetry
N2 single breath distribution
Peak expiratory flow only
Functional residual capacity or residual volume: Helium method, nitrogen open circuit method, or
other method
Thoracic gas volume
Determination of resistance to airflow, oscillary or plethysmographic methods
Compliance and resistance, using oesophageal balloon
Prolonged post exposure evaluation of bronchospasm with multiple spirometric determinations after
antigen, cold air, methacholine, other chemical agent or after exercise, with subsequent spirometry

2004.00

20

50.000 1.0 R

466.22

20

50.000 1.0 R

466.22

20

50.000 1.0 R

466.22

2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

10.000
45.310
10.000
5.000
37.760

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

93.27
422.37
93.27
46.64
351.97

20

10.000 1.0 R

20

10.000 1.0 R

10.000 1.0 R
5.000 1.0 R

20
20

10.000 1.0 R
5.000 1.0 R

93.27
93.27
46.64
-

20
20

93.27
93.27
46.64
-

2004.00
2004.00
2004.00
2004.00

20
20
20
20

37.930
45.310
24.000
55.890

1.0
1.0
1.0
1.0

R
R
R
R

353.59
422.37
223.80
521.07

Pulmonary stress testing: For determination of VO2 max

Carbon monoxide diffusing capacity, any method
Maximum inspiratory/expiratory pressure
Intensive care
RULES GOVERNING THIS SECTION
Intensive care/High Care: Units in respect of items 1204 to 1210 (Categories 1 to 3) EXCLUDE the
following: (a) Anaesthetic and/or surgical fees for any condition or procedure, as well as a first
consultation/visit, which is, regarded as the assessment of the patient, while the daily intensive
care/high care fee covers the daily care in the intensive/high care unit. (b) Cost of any drugs and/or
materials. (c) Any other cost which may be incurred before, during or after the consultation/visit
and/or the therapy. (d) Blood gases and chemistry tests, including the arterial puncture to obtain the
specimen. (e) Procedural items 1202 and 1212 to 1221. but INCLUDE the following: (f) Performing
and interpretation of a resting ECG. (g) Interpretation of chemistry tests and x-rays. (h) Intravenous
treatment (items 0206 and 0207), except intravenous infusion in patients under the age of three
years (item 0205) that does not form a part of the daily ICU/High Care fee and may be charged for
separately on a daily basis (fee includes the introduction of the cannula as well as the daily
management)
Multiple organ failure: Units for items 1208, 1209 and 1210 (Category 3: Cases with multiple organ
failure) include resuscitation (i.e. item 1211: Cardio-respiratory resuscitation)
Ventilation: Units for items 1212, 1213 and 1214 (ventilation) include the following: (a)
Measurement of minute volume, vital capacity, time- and vital capacity studies. (b) Testing and
connecting the machine. (c) Putting patient on machine: setting machine, synchronising patient with
machine. (d) Instruction to nursing staff. (e) All subsequent visits for 24 hours.
Ventilation (items 1212 to 1214) does not form a part of normal post-operative care, but may not be
added to item 1204: Category 1: Cases requiring intensive monitoring
Intensive care: (in intensive care or high care unit): Respiratory, cardiac, general: Neonatal
procedures
Insertion of central venous catheter via peripheral vein in neonates
Intensive care: (in intensive care or high care unit): Respiratory, cardiac, general: Tariff items for
intensive care
Intensive care: Category 1: Cases requiring intensive monitoring (to include cases where
physiological instability is anticipated e.g. diabetic pre-coma, asthma, gastro-intestinal haemorrhage,
etc.): Per day
Intensive care: 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 pancreatitis, eclampsia, flail chest, etc. Ventilation may or may not be part of
the active system support): First day
Intensive care: Category 2: Cases requiring active system support (where active specialised
intervention is required in cases such as acute myocardial infarction, diabetic coma, head injury,
severe asthma, acute pancreatitis, eclampsia, flail chest, etc. Ventilation may or may not be part of
the active system support): Subsequent days, per day
Intensive care: Category 2: Cases requiring active system support (where active specialised
intervention is required in cases such as acute myocardial infarction, diabetic coma, head injury,
severe asthma, acute pancreatitis, eclampsia, flail chest, etc. Ventilation may or may not be part of
the active system support): After two weeks, per day
Please Note: The principal practitioner may charge items 1205 - 1207, other participating
practitioners must charge the consultation item, e.g. item 0109
Intensive care: Category 3: Cases with multiple organ failure or Category 2 patients which may
require multidisciplinary intervention: First day (primary practitioner)

2004.00
2004.00
2004.00

20
20
20

96.500 1.0 R
38.060 1.0 R
5.000 1.0 R

2006.05

899.73
354.76
46.64
-

2004.00

2004.00

2004.00

20
20

24.000 1.0 R
55.890 1.0 R

20

96.500 1.0 R

20

5.000 1.0 R

223.80
521.07

899.73
46.64
-

20

20

24.000 1.0 R

5.000 1.0 R

223.80
-

46.64
-

2004.00

20

40.000 1.0 R

372.95
-

20

40.000 1.0 R

372.95
-

20

40.000 1.0 R

372.95
-

2004.00

20

30.000 1.0 R

279.67

20

30.000 1.0 R

279.67

20

30.000 1.0 R

279.67

2004.00

20 100.000 1.0 R

932.29

20 100.000 1.0 R

932.29

20 100.000 1.0 R

932.29

2004.00

20

50.000 1.0 R

466.22

20

50.000 1.0 R

466.22

20

50.000 1.0 R

466.22

2004.00

20

30.000 1.0 R

279.67

20

30.000 1.0 R

279.67

20

30.000 1.0 R

279.67

2004.00

2004.00

20 137.000 1.0 R 1 277.23

20 120.000 1.0 R 1 118.69

20 137.000 1.0 R 1 277.23

Page 28 of 84

1209
1210
4.7.3
1211

1212
1213
1214
1215
1216
1217
1218
1219
1220
1221
4.8

4804

4820
4805

4821
4806

4822
4809

4825
4810

4826
4811

Intensive care: Category 3: Cases with multiple organ failure or Category 2 patients which may
require multidisciplinary intervention: First day (per involved practitioner)
Intensive care: Category 3: Cases with multiple organ failure or Category 2 patients which may
require multidisciplinary intervention: Subsequent days (per involved practitioner)
Intensive care: (in intensive care or high care unit): Respiratory, cardiac, general: Procedures
Cardio-respiratory resuscitation: Prolonged attendance in cases of emergency (not necessarily in
ICU) - 50,00 clinical procedure units per half hour or part thereof for the first hour per practitioner,
thereafter 25,00 clinical procedure units per half hour up to a maximum of 150,00 clinical procedure
units per practitioner. Resuscitation fee includes all necessary additional procedures e.g. infusion,
intubation, etc.
Ventilation: First day
Ventilation: Subsequent days, per day
Ventilation: After two weeks, per day
Insertion of arterial pressure cannula
Insertion of Swan Ganz catheter for haemodynamics monitoring
Insertion of central venous line via peripheral vein
Insertion of central venous line via subclavian or jugular veins
Hyperalimentation (daily tariff)
Patient-controlled analgesic pump: Hire fee: Per 24 hours (Cassette to be charged for according to
item 0201 per patient)
Professional fee for managing a patient-controlled analgesic pump: First 24 hours (for subsequent
days charged the appropriate hospital follow-up consultation/visit code)
Hyperbaric Oxygen Therapy
Internationally recognized scientific indications for Hyperbaric Oxygen Therapy:
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.
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
Monitoring of a patient at the hyperbaric chamber during hyperbaric treatment (includes prehyperbaric assessment, monitoring during treatment, and post treatment evaluation): Low pressure
table (1,5-1,8 ATA x 45-60 min): PROFESSIONAL COMPONENT
Low pressure table (1,5-1,8 ATA x 45-60 min): TECHNICAL COMPONENT
Monitoring of a patient at the hyperbaric chamber during hyperbaric treatment (includes prehyperbaric assessment, monitoring during treatment, and post treatment evaluation): Routine HBO
table (2-2,5 ATA x 90-120 min): PROFESSIONAL COMPONENT
Routine HBO table (2-2,5 ATA x 90-120 min): TECHNICAL COMPONENT
Monitoring of a patient at the hyperbaric chamber during hyperbaric treatment (includes prehyperbaric assessment, monitoring during treatment, and post treatment evaluation): Emergency
HBO table (2,5-3 ATA x 90-120 min): PROFESSIONAL COMPONENT
Emergency HBO table (2,5-3 ATA x 90-120 min): TECHNICAL COMPONENT
Monitoring of a patient at the hyperbaric chamber during hyperbaric treatment (includes prehyperbaric assessment, monitoring during treatment, and post treatment evaluation): USN TT5 (2,8
ATA x 135 min): PROFESSIONAL COMPONENT
USN TT5 (2,8 ATA x 135 min): TECHNICAL COMPONENT
Monitoring of a patient at the hyperbaric chamber during hyperbaric treatment (includes prehyperbaric assessment, monitoring during treatment, and post treatment evaluation): USN TT6 (2,8
ATA x 285 min): PROFESSIONAL COMPONENT
USN TT6 (2,8 ATA x 285 min): TECHNICAL COMPONENT
Monitoring of a patient at the hyperbaric chamber during hyperbaric treatment (includes prehyperbaric assessment, monitoring during treatment, and post treatment evaluation): USN
TT6ext/6A or Cx 30 (2,8-6 ATA x 305-490 min): PROFESSIONAL COMPONENT

2004.00

20

58.000 1.0 R

540.72

20

58.000 1.0 R

540.72

20

58.000 1.0 R

540.72

2004.00

20

50.000 1.0 R

466.22

20

50.000 1.0 R

466.22

20

50.000 1.0 R

466.22

2004.00

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

2004.00
2004.00
2004.00
2004.00
2004.11
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20

75.000
50.000
25.000
25.000
50.000
10.000
25.000
15.000
30.000

R
R
R
R
R
R
R
R
R

699.26
466.22
233.04
233.04
466.22
93.27
233.04
139.91
279.67

20
20
20
20
20
20
20
20
20

75.000
50.000
25.000
25.000
50.000
10.000
25.000
15.000
30.000

R
R
R
R
R
R
R
R
R

699.26
466.22
233.04
233.04
466.22
93.27
233.04
139.91
279.67

20
20
20
20
20
20
20
20
20

75.000
50.000
25.000
25.000
50.000
10.000
25.000
15.000
30.000

R
R
R
R
R
R
R
R
R

699.26
466.22
233.04
233.04
466.22
93.27
233.04
139.91
279.67

2004.00

20

30.000 1.0 R

279.67

20

30.000 1.0 R

279.67

20

30.000 1.0 R

279.67

2004.00

30.000 1.0 R

279.67

2004.00

20

30.000 1.0 R

279.67

2005.03
2004.00

20 101.130 1.0 R
20 60.000 1.0 R

942.85
559.35

20 101.130 1.0 R
20 60.000 1.0 R

942.85
559.35

2005.03
2004.00

20 131.260 1.0 R 1 223.70

20 80.000 1.0 R
745.89

20 131.260 1.0 R 1 223.70

20 80.000 1.0 R
745.89

2005.03
2004.00

20 131.260 1.0 R 1 223.70

20 90.000 1.0 R
839.02

20 131.260 1.0 R 1 223.70

20 90.000 1.0 R
839.02

2005.03
2004.00

20 214.180 1.0 R 1 996.72

20 190.000 1.0 R 1 771.31

20 214.180 1.0 R 1 996.72

20 190.000 1.0 R 1 771.31

2005.03
2004.00

20 386.420 1.0 R 3 602.60

20 327.000 1.0 R 3 048.53

20 386.420 1.0 R 3 602.60

20 327.000 1.0 R 3 048.53

Page 29 of 84

20

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

4827
4828
4829
4815

5
1222
1223
1224
1225
1226
6

6.1
1227

1228
1229

1230
1231

1232
1233
1234
1235
1236
1237
1238
1239
1240
1241
1242
1243
1244
1245
1246
1247
1248
1271

0073

6.2
6.2.1
1249
1250
1251
1252
1253
1254
1255
6.2.2
1256

USN TT6ext (2,8-6 ATA x 305-490 min): TECHNICAL COMPONENT

USN 6A (2,8-6 ATA x 305-490 min): TECHNICAL COMPONENT
USN Cx 30 (2,8-6 ATA x 305-490 min): TECHNICAL COMPONENT
Prolonged attendance inside a hyperbaric chamber: 40,00 clinical procedure units per half hour or
part thereof for the first hour, thereafter 20,00 clinical procedure units per half hour: Minimum 40,00
clinical procedure units; maximum 320,00 clinical procedure units
Mediastinal Procedures
Mediastinal tumours
Mediastinoscopy
Mediastinotomy
Excision of malignant chest wall tumours involving sternum and multiple ribs
Removal of single rib with a lesion
Cardiovascular System
MODIFIER GOVERNING FEES FOR AN ANAESTHESIOLOGIST OPERATING INTRA-AORTIC
BALLOON PUMP
Cardiovascular system: General
Prolonged neonatal resuscitation
Where ECG is done by a general practitioner but interpreted by a physician, the general practitioner
is entitled to a consultation fee, plus half of fee determined for ECG
General Practitioner's fee for the taking of an ECG only: Without effort: (item 1232)
General Practitioner's fee for the taking of an ECG only: Without and with effort: (item 1233)
Note: Items 1228 and 1229 deal only with the fees for taking of the ECG, the consultation fee must
still be added
Physician's fee for interpreting an ECG: Without effort
Physician's fee for interpreting an ECG: With and without effort
A specialist physician is entitled to the fees specified in item 1230 and 1231 for interpretation of an
ECG tracing referred for interpretation. This applies also to a paediatrician when an ECG of a child
is referred to him for interpretation
Electrocardiogram: Without effort
Electrocardiogram: With and without effort
Effort electrocardiogram with the aid of a special bicycle ergometer, monitoring apparatus and
availability of associated apparatus
Multi-stage treadmill test
Electrocardiogram without effort: Under 4 years old
24 Hour ambulatory blood pressure: Hire fee
24 Hour ambulatory ECG monitoring (holter): Hire fee
24 Hour ambulatory ECG monitoring (holter): Interpretation
Signal averaged electrocardiogram
X-ray Screening: Chest
X-ray screening: Prosthetic valves
Two week event triggered ambulatory ECG monitoring: Hire fee
Two week event triggered ambulatory ECG monitoring: Interpretation
Angiography cerebral: First two series
Angiography peripheral: Per limb
Cardioversion for arrhythmias (any method) with doctor in attendance
Paracentesis of pericardium
Cardiological supervision of Dobutamine magnetic resonance stress testing
MODIFIER GOVERNING PAEDIATRIC CARDIAC CATHETERISATION BY PAEDIATRIC
CARDIOLOGISTS WITH A "33" PRACTICE NUMBER
When item 1288 (Cardiac catheterisation for congenital heart disease: All ages above 1 year old) or
item 1289 (Paediatric cardiac catheterisation: Infants below the age of one year) is performed by
paediatric cardiologists (33): fee for procedure + 100%
Invasive Cardiology
Invasive cardiology: Cardiac catheterisation
Right and left cardiac catheterisation without coronary angiography (with or without biopsy)
Endomyocardial biopsy
Transseptal puncture
Left heart catheterisation with coronary angiography (with or without biopsy)
Right heart catheterisation (with or without biopsy)
Catheterisation of coronary artery bypass grafts and/or internal mammary grafts
Tilt test
Invasive cardiology: Electrophysiological study
Ventricular stimulation study

2005.03
2005.03
2005.03
2004.00

20 680.850 1.0 R 6 347.56

20 678.280 1.0 R 6 323.51
20 671.850 1.0 R 6 263.67
-

2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

2004.00
2004.00

20

285.000
95.000
115.000
350.000
282.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

20.000 1.0 R

2004.00
2004.00
2004.00

2 656.96
885.65
1 072.20
3 263.09
2 629.10
186.40
-

Z
Z
Z

20 680.850 1.0 R 6 347.56

20 678.280 1.0 R 6 323.51
20 671.850 1.0 R 6 263.67
-

20
20
20
20
20

228.000
95.000
115.000
280.000
225.600

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

20

20.000 1.0 R

20
20

4.500 1.0 R
6.500 1.0 R

2 125.63
885.65
1 072.20
2 610.47
2 103.19
186.40
-

Z
Z
Z

30
30
30
30
30

11.000
5.000
11.000
11.000
11.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

20

20.000 1.0 R

643.53
292.58
643.53
643.53
643.53
186.40
-

41.94
60.57
-

2004.00
2006.04
2004.00

20
20

6.000 1.0 R
10.000 1.0 R

55.88
93.27
-

2004.00
2006.04
2004.00

20
20
20

9.000 1.0 R
13.000 1.0 R
40.000 1.0 R

83.89
121.14
372.95

20
20
20

9.000 1.0 R
13.000 1.0 R
40.000 1.0 R

83.89
121.14
372.95

2004.00
2006.04
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

60.000
18.000
30.000
55.000
27.000
80.000
4.000
10.000
55.000
25.000
34.300
25.000
65.000
50.000
51.000

559.35
167.77
279.67
512.71
251.66
745.89
37.25
93.27
512.71
233.04
319.71
233.04
605.98
466.22
475.46
-

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

60.000
18.000
30.000
55.000
27.000
80.000
4.000
10.000
55.000
25.000
34.300
25.000
65.000
50.000
51.000

559.35
167.77
279.67
512.71
251.66
745.89
37.25
93.27
512.71
233.04
319.71
233.04
605.98
466.22
475.46
-

234.06
234.06
351.09
526.64
-

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

30
30
30
30

4.000
4.000
6.000
9.000

1.0
1.0
1.0
1.0

R
R
R
R

2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 140.000 1.0 R
20 70.000 1.0 R
20 70.000 1.0 R
20 140.000 1.0 R
20 70.000 1.0 R
20 40.000 1.0 R
20 31.300 1.0 R

2004.00

20 160.000 1.0 R

1 305.24
652.62
652.62
1 305.24
652.62
372.95
291.85
1 491.64

652.62
652.62
372.95
291.85
-

526.64
526.64
526.64
526.64
526.64
526.64
526.64

Page 30 of 84

20
20

70.000 1.0 R
70.000 1.0 R

20
20

40.000 1.0 R
31.300 1.0 R

30
30
30
30
30
30

9.000
9.000
9.000
9.000
9.000
9.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

30

9.000 1.0 R

T
T
T
T
T

T
T
T
T

T
T
T
T
T
T

1257
6.2.3
1258
1259
1260
1261
1262
1263
1264
1265
1266
1267
1268
1269
1270
1273
1275
6.2.4
1276
1277
1278
1279
1280
1281

Full electrophysiological study

Invasive cardiology: Pacemakers
Pacemaker: Permanent - single chamber
Pacemaker: Permanent - dual chamber
AV nodal ablation
Accessory pathway ablation
Electrophysiological mapping
Insertion transvenous implantable defibrillator
Test for implantable transvenous defibrillator
Renewal of pacemaker unit only, team fee
Resiting pacemaker generator
Repositioning of catheter electrode
Threshold testing: Own equipment
Threshold testing: Hospital equipment
Programming of atrio-ventricular sequential pacemaker
Insertion of temporary pacemaker (modifier 0005 not applicable)
Termination of arrhythmia - programmed stipulation and lead insertion of temporary pacer
Invasive cardiology: Percutaneous translumical angioplasty
Percutaneous transluminal angioplasty: First cardiologist: Single lesion
Percutaneous transluminal angioplasty: Second cardiologist: Single lesion
Percutaneous transluminal angioplasty: First cardiologist: Second lesion
Percutaneous transluminal angioplasty: Second cardiologist: Second lesion
Percutaneous transluminal angioplasty: First cardiologist: Third or subsequent lesions (each)
Percutaneous transluminal angioplasty: Second cardiologist: Third or subsequent lesions (each)

2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 300.000 1.0 R 2 796.87

20 155.000 1.0 R 1 445.00
20 230.000 1.0 R 2 144.25
20 300.000 1.0 R 2 796.87
20 600.000 1.0 R 5 593.75
20 500.000 1.0 R 4 661.46
20 212.000 1.0 R 1 976.48
20 120.000 1.0 R 1 118.69
20 125.000 1.0 R 1 165.33
20 80.000 1.0 R
745.89
20 50.000 1.0 R
466.22
20 15.000 1.0 R
139.91
20 11.000 1.0 R
102.51
20 50.000 1.0 R
466.22
20 120.000 1.0 R 1 118.69
20 200.000 1.0 R 1 864.58
20 260.000 1.0 R 2 423.93
20 140.000 1.0 R 1 305.24
20 60.000 1.0 R
559.35
20 40.000 1.0 R
372.95
20 60.000 1.0 R
559.35
20 40.000 1.0 R
372.95

1282

Use of balloon procedures including: First cardiologist: Atrial septostomy; Pulmonary valve
valvuloplasty; Aortic valve valvuloplasty; Coarctation dilation; Mitral valve valvuloplasty
Use of balloon procedure as in item 1282: Second cardiologist
Atherectomy: Single lesion: First cardiologist
Atherectomy: Single lesion: Second cardiologist
Insertion of intravascular stent: First cardiologist
Insertion of intravascular stent: Second cardiologist
Use of balloon procedures including: First paediatric cardiologist (33): Atrial septostomy; Pulmonary
valve valvuloplasty; Aortic valve valvuloplasty; Coarctation dilation; Mitral valve valvuloplasty;
Closure atrial septal defect; Closure of patient ductus arteriosus
Use of balloon procedure as in item 1290: Second paediatric cardiologist (33)
Invasive cardiology: Paediatric cardiac catheterisation
Cardiac catheterisation for congenital heart disease: All ages above 1 year old
Paediatric cardiac catheterisation: Infants below the age of one year
Cardiac surgery
Patent ductus arteriosus
Pericardiectomy for constrictive pericarditis
Coarctation of aorta
Systemo-pulmonary anastomosis
Mitral valvotomy: Closed heart technique
Heart transplant
Harvesting donor heart
Operative implantation of cardiac pacemaker by thoracotomy
Re-exploration after cardiac surgery
Heart and lung transplant
Harvesting donor heart and lungs
Pericardial drainage
Cardiac surgery: Open heart surgery
Evaluation of coronary angiogram by cardiothoracic surgeon
Repeat open heart surgery (additional fee above procedure fee)
Stand-by fee for coronary angioplasty
Attendance at other operations or monitoring at bedside, by physician e.g. heart block etc.: Per hour

2004.00

1283
1284
1285
1286
1287
1290

1291
6.2.5
1288
1289
6.3
1294
1295
1297
1299
1301
1302
1303
1305
1307
1308
1309
1311
6.3.1
1312
1320
1321
1322

6.3.1.1 Cardiac surgery: Open heart surgery: Congenital conditions

1323 Atrial septal defect: Osteum secundum
1325 Atrial septal defect: Sinus venosus or osteum primum
1327 Atrial septal defect: Ventricular septal defect
1329 Atrial septal defect: Fallot's tetralogy

1 156.09
1 715.43
2 237.53
4 475.06
3 729.16
1 581.10
1 118.69
1 118.69
745.89
466.22
466.22
1 118.69
1 491.64
1 939.23
1 118.69
559.35
372.95
559.35
372.95

30

9.000 1.0 R

30
30
30
30

9.000
9.000
9.000
9.000

30
30
30
30
30
30

13.000
13.000
13.000
13.000
13.000
13.000

20 260.000 1.0 R 2 423.93

20 208.000 1.0 R 1 939.23

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20

20
20
20
20
20

2004.00

2004.00
2004.00
2004.00
2004.00

20 160.000 1.0 R 1 491.64

20 210.000 1.0 R 1 957.86
20 263.000 1.0 R 2 451.94
20 320.000 1.0 R 2 983.27
20 400.000 1.0 R 3 729.16
20 425.000 1.0 R 3 962.20
20 425.000 1.0 R 3 962.20
20 350.000 1.0 R 3 263.09
20 875.000 1.0 R 8 157.58
20 75.000 1.0 R
699.26
20 220.000 1.0 R 2 050.98
20 215.000 1.0 R 2 004.49
20 ####### 1.0 R 9 322.91
20 120.000 1.0 R 1 118.69
20 140.000 1.0 R 1 305.24
20 25.000 1.0 R
233.04
20 250.000 1.0 R 2 330.80
20 30.000 1.0 R
279.67
20 20.000 1.0 R
186.40

2004.00
2004.00
2004.00
2004.00

20
20
20
20

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

Page 31 of 84

140.000
300.000
180.000
100.000
50.000
300.000

500.000
563.000
603.800
563.000

1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0

R
R
R
R
R
R

R
R
R
R

1 305.24
2 796.87
1 678.18
932.29
466.22
2 796.87

4 661.46
5 248.81
5 629.24
5 248.81

20
20
20
20
20
20
20
20
20
20

124.000
184.000
240.000
480.000
400.000
169.600
120.000
120.000
80.000
50.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

526.64
526.64
526.64
526.64
526.64
877.59
877.59
526.64
526.64
526.64
526.64
760.56
760.56
760.56
760.56
760.56
760.56

30

15.000 1.0 R

877.59

R 1 118.69
R 2 237.53
R 1 342.49
R
932.29
R
466.22
-

30

15.000 1.0 R

30

15.000 1.0 R

877.59
877.59

1 566.28
1 961.52
2 386.68
2 983.27
3 169.82
3 169.82
2 610.47
6 526.04
699.26
1 640.79
1 603.53
7 458.33
1 118.69
1 118.69
1 864.58
279.67
-

30

15.000 1.0 R

30
30

12.000 1.0 R
12.000 1.0 R

30
30
30
30
30
30
30
30
30
30
30
30

13.000
15.000
15.000
15.000
15.000
15.000
5.000
15.000
15.000
15.000
5.000
13.000

30
20

15.000 1.0 R
30.000 1.0 R

877.59
702.04
702.04
760.56
877.59
877.59
877.59
877.59
877.59
292.58
877.59
877.59
877.59
292.58
760.56
877.59
279.67
-

30
30
30
30

15.000
15.000
15.000
15.000

R
R
R
R
R
R
R
R
R
R

20 50.000 1.0 R
20 120.000 1.0 R
20 160.000 1.0 R
20 208.000 1.0 R
20 120.000 1.0 R
20 60.000 1.0 R
20 40.000 1.0 R
20 60.000 1.0 R
20 40.000 1.0 R

120.000
240.000
144.000
100.000
50.000

1.0
1.0
1.0
1.0
1.0

20 168.000 1.0 R
20 210.400 1.0 R
20
20
20
20
20
20
20
20
20
20
20
20

256.000
320.000
340.000
340.000
280.000
700.000
75.000
176.000
172.000
800.000
120.000
120.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R

20 200.000 1.0 R
20 30.000 1.0 R

20
20
20
20

400.000
450.400
483.040
450.400

1.0
1.0
1.0
1.0

R
R
R
R

3 729.16
4 199.05
4 503.36
4 199.05

1.0
1.0
1.0
1.0

R
R
R
R

30
30
30

15.000 1.0 R
15.000 1.0 R
9.000 1.0 R

30

9.000 1.0 R

30
30

9.000 1.0 R
9.000 1.0 R
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R

R
R
R
R

877.59
877.59
877.59
877.59

T
T
T
T
T
T
T
T

T
T
T
T
T
T
T
T

T
T
T
T
T
T
T
T
T
T
T
T
T
T

T
T
T
T

Atrial septal defect: Pulmonary stenosis

2004.00
Transposition of large vessels (venous repair)
2004.00
Transposition of great arteries (arterial repair)
2004.00
Ebstein's Anomaly
2004.00
Aorto-coronary bypass operation as a MidCab procedure (thoracotomy with coronary grafting without 2004.00
bypass or hypothermal)
1335 Total anomalous venous drainage
2004.00
1336 Aorto-coronary bypass operation as a OpCab procedure (sternotomy with coronary grafting without 2004.00
bypass or hypothermia)
1337 Creation of atrial septal defect by thoracotomy with or without cardiac bypass
2004.00
1338 Fontan type repair
2004.00
6.3.1.2 Cardiac surgery: Open heart surgery: Acquired conditions
1339 Mitral valve replacement
2004.00
1340 Mitral valvuloplasty
2004.00
Aortic
valve
replacement
1341
2004.00
Tricuspid
annulo
plasty
1342
2004.00
1343 Double valve replacement
2004.00
1344 Acute dissecting aneurysm repair
2004.00
1345 Aortic arch aneurysm repair utilising deep hypothermal and circulatory arrest
2004.00
1346 Aorta-coronary bypass operation (including interpretation of angiogram): Harvesting of saphenous
2004.00
veins: Unilateral (modifier 0005 not applicable)
1347 Aorta-coronary bypass operation (including interpretation of angiogram): Harvesting of saphenous
2004.00
veins: Bilateral (modifier 0005 not applicable)
1348 Aorta-coronary bypass operation (including interpretation of angiogram): Utilizing saphenous veins 2004.00

20
20
20
20
20

Aorta-coronary bypass operation (including interpretation of angiogram): Additional arterial implant:

Any artery
1350 Aorta-coronary bypass operation (including interpretation of angiogram): Additional double arterial
implant: Any artery
1351 Aorta-coronary bypass operation with valve replacement or excision of cardiac aneurysm
1352 Cardiac aneurysm
1353 Ascending/descending thoracic aortic aneurysm repair
1354 Arrhythmia surgery
1355 Cardiac tumour
1356 Insertion and removal of intra-aortic balloon pump (modifier 0005 not applicable)
1358 Harvesting of radial artery
Peripheral vascular system
6.4
MODIFIER GOVERNING THIS SECTION
0072 Non invasive peripheral vascular tests: The number of tests in a single case is restricted to two (2)
per diagnosis. Tests are not justified in cases of uncomplicated varicose veins
6.4.1 Peripheral vascular system: Investigations
1357 Skin temperature test: Response to reflex heating
1359 Skin temperature test: Response to reflex cooling
1361 Cold sensitivity test
1363 Oscillometry test
1365 Sweating test
1366 Transcutaneous oximetry: Transcutaneous oximetry - single site
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
6.4.2 Peripheral vascular system: Arterio-venous abnormalities
1369 Fistula or aneurysm (as for grafting of various arteries)
6.4.3 Arteries
6.4.3.1 Peripheral vascular system: Arteries: Aorta-iliac and major branches
1372 Abdominal aorta and iliac artery: Unruptured
1373 Abdominal aorta and iliac artery: Ruptured
1375 Grafting and/or thrombo-endarterectomy for thrombosis

1330
1331
1332
1333
1334

1349

500.000
563.000
750.000
563.000
548.800

3 729.16
4 199.05
5 593.75
4 199.05
4 093.16

30
30
30
30
30

15.000
15.000
15.000
15.000
20.000

R
877.59
R
877.59
R
877.59
R
877.59
R 1 170.17

T
T
T
T
T

20 563.000 1.0 R 5 248.81

20 658.900 1.0 R 6 142.83

20 450.400 1.0 R 4 199.05

20 527.120 1.0 R 4 914.29

30
30

15.000 1.0 R
877.59
20.000 1.0 R 1 170.17

T
T

20 500.000 1.0 R 4 661.46

20 750.000 1.0 R 6 992.26
20 657.000 1.0 R 6 125.08
20 688.000 1.0 R 6 414.14
20 623.800 1.0 R 5 815.64
20 188.000 1.0 R 1 752.68
20 968.900 1.0 R 9 032.97
20 750.000 1.0 R 6 992.26
20 ####### 1.0 R 9 322.91
20 100.000 1.0 R
932.29

20 400.000 1.0 R 3 729.16

20 600.000 1.0 R 5 593.75
20 525.600 1.0 R 4 900.06
20 550.400 1.0 R 5 131.34
20 499.040 1.0 R 4 652.51
20 150.400 1.0 R 1 402.18
20 775.120 1.0 R 7 226.32
20 600.000 1.0 R 5 593.75
20 800.000 1.0 R 7 458.33
20 100.000 1.0 R
932.29

30
30

15.000 1.0 R
15.000 1.0 R

T
T

30
30
30
30
30
30
30

15.000
15.000
15.000
15.000
15.000
15.000
15.000

20 175.000 1.0 R 1 631.55

20 140.000 1.0 R 1 305.24

20 750.000 1.0 R 6 992.26

20 600.000 1.0 R 5 593.75

30

15.000 1.0 R

877.59

2004.00

20 781.000 1.0 R 7 281.17

20 624.800 1.0 R 5 825.02

30

15.000 1.0 R

877.59

2004.00

20 813.000 1.0 R 7 579.47

20 650.400 1.0 R 6 063.63

30

15.000 1.0 R

877.59

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20

20
20
20
20
20
20
20

30
30
30
30
30
30

15.000
15.000
15.000
15.000
15.000
15.000

877.59
877.59
877.59
877.59
877.59
877.59
-

T
T
T
T
T
T

875.000
563.000
625.000
688.000
625.000
188.000
175.000

1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

R
R
R
R
R
R
R

2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

2004.00
2004.00
2004.00

4 661.46
5 248.81
6 992.26
5 248.81
5 116.38

8 157.58
5 248.81
5 826.78
6 414.14
5 826.78
1 752.68
1 631.55
-

139.91
139.91
158.53
46.64
158.53
245.21
55.88
55.88
93.27
111.90
83.89
149.15
46.64
363.56
20 540.000 1.0 R 5 034.40
20 600.000 1.0 R 5 593.75
20 444.000 1.0 R 4 139.36
20
20
20
20
20
20
20
20
20
20
20
20
20
20

Page 32 of 84

15.000
15.000
17.000
5.000
17.000
26.300
6.000
6.000
10.000
12.000
9.000
16.000
5.000
39.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R

20
20
20
20
20

400.000
450.400
600.000
450.400
439.040

700.000
450.400
500.000
550.400
500.000
150.400
140.000

1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

R
R
R
R
R
R
R

6 526.04
4 199.05
4 661.46
5 131.34
4 661.46
1 402.18
1 305.24
-

139.91
139.91
158.53
46.64
158.53
245.21
55.88
55.88
93.27
111.90
83.89
149.15
46.64
363.56
20 432.000 1.0 R 4 027.46
20 480.000 1.0 R 4 475.06
20 355.200 1.0 R 3 311.49
20
20
20
20
20
20
20
20
20
20
20
20
20
20

15.000
15.000
17.000
5.000
17.000
26.300
6.000
6.000
10.000
12.000
9.000
16.000
5.000
39.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

877.59
877.59
877.59
877.59
877.59
877.59
877.59
877.59
877.59
-

T
T
T
T
T
T
T

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

R
R
R
R
R
R
R
R
R
R
R
R
R
R

30
30
30

15.000 1.0 R
15.000 1.0 R
15.000 1.0 R

877.59
877.59
877.59

T
T
T

1376

Aorta bi-femoral graft, including proximal and distal endarterectomy and preparation for anastomosis 2004.00

6.4.3.2 Peripheral vascular system: Arteries: Iliac artery

1379 Prosthetic grafting and/or thrombo-endarterectomy
6.4.3.3 Peripheral vascular system: Arteries: Peripheral
1385 Prosthetic grafting
1387 Grafting vein: Vein grafting proximal to knee joint
1388 Grafting vein: Distal to knee joint
1389 Grafting vein: Endarterectomy when not part of another specified procedure
1390 Grafting vein: Carotid endarterectomy
1393 Embolectomy: Peripheral embolectomy transfemoral
1395 Miscellaneous arterial procedures: Arterial suture: Trauma
1396 Suture major blood vessel (artery or vein) - trauma (major blood vessels are defined as aorta,
innominate artery, carotid artery and vertebral artery, subclavian artery, axillary artery, iliac artery,
common femoral and popliteal arteries are included because of popliteal artery. The vertebral and
popliteal arteries are included because of the relevant inaccessibility of the arteries and difficult
surgical exposure
1397 Profundoplasty
1399 Distal tibial (ankle region)
1401 Femoro-femoral
1402 Carotid-subclavian
1403 Axillo-femoral: (Bifemoral + 50%)
6.4.4 Peripheral vascular system: Veins
1407 Ligation of saphenous vein
1408 Placement of Hickman catheter or similar
1410 Litigation of inferior vena cava: Abdominal
1412 Umbrella operation on inferior vena cava: Abdominal
1413 Combined procedure for varicose veins: Ligation of saphenous vein stripping, multiple ligation
including of perforating veins as indicated: Unilateral
1415 Combined procedure for varicose veins: Ligation of saphenous vein stripping, multiple ligation
including of perforating veins as indicated: Bilateral
1417 Extensive sub-fascial ligation of perforating veins
1419 Lesser varicose vein procedures
1421 Compression sclerotherapy of varicose veins: Per injection to a maximum of nine (9) injections per
leg (excluding cost of material)
1425 Thrombectomy: Inferior vena cava (Trans-abdominal)
1427 Thrombectomy: IIlio-femoral
6.4.5 Peripheral vascular system: Portal hypertension
1429 Porto-caval shunt
Cardiac rehabilitation
6.5
1431 Cardiac rehabilitation: Phase II: Exercise rehabilitation: Per patient per 60 minute session with a
maximum of 5 patients per group
1432 Cardiac rehabilitation: Phase III: Exercise rehabilitation: Per patient per 60 minute 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
7.1
1435
1436
7.2
1439
1441
1443
1445
1447
1449
1450
1451
1453

Lympho Reticular System

Spleen
Splenectomy (in all cases)
Splenorrhaphy
Lymph nodes and lymphatic channels
Excision of lymph node for biopsy: Neck or axilla
Excision of lymph node for biopsy: Groin
Simple excision of lymph nodes for tuberculosis
Radical excision of lymph nodes of neck: Total: Unilateral
Radical excision of lymph nodes of neck: Total: Suprahyoid unilateral
Radical excision of lymph nodes of axilla
Bone marrow transplantation: Cryopreservation of bone marrow or peripheral blood stem cells
Radical excision of lymph nodes of groin: Ilio-inguinal
Radical excision of lymph nodes of groin: Inguinal

20 594.000 1.0 R 5 537.87

20 475.200 1.0 R 4 430.18

30

15.000 1.0 R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 300.000 1.0 R 2 796.87

20 255.000 1.0 R 2 377.29
20 300.000 1.0 R 2 796.87
20 444.000 1.0 R 4 139.36
20 264.000 1.0 R 2 461.18
20 321.000 1.0 R 2 992.66
20 168.000 1.0 R 1 566.28
20 125.000 1.0 R 1 165.33
20 264.000 1.0 R 2 461.18

20 240.000 1.0 R 2 237.53

20 204.000 1.0 R 1 901.83
20 240.000 1.0 R 2 237.53
20 355.200 1.0 R 3 311.49
20 211.200 1.0 R 1 969.00
20 256.800 1.0 R 2 394.16
20 134.400 1.0 R 1 253.03
20 100.000 1.0 R
932.29
20 211.200 1.0 R 1 969.00

30

13.000 1.0 R

30
30
30
30
30
30
30
30

5.000
5.000
5.000
5.000
15.000
5.000
5.000
15.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

20
20
20
20
20

1 566.28
3 400.95
1 894.35
2 148.07
2 148.07
466.22
848.40
1 342.49
932.29
1 118.69

30
30
30
30
30

5.000
5.000
5.000
8.000
8.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00

20 50.000 1.0 R
20 91.000 1.0 R
20 180.000 1.0 R
20 100.000 1.0 R
20 141.000 1.0 R

30
30
30
30
30

3.000
4.000
8.000
8.000
3.000

1.0
1.0
1.0
1.0
1.0

2004.00

20 247.000 1.0 R 2 302.79

20 197.600 1.0 R 1 842.14

2004.00
2004.00
2004.00

20 125.000 1.0 R 1 165.33

20 31.000 1.0 R
289.06
20
9.000 1.0 R
83.89

2004.00
2004.00

2004.00

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

30

3.000 1.0 R

175.55

20 120.000 1.0 R 1 118.69

20 31.000 1.0 R
289.06
20
9.000 1.0 R
83.89

30
30

3.000 1.0 R
3.000 1.0 R

175.55
175.55
-

T
T

20 192.000 1.0 R 1 789.93

20 140.000 1.0 R 1 305.24
20 400.000 1.0 R 3 729.16
20 12.000 1.0 R
111.90

30
30

11.000 1.0 R
6.000 1.0 R

30

11.000 1.0 R

643.53
351.09
643.53
-

T
T

2004.00

20 240.000 1.0 R 2 237.53

20 175.000 1.0 R 1 631.55
20 500.000 1.0 R 4 661.46
20 12.000 1.0 R
111.90

2004.00

20

20

2004.00

2004.00
2004.00

20 221.300 1.0 R
20 231.800 1.0 R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20

Page 33 of 84

65.000
65.000
91.000
315.000
235.000
160.000
58.000
175.000
150.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

T
T
T
T
T
T
T
T

R
R
R
R
R

55.88

168.000
364.800
203.200
230.400
230.400

T
T
T
T
T

6.000 1.0 R

1 957.86
4 251.26
2 368.05
2 684.98
2 684.98
466.22
848.40
1 678.18
932.29
1 314.48

760.56
292.58
292.58
292.58
292.58
877.59
292.58
292.58
877.59

292.58
292.58
292.58
468.13
468.13
175.55
234.06
468.13
468.13
175.55

2004.00

210.000
456.000
254.000
288.000
288.000

877.59

20 50.000 1.0 R
20 91.000 1.0 R
20 144.000 1.0 R
20 100.000 1.0 R
20 120.000 1.0 R

6.000 1.0 R

55.88

2 063.15
2 161.12
605.98
605.98
848.40
2 936.78
2 190.89
1 491.64
540.72
1 631.55
1 398.51

1 650.46
1 728.78
605.98
605.98
848.40
2 349.43
1 752.68
1 193.34
540.72
1 305.24
1 118.69

526.64
526.64
234.06
175.55
175.55
292.58
292.58
234.06
292.58
234.06
234.06

20 177.040 1.0 R
20 185.440 1.0 R
20
20
20
20
20
20
20
20
20

65.000
65.000
91.000
252.000
188.000
128.000
58.000
140.000
120.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

30
30

9.000 1.0 R
9.000 1.0 R

30
30
30
30
30
30
30
30
30

4.000
3.000
3.000
5.000
5.000
4.000
5.000
4.000
4.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

T
T
T
T
T

T
T
T
T
T
T
T
T
T
T
T

1454
1455
1456
1457
1458
1459
8
0074

0075

8.1
1461
1463
1465
1467
1469
1471
1473
1475
1477
1478
1479
1480
1481
1482
1483
1486
8.2
1484
1485
1487
1489
1490
1491
1492
1493
1494
1495
1497
1499
1501
1503
1504
8.3
1505
1507
8.4
1509
1511
1513
1515
1517
1519
1521

Bone marrow transplantation: Plasma/cell separation using designated cell separator equipment (per
hour) (specify time used)
Retroperitoneal lymph adenectomy including pelvic, aortic and renal nodes
Bone marrow transplantation: Preparation for extra-corporeal equipment by the medical practitioner
for plasma, platelet and leucocyte phaeresis
Bone marrow biopsy: By trephine
Bone marrow biopsy: Simple aspiration of marrow by means of trocar or cannula
Staging laparotomy for lymphoma (including splenectomy
Digestive System
MODIFIERS GOVERNING THIS SECTION
Endoscopic procedures performed with own equipment: The basic procedure fee plus 33.33% (1/3)
of that fee ("+" codes excluded) will apply where endoscopic procedures are performed with own
equipment.
Endoscopic procedures performed in own procedure room: The fee plus 21,00 clinical procedure
units will apply where endoscopic procedures are performed in rooms with own equipment. This fee
is chargeable by medical practitioners who own or rent the facility. Please note: Modifier 0075 is not
applicable to any of the items for diagnostic procedures in the otorhinolaryngology sections of the
tariff.
Oral cavity
All dental procedures
Surgical biopsy of tongue or palate: Under general anaesthetic
Surgical biopsy of tongue or palate: Under local anaesthetic
Drainage of intra-oral abscess
Local excision of mucosal lesion of oral cavity
Resection of malignant lesion of buccal mucosa including radical neck dissection (Commando
operation), but not including reconstructive plastic procedure
Complicated reconstruction following major ablative procedure for head and neck cancer
Cleft palate: Repair primary deformity with or without pharyngoplasty
Cleft palate: Secondary repair
Velopharyngeal reconstruction with myoneuro-vascular transfer (dynamic repair)
Velopharyngeal reconstruction with or without pharyngeal flap (static repair)
Repair of oronasal fistula (large) e.g. distant flap
Repair of oronasal fistula (small) e.g. trapdoor: One stage or first stage
Repair of oronasal fistula (large): Second stage
Alveolar periosteal or other flaps for arch closure
Closure of anterior nasal floor
Lips
Cleft lip repair: Lip adhesion (cleft lip)
Local excision of benign lesion of lip
Resection for lip malignancy
Cleft lip repair: Repair unilateral cleft lip (with muscle reconstruction)
Cleft lip repair: Bilateral cleft lip repair (with muscle reconstruction): One of two stages
Cleft lip repair: Repair bilateral cleft lip (with muscle reconstruction): One stage
Cleft lip repair: Bilateral cleft lip repair: Second stage
Cleft lip repair: Total revision of secondary cleft lip deformities
Cleft lip repair: Partial revision of secondary cleft lip deformity
Abb or Estlander type flap (all stages included)
Vermilionectomy
Lip reconstruction following an injury: Direct repair
Lip reconstruction following an injury or tumour removal: Flap repair
Lip reconstruction following an injury or tumour removal: Total reconstruction (first stage)
Lip reconstruction following an injury or tumour removal: Subsequent stages (see item 0297)
Tongue
Partial glossectomy
Local excision of lesion of tongue
Palate, uvula and salivary glands
Wide excision of lesion of palate
Radical resection of palate (including skin graft)
Excision of ranula
Excision of sublingual salivary gland
Excision of submandibular salivary gland
Excision of submandibular salivary gland with suprahyoid dissection
Excision of submandibular salivary gland: With radical neck dissection

2004.00

20

2004.00
2004.00
2004.00
2004.00
2004.00

39.000 1.0 R

363.56

30

5.000 1.0 R

292.58

20 275.000 1.0 R 2 563.84

20 42.000 1.0 R
391.57

20 220.000 1.0 R 2 050.98

20 42.000 1.0 R
391.57

30
30

6.000 1.0 R
5.000 1.0 R

351.09
292.58

T
T

20 13.000 1.0 R
121.14
20
8.000 1.0 R
74.65
20 196.000 1.0 R 1 827.33
-

30

3.000 1.0 R

30

7.000 1.0 R

175.55
409.61
-

2004.00

20 13.000 1.0 R
121.14
20
8.000 1.0 R
74.65
20 245.000 1.0 R 2 284.16
-

2004.00

20

20

21.000 1.0 R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 35.000
20 15.000
20 31.000
20 23.000
20 549.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20

215.000
174.200
240.000
227.000
227.000
138.000
138.000
138.000
138.000

0.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

95.000
27.000
91.000
227.000
251.600
329.900
227.000
251.600
91.000
273.100
94.900
105.600
206.000
206.000
104.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

2004.00
2004.00

20 225.000 1.0 R
20 27.000 1.0 R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20

Page 34 of 84

100.000
250.000
85.600
120.000
146.000
150.000
352.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

363.56

20

195.79

326.31
139.91
289.06
214.41
5 118.29
2 004.49
1 624.07
2 237.53
2 116.24
2 116.24
1 286.61
1 286.61
1 286.61
1 286.61
885.65
251.66
848.40
2 116.24
2 345.61
3 075.67
2 116.24
2 345.61
848.40
2 546.09
884.77
984.50
1 920.46
1 920.46
969.54
2 097.62
251.66
932.29
2 330.80
798.10
1 118.69
1 361.11
1 398.51
3 281.72

39.000 1.0 R

21.000 1.0 R

20 35.000
20 15.000
20 31.000
20 23.000
20 439.200

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

20
20
20
20
20
20
20
20
20
20

172.000
139.360
192.000
181.600
181.600
120.000
120.000
120.000
120.000

0.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

95.000
27.000
91.000
181.600
201.280
263.920
181.600
201.280
91.000
218.480
94.900
105.600
164.800
164.800
104.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

20 180.000 1.0 R
20 27.000 1.0 R
20
20
20
20
20
20
20

100.000
200.000
85.600
120.000
120.000
120.000
281.600

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

195.79

326.31
139.91
289.06
214.41
4 094.63
1 603.53
1 299.22
1 789.93
1 692.99
1 692.99
1 118.69
1 118.69
1 118.69
1 118.69
885.65
251.66
848.40
1 692.99
1 876.46
2 460.44
1 692.99
1 876.46
848.40
2 036.90
884.77
984.50
1 536.37
1 536.37
969.54
1 678.18
251.66
932.29
1 864.58
798.10
1 118.69
1 118.69
1 118.69
2 625.29

30
30
30
30
30
30

4.000
4.000
4.000
4.000
4.000
7.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

30
30
30
30
30
30
30
30
30
30

7.000
6.000
6.000
6.000
6.000
6.000
5.000
5.000
4.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

5.000
4.000
4.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
4.000
4.000
4.000
4.000
4.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

30
30

6.000 1.0 R
4.000 1.0 R

30
30
30
30
30
30
30

5.000
7.000
5.000
4.000
4.000
5.000
6.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

234.06
234.06
234.06
234.06
234.06
409.61
409.61
351.09
351.09
351.09
351.09
351.09
292.58
292.58
234.06
292.58
292.58
234.06
234.06
292.58
292.58
292.58
292.58
292.58
292.58
292.58
234.06
234.06
234.06
234.06
234.06
351.09
234.06
292.58
409.61
292.58
234.06
234.06
292.58
351.09

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

1523
1525
1526
1527
1529
1531
1533
1535
1537
1539
1541
1543
1544
8.5
1545
1549
1550
1551
1552
1553
1554
1555
1557
1559
1560
1561
1563
1565
1566
1567
1568
1569
1575
1578
1579
1580
1581
1582
1583
1584
1585
8.6
1587
1588
1589

1591
1593
1597
1598
1599
1601
1603
1604
1605
1607
1609
1611
1613

Local resection of parotid tumour

Partial parotidectomy
Total parotidectomy with preservation of facial nerve
Total parotidectomy
Parotidectomy: Extracapsular
Drainage of parotid abscess
Closure of salivary fistula
Dilatation of salivary duct
Operative removal of salivary calculus
Salivary duct: Meatotomy
Branchial cyst and/or fistula: Excision
Excision of cystic hygroma
Ludwig's Angina: Drainage
Oesophagus
Oesophagoscopy with rigid instrument: First and subsequent
Oesophagoscopy with dilatation of stricture
Oesophagoscopy with removal of foreign body
Oesophagoscopy with insertion of indwelling oesophageal tube
Injection and/or ligation of oesophageal varices (endoscopy inclusive)
Subsequent injection and/or ligation of oesophageal varices (endoscopy inclusive)
Per-oral small bowel biopsy
Repair of tracheal oesophageal fistula and oesophageal atresia
Oesophageal dilatation
Oesophagectomy: Two stage
Oesophagectomy: Three stage
Thoraco-abdominal oesophagogastrectomy
Hiatus hernia and diaphragmatic hernia repair: With anti-reflux procedure
Hiatus hernia and diaphragmatic hernia repair: With Collis Nissen oesophageal lengthening
procedure
Private fee: Gastroplasty
Bochdalek hernia repair in newborn
Hiatus hernia and diaphragmatic repair: Revision after previous repair
Heller's operation
Insertion of indwelling oesophageal tube by laparotomy
Oesophageal motility (4 channel + pneumograph)
Oesophageal substitution (without oesophagectomy) using colon, small bowel or stomach
Oesophageal motility (6 Channel + pneumograph + pH pull-through)
Removal of benign oesophageal tumours
Oesophageal motility (4 or 6 channel + pneumograph - ECG + provocative tests for oesophageal
spasm vs. myocardial ischaemia)
Excision of intrathoracic oesophageal diverticulum
24 Hour oesophageal pH studies: Hire fee (Item 0201 applicable for pro-rata of probe: 50
examinations per glass electrode pH probe and 10 examinations per antimone pH probe)
24 Hour oesophageal pH studies: Interpretation
Stomach
Upper gastro-intestinal endoscopy: Hospital equipment
Plus polypectomy: ADD to gastro-intestinal endoscopy (Item 1587)
Endoscopic control of gastrointestinal haemorrhage from upper gastrointestinal tract, intestines or
large bowel by injection, ligation or application of energy device (endoscopic haemostasis) to be
added to gastroscopy (item 1587) or colonoscopy (item 1653)
Plus removal of foreign bodies (stomach): ADD to gastro-intestinal endoscopy (Item 1587)
Augmented histamine test: Gastric intubation with x-ray screening
Gastrostomy or Gastrotomy
Gastrotomy with suture repair of bleeding ulcer
Pyloromyotomy (Rammstedt)
Local excision of ulcer or benign neoplasm
Vagotomy: Abdominal
Vagotomy: Thoracic
Truncal or selective with drainage procedures
Vagotomy and antrectomy
Highly selective vagotomy
Pyloroplasty
Gastroenterostomy

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20

169.600
310.000
358.500
358.500
300.000
25.000
91.000
10.000
55.000
20.000
140.000
140.000
42.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20

47.000
70.000
70.000
80.000
80.000
65.000
25.000
400.000
40.000
500.000
550.000
500.000
300.000
350.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20

325.000
250.000
375.000
250.000
142.000
100.000
400.000
110.000
285.000
150.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

2004.00
2004.00
2004.00
2005.03
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

+
+

30
30
30
30
30
30
30
30
30
30
30
30
30

5.000
5.000
5.000
5.000
5.000
4.000
4.000
4.000
4.000
4.000
5.000
5.000
9.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R

R
R
R
R
R
R
R
R
R
R
R
R
R
R

1 264.91
2 312.03
2 673.83
2 673.83
2 237.53
233.04
848.40
93.27
512.71
186.40
1 118.69
1 118.69
391.57
438.21
652.62
652.62
745.89
745.89
605.98
233.04
2 983.27
372.95
3 729.16
4 102.11
3 729.16
2 237.53
2 610.47

30
30
30
30
30
30
30
30
30
30
30
30
30
30

4.000
4.000
4.000
4.000
4.000
4.000
4.000
15.000
4.000
11.000
11.000
11.000
11.000
11.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

2 423.93
1 864.58
2 796.87
1 864.58
1 118.69
932.29
2 983.27
1 025.56
2 125.63
1 118.69

30
30
30
30
30
30
30
30
30
30

8.000
14.000
11.000
14.000
6.000
4.000
11.000
4.000
11.000
4.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

20 250.000 1.0 R 2 330.80

20 55.000 1.0 R
512.71

20 200.000 1.0 R 1 864.58

20 55.000 1.0 R
512.71

30

20

27.000 1.0 R

20

27.000 1.0 R

20
20
20

48.750 1.0 R
25.000 1.0 R
34.000 1.0 R

Z
Z

20
20
20

48.750 1.0 R
25.000 1.0 R
34.000 1.0 R

20
20
20
20
20
20
20
20
20
20
20
20
20

20
20
20
20
20
20
20
20
20
20
20
20
20

Page 35 of 84

25.000
5.000
147.500
251.200
116.000
195.600
150.000
150.000
250.000
320.000
250.000
180.200
203.600

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

20
20
20
20
20
20
20
20
20
20
20
20
20

135.680
248.000
286.800
286.800
240.000
25.000
91.000
10.000
55.000
20.000
120.000
120.000
42.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R

R
R
R
R
R
R
R
R
R
R
R
R
R
R

1 581.10
2 890.15
3 342.29
3 342.29
2 796.87
233.04
848.40
93.27
512.71
186.40
1 305.24
1 305.24
391.57
438.21
652.62
652.62
745.89
745.89
605.98
233.04
3 729.16
372.95
4 661.46
5 127.67
4 661.46
2 796.87
3 263.09

20
20
20
20
20
20
20
20
20
20
20
20
20
20

47.000
70.000
70.000
80.000
80.000
65.000
25.000
320.000
40.000
400.000
440.000
400.000
240.000
280.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

3 029.91
2 330.80
3 496.13
2 330.80
1 323.86
932.29
3 729.16
1 025.56
2 656.96
1 398.51

20
20
20
20
20
20
20
20
20
20

260.000
200.000
300.000
200.000
120.000
100.000
320.000
110.000
228.000
120.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R

251.66
454.49
233.04
316.92

233.04
46.64
1 375.19
2 341.95
1 081.44
1 823.52
1 398.51
1 398.51
2 330.80
2 983.27
2 330.80
1 679.94
1 898.17

25.000
5.000
120.000
200.960
116.000
156.480
120.000
120.000
200.000
256.000
200.000
144.160
162.880

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R

251.66
454.49
233.04
316.92

233.04
46.64
1 118.69
1 873.53
1 081.44
1 458.79
1 118.69
1 118.69
1 864.58
2 386.68
1 864.58
1 343.95
1 518.47

T
T
T
T
T
T
T
T
T
T
T
T
T

R
R
R
R
R
R
R
R
R
R
R
R
R
R

292.58
292.58
292.58
292.58
292.58
234.06
234.06
234.06
234.06
234.06
292.58
292.58
526.64
234.06
234.06
234.06
234.06
234.06
234.06
234.06
877.59
234.06
643.53
643.53
643.53
643.53
643.53

R
R
R
R
R
R
R
R
R
R

468.13
819.07
643.53
819.07
351.09
234.06
643.53
234.06
643.53
234.06

T
T
T
T
T
T
T
T
T
T

11.000 1.0 R

643.53
-

Z
Z

30
30
30

4.000 1.0 R
4.000 1.0 R
6.000 1.0 R

30

4.000 1.0 R

30
30
30
30
30
30
30
30
30
30
30

6.000
6.000
6.000
6.000
6.000
11.000
6.000
6.000
6.000
6.000
6.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R

234.06
234.06
351.09

234.06
351.09
351.09
351.09
351.09
351.09
643.53
351.09
351.09
351.09
351.09
351.09

T
T
T
T
T
T
T
T
T
T
T
T
T
T

T
T
T

T
T
T
T
T
T
T
T
T
T
T
T

1615
1617
1619
1621
1625
8.7
1626
1627
1629
1631
8.8
1632
1633
1634
1635
1637
1639
1641
1642

1643
1645
1647
1649
1651
1652
1653
1654
1656
1657
1658
1661
1663
1665
1666
1667
1668
1669
1670
1671
8.9
1673
1675
8.10
1676
1677
1678
1679
1681
1683
1685
1687
1688
1689

1691
1692

Suture of perforated gastric or duodenal ulcer or wound or injury

Partial gastrectomy
Total gastrectomy
Revision of gastrectomy or gastro-enterostomy
Gastro-esophageal operation for portal hypertension (Tanner)
Duodenum
Endoscopic examination of the small bowel beyond the duodenojenunal flexure with biopsy with or
without polypectomy with or without arrest of haemorrhage (enteroscopy)
Duodenal intubation (under X-ray screening)
Duodenal intubation with biliary drainage after gall bladder stimulation
Duodenal intubation: Under 3 years of age
Intestines
H2 breath test (intestines)
Complete test using lactose or lactulose
Enterotomy or Enterostomy
Intestinal obstruction of the newborn
Operation for relief of intestinal obstruction
Resection of small bowel with enterostomy or anastomosis
Entero-enterostomy or entero-colostomy for bypass
Gastrointestinal tract imaging, intraluminal (e.g. video capsule endoscopy): Hire fee (item 0201
applicable for video capsule - disposable single patient use) (Please note: All patients should have
had a normal gastroscopy and colonoscopy)
Gastrointestinal tract imaging, intraluminal (e.g. video capsule endoscopy), oesophagus through
ileum: Doctor interpretation and report
Suture of intestine (small or large): Perforated ulcer, wound or injury
Closure of intestinal fistula
Excision of Meckel's diverticulum
Excision of lesion of mesentery
Laparotomy for mesenteric thrombosis
Total colonoscopy: With hospital equipment (including biopsy)
Plus removal of polyps: ADD to colonoscopy (Item 1653)
Left-sided colonoscopy
Right or left hemicolectomy or segmental colectomy
Reconstruction of colon after Hartmans procedure
Colotomy: Including removal of tumour or foreign body
Total colectomy
Colostomy or ileostomy isolated procedure
Continent ileostomy pouch (all types)
Colostomy: Closure
Revision of ileostomy pouch
Total proctocolectomy and ileostomy
Proctocolectomy, ileostomy and ileostomy pouch
Colomyotomy (Reilly operation)
Appendix
Drainage of appendix abscess
Appendicectomy
Rectum and anus
Flexible sigmoidoscopy (including rectum and anus): Hospital equipment.
Sigmoidoscopy: First and subsequent, with or without biopsy
Plus polypectomy: ADD to sigmoidoscopy (Item 1676)
Sigmoidoscopy with removal of polyps, first and subsequent
Proctoscopy with removal of polyps: First time
Proctoscopy with removal of polyps: Subsequent times
Endoscopic fulguration of tumour
Anterior resection of rectum performed for carcinoma of rectum including excision of any part of
proximal colon necessary
Total mesorectal excision with colo-anal anastomosis and defunctioning enterostomy or colostomy

2004.00
2004.00
2004.00
2004.00
2004.00

2004.00

20 445.000 1.0 R 4 148.75

Perineal resection of rectum

Please note: Items 1691 and 1692: Abdominal and/or perineal assistant's fee to be charged
additionally.
Abdomino-perineal resection of rectum: Abdominal surgeon
Abdomino-perineal resection of rectum: Perineal surgeon

2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

2004.00

1 864.58
3 060.71
3 583.98
3 496.13
3 496.13
20 120.000 1.0 R 1 118.69

2004.00
2004.00
2006.04

20
20
20

2004.00
2004.00
2004.11
2004.00
2004.00
2004.00
2004.00
2005.03

20
20
20
20
20
20
20
20

2005.03

20

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

200.000
328.300
384.430
375.000
375.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

8.000 1.0 R
21.000 1.0 R
15.000 1.0 R

1 491.64
2 448.57
2 867.12
2 796.87
2 796.87
20 120.000 1.0 R 1 118.69

R
R
R
R
R
R
R
R

74.65
195.79
139.91
83.89
251.66
1 888.78
2 237.53
2 237.53
2 283.14
1 986.75
1 398.51

20
20
20
20
20
20
20
20

90.000 1.0 R

839.02

20

9.000
27.000
202.600
240.000
240.000
244.900
213.100
150.000

185.200
258.000
179.800
171.600
300.000
90.000
30.000
60.000
325.000
359.400
205.700
390.000
233.800
300.000
179.100
375.000
480.000
540.000
185.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

R
R
R
R
R

30
30
30
30
30
30

7.000
7.000
7.000
7.000
11.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

6.000 1.0 R

R
R
R
R
R
R
R
R

351.09
409.61
409.61
351.09
351.09
-

90.000 1.0 R

839.02

9.000
27.000
162.080
192.000
192.000
195.920
170.480
120.000

20 141.000 1.0 R 1 314.48

20 409.300 1.0 R 3 815.84
20 158.500 1.0 R 1 477.70

Page 36 of 84

Z
Z

T
T
T
T
T

R
R
R
R
R
R
R
R

30

8.000 1.0 R

468.13

20 120.000 1.0 R 1 118.69

-

30

5.000 1.0 R

292.58
-

20 327.440 1.0 R 3 052.64

20 126.800 1.0 R 1 182.19

30

7.000 1.0 R

409.61
-

20 48.750
20 13.000
20 25.000
20 30.000
20 21.000
20 15.000
20 50.000
20 305.040

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

Z
Z

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

Z
Z
Z

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

T
T
T
T
T

351.09
351.09
351.09
234.06
468.13
234.06
234.06
234.06
351.09
351.09
351.09
351.09
351.09
351.09
292.58
351.09
409.61
409.61
351.09
292.58
234.06
175.55
175.55
175.55
175.55
175.55
175.55
234.06
351.09

20 120.000 1.0 R
20 128.000 1.0 R

1 381.35
1 924.27
1 341.02
1 279.87
2 237.53
839.02
279.67
559.35
2 423.93
2 680.58
1 534.17
2 908.77
1 743.74
2 237.53
1 335.74
2 796.87
3 580.02
4 027.46
1 379.74
1 118.69
1 193.34
454.49
121.14
233.04
279.67
195.79
139.91
466.22
2 843.80

1.0
1.0
1.0
1.0
1.0

20 356.000 1.0 R 3 318.97

R
R
R
R
R
R
R
R

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

6.000
7.000
7.000
6.000
6.000

3.000
3.000
3.000
3.000
3.000
3.000
4.000
6.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

30
30
30
30
30

30
30
30
30
30
30
30
30

20 48.750
20 13.000
20 25.000
20 30.000
20 21.000
20 15.000
20 50.000
20 381.300

148.160
206.400
143.840
137.280
240.000
90.000
30.000
60.000
260.000
287.520
164.560
312.000
187.040
240.000
143.280
300.000
384.000
432.000
148.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

5.000 1.0 R
4.000 1.0 R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

409.61
409.61
409.61
409.61
643.53
351.09

83.89
251.66
1 511.00
1 789.93
1 789.93
1 826.60
1 589.31
1 118.69

30
30

Z
Z
Z

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

1.0
1.0
1.0
1.0
1.0

6.000
6.000
6.000
4.000
8.000
4.000
4.000
4.000
6.000
6.000
6.000
6.000
6.000
6.000
5.000
6.000
7.000
7.000
6.000

20 150.000 1.0 R
20 160.000 1.0 R

1 726.58
2 405.30
1 676.28
1 599.87
2 796.87
839.02
279.67
559.35
3 029.91
3 350.65
1 917.67
3 635.89
2 179.75
2 796.87
1 669.68
3 496.13
4 475.06
5 034.40
1 724.67
1 398.51
1 491.64
454.49
121.14
233.04
279.67
195.79
139.91
466.22
3 554.79

160.000
262.640
307.540
300.000
300.000

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

2004.00
2004.00

20
20
20
20
20

T
T
T
T
T
T
T
T
T
T

1693
1695
1697
1699
1701
1703
1705
1707
1709
1711
1713
1715
1719
1721
1723
1725
1727
1728
1729
1731
1733
1735
1737
1739
1741
1742
8.11
1743
1745
1747
1748
1749
1751
1752
1753
1754
1755
1756
1757
8.12
1759
1761
1762
1763
1765
1767
1768
1769
1772
1773
1774
1775
1777
8.13
1778
1779
1780
1781
1782
1783

Abdomino-perineal resection of rectum: Local excision of rectal tumour (posterior approach)

Abdomino-perineal resection of rectum: Combined abdomino-anal pull-through procedure for
Hirschsprung's disease, rectal agenesis or tumour
Repair of prolapsed rectum: Abdominal: Roscoe Graham Moskovitz
Repair of prolapsed rectum: Abdominal: Ivalon sponge
Repair of prolapsed rectum: Abdominal: Perineal
Repair of prolapsed rectum: Abdominal: Thierisch suture
Incision and drainage of peri-anal abscess
Drainage of submucous abscess
Drainage of ischio-rectal abscess
Excision of pelvi-rectal fistula
Excision of fistula-in-ano
Operation for fissure-in-ano
Rubber band ligation of haemorrhoids: Per haemorrhoid
Sclerosing injection for haemorrhoids: Per injection
Haemorrhoidectomy
Drainage of external thrombosed pile
Multiple procedures (haemorrhoids, fissure, etc.)
Biopsy of ano-rectal wall, for congenital megacolon
Excision of anal skin tags
Operation for low imperforate anus
Anoplasty: Y-V-plasty
Anal sphincteroplasty for incontinence
Dilation of ano-rectal stricture
Closure of recto-vesical fistula
Closure of recto-urethral fistula
Bio-feedback training for faecal incontinence during anorectal manometry performed by doctor
Liver
Needle biopsy of liver
Biopsy of liver by laparotomy
Drainage of liver abscess or cyst
Body composition measured by bio-electrical impedance
Hemi-hepatectomy: Right
Hemi-hepatectomy: Left
Extended right or left hepatectomy
Partial or segmental hepatectomy
Hepatico-jejunostomy
Liver transplant
Harvesting donor hepatectomy
Suture of liver wound or injury
Biliary tract
Cholecystostomy
Cholecystectomy
Cholecystectomy and operative cholangiogram
With exploration of common bile duct
Exploration of common bile duct: Secondary operation
Reconstruction of common bile duct
Resection bile duct tumour with reconstruction
Cholecysto-enterostomy or gastrostomy
Endoscopic placement of a nasobiliary drainage tube: ADD to ERCP (item 1778)
Transduodenal sphincteroplasty
Balloon dilatation of common bile duct strictures
Excision choledochal cyst with reconstruction
Porto-enterostomy for biliary atresia
Pancreas
Endoscopic Retrograde Cholangiopancreatography (ERCP): Endoscopy + catheterisation of
pancreas duct or choledochus
Endoscopic retrograde removal of stone(s) as for biliary and/or pancreatic duct. ADD to ERCP (item
1778)
Gastric and duodenal intubation
Procedure (excluding laboratory tests)
Endoscopic Sphincterotomy: ADD to ERCP (item 1778)
Drainage of pancreatic abscess

2004.00
2004.00

20 200.000 1.0 R 1 864.58

20 400.000 1.0 R 3 729.16

20 160.000 1.0 R 1 491.64

20 320.000 1.0 R 2 983.27

30
30

4.000 1.0 R
7.000 1.0 R

234.06
409.61

T
T

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2005.03
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

300.000
200.000
150.000
35.000
40.000
40.000
87.000
200.000
105.000
66.800
10.000
5.000
120.000
12.500
90.000
60.600
25.000
105.000
41.000
120.000
12.500
241.000
241.000
27.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

240.000
160.000
120.000
35.000
40.000
40.000
87.000
160.000
105.000
66.800
10.000
5.000
120.000
12.500
90.000
60.600
25.000
105.000
41.000
120.000
12.500
192.800
192.800
27.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

30
30
30
30
30
30
30
30
30
30
30

6.000
6.000
4.000
4.000
3.000
3.000
3.000
5.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R

T
T
T
T
T
T
T
T
T
T
T

30
30
30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
5.000
3.000
6.000
3.000
3.000
3.000
5.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20

30.300
125.000
179.100
3.000
564.000
521.100
570.900
378.000
369.200
#######
616.200
214.200

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

20
20
20
20
20
20
20
20
20
20
20
20

30.300
120.000
143.280
3.000
451.200
416.880
456.720
302.400
295.360
#######
492.960
171.360

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

30
30
30

3.000 1.0 R
4.000 1.0 R
7.000 1.0 R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2006.04
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20

171.600
225.000
255.000
264.500
327.700
371.700
327.700
236.300
25.600
225.000
125.000
327.700
400.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

20
20
20
20
20
20
20
20
20
20
20
20
20

137.280
180.000
204.000
211.600
262.160
297.360
262.160
189.040
25.600
180.000
100.000
262.160
320.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 105.900 1.0
+

20

2 796.87
1 864.58
1 398.51
326.31
372.95
372.95
811.15
1 864.58
978.93
622.70
93.27
46.64
1 118.69
116.59
839.02
564.92
233.04
978.93
382.19
1 118.69
116.59
2 246.77
2 246.77
251.66
R
282.46
R 1 165.33
R 1 669.68
R
28.01
R 5 258.05
R 4 858.12
R 5 322.43
R 3 523.99
R 3 442.01
R 13 059.56
R 5 744.80
R 1 997.01
R 1 599.87
R 2 097.62
R 2 377.29
R 2 465.87
R 3 055.13
R 3 465.33
R 3 055.13
R 2 203.06
R
238.61
R 2 097.62
R 1 165.33
R 3 055.13
R 3 729.16
R
987.29

15.820 1.0 R

20
8.000
20 21.000
20 30.000
20 239.300

Page 37 of 84

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

1.0
1.0
1.0
1.0

147.54

R
74.65
R
195.79
R
279.67
R 2 230.93

20 105.900 1.0
20

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

2 237.53
1 491.64
1 118.69
326.31
372.95
372.95
811.15
1 491.64
978.93
622.70
93.27
46.64
1 118.69
116.59
839.02
564.92
233.04
978.93
382.19
1 118.69
116.59
1 797.41
1 797.41
251.66
R
282.46
R 1 118.69
R 1 335.74
R
28.01
R 4 206.53
R 3 886.53
R 4 258.01
R 2 819.31
R 2 753.61
R 10 447.62
R 4 595.75
R 1 597.52
R 1 279.87
R 1 678.18
R 1 901.83
R 1 972.67
R 2 444.17
R 2 772.24
R 2 444.17
R 1 762.36
R
238.61
R 1 678.18
R
932.29
R 2 444.17
R 2 983.27
R
987.29

15.820 1.0 R

20
8.000
20 21.000
20 30.000
20 191.440

1.0
1.0
1.0
1.0

147.54

R
74.65
R
195.79
R
279.67
R 1 784.80

30

4.000 1.0 R

351.09
351.09
234.06
234.06
175.55
175.55
175.55
292.58
175.55
175.55
175.55
175.55
175.55
175.55
292.58
175.55
351.09
175.55
175.55
175.55
292.58
292.58
175.55
234.06
409.61
526.64
526.64
526.64
526.64
526.64
877.59
292.58
526.64
351.09
351.09
351.09
351.09
351.09
351.09
351.09
351.09
351.09
351.09
351.09
351.09
643.53
234.06

30

4.000 1.0 R

234.06

4.000 1.0 R
6.000 1.0 R

234.06
351.09

T
T

30
30
30
30
30
30
30
30

9.000
9.000
9.000
9.000
9.000
15.000
5.000
9.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

30
30
30
30
30
30
30
30
30
30
30
30
30

6.000
6.000
6.000
6.000
6.000
6.000
6.000
6.000
6.000
6.000
6.000
6.000
11.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R

30
30

T
T
T
T
T
T
T
T
T
T
T

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

1784
1785
1770
1786
1787
1788
1789
1791
1793
8.14
1797
1799
1800
1801
1803
1807
1809
1810
1811
1812
1813
1815
1817
9
1819
1821
1823
1825
1827
1829
1831
1833
1835
1836
1837
10
FF.

10.1
1839
1841
1843
1845
1847
1849
1851
1852
1853
1855
1857
1859
1861
1863
1865

Debridement pancreatic necrosis

Internal drainage of pancreatic cyst
Endoscopic placement of biliduodenal endoprosthesis: ADD to ERCP (item 1778)
Internal drainage of pancreatic cyst with Roux-Y
Operative pancreatogram: ADD
Biopsy of pancreas
Pancreatico-duodenectomy
Local, partial or subtotal pancreatectomy
Distal pancreatectomy with internal drainage
Peritoneal cavity
Pneumo-peritoneum: First
Pneumo-peritoneum: Repeat
Peritoneal lavage
Diagnostic paracentesis: Abdomen
Therapeutic paracentesis: Abdomen
ADD to open procedure where procedure was performed through a laparoscope (for anaesthetic
refer to modifier 0027)
Laparotomy
Radical removal of retro-peritoneal malignant tumours (including sacro-coccygeal and pre-sacral)

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

2004.00
2004.00

Suture of burst abdomen

Laparotomy for control of surgical haemorrhage
Drainage of sub-phrenic abscess
Drainage of other intraperitoneal abscess (excluding appendix abscess): Transabdominal
Drainage of other intraperitoneal abscess (excluding appendix abscess): Transrectal drainage of
pelvic abscess
Herniae
Inguinal or femoral hernia: Adult
Inguinal or femoral hernia: Child under 14 years
Inguinal hernia: Infant under one year
Recurrent inguinal or femoral hernia
Strangulated hernia or femoral hernia
Epigastric hernia
Umbilical hernia: Adult
Umbilical hernia: Child under 14 years
Incisional hernia
Implantation of mesh or other prosthesis for incisional or ventral hernia repair (List separately in
addition to item for the incisional or ventral hernia repair)
Repair of omphalocele in new-born (one or more procedures)
Urinary System
RULES GOVERNING THE SECTION URINARY SYSTEM
(a) When a cystoscopy precedes a related operation, Modifier 0013: Endoscopic examination done
at an operation, applies, e.g. cystoscopy followed by transurethral (TUR) prostatectomy. (b) When a
cystoscopy precedes an unrelated operation, Modifier 0005: Multiple procedures/operations under
the same anaesthetic, applies, e.g. cystoscopy for urinary tract infection followed by inguinal hernia
repair. (c) No modifier applies to item 1949: Cystoscopy, when performed together with any of items
1951 to 1973.
Kidney
Renal biopsy: Per kidney: Open
Renal biopsy: Needle
Peritoneal dialysis: First day
Peritoneal dialysis: Every subsequent day
Haemodialysis: Per hour or part thereof
Haemodialysis: Maximum: Eight hours
Haemodialysis: Thereafter per week
Continuous haemodiafiltration per day in intensive or high care unit
Nephrectomy: Primary nephrectomy
Nephrectomy: Secondary nephrectomy
Radical with regional lymph adenectomy for tumour
Nephrectomy: Partial
Symphysiotomy for horse-shoe kidney
Nephro-ureterectomy
Nephrotomy with drainage nephrostomy

2 598.45
1 869.13
279.67
2 288.27
93.27
1 325.33
5 256.59
2 620.15
2 814.77
121.14
55.88
186.40
74.65
121.14
419.58

30
30
30
30

6.000
6.000
6.000
6.000

1.0
1.0
1.0
1.0

R
R
R
R

30
30
30
30

6.000
8.000
8.000
8.000

1.0
1.0
1.0
1.0

R
R
R
R

30
30

4.000 1.0 R
4.000 1.0 R

30

20 196.000 1.0 R 1 827.33

20 350.000 1.0 R 3 263.09

20 156.800 1.0 R 1 461.87

20 280.000 1.0 R 2 610.47

2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

188.300
105.000
180.000
248.400
75.000

1.0
1.0
1.0
1.0
1.0

R 1 755.47
R
978.93
R 1 678.18
R 2 315.84
R
699.26

20
20
20
20
20

150.640
105.000
144.000
198.720
75.000

1.0
1.0
1.0
1.0
1.0

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20

125.000
90.000
100.000
155.000
238.000
93.300
140.000
60.000
166.800
77.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

1 165.33
839.02
932.29
1 445.00
2 218.90
869.82
1 305.24
559.35
1 554.99
717.88

20
20
20
20
20
20
20
20
20
20

120.000
90.000
100.000
124.000
190.400
93.300
120.000
60.000
133.440
77.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

2004.00

+
+

20
20
20
20
20
20
20
20
20

348.400
250.600
30.000
306.800
10.000
177.700
704.800
351.300
377.400

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

20
20
20
20
20
20

13.000
6.000
20.000
8.000
13.000
45.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

3 248.13
2 336.37
279.67
2 860.23
93.27
1 656.62
6 570.77
3 275.12
3 518.42
121.14
55.88
186.40
74.65
121.14
419.58

2004.00

20 275.000 1.0 R 2 563.84

-

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.11
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

Page 38 of 84

71.000
30.000
33.000
33.000
21.000
168.000
55.000
33.000
225.000
267.000
280.000
267.000
287.000
305.000
189.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

661.86
279.67
307.68
307.68
195.79
1 566.28
512.71
307.68
2 097.62
2 489.19
2 610.47
2 489.19
2 675.74
2 843.51
1 762.07

20
20
20
20
20
20
20
20
20

278.720
200.480
30.000
245.440
10.000
142.160
563.840
281.040
301.920

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

T
T
T
T

5.000 1.0 R

351.09
351.09
351.09
351.09
351.09
468.13
468.13
468.13
234.06
234.06
292.58

20
20
20
20
20
20

13.000
6.000
20.000
8.000
13.000
45.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

30
30

4.000 1.0 R
7.000 1.0 R

234.06
409.61

T
T

R 1 404.38
R
978.93
R 1 342.49
R 1 852.70
R
699.26

30
30
30
30
30

7.000
9.000
7.000
5.000
4.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

409.61
526.64
409.61
292.58
234.06

T
T
T
T
T

1 118.69
839.02
932.29
1 156.09
1 775.12
869.82
1 118.69
559.35
1 244.08
717.88

30
30
30
30
30
30
30
30
30
30

4.000
4.000
4.000
4.000
7.000
4.000
4.000
4.000
4.000
4.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

234.06
234.06
234.06
234.06
409.61
234.06
234.06
234.06
234.06
234.06

T
T
T
T
T
T
T
T
T
T

30

7.000 1.0 R

30
30

5.000 1.0 R
3.000 1.0 R

30
30
30
30
30
30
30

5.000
5.000
6.000
5.000
6.000
5.000
6.000

20 220.000 1.0 R 2 050.98

-

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

71.000
30.000
33.000
33.000
21.000
134.400
55.000
33.000
180.000
213.600
224.000
213.600
229.600
244.000
151.200

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

661.86
279.67
307.68
307.68
195.79
1 253.03
512.71
307.68
1 678.18
1 991.44
2 088.38
1 991.44
2 140.59
2 274.78
1 409.66

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

409.61
-

292.58
175.55
292.58
292.58
351.09
292.58
351.09
292.58
351.09

T
T
T
T
T
T

T
T

T
T
T
T
T
T
T

1869
1870
1871
1873
1875
1877
1879
1881
1883
1885
1887
1889
1891
1893
1894
1895
10.2
1897
1898
1899
1901
1902
1903
1905
1907
1909
1911
1913
1915
1917
1919
1921
1923
1925
1927
1929
1931
1933
1935
1937
1939
1941
1943
10.3
1952
1953
1954
1955
1957
1959
1961
1963
1964
1965
1967
1969
1971
1973
1975
1976
1977

Nephrolithotomy
Nephrolithotomy: Multiple calculi: Repeat open operation + 25%
Staghorn stone: Surgical
Suture renal laceration (renorraphy)
Percutaneous aspiration cyst: Nephrostomy, pyelostomy
Operation for renal cyst: Marsupialisation or excision
Closure renal fistula
Pyeloplasty
Pyelostomy
Pyelolithotomy
Complicated pyelo-lithotomy (e.g. solitary, ectopic, horse-shoe kidney or secondary operation)
Nephrectomy for Allograft: Living or dead
Perinephric abscess or renal abscess: Drainage
Aberrant renal vessels: Repositioning with pyeloplasty
Auto transplantation of kidney
Allo transplantation of kidney
Ureter
Ureterorraphy: Suture of ureter
Ureterorraphy: Lumbar approach
Ureteroplasty
Ureterolysis
Ureterolysis: Lumbar approach
Ureterectomy only
Ureterolithotomy
Cutaneous ureterostomy: Unilateral
Cutaneous ureterostomy: Bilateral
Uretero-enterostomy: Unilateral
Uretero-enterostomy: Bilateral
Uretero-ureterostomy
Transuretero-ureterostomy
Closure of ureteric fistula
Immediate deligation of ureter
Ureterolysis for retrocaval ureter with anastomosis
Uretero-pyelostomy
Uretero-neo-cystostomy: Unilateral
Uretero-neo-cystostomy: Bilateral
Uretero-neo-cystostomy: With Boariplasty
Uretero-sigmoidostomy with rectal bladder and colostomy
Uretero-ileal conduit
Replacement of ureter by bowel segment: Unilateral
Replacement of ureter by bowel segment: Bilateral
Ureterostomy-in-situ: Unilateral
Ureterostomy-in-situ: Bilateral
Bladder
J J Stent catheter
With hydrodilatation of the bladder for interstitial cystitis
Uretroscopy
And bilateral ureteric catheterisation with differential function studies requiring additional attention
time
With dilatation of the ureter or ureters
With manipulation of ureteral calculus
With removal of foreign body or calculus from urethra or bladder
With fulguration or treatment of minor lesions, with or without biopsy
And control of haemorrhage and blood clot evacuation
And catheterisation of the ejaculatory duct
With ureteric meatotomy: Unilateral or bilateral
And cold biopsy
With cryosurgery for bladder or prostatic disease
With incision fulguration, or resection of bladder neck and/or posterior urethra for congenital valves
or obstructive hypertrophic bladder neck in a child
Ultraviolet cystoscopy for bladder tumour
Optic urethrotomy
Transurethral resection of ejaculatory duct

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2006.04
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

227.000
284.000
341.000
193.000
34.000
189.000
189.000
252.000
189.000
189.000
223.000
255.000
200.000
210.000
420.000
420.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00

+
+
+
+

20
20
20
20

44.000
5.000
35.000
35.000

1.0
1.0
1.0
1.0

R
R
R
R

2 116.24
2 647.72
3 179.06
1 799.32
316.92
1 762.07
1 762.07
2 349.43
1 762.07
1 762.07
2 078.99
2 377.29
1 864.58
1 957.86
3 915.56
3 915.56
1 370.50
1 762.07
1 687.42
1 100.07
1 762.07
1 277.23
2 478.04
1 006.94
1 762.07
1 277.23
2 237.53
1 277.23
1 445.00
1 370.50
1 370.50
1 566.28
2 349.43
2 946.90
4 420.50
3 279.81
2 349.43
3 617.27
2 582.46
4 521.55
932.29
1 631.55
410.20
46.64
326.31
326.31

2004.11
2004.11
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

147.000
189.000
181.000
118.000
189.000
137.000
265.800
108.000
189.000
137.000
240.000
137.000
155.000
147.000
147.000
168.000
252.000
316.100
474.150
351.800
252.000
388.000
277.000
485.000
100.000
175.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

+
+
+
+
+
+
+
+
+
+

20
20
20
20
20
20
20
20
20
20

25.000
20.000
20.000
15.000
15.000
10.000
15.000
15.000
55.000
35.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

20
20
20

60.000 1.0 R
80.000 1.0 R
60.700 1.0 R

2004.00
2004.00
2004.00

Page 39 of 84

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

181.600
227.200
272.800
154.400
34.000
151.200
151.200
201.600
151.200
151.200
178.400
204.000
160.000
168.000
336.000
336.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

120.000
151.200
144.800
118.000
151.200
120.000
212.640
108.000
151.200
120.000
192.000
120.000
124.000
120.000
120.000
134.400
201.600
252.880
379.320
281.440
201.600
310.400
221.600
388.000
100.000
140.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

1 692.99
2 118.15
2 543.31
1 439.43
316.92
1 409.66
1 409.66
1 879.54
1 409.66
1 409.66
1 663.22
1 901.83
1 491.64
1 566.28
3 132.57
3 132.57
1 118.69
1 409.66
1 349.97
1 100.07
1 409.66
1 118.69
1 982.49
1 006.94
1 409.66
1 118.69
1 789.93
1 118.69
1 156.09
1 118.69
1 118.69
1 253.03
1 879.54
2 357.64
3 536.31
2 623.82
1 879.54
2 893.81
2 065.94
3 617.27
932.29
1 305.24
410.20
46.64
326.31

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

5.000
5.000
6.000
6.000
3.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
7.000
5.000
10.000
10.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

R
R
R
R

292.58
292.58
351.09
351.09
175.55
292.58
292.58
292.58
292.58
292.58
292.58
292.58
409.61
292.58
585.16
585.16
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
175.55
175.55
175.55
175.55

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

30
30
30
30

3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

20
20

44.000 1.0 R
5.000 1.0 R

20

35.000 1.0 R

233.04
186.40
186.40
139.91
139.91
93.27
139.91
139.91
512.71
326.31

20
20
20
20
20
20
20
20
20
20

25.000
20.000
20.000
15.000
15.000
10.000
15.000
15.000
55.000
35.000

R
R
R
R
R
R
R
R
R
R

233.04
186.40
186.40
139.91
139.91
93.27
139.91
139.91
512.71
326.31

30
30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000

R
R
R
R
R
R
R
R
R
R

175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55

T
T
T
T
T
T
T
T
T
T

559.35
745.89
565.94

20
20
20

60.000 1.0 R
80.000 1.0 R
60.700 1.0 R

559.35
745.89
565.94

30
30
30

3.000 1.0 R
3.000 1.0 R
3.000 1.0 R

175.55
175.55
175.55

T
T
T

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

T
T
T
T

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

1949
1951
2001
2003
2005
2006
2007
2008
2009
2010
2011
2012
2013
2015
2016
2017
2019
2020
2021
2023
2025
2027
2029
2031
2033

Internal urethrotomy: Female

Internal urethrotomy: Male
Transurethral resection of bladder tumour
Transurethral resection of bladder tumours: Large multiple tumours
Transurethral resection of bladder neck: Female or child
Transurethral resection of bladder neck: Male
Litholapaxy
Cystometrogram
Flometric bladder, studies with videocystograph
Without videocystograph
Voiding cysto-urethrogram
Rigiscan examination
Percutaneous aspiration of bladder
Bladder catheterisation: Male (not at operation)
Bladder catheterisation: Female (not at operation)
Percutaneous cystostomy
Instillation of radio-opaque material for cystography or urethrocystography
Instillation of anti-carcinogenic agent including retention time, but not cost of material or hydrodilatation of bladder
Cystoscopy: Hospital equipment
And retrograde pyelography or retrograde ureteral catheterisation: Unilateral or bilateral
Total cystectomy: After previous urinary diversion
Total cystectomy: With conduit construction and ureteric anastomosis
Cystectomy with substitute bowel bladder construction with anastomosis to urethra or trigone
Cystectomy with continent urinary diversion (e.g. Kocks Pouch)
Partial cystectomy
Continent urinary diversion without cystectomy (e.g. Kocks Pouch)
Radical total cystectomy with block dissection, ileal conduit and transplantation of ureters
Reversion of temporary conduit
Partial cystectomy with uretero-neo-cystostomy
Reversion of conduit with major urinary tract reconstruction
Diverticulectomy (independent procedure): Multiple or single
Suprapubic cystostomy
Abdomino-neo-urethrostomy
Open loop fulguration or excision of bladder tumour
Operation for vesico-vaginal or urethra-vaginal fistula
Repair of vesico vaginal fistula: Abdominal approach
Vesico-plication (Hamilton Stewart)
Vesico-urethropexy for correction or urinary incontinence: Abdominal approach
Vesico-urethropexy with rectus sling
Open operation for ureterocele: Unilateral
Open operation for ureterocele: Bilateral
Reconstruction of ectopic bladder exclusive of orthopaedic operation (if required): Initial
Reconstruction of ectopic bladder exclusive of orthopaedic operation (if required): Subsequent

2035
2037
2039
2042
2043
2045
2047
2049
2050
2051
2053
2057
10.4
2059
2061
2063
2065
2067

Cutaneous vesicostomy
Cystoplasty, cysto-urethraplasty, vesicolysis
Operation for ruptured bladder
Enterocystoplasty plus bowel anastomosis
Cysto-lithotomy
Excision of patent-urachus or urachal cyst
Drainage of perivesical or prevesical abscess
Evacuation of clots from bladder: Other than post-operative
Evacuation of clots from bladder: Post-operative
Simple bladder lavage: Including catheterisation
Bladder neck plasty: Male
Bladder neck plasty: Female
Urethra
Open biopsy of urethra: Male
Open biopsy of urethra: Female
Dilatation of urethra stricture: By passage sound: Initial (male)
Dilatation of urethra stricture: By passage sound: Subsequent (male)
Dilatation of urethra stricture: By passage sound: By passage of filiform and follower (male)

1979
1981
1983
1984
1985
1986
1987
1989
1991
1992
1993
1994
1995
1996
1997
1999
1945
1947

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

50.000
76.200
100.000
115.000
105.000
125.000
80.000
25.000
40.000
25.000
21.000
66.000
10.000
6.000
3.000
24.000
5.000
10.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
466.22
R
710.40
R
932.29
R 1 072.20
R
978.93
R 1 165.33
R
745.89
R
233.04
R
372.95
R
233.04
R
195.79
R
615.37
R
93.27
R
55.88
R
28.01
R
223.80
R
46.64
R
93.27

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

50.000
76.200
100.000
115.000
105.000
120.000
80.000
25.000
40.000
25.000
21.000
66.000
10.000
6.000
3.000
24.000
5.000
10.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
466.22
R
710.40
R
932.29
R 1 072.20
R
978.93
R 1 118.69
R
745.89
R
233.04
R
372.95
R
233.04
R
195.79
R
615.37
R
93.27
R
55.88
R
28.01
R
223.80
R
46.64
R
93.27

30
30
30
30
30
30
30
30
30
30
30

3.000
3.000
5.000
5.000
5.000
5.000
5.000
3.000
3.000
3.000
3.000

30
30

3.000 1.0 R
3.000 1.0 R

30
30
30

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

44.000
10.000
294.000
554.700
650.000
700.000
147.000
600.000
462.000
360.000
202.000
600.000
137.000
67.000
252.000
101.000
155.000
255.000
118.000
195.000
229.400
118.000
207.000
264.000
53.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

410.20
93.27
2 741.00
5 171.38
6 059.97
6 526.04
1 370.50
5 593.75
4 307.14
3 356.22
1 883.21
5 593.75
1 277.23
624.61
2 349.43
941.68
1 445.00
2 377.29
1 100.07
1 817.95
2 138.68
1 100.07
1 929.84
2 461.18
494.08

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

44.000
10.000
235.200
443.760
520.000
560.000
120.000
480.000
369.600
288.000
161.600
480.000
120.000
67.000
201.600
101.000
124.000
204.000
118.000
156.000
183.520
118.000
165.600
211.200
53.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

410.20
93.27
2 192.80
4 137.16
4 847.86
5 220.80
1 118.69
4 475.06
3 445.68
2 684.98
1 506.60
4 475.06
1 118.69
624.61
1 879.54
941.68
1 156.09
1 901.83
1 100.07
1 454.39
1 710.89
1 100.07
1 543.85
1 969.00
494.08

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20

118.000
126.000
137.000
419.900
132.000
112.000
105.000
132.100

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

20
20
20
20
20
20
20
20

118.000
120.000
120.000
335.920
120.000
112.000
105.000
120.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

1 100.07
1 174.71
1 277.23
3 914.68
1 230.59
1 044.19
978.93
1 231.62
111.90
1 277.23
1 277.23
419.58
419.58
186.40
93.27
186.40

1 100.07
1 118.69
1 118.69
3 131.69
1 118.69
1 044.19
978.93
1 118.69
111.90
1 118.69
1 118.69
419.58
419.58
186.40
93.27
186.40

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.11
2004.11
2004.00
2004.00
2004.00
2004.00

20 12.000 1.0 R
20 137.000 1.0 R
20 137.000 1.0 R

Page 40 of 84

45.000
45.000
20.000
10.000
20.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

20 12.000 1.0 R
20 120.000 1.0 R
20 120.000 1.0 R
20
20
20
20
20

45.000
45.000
20.000
10.000
20.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R

T
T
T
T
T
T
T
T
T
T
T

3.000 1.0 R
3.000 1.0 R
3.000 1.0 R

175.55
175.55
292.58
292.58
292.58
292.58
292.58
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

3.000
3.000
8.000
8.000
8.000
8.000
6.000
8.000
8.000
8.000
6.000
8.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
8.000
8.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

175.55
175.55
468.13
468.13
468.13
468.13
351.09
468.13
468.13
468.13
351.09
468.13
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
468.13
468.13

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

30
30
30
30
30
30
30
30
30
30
30
30

5.000
5.000
6.000
5.000
5.000
5.000
5.000
3.000
4.000
3.000
5.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R

T
T
T
T
T
T
T
T
T
T
T
T

30
30
30
30
30

3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

292.58
292.58
351.09
292.58
292.58
292.58
292.58
175.55
234.06
175.55
292.58
292.58
175.55
175.55
175.55
175.55
175.55

T
T
T
T
T

T
T
T
T
T

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20

5.000
139.000
67.000
71.000
145.000
147.000
261.600
168.000
168.000
294.000
147.000
86.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R

46.64
1 295.85
624.61
661.86
1 351.87
1 370.50
2 438.89
1 566.28
1 566.28
2 741.00
1 370.50
801.77

20
20
20
20
20
20
20
20
20
20
20
20

5.000
120.000
67.000
71.000
120.000
120.000
209.280
134.400
134.400
235.200
120.000
86.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R

46.64
1 118.69
624.61
661.86
1 118.69
1 118.69
1 951.11
1 253.03
1 253.03
2 192.80
1 118.69
801.77

30
30
30
30
30
30
30
30
30
30
30

3.000
4.000
3.000
4.000
4.000
4.000
4.000
6.000
6.000
6.000
4.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R

175.55
234.06
175.55
234.06
234.06
234.06
234.06
351.09
351.09
351.09
234.06
-

T
T
T
T
T
T
T
T
T
T
T

2004.00
2004.00
2004.00
2004.00
2005.05
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2006.04
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20

115.100
147.000
189.000
128.800
137.000
53.600
53.600
26.300
123.100
123.100
181.000
108.000
42.300
168.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R

1 073.08
1 370.50
1 762.07
1 200.82
1 277.23
499.66
499.66
245.21
1 147.58
1 147.58
1 687.42
1 006.94
394.36
1 566.28

20
20
20
20
20
20
20
20
20
20
20
20
20
20

115.100
120.000
151.200
120.000
120.000
53.600
53.600
26.300
120.000
120.000
144.800
108.000
42.300
134.400

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R

1 073.08
1 118.69
1 409.66
1 118.69
1 118.69
499.66
499.66
245.21
1 118.69
1 118.69
1 349.97
1 006.94
394.36
1 253.03

30
30
30
30
30
30
30
30
30
30
30
30
30
30

4.000
5.000
5.000
5.000
5.000
3.000
3.000
3.000
3.000
3.000
5.000
5.000
3.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R

234.06
292.58
292.58
292.58
292.58
175.55
175.55
175.55
175.55
175.55
292.58
292.58
175.55
292.58

T
T
T
T
T
T
T
T
T
T
T
T
T
T

2004.00
2004.00
2004.00

20 101.500 1.0 R
946.22
20 120.240 1.0 R 1 121.04
20 151.200 1.0 R 1 409.66
20 52.100 1.0 R
485.72
20 16.600 1.0 R
154.72
20 41.600 1.0 R
387.90
20 20.800 1.0 R
193.88
20 41.600 1.0 R
387.90
20 106.100 1.0 R
989.19
20 42.300 1.0 R
394.36
20 60.000 1.0 R
559.35
20 36.800 1.0 R
343.03
20 101.000 1.0 R
941.68
20 150.880 1.0 R 1 406.58

30
30
30

3.000 1.0 R
3.000 1.0 R
5.000 1.0 R

30
30
30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000

R
R
R
R
R
R
R
R
R
R
R

175.55
175.55
292.58
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55

T
T
T

2004.00
2006.04
2006.04
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 101.500 1.0 R
946.22
20 150.300 1.0 R 1 401.30
20 189.000 1.0 R 1 762.07
20 52.100 1.0 R
485.72
20 16.600 1.0 R
154.72
20 41.600 1.0 R
387.90
20 20.800 1.0 R
193.88
20 41.600 1.0 R
387.90
20 106.100 1.0 R
989.19
20 42.300 1.0 R
394.36
20 60.000 1.0 R
559.35
20 36.800 1.0 R
343.03
20 101.000 1.0 R
941.68
20 188.600 1.0 R 1 758.26

2145

Dilatation of female urethra

Urethrorraphy: Suture of urethral wound or injury
External urethrotomy: Pendulous urethra (anterior)
Urethraplasty: Pendulous urethra: First stage
Urethraplasty: Pendulous urethra: Second stage
Reconstruction of female urethra
Reconstruction or repair of male anterior urethra (one stage)
Reconstruction or repair of prostatic or membranous urethra: First stage
Reconstruction or repair of prostatic or membranous urethra: Second stage
Reconstruction or repair of prostatic or membranous urethra: If done in one stage
Urethral diverticulectomy: Male or female
Peri-urethral teflon injection: Male or female - fee as for cystoscopy (item 1949) plus 42,00 clinical
procedure units
Marsupialisation of urethral diverticula: Male or female
Total urethrectomy: Female
Total urethrectomy: Male
Drainage of simple localised perineal urinary extravasation
Drainage of extensive perineal and/or abdominal urinary extravasation
Fulguration for urethral caruncle or polyp
Excision of urethral caruncle
Simple urethral meatotomy
Incision of deep peri-urethral abscess: Female
Incision of deep peri-urethral abscess: Male
Badenoch pull-through for intractable stricture or incontinence
External sphincterotomy
Drainage of Skene gland abscess or cyst
Operation for correction of male urinary incontinence with or without introduction of prostheses
(excluding cost of prostheses)
Urethral meatoplasty
Closure of urethrostomy or urethro-cutaneous fistula (independent procedure)
Closure of urethrovaginal fistula: Including diversionary procedures
Male Genital System
Penis
Biopsy of penis (independent procedure)
Destruction of condylomata/chemo- or cryotherapy: Limited number (see item 2317)
Destruction of condylomata/chemo-or cryotherapy: Multiple extensive
Electrodesiccation: Limited number
Electrodesiccation: Multiple extensive
Ligation of abnormal venous drainage
Circumcision: Clamp procedure
Circumcision: Surgical excision other than by clamp or dorsal slit, any age
Circumcision: Dorsal slit of prepuce (independent procedure)
Reconstructive operation of penis: Reconstructive operation for insertion of prostheses
Reconstructive operation of penis: For straightening of chordee e.g. hypospadias with or without
mobilisation of urethra
Reconstructive operation of penis: For straightening of chordee with transplantation of prepuce

2004.00

20 224.600 1.0 R 2 093.95

20 179.680 1.0 R 1 675.10

30

3.000 1.0 R

175.55

2147

Reconstructive operation of penis: For injury: Including fracture of penis and skin graft, if required

2004.00

20 168.000 1.0 R 1 566.28

20 134.400 1.0 R 1 253.03

30

3.000 1.0 R

175.55

2149
2153
2154
2155
2157
2159
2161
2163
2165
2167
2169
2171
2173
2174

Reconstructive operation of penis: For epispadias distal to the external sphincter

Reconstructive operation for epispadias with incontinence
Induction of artificial erection
Hypospadias: Urethral reconstruction
Hypospadias: Subsequent procedures for repair of urethra: Total
Hypospadias: Urethraplasty: Complete, one stage for hypospadias
Total amputation of penis: Without gland dissection
Total amputation of penis: With gland-dissection
Partial amputation of penis: With gland-dissection
Partial amputation of penis: Without gland-dissection
Injection procedure for Peyronie's disease
Priapism operation: Irrigation of corpora cavernosa for priapism
Priapism operation: Shunt procedure: Any type
Priapism operation: Stab shunt

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20

20
20
20
20
20
20
20
20
20
20
20
20
20
20

30
30
30
30
30
30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000
4.000
6.000
6.000
4.000
3.000
3.000
4.000
4.000

175.55
175.55
175.55
175.55
175.55
175.55
234.06
351.09
351.09
234.06
175.55
175.55
234.06
234.06

T
T
T
T
T
T
T
T
T
T
T
T
T
T

2069
2071
2073
2075
2077
2079
2081
2083
2085
2086
2087
2088
2089
2091
2093
2095
2097
2099
2101
2103
2105
2107
2109
2111
2113
2115
2116
2117
2121
11
11.1
2123
2125
2127
2129
2131
2132
2133
2137
2139
2141
2143

Page 41 of 84

168.000
168.000
16.000
187.000
84.000
300.000
210.000
336.000
210.000
84.000
14.000
42.000
252.000
114.400

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R

1 566.28
1 566.28
149.15
1 743.44
783.14
2 796.87
1 957.86
3 132.57
1 957.86
783.14
130.52
391.57
2 349.43
1 066.48

134.400
134.400
16.000
149.600
84.000
240.000
168.000
268.800
168.000
84.000
14.000
42.000
201.600
114.400

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R

1 253.03
1 253.03
149.15
1 394.70
783.14
2 237.53
1 566.28
2 506.05
1 566.28
783.14
130.52
391.57
1 879.54
1 066.48

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R

T
T
T
T
T
T
T
T
T
T
T

11.2
0078
2175
2177
2179
2181
2183
2185
2187
2189
2191
2193
2195
2197
2199
2201
2203
2205
2207
2209
2210
2211
2212
2213
2215
2217
2219
2221
2223
2225
2227
2229
2231
2233
11.3
2235
2237
2239
2241
2243
2245
2247
2249
2251
2253
2254
2255
2257
2259
2260
12
12.1
2271
2272
2273
2274
2275
2277
2279
2280
2281

Testis and epididymis

When a testis biopsy is done combined with vasogram or seminal vesiculogram or epididymogram,
add 50% of the units for the appropriate procedure
Testis biopsy: Needle (independent procedure)
Testis biopsy: Incisional: Independent procedure: Unilateral
Testis biopsy: Incisional: Independent procedure: Bilateral
Epididymis biopsy: Needle
Puncture aspiration hydrocele with or without injection of medication
Operation for maldescended testicle: Including herniotomy
Operation for torsion appendix testis
Operation for torsion testis with fixation of contralateral testis
Orchidectomy (total or subcapsular): Unilateral
Orchidectomy (total or subcapsular): Bilateral
Radical operation for malignant testis: Excluding gland dissection
Operation for hydrocele or spermatocele
Varicocelectomy
Abdominal ligation of spermatic vein for varicocele
Epididymectomy: Unilateral
Epididymectomy: Bilateral
Vasectomy: Unilateral or bilateral (no extra fee to be charged if done in combination with
prostatectomy)
Vasotomy: Unilateral or bilateral
Vasogram, seminal vesiculogram: Unilateral
Vasogram, seminal vesiculogram: Bilateral
Insertion of testicular prosthesis: Independent procedure (exclusive of cost of material)
Suture or repair of testicular injury
Incision and drainage of testis or epididymis e.g. abscess or haematoma
Excision of local lesion of testis or epididymis
Vaso-vasostomy: Unilateral
Vaso-vasostomy: Bilateral
Epididymo-vasostomy: Unilateral
Epididymo-vasostomy: Bilateral
Incision and drainage of scrotal wall abscess
Excision of Mullerian duct cyst
Excision of lesion of spermatic cord
Seminal Vesiculectomy
Prostate
Biopsy prostate: Needle or punch, single or multiple, any approach
Biopsy prostate: Incisional, any approach
Transurethral drainage of prostatic abscess
Perineal drainage of prostatic abscess
Trans-urethral cryo-surgical removal of prostate
Trans-urethral resection of prostate
Trans-urethral resection of residual prostatic tissue 90 days post-operative or longer
Trans-urethral resection of post-operative bladder neck contracture
Prostatectomy: Perineal: Sub-total
Prostatectomy: Perineal: Radical
Pelvic lymph adenectomy
Supra-pelvic, transversical
Retropubic: Sub-total
Retropubic: Radical
Prostate brachytherapy
Female Genital System
Vulva and introitus
Removal of tag or polyp
Removal of small superficial benign lesions
Biopsy with suture in theatre (excluding after-care)
Laser therapy of vulva and/or vagina (colposcopically directed)
Reduction labial hypertrophy
Removal of extensive benign vulva tumour
Secondary perineal repair: Repair second degree tear
Secondary perineal repair: Repair third degree tear
Excision of inclusion cyst

2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

18.500
58.900
58.900
86.100
10.000
135.000
119.200
119.200
98.000
147.000
155.300
99.800
106.100
112.800
114.400
158.200
55.900

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

172.47
549.08
549.08
802.65
93.27
1 258.60
1 111.36
1 111.36
913.67
1 370.50
1 447.79
930.38
989.19
1 051.67
1 066.48
1 474.92
521.21

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

18.500
58.900
58.900
86.100
10.000
120.000
119.200
119.200
98.000
120.000
124.240
99.800
106.100
112.800
114.400
126.560
55.900

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

172.47
549.08
549.08
802.65
93.27
1 118.69
1 111.36
1 111.36
913.67
1 118.69
1 158.29
930.38
989.19
1 051.67
1 066.48
1 179.85
521.21

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
4.000
4.000
4.000
3.000
3.000
6.000
4.000
4.000
4.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

175.55
175.55
175.55
175.55
175.55
234.06
234.06
234.06
175.55
175.55
351.09
234.06
234.06
234.06
175.55
175.55
175.55

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

70.400
58.100
58.100
91.200
110.300
90.000
90.800
67.000
117.000
67.000
117.000
42.700
189.000
84.000
220.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

70.400
58.100
58.100
91.200
110.300
90.000
90.800
67.000
117.000
67.000
117.000
42.700
151.200
84.000
176.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

3.000
3.000
3.000
4.000
4.000
4.000
4.000
3.000
3.000
3.000
3.000
3.000
4.000
3.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

23.300
105.000
117.400
77.000
126.000
252.000
126.000
126.000
252.000
336.000
175.000
252.000
252.000
336.000
230.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

23.300
105.000
117.400
77.000
120.000
201.600
120.000
120.000
201.600
268.800
140.000
201.600
201.600
268.800
184.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

3.000
4.000
4.000
4.000
6.000
6.000
6.000
5.000
6.000
8.000
8.000
6.000
6.000
8.000
8.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20

6.000
23.000
27.000
71.000
67.000
67.000
45.000
96.000
43.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

20
20
20
20
20
20
20
20
20

6.000
23.000
27.000
71.000
67.000
67.000
45.000
96.000
43.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
4.000
4.000
6.000
6.000
4.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

175.55
175.55
175.55
234.06
234.06
234.06
234.06
175.55
175.55
175.55
175.55
175.55
234.06
175.55
292.58
175.55
234.06
234.06
234.06
351.09
351.09
351.09
292.58
351.09
468.13
468.13
351.09
351.09
468.13
468.13
175.55
175.55
175.55
175.55
234.06
234.06
351.09
351.09
234.06

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

656.28
541.60
541.60
850.31
1 028.35
839.02
846.50
624.61
1 090.83
624.61
1 090.83
398.02
1 409.66
783.14
1 640.79
217.20
978.93
1 094.49
717.88
1 118.69
1 879.54
1 118.69
1 118.69
1 879.54
2 506.05
1 305.24
1 879.54
1 879.54
2 506.05
1 715.43
55.88
214.41
251.66
661.86
624.61
624.61
419.58
895.04
400.96

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.11
2004.00
2004.00
2004.00
2004.00

656.28
541.60
541.60
850.31
1 028.35
839.02
846.50
624.61
1 090.83
624.61
1 090.83
398.02
1 762.07
783.14
2 050.98
217.20
978.93
1 094.49
717.88
1 174.71
2 349.43
1 174.71
1 174.71
2 349.43
3 132.57
1 631.55
2 349.43
2 349.43
3 132.57
2 144.25
55.88
214.41
251.66
661.86
624.61
624.61
419.58
895.04
400.96

Page 42 of 84

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

T
T
T
T
T
T
T
T
T

2283
2285
2287
2288
2289
2291
2293
2295
2297
2299
2301
2303
2305
2307
2309
2311
12.2
2312
2313

Hymenectomy
Drainage haematocolpos
Clitoris repair for injury: Including skin graft, if required
Clitoral reduction
Denervation or alcohol infiltration vulva (Woodruff)
Vulva: Undercutting skin (ball)
Vulva and introitus: Drainage of abscess
Bartholin gland: Bartholin abscess marsupialisation
Bartholin gland: Bartholin gland excision
Bartholin gland: Bartholin radical excision for malignant lesion
Operation for enlarging introitus: Fenton plasty
Operation for enlarging introitus: Bilateral Z-plastic
Vulvectomy: Partial
Vulvectomy
Radical vulvectomy with bilateral lymphdenectomy
Radical vulvectomy with bilateral lymphadenectomy, plus deep lymph gland dissection
Vaginal procedures and operations
Artificial insemination
Examination under anaesthetic when no other procedures are performed (not limited to female
patients only) - Stand alone procedure
Intra uterine insemination
Simms Hhner test plus wet smear
Destruction of condylomata by chemo-, cryo-, or electrotherapy, or harmonic scalpel: First lesion

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

20
20

400.96
503.47
624.61
1 491.64
503.47
540.72
251.66
335.70
419.58
3 328.21
466.22
820.39
1 501.02
2 097.62
3 328.21
3 747.79
13.000 1.0 R
121.14
25.500 1.0 R
237.73

20
20

400.96
503.47
624.61
1 193.34
503.47
540.72
251.66
335.70
419.58
2 662.68
466.22
820.39
1 200.82
1 678.18
2 662.68
2 998.23
13.000 1.0 R
121.14
25.500 1.0 R
237.73

2004.00
2004.00
2004.00

20
20
20

18.000 1.0 R
5.000 1.0 R
14.000 1.0 R

167.77
46.64
130.52

20
20
20

18.000 1.0 R
5.000 1.0 R
14.000 1.0 R

167.77
46.64
130.52

2004.00

20

7.000 1.0 R

65.26

20

7.000 1.0 R

2318

Destruction of condylomata by chemo-, cryo-, or electrotherapy, or harmonic scalpel: Repeat Limited

Destruction of condylomata by chemo-, cryo-, or electrotherapy, or harmonic scalpel: Widespread

2004.00

20

56.000 1.0 R

522.09

20

56.000 1.0 R

2319
2321
2322
2323
2325
2327
2329
2331
2333
2334
2335
2336
2339
2341
2343
2345
2357
2361
2363
2365
2366
2367
2368
2369
2370
2371
2372
2373
2374
2375
2377
2379
2381
2383
2385

Excision of cysts or tumours

Drainage of vaginal abscess
Pudendal nerve block
Reconstruction of vagina after atresia
Construction of artificial vagina: Labial fusion
Construction of artificial vagina: Macindoe type
Construction of vagina: Bowel pull-through operation: Two surgeons: Each
Vaginal septum removal
Vaginal prolapse: Abdominal approach: Sacrocolpopexy with use of mesh
Vaginal prolapse: Abdominal approach: Use of rectus sheath or tape
Vaginal prolapse: Vaginal approach: Sacrospinous fixations
Vaginal prolapse: Vaginal approach: Use of mesh or tape
Colpotomy: Diagnostic (excluding after-care)
Colpotomy: Therapeutic, with or without sterilisation
Vaginal hysterectomy: Without repair
Vaginal hysterectomy: With repair
Vaginal hysterectomy and repair with unilateral or bilateral salpingo-oophorectomy
Vaginal hysterectomy and repair for total prolapse
Fothergill or Manchester repair operation
Repair of recurrent enterocele or vault prolapse (except at the time of hysterectomy)
Posterior repair alone
Other operations for prolapse: Anterior repair - with or without posterior repair
Uterovesical fistula
Repair of Vesico- or urethro-vaginal fistula
Repair of VVF - Obstetric or radiation
Closure of uretero-vaginal fistula
Closure of uretero-vaginal fistula: Obstetric or radiation
Closure of recto-vaginal fistula
Closure of recto-vaginal fistula: Obstetric or radiation
Colpocleisis
Le Fort operation
Schauta operation
Vaginectomy
Synchronous combined hysterocolpectomy: One or two surgeons - total fee
Vaginal laceration or trauma: Repair

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.11
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

503.47
503.47
139.91
997.55
1 668.80
1 827.33
2 246.77
997.55
2 268.33
2 268.33
1 556.02
1 556.02
186.40
960.30
1 962.40
2 160.09
2 983.27
2 983.27
1 827.33
2 162.88
997.55
1 501.02
1 957.86
1 668.80
2 162.88
2 330.80
2 330.80
1 249.21
1 407.75
1 202.72
1 202.72
3 328.21
2 498.58
3 999.60
466.22

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

2314
2315
2316
2317

Page 43 of 84

43.000
54.000
67.000
160.000
54.000
58.000
27.000
36.000
45.000
357.000
50.000
88.000
161.000
225.000
357.000
402.000

54.000
54.000
15.000
107.000
179.000
196.000
241.000
107.000
243.300
243.300
166.900
166.900
20.000
103.000
210.500
231.700
320.000
320.000
196.000
232.000
107.000
161.000
210.000
179.000
232.000
250.000
250.000
134.000
151.000
129.000
129.000
357.000
268.000
429.000
50.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

43.000
54.000
67.000
128.000
54.000
58.000
27.000
36.000
45.000
285.600
50.000
88.000
128.800
180.000
285.600
321.600

54.000
54.000
15.000
107.000
143.200
156.800
192.800
107.000
194.640
194.640
133.520
133.520
20.000
103.000
168.400
185.360
256.000
256.000
156.800
185.600
107.000
128.800
168.000
143.200
185.600
200.000
200.000
120.000
120.800
120.000
120.000
285.600
214.400
343.200
50.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

4.000
4.000
4.000
4.000
4.000
4.000
3.000
3.000
3.000
6.000
4.000
4.000
4.000
6.000
6.000
6.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

30

3.000 1.0 R

234.06
234.06
234.06
234.06
234.06
234.06
175.55
175.55
175.55
351.09
234.06
234.06
234.06
351.09
351.09
351.09
175.55

30

3.000 1.0 R

175.55

65.26

30

3.000 1.0 R

175.55

522.09

30

3.000 1.0 R

175.55

503.47
503.47
139.91
997.55
1 335.01
1 461.87
1 797.41
997.55
1 814.57
1 814.57
1 244.81
1 244.81
186.40
960.30
1 569.95
1 728.05
2 386.68
2 386.68
1 461.87
1 730.39
997.55
1 200.82
1 566.28
1 335.01
1 730.39
1 864.58
1 864.58
1 118.69
1 126.17
1 118.69
1 118.69
2 662.68
1 998.77
3 199.59
466.22

30
30

3.000 1.0 R
3.000 1.0 R

T
T

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

5.000
4.000
5.000
6.000
4.000
6.000
6.000
6.000
6.000
4.000
4.000
6.000
6.000
6.000
6.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
4.000
4.000
8.000
8.000
8.000
4.000

175.55
175.55
292.58
234.06
292.58
351.09
234.06
351.09
351.09
351.09
351.09
234.06
234.06
351.09
351.09
351.09
351.09
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
234.06
234.06
468.13
468.13
468.13
234.06

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

12.3
2389
2391
2392
2395
2396
2397
2399
2400
2403
2404
2405
2407
2409
2411
2413
2415
2416
2417
2418
2421
2423
2425
2427
2429
12.4
2433
2434
2435
2436
2437
2438
2439
2440
2441
2442
2443
2444
2445
2447
2448
2449
2451
2452
2453
2455
2461
2463
2465
2467
2469
2471
2473
2475
2477
2478
2479

Cervix
Paracervical (pelvis) nerve block (for neck refer to item 3294)
Cervix: Canal reconstruction
Cryo- or electro-cauterisation, or Lletz of cervix (excluding cost of disposable loop electrode): In
consulting room
Cryo- or electro-cauterisation, or Lletz of cervix (excluding cost of disposable loop electrode): Under
anaesthetic
Laser or harmonic scalpel treatment of the cervix
Dilation of cervix for stenosis and insertion of prosthesis and Budge suture
Punch biopsy (excluding after-care)
Biopsy during pregnancy (excluding after-care)
Wedge biopsy: Cervix (excluding after-care)
Biopsy: Wedge during pregnancy: Cervix (excluding after-care)
Cone biopsy: Cervix (excluding after-care)
Amputation: Cervix
Cervix encirclage: McDonald stitch
Cervix encirclage: Shirodkar suture
Cervix encirclage: Lash
Cervix encirclage: Removal items 2409 and 2411: Without anaesthetic
Cervix: Removal items 2409 and 2411: With anaesthetic in theatre
Repair of tears: Emmet repair of tears
Repair of tears: Sturmdorff repair of tears
Extirpation of cervical stump: Vaginal
Extirpation of cervical stump: Abdominal
Removal of cervical polyps (excluding after-care)
Removal of cervical myomata
Colposcopy (excluding after-care)
Uterus
Embryo transfer
Endometrial biopsy (excluding after-care)
Hysterosalpingogram (excluding after-care)
Hysteroscopy (excluding after-care)
Hysteroscopy and D&C (excluding after-care)
Hysteroscopy and removal of uterine septum (excluding after-care)
Hysteroscopy and division of endometrial and endocervical bands (excluding after-care)
Hysteroscopy and polypectomy (excluding after-care)
Hysteroscopy and myomectomy (excluding after-care)
Insertion of intra uterine contraceptive device (IUCD) (excluding after-care)
Dilatation and curettage (D&C) (excluding after-care)
Fractional dilatation and curettage (D&C) (excluding after-care)
Evacuation of uterus: Incomplete abortion: Before 12 weeks gestation
Evacuation of uterus, incomplete abortion: After 12 weeks gestation
Termination of pregnancy before 12 weeks
Evacuation: Missed abortion: Before 12 weeks gestation
Evacuation: Missed abortion: After 12 weeks gestation
Termination of pregnancy after 12 weeks - administration of intra/extra amniotic prostaglandin
Evacuation hydatidiform mole
Evacuation uterus post-partum
Ventrosuspension
Uteroplasty: Strassman
Uteroplasty: Tompkins
Myomectomy
Subtotal hysterectomy with or without unilateral or bilateral salpingo-oophorectomy
Total abdominal hysterectomy: With or without unilateral or bilateral salpingo-oophorectomy uncomplicated
Total abdominal hysterectomy plus vaginal cuff with or without unilateral or bilateral salpingooophorectomy
Radical abdominal hysterectomy with bilateral lymphadenectomy (Wertheim)
Abdominal hysterotomy with or without sterilisation
Non-surgical endometrial destruction, any method, not utilising hysteroscopic instrumentation or
assistance
Surgical endometrial destruction: Any method, utilising hysteroscopic instrumentation or assistance

2006.05
2004.00
2004.00

20 20.000 1.0 R
186.40
20 147.000 1.0 R 1 370.50
20 14.000 1.0 R
130.52

20 20.000 1.0 R
186.40
20 120.000 1.0 R 1 118.69
20 14.000 1.0 R
130.52

2004.00

20

20

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

175.55
-

30

3.000 1.0 R

205.17

30

3.000 1.0 R

175.55

20 80.000 1.0 R
745.89
20 31.000 1.0 R
289.06
20
9.000 1.0 R
83.89
20 13.000 1.0 R
121.14
20 18.000 1.0 R
167.77
20 24.000 1.0 R
223.80
20 54.000 1.0 R
503.47
20 67.000 1.0 R
624.61
20 35.000 1.0 R
326.31
20 60.000 1.0 R
559.35
20 49.000 1.0 R
456.83
20
5.000 1.0 R
46.64
20 30.000 1.0 R
279.67
20 45.000 1.0 R
419.58
20 54.000 1.0 R
503.47
20 120.000 1.0 R 1 118.69
20 120.000 1.0 R 1 118.69
20 13.000 1.0 R
121.14
20 54.000 1.0 R
503.47
20 27.000 1.0 R
251.66
20 45.000 1.0 R
419.58
20 18.000 1.0 R
167.77
20 22.000 1.0 R
205.17
20 40.000 1.0 R
372.95
20 58.000 1.0 R
540.72
20 80.000 1.0 R
745.89
20 63.000 1.0 R
587.36
20 75.000 1.0 R
699.26
20 120.000 1.0 R 1 118.69
20 18.000 1.0 R
167.77
20 35.000 1.0 R
326.31
20 45.000 1.0 R
419.58
20 50.000 1.0 R
466.22
20 71.000 1.0 R
661.86
20 50.000 1.0 R
466.22
20 50.000 1.0 R
466.22
20 80.000 1.0 R
745.89
20 54.000 1.0 R
503.47
20 80.000 1.0 R
745.89
20 54.000 1.0 R
503.47
20 80.000 1.0 R
745.89
20 120.000 1.0 R 1 118.69
20 120.000 1.0 R 1 118.69
20 120.000 1.0 R 1 118.69
20 203.280 1.0 R 1 895.23
20 201.760 1.0 R 1 881.01

30
30
30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R

30
30
30
30
30
30
30
30

3.000
3.000
3.000
5.000
5.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

4.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
3.000
4.000
4.000
4.000
4.000
4.000
4.000
5.000
6.000
4.000
6.000
6.000
6.000
6.000
6.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
292.58
292.58
175.55
175.55
175.55
234.06
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
234.06
234.06
234.06
234.06
234.06
234.06
292.58
351.09
234.06
351.09
351.09
351.09
351.09
351.09

T
T
T
T
T
T
T
T
T
T
T

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2006.04
2006.04
2006.04
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 80.000 1.0 R
745.89
20 31.000 1.0 R
289.06
20
9.000 1.0 R
83.89
20 13.000 1.0 R
121.14
20 18.000 1.0 R
167.77
20 24.000 1.0 R
223.80
20 54.000 1.0 R
503.47
20 67.000 1.0 R
624.61
20 35.000 1.0 R
326.31
20 60.000 1.0 R
559.35
20 49.000 1.0 R
456.83
20
5.000 1.0 R
46.64
20 30.000 1.0 R
279.67
20 45.000 1.0 R
419.58
20 54.000 1.0 R
503.47
20 134.000 1.0 R 1 249.21
20 134.000 1.0 R 1 249.21
20 13.000 1.0 R
121.14
20 54.000 1.0 R
503.47
20 27.000 1.0 R
251.66
20 45.000 1.0 R
419.58
20 18.000 1.0 R
167.77
20 22.000 1.0 R
205.17
20 40.000 1.0 R
372.95
20 58.000 1.0 R
540.72
20 80.000 1.0 R
745.89
20 63.000 1.0 R
587.36
20 75.000 1.0 R
699.26
20 130.000 1.0 R 1 211.96
20 18.000 1.0 R
167.77
20 35.000 1.0 R
326.31
20 45.000 1.0 R
419.58
20 50.000 1.0 R
466.22
20 71.000 1.0 R
661.86
20 50.000 1.0 R
466.22
20 50.000 1.0 R
466.22
20 80.000 1.0 R
745.89
20 54.000 1.0 R
503.47
20 80.000 1.0 R
745.89
20 54.000 1.0 R
503.47
20 80.000 1.0 R
745.89
20 143.000 1.0 R 1 333.25
20 143.000 1.0 R 1 333.25
20 143.000 1.0 R 1 333.25
20 254.100 1.0 R 2 368.93
20 252.200 1.0 R 2 351.19

2004.00

20 355.000 1.0 R 3 309.58

20 284.000 1.0 R 2 647.72

30

6.000 1.0 R

351.09

2004.00
2004.00
2004.00

20 472.800 1.0 R 4 407.89

20 188.000 1.0 R 1 752.68
20 200.000 1.0 R 1 864.58

20 378.240 1.0 R 3 526.34

20 150.400 1.0 R 1 402.18
20 160.000 1.0 R 1 491.64

30
30
30

8.000 1.0 R
6.000 1.0 R
6.000 1.0 R

468.13
351.09
351.09

T
T
T

2004.00

20 225.000 1.0 R 2 097.62

20 180.000 1.0 R 1 678.18

30

6.000 1.0 R

351.09

Page 44 of 84

22.000 1.0 R

205.17

22.000 1.0 R

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

2480
12.5
0066
2481
2483
2485
2487
2489
2490
2491
2492

2493
2496
2497
2499
2500
2501
2502
2503
2504
2505
2506
12.6
2525
2527
2529
2531
2532
12.7
2535
2537
2539
2541
2543
2544
2545
2546
2547
2548
2550
2551
2552
2553
2554
2556
2558
2560
2561
2562
2565
2570
13

Laparoscopy by second gynaecologist during endometrial ablation (item 2479)

Fallopian tubes
Microsurgery of the fallopian-tubes and ovaries: Where micro-surgical techniques are used, with the
aid of a microscope, 25% may be added to the fee
Insufflation Fallopian tubes (excluding after-care)
Salpingolysis
Salpingostomy
Tuboplasty tubal anastomosis or re-implantation
Ectopic pregnancy under 12 weeks (salpingectomy)
Ectopic pregnancy under 12 weeks (salpingostomy)
Ectopic pregnancy - after 12 weeks
Salpingectomy: Uni- or bilateral or sterilisation for accepted medical reasons
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
Diagnostic laparoscopy (excluding after-care)
Laparoscopy: Plus aspiration of a cyst (excluding after-care)
Laparoscopy: Plus sterilisation
Laparoscopy: Plus biopsy (excluding after-care)
Laparoscopy: Plus ablation of endometriosis by laser, harmonic scalpel or cautery
Laparoscopy: Plus cauterisation and/or lysis of adhesions
Laparoscopy: Plus aspiration of follicles (IVF) (excluding after-care)
Laparoscopy: Plus ovarian drilling
Laparoscopy: Plus Gamete intra fallopian tube transfer (includes follicle aspiration) (GIFT)
Laparoscopy: Plus laparoscopic uterosacral nerve ablation
Transcervical gamete/embryo intra-fallopian tube transfer (TET/TEST)
Ovaries
Wedge resection of ovaries, unilateral or bilateral
Removal of ovarian tumour or cyst
Oophorectomy: Uni- or bilateral
Ovarian carcinoma debulking and omentectomy
Ovarian carcinoma: Abdominal hysterectomy, bilateral salpingo-oophorectomy, debulking and
omentectomy
Miscellaneous procedures
Exenteration: Anterior Exenteration
Exenteration: Posterior Exenteration
Exenteration: Total
Presacral neurectomy
Moschowitz operation
Laparoscopic vaginal suspension for stress incontinence (item 1807 may not be used together with
this item)
Operations for stress incontinence: Marshall-Marchetti-Kranz operation
Operations for stress incontinence: Urethro-vesicopexy: Abdominal approach
Operations for stress incontinence: Burch colposuspension
Operation for stress incontinence: Use of tape
Operations for stress incontinence: Urethro-vesicopexy: Combined abdominal and vaginal approach

2004.00

Laparotomy
Removal benign retroperitoneal tumour
Radical removal of malignant retroperitoneal tumour
Drainage of pelvic abscess per abdomen
Drainage of pelvic abscess per vagina (refer to item 2341)
Drainage intra-abdominal abscess: Delayed closure
Surgery for moderate endometriosis (AFS stages 2 + 3): Any method
Surgery for severe endometriosis (AFS stage 4 - retrovaginal septum): Any method (may not be
used with another procedure or as a modifier)
Treatment of endometriosis (any method) found as an incidental finding during surgery for unrelated
condition (histology required)
Implantation hormone pellets (excluding after-care)
Ligation of internal iliac vessels (when not part of another procedure)
Obstetric Procedures
RULES GOVERNING THIS SECTION

20 120.000 1.0 R 1 118.69

-

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20

16.000
125.000
161.000
196.000
125.000
161.000
225.000
94.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

149.15
1 165.33
1 501.02
1 827.33
1 165.33
1 501.02
2 097.62
876.42
-

20
20
20
20
20
20
20
20

R
R
R
R
R
R
R
R

149.15
1 118.69
1 200.82
1 461.87
1 118.69
1 200.82
1 678.18
876.42
-

30
30
30
30
30
30
30
30

3.000
4.000
4.000
4.000
6.000
6.000
6.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

175.55
234.06
234.06
234.06
351.09
351.09
351.09
292.58
-

T
T
T
T
T
T
T
T

20 94.400 1.0 R
20 18.000 1.0 R
20 40.000 1.0 R
20 18.000 1.0 R
20 51.000 1.0 R
20 18.000 1.0 R
20 52.000 1.0 R
20 40.000 1.0 R
20 107.000 1.0 R
20 52.000 1.0 R
20 58.000 1.0 R

20 94.400 1.0 R
20 18.000 1.0 R
20 40.000 1.0 R
20 18.000 1.0 R
20 51.000 1.0 R
20 18.000 1.0 R
20 52.000 1.0 R
20 40.000 1.0 R
20 107.000 1.0 R
20 52.000 1.0 R
20 58.000 1.0 R

30
30
30
30
30
30
30
30
30
30

5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

T
T
T
T
T
T
T
T
T
T

30
30
30
30
30

4.000
4.000
4.000
6.000
6.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
234.06
234.06
234.06
351.09
351.09

2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

105.000
187.000
134.500
357.000
469.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20

402.000
402.000
625.000
98.000
120.000
193.100

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

195.000
149.000
161.000
229.400
196.000

1.0
1.0
1.0
1.0
1.0

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20

196.000
223.000
350.000
180.000
75.000
268.000
150.000
210.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

2004.00

20

2004.00
2004.00

20
3.000 1.0 R
28.01
20 225.000 1.0 R 2 097.62
-

Page 45 of 84

16.000
120.000
128.800
156.800
120.000
128.800
180.000
94.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

880.08
167.77
372.95
167.77
475.46
167.77
484.84
372.95
997.55
484.84
540.72
978.93
1 743.44
1 253.91
3 328.21
4 372.40

+
+
+
+
+
+
+
+
+

20
20
20
20
20

105.000
149.600
120.000
285.600
375.200

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

880.08
167.77
372.95
167.77
475.46
167.77
484.84
372.95
997.55
484.84
540.72
978.93
1 394.70
1 118.69
2 662.68
3 497.89

3 747.79
3 747.79
5 826.78
913.67
1 118.69
1 800.20

20
20
20
20
20
20

321.600
321.600
500.000
98.000
120.000
154.480

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

2 998.23
2 998.23
4 661.46
913.67
1 118.69
1 440.16

30
30
30
30
30
30

8.000
8.000
8.000
5.000
5.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

468.13
468.13
468.13
292.58
292.58
292.58

T
T
T
T
T
T

R
R
R
R
R

1 817.95
1 389.12
1 501.02
2 138.68
1 827.33

20
20
20
20
20

156.000
120.000
128.800
183.520
156.800

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

1 454.39
1 118.69
1 200.82
1 710.89
1 461.87

30
30
30
30
30

5.000
6.000
5.000
5.000
5.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

292.58
351.09
292.58
292.58
292.58

T
T
T
T
T

R
R
R
R
R
R
R
R

1 827.33
2 078.99
3 263.09
1 678.18
699.26
2 498.58
1 398.51
1 957.86

20
20
20
20
20
20
20
20

156.800
178.400
280.000
144.000
75.000
214.400
120.000
168.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

1 461.87
1 663.22
2 610.47
1 342.49
699.26
1 998.77
1 118.69
1 566.28

30
30
30
30
30
30
30
30

4.000
6.000
8.000
6.000
5.000
6.000
6.000
6.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

234.06
351.09
468.13
351.09
292.58
351.09
351.09
351.09

T
T
T
T
T
T
T
T

51.000 1.0 R

475.46

20

51.000 1.0 R

475.46

30

6.000 1.0 R

351.09

30

8.000 1.0 R

20
3.000 1.0 R
28.01
20 180.000 1.0 R 1 678.18
-

468.13
-

T
T
T
T
T

U.

Obstetric procedures: (a) When a general practitioner treats a patient in the ante-natal period and, 2004.00
after starting the confinement, requests an obstetrician to take over the case, the general practitioner
shall be entitled to charge for all the ante-natal consultations he/she has performed. (i) If the patient
has been in labour for less than 6 hours, the general practitioner shall charge 50,00 clinical
procedure units according to item 2614: Global obstetric care. (ii) If the patient has been in labour
for more than 6 hours, the general practitioner shall charge 80,00 clinical procedure units according
to item 2614: Global obstetric care. (b) When a general practitioner calls an obstetrician to help with
a confinement, take over the management of a confinement, and treats the patient until after the postpartum visit, the obstetrician shall charge according to item 2614: Global obstetric care. (c) When a
general practitioner calls an obstetrician (specialist or general practitioner) to help with a
confinement, or take over the management of a confinement, but the general practitioner treats the
patient until after the post-partum visit, the obstetrician shall charge according to item 2616:
Intrapartum obstetric care by obstetrician in consultation, and the general practitioner according to
item 2614: Global obstetric care.

13.1
2603
2605
2607
2609
2610

Pre-natal care and procedures

External cephalic version (excluding after-care)
Amniocentesis (excluding after-care)
Amnioscopy (excluding after-care)
Intra-uterine transfusion of foetus or cordocentesis
Tococardiography - pre-natal and intrapartum (including stress and non-stress test: Own machine)
(excluding after-care)
Chorion villus sampling (excluding after-care)
Confinements
Global obstetric care: All inclusive fee that includes all modes of vaginal delivery (excluding
Caesarean section) and obstetric care from the commencement of labour until after the post-partum
visit (6 weeks visit)
Global obstetric care: All inclusive fee for 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)
Intrapartum obstetric care by obstetrician in consultation (excluding after-care)
Global obstetric care includes
o All modes of delivery (including Caesarean)
o All inductions of labour (medical or surgical)
o Intrapartum paracervical and pudential blocks
o Intrapartum amnioscopy
o Foetal blood sampling
o Application of scalp leads
o Symphysiotomy
o Manual removal of placenta
o Repair cervical tears
o Correction of uterine inversion
o Drainage of vulval haematoma
o Repair third degree tear
o Repair second degree tear
o Repair episiotomy
o Resuscitation of newborn by obstetrician
o Tracheal intubation
o Missed confinement
Global obstetric care excludes
o Prenatal consultations
o Prenatal procedures (Items 2603 - 2611)
o Emergency hysterectomy for obstetrical reasons
o Abdominal operation for repair of ruptured gravid uterus
o Intensive care for obstetrical emergencies
o Tubal ligation performed as a post-partum procedure
o Post-partum complications occurring after discharge from the hospital
Operative procedures (excluding antenatal care)
Caesarean-hysterectomy
Post-partum hysterectomy
Abdominal operation for ruptured gravid uterus: Repair
Nervous System
Diagnostic procedures

2611
13.2
2614

2615

2616

13.3
2653
2657
2669
14
14.1

2004.00
2004.00
2004.00
2004.00
2004.00

20 22.000 1.0
20 36.000 1.0
20 18.000 1.0
20 134.000 1.0
20 16.000 1.0

2004.00

20

R
205.17
R
335.70
R
167.77
R 1 249.21
R
149.15

R
205.17
R
335.70
R
167.77
R 1 118.69
R
149.15

20

2004.11

503.47
20 282.000 1.0 R 2 629.10

503.47
20 225.600 1.0 R 2 103.19

30

2004.00

20 267.000 1.0 R 2 489.19

20 213.600 1.0 R 1 991.44

30

2004.00
2004.00

20 190.000 1.0 R 1 771.31

-

20 152.000 1.0 R 1 417.14

-

2004.00

20 335.000 1.0 R 3 123.18

20 300.000 1.0 R 2 796.87
20 250.000 1.0 R 2 330.80
-

20 268.000 1.0 R 2 498.58

20 240.000 1.0 R 2 237.53
20 200.000 1.0 R 1 864.58
-

2004.00
2004.00
2004.00

Page 46 of 84

54.000 1.0 R

20 22.000 1.0
20 36.000 1.0
20 18.000 1.0
20 120.000 1.0
20 16.000 1.0

54.000 1.0 R

30
30
30

6.000 1.0 R

351.09

6.000 1.0 R

351.09

9.000 1.0 R
8.000 1.0 R
9.000 1.0 R

526.64
468.13
526.64
-

T
T
T

2681
2682
2683
2684
2685
2686
2687
2689
2690
2703
2705
2707
2708
2709
2710
2711
2712
2713
2714
2715
2716
2717
2718
2719
2720
2721
2722
2723
2724
2725
2726
2727
2729
2730
2731
2733
2734
2735
2737
2739
2741
2743
2745
6001
6002
6003
6004
6010

6011
14.2
2747

Visual evoked potentials (VEP): Unilateral

2004.00
Visual evoked potentials (VEP): Bilateral
2004.00
Electro-retinography (Ganzfeld method): Unilateral
2004.00
Electro-retinography (Ganzfeld method): Bilateral
2004.00
Electro-oculography: Unilateral
2004.00
Electro-oculography: Bilateral
2004.00
VEP stable condition (photic drive): Unilateral
2004.00
VEP stable condition (photic drive): Bilateral
2004.00
Total fee for full evaluation of visual tracts including bilateral electroretinography and VEP
2004.00
Note: See items 2691 to 2702 under section 17.5.1: Audiometry
2004.00
Somatosensory evoked potentials (SEP) single nerve examination to brachial or lumbosacral plexus, 2004.00
spinal cord and cortex
Transcutaneous nerve stimulation in the treatment of post-operative and chronic intractable pain, per 2004.00
treatment
Full fee for complete neurological evoked potential evaluation including neurological AEP, bilateral 2004.00
VEP, and bilateral median and/or posterior tibial stimulation
Evaluation of cognitive evoked potential with visual or audiology stimulus
2004.00
Full spinogram including bilateral median and posterior-tibial studies
2004.00
Morphia saturation testing in rooms (consultation x2 plus item 0206: Intravenous infusion) (excluding 2004.00
injection material)
Electro-encephalography: Taking of record
2004.00
Electro-encephalography: Interpretation
2004.00
Spinal (lumbar) puncture. For diagnosis, for drainage of spinal fluid or for therapeutic indications
2006.02

20 50.000 1.0 R
466.22
20 88.000 1.0 R
820.39
20 60.000 1.0 R
559.35
20 105.000 1.0 R
978.93
20 30.000 1.0 R
279.67
20 53.000 1.0 R
494.08
20 50.000 1.0 R
466.22
20 88.000 1.0 R
820.39
20 150.000 1.0 R 1 398.51
20 48.000 1.0 R
447.45

Cisternal puncture and/or intrathecal injections

8 Hour ambulatory EEG monitoring (Holter): Hire
8 Hour ambulatory EEG monitoring (Holter): Interpretation
Electromyography: First
Electromyography: Subsequent
Overnight polysomnogram and sleep staging: Hire
Overnight polysomnogram and sleep staging: Interpretation
Daytime polysomnogram: Hire
Daytime polysomnogram: Interpretation
Multiple sleep latency test: Interpretation
Overnight continuous positive airways pressure (CPAP) titration
Angiography carotis: Unilateral
Angiography carotis: Bilateral
Vertebral artery: Direct needling
Vertebral catheterisation
Neostigmine Test, the diagnostic test for Myasthenia Gravis under the supervision of a neurologist
('20') (not to be used with item 0714)
Air encephalography and posterior fossa tomography: Injection of air (independent procedure)
Cortical Stimulation
Sodium Amytal Testing (WADA test)
Air encephalography and posterior fossa tomography: Posterior fossa tomography attendance by
clinician
Air encephalography and posterior fossa tomography: Visual field charting on Bjerrum Screen
Ventricular needling without burring: Tapping only
Ventricular needling without burring: Plus introduction of air and/or contrast dye for ventriculography

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2006.02

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

15.000
136.000
30.000
75.000
75.000
125.000
23.000
125.000
17.000
125.000
155.000
25.000
44.000
50.000
50.000
60.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

2004.00
2004.00
2004.00
2004.00

20
20
20
20

14.500
58.900
88.700
31.500

1.0
1.0
1.0
1.0

2004.00
2004.00
2004.00

20
20
20

Subdural tapping: First sitting

Subdural tapping: Subsequent
Sleep electro-encephalography: Infants that fit into a perambulator: Taking of record
Sleep electro-encephalography: Infants that fit into a perambulator: Interpretation
Sleep electro-encephalography: Adults and children over infant age: Taking of record
Sleep electro-encephalography: Adults and children over infant age: Interpretation
Electroenchephalogram monitoring: Monitoring for localisation of cerebral seizure focus using
computerised sixteen or more channel EEG, which may include video recording (e.g. for preoperative localisation): Each full 24 hour period
Interpretation of item 6010: Electro-encephalogram monitoring: To be charged once only for each full
24 hour period of monitoring
Introduction of burr holes for
Ventriculography

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 15.000
20 10.000
20 36.100
20 24.500
20 36.100
20 24.500
20 294.600

2004.00

20 128.600 1.0 R 1 198.91

20 120.000 1.0 R 1 118.69

2004.00

20 150.000 1.0 R 1 398.51

20 120.000 1.0 R 1 118.69

55.88

20 220.000 1.0 R 2 050.98

20 80.000 1.0 R
745.89
20 140.000 1.0 R 1 305.24
-

20

20
20
20

Page 47 of 84

6.000 1.0 R

36.100 1.0 R
24.000 1.0 R
18.400 1.0 R

55.88

20

6.000 1.0 R

336.58
223.80
171.59

20
20
20

36.100 1.0 R
24.000 1.0 R
18.400 1.0 R

336.58
223.80
171.59

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

139.91
1 267.99
279.67
699.26
699.26
1 165.33
214.41
1 165.33
158.53
1 165.33
1 445.00
233.04
410.20
466.22
466.22
559.35

20

15.000 1.0 R

20
20

75.000 1.0 R
75.000 1.0 R

139.91
699.26
699.26
1 156.09
233.04
410.20
466.22
466.22
-

R
R
R
R

135.22
549.08
826.99
293.60

20
20
20

58.900 1.0 R
88.700 1.0 R
- 1.0

549.08
826.99
-

7.000 1.0 R
16.000 1.0 R
43.000 1.0 R

65.26
149.15
400.96

20
20
20

7.000 1.0 R
16.000 1.0 R
43.000 1.0 R

65.26
149.15
400.96

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
139.91
R
93.27
R
336.58
R
228.34
R
336.58
R
228.34
R 2 746.57

20 124.000 1.0 R
20 25.000 1.0 R
20 44.000 1.0 R
20 50.000 1.0 R
20 50.000 1.0 R
Z

20 15.000
20 10.000
20 36.100
20 24.500
20 36.100
20 24.500
20 235.680

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
139.91
R
93.27
R
336.58
R
228.34
R
336.58
R
228.34
R 2 197.20

30
30
30
30

4.000
4.000
4.000
4.000

1.0
1.0
1.0
1.0

R
R
R
R

30

4.000 1.0 R

30

13.000 1.0 R

30
30

4.000 1.0 R
4.000 1.0 R

30
30

4.000 1.0 R
4.000 1.0 R

234.06
234.06
234.06
234.06
234.06
760.56
234.06
234.06
234.06
234.06
-

T
T
T
T

T
T

T
T
T
T

30

8.000 1.0 R

468.13

Catheterisation for ventriculography and/or drainage

2004.00
Biopsy of brain tumour
2004.00
Subdural haematoma or hygroma
2004.00
Subdural empyema
2004.00
Brain abscess
2004.00
Nerve procedures
Nerve biopsy: Peripheral
2004.00
Nerve biopsy: Cranial nerves: Extra-cranial
2004.00
Nerve biopsy: Nerve conduction studies (see items 0733 and 3285)
2004.00
Botulinus toxin injections: For blepharospasm (+ 0198 + item 0201 + item 0202)
2004.00
Botulinus toxin injections: For hemifacial spasm or for hyperhidrosis per region (+ item 0198 + item 2004.00
0201 + item 0202)
6007 Botulinus toxin injections: For adductor disphonia (+ item 0198 + 0201 + item 0202)
2004.00
6008 Botulinus toxin injections: In extra-ocular muscles (+ item 0198 + item 0201 + item 0202)
2004.00
6009 Botulinus toxin injections: For spasmodic torticollis and/or cranial dystonia or for spasticity or for focal 2004.00
dystonia (+ item 0198 + item 0201 + item 0202)
14.3.1 Nerve procedures: Nerve repair or suture
2767 Suture brachial plexus (see also items 2837 and 2839)
2004.00
2769 Suture: Large nerve: Primary
2004.00
2771 Suture: Large nerve: Secondary
2004.00
2773 Digital nerve: Primary
2004.00
2775 Digital nerve: Secondary
2004.00
2777 Nerve graft: Simple
2004.00
2779 Fascicular: First fasciculus
2004.00
2781 Fascicular: Each additional fasciculus
2004.00
2783 Fascicular: Nerve flap: To include all stages
2004.00
2785 Fascicular: Facio-accessory or facio-hypoglossal anastomosis
2004.00
2787 Fascicular: Grafting of facial nerve
2004.00
14.3.2 Nerve procedures: Neurectomy
2789 Trigeminal ganglion: Injection of alcohol
2004.00
2791 Trigeminal ganglion: Injection of cortisone
2004.00
2793 Trigeminal ganglion: Coagulation through high frequency
2004.00
2799 Procedures for pain relief: Intrathecal injections for pain
2004.00
2800 Procedures for pain relief: Plexus nerve block
2004.00
2801 Procedures for pain relief: Epidural injection for pain (refer to modifier 0045 for post-operative pain 2004.00
relief) (refer to modifier 0021 for epidural anaesthetic)
2802 Procedures for pain relief: Peripheral nerve block
2004.00
2803 Alcohol injection in peripheral nerves for pain: Unilateral
2004.00
2804 Inserting an indwelling nerve catheter (includes removal of catheter) (not for bolus technique)
2004.00
2805 Alcohol injection in peripheral nerves for pain: Bilateral
2004.00
2809 Peripheral nerve section for pain
2004.00
2811 Pudendal neurectomy: Bilateral
2004.00
2813 Obturator or Stoffels
2004.00
2815 Interdigital
2004.00
2825 Excision: Neuroma: Peripheral
2004.00
14.3.3 Nerve procedures: Other nerve procedures
2827 Transposition of ulnar nerve
2004.00
2829 Neurolysis: Minor
2004.00
2831 Neurolysis: Major
2004.00
2833 Neurolysis: Digital
2004.00
2835 Scalenotomy
2004.00
2837 Brachial plexus, suture or neurolysis (item 2767)
2004.00
2839 Total brachial plexus exposure with graft, neurolysis and transplantation
2004.00
2841 Carpal Tunnel
2004.00
2843 Lumbar sympathectomy: Unilateral
2004.00
2845 Lumbar sympathectomy: Bilateral
2004.00
2846 Cervical sympathectomy: Trans-thoracic approach (use item 2847 or item 2848 as appropriate)
2004.00
2749
2751
2753
2755
2757
14.3
2759
2763
2765
6005
6006

2847
2848
2849
2851

Cervical sympathectomy: Unilateral

Cervical sympathectomy: Bilateral
Sympathetic block: Other levels: Unilateral
Sympathetic block: Other levels: Bilateral

2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

150.000
150.000
150.000
150.000
150.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

20
20
20
20
20

37.000
20.000
26.000
25.000
30.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

1 398.51
1 398.51
1 398.51
1 398.51
1 398.51
344.93
186.40
242.42
233.04
279.67

20
20
20

35.000 1.0 R
35.000 1.0 R
50.000 1.0 R

326.31
326.31
466.22

20
20
20
20
20
20
20
20
20
20
20

300.000
134.000
202.000
65.000
96.000
202.000
202.000
50.000
224.000
124.000
215.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R

20 150.000 1.0 R
20 65.000 1.0 R
20 170.000 1.0 R
20 36.000 1.0 R
20 36.000 1.0 R
20 36.000 1.0 R

2 796.87
1 249.21
1 883.21
605.98
895.04
1 883.21
1 883.21
466.22
2 088.38
1 156.09
2 004.49
1 398.51
605.98
1 584.91
335.70
335.70
335.70

20
20
20
20
20
20
20
20

120.000
120.000
120.000
120.000
120.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

1 118.69
1 118.69
1 118.69
1 118.69
1 118.69
37.000 1.0 R
344.93
20.000 1.0 R
186.40
26.000 1.0 R
242.42
-

30
30
30
30
30

8.000
8.000
8.000
8.000
8.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

30
30
30

4.000 1.0 R
4.000 1.0 R
4.000 1.0 R

20
20
20
20
20
20
20
20
20
20
20

240.000
120.000
161.600
65.000
96.000
161.600
161.600
50.000
179.200
120.000
172.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R

20 120.000 1.0 R
20 65.000 1.0 R
20 136.000 1.0 R
20 36.000 1.0 R
20 36.000 1.0 R
20 36.000 1.0 R

2 237.53
1 118.69
1 506.60
605.98
895.04
1 506.60
1 506.60
466.22
1 670.70
1 118.69
1 603.53
1 118.69
605.98
1 267.99
335.70
335.70
335.70

T
T
T
T
T
T
T
T

30
30
30
30
30
30
30
30
30
30
30

6.000
5.000
5.000
3.000
3.000
4.000
4.000
4.000
4.000
6.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R

30
30
30
30
20

4.000
3.000
3.000
4.000
36.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

20 25.000 1.0 R
233.04
20 20.000 1.0 R
186.40
20 10.000 1.0 R
93.27
20 35.000 1.0 R
326.31
20 45.000 1.0 R
419.58
20 116.000 1.0 R 1 081.44
20 96.000 1.0 R
895.04
20 82.300 1.0 R
767.30
20 109.500 1.0 R 1 020.87
20 100.000 1.0 R
932.29
20 51.000 1.0 R
475.46
20 132.000 1.0 R 1 230.59
20 96.000 1.0 R
895.04
20 132.000 1.0 R 1 230.59
20 300.000 1.0 R 2 796.87
20 895.200 1.0 R 8 345.89
20 64.000 1.0 R
596.60
20 153.000 1.0 R 1 426.37
20 268.000 1.0 R 2 498.58
-

20 25.000 1.0 R
233.04
20 20.000 1.0 R
186.40
20 10.000 1.0 R
93.27
20 35.000 1.0 R
326.31
20 45.000 1.0 R
419.58
20 116.000 1.0 R 1 081.44
20 96.000 1.0 R
895.04
20 82.300 1.0 R
767.30
20 109.500 1.0 R 1 020.87
20 100.000 1.0 R
932.29
20 51.000 1.0 R
475.46
20 120.000 1.0 R 1 118.69
20 96.000 1.0 R
895.04
20 120.000 1.0 R 1 118.69
20 240.000 1.0 R 2 237.53
20 716.160 1.0 R 6 676.65
20 64.000 1.0 R
596.60
20 122.400 1.0 R 1 141.13
20 214.400 1.0 R 1 998.77
-

20
30
20
30
30
30
30
30
30

25.000
3.000
10.000
3.000
3.000
3.000
3.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

30
30
30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
6.000
6.000
6.000
3.000
4.000
6.000
11.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

20 153.000 1.0 R 1 426.37

20 268.000 1.0 R 2 498.58
20 20.000 1.0 R
186.40
20 35.000 1.0 R
326.31

20 122.400 1.0 R 1 141.13

20 214.400 1.0 R 1 998.77
20 20.000 1.0 R
186.40
20 35.000 1.0 R
326.31

30
30
30
30

4.000
6.000
3.000
3.000

1.0
1.0
1.0
1.0

Page 48 of 84

468.13
468.13
468.13
468.13
468.13
234.06
234.06
234.06
-

351.09
292.58
292.58
175.55
175.55
234.06
234.06
234.06
234.06
351.09
292.58
234.06
175.55
175.55
234.06
335.70
-

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

T
T
T
T
T
T

R
R
R
R
R
R
R
R
R
R
R

233.04
175.55
93.27
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
175.55
351.09
351.09
351.09
175.55
234.06
351.09
643.53

R
R
R
R

234.06
351.09
175.55
175.55

T
T
T
T

T
T
T
T
T
T
T
T
T
T
T

Sympathetic block: Other levels: Diagnostic/Therapeutic nerve block (unassociated with surgery) either intercostal, or brachial, or peripheral, or stellate ganglion
14.4 Skull procedures
2855 Removal of skull tumour: With or without plastic repair: Small
2857 Removal of skull tumour: With or without plastic repair: Major
2859 Repair of depressed fracture of skull: Without brain laceration: Major
2860 Repair of depressed fracture of skull: Without brain laceration: Small
2861 Repair of depressed fracture of skull: With brain lacerations: Small
2862 Repair of depressed fracture of skull: With brain lacerations: Major
2863 Cranioplasty
2864 Encephalocele (excluding frontal)
2865 Craniostenosis: Few suturae
2867 Craniostenosis: Multiple suturae
14.5 Shunt procedures
2869 Ventriculo-cisternostomy
2871 Ventriculo-caval shunt
2873 Ventriculo-peritoneal shunt
2875 Theco-peritoneal C.S.F. shunt
14.6 Aneurysm repair
2876 Repair of aneurysms or arteriovenous anomalies (Intracranial)
2877 Extracranial to intracranial vascular
2878 Posterior fossa arteriovenous anomalies
14.7 Posterior fossa surgery
2879 Glosso pharyngeal nerve
2881 Eighth nerve: Intracranial
2883 Eighth nerve: Extracranial
2884 Sub-temporal section of the trigeminal nerve
2885 Trigeminal tractotomy
2886 Posterior fossa decompression with or without laminectomy with or without dural insertion for Arnold
Chiarri malformation or obstructive cysts e.g. Dandy Walker or parasites
2887 Vestibular nerve
2889 Posterior fossa tumour removal: Acoustic neuroma, benign cerebello-pontine tumours, meningioma,
clivus meningioma, chordoma, clivus chordoma or cholesteatoma
2891 Posterior fossa tumour removal: Glioma, secondary deposits
2893 Posterior fossa tumour removal: Abscess
2895 Excision of tumour of glomus jugulare: Intracranial
2897 Excision of tumour of glomus jugulare: Extracranial
2898 Excision of tumour of glomus jugulare: Hemispherectomy
14.7.1 Posterior fossa surgery: Supratentorial procedures
2899 Craniectomy for extra-dural haematoma or empyema
14.8 Craniotomy for
2900 Craniotomy for Extra-dural orbital decompression or excision of orbital tumour
2901 Craniotomy for Osteoplastic Flap for removal of: Meningioma, basal extracerebral mass, intra
ventricular tumours, pineal tumours, pituitary adenoma, total excision craniopharyngioma/pharyngioma
2903 Craniotomy for Abscess, Glioma
2904 Craniotomy for Haematoma, foreign body: Cerebral or cerebellar
2905 Craniotomy for Focal epilepsy: Excision of cortical scar
2906 Craniotomy with anterior fossa meningocele and repair of bony skull defect
2907 Craniotomy for Temporal lobectomy
2908 Craniotomy for Torkildsen anastomosis
2909 Craniotomy for CSF-leaks
2910 Craniotomy for removal of arteriovenous malformation
14.8.1 Craniotomy for Stereo-tactic cerebral and spinal cord procedures
2911 Stereo-tactic cerebral and spinal cord procedure: First sitting
2913 Stereo-tactic cerebral and spinal cord procedure: Repeat
2915 Transnasal hypophysectomy
2916 Transfrontal hypophysectomy
2917 Transnasal hypophyseal implants
2918 Non-operative supervision of paraplegics for all disciplines except urologists. Per service (specified)
2853

14.9

Spinal operations
See section 3.8.7 for laminectomy procedures

2004.00

20

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.11
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20

170.000
200.000
200.000
170.000
200.000
375.000
280.000
200.000
213.000
280.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00

20
20
20
20

280.000
280.000
280.000
280.000

1.0
1.0
1.0
1.0

R
R
R
R

2004.00
2004.00
2004.00

20 700.000 1.0 R
20 700.000 1.0 R
20 700.000 1.0 R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20

2004.00
2006.04

20 480.000 1.0 R 4 475.06

20 700.000 1.0 R 6 526.04

20 384.000 1.0 R 3 580.02

20 560.000 1.0 R 5 220.80

2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

20
20
20
20
20

2004.00
2004.00

4 195.38
4 195.38
3 915.56
3 915.56
4 661.46
20 375.000 1.0 R 3 496.13
20 700.000 1.0 R 6 526.04
20 700.000 1.0 R 6 526.04

2004.00
2004.00
2004.00
2004.11
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20

450.000
450.000
450.000
375.000
450.000
375.000
450.000
700.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20

280.000
196.000
300.000
480.000
172.000
-

1.0
1.0
1.0
1.0
1.0
0.0

R
R
R
R
R

2004.00

20.000 1.0 R

480.000
480.000
480.000
375.000
480.000
450.000

450.000
450.000
420.000
420.000
500.000

1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

186.40
1 584.91
1 864.58
1 864.58
1 584.91
1 864.58
3 496.13
2 610.47
1 864.58
1 985.72
2 610.47
2 610.47
2 610.47
2 610.47
2 610.47
6 526.04
6 526.04
6 526.04
4 475.06
4 475.06
4 475.06
3 496.13
4 475.06
4 195.38

R
R
R
R
R

4 195.38
4 195.38
4 195.38
3 496.13
4 195.38
3 496.13
4 195.38
6 526.04
2 610.47
1 827.33
2 796.87
4 475.06
1 603.53
-

2004.00

Page 49 of 84

20

20.000 1.0 R

186.40

4.000 1.0 R

30
30
30
30
30
30
30
30
30
30

5.000
8.000
8.000
8.000
8.000
8.000
8.000
8.000
9.000
9.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

30
30
30
30

8.000
11.000
8.000
8.000

1.0
1.0
1.0
1.0

R
R
R
R

30
30
30

15.000 1.0 R
15.000 1.0 R
15.000 1.0 R

234.06

R
R
R
R
R
R

292.58
468.13
468.13
468.13
468.13
468.13
468.13
468.13
526.64
526.64
468.13
643.53
468.13
468.13
877.59
877.59
877.59
351.09
468.13
234.06
526.64
526.64
526.64

30
30

9.000 1.0 R
11.000 1.0 R

526.64
643.53

T
T

3 356.22
3 356.22
3 132.57
3 132.57
3 729.16
20 300.000 1.0 R 2 796.87
20 560.000 1.0 R 5 220.80
20 560.000 1.0 R 5 220.80

30
30
30
30
30

11.000
11.000
11.000
9.000
15.000

T
T
T
T
T

30

11.000 1.0 R

30
30

11.000 1.0 R
11.000 1.0 R

643.53
643.53
643.53
526.64
877.59
643.53
643.53
643.53

20
20
20
20
20
20
20
20

360.000
360.000
360.000
300.000
360.000
300.000
360.000
560.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

30
30
30
30
30
30
30
30

11.000
11.000
11.000
11.000
11.000
11.000
11.000
11.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

T
T
T
T
T
T
T
T

20
20
20
20
20
20

224.000
156.800
240.000
384.000
137.600
-

1.0
1.0
1.0
1.0
1.0
0.0

R
R
R
R
R

30
30
30
30
30

4.000
4.000
11.000
11.000
11.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

643.53
643.53
643.53
643.53
643.53
643.53
643.53
643.53
234.06
234.06
643.53
643.53
643.53
-

20
20
20
20
20
20
20
20
20
20

136.000
160.000
160.000
136.000
160.000
300.000
224.000
160.000
170.400
224.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

20
20
20
20

224.000
224.000
224.000
224.000

1.0
1.0
1.0
1.0

R
R
R
R

20 560.000 1.0 R
20 560.000 1.0 R
20 560.000 1.0 R
20
20
20
20
20
20

384.000
384.000
384.000
300.000
384.000
360.000

360.000
360.000
336.000
336.000
400.000

1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

1 267.99
1 491.64
1 491.64
1 267.99
1 491.64
2 796.87
2 088.38
1 491.64
1 588.58
2 088.38
2 088.38
2 088.38
2 088.38
2 088.38
5 220.80
5 220.80
5 220.80
3 580.02
3 580.02
3 580.02
2 796.87
3 580.02
3 356.22

30

R
R
R
R
R

3 356.22
3 356.22
3 356.22
2 796.87
3 356.22
2 796.87
3 356.22
5 220.80
2 088.38
1 461.87
2 237.53
3 580.02
1 282.80
-

30
30
30
30
30
30

6.000
8.000
4.000
9.000
9.000
9.000

1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

T
T
T

T
T
T
T
T

Chordotomy: Unilateral
Chordotomy: Open
Rhizotomy: Extradural, but intraspinal
Rhizotomy: Intradural
Removal of spinal cord tumour: Intramedullar: Posterior approach
Removal of spinal cord tumour: Intramedullar: Anterio-lateral approach
Removal of spinal cord tumour: Extramedullary, but intradural: Posterior approach
Removal of spinal cord tumour: Extramedullary, but intradural: Anterio-lateral approach
Removal of spinal cord tumour: Extramedullary, but intradural: Intraspinal, but extradural: Posterior
approach
2935 Removal of spinal cord tumour: Extramedullary, but intradural: Transcutaneous chordotomy
2937 Repair of meningocele, involving nerve tissue
2938 Simple
2939 Excision of arterial vascular malformations and cysts of the spinal cord
2940 Lumbar osteophyte removal
2941 Cervical or thoracic osteophyte removal
14.10 Arterial ligations
2951 Carotis: Trauma
2953 Carotis: For aneurysm (AV anomaly)
2955 Removal of carotid body tumour (without vascular reconstruction)
14.11 Medical psychotherapy
2957 Individual psychotherapy (specify type): Including play therapy for children: Per short session (20
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
2968 Group therapy: Adults (specify number): Tariff per person per 80-minute session; Children (specify
number): Tariff per person per 80-minute session
2974 Individual psychotherapy (specify type): Including play therapy for children: Per intermediate session
(40 minutes)
2975 Individual psychotherapy (specify type): Including play therapy for children: Per extended session (60
minutes or longer)
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
RULES GOVERNING THE SECTION MEDICAL PSYCHOTHERAPY
(a) Electro-convulsive treatment: Visits at hospital or nursing home during a course of electroV.
convulsive treatment are justified and may be charged for in addition to the fees for the procedure.
(b) Except where otherwise indicated, the duration of a medical psychotherapeutic session is set at
20 minutes or part thereof, provided that such a part comprises 50% or more of the time of a
session. This set duration is also applicable for psychiatric examination methods

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20

178.000
350.000
320.000
350.000
700.000
700.000
350.000
350.000
320.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20

225.000
250.000
150.000
700.000
187.000
285.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

When a first consultation/visit proceeds into, or is immediately followed by a medical

psychotherapeutic procedure, fees for the procedure are calculated according to the appropriate
individual psychotherapy code (items 2957, 2974 or 2975)
14.12 Physical treatment methods
2970 Electro-convulsive treatment (ECT): Each time (See rule Va)
14.13 Psychiatric examination methods
2972 Narco-analysis (Maximum of 3 sessions per treatment): Per 60 min session
2973 Psychometry (specify examination): Per session (Maximum of 3 sessions per examination)
Endocrine System
15
15.1 Thyroid
2983 Lobectomy: Partial
2985 Lobectomy: Total
2987 Thyroidectomy: Subtotal
2989 Thyroidectomy: Total
2991 Thyroglossal cyst or fistula excision
15.2 Parathyroid
2993 Exploration of parathyroid glands for hyperparathyroidism including removal
15.3 Adrenals
2995 Adrenalectomy: Unilateral
2997 Bilateral exploration of adrenal glands: Including removal
15.4 Hypophysis
2999 Transethmoidal hypophysectomy

2923
2925
2927
2928
2929
2930
2931
2932
2933

0079

1 659.41
3 263.09
2 983.27
3 263.09
6 526.04
6 526.04
3 263.09
3 263.09
2 983.27

20
20
20
20
20
20
20
20
20

142.400
280.000
256.000
280.000
560.000
560.000
280.000
280.000
256.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

1 327.53
2 610.47
2 386.68
2 610.47
5 220.80
5 220.80
2 610.47
2 610.47
2 386.68

30
30
30
30
30
30
30
30
30

3.000
3.000
3.000
3.000
8.000
8.000
3.000
8.000
7.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

175.55
175.55
175.55
175.55
468.13
468.13
175.55
468.13
409.61

TM
TM
TM
TM
T
T
TM
T
T

20
20
20
20
20
20

180.000
200.000
120.000
560.000
149.600
228.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

3.000
9.000
9.000
9.000
3.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

30
30
30

8.000 1.0 R
8.000 1.0 R
8.000 1.0 R

16.000 1.0 R

175.55
526.64
526.64
526.64
175.55
175.55
468.13
468.13
468.13
-

T
T
T
T
TM
TM

20

1 678.18
1 864.58
1 118.69
5 220.80
1 394.70
2 125.63
1 118.69
1 118.69
2 502.98
149.15

30
30
30
30
30
30

2004.00

2 097.62
2 330.80
1 398.51
6 526.04
1 743.44
2 656.96
20 120.000 1.0 R 1 118.69
20 150.000 1.0 R 1 398.51
20 335.600 1.0 R 3 128.76
-

2004.00
2004.00
2004.00
2004.00

20
20
20
20

48.000
16.000
16.000
8.000

R
R
R
R

447.45
149.15
149.15
74.65

2004.00

20

32.000 1.0 R

298.30

2004.00

20

48.000 1.0 R

447.45

2004.00
2004.00

20
20

32.000 1.0 R
48.000 1.0 R

2004.00

298.30
447.45
-

2004.00

2004.00
2004.00
2004.00

2004.00
2006.05
2004.00

2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

2004.00

20 275.000 1.0 R

2004.00
2004.00

20 225.000 1.0 R
20 394.000 1.0 R

2004.00

20 300.000 1.0 R

Page 50 of 84

198.100
200.000
266.000
279.000
126.200

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

1 846.84
1 864.58
2 479.95
2 601.09
1 176.62
2 563.84
2 097.62
3 673.29
2 796.87

20 120.000 1.0 R
20 120.000 1.0 R
20 268.480 1.0 R

1.0
1.0
1.0
1.0

20

17.000 1.0 R

20
20

16.000 1.0 R
16.000 1.0 R

20
20
20
20
20

158.480
160.000
212.800
223.200
120.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

20 220.000 1.0 R
20 180.000 1.0 R
20 315.200 1.0 R
20 240.000 1.0 R

158.53
149.15
149.15
1 477.56
1 491.64
1 983.96
2 080.90
1 118.69
2 050.98
1 678.18
2 938.54
2 237.53

30

3.000 1.0 R

30
30
30
30
30

5.000
5.000
5.000
5.000
5.000

30

5.000 1.0 R

30
30

9.000 1.0 R
11.000 1.0 R

30

11.000 1.0 R

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

175.55
292.58
292.58
292.58
292.58
292.58
292.58
526.64
643.53
643.53

T
T
T

T
T
T
T
T
T
T
T
T

3000
15.5
3001
16
16.1

Transnasal hypophysectomy (see also item 2915)

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

2004.00

20 300.000 1.0 R 2 796.87

20
3.000 1.0 R
28.01
-

2004.00

2004.00

Eye investigations
Gonioscopy
2004.00
Fundus contact lens or 90 D lens examination (not to be charged with item 3004 or item 3012)
2004.00
Peripheral fundus examination with indirect ophthalmoscope (not to be charged with item 3003
2004.00
and/or item 3012)
Keratometry
3006
2004.00
3009 Basic capital equipment used in own rooms by ophthalmologists. Only to be charged at first and
2004.00
follow-up consultations. Not to be charged for post-operative follow-up consultations
Pre-surgical
retinal
examination
before
retinal
surgery
3012
2004.00
3013 Ocular motility assessment: Comprehensive examination
2004.00
3014 Tonometry per test with maximum of 2 tests for provocative tonometry (one or both eyes)
2004.00
3021 Special eye investigations: Retinal function assessment including refraction after ocular surgery
2004.00
(within four months), maximum two examinations
16.1.2 Special eye investigations
3005 Endothelial cell count
2004.00
3007 Potential acuity measurement
2004.00
3008 Contrast sensitivity test
2004.00
3010 Orthoptics consultation
2004.00
3011 Orthoptic subsequent sessions
2004.00
3015 Charting of visual field with manual perimeter
2004.00
3016 Retinal threshold test without storage facilities
2004.00
3017 Retinal threshold test inclusive of computer disc storage for Delta of Statpak programs
2004.00
3018 Retinal threshold trend evaluation (additional to item 3017)
2004.00
3019 Ocular muscle function with Hess screen or perimeter
2004.00
3020 Special eye investigations: Pachymetry: Only when own instrument is used, per eye. Only in addition 2004.00
to corneal surgery
3022 Digital fluorescein video angiography
2004.00
3023 Digital indocyanine video angiography
2004.00
3024 Infusion of dye used during Fluorescein Angiography, Indocyanine Green Video Angiography and
2004.00
Photodynamic therapy. Linked to items 3022, 3023, 3031, 3039
3025 Electronic tonography
2004.00
3026 Digital Tomography of optic nerve with Scanning Laser Ophthalmoscope (SLO). Limited to two
2004.00
exams per annum
3027 Fundus photography
2004.00
3028 Optical Coherent Tomography (OCT) of Optic nerve or macula: Per eye
2004.00
3029 Anterior segment microphotography
2004.00
3031 Fluorescein Angiography: One or both eyes (not to be used with item 3022)
2004.00
3032 Eyelid and orbit photography
2004.00
3033 Interpretation of items 3022, 3023 and 3031 referred by other clinicians
2004.00
3034 Determination of lens implant power per eye
2004.00
3035 Where a minor procedure usually done in the consulting rooms requires a general anaesthetic or use 2004.00
of an operating theatre, an additional fee may be charged
3036 Corneal topography: For pathological corneas only on special motivation. For refractive surgery 2004.00
may be charged once pre-operative and once post-operative per sitting (for one or both eyes)
16.1.1
3002
3003
3004

16.2
3037

Retina
Surgical treatment of retinal detachment including vitreous replacement but excluding vitrectomy

3039

Prophylaxis and treatment of retina and choroid by cryotherapy and/or diathermy and/or
photocoagulation and/or laser per eye
Pan retinal photocoagulation (per eye): Done in one sitting
Removal of encircling band and/or buckling material
Cataract

3041
3044
16.3

20
20
20

7.000 1.0 R
7.000 1.0 R
7.000 1.0 R

65.26
65.26
65.26

20
20

7.000 1.0 R
11.680 1.0 R

20
20
20
20

32.000
12.000
7.000
9.000

1.0
1.0
1.0
1.0

20
20
20
20
20
20
20
20
20
20
20

7.000
7.000
7.000
10.000
5.000
28.000
30.000
74.000
16.000
16.000
46.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

20 240.000 1.0 R 2 237.53

20
3.000 1.0 R
28.01
-

30

11.000 1.0 R

643.53
-

65.26
65.26
65.26

65.26
-

R
R
R
R

298.30
111.90
65.26
83.89

R
R
R
R
R
R
R
R
R
R
R

65.26
65.26
65.26
93.27
46.64
261.05
279.67
689.87
149.15
149.15
428.82

20
20
20

7.000 1.0 R
7.000 1.0 R
7.000 1.0 R

65.26
108.82

20

7.000 1.0 R

R
R
R
R

298.30
111.90
65.26
83.89

20
20
20
20

32.000
12.000
7.000
9.000

1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R

65.26
65.26
65.26
93.27
46.64
261.05
279.67
689.87
149.15
149.15
428.82

20
20
20
20
20
20
20
20
20
20
20

7.000
7.000
7.000
10.000
5.000
28.000
30.000
74.000
16.000
16.000
46.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

20 68.000 1.0 R
633.99
20 110.000 1.0 R 1 025.56
20 12.000 1.0 R
111.90

20 68.000 1.0 R
633.99
20 110.000 1.0 R 1 025.56
20 12.000 1.0 R
111.90

20
20

19.000 1.0 R
19.300 1.0 R

177.16
179.95

20
20

19.000 1.0 R
19.300 1.0 R

177.16
179.95

20
20
20
20
20
20
20
20

21.000
40.000
21.000
45.000
9.000
16.000
15.000
22.000

R
R
R
R
R
R
R
R

195.79
372.95
195.79
419.58
83.89
149.15
139.91
205.17

20
20
20
20
20
20
20
20

21.000
40.000
21.000
45.000
9.000
16.000
15.000
22.000

R
R
R
R
R
R
R
R

195.79
372.95
195.79
419.58
83.89
149.15
139.91
205.17

20

36.000 1.0 R

335.70

20

36.000 1.0 R

335.70

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

30
30

9.000 1.0 R
9.000 1.0 R

526.64
526.64
-

T
T

2004.00

20 306.900 1.0 R 2 861.26

20 245.520 1.0 R 2 289.00

30

6.000 1.0 R

351.09

2004.00

20 105.000 1.0 R

20 105.000 1.0 R

978.93

30

6.000 1.0 R

351.09

2004.00
2004.00

20 150.000 1.0 R 1 398.51

20 105.000 1.0 R
978.93
-

20 120.000 1.0 R 1 118.69

20 105.000 1.0 R
978.93
-

30
30

6.000 1.0 R
6.000 1.0 R

351.09
351.09
-

T
T

Page 51 of 84

978.93

20 210.000 1.0 R 1 957.86

20 210.000 1.0 R 1 957.86
20 57.000 1.0 R
531.33

20 168.000 1.0 R 1 566.28

20 168.000 1.0 R 1 566.28
20 57.000 1.0 R
531.33

30
30
30

7.000 1.0 R
7.000 1.0 R
7.000 1.0 R

409.61
409.61
409.61

T
T
T

20
20
20
20
20
20
20

20
20
20
20
20
20

30
30
30
30
30
30

7.000
4.000
4.000
7.000
7.000
7.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

409.61
234.06
234.06
409.61
409.61
409.61
-

T
T
T
T
T
T

30
30
30
30
30
30

6.000
6.000
6.000
6.000
4.000
7.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

30
30

4.000 1.0 R
6.000 1.0 R

3075

Cataract: Intra-capsular
2004.00
Cataract: Extra-capsular (including capsulotomy)
2004.00
Insertion of lenticulus in addition to item 3045 or item 3047 (cost of lens excluded) (modifier 0005 not 2004.00
applicable)
Repositioning of intra ocular lens
2004.00
Needling or capsulotomy
2004.00
Laser capsulotomy
2004.00
Removal of lenticulus
2004.00
Exchange of intra ocular lens
2004.00
Insertion of lenticulus when item 3045 or item 3047 was not executed (cost of lens excluded)
2004.00
Use of own surgical microscope for surgery or examination (not for slit lamp microscope) (for use by 2004.00
ophthalmologists only)
Glaucoma
Drainage operation
2004.00
Implantation of aqueous shunt device/seton in glaucoma (additional to item 3061)
2004.00
Cyclocryotherapy or cyclodiathermy
2004.00
Laser trabeculoplasty
2004.00
Removal of blood from anterior chamber
2004.00
Goniotomy
2004.00
Intra-ocular foreign body
Intra-ocular foreign body: Anterior to Iris
2004.00
Intra-ocular foreign body: Posterior to Iris (including prophylactic thermal treatment to retina)
2004.00
Strabismus
Strabismus (whether operation performed on one eye or both): Adjustment of sutures if not done at 2004.00
the time of the operation. Additional fee for sterile tray (refer to item 0202)
Strabismus (whether operation performed on one eye or both): Operation on one or two muscles
2004.00

20 175.600 1.0 R 1 637.12

20 140.480 1.0 R 1 309.64

30

5.000 1.0 R

292.58

3076

Strabismus (whether operation performed on one eye or both): Operation on three or four muscles

2004.00

20 200.000 1.0 R 1 864.58

20 160.000 1.0 R 1 491.64

30

5.000 1.0 R

292.58

3077

Strabismus (whether operation performed on one eye or both): Subsequent operation one or two
muscles
Strabismus (whether operation performed on one eye or both): Subsequent operation on three or
four muscles
Globe
Transcleral biopsy
Examination of eyes under general anaesthetic where no surgery is done
Treatment of minor perforating injury
Treatment of major perforating injury
Enucleation or Evisceration
Enucleation or Evisceration with mobile implant: Excluding cost of implant and prosthesis
Hydroxyapetite insertion (additional to item 3087)
Subconjunctival injection if not done at time of operation
Intra vitreal injection drug
Retrobulbar injection (if not done at time of operation)
External laser treatment for superficial lesions
Treatment of tumours of retina or choriod by radioactive plaque and/or diathermy and/or cryotherapy
and/or laser therapy and/or photocoagulation
Implantation of intra vitreal drug delivery system
Biopsy of vitreous body or anterior chamber contents
Adding of air or gas in vitreous as a post-operative procedure or pneumo-retinopexy
Anterior vitrectomy
Removal of silicon from globe
Posterior vitrectomy including anterior vitrectomy, encircling of globe and vitreous replacement
Lensectomy done at time of posterior vitrectomy
Orbit
Drainage of orbital abscess
Orbit: Removal of tumour
Removal orbital prosthesis
Orbit: Exenteration
Orbitotomy requiring bone flap
Eye socket reconstruction
Hydroxyapetite implantation in eye cavity when evisceration or enucleation was done previously

2004.00

20 120.000 1.0 R 1 118.69

20 120.000 1.0 R 1 118.69

30

5.000 1.0 R

292.58

2004.00

20 150.000 1.0 R 1 398.51

20 120.000 1.0 R 1 118.69

30

5.000 1.0 R

292.58

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2005.06
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20
20
20
20

132.000
80.000
161.600
267.500
105.000
160.000
40.000
10.000
47.600
16.000
53.000
209.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R

30
30
30
30
30
30
30
30
30
30

4.000
4.000
6.000
6.000
5.000
5.000
5.000
5.000
4.000
4.000

30

6.000 1.0 R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20

247.600
105.000
130.000
280.000
280.000
419.000
30.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

30
30
30
30
30
30
30

4.000
6.000
7.000
6.000
6.000
6.000
7.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20

105.000
240.000
212.700
275.000
393.000
206.000
300.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

30
30
30
30
30
30
30

5.000
5.000
5.000
5.000
5.000
5.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

3045
3047
3049
3050
3051
3052
3057
3058
3059
3060
16.4
3061
3062
3063
3064
3065
3067
16.5
3071
3073
16.6
3074

3078
16.7
3079
3080
3081
3083
3085
3087
3088
3089
3090
3091
3092
3093
3094
3095
3096
3097
3098
3099
3100
16.8
3101
3103
3104
3105
3107
3108
3109

171.100
130.000
105.000
210.000
236.000
210.000
4.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

1 595.18
1 211.96
978.93
1 957.86
2 200.28
1 957.86
37.25

R 2 308.36
R
559.35
R
978.93
R
978.93
R
978.93
R 1 957.86
20 127.000 1.0 R 1 183.95
20 210.000 1.0 R 1 957.86
20 20.000 1.0 R
186.40
20
20
20
20
20
20

Page 52 of 84

247.600
60.000
105.000
105.000
105.000
210.000

1.0
1.0
1.0
1.0
1.0
1.0

1 230.59
745.89
1 506.60
2 493.88
978.93
1 491.64
372.95
93.27
443.78
149.15
494.08
1 948.47
2 308.36
978.93
1 211.96
2 610.47
2 610.47
3 906.32
279.67
978.93
2 237.53
1 982.93
2 563.84
3 663.90
1 920.46
2 796.87

136.880
120.000
105.000
168.000
188.800
168.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

1 276.05
1 118.69
978.93
1 566.28
1 760.16
1 566.28
-

R 1 846.69
R
559.35
R
978.93
R
978.93
R
978.93
R 1 566.28
20 120.000 1.0 R 1 118.69
20 168.000 1.0 R 1 566.28
20 20.000 1.0 R
186.40
20
20
20
20
20
20

198.080
60.000
105.000
105.000
105.000
168.000

1.0
1.0
1.0
1.0
1.0
1.0

20
20
20
20
20
20
20
20
20
20
20
20

120.000
80.000
129.280
214.000
105.000
128.000
40.000
10.000
47.600
16.000
53.000
167.200

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R

20
20
20
20
20
20
20

198.080
105.000
120.000
224.000
224.000
335.200
30.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

20
20
20
20
20
20
20

105.000
192.000
170.160
220.000
314.400
164.800
240.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

1 118.69
745.89
1 205.22
1 995.11
978.93
1 193.34
372.95
93.27
443.78
149.15
494.08
1 558.80
1 846.69
978.93
1 118.69
2 088.38
2 088.38
3 125.09
279.67
978.93
1 789.93
1 586.38
2 050.98
2 931.06
1 536.37
2 237.53

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

351.09
351.09
351.09
351.09
234.06
409.61
234.06
351.09
-

234.06
234.06
351.09
351.09
292.58
292.58
292.58
292.58
234.06
234.06
351.09
234.06
351.09
409.61
351.09
351.09
351.09
409.61
292.58
292.58
292.58
292.58
292.58
292.58
292.58

T
T
T
T
T
T
T
T

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

3110
16.9
3111
3112
3113
3114
3115
3116
3117
3118
3119
3120
3121
3122
3123
3124
3125
3126
3127
3128

Second stage hydroxyapetite implantation

Cornea
Contact lenses: Assessment involving preliminary fittings and tolerance visits (costs of lenses borne
by patient)
Fitting of contact lens for treatment of disease including supply of lens
Fitting of contact lenses and instructions to patient: Includes eye examination, first fitting of the
contact lenses and further post-fitting visits for one (1) year
Wavefront analysis (Aberometry) for customized ablation of pathological corneas prior to LASIK
surgery - EQUIPMENT component only
Fitting of only one contact lens and instructions to the patient: Eye examination, first fitting of the
contact lens and further post-fitting visits for one year included
Astigmatic correction with T-cuts or wedge resection in pathological corneal astigmatism following
trauma, intra ocular surgery or penetrating keratoplasty
Removal of foreign body: On the basis of fee per consultation
Curettage of cornea after removal of foreign body (after-care excluded)
Tattooing
Excimer laser (per eye) for refractive keratectomy or Holmium laser thermo keratoplasty (LTK) (For
machine hire fee for LTK: Use item 3201)
Corneal graft (Lamellar or full thickness)
Epikeratophakia
Insertion of intra-corneal or intrascleral prosthesis for refractive surgery
Removal of corneal stitches under microscope (maximum of 2 procedures). Additional fee for sterile
tray (see item 0202)
Keratectomy
Additional to item 3120 for the use of own microkeratome used with a excimer laser
Cauterisation of cornea (by chemical, thermal or cryotherapy methods)
Radial keratotomy or keratoplasty for astigmatism (cosmetic unless medical reasons can be proved)

Additional to item 3128 for the use of own diamond knives

Pterygium or conjunctival cyst or conjunctival tumour. No conjunctival flap or graft used
Cornea: Paracentesis
Lamellar keratectomy for refractive surgery (LK, ALK, MLK)
Pterygium or conjunctival cyst or conjunctival tumour. Conjunctival flap or graft used - stand alone
procedure
3136 Conjunctival flap or graft (not for use with pterigium surgery)
3138 Removal corneal epithelium and chelating agent for band keratopathy
16.10 Ducts
3133 Probing and/or syringing, per duct
3135 Insert polythene tubes
3137 Excision of lacrimal sac: Unilateral
3139 Dacrocystorhinostomy (Single) with or without polythene tube
3141 Sealing Punctum surgical or by cautery: Per eye
3142 Sealing Punctum with plugs: Per eye
3143 Three-snip operation
3145 Repair of caniculus: Primary procedure
3147 Repair of caniculus: Secondary procedure
16.11 Iris
3149 Iridectomy or iridotomy by open operation as isolated procedure
3151 Excision of iris tumour
3153 Iridectomy or iridotomy by laser or photocoagulation as isolated procedure (maximum one
procedure)
3155 Iridocyclectomy for tumour
3157 Division of anterior synechiae as isolated procedure
3158 Repair iris as in dialysis: Anterior chamber reconstruction
16.12 Lids
3161 Tarsorrhaphy
3163 Excision of superficial lid tumour
3165 Repair of skin laceration lid: Simple
3167 Diathermy to wart on lid margin
3169 Electrolysis of any number of eyelashes: Per eye
3171 Excision of Meibomian cyst. Additional fee for sterile tray (see item 0202)
3173 Epicanthal folds
3174 Botulinus toxin injection for blepharospasm (+ item 0198 + item 0201 + item 0202)
3129
3130
3131
3132
3134

2004.00
2004.00

20 110.000 1.0 R 1 025.56

20
- 0.0
-

2004.00
2004.00

20 12.200 1.0 R
113.80
20 200.000 1.0 R 1 864.58

2004.00

20

20 110.000 1.0 R 1 025.56

20
- 0.0
-

30

5.000 1.0 R

292.58
-

20 12.200 1.0 R
113.80
20 160.000 1.0 R 1 491.64

735.04

2004.00

20 166.000 1.0 R 1 547.66

20 132.800 1.0 R 1 238.07

2004.00

20 135.200 1.0 R 1 260.51

20 120.000 1.0 R 1 118.69

2004.00
2004.00
2004.00
2004.00

20
20 10.000
20 26.000
20 150.000

2004.00
2004.00
2004.00
2004.00

20 289.000 1.0 R 2 694.36

20 289.000 1.0 R 2 694.36
20 254.000 1.0 R 2 368.05
20
9.000 1.0 R
83.89

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

78.850 1.0 R

30

6.000 1.0 R

351.09

30

4.000 1.0 R

30
30

4.000 1.0 R
6.000 1.0 R

234.06
234.06
351.09

20 231.200 1.0 R 2 155.40

20 231.200 1.0 R 2 155.40
20 203.200 1.0 R 1 894.35
20
9.000 1.0 R
83.89

30

6.000 1.0 R

30

6.000 1.0 R

351.09
351.09
-

20 127.000 1.0 R 1 183.95

20 52.180 1.0 R
486.46
20 10.000 1.0 R
93.27
20 150.000 1.0 R 1 398.51

20 120.000 1.0 R 1 118.69

20 52.180 1.0 R
486.46
20 10.000 1.0 R
93.27
20 120.000 1.0 R 1 118.69

30

6.000 1.0 R
4.000 1.0 R
6.000 1.0 R

351.09
234.06
351.09

30
30

20 40.000 1.0
20 96.900 1.0
20 53.000 1.0
20 150.000 1.0
20 116.300 1.0

20 40.000 1.0
20 96.900 1.0
20 53.000 1.0
20 120.000 1.0
20 116.300 1.0

30
30
30
30

4.000
4.000
6.000
4.000

234.06
234.06
351.09
234.06

892.25
647.93
93.27
482.94
1 118.69
1 566.28
232.16
186.40
93.27
1 118.69
1 305.24
1 118.69
1 379.74
978.93

30
30

6.000 1.0 R
4.000 1.0 R

30
30
30
30
30
30
30
30
30

4.000
4.000
4.000
5.000
4.000
4.000
4.000
4.000
4.000

30
30
30

4.000 1.0 R
6.000 1.0 R
4.000 1.0 R

20 212.800 1.0 R 1 983.96

20 120.000 1.0 R 1 118.69
20 120.000 1.0 R 1 118.69
20 47.000 1.0 R
438.21
20 47.000 1.0 R
438.21
20 27.300 1.0 R
254.45
20 12.000 1.0 R
111.90
20 15.000 1.0 R
139.91
20 20.400 1.0 R
190.21
20 120.000 1.0 R 1 118.69
-

30
30
30

6.000 1.0 R
4.000 1.0 R
4.000 1.0 R

30
30
30
30

4.000
4.000
4.000
4.000

30
30

4.000 1.0 R
4.000 1.0 R

0.0
1.0 R
93.27
1.0 R
242.42
1.0 R 1 398.51

R
372.95
R
903.40
R
494.08
R 1 398.51
R 1 084.23

2004.00
2004.00

20
20

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20
20

2004.00
2004.00
2004.00

20 132.000 1.0 R
20 185.000 1.0 R
20 105.000 1.0 R

2004.00
2004.00
2004.00

20 266.000 1.0 R 2 479.95

20 132.000 1.0 R 1 230.59
20 142.400 1.0 R 1 327.53
20 47.000 1.0 R
438.21
20 47.000 1.0 R
438.21
20 27.300 1.0 R
254.45
20 12.000 1.0 R
111.90
20 15.000 1.0 R
139.91
20 20.400 1.0 R
190.21
20 128.700 1.0 R 1 199.79
20 25.000 1.0 R
233.04

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

Page 53 of 84

95.700 1.0 R
69.500 1.0 R
10.000
51.800
132.000
210.000
24.900
20.000
10.000
132.000
175.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

892.25
647.93
93.27
482.94
1 230.59
1 957.86
232.16
186.40
93.27
1 230.59
1 631.55
1 230.59
1 724.67
978.93

20
20 10.000
20 26.000
20 120.000

20
20
20
20
20
20
20
20
20
20
20

0.0
1.0 R
93.27
1.0 R
242.42
1.0 R 1 118.69

R
372.95
R
903.40
R
494.08
R 1 118.69
R 1 084.23

95.700 1.0 R
69.500 1.0 R
10.000
51.800
120.000
168.000
24.900
20.000
10.000
120.000
140.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

20 120.000 1.0 R
20 148.000 1.0 R
20 105.000 1.0 R

1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0

R
R
R
R

R
R
R
R
R
R
R
R
R

R
R
R
R

T
T

T
T

T
T
T
T

351.09
234.06
234.06
234.06
234.06
292.58
234.06
234.06
234.06
234.06
234.06
234.06
351.09
234.06

T
T

351.09
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
-

T
T
T

T
T
T
T
T
T
T
T
T
T
T
T

T
T
T
T
T
T

3175 Botulinus toxin injection in extra-ocular muscles (+ item 0198 + item 0201+ item 0202)
3176 Lid operation for facial nerve paralysis including tarsorrhaphy but excluding cost of material
16.12.1Lids: Entropion or ectropion by
3177 Entropion or ectropion by Cautery
3179 Entropion or ectropion by Suture
3181 Entropion or ectropion by Open operation
3183 Entropion or ectropion by Free skin, mucosal grafting or flap
16.12.2Lids: Reconstruction of eyelid
3185 Staged procedure for partial or total loss of eyelid: First stage
3187 Staged procedure for partial or total loss of eyelid: Subsequent stage
3189 Full thickness eyelid laceration for tumour or injury: Direct repair
3191 Blepharoplasty: Upper lid for improvement in function (unilateral)
3172 Blepharoplasty lower eyelid plus fat pad
16.12.3Lids: Ptosis
3193 Repair by superior rectus, levator or frontalis muscle operation
3195 Ptosis: By lesser procedure e.g. sling operation: Unilateral
3197 Ptosis: By lesser procedure e.g. sling operation: Bilateral
16.13 Conjunctiva
3199 Repair of conjunctiva by grafting
3200 Repair of lacerated conjunctiva
16.14 Eye: General
OWN EQUIPMENT USED IN TREATMENT:
Only the owner of the equipment may charge hire fees for equipment used and not the person using
the equipment.
3190 Holmium laser apparatus (ophthalmic): Hire fee for one or both eyes done in one sitting
3192 Applicable to Medical Scheme Benefits only: Item 3192: If a practitioner performs the procedure in
his own facility an excimer laser theatre fee of R15,00 per minute may be charged

2004.00
2004.00

Diamond knife: Use of own diamond knife during intraocular surgery

Excimer laser: Hire fee (per eye)
Laser apparatus (ophthalmic): Hire fee for one or both eyes done in one sitting (Not to be used with
IOL Master)
Phako emulsification apparatus: Hire fee
Vitrectomy apparatus: Hire fee
Ear
External ear (Pinna)
Major congenital deformity reconstruction of external ear: Unilateral
Major congenital deformity reconstruction of external ear: Bilateral
Excision of superficial pre-auricular fistula
Partial or total reconstruction for congenital or traumatic absence or following tumour excision of
external ear
Excision of complicated pre-auricular fistula
External ear canal
External ear canal: Removal of foreign body: At rooms
External ear canal: Removal of foreign body: Under general anaesthetic
Meatus atresia: Repair of stenosis of cartilaginous portion
Meatus atresia: Congenital
Meatus atresia: Removal of osteoma from meatus: Solitary
Meatus atresia: Removal of osteoma from meatus: Multiple
Middle ear
Microscopic examination of tympanic membrane including microsuction
Myringotomy: Unilateral
Myringotomy: Bilateral
Unilateral myringotomy with insertion of ventilation tube
Bilateral myringotomy with insertion of unilateral ventilation tube
Bilateral myringotomy with insertion of bilateral ventilation tube (modifier 0005 not applicable)
Reconstruction of middle ear ossicles (ossiculoplasty)
Exploratory tympanotomy
Myringoplasty
Functional reconstruction of tympanic membrane
Stapedotomy and stapedectomy
Cortical mastoidectomy
Radical mastoidectomy (excluding minor procedures)

3196
3198
3201
3202
3203
17
17.1
3267
3269
3270
3271
3272
17.2
3204
3205
3215
3217
3219
3221
17.3
3206
3207
3209
3211
3212
3213
3214
3237
3243
3245
3249
3257
3259

2004.00

20 35.000 1.0 R
326.31
20 187.000 1.0 R 1 743.44
20 10.000 1.0 R
93.27
20 49.400 1.0 R
460.50
20 111.500 1.0 R 1 039.50
20 122.600 1.0 R 1 143.04
20 259.000 1.0 R 2 414.69
20 206.000 1.0 R 1 920.46
20 136.500 1.0 R 1 272.53
20 150.200 1.0 R 1 400.27
20 125.800 1.0 R 1 172.81
20 190.000 1.0 R 1 771.31
20 137.600 1.0 R 1 282.80
20 166.000 1.0 R 1 547.66
20 132.000 1.0 R 1 230.59
20 47.000 1.0 R
438.21
-

20 149.600 1.0 R 1 394.70

20 10.000 1.0 R
93.27
20 49.400 1.0 R
460.50
20 111.500 1.0 R 1 039.50
20 122.600 1.0 R 1 143.04
20 207.200 1.0 R 1 931.75
20 164.800 1.0 R 1 536.37
20 120.000 1.0 R 1 118.69
20 120.160 1.0 R 1 120.30
20 120.000 1.0 R 1 118.69
20 152.000 1.0 R 1 417.14
20 120.000 1.0 R 1 118.69
20 132.800 1.0 R 1 238.07
20 120.000 1.0 R 1 118.69
20 47.000 1.0 R
438.21
-

2004.00
2004.00

20 109.000 1.0 R 1 016.18

-

2004.00
2004.00
2004.00

20 12.000 1.0 R
111.90
20 284.130 1.0 R 2 648.90
20 109.000 1.0 R 1 016.18

2004.00
2004.00

20 109.000 1.0 R 1 016.18

20 120.000 1.0 R 1 118.69
20 138.000 1.0 R 1 286.61
20 242.000 1.0 R 2 256.15
20 55.000 1.0 R
512.71
20
- 0.0
-

20 120.000 1.0 R 1 118.69

20 193.600 1.0 R 1 804.89
20 55.000 1.0 R
512.71
-

292.58
292.58
234.06
-

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20 140.000 1.0 R 1 305.24

20
- 0.0
20 21.000 1.0 R
195.79
20 164.000 1.0 R 1 528.89
20 277.000 1.0 R 2 582.46
20 77.000 1.0 R
717.88
20 215.000 1.0 R 2 004.49
20
8.000 1.0 R
74.65
20 28.000 1.0 R
261.05
20 46.000 1.0 R
428.82
20 38.000 1.0 R
354.32
20 57.000 1.0 R
531.33
20 65.000 1.0 R
605.98
20 255.000 1.0 R 2 377.29
20 158.900 1.0 R 1 481.37
20 138.000 1.0 R 1 286.61
20 277.000 1.0 R 2 582.46
20 277.000 1.0 R 2 582.46
20 188.500 1.0 R 1 757.38
20 277.400 1.0 R 2 586.13

Page 54 of 84

20 120.000 1.0 R 1 118.69

20
- 0.0
20 21.000 1.0 R
195.79
20 131.200 1.0 R 1 223.11
20 221.600 1.0 R 2 065.94
20 77.000 1.0 R
717.88
20 172.000 1.0 R 1 603.53
20
8.000 1.0 R
74.65
20 28.000 1.0 R
261.05
20 46.000 1.0 R
428.82
20 38.000 1.0 R
354.32
20 57.000 1.0 R
531.33
20 65.000 1.0 R
605.98
20 204.000 1.0 R 1 901.83
20 127.120 1.0 R 1 185.13
20 120.000 1.0 R 1 118.69
20 221.600 1.0 R 2 065.94
20 221.600 1.0 R 2 065.94
20 150.800 1.0 R 1 405.84
20 221.920 1.0 R 2 068.87

30

4.000 1.0 R

30
30
30
30

4.000
4.000
4.000
4.000

1.0
1.0
1.0
1.0

R
R
R
R

30
30
30
30
30

4.000
4.000
4.000
4.000
4.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

30
30
30

4.000 1.0 R
4.000 1.0 R
4.000 1.0 R

30
30

4.000 1.0 R
4.000 1.0 R

30
30
30

5.000 1.0 R
5.000 1.0 R
4.000 1.0 R

30

4.000 1.0 R

30
30
30
30
30

4.000
4.000
4.000
4.000
4.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

30
30
30
30
30
30
30
30
30
30
30
30

4.000
4.000
4.000
4.000
4.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R

234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
-

234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
292.58
292.58
292.58
292.58
292.58
292.58
292.58

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

T
T
T

T
T
T
T
T

T
T
T
T
T
T
T
T
T
T
T
T

Muscle grafting to mastoid cavity without tympanoplasty

Autogenous bone graft to mastoid cavity
Tympanomastoidectomy
Reconstruction of posterior canal wall, following radical mastoid
Gentamycin steroids instillation into the middle ear for Mnire's disease (myringotomy and cost of
material excluded)
17.4 Facial nerve
17.4.1 Facial nerve: Facial nerve tests
3223 Percutaneous stimulation of the facial nerve
3224 Electroneurography (ENOG)
17.4.2 Facial nerve: Facial nerve surgery
3227 Exploration of facial nerve: Exploration of tympanomastiod segment
3228 Exploration of facial nerve: Grafting of the tympanomastoid section (including item 3227)
3230 Exploration of facial nerve: Extratemporal grafting of the facial nerve
3232 Exploration of facial nerve: Facio-assessory or facio-hypoglossal anastomosis
17.5 Inner ear
17.5.1 Inner ear: Audiometry
2691 Short latency brainstem evoked potentials (AEP) neurological examination, single decibel: Unilateral
3261
3263
3264
3265
3266

2692

Short latency brainstem evoked potentials (AEP) neurological examination, single decibel: Bilateral

AEP: Audiological examination: Unilateral at a minimum of 4 decibels

AEP: Audiological examination: Bilateral at a minimum of 4 decibels
Audiology 40Hz response: Unilateral
Audiology 40Hz response: Bilateral
Mid- and long latency auditory evoked potentials: Unilateral
Mid- and long latency auditory evoked potentials: Bilateral
Electro-cochleography: Unilateral
Electro-cochleography: Bilateral
Total fee for audiological evaluation including bilateral AEP and bilateral electro-cochleography
Otoacoustic emission performed as a screening test
Otoacoustic emission (high risk patients only)
Pure tone audiometry (air conduction)
Pure tone audiometry (bone conduction with masking)
Impedance audiometry (tympanometry)
Impedance audiometry (stapedial reflex) - no charge for volume, compliance etc.
Speech audiometry: Fee includes speech audiogram, speech reception threshold, discrimination
score
3278 Recruitment tests: Inclusive fee (Bekesy, Fowler, etc.)
17.5.2 Inner ear: Balance tests
3251 Minimal caloric test (excluding consultation fee)
3252 Bithermal Halpike caloric test (excluding consultation fee)
3253 Electro-nystagmography for spontaneous and positional nystagmus
3254 Video nystagmoscopy (monocular)
3255 Caloric test done with electronystamography
3256 Video nystagmoscopy (binocular)
3258 Otolith repositioning manoeuvre
3260 Computerised static posturography consists of standing a patient on a Piezo-electric platform which
tests the vestibular and proprioceptive systems
17.5.3 Inner ear surgery
3233 Labyrinthectomy via the middle ear or mastoid
3240 Endolymphatic sac surgery
3244 Fenestration and occulasion of the posterior semicircular canal (FOS) for benign paroxysmal
positioning vertigo (BPPV)
3246 Cochlear implant surgery
17.6 Microsurgery of the skull base
17.6.1 Microsurgery of the skull base: Middel fossa approach (i.e transtemporal or supralabyrinthine)
3229 Facial nerve: Exploration of the labyrinthine segment
5221 Facial nerve: Grafting of labyrinthine segment (graft removal and exploration of labyrinthine segment
are included)
5222 Facial nerve surgery inside the internal auditory canal (if grafting is required, the grafting and
harvesting of graft are included)
5223 Vestibular neurectomy, removal of supra-labyrinthine tumours, or similar procedures
2693
2694
2695
2696
2697
2698
2699
2700
2702
3248
3250
3273
3274
3275
3276
3277

2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20

180.000
180.000
375.000
320.000
30.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

1 678.18
1 678.18
3 496.13
2 983.27
279.67

20
20
20
20
20

144.000
144.000
300.000
256.000
30.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

1 342.49
1 342.49
2 796.87
2 386.68
279.67

30
30
30
30
30

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

292.58
292.58
292.58
292.58
292.58

2004.00
2004.00

20
20

2004.00
2004.00
2004.00
2004.00

20
20
20
20

2004.00

20

50.000 1.0 R

83.89
699.26
2 768.86
4 064.86
4 064.86
1 156.09
466.22

2004.00

20

88.000 1.0 R

820.39

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2005.03
2004.00
2004.00
2004.00
2004.00
2004.00
2006.04

20 60.000 1.0 R
559.35
20 105.000 1.0 R
978.93
20 30.000 1.0 R
279.67
20 53.000 1.0 R
494.08
20 30.000 1.0 R
279.67
20 53.000 1.0 R
494.08
20 50.000 1.0 R
466.22
20 88.000 1.0 R
820.39
20 140.000 1.0 R 1 305.24
20 33.240 1.0 R
309.88
20 66.480 1.0 R
619.77
20
6.500 1.0 R
60.57
20
6.500 1.0 R
60.57
20
6.500 1.0 R
60.57
20
6.500 1.0 R
60.57
20 10.000 1.0 R
93.27

309.88
619.77
60.57
60.57
60.57
60.57
93.27

234.06
-

2004.00

20

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

20
20
20
20
20
20
20
20

2004.00
2004.00
2004.00

20 277.000 1.0 R 2 582.46

20 277.000 1.0 R 2 582.46
20 310.000 1.0 R 2 890.15

20 221.600 1.0 R 2 065.94

20 221.600 1.0 R 2 065.94
20 248.000 1.0 R 2 312.03

2004.00
2006.04

20 340.500 1.0 R 3 174.51

20 420.000 1.0 R 3 915.56
20 510.000 1.0 R 4 754.73

2006.04
2004.00

2004.00

9.000 1.0 R
75.000 1.0 R
297.000
436.000
436.000
124.000

1.0
1.0
1.0
1.0

R
R
R
R

6.500 1.0 R
10.000
20.000
25.000
25.000
70.000
50.000
14.000
71.480

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

60.57
93.27
186.40
233.04
233.04
652.62
466.22
130.52
666.40

20
20
20
20
20
20

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

9.000 1.0 R
75.000 1.0 R
237.600
348.800
348.800
120.000

33.240
66.480
6.500
6.500
6.500
6.500
10.000

1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R

R
R
R
R
R
R
R

6.500 1.0 R
10.000
20.000
25.000
25.000
70.000
50.000
14.000
71.480

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

83.89
699.26
2 215.09
3 251.80
3 251.80
1 118.69
-

5.000
5.000
5.000
5.000
5.000

60.57
93.27
186.40
233.04
233.04
652.62
466.22
130.52
666.40

30
30

4.000 1.0 R
4.000 1.0 R

30
30
30
30

5.000
5.000
5.000
6.000

30

1.0
1.0
1.0
1.0

R
R
R
R

4.000 1.0 R

30

4.000 1.0 R

30
30
30

5.000 1.0 R
4.000 1.0 R
5.000 1.0 R

20 272.400 1.0 R 2 539.49

20 336.000 1.0 R 3 132.57
20 408.000 1.0 R 3 803.81

30

5.000 1.0 R

30
30

20 620.000 1.0 R 5 780.15

20 496.000 1.0 R 4 624.21

20 530.000 1.0 R 4 941.13

20 424.000 1.0 R 3 952.96

Page 55 of 84

234.06
234.06
292.58
292.58
292.58
351.09
-

234.06
292.58
234.06
292.58

T
T
T
T
T

T
T
T
T
T
T

T
T
T
T

5.000 1.0 R
11.000 1.0 R

292.58
292.58
643.53

30

11.000 1.0 R

643.53

30

11.000 1.0 R

643.53

T
T

Removal of acoustic neuroma via the middle fossa approach

Microsurgery of the skull base: Translabyrinthe approach
Acoustic neuroma removal translabyrinthine
Cochleo-vestibular neurectomy
Facial nerve surgery in the internal auditory canal, translabyrinthine (if grafting is required, the
grafting and harvesting of graft are included)
Microsurgery of the skull base: Transotic approach to the cerebellopontime angle
Removal of acoustic neuroma or cyst of the internal auditory canal
Microsurgery of the skull base: Intratemporal fossa approach type A
Removal of tumour for the jugular foramen, internal carotid artery, petrous apex and large
intratemporal tumours
Microsurgery of the skull base: Intratemporal fossa approach type B
Removal of tumour of the petrous apex
Removal of tumour of the clivus
Microsurgery of the skull base: Intrafemoral approach type C
Removal of nasopharyngeal angiofibroma or carcinoma
Removal of tumour from the intratemporal fossa, pterygopalatine fossa, parasellar region or
nasopharynx
Microsurgery of the skull base: Subtotal petrosectomy
Subtotal petrosectomy for removal of temporal bone tumour
Subtotal petrosectomy for CSF leak and/or for total obliteration of the mastoid cavity
Microsurgery of the skull base: Petrosectomy and radical dissection of petromandibular fossa
Partial mastoido-tympanectomy for malignancy of the deep lobe of the parotid gland
Total mastoido-tympanectomy for more extensive malignancy of the deep lobe of the parotid gland

2004.00

Extended petrosectomy for extensive malignancy of the deep lobe of the parotid gland
Physical Treatment
Domiciliary or nursing home treatment (only applicable where a patient is physically incapable of
attending the rooms, and the equipment has to be transported to the patient)
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
3288 Epidural 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 (neck) nerve block (for pelvis refer to item 2389)
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 anaesthesia
3299a Manipulation of large joints: Under general anaesthesia
3300 Manipulation of large joints: Without anaesthetic
3301 Muscle fatigue studies
3302 Strength duration curve per session
3303 Electromyography
3304 All other physical treatments carried out: 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)
SPECIAL MODIFIER: SECTION ON PHYSICAL TREATMENT
0077 Physical treatment: When two separate areas are treated simultaneously for totally different
conditions, such treatment shall be regarded as two treatments for which separate fees may be
charged. (Only applicable if services are provided by a specialist in physical medicine)
Radiology
19
Please note: The calculated amounts in this section (except for sections 19.9 and 19.11) are
calculated according to the radiology unit values
RULES GOVERNING THE SECTION RADIOLOGY

2004.00

5224
17.6.2
3239
5227
5229
17.6.3
5232
17.6.4
5235
17.6.5
5238
5239
17.6.6
5242
5243
17.6.7
5246
5247
17.6.8
5250
5251
5252
18
3279

2004.00
2004.00
2006.04

2004.00
2004.00

2004.00
2004.00
2004.00
2004.00

2004.00
2004.00
2004.00
2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2006.05
2004.00
2004.00
2004.00
2004.00
2004.00
2005.01
2004.00
2004.00
2004.00
2004.00
2004.00

20 660.000 1.0 R 6 153.09

20 660.000 1.0 R 6 153.09
20 530.000 1.0 R 4 941.13
20 660.000 1.0 R 6 153.09

20 528.000 1.0 R 4 922.50

20 528.000 1.0 R 4 922.50
20 424.000 1.0 R 3 952.96
20 528.000 1.0 R 4 922.50

20 660.000 1.0 R 6 153.09

20 710.000 1.0 R 6 619.31

20 528.000 1.0 R 4 922.50

20 568.000 1.0 R 5 295.45

20 620.000 1.0 R 5 780.15

20 620.000 1.0 R 5 780.15
20 520.000 1.0 R 4 847.86
20 520.000 1.0 R 4 847.86

20 496.000 1.0 R 4 624.21

20 496.000 1.0 R 4 624.21
20 416.000 1.0 R 3 878.31
20 416.000 1.0 R 3 878.31

20 600.000 1.0 R 5 593.75

20 480.000 1.0 R 4 475.06
20 520.000 1.0 R 4 847.86
20 600.000 1.0 R 5 593.75

20 480.000 1.0 R 4 475.06

20 384.000 1.0 R 3 580.02
20 416.000 1.0 R 3 878.31
20 480.000 1.0 R 4 475.06

20 660.000 1.0 R 6 153.09

20
0.750 1.0 R
7.00

20 528.000 1.0 R 4 922.50

-

20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

13.500
10.000
10.000
31.000
26.000
20.000
36.000
7.500
4.500
9.000
9.000
9.000
20.000
20.000
30.000
14.000
6.000
14.000
14.000
20.000
10.500
75.000
10.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
0.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

125.83
93.27
93.27
289.06
242.42
186.40
335.70
69.95
41.94
83.89
83.89
83.89
186.40
186.40
279.67
130.52
55.88
130.52
130.52
186.40
97.82
699.26
93.27

20

20

20

20.000 1.0 R

- 0.0

10.000 1.0 R

186.40
93.27

30

11.000 1.0 R

30
30
30

5.000 1.0 R
11.000 1.0 R
11.000 1.0 R

30

11.000 1.0 R

30

11.000 1.0 R

30
30

11.000 1.0 R
11.000 1.0 R

30
30

8.000 1.0 R
11.000 1.0 R

30
30

11.000 1.0 R
11.000 1.0 R

30
30

11.000 1.0 R
8.000 1.0 R

30

8.000 1.0 R

30
30
F

3.000 1.0 R
4.000 1.0 R

643.53
292.58
643.53
643.53
643.53
643.53
643.53
643.53
468.13
643.53
643.53
643.53
643.53
468.13
468.13
175.55
234.06
-

2004.00

2004.00

Page 56 of 84

T
T
T
T

T
T

T
T
T
T

T
T
T
T
T

T
T

Y.

Except where otherwise indicated, radiologists are entitled to charge for contrast material used

2004.00

Z.
GG.

No fee is subject to more than one reduction

Capturing and recording of examinations: Images from all radiological, ultrasound and magnetic
resonance imaging procedures must be captured during every examination and a permanent record
generated by means of film, paper, or magnetic media. A report of the examination, including the
findings and diagnostic comment, must be written and stored for five years
The radiology section in this price list is not for use by registered specialist radiology practices (Pr No
"038") or nuclear medicine practices (Pr No "025"), but only for use by other specialist practices or
general practitioners.
A separate radiology schedule is for the exclusive use of registered specialist radiology practices (Pr
No "038") and nuclear medicine practices (Pr No "025").
MODIFIERS GOVERNING THE SECTION
Written report on X-rays: The lowest level code for a new patient office (consulting rooms) visit, is
applicable only where a radiologist is requested to give a written report on X-rays taken elsewhere
and submitted to him. The above mentioned item and the lowest level initial hospital visit code, as
appropriate are not to be used for routine reporting of X-rays taken elsewhere

2004.00
2004.00

2004.00

2004.00

Multiple examinations: Full Fee

Repeat examinations: No reduction
+ Means that this item is complementary to a preceding item and is therefore not subject to
reduction
A reduction of 33,33% (1/3) in the fee will apply to radiological examinations as indicated in section
19: Radiology where hospital equipment is used
Film costs: In the case of radiological items where films are used, practitioners should adjust the fee
upwards or downwards in accordance with changes in the price of films in comparison with
November 1979; the calculation must be done on the basis that film costs comprise 10% of the
monetary value of the unit (This information is obtainable from the Radiological Society of SA)

2004.00
2004.00
2004.00

2004.00

2004.00

83.15
511.10
101.63
204.73
262.81
369.72
203.41
182.29
101.63
101.63
101.63
101.63
101.63
101.63
101.63
101.63
101.63
101.63
101.63
101.63
101.63
101.63
101.63
101.63
101.63
101.63
101.63
145.34
145.34
277.33
145.34

RR.

0002

0080
0081
0082
0083
0084

19.1
19.1.1
3305
3309
3311
3313
3315
3317
3319
3320
6500
6501
6503
6504
6505
6506
6507
6508
6509
6510
6511
6512
6513
6514
6515
6516
6517
6518
6519
19.1.2
3321
3325
3329
3331

Skeleton
Skeleton: Limbs
Finger, toe
Smith-Petersen or equivalent control, in theatre
Stress studies, e.g, joint
Full length study, both legs
Skeletal survey under 5 years
Skeletal survey over 5 years
Arthrography per joint
Introduction of contrast medium or air: ADD
Hand
Wrist (specify region)
Scaphoid
Radius and ulna
Elbow
Humerus
Shoulder
Acromio-Clavicula joint
Clavicle
Scapula
Foot
Ankle
Calcaneus
Tibia and fibula
Knee
Patella
Femur
Hip
Sesamoid Bone
Skeleton: Spinal column
Per region, e.g. cervical, sacral, lumbar coccygeal, one region thoracic
Stress studies
Scoliosis studies
Pelvis (Sacro-iliac or hip joints only to be added where an extra set of view is required)

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

2004.00
2004.00
2004.00
2004.00

Page 57 of 84

40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40

6.300
38.700
7.700
15.500
19.900
28.000
15.400
13.800
7.700
7.700
7.700
7.700
7.700
7.700
7.700
7.700
7.700
7.700
7.700
7.700
7.700
7.700
7.700
7.700
7.700
7.700
7.700

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

40
40
40
40

11.000
11.000
21.000
11.000

1.0
1.0
1.0
1.0

R
R
R
R

Myelography: Lumbar
Myelography: Thoracic
Myelography: Cervical
Multiple (lumbar, thoracic, cervical): Same fee as for first segment (no additional introduction of
contrast medium)
3344 Introduction of contrast medium
3345 Discography
3347 Introduction of contrast medium per disc level: ADD
19.1.3 Skeleton: Skull
3349 Skull studies
3351 Paranasal sinuses
3353 Facial bones and/or orbits
3355 Mandible
3357 Nasal bone
3359 Mastoid: Bilateral
3361 Teeth: One quadrant
3363 Teeth: Two quadrants
3365 Teeth: Full mouth
3366 Teeth: Rotation tomography of the teeth and jaws
3367 Teeth: Tempero-mandibular joints: Per side
3369 Teeth: Tomography: Per side
3371 Localisation of foreign body in the eye
3381 Ventriculography
3385 Post-nasal studies: Lateral neck
3387 Maxillo-facial cephalometry
3389 Dacrocystography
3391 For introduction of contrast medium: ADD
19.2 Alimentary tract
3393 Bowel washout: ADD
3395 Sialography (plus 80% for each additional gland)
3397 Introduction of contrast medium (plus 80% for each additional gland: ADD)
3399 Pharynx and oesophagus
3403 Oesophagus, stomach and duodenum (control film of abdomen included) and limited follow through
3333
3334
3335
3336

3405
3406
3408
3409
3411
3415
3416
3417
3419
3421
3423
19.3
3425
3427
3431
3433
3435
3437
3439
3441
19.4
3443
3445
3447
3449
3451

Double contrast: ADD

Small bowel meal (control film of abdomen included except when part of item 3408)
Barium meal and dedicated gastro-intestinal tract follow through (including control film of the
abdomen, oesophagus, duodenum, small bowel and colon)
Barium enema (control film of abdomen included)
Air contrast study: ADD
Biliary Tract: ERCP own equipment: Choledogram and/or pancreatography screening included
Pancreas: ERCP hospital equipment: Choledogram and/or pancreatography screening included
Note: For items 3415 and 3416: Endoscopy (see item 1778)
Gastric/oesophageal/duodenal intubation control
Gastric/oesophageal intubation insertion of tube: ADD
Duodenal intubation: Insertion of tube: ADD
Hypotonic duodenography (item 3403 and item 3405 included)
Biliary tract
Oral cholecystography
Cholangiography: Intravenous
Operative cholangiography: First series: ADD item 3607 only when the Radiologist attends
personally in theatre
Post operative: T-tube
Introduction of contrast medium: ADD
Trans hepatic, percutaneous
Introduction of contrast medium: ADD
Tomography of biliary tract: ADD
Chest
Larynx (Tomography included)
Chest (item 3601 included)
Chest and cardiac studies (item 3601)
Ribs
Sternum or sterno-clavicular joints

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

+
+

2004.00
2004.00
2004.00
2004.00
2004.00

2004.00
2004.00
2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

+
+
+

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

+
+
+

2004.00
2004.00
2004.00
2004.00
2004.00

Page 58 of 84

40
40
40

28.900 1.0 R
22.200 1.0 R
35.500 1.0 R

381.60
293.17
468.86
-

40
40
40

18.700 1.0 R
34.600 1.0 R
28.200 1.0 R

40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40

15.700
11.000
12.600
9.400
7.800
18.000
3.700
6.300
11.000
13.300
11.000
11.000
15.700
27.300
6.300
8.800
11.000
11.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

40
40
40
40
40

4.800
12.700
11.000
12.700
20.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

246.97
456.98
372.36
207.37
145.34
166.45
124.07
102.95
237.73
48.84
83.15
145.34
175.69
145.34
145.34
207.37
360.48
83.15
116.15
145.34
145.34
63.36
167.77
145.34
167.77
264.13

40
40
40

7.300 1.0 R
20.000 1.0 R
28.900 1.0 R

96.35
264.13
381.60

40
40
40
40

18.300
19.300
23.300
15.500

1.0
1.0
1.0
1.0

R
R
R
R

40
40
40
40

5.900
5.600
11.000
29.300

1.0
1.0
1.0
1.0

R
R
R
R

40
40
40

15.700 1.0 R
22.000 1.0 R
21.000 1.0 R

241.69
254.89
307.68
204.73
77.87
73.91
145.34
386.88
207.37
290.53
277.33

234.06
234.06
-

40
40
40
40
40

16.700
5.600
18.300
33.100
9.400

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

40
40
40
40
40

12.500
9.400
12.600
12.300
12.600

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

220.57
73.91
241.69
437.18
124.07
165.13
124.07
166.45
162.49
166.45

30
30
30
30

4.000
4.000
4.000
4.000

30

4.000 1.0 R

30

4.000 1.0 R

30

4.000 1.0 R

30

4.000 1.0 R

30
30

1.0
1.0
1.0
1.0

R
R
R
R

4.000 1.0 R
4.000 1.0 R

234.06
234.06
234.06
234.06
234.06
234.06
234.06
234.06
-

T
T
T
T

T
T

3453
3455
3457
3461
3463
3465
3467
3468
19.5
3477
3479
19.6
3487
3493
3497
3499
3503
3505
3511
3513
19.7
3515
3517
3519
3521
19.8

Bronchography: Unilateral
Bronchography: Bilateral
Introduction of contrast medium included
Pleurography
For introduction of contrast medium: ADD
Laryngography
For introduction of contrast medium: ADD
Thoracic inlet
Abdomen
Control films of the Abdomen (not being part of examination for barium meal, barium enema,
pyelogram, cholecystogram, cholangiogram etc.)
Acute abdomen or equivalent studies
Urinary tract
Excretory urogram: Control film included and bladder views before and after micturition (intravenous
pyelogram) (item 0206 not applicable)
Waterload test: ADD
Cystography only or urethrography only (retrograde)
Cysto-urethrography: Retrograde
Cysto-urethrography: Introduction of contrast medium
Retrograde-prograde pyelography
Aspiration renal cyst
Tomography of renal tract: ADD
Gynaecology and obstetrics
Pregnancy
Pelvimetry
Hystero-salpingography
Introduction of contrast medium: ADD
Vascular studies
The following rules are applicable to Section 19.8 (Vascular studies) and Section 19.14
(Interventional Radiological Procedures):

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

40
40
40
40
40
40
40
40
40

9.400 1.0 R

40

15.700 1.0 R

40

25.100 1.0 R

40
40
40
40
40
40
40

12.200
19.300
31.900
3.700
18.300
18.400
9.400

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

40
40
40
40

9.400
17.400
12.500
15.300

1.0
1.0
1.0
1.0

R
R
R
R

2004.00

2004.00

2004.00

2004.00

2004.00

+
+

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

12.600
22.100
35.700
12.600
2.800
11.000
10.000
6.300

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

166.45
291.85
471.50
166.45
36.96
145.34
132.14
83.15
124.07

30
30

8.000 1.0 R
8.000 1.0 R

30

3.000 1.0 R

468.13
468.13
175.55
-

207.37
331.44

161.17
254.89
421.34
48.84
241.69
243.01
124.07
124.07
229.81
165.13
202.09
-

175.55
175.55
-

30

3.000 1.0 R

30

3.000 1.0 R

a. The machine fee (items 3536 to 3550 includes the cost of the following:
i. All runs (runs may not be billed for separately).
ii. All film costs (modifier 0084 is not applicable).
iii All fluoroscopy (item 3601 does not apply).
iv All minor consumables (defined as any item other than catheters, guidewires, introducer sets,
specialised catheters, balloon catheters, stents, embolic agents, drugs and contrast media).
b. The machine fee (items 3536 to 3550) may only be billed for as a once off fee per case per day
by the owner of the equipment and is only applicable to radiology practices.
c. If a procedure is performed by a non-radiologist together with a radiologist as a team, in a facility
owned by the radiologist, each member of the team will fee at their respective full rates as per
modifiers and the applicable items.
d. If a procedure is performed by a non-radiologists and a radiologist as a team, in a facility not
owned by the radiologist, modifiers 6301 and 6302 applies.
Please note : Modifier 0083 is not applicable to section 19.8 (Vascular Studies) and section 19.14
(Interventional Radiological Procedures)

0086

6300
6301
6302

MODIFIER GOVERNING VASCULAR STUDIES

Vascular groups: Film series and Introduction of Contrast Media are complementary and together
constitute a single examination: neither fee is therefore subject to increase in terms of Modifier 0080:
Multiple examinations
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)
If a procedure is performed by a radiologist in a facility not owned by himself, the fee will be reduced
by 40% (i.e. 60% of the fee will be charged)
When the procedure is performed by a non-radiologist, the fee will be reduced by 40% (i.e. 60% of
the fee will be charged)

Page 59 of 84

T
T
T

When a procedure is performed entirely by a non-radiologist in a facility owned by a radiologist, the 2004.00
radiologist owning the facility may charge 55% of the procedure units used. Modifier 6302 applies to
the non radiologist performing the procedure
6305 When multiple catheterisation procedures are used (items 3557, 3559, 3560, 3562) and an
2004.00
angiogram investigation is performed at each level, the unit value of each such multiple procedure
will be reduced by 20,00 radiological units for each procedure after the initial catheterisation. The
first catheterisation is charged at 100% of the unit value
19.8.1 Vascular studies: Film Series
Note: In the case of selective catheterisation of a branch of the aorta, the fee for catheterisation of 2004.00
the aorta is not added.
3536 Dedicated angiography suite: Analogue monoplane unit. Once off charge per patient by owner of
2004.00
equipment
3537 Dedicated angiography suite: Digital monoplane unit. Once off charge per patient by owner of
2004.00
equipment
3538 Analogue monoplane table with DSA attachment
2004.00
3539 Dedicated angiography suite: Digital bi-plane unit. Once off charge per patient by owner of
2004.00
equipment
3540 Radiography fee for coronary catheterisation laboratory, per radiographer, per half hour or part
2004.00
thereof
3545 Venography: Per limb
2004.00
3548 Analogue monoplane screening table
2004.00
Digital
monoplane
screening
table
3550
2004.00
Lymphangiogram
per
limb
(global
fee)
including
lymphatic
catheterisation
(no
machine
fee
3551
2004.00
applicable)
Catheterisation
aorta
or
vena
cava,
any
level,
any
route,
with
aortogram/cavogram
3557
2004.00
3558 Translumbar aortic puncture, with full study
2004.00
3559 Selective first order catheterisation, arterial or venous, with angiogram/venogram
2004.00
3560 Selective second order catheterisation, arterial or venous, with angiogram/ venogram
2006.04
3562 Selective third order catheterisation, arterial or venous, with angiogram/venogram
2004.00
3564 Direct femoral arterial or venous or jugular venous puncture
2004.00
3566 Guiding catheter placement, any site arterial or venous, for any intracranial procedure or
2004.00
anteriovenous malformation (AVM)
3569 Intravascular pressure studies, arterial or venous, once off per case
2004.00
3570 Microcatheter insertion, any cranial vessel and/or pulmonary vessel, arterial or venous (including
2004.00
guiding catheter placement)
3572 Transcatheter selective blood sampling, arterial or venous
2004.00
3574 Spinal angiogram (global fee) including all selective catheterisations
2004.00
19.8.2 Vascular studies: Introduction of contrast medium
3563 Direct intravenous for limb
2004.00
3575 Cut-downs for venography: ADD
2004.00
19.9 Tomography and cinematography
Please note: The calculated amounts in this section are calculated according to the computed
2004.00
tomography unit values
3577 Tomography (conventional except where otherwise specified): ADD 100% provided that if it is more 2004.00
than one dimension fee shall be charged for the additional investigation at 50% of the tariff with a
maximum of two additional investigations
3579 Tomography (multi-dimensional in motion): ADD 150%
2004.00
3581 Cinematography: For first series: ADD 100%
2004.00
3583 Cinematography: For each series after the first: ADD 80% of the primary fee
2004.00
19.9.1 Tomography and cinematography: Computed Tomography
3592 Where a fully digital C-arm portable x-ray unit, with angiography/interventional capability is used in
2004.00
hospital or theatre, per half hour
3597 Contrast media: General Rule Y applies (Please note: Item 0201 is not applicable for contrast
2004.00
media)
3598 Electron beam computed tomography (EBCT) for assessment of coronary artery calcification
2004.00
(complete fee - no additions)
3599 Electron beam computed tomography (EBCT) of the heart. Total fee for contract examination
2004.00
excluding cost of contrast medium (not to be used for coronary artery calcium assessment or scoring
- see item 3598)
6400 Plus spiral CT
2004.00
6401 Plus 3D reconstruction
2004.00
6402 Plus high resolution study
2004.00
6403 CT limb uncontrasted
2004.00
6303

+
+

217.93
40 166.800 1.0 R 2 202.77

40

16.500 1.0 R

40
40
40
40
40
40
40

48.600
69.600
57.000
65.400
73.200
37.200
85.800

40 19.800 1.0 R
261.49
40 130.800 1.0 R 1 727.46

40 32.400 1.0 R
427.94
40 480.000 1.0 R 6 339.05
40
7.400 1.0 R
97.67
40 11.000 1.0 R
145.34
-

R
641.77
R
919.09
R
752.78
R
863.66
R
966.76
R
491.30
R 1 133.06

30
30
30
30
30

4.000
5.000
4.000
4.000
4.000

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

30

5.000 1.0 R

234.06
292.58
234.06
234.06
234.06
292.58

30

5.000 1.0 R

292.58

30

5.000 1.0 R

292.58
-

70

- 1.0

70

- 1.0

292.58

Page 60 of 84

1.0
1.0
1.0
1.0
1.0
1.0
1.0

30

5.000 1.0 R

T
T
T
T
T
T

6404
6405
6406
6407
6408
6409
6410
6411
6412
6413
6414
6415
6416
6417
6418
6419
6420
6421
6422
6423
6424
6425
6426
6427
6428
6429
6430
6431
6432
6433
6434
6435
6436
6437
6438
6439
6440
6441
6442
6443
6444
6445
6446
6447
6448
6449
6450
6451
6452
6453
6454
6455
6456
6457
6458
6459
6460
6461
6462
6463
6464
6465

CT limb with contrast only

CT limb pre- AND post contrast
CT joint uncontrasted
CT joint with contrast only
CT joint pre AND post contrast
CT brain uncontrasted (including posterior fossa)
CT brain with contrast only (including posterior fossa)
CT brain pre AND post contrast (including posterior fossa)
CT orbits complete study, axial OR coronal, uncontrasted
CT orbits complete study, axial AND coronal, uncontrasted
CT orbits complete study, axial OR coronal pre AND post contrast
CT orbits complete study, axial AND coronal pre AND post contrast
CT paranasal sinuses limited study axial OR coronal
CT paranasal sinuses limited study axial AND coronal
CT paranasal sinuses complete study, axial or coronal, uncontrasted
CT paranasal sinuses complete study, axial AND coronal, uncontrasted
CT paranasal sinuses complete study, axial OR coronal, pre AND post contrast
CT paranasal sinuses complete study, axial AND coronal, pre AND post contrast
CT pituitary fossa, uncontrasted
CT pituitary fossa, pre AND post contrast
CT internal auditory meati, uncontrasted
CT internal audiory meati, pre AND post contrast
CT mastoids
CT ear structures, limited study
CT middle AND inner ear, complete study including reconstructions
CT facial bones
CT neck soft tissue, uncontrasted
CT neck soft tissue with contrast only
CT neck pre AND post contrast
CT cervical spine uncontrasted
CT cervical spine pre AND post contrast
CT cervical spine post myelogram
CT dorsal spine uncontrasted
CT dorsal spine pre AND post contrast
CT dorsal spine post myelogram
CT lumbar spine uncontrasted
CT lumbar spine pre AND post contrast
CT lumbar spine post myelogram
CT pelvimetry (topogram only)
CT chest uncontrasted
CT chest with contrast
CT chest pre AND post contrast
CT chest high resolution lungs, limited study
CT high resolution lungs, complete study
CT abdomen uncontrasted
CT abdomen with contrast
CT abdomen pre AND post contrast
CT abdomen triphasic study
CT pelvis uncontrasted
CT pelvis with contrast
CT pelvis pre AND post contrast
CT abdomen AND pelvis uncontrasted
CT abdomen AND pelvis with contrast
CT abdomen AND pelvis pre AND post contrast
CT chest, abdomen AND pelvis with contrast
CT base of skull to symphysis pubis with contrast
CT for dental implants maxilla OR mandible
CT for dental implants maxilla AND mandible
CT angiography per limited region (including spiral, high resolution, AND all reconstructions)
CT angiography per extensive region (including spiral, high resolution, 3D AND all other
reconstructions)
CT limited study, any region. Region to be identified on the account
CT guidance for aspiration, biopsy or drainage

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000

30
30

2004.00
2004.00

30
30

Page 61 of 84

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

5.000 1.0 R
5.000 1.0 R

292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58

5.000 1.0 R
11.000 1.0 R

292.58
643.53

T
T

T
T

6466
6467
6468
6469
6470
6471
6472
19.10
3594
3600
3601
3602
3603
3604
3605

CT guidance for aspiration at time of CT diagnostic study

CT stereotactic localisation for biopsy
CT for radiotherapy planning (not to be used as an add-on)
Quantitative CT for bone mineral density
Triphasic study of the liver with CT Abdomen and Pelvis pre and post contrast
CT of the chest, triphasic study of the liver, abdomen and pelvis with contrast
Computer Aided Diagnosis for Mammography
Radiology: Miscellaneous
Mammogram of surgically removed breast biopsy specimen
Peripheral bone densitometry utilizing ionizing radiation
Fluoroscopy: Per half hour: ADD (not applicable for items 3445 and 3447)
Where a C-arm portable X-ray unit is used in hospital or theatre: Per half hour: ADD
Sinography
Bone densitometry (to be charged once only for one or more levels done at the same session)
Mammography: Unilateral or bilateral, including ultrasound and doppler ultrasound examination,
where necessary. This item may not be used together with an item from the ultrasound section. Note
that when an ultrasound of the breast is requested without mammography, item 3629 is used

3606
3607

Repeat mammography, unilateral or bilateral, for localisation of tumour

2004.00
Attendance at operation in theatre or at radiological procedure performed by a surgeon or physician 2004.00
in X-ray department (except item 3309): Per half hour: Plus fee or examination performed (Only to
be used by radiological technical staff)
Repeat mammography procedure with minimally invasive breast biopsy, core biopsy or fine needle 2004.00
aspiration biopsy utilising dedicated stereotactic equipment with patient in erect or prone position

3608

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

13.000 1.0 R
171.73
77.000 1.0 R 1 016.91
-

40
40
40
40
40
40

13.000
7.700
10.700
18.400
77.000
33.000

R
R
R
R
R
R

171.73
101.63
141.38
243.01
1 016.91
435.86

40
40

21.000 1.0 R
5.600 1.0 R

277.33
73.91

40

40.000 1.0 R

528.25

40
40
40

11.000 1.0 R
3.300 1.0 R

40

25.000 1.0 R

2004.00

2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

40
+

40

1.0
1.0
1.0
1.0
1.0
1.0

30

11.000 1.0 R

30
30

5.000 1.0 R
5.000 1.0 R

643.53
292.58
292.58
-

30

3.000 1.0 R

175.55

2004.00

2004.00
2004.00

60 30.000 1.0 R
60 110.000 1.0 R

266.62
977.46

60 30.000 1.0 R
60 110.000 1.0 R

266.62
977.46

Ultrasonic bone densitometry

Transvaginal aspiration of ova
Routine obstetric ultrasound at 10 to 20 weeks gestational age preferable at 10 to 14 weeks
gestational age to include nuchal translucency assessment
Contrast media: General Rule Y applies
Routine obstetric ultrasound at 20 to 24 weeks to include detailed anatomical assessment
Pelvic organs ultrasound transabdominal probe (this is a gynaecological ultrasound examination and
may not be used in pregnancy)
Intravascular ultrasound imaging assesses the 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

2004.00
2004.00
2004.00

60 19.000 1.0 R
60 110.000 1.0 R
60 50.000 1.0 R

168.80
977.46
444.37

60 19.000 1.0 R
60 110.000 1.0 R
60 50.000 1.0 R

168.80
977.46
444.37

2004.00
2004.00
2004.00

60
60

50.000 1.0 R
40.000 1.0 R

444.37
355.49

60
60

50.000 1.0 R
40.000 1.0 R

444.37
355.49

2004.00

60

30.000 1.0 R

266.62

60

30.000 1.0 R

266.62

Cardiac examination plus Doppler colour mapping

2004.00
Cardiac examination (MMode)
2004.00
Cardiac examination: 2 Dimensional
2004.00
Cardiac examination + effort
2004.00
Cardiac examinations + contrast
2004.00
Cardiac examinations + doppler
2004.00
Cardiac examination + phonocardiography
2004.00
Ultrasound examination includes whole abdomen and pelvic organs, where pelvic organs are
2004.00
clinically indicated (including liver, gall bladder, spleen, pancreas, abdominal vascular anatomy, paraaortic area, renal tract, pelvic organs)
Renal tract
2004.00
High definition (small parts) scan: Thyroid, breast lump, scrotum, etc.
2004.00

60
60
60
60
60
60
60
60

50.000
25.000
50.000
10.000
10.000
50.000
10.000
60.000

R
R
R
R
R
R
R
R

444.37
222.18
444.37
88.87
88.87
444.37
88.87
533.09

60
60
60
60
60
60
60
60

50.000
25.000
50.000
10.000
10.000
50.000
10.000
60.000

R
R
R
R
R
R
R
R

444.37
222.18
444.37
88.87
88.87
444.37
88.87
533.09

60
60

50.000 1.0 R
50.000 1.0 R

444.37
444.37

60
60

50.000 1.0 R
50.000 1.0 R

444.37
444.37

3612
3614
3615
3616
3617
3618
3619

3620
3621
3622
3623
3624
3625
3626
3627

3628
3629

2004.00
2004.00
2004.00
2004.00

+
+
+

Page 62 of 84

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

- 1.0

145.34
43.56
330.12
-

351.09
-

30

6.000 1.0 R

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

T
T

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 sterile needle markers: ADD
3613 Setting of sterile trays
5029 Mammotome - stereotaxis: Hand held
5034 Fine needle aspiration or biopsy or core biopsy of mamma
19.11 Ultrasound investigations
Please note: The calculated amounts in this section are calculated according to the ultrasound unit
values
Note: See rule GG for requirements for reports and the keeping of records which are also applicable
to ultrasonic investigations.
3596 Intravascular ultrasound per case, arterial or venous, for intervention
3610 Transrectal ultrasonographic prostate volume study for prostate brachytherapy (own equipment)
3609

30

30

5.000 1.0 R

9.000 1.0 R

292.58

526.64

3631
3632
3633
3634
3635
3636
3637
5026
5100
5101
5102
5103
5106

5107
5108
5110
5111

5112

5113
5114

5115
5117
5118

0160
0165
5104
EE.

Ophthalmic examination
Axial length measurement and calculation of intra ocular lens power. Per eye. Not to be used with
item 3034
Neonatal head scan
Peripheral vascular study, B mode only
+ Doppler
Trans-oesophageal echocardiography including passing the device
+ Colour Doppler (may be added onto any other regional exam, but not to be added to items 3605,
5110, 5111, 5112, 5113 or 5114)
Ultrasound guided amniocentesis
Pelvic organs ultrasound: Transvaginal or trans rectal probe
Pleural space ultrasound
Ultrasound of joints (e.g. shoulder, hip, knee), per joint
Ultrasound soft tissue, any region
Obstetric ultrasound before 10 weeks gestational age for complicated pregnancy i.e. suspected
ectopic pregnancy abortion or discrepancy between gestational age and dates. Not to be used for
routine diagnosis of pregnancy
Ultrasound after 24 weeks - motivation required
Second opinion obstetric ultrasound may be charged by practitioners accepted by SASOG or RSSA
(list of names available from SASOG or RSSA)
Carotid ultrasound vascular study: B mode, pulsed and colour Doppler; bilateral study, internal,
external and common carotid flow and anatomy
Full ultrasonic and colour Doppler evaluation of entire extracranial vascular tree: Carotids, vertebral
and subclavian vessels (not to be used together with items 5110, 5112, 5113 or 5114)

2004.00
2004.00

60
60

50.000 1.0 R
50.000 1.0 R

444.37
444.37

60
60

2004.00
2004.00
2004.00
2004.00
2004.00

60 50.000 1.0
60 39.000 1.0
60 39.000 1.0
60 100.000 1.0
60 78.000 1.0

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

60
60
60
60
60
60

39.000
50.000
50.000
50.000
50.000
25.000

444.37
444.37

R
R
R
R
R

444.37
346.55
346.55
888.59
693.10

60 50.000 1.0
60 39.000 1.0
60 39.000 1.0
60 100.000 1.0
60 78.000 1.0

R
R
R
R
R

444.37
346.55
346.55
888.59
693.10

R
R
R
R
R
R

346.55
444.37
444.37
444.37
444.37
222.18

60
60
60
60
60

50.000
50.000
50.000
50.000
25.000

R
R
R
R
R

444.37
444.37
444.37
444.37
222.18

2004.00
2004.00

60
60

25.000 1.0 R
50.000 1.0 R

222.18
444.37

60
60

25.000 1.0 R
50.000 1.0 R

222.18
444.37

2004.00

60 128.000 1.0 R 1 137.46

60 120.000 1.0 R 1 066.33

2004.00

60 206.000 1.0 R 1 830.56

60 164.800 1.0 R 1 464.36

Peripheral arterial ultrasound vascular study: B mode, pulsed and colour Doppler; per limb; to
2004.00
include waveforms at minimum of three levels, pressure studies at two levels and full interpretation
of results
Peripheral venous ultrasound vascular study; B mode, pulsed and colour Doppler; to evaluate deep 2004.00
vein thrombosis
Peripheral venous ultrasound vascular study; B mode, pulsed and colour Doppler; in erect and
2004.00
supine position including compression manoeuvres and reflux in superficial and deep systems,
bilaterally
Intra-operative ultrasound study
2004.00
Diagnostic intravascular ultrasound (IVUS) imaging or wave wire mapping (without accompanying
2004.00
angioplasty). May be used only once per angiographic procedure
Diagnostic intravascular ultrasound imaging or wave wire imaging (with accompanying angioplasty or 2004.00
accompanying intravascular ultrasound imaging or wave wire mapping in a different coronary artery
[LAD (left anterior desending), Circumflex or Right coronary artery]). May be used a maximum of
twice per angiographic procedure
MODIFIERS GOVERNING ULTRASONIC INVESTIGATIONS
Aspiration of biopsy procedure performed under direct ultrasound control by an ultrasound aspiration 2004.00
biopsy transducer (Static Realtime): Fee for part examined plus 30% of the units
Use of contrast during ultrasound study: add 6.00 ultrasound units
2004.00
Ultrasound in pregnancy, multiple gestation, after twenty weeks: plus 30%
2004.00
GENERAL RULE GOVERNING ULTRASONIC EXAMINATIONS DURING PREGNANCY
Ultrasound examinations: The international norm approved for use in South Africa for NORMAL
2004.00
PREGNANCY is two ultrasound exams: (a) The first scan should preferably include a nuchal
thickness estimation and be performed between 10 and 14 weeks gestation. The second scan
should be performed between 20 and 24 weeks and should include a full anatomical report. All
subsequent ultrasound scans are excluded from the benefits of medical schemes unless
accompanied by proper motivation. An ultrasound scan to assess an abnormal early pregnancy may
be formed before 10 weeks but this scan may not be used to diagnose a normal uncomplicated
pregnancy. Item 3618 is a gynaecological scan and its use is not approved for use in pregnancy. (b)
In cases where the scan is performed by the attending practitioner, a clear indication for such a scan
must be entered on the account rendered, or a letter of motivation must be attached to the account
(the practitioner must elect one of the two options). (c) In case of a referral, the referring doctor must
submit a letter of motivation to the radiologist or other practitioner doing the scan. A copy of the
letter of motivation must be attached to the first account rendered to the patient (by the radiologist or
the other practitioner doing the scan) and must be attached to the first account submitted to the
medical scheme by the patient or the doctor, as the case may be. (d) In case of a referral to a
radiologist, no motivation should be required from the radiologist

60 117.000 1.0 R 1 039.64

60 117.000 1.0 R 1 039.64

60 117.000 1.0 R 1 039.64

60 117.000 1.0 R 1 039.64

60 178.000 1.0 R 1 581.68

60 142.400 1.0 R 1 265.35

60
60

50.000 1.0 R
88.000 1.0 R

444.37
781.97

60
60

50.000 1.0 R
88.000 1.0 R

444.37
781.97

60

44.000 1.0 R

390.98

60

44.000 1.0 R

390.98

53.31
-

1.0
1.0
1.0
1.0
1.0
1.0

50.000 1.0 R
50.000 1.0 R

1.0
1.0
1.0
1.0
1.0

60

Page 63 of 84

6.000 1.0 R

53.31
-

60

6.000 1.0 R

30

30

6.000 1.0 R

3.000 1.0 R

351.09
-

175.55
-

19.12
3639
3640
19.13
AA.
3641
3642
3643
3644
3645
3646
6474
6475

Portable unit examinations

Where portable X-ray unit is used in the hospital or theatre: ADD
Theatre investigations with fixed installation
Diagnostic procedures requiring the use of radio-isotopes
Procedures to exclude cost of isotope
Tracer test
Repeat of further tracer tests for same investigation: Half of above fee
If both tracer and therapeutic procedures are done, half fee of tracer test to be charged plus
therapeutic fee
Tracer test of complete body or brain tumour location
Other organ scanning with use of relevant radio isotopes
Thyroid scanning
Positron Emission Tomography (PET) imaging of the whole body using a Coincidence Camera
Positron Emission Tomography (PET) imaging of a limited body region using a Coincidence Camera

19.14 Interventional radiological procedures

The following rules are applicable to Section 19.8 (Vascular studies) and Section 19.14
(Interventional Radiological Procedures):

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

+
+

438.50
219.25
-

40
40

33.200 1.0 R
16.600 1.0 R

40
40
40

82.200 1.0 R 1 085.55

82.200 1.0 R 1 085.55
28.800 1.0 R
380.28
-

2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2006.04
2004.00

40
40

7.000 1.0 R
3.000 1.0 R

40
40

22.100 1.0 R
11.100 1.0 R

40
40
40

54.800 1.0 R
54.800 1.0 R
19.200 1.0 R

92.39
39.60
291.85
146.66
-

723.75
723.75
253.57
-

a. The machine fee (items 3536 to 3550 includes the cost of the following:
i. All runs (runs may not be billed for separately).
ii. All film costs (modifier 0084 is not applicable).
iii All fluoroscopy (item 3601 does not apply).
iv All minor consumables (defined as any item other than catheters, guidewires, introducer sets,
specialised catheters, balloon catheters, stents, embolic agents, drugs and contrast media).
b. The machine fee (items 3536 to 3550) may only be billed for as a once off fee per case per day
by the owner of the equipment and is only applicable to radiology practices.
c. If a procedure is performed by a non-radiologist together with a radiologist as a team, in a facility
owned by the radiologist, each member of the team will fee at their respective full rates as per
modifiers and the applicable items.
d. If a procedure is performed by a non-radiologists and a radiologist as a team, in a facility not
owned by the radiologist, modifiers 6301 and 6302 applies.
Please note : Modifier 0083 is not applicable to section 19.8 (Vascular Studies) and section 19.14
(Interventional Radiological Procedures)

5002
5004
5006
5008
5010
5012
5014
5016
5018
5022
5030
5031
5033
5035
5036
5037
5038
5039
5040
5041
5042
5043

Note: In regard to multiple examinations see modifier 0080

Percutaneous transluminal angioplasty: Aortic/IVC
Percutaneous transluminal angioplasty, arterial or venous, iliac vessel/subclavian vessel
Percutaneous transluminal angioplasty: Femoral to popliteal bifurcation, axillary and brachial
Percutaneous transluminal angioplasty: Sub-popliteal sub-brachial
Percutaneous transluminal angioplasty: Renal/Visceral/Brachiocephalic
Percutaneous transluminal angioplasty: Extracranial Carotid/Vertebral - stand alone procedure
Atherectomy (per vessel)
Aspiration thrombectomy (per vessel)
On-table thrombolysis/transcatheter infusion performed in angiography suite
Embolisation non-intracranial, per vessel
Percutaneous nephrostomy for further procedure or drainage
Antegrade ureteric stent insertion
Percutaneous cystostomy in radiology suite
Urethral balloon dilatation in radiology suite
Percutaneous abdominal/pelvic/other drain insertion, any modality
Urethral stenting in radiology suite
Intracranial/spinal AVM embolisation (per session)
Intracranial thrombolysis (on-table) per session
Intracranial aneurysm occlusion
Balloon occlusion/Wada test
Carotico/cavernous fistula/head and neck AV fistula embolisation
Intracranial angioplasty

Page 64 of 84

40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40

102.600
102.600
102.600
139.200
139.200
172.200
204.600
131.400
106.800
106.800
73.800
69.600
30.000
22.800
34.200
102.600
335.400
139.200
286.800
106.800
286.800
204.600

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

1 354.95
1 354.95
1 354.95
1 838.33
1 838.33
2 274.19
2 701.99
1 735.38
1 410.39
1 410.39
974.67
919.09
396.26
301.08
451.70
1 354.95
4 429.45
1 838.33
3 787.53
1 410.39
3 787.53
2 701.99

30
30
30
30
30
30

13.000
13.000
13.000
13.000
13.000
13.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

30
30
30
30

5.000
9.000
6.000
6.000

1.0
1.0
1.0
1.0

R
R
R
R

30
30
30
30
30
30

13.000
13.000
13.000
9.000
13.000
13.000

1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R

760.56
760.56
760.56
760.56
760.56
760.56
292.58
526.64
351.09
351.09
760.56
760.56
760.56
526.64
760.56
760.56

T
T
T
T
T
T

T
T
T
T

T
T
T
T
T
T

5044
5045
5046
5047
5048
5049
5050
5058
5060

Transhepatic portogram
Hepatic arterial infusion catheter insertion
Percutaneous biliary drainage (external)
Combined internal/external biliary drainage
Biliary stent insertion
Percutaneous gall bladder drainage
Percutaneous or renal gall bladder stone removal
Stent insertion: Aortic/IVC - including percutaneous transluminal angioplasty (PTA)
Stent insertion: Iliac/subclavian/AV fistula - including percutaneous transluminal angioplasty (PTA)

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

40
40
40
40
40
40
40
40
40

1 838.33
2 060.22
1 354.95
1 354.95
1 838.33
919.09
2 274.19
1 838.33
1 838.33

30
30
30
30
30
30
30
30
30

9.000
6.000
9.000
9.000
9.000
9.000
5.000
13.000
13.000

R
R
R
R
R
R
R
R
R

526.64
351.09
526.64
526.64
526.64
526.64
292.58
760.56
760.56

T
T
T
T
T
T
T
T
T

2004.00

40 139.200 1.0 R 1 838.33

30

13.000 1.0 R

760.56

2004.00
2004.00

40 172.200 1.0 R 2 274.19

40 204.600 1.0 R 2 701.99

30
30

13.000 1.0 R
13.000 1.0 R

760.56
760.56

T
T

2004.00

40 204.600 1.0 R 2 701.99

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40

2004.00

2004.00

2004.00

2004.00

2004.00
2004.00

2004.00

2004.00

Where a magnetic resonance angiography (MRA) of the vessels is performed additional to an

2004.00
examination of a particular region, 50% of the fee is applicable for the angiography. This modifier is
only applicable if the series is performed by use of a recognised angiographic software package with
reconstruction capability

Stent insertion: Femoral popliteal bifurcation, axillary and brachial - including percutaneous
transluminal angioplasty (PTA)
5064 Stent insertion: Sub-popliteal - including percutaneous transluminal angioplasty (PTA)
5066 Stent insertion: Renal/visceral/brachiocephalic - including percutaneous transluminal angioplasty
(PTA)
5068 Stent insertion: Extracranial carotid/vertebral - including percutaneous transluminal angioplasty
(PTA) - stand alone procedure
5070 Stent insertion: Aorto-iliac stent graft - including percutaneous transluminal angioplasty (PTA)
5072 Tunnelled/subcutaneous arterial/venous line performed in radiology suite
5074 IVC filter insertion jugular or femoral route
5076 Intravascular foreign body removal, arterial or venous, any route
5078 Percutaneous sclerotherapy of an arteriovenous malformation (AVM)
5080 Transjugular intrahepatic porto-systemic shunt
5082 Transjugular liver biopsy
5084 Endoluminal fallopian tube recanalisation
5086 Renal cyst aspiration/ablation
5088 Oesophageal stent insertion in radiology suite
5090 Tracheal stent insertion
5091 GIT balloon dilatation under fluoroscopy
5092 Other GIT stent insertion
5093 Percutaneous gastrostomy in radiology suite
5094 Cutting needle biopsy with image guidance
5095 Chest drain insertion in radiology suite
5096 Percutaneous cyst or tumour ablation (non aspiration)
5097 Vertebroplasty - Introduction of stabilising material under screening or CT control - per level
MODIFIER GOVERNING INTERVENTIONAL RADIOLOGICAL PROCEDURES
0090 Radiologists fee for participation in a team: 30,00 radiology units per hour or part thereof for all
interventional radiological procedures, excluding any pre- or post-operative angiography,
catheterisation, CT-scanning, ultrasound-scanning or x-ray procedures. (Only to be charged if
radiologist is hands-on, and not for interpretation of images only)
19.15 Magnetic Resonance Imaging (MRI)
6100 In order to charge the full fee (600,00 magnetic resonance units) for an examination of a specific
single anatomical region, it should be performed with the applicable radio frequency coil including T1
and T2 weighted images on at least two planes
6101 Where a limited series of a specific anatomical region is performed (except bone tumour), e.g a T2
weighted image of a bone for an occult stress fracture, not more than two-thirds (2/3) of the fee may
be charged. Also applicable to all radiotherapy planning studies, per region
6102 All post-contrast studies (except bone tumour), including perfusion studies, to be charges at 50% of
the fee
6103 Post-contrast study: Bone tumour: 100% of the fee
6104 Limited examination of the hypophysis e.g. where a coronal T1 and sagittal T1 series are performed,
two-thirds (2/3) of the fee is applicable
6105 Where, in a limited hypophysis examination, Gadolinium is administered and coronal T1 and sagittal
T1 series are repeated, a single full fee for the entire examination is applicable + cost of Gadolinium
+ disposable items
6106 Where a magnetic resonance angiography (MRA) of large vessels is performed as primary
examination, 100% of the fee is applicable. This modifier is only applicable if the series is performed
by use of a recognised angiographic software package with reconstruction capability
5062

6107

Page 65 of 84

139.200
156.000
102.600
102.600
139.200
69.600
172.200
139.200
139.200

311.400
82.200
156.000
204.600
70.200
335.400
69.600
172.200
22.800
102.600
102.600
66.600
102.600
85.800
22.800
32.400
54.600

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

4 112.52
1 085.55
2 060.22
2 701.99
927.16
4 429.45
919.09
2 274.19
301.08
1 354.95
1 354.95
879.50
1 354.95
1 133.06
301.08
427.94
721.11
-

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

30
30
30
30
30
30
30
30

13.000
5.000
9.000
9.000
5.000
13.000
9.000
6.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R

30
30
30
30

6.000
6.000
6.000
6.000

1.0
1.0
1.0
1.0

R
R
R
R

30

13.000 1.0 R

760.56
292.58
526.64
526.64
292.58
760.56
526.64
351.09
351.09
351.09
351.09
351.09
760.56
-

T
T
T
T
T
T
T
T
T
T
T
T

6108

6109
6110

6200
6201
6202
6203
6204
6205
6206
6207
6208
6209
6210
6211
6212
6213
6214
6215
6216
6217
6218
6219
6220
6221
6222
6223
6224
6225
6226
6227
6228
6229
6230
6231
6232
6233
6234
6235
6236
6237
6238
6239
6240
6241
6242
6250
6251
6252
6253
6254
6255
6260

Where only a gradient echo series is performed with a machine without a recognised angiographic
software package with reconstruction ability, 20% of the full fee is applicable specifying that it is a
flow sensitive series
Very limited studies to be charged at 33,33% of the full fee e.g. MR urography for renal colic,
diffusion studies of the brain additional to routine brain
MRI spectroscopy: 50% of fee
Please note: The calculated amounts in this section are calculated according to the magnetic
resonance imaging unit value.
Items 6200 to 6255 reflect the anatomical region examined. The modifiers above reflect what was
done and how the fee was arrived at.
Magnetic Resonance Imaging: Per anatomical region: Brain
Magnetic Resonance Imaging: Per anatomical region: Orbitae
Magnetic Resonance Imaging: Per anatomical region: Paranasal sinuses
Magnetic Resonance Imaging: Per anatomical region: Soft tissue: Face/skull
Magnetic Resonance Imaging: Per anatomical region: Skull basis/cranio-cervical joint
Magnetic Resonance Imaging: Per anatomical region: Middle and internal ears
Magnetic Resonance Imaging: Per anatomical region: Soft tissue: Neck
Magnetic Resonance Imaging: Per anatomical region: Thyroid/para-thyroid
Magnetic Resonance Imaging: Per anatomical region: Hypophysis (see modifiers 6104 and 6105 for
limited examinations)
Magnetic Resonance Imaging: Per anatomical region: Bone tumour (see modifier 6103)
Magnetic Resonance Imaging: Per anatomical region: Cervical vertebrae
Magnetic Resonance Imaging: Per anatomical region: Thoracic vertebrae
Magnetic Resonance Imaging: Per anatomical region: Lumbar vertebrae
Magnetic Resonance Imaging: Per anatomical region: Sacrum
Magnetic Resonance Imaging: Per anatomical region: Pelvis
Magnetic Resonance Imaging: Per anatomical region: Pelvic organs
Magnetic Resonance Imaging: Per anatomical region: Abdomen
Magnetic Resonance Imaging: Per anatomical region: Thorax wall
Magnetic Resonance Imaging: Per anatomical region: Mediastinum
Magnetic Resonance Imaging: Per anatomical region: Soft tissue: Back
Magnetic Resonance Imaging: Per anatomical region: Left shoulder
Magnetic Resonance Imaging: Per anatomical region: Right shoulder
Magnetic Resonance Imaging: Per anatomical region: Both hips
Magnetic Resonance Imaging: Per anatomical region: Left hip
Magnetic Resonance Imaging: Per anatomical region: Right hip
Magnetic Resonance Imaging: Per anatomical region: Left upper-arm
Magnetic Resonance Imaging: Per anatomical region: Right upper-arm
Magnetic Resonance Imaging: Per anatomical region: Left elbow
Magnetic Resonance Imaging: Per anatomical region: Right elbow
Magnetic Resonance Imaging: Per anatomical region: Left fore-arm
Magnetic Resonance Imaging: Per anatomical region: Right fore-arm
Magnetic Resonance Imaging: Per anatomical region: Left wrist and hand
Magnetic Resonance Imaging: Per anatomical region: Right wrist and hand
Magnetic Resonance Imaging: Per anatomical region: Left upper-leg
Magnetic Resonance Imaging: Per anatomical region: Right upper-leg
Magnetic Resonance Imaging: Per anatomical region: Left knee
Magnetic Resonance Imaging: Per anatomical region: Right knee
Magnetic Resonance Imaging: Per anatomical region: Left lower-leg
Magnetic Resonance Imaging: Per anatomical region: Right lower-leg
Magnetic Resonance Imaging: Per anatomical region: Left ankle
Magnetic Resonance Imaging: Per anatomical region: Right ankle
Magnetic Resonance Imaging: Per anatomical region: Left foot
Magnetic Resonance Imaging: Per anatomical region: Right foot
Magnetic Resonance angiography (See modifiers 6106 to 6108): Brain
Magnetic Resonance angiography (See modifiers 6106 to 6108): Large vessels: Neck
Magnetic Resonance angiography (See modifiers 6106 to 6108): Large vessels: Chest
Magnetic Resonance angiography (See modifiers 6106 to 6108): Large vessels: Abdomen
Magnetic Resonance angiography (See modifiers 6106 to 6108): Large vessels: Legs
Magnetic Resonance angiography (See modifiers 6106 to 6108): Heart
Contrast medium: Current price according the regular price list published by the Radiology Society of
SA

2004.00

2004.00

2004.00
2004.00

2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

75
75
75
75
75
75
75
75
75

400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13

30
30
30
30
30
30
30
30
30

5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58

T
T
T
T
T
T
T
T
T

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75
75

400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000
400.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
4 020.13
-

30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30

5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000
5.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
292.58
-

T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T

Page 66 of 84

6270

20

Low field strength peripheral joint magnetic resonance imaging: Low field strength peripheral joint
2004.00
examination (feet, knees, hands, and elbows), in dedicated limb units not able to perform body, spine
or head examinations
Radiation Oncology
GENERAL RULES REGARDING THIS SECTION OF THE NATIONAL REFERENCE PRICE
2004.00
LIST

75

70.000 1.0 R

703.51

30

5.000 1.0 R

292.58

Megavolt therapy
Beta-ray therapy with strontium-90-applicator
Planning of therapy
Technical aids
Radiation materials (see modifier 0095)
2005.03
Oncological surgical procedures
Special procedures
Chemotherapy
Where patients are not treated in chemotherapy facilities, items 0213, 0214 and 0215 are used
2004.11
instead of items 5790, 5793 and 5795. Codes 0213, 0214 and 0215 are applicable to providers who
only administer the drugs i.e. don't own or rent a facility and do not manage the patient.

Codes 5790 to 5795 are for exclusive use by oncology trained doctors working within chemotherapy 2004.11
facilities
Non Infusional Chemotherapy: Global Fee for the management of and for related services delivered 2004.11
in the treatment of cancer with oral chemotherapy (per cycle), intramuscular (IMI), subcutaneous,
intrathecal or bolus chemotherapy or oncology specific drug administration per treatment day - for
exclusive use by doctors with appropriate oncology training (consultations to be charged separately) (not applicable to oral hormonal therapy)
Non Infusional Chemotherapy Facility Fee: A facility where oncology medicines are procured or
2005.03
scripted for oral chemotherapy, intramuscular (IMI), subcutaneous, intrathecal or bolus
chemotherapy or oncology specific drug administration per treatment day. This fee is chargeable by
doctors with appropriate oncology training who owns or rents the facility, and by others e.g. hospitals
or clinics that provide the services as per the appropriate billing structure. Said facilities are to be
accredited under the auspices of SASMO and/or SASCRO (to be used in conjunction with item
5790) - (not applicable to oral hormonal therapy) - only one of the parties are to charge this fee

(a) Unless specifically stated in this section of the NRPL-HS, the general descriptors between the
professional and technical component apply to both components of the services.

BB.

20.1
20.2
20.3
0096
20.4
20.5
20.6
20.7
5141
20.8
20.9
20.10

5790

5791

5792

5793

(b) The items reflecting the technical component in this section of the NRPL-HS may only be
charged by the owner of the equipment.
The fees in this section (radiation oncology) do NOT include the cost of radium or isotopes
2004.00
Please note: The calculated amounts in this section are calculated according to the radiotherapy unit 2004.00
values
Kilovolt therapy
Radium therapy
Isotope therapy
Radio-isotope therapy patients who fail to keep their appointments: Fee will include cost of isotope 2004.00

Non Infusional Chemotherapy Facility Fee: A facility where oncology medicines are purchased,
stored and dispensed during oral chemotherapy (per cycle), intramuscular (IMI), subcutaneous,
intrathecal or bolus chemotherapy or oncology specific drug administration per treatment day. This
fee is chargeable by doctors with appropriate oncology training who owns or rents the facility, and by
others e.g. hospitals or clinics that provide the services as per the appropriate billing structure. Said
facilities are to be accredited under the auspices of SASMO and/or SASCRO (to be used in
conjunction with item 5790) - (not applicable to oral hormonal therapy) - only one of the parties are to
charge this fee
Non-infusional chemotherapy: Consultations are charged separately.
Non-infusional chemotherapy: In the case of intramuscular (IMI), subcutaneous, intrathecal or bolus
chemotherapy administration the management fee can only be charged once per treatment day.
Consultations are charged separately.
Infusional Chemotherapy: Global fee for the management of and for services delivered during
infusional chemotherapy per treatment day - for exclusive use by doctors with appropriate oncology
training using recognised chemotherapy facilities(consultations to be charged separately)

2005.03

20

42.950 1.0 R

400.37

20

42.950 1.0 R

400.37

20

24.490 1.0 R

228.34

20

24.490 1.0 R

228.34

20

30.610 1.0 R

285.39

20

30.610 1.0 R

285.39

2005.05
2004.11

2004.11

20 159.470 1.0 R 1 486.80

Page 67 of 84

20 127.580 1.0 R 1 189.38

5794

Infusional Chemotherapy Facility Fee: A facility where oncology medicines are procured, stored,
2005.03
admixed and administered, and in which appropriately-trained medical, nursing and support staff are
in attendance. This fee is chargeable by doctors with appropriate oncology training who owns or
rents the facility, and by others e.g. hospitals or clinics that provide the services as per the
appropriate billing structure. Said facilities are to be accredited under the auspices of SASMO and/or
SASCRO (to be used in conjunction with item 5793) - only one of the parties are to charge this fee

Infusional Chemotherapy Facility Fee: A facility where oncology medicines are purchased, stored,
2004.11
dispensed, admixed and administered and in which appropriately-trained medical, nursing and
support staff are in attendance. This fee is chargeable by doctors with appropriate oncology training
who owns or rents the facility, and by others e.g. hospitals or clinics that provide the services as per
the appropriate billing structure. Said facilities are to be accredited under the auspices of SASMO
and/or SASCRO (to be used in conjunction with item 5793) - only one of the parties are to charge
this fee
Item 5795 is chargeable in addition to item 5793 by the Oncologist who owns or rents the
2004.11
chemotherapy facility, and by others e.g. hospitals or clinics that provide the services as per the
appropriate billing structure. Said facilities are to be accredited under the auspices of SASMO and/or
SASCRO (only to be added to item 5793 if own or rented facility is used).
20.11 Radiation Therapy Planning
20.11.1Manual Radiotherapy Planning Procedures
5801 Manual Radiotherapy Planning Procedures: No Simulation, Limited Graphic Planning, Single Volume 2005.03
of Interest - PROFESSIONAL COMPONENT
5601 Manual Radiotherapy Planning Procedures: No Simulation, Limited Graphic Planning, Single Volume 2005.01
of Interest -TECHNICAL COMPONENT
5802 Manual Radiotherapy Planning Procedures: No Simulation, Limited Graphic Planning, Multiple
2005.03
Volumes of Interest - PROFESSIONAL COMPONENT
5602 Manual Radiotherapy Planning Procedures: No Simulation, Limited Graphic Planning, Multiple
2005.01
Volumes of Interest - TECHNICAL COMPONENT
5803 Manual Radiotherapy Planning Procedures: No Simulation, Limited Graphic Planning, Special
2005.03
Technique - PROFESSIONAL COMPONENT
5603 Manual Radiotherapy Planning Procedures: No Simulation, Limited Graphic Planning, Special
2005.01
Technique - TECHNICAL COMPONENT
20.11.2Conventional Radiotherapy Planning Procedures
5808 Conventional Radiotherapy Planning: Simulation, Limited Graphic Planning, Single Volume of
2005.03
Interest - PROFESSIONAL COMPONENT
5608 Conventional Radiotherapy Planning: Simulation, Limited Graphic Planning, Single Volume of
2005.01
Interest - TECHNICAL COMPONENT
5809 Conventional Radiotherapy Planning: Simulation, Limited Graphic Planning, Multiple Volumes of
2005.03
Interest - PROFESSIONAL COMPONENT
5609 Conventional Radiotherapy Planning: Simulation, Limited Graphic Planning, Multiple Volumes of
2005.01
Interest - TECHNICAL COMPONENT
5810 Conventional Radiotherapy Planning: Simulation, Limited Graphic Planning, Special Technique 2005.03
PROFESSIONAL COMPONENT
5610 Conventional Radiotherapy Planning: Simulation, Limited Graphic Planning, Special Technique 2005.01
TECHNICAL COMPONENT
20.11.3Three Dimensional Radiotherapy Planning Procedures
5820 Three Dimensional Radiotherapy Planning Procedures: 3-Dimensional Simulation and Graphic
2006.02
Planning, Single Volume of Interest - PROFESSIONAL COMPONENT (excludes imaging costs for
CT and MRI)
5620 Three Dimensional Radiotherapy Planning Procedures: 3-Dimensional Simulation and Graphic
2006.02
Planning, Single Volume of Interest - TECHNICAL COMPONENT (excludes imaging costs for CT
and MRI)
5821 Three Dimensional Radiotherapy Planning Procedures: 3-Dimensional Simulation and Graphic
2006.02
Planning, Multiple Volumes of Interest - PROFESSIONAL COMPONENT (excludes imaging costs
for CT and MRI)
5621 Three Dimensional Radiotherapy Planning Procedures: 3-Dimensional Simulation and Graphic
2006.02
Planning, Multiple Volumes of Interest - TECHNICAL COMPONENT (excludes imaging costs for CT
and MRI)
5822 Three Dimensional Radiotherapy Planning Procedures: 3-Dimensional Simulation and Graphic
2006.02
Planning, Special Technique - PROFESSIONAL COMPONENT (excludes imaging costs for CT and
MRI)
5795

20

90.030 1.0 R

839.31

20

90.030 1.0 R

839.31

20 112.540 1.0 R 1 049.18

20 112.540 1.0 R 1 049.18

50

42.560 1.0 R

482.20

50

99.320 1.0 R 1 125.14

50

56.180 1.0 R

636.49

50 131.100 1.0 R 1 485.18

50

868.06

50 178.770 1.0 R 2 025.32

50 170.260 1.0 R 1 928.96

50 397.270 1.0 R 4 500.72

50 238.360 1.0 R 2 700.37

50 556.180 1.0 R 6 301.07

50 297.950 1.0 R 3 375.58

50 695.220 1.0 R 7 876.30

50 240.230 1.0 R 2 721.64

50 977.200 1.0 R 11 070.90

50 407.750 1.0 R 4 619.51

50 ####### 1.0 R 15 499.03

50 554.330 1.0 R 6 280.10

Page 68 of 84

76.620 1.0 R

Three Dimensional Radiotherapy Planning Procedures: 3-Dimensional Simulation and Graphic

Planning, Special Technique - TECHNICAL COMPONENT (excludes imaging costs for CT and
MRI)
20.11.4Intensity Modulated Radiotherapy Planning Procedures
5823 Intensity Modulated Radiotherapy Planning Procedures: Intensity Modulated Radiotherapy
Simulation, Inverse Planning, Radical Course - PROFESSIONAL COMPONENT (excludes imaging
costs for CT and MRI)
5623 Intensity Modulated Radiotherapy Planning Procedures: Intensity Modulated Radiotherapy
Simulation, Inverse Planning, Radical Course - TECHNICAL COMPONENT (excludes imaging costs
for CT and MRI)
5825 Intensity Modulated Radiotherapy Planning Procedures: Intensity Modulated Radiotherapy
Simulation, Inverse Planning, Booster Volumes (not for use with other IMRT planning codes) PROFESSIONAL COMPONENT (excludes imaging costs for CT and MRI)
5625 Intensity Modulated Radiotherapy Planning Procedures: Intensity Modulated Radiotherapy
Simulation, Inverse Planning, Booster Volumes (not for use with other IMRT planning codes) TECHNICAL COMPONENT (excludes imaging costs for CT and MRI)
5826 Intensity Modulated Radiotherapy Planning Procedures: Intensity Modulated Radiotherapy
Simulation, Inverse Planning, CT Scan with Magnetic Resonance Imaging or other Similar Imaging
Fusion Techniques - PROFESSIONAL COMPONENT (excludes imaging costs for CT and MRI)
5622

5626

Intensity Modulated Radiotherapy Planning Procedures: Intensity Modulated Radiotherapy

Simulation, Inverse Planning, CT Scan with Magnetic Resonance Imaging or other Similar Imaging
Fusion Techniques - TECHNICAL COMPONENT (excludes imaging costs for CT and MRI)

20.11.5Kilovolt Radiation Treatment

5834 Kilovolt Radiation Treatment: Weekly Treatment, Kilovolt or Similar, per week or part thereof PROFESSIONAL COMPONENT
5634 Kilovolt Radiation Treatment: Weekly Treatment, Kilovolt or Similar, per week or part thereof TECHNICAL COMPONENT
20.11.6Short Course Radiation Treatment
5835 Short Course Radiation Treatment: Short course treatment, Single Volume of Interest PROFESSIONAL COMPONENT
5635 Short Course Radiation Treatment: Short course treatment, Single Volume of Interest - TECHNICAL
COMPONENT
5836 Short Course Radiation Treatment: Short course treatment, Multiple Volumes of Interest PROFESSIONAL COMPONENT
5636 Short Course Radiation Treatment: Short course treatment, Multiple Volumes of Interest TECHNICAL COMPONENT
5837 Short Course Radiation Treatment: Short course Treatment, Special Technique - PROFESSIONAL
COMPONENT
5637 Short Course Radiation Treatment: Short course Treatment, Special Technique - TECHNICAL
COMPONENT
20.11.7Weekly Radiation Treatment Sessions
Weekly Radiation Treatment Sessions - Conventional Techniques
20.11.7.1
5839 Weekly Radiation Treatment Sessions - Conventional Techniques: Weekly Treatment, Single
Volume of Interest - PROFESSIONAL COMPONENT
5639 Weekly Radiation Treatment Sessions - Conventional Techniques: Weekly Treatment, Single
Volume of Interest - TECHNICAL COMPONENT
5840 Weekly Radiation Treatment Sessions - Conventional Techniques: Weekly Treatment, Multiple
Volumes of Interest - PROFESSIONAL COMPONENT
5640 Weekly Radiation Treatment Sessions - Conventional Techniques: Weekly Treatment, Multiple
Volumes of Interest - TECHNICAL COMPONENT
5841 Weekly Radiation Treatment Sessions - Conventional Techniques: Weekly Treatment, Special
Technique - PROFESSIONAL COMPONENT
5641 Weekly Radiation Treatment Sessions - Conventional Techniques: Weekly Treatment, Special
Technique - TECHNICAL COMPONENT
Weekly Radiation Treatment Sessions - Advanced Techniques
20.11.7.2
5849 Weekly Radiation Treatment Sessions - Advanced Techniques: Weekly Treatment, Multi Leaf
Collimators, Single Volume of Interest - PROFESSIONAL COMPONENT
5649 Weekly Radiation Treatment Sessions - Advanced Techniques: Weekly Treatment, Multi Leaf
Collimators, Single Volume of Interest - TECHNICAL COMPONENT
5850 Weekly Radiation Treatment Sessions - Advanced Techniques: Weekly Treatment, Multi Leaf
Collimators, Multiple Volumes of Interest - PROFESSIONAL COMPONENT

2006.02

50 ####### 1.0 R 19 373.82

2006.02

50 642.920 1.0 R 7 283.81

2006.02

50 ####### 1.0 R 21 715.92

2006.02

50 232.180 1.0 R 2 630.42

2006.02

50 958.400 1.0 R 10 857.81

2006.02

50 753.350 1.0 R 8 534.78

2006.02

50 ####### 1.0 R 24 635.10

2005.03

50

555.97

2005.01

50 114.520 1.0 R 1 297.46

2005.03

50 105.740 1.0 R 1 197.88

2005.01

50 246.730 1.0 R 2 795.26

2005.03

50 148.040 1.0 R 1 677.16

2005.01

50 345.410 1.0 R 3 913.22

2005.03

50 190.330 1.0 R 2 156.28

2005.01

50 444.110 1.0 R 5 031.32

2005.03

50 193.860 1.0 R 2 196.32

2005.01

50 452.330 1.0 R 5 124.45

2005.03

50 246.730 1.0 R 2 795.26

2005.01

50 575.690 1.0 R 6 522.08

2005.03

50 317.220 1.0 R 3 593.80

2005.01

50 740.180 1.0 R 8 385.63

2005.03

50 236.240 1.0 R 2 676.47

2005.01

50 551.210 1.0 R 6 244.75

2005.03

50 330.730 1.0 R 3 746.91

Page 69 of 84

49.080 1.0 R

Weekly Radiation Treatment Sessions - Advanced Techniques: Weekly Treatment, Multi Leaf
Collimators, Multiple Volumes of Interest - TECHNICAL COMPONENT
5851 Weekly Radiation Treatment Sessions - Advanced Techniques: Weekly Treatment, Multi Leaf
Collimators, Special Technique - PROFESSIONAL COMPONENT
5651 Weekly Radiation Treatment Sessions - Advanced Techniques: Weekly Treatment, Multi Leaf
Collimators, Special Technique - TECHNICAL COMPONENT
5854 Weekly Radiation Treatment Sessions - Advanced Techniques: Weekly Treatment, Intensity
Modulated Radiotherapy - PROFESSIONAL COMPONENT
5654 Weekly Radiation Treatment Sessions - Advanced Techniques: Weekly Treatment, Intensity
Modulated Radiotherapy - TECHNICAL COMPONENT
5855 Weekly Radiation Treatment Sessions - Advanced Techniques: Weekly Treatment, Total Body
Radiotherapy or Similar - PROFESSIONAL COMPONENT
5655 Weekly Radiation Treatment Sessions - Advanced Techniques: Weekly Treatment, Total Body
Radiotherapy or Similar - TECHNICAL COMPONENT
20.11.8Stereotactic Radiation
5860 Stereotactic Radiation: Stereotactic Radiation, Single or up to 4 (four) Fractions, Global Fee PROFESSIONAL COMPONENT
5660 Stereotactic Radiation: Stereotactic Radiation, Single Fraction, Global Fee - TECHNICAL
COMPONENT
5861 Stereotactic Radiation: Stereotactic Radiation, 5 (five) or more Fractions, Full course, Global Fee PROFESSIONAL COMPONENT
5661 Stereotactic Radiation: Stereotactic Radiation, Fractionated, Full course, Global Fee - TECHNICAL
COMPONENT
20.12 Brachytherapy
20.12.1Isotope/Applicator Therapy
5870 Isotope/Applicator Therapy: Isotopes - Low Complexity, administration of low dose oral isotopes or
use of surface applicators, up to five applications. Typically an out patient procedure. The cost of any
isotopes and materials are not included
5872 Isotope/Applicator Therapy: Isotopes - Intermediate Complexity, administration of isotopes requiring
invasive techniques such as intravenous, intracavitary or intra-articular radioactive isotopes. Typical
out patient procedure or admission and monitoring less than 48 hours. The cost of any isotopes and
materials are not included
5873 Isotope/Applicator Therapy: Isotopes - High Complexity, surface application of seed arrays requiring
dosimetric assessment and/or high dose radio-active isotopes requiring admission and monitoring.
Typically requires in patient admission and monitoring for more than 48 hours. The cost of any
isotopes and materials are not included
20.12.2Brachytherapy Implants
5882 Brachytherapy Implants: Implants - Low Complexity, placement of a single guide tube for the
administration of brachytherapy requiring <8 dwell points. The cost of materials are not included
5650

5883

5885

2005.01

50 771.710 1.0 R 8 742.89

2005.03

50 425.230 1.0 R 4 817.50

2005.01

50 992.190 1.0 R 11 240.73

2005.03

50 348.870 1.0 R 3 952.37

2005.01

50 814.030 1.0 R 9 222.31

2005.03

50 826.830 1.0 R 9 367.35

2005.01

50 ####### 1.0 R 21 856.85

2005.03

50 ####### 1.0 R 42 137.01

2005.01

50 ####### 1.0 R 98 319.69

2005.03

50 ####### 1.0 R 48 457.58

2005.01

50 ####### 1.0

2005.03

50 108.400 1.0 R 1 228.10

2005.03

50 216.800 1.0 R 2 456.19

2005.03

50 601.160 1.0 R 6 810.70

2005.03

50 216.800 1.0 R 2 456.19

50 786.800 1.0 R 8 913.74

50 ####### 1.0 R 11 885.14

2005.03

50 613.040 1.0 R 6 945.18

2005.03

50 415.960 1.0 R 4 712.49

2005.03

50 970.560 1.0 R 10 995.67

2005.03

50 156.770 1.0 R 1 776.00

Brachytherapy Implants: Implants - Intermediate Complexity, planar implants requiring >1 guide tube 2005.03
for the administration of brachytherapy, or the use of >8 dwell points in a single guide tube, or any
procedure requiring <8 dwell points but which requires general anaesthesia for insertion. The cost of
materials are not included
Brachytherapy Implants: Implants - High Complexity requiring complex volumetric studies. Inclusive 2005.03
fee for implant under local or general anaesthetic. The cost of materials are not included

20.12.3Brachytherapy Treatment
5890 Brachytherapy Treatment: Global fee for manual afterloading - includes storage, handling,
calibration, planning (manual or computerized), manual loading, daily treatment, monitoring, removal
and disposal of the isotopes. The cost of any isotopes and materials are not included
5892 Brachytherapy Treatment: Global fee for remote afterloading - includes input in calibration, graphic
planning, daily treatment, monitoring, removal and disposal of implant materials on completion. The
cost of materials are not included - PROFESSIONAL COMPONENT
5893 Global Fee for remote afterloading - includes input in calibration, graphic planning, daily treatment,
monitoring, removal and disposal of implant materials on completion. The cost of materials are not
included - TECHNICAL COMPONENT
20.12.4Brachytherapy Imaging
5895 Brachytherapy Imaging: Brachytherapy: Special imaging where needed and if used, unusual to be
added to any code other than items 5883 or 5885
Clinical Pathology
21

##########

Page 70 of 84

0097

21.1
3705
3709
3710
3711
3712
3713
3714
3715
3716
3717
3719
3720
3721
3722
3723
3724
3726
3727
3728
3729
3730
3731
3732
3734
3735
3736
3737
3738
3739
3740
3741
3742
3743
3744
3746
3748
3750
3751
3752
3753
3754
3755
3756
3757
3758
3759
3761
3762
3763
3764
3765
3766
3767
3768
3769

Pathology tests performed by non-pathologists: Where items under Clinical Pathology (section 21) 2004.00
and Anatomical Pathology (section 22) fall within the province of other specialists or general
practitioners, the fee is to be charged at two-thirds of the pathologists fee
Please note: The calculated amounts in this section are calculated according to the clinical pathology 2004.00
unit values.
Note: For fees for Histology and Cytology refer to items 4561-4593 under Section 22: Anatomical
Pathology.
Haematology
Alkali resistant haemoglobin
2004.00
Antiglobulin test (Coombs' or trypsinzied red cells)
2004.00
Antibody titration
2004.00
Arneth count
2004.00
Antibody identification
2004.00
Bleeding time (does not include the cost of the simplate device)
2004.00
Blood volume, dye method
2004.00
Buffy layer examination
2004.00
Mean Cell Volume
2004.00
Bone marrow cytological examination only
2004.00
Bone marrow: Aspiration
2004.00
Bone marrow trephine biopsy
2004.00
Bone marrow aspiration and trephine biopsy (excluding histology)
2004.00
Capillary fragility: Hess
2004.00
Circulating anticoagulants
2004.00
Coagulation factor inhibitor assay
2004.00
Activated protein C resistance
2004.00
Coagulation time
2004.00
Anti-factor Xa Activity
2004.00
Cold agglutinins
2004.00
Protein S: Functional
2004.00
Compatibility for blood transfusion
2004.00
Cryoglobulin
2004.00
Protein C (chromogenic)
2004.00
Anti-thrombin III (chromogenic)
2004.00
Plasminogen (chromogenic)
2004.00
Lupus Russel Viper method
2004.00
Lupus Kaolin Exner method
2004.00
Erythrocyte count
2004.00
Factors V and VII: Qualitative
2004.00
Coagulation factor assay: Functional
2004.00
Coagulation factor assay: Immunological
2004.00
Erythrocyte sedimentation rate
2004.00
Fibrin stabilizing factor (urea test)
2004.00
Fibrin monomers
2004.00
Plasminogen activator inhibitor (PAI-I)
2004.00
Tissue plasminogen Activator (tPA)
2004.00
Osmotic fragility (screen)
2004.00
Osmotic fragility test: Quantitative
2004.00
Osmotic fragility (before and after incubation)
2004.00
ABO Reverse Group
2004.00
Full blood count (including items 3739, 3762, 3783, 3785, 3791)
2004.00
Full cross match
2004.00
Coagulation factors: Quantitative
2004.00
Factor VIII related antigen
2004.00
Coagulation factor correction study
2004.00
Factor XIII related antigen
2004.00
Haemoglobin estimation
2004.00
Contact activated product assay
2004.00
Grouping: A B and O antigens
2004.00
Grouping: Rh antigen
2004.00
PIVKA
2004.00
Euglobulin Lysis time
2004.00
Haemoglobin A2 (column chromatography)
2004.00
Haemoglobin electrophoresis
2004.00

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

Page 71 of 84

4.500
3.650
7.200
2.250
8.450
6.940
7.200
19.900
2.250
19.900
8.400
32.600
36.800
2.020
5.850
57.560
26.000
3.160
53.600
3.600
37.500
3.600
3.600
30.290
22.000
61.650
17.000
25.000
2.250
7.200
9.450
4.500
3.000
4.500
2.700
65.950
67.790
2.250
10.000
18.000
5.500
10.500
7.200
32.200
60.460
11.720
61.110
1.800
16.200
3.600
3.600
43.490
25.580
15.000
26.820

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
0.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
0.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

32.26
26.40
51.77
16.13
60.86
49.86
51.77
142.99
142.99
60.42
233.92
264.13
14.55
42.09
413.57
186.40
22.73
385.12
25.81
269.41
25.81
25.81
217.64
158.39
442.90
121.72
179.95
16.13
51.77
67.90
32.26
21.56
32.26
19.36
473.85
487.04
16.13
71.71
129.35
75.38
51.77
231.42
434.39
84.18
439.09
12.94
116.44
25.81
25.81
312.38
183.76
107.79
192.71

48.54
39.30
77.58
24.20
91.07
74.79
77.58
214.41
214.41
90.49
351.39
396.56
21.71
63.06
620.35
280.26
34.02
577.68
38.86
404.18
38.86
38.86
326.46
237.14
664.50
183.17
269.41
24.20
77.58
101.78
48.54
32.26
48.54
29.04
710.84
730.64
24.20
107.79
194.03
113.22
77.58
346.99
651.59
126.27
658.63
19.36
174.67
38.86
38.86
468.71
275.71
161.61
289.06

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

3.000
2.450
4.800
1.500
5.650
4.630
4.800
13.270
1.500
13.270
5.600
21.700
24.500
1.350
3.900
38.370
17.300
2.110
35.730
2.400
25.000
2.400
2.400
20.190
14.700
41.100
11.300
16.700
1.500
4.800
6.300
3.000
2.000
3.000
1.800
43.970
45.190
1.500
6.650
12.000
3.670
7.000
4.800
21.470
40.310
7.810
40.740
1.200
10.800
2.400
2.400
28.990
17.050
10.000
17.880

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
0.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
0.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

3770
3771
3772
3773
3775
3776
3781
3783
3785
3786
3787
3789
3791
3792
3793
3794
3795
3796
3797
3799
3801
3803
3805
3806
3807
3809
3810
3811
3814
3816
3820
3825
3829
3830
3832
3834
3835
3837
3841
3843
3847
3851
3853
3854
3855
3856
3857
3858
21.2
3863
3864
3865
3867
3868
3869
3873
3874
3875
3878
3879
3880
3881
3882

Haemoglobin-S (solubility test)

Factor III-availability test
Haptoglobin: Quantitative
Ham's acidified serum test
Heinz bodies
Haemosiderin in urinary sediment
Heparin tolerance
Leucocyte differential count
Leucocytes: Total count
QBC malaria concentration and fluorescent staining
LE-cells
Neutrophil alkaline phosphatase
Packed cell volume: Haematocrit
Plasmodium falciparum: Monoclonal immunological identification
Plasma haemoglobin
Platelet sensitivities
Platelet aggregation per aggregant
Platelet antibodies: Agglutination
Platelet count
Platelet adhesiveness
Prothrombin consumption
Prothrombin determination (two stages)
Prothrombin index
Therapeutic drug level: Dosage
Recalcification time
Reticulocyte count
Schumm's test
Sickling test
Sucrose lysis test for PNH
T and B-cells EAC markers (limited to ONE marker only for CD4/8 counts)
Thrombo - Elastogram
Fibrinogen titre
Glucose 6-phosphate-dehydrogenase: Qualitative
Glucose 6-phosphate-dehydrogenase: Quantitative
Red cell pyruvate kinase: Quantitative
Red cell Rhesus phenotype
Haemoglobin F in blood smear
Partial thromboplastin time
Thrombin time (screen)
Thrombin time (serial)
Haemoglobin H
Fibrin degeneration products (diffusion plate)
Fibrin degeneration products (latex slide)
XDP (Dimer test or equivalent latex slide test)
Haemagglutination inhibition
D-Dimer (quantitative)
Ristocetin Cofactor
Heparin removal
Microscopic and miscellaneous tests
Autogenous vaccine
Entomological examination
Parasites in blood smear
Miscellaneous (body fluids, urine, exudate, fungi, puss, scrapings, etc.)
Fungus identification
Faeces (including parasites)
Transmission electron microscopy
Scanning electron microscopy
Inclusion bodies
Crystal identification polarized light microscopy
Campylobacter in stool: Fastidious culture
Antigen detection with polyclonal antibodies
Mycobacteria
Antigen detection with monoclonal antibodies

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

80 12.600 1.0 R
80 20.700 1.0 R
80
5.600 1.0 R
80
4.900 1.0 R
80
8.300 1.0 R
80
4.900 1.0 R
80 85.000 1.0 R
80 100.000 1.0 R
80
4.500 1.0 R
80
4.500 1.0 R
80
9.900 1.0 R
80
4.500 1.0 R
80
3.000 1.0 R
80 10.800 1.0 R

Page 72 of 84

3.600
5.850
9.450
8.000
2.250
2.250
7.200
6.200
1.800
25.000
8.300
28.000
1.800
9.000
6.750
18.640
12.140
5.400
2.250
4.500
5.850
5.850
6.000
4.500
2.250
3.000
3.600
2.250
3.600
21.100
26.000
3.600
8.000
16.000
16.000
9.900
5.850
5.850
7.160
7.650
2.250
10.350
4.500
8.500
9.900
27.520
35.530
28.880

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

38.86
63.06
101.78
86.23
24.20
24.20
77.58
66.88
19.36
269.41
89.46
301.82
19.36
96.94
72.74
200.92
130.82
58.22
24.20
48.54
63.06
63.06
64.68
48.54
24.20
32.26
38.86
24.20
38.86
227.46
280.26
38.86
86.23
172.47
172.47
106.77
63.06
63.06
77.14
82.42
24.20
111.61
48.54
91.66
106.77
296.54
382.92
311.20
135.80
223.06
60.42
52.80
89.46
52.80
916.16
1 077.77
48.54
48.54
106.77
48.54
32.26
116.44

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

2.400
3.900
6.300
5.330
1.500
1.500
4.800
4.150
1.200
16.700
5.550
18.700
1.200
6.000
4.500
12.430
8.090
3.600
1.500
3.000
3.900
3.900
4.000
3.000
1.500
2.000
2.400
1.500
2.400
14.070
17.330
2.400
5.330
10.700
10.700
6.600
3.900
3.900
4.770
5.100
1.500
6.900
3.000
5.670
6.600
18.350
23.690
19.250

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

80
80
80
80
80
80
80
80
80
80
80
80
80
80

8.400
13.800
3.730
3.300
5.500
3.270
57.000
67.000
3.000
3.000
6.600
3.000
2.000
7.200

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R

25.81
42.09
67.90
57.49
16.13
16.13
51.77
44.73
12.94
179.95
59.84
201.51
12.94
64.68
48.54
133.90
87.26
38.86
16.13
32.26
42.09
42.09
43.12
32.26
16.13
21.56
25.81
16.13
25.81
151.64
186.84
25.81
57.49
115.27
115.27
71.13
42.09
42.09
51.48
55.00
16.13
74.35
32.26
61.16
71.13
197.84
255.33
207.52
90.49
148.71
40.18
35.64
59.25
35.20
614.34
722.13
32.26
32.26
71.13
32.26
21.56
77.58

3883
3884
3885
21.3
3887
3888
3889
3890
3891
3892
3893
3894
3895
3896
3897
3898
3899
3901
3902
3903
3904
3905
3906
3907
3908
3909
3911
3914
3915
3916
3917
3918
3919
3920
3921
3922
3923
3924
3925
3926
3927
3928
3929
3930
3931
4650
4651
4652
4653
4654
4655
4656
4657
21.4
3958
3959
3960
3961
3962
3963
3965
3966
3967

Concentration techniques for parasites

Dark field, phase or interference contrast microscopy, Nomarski or Fontana
Cytochemical stain
Bacteriology
Antibiotic susceptibility test: Per organism
Adhesive tape preparation
Clostridium difficile toxin: Monoclonal immunological
Antibiotic assay of tissues and fluids
Blood culture: Aerobic
Blood culture: Anaerobic
Bacteriological culture: Miscellaneous
Radiometric blood culture
Bacteriological culture: Fastidious organisms
In vivo culture: Bacteria
In vivo culture: Virus
Bacterial exotoxin production (in vitro assay)
Bacterial exotoxin production (in vivo assay)
Fungal culture
Clostridium difficile (cytotoxicity neutralisation)
Antibiotic level: Biological fluids
Rotavirus latex slide test
Identification of virus or rickettsia
Identification: Chlamydia
Culture for staphylococcus aureus
Anaerobe culture: Comprehensive
Anaerobe culture: Limited procedure
Beta-lactamase assay
Sterility control test: Biological method
Mycobacterium culture
Radiometric tuberculosis culture
Mycoplasma culture: Limited
Mycoplasma culture: Comprehensive
Identification of mycobacterium
Mycobacterium: Antibiotic sensitivity
Antibiotic synergistic study
Viable cell count
Biochemical identification of bacterium: Abridged
Biochemical identification of bacterium: Extended
Serological identification of bacterium: Abridged
Serological identification of bacterium: Extended
Grouping for streptococci
Antimicrobic substances
Radiometric mycobacterium identification
Radiometric mycobacterium antibiotic sensitivity
Helicobacter: Monoclonal immunological
Antibiotic MIC per organism per antibiotic
Non-radiometric automated blood cultures
Rapid automated bacterial identification per organism
Rapid automated antibiotic susceptibility per organism
Rapid automated MIC per organism per antibiotic
Mycobacteria: MIC determination - E Test
Mycobacteria: Identification HPLC
Mycobacteria: Liquefied, consentrated, fluorochrome stain
Serology
Anti Gad/Ia2 Ab
Rose Waaler agglutination test
Gonococcal, listeria or echinococcus agglutination
Slide agglutination test
Rebuck skin window
Serum complement level: Each component
Anti Ia2 Antibodies
Anti Gad Antibodies
Auto-antibody: Sensitized erythrocytes

2004.00
2004.00
2004.00

80
80
80

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2005.03
2005.03
2005.03

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

8.000
2.700
12.400
13.900
5.850
5.850
6.300
10.800
9.900
16.000
16.000
4.500
20.700
4.500
30.000
11.700
5.620
20.700
16.000
2.250
9.900
4.500
4.500
4.500
4.500
10.800
2.250
9.900
9.900
9.900
20.700
1.350
3.150
12.500
3.150
10.200
7.300
3.800
14.000
25.000
12.400
8.000
13.900
15.000
17.000
17.000
16.500
35.000
9.900

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

80
80
80
80
80
80
80
80
80

67.950
4.500
9.500
2.630
5.400
3.150
36.000
36.000
4.500

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

Page 73 of 84

3.000 1.0 R
6.300 1.0 R
5.450 1.0 R

32.26
67.90
58.81
86.23
29.04
133.60
149.88
63.06
63.06
67.90
116.44
106.77
172.47
172.47
48.54
223.06
48.54
323.38
126.12
60.57
223.06
172.47
24.20
106.77
48.54
48.54
48.54
48.54
116.44
24.20
106.77
106.77
106.77
223.06
14.55
33.88
134.78
33.88
109.99
78.61
40.92
150.91
269.41
133.60
86.23
149.88
161.61
183.17
183.17
177.89
377.20
106.77
732.40
48.54
102.37
28.30
58.22
33.88
388.05
388.05
48.54

80
80
80

Z
Z
Z

2.000 1.0 R
4.200 1.0 R
3.650 1.0 R

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

5.330
1.800
8.270
9.270
3.900
3.900
4.200
7.200
6.600
10.650
10.650
3.000
13.800
3.000
20.000
7.800
3.750
13.800
10.650
1.500
6.600
3.000
3.000
3.000
3.000
7.200
1.500
6.600
6.600
6.600
13.800
0.900
2.100
8.330
2.100
6.800
4.850
2.500
9.300
16.700
8.270
5.330
9.270
10.000
11.330
11.330
11.000
23.330
6.600

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

80
80
80
80
80
80
80
80
80

45.300
3.000
6.300
1.750
3.600
2.100
24.000
24.000
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R

21.56
45.32
39.30
57.49
19.36
89.17
99.87
42.09
42.09
45.32
77.58
71.13
114.83
114.83
32.26
148.71
32.26
215.58
84.03
40.48
148.71
114.83
16.13
71.13
32.26
32.26
32.26
32.26
77.58
16.13
71.13
71.13
71.13
148.71
9.69
22.58
89.75
22.58
73.33
52.21
26.98
100.17
179.95
89.17
57.49
99.87
107.79
122.16
122.16
118.50
251.51
71.13
488.22
32.26
67.90
18.92
38.86
22.58
258.70
258.70
32.26

Z
Z
Z

3968
3969
3970
3932
3933
3934
3935
3936
3937
3938
3939
3940
3941
3942
3943
3944
3945
3946
3947
3948
3949
3950
3951
3952
3953
3955
3956
3957
3971
3972
3973
3974
3975
3977
3978
3980
3982
4600
4601
4602
4603
4604
4605
4606
4607
4608
4609
4610
4611
4612
4613
4614
21.5

21.6
3991
3993
3995
3996
3997
3998
3999

Herpes virus typing: Monoclonal immunological

Western blot technique
Epstein-Barr virus antibody titer
Antibodies to human immunodeficiency virus (HIV): ELISA
IgE: Total: EMIT or ELISA
Auto antibodies by labelled antibodies
Sperm antibodies
Virus neutralisation test: First antibody
Virus neutralisation test: Each additional antibody
Precipitation test per antigen
Agglutination test per antigen
Haemagglutination test: Per antigen
Modified Coombs' test for brucellosis
Hepatitis Rapid Viral Ab
Antibody titer to bacterial exotoxin
IgE: Specific antibody titer: ELISA/EMIT: Per Ag
Complement fixation test
IgM: Specific antibody titer:ELISA/EMIT: Per Ag
C-reactive protein
IgG: Specific antibody titer: ELISA/EMIT: Per Ag
Qualitative Kahn, VDRL or other flocculation
Neutrophil phagocytosis
Quantitative Kahn, VDRL or other flocculation
Neutrophil chemotaxis
Tube agglutination test
Paul Bunnell: Presumptive
Infectious mononucleosis latex slide test (Monospot or equivalent)
Paul Bunnell: Absorption
Immuno-diffusion test: Per antigen
Respiratory syncytial virus (ELISA technique)
Immuno electrophoresis: Per immune serum
Polymerase chain reaction
Indirect immuno-fluorescence test (bacterial, viral, parasitic)
Counter immuno-electrophoresis
Lymphocyte transformation
Bilharzia Ag Serum/Urine
Histone Ab
Anti-CCP
Panel typing: Antibody detection: Class I
Panel typing: Antibody detection: Class II
HLA test for specific locus/antigen - serology
HLA typing: Class I - serology
HLA typing: Class II - serology
HLA typing: Class I & II - serology
Cross matching T-cells (per tray)
Cross matching B-cells
Cross matching T- & B-cells
Helicobacter: Pylori antigen test
Erythropoietin
HTLV I/II
Anti-Gm1 Antibody Assay
HIV Ab - Rapid Test
Skin tests
For skin-prick allergy tests, please refer to items 0218, 0220 and 0221 in Section 2: Integumentary
Section
Biochemical tests: Blood
Abnormal pigments: Qualitative
Abnormal pigments: Quantitative
Acid phosphate
Serum Amyloid A
Acid phosphatase fractionation
Amino acids Quantitative (Post derivatisation HPLC)
Albumin

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2005.03
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

20.690
74.000
6.750
14.100
11.700
16.000
16.000
75.000
15.000
4.500
5.500
9.900
4.500
12.240
3.600
12.400
5.850
14.050
10.840
12.950
2.250
25.200
3.600
67.950
4.150
2.250
8.500
4.500
3.150
35.000
9.450
75.000
12.000
6.750
51.700
14.500
16.000
17.460
36.000
44.000
27.000
52.000
52.000
90.000
18.000
38.000
48.000
34.600
20.000
20.000
75.000
12.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

80
80
80
80
80
80
80

4.500
9.000
5.180
8.280
1.800
78.120
4.800

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

2004.00

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

Page 74 of 84

223.06
797.51
72.74
151.94
126.12
172.47
172.47
808.37
161.61
48.54
59.25
106.77
48.54
131.99
38.86
133.60
63.06
151.50
116.88
139.62
24.20
271.61
38.86
732.40
44.73
24.20
91.66
48.54
33.88
377.20
101.78
808.37
129.35
72.74
557.15
156.34
172.47
188.16
388.05
474.28
290.97
560.37
560.37
969.98
194.03
409.61
517.40
372.95
215.58
215.58
808.37
129.35
48.54
96.94
55.88
89.17
19.36
841.95
51.77

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

13.790
49.000
4.500
9.400
7.800
10.650
10.650
50.000
10.000
3.000
3.670
6.600
3.000
8.160
2.400
8.270
3.900
9.370
7.227
8.630
1.500
16.800
2.400
45.300
2.760
1.500
5.670
3.000
2.100
23.000
6.300
50.000
8.000
4.500
34.500
9.670
10.670
11.640
24.000
29.300
18.000
34.700
34.700
60.000
12.000
25.300
32.000
23.070
13.330
13.330
50.000
8.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

80
80
80
80
80
80
80

3.000
6.000
3.450
5.520
1.200
52.080
3.200

1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R

148.56
528.11
48.54
101.34
84.03
114.83
114.83
538.96
107.79
32.26
39.60
71.13
32.26
87.99
25.81
89.17
42.09
101.05
77.87
92.98
16.13
181.12
25.81
488.22
29.77
16.13
61.16
32.26
22.58
247.85
67.90
538.96
86.23
48.54
371.77
104.27
114.98
125.39
258.70
315.75
194.03
373.97
373.97
646.61
129.35
272.63
344.93
248.58
143.72
143.72
538.96
86.23
32.26
64.68
37.25
59.54
12.94
561.25
34.46

4000
4001
4002
4003
4004
4005
4006
4007
4008
4009
4010
4011
4012
4013
4014
4016
4017
4018
4019
4020
4021
4022
4023
4025
4026
4027
4028
4029
4030
4031
4032
4033
4034
4035
4036
4038
4040
4041
4042
4045
4047
4049
4050
4051
4052
4053
4057
4061
4062
4063
4064
4066
4067
4068
4071
4073
4076
4078
4079
4081
4082
4083

Alcohol
Alkaline phosphatase
Alkaline phosphatase-iso-enzymes
Ammonia: Enzymatic
Ammonia: Monitor
Alpha-1-antitrypsin: Total
Amylase
Arsenic in blood, hair or nails
Bilirubin - Reflectance
Bilirubin: Total
Bilirubin: Conjugated
Breath Hydrogen Test
CSF Nicotinic Acid
CSF Glutamine
Cadmium: Atomic absorption
Calcium: Ionized
Calcium: Spectrophotometric
Calcium: Atomic absorption
Carotene
Carnitine (Total or free) in biological fluid: Each
Carnitine (Total or free) in muscle: Each
Acyl Carnitine
Chloride
Chol/HDL/LDL/Trig
LDL cholesterol (chemical determination)
Cholesterol total
HDL cholesterol
Cholinesterase: Serum or erythrocyte: Each
Cholinesterase phenotype (Dibucaine or fluoride each)
Total CO2
Creatinine
CSF-Immunoglobulin G
C1-Esterase Inhibitor
CSF-Albumin
CSF-IgG Index
Glutamic acid
Homocysteine (random)
Homocysteine (after Methionine load)
D-Xylose absorption test: Two hours
Fibrinogen: Quantitative
Hollander test
Glucose tolerance test (2 specimens)
Glucose strip-test with photometric reading
Galactose
Glucose tolerance test (3 specimens)
Glucose tolerance test (4 specimens)
Glucose: Quantitative
Glucose tolerance test (5 specimens)
Galactose-1-phosphate uridyl transferase
Fructosamine
HbA1C
Immunofixation: Total protein, IgG, IgA, IgM, Kappa, Lambda
Lithium: Flame ionisation
Lithium: Atomic absorption
Iron
Iron-binding capacity
Blood gases: Astrup/pO2 and ancillary tests - can only be charged to a maximum of 6 times per
patient per day
Oximetry analysis: MetHb, COHb, O2Hb, RHb, SulfHb
Ketones in plasma: Qualitative
Drug level-biological fluid: Quantitative
Tacrolimus assay
Lysosomal enzyme assay

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2006.04
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

12.400
5.180
11.700
7.710
4.500
7.200
5.180
36.250
4.770
4.770
3.620
21.560
12.420
11.250
18.120
6.750
3.620
7.250
2.250
11.690
23.380
23.380
2.590
27.070
6.900
5.340
6.900
7.480
9.000
5.180
3.620
9.450
9.450
9.450
22.050
29.060
15.300
18.100
13.150
3.600
24.750
8.970
1.800
11.250
13.170
17.370
3.620
21.560
16.000
7.200
14.250
46.880
5.180
7.480
6.750
7.650
19.100

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

133.60
55.88
126.12
83.15
48.54
77.58
55.88
390.69
51.48
51.48
39.01
232.30
133.90
121.28
195.35
72.74
39.01
78.17
24.20
125.98
251.95
251.95
27.86
291.70
74.35
57.49
74.35
80.66
96.94
55.88
39.01
101.78
101.78
101.78
237.58
313.26
164.84
195.05
141.67
38.86
266.77
96.65
19.36
121.28
141.96
187.28
39.01
232.30
172.47
77.58
153.55
505.23
55.88
80.66
72.74
82.42
205.90

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

8.270
3.450
7.800
5.140
3.000
4.800
3.450
24.170
3.180
3.180
2.410
14.370
8.280
7.500
12.080
4.500
2.410
4.830
1.500
7.790
15.590
15.590
1.730
18.050
4.600
3.560
4.600
4.990
6.000
3.450
2.410
6.300
6.300
6.300
14.700
19.370
10.200
12.060
8.750
2.400
16.500
5.980
1.200
7.500
8.780
11.580
2.410
14.370
10.700
4.800
9.500
31.250
3.450
4.990
4.500
5.100
12.730

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

89.17
37.25
84.03
55.44
32.26
51.77
37.25
260.46
34.32
34.32
25.96
154.87
89.17
80.81
130.23
48.54
25.96
52.06
16.13
83.89
168.07
168.07
18.63
194.47
49.57
38.42
49.57
53.82
64.68
37.25
25.96
67.90
67.90
67.90
158.39
208.84
109.99
129.94
94.30
25.81
177.89
64.38
12.94
80.81
94.59
124.80
25.96
154.87
115.27
51.77
102.37
336.87
37.25
53.82
48.54
55.00
137.27

2004.11
2004.00
2004.00
2004.00
2004.00

80
80
80
80
80

6.750
2.250
10.800
20.100
36.560

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

72.74
24.20
116.44
216.61
394.06

80
80
80
80
80

4.500
1.500
7.200
13.400
24.370

1.0
1.0
1.0
1.0
1.0

R
R
R
R
R

48.54
16.13
77.58
144.46
262.66

Page 75 of 84

4084
4085
4086
4091
4092
4093
4094
4095
4096
4098
4105
4106
4109
4111
4113
4114
4117
4121
4123
4125
4126
4127
4128
4129
4130
4131
4132
4133
4134
4135
4136
4137
4138
4139
4142
4143
4144
4146
4147
4148
4149
4151
4152
4153
4154
4155
4156
4157
4158
4159
4160
4161
4163
4165
4167
4170
4171
4172
4173
4181
4182
4183
4184

Thymidine kinase
Lipase
Lactate
Lipoprotein electrophoresis
Orosmucoid
Osmolality: Serum or urine
Magnesium: Spectrophotometric
Magnesium: Atomic absorption
Mercury: Atomic absorption
Copper: Atomic absorption
Protein electrophoresis
IgG sub-class 1, 2, 3 or 4: Per sub-class
Phosphate
Phospholipids
Potassium
Sodium
Protein: Total
pH, pCO2 or pO2: Each
Pyruvic acid
Salicylates
Secretin-pancreozymin response
Caeruloplasmin
Phenylalanine: Quantitative
Glutamate dehydrogenase (GDH)
Aspartate aminotransferase (AST)
Alanine aminotransferase (ALT)
Creatine kinase (CK)
Lactate dehidrogenase (LD)
Gamma glutamyl transferase (GGT)
Aldolase
Angiotensin converting enzyme (ACE)
Lactate dehydrogenase isoenzyme
CK-MB: Immunoinhibition/precipitation
Adenosine deaminase
Red cell enzymes: Each
Serum/plasma enzymes
Transferrin
Lead: Atomic absorption
Triglyceride
Tay - Sachs Study
Red cell magnesium
Urea
CK-MB: Mass determination: Quantitative (Automated)
CK-MB: Mass determination: Quantitative (Not automated)
Myoglobin quantitative: Monoclonal immunological
Uric acid
Vitamin D3
Vitamin A-saturation test
Vitamin E (tocopherol)
Vitamin A
Vitamin C (ascorbic acid)
Troponin isoforms: Each
Apoprotein AI: Turbidometric method
Apoprotein AII: Turbidometric method
Apoprotein B: Turbidometric method
Lipoprotein (a)(Lp(a)) assay
Sodium + potassium + chloride + CO2 + urea
ELISA/EMIT technique
Sirolimus Assay
Quantitative protein estimation: Mancini method
Quantitative protein estimation: Nephelometer or Turbidometeric method
Quantitative protein estimation: Labelled antibody
C-reactive protein (Ultra sensitive)

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.11
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

Page 76 of 84

20.000
5.180
16.000
9.000
9.450
6.750
3.620
7.250
18.120
18.120
9.000
20.000
3.620
3.150
3.620
3.620
3.110
6.750
4.500
4.500
26.100
4.500
11.250
5.400
5.400
5.400
5.400
5.400
5.400
5.400
9.000
10.800
10.800
5.400
7.800
5.400
11.700
15.000
7.930
36.560
11.700
3.620
12.400
17.470
12.400
3.780
12.420
15.300
3.600
6.300
2.250
20.000
8.280
8.280
8.280
12.420
15.840
12.420
78.000
7.760
8.280
12.420
11.680

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

215.58
55.88
172.47
96.94
101.78
72.74
39.01
78.17
195.35
195.35
96.94
215.58
39.01
33.88
39.01
39.01
33.58
72.74
48.54
48.54
281.29
48.54
121.28
58.22
58.22
58.22
58.22
58.22
58.22
58.22
96.94
116.44
116.44
58.22
84.03
58.22
126.12
161.61
85.50
394.06
126.12
39.01
133.60
188.31
133.60
40.77
133.90
164.84
38.86
67.90
24.20
215.58
89.17
89.17
89.17
133.90
170.71
133.90
840.63
83.59
89.17
133.90
125.83

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

13.330
3.450
10.670
6.000
6.300
4.500
2.410
4.830
12.080
12.080
6.000
13.200
2.410
2.100
2.410
2.410
2.070
4.500
3.000
3.000
17.400
3.000
7.500
3.600
3.600
3.600
3.600
3.600
3.600
3.600
6.000
7.200
7.200
3.600
5.200
3.600
7.800
10.000
5.290
24.370
7.800
2.410
8.270
11.650
8.270
2.520
8.280
10.200
2.400
4.200
1.500
13.330
5.520
5.520
5.520
8.280
10.560
8.280
52.000
5.170
5.520
8.280
7.790

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

143.72
37.25
114.98
64.68
67.90
48.54
25.96
52.06
130.23
130.23
64.68
142.26
25.96
22.58
25.96
25.96
22.29
48.54
32.26
32.26
187.57
32.26
80.81
38.86
38.86
38.86
38.86
38.86
38.86
38.86
64.68
77.58
77.58
38.86
56.02
38.86
84.03
107.79
57.05
262.66
84.03
25.96
89.17
125.54
89.17
27.13
89.17
109.99
25.81
45.32
16.13
143.72
59.54
59.54
59.54
89.17
113.80
89.17
560.37
55.73
59.54
89.17
83.89

4185
4186
4187
21.7
4188
4189
4193
4194
4195
4197
4198
4199
4201
4203
4204
4205
4206
4209
4210
4211
4213
4216
4217
4218
4219
4220
4221
4223
4227
4228
4229
4230
4231
4232
4233
4234
4237
4238
4239
4247
4248
4251
4252
4253
4254
4255
4256
4261
4262
4263
4265
4266
4267
4268
4269
4270
4271
4272
4273
4283
4284
4285
4287

Lactose
Vitamin B6
Zinc: Atomic absorption
Biochemical tests: Urine
Urine dipstick, per stick (irrespective of the number of tests on stick)
Abnormal pigments
Alkapton test: Homogentisic acid
Amino acids: Quantitative (Post derivatisation HPLC)
Amino laevulinic acid
Amylase
Arsenic
Ascorbic acid
Bence-Jones protein
Phenol
Calcium: Atomic absorption
Calcium: Spectrophotometric
Calcium: Absorption and excretion studies
Lead: Atomic absorption
Urine collagen telopeptides
Bile pigments: Qualitative
Protein: Quantitative
Mucopolysaccharides: Qualitative
Oxalate
Glucose: Quantitative
Steroids: Chromatography (each)
Klinolab Newborn Screen
Creatinine
Creatinine clearance
Electrophoresis: Qualitative
Fetal Lung Maturity
Uric acid clearance
Urine/Fluid - Specific Gravity
Metabolites HPLC (High Pressure Liquid Chromatography)
Metabolites (Gaschromatography/Mass spectrophotometry)
Pharmacological/Drugs of abuse: Metabolites HPLC (High Pressure Liquid Chromatography)
Pharmacological/Drugs of abuse: Metabolites (Gaschromatography/Mass spectrophotometry)
5-Hydroxy-indole-acetic acid: Screen test
5HIAA (Hplc)
5-Hydroxy-indole-acetic acid: Quantitative
Ketones: Excluding dip-stick method
Reducing substances
Metanephrines: Column chromatography
Metanephrine (Hplc)
Aromatic amines (gas chromatography/mass spectrophotometry)
Nitrosonaphtol test for tyrosine
Orotic Acid - Urine
Very long Chain Fatty Acids
Micro Albumin: Quantitative
Micro Albumin: Qualitative
pH: Excluding dip-stick method
Thin layer chromatography: One way
Thin layer chromatography: Two way
Total organic matter screen: Infrared
Organic acids: Quantitative: GCMS
Phenylpyruvic acid: Ferric chloride
Chromium Total Urine
Phosphate excretion index
Porphobilinogen qualitative screen: Urine
Porphobilinogen/ALA: Quantitative each
Magnesium: Spectrophotometric
Magnesium: Atomic absorption
Identification of carbohydrate
Identification of drug: Qualitative

2004.00
2004.00
2004.00

80
80
80

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2005.03
2005.03
2005.03
2005.03
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

80
1.500 1.0 R
80
4.500 1.0 R
80
4.500 1.0 R
80 78.120 1.0 R
80 18.000 1.0 R
80
5.180 1.0 R
80 18.120 1.0 R
80
2.250 1.0 R
80
2.700 1.0 R
80
3.600 1.0 R
80
7.250 1.0 R
80
3.620 1.0 R
80 25.000 1.0 R
80 15.000 1.0 R
80 36.500 1.0 R
80
2.250 1.0 R
80
2.250 1.0 R
80
3.600 1.0 R
80
9.380 1.0 R
80
2.250 1.0 R
80
7.200 1.0 R
80 36.560 1.0 R
80
3.620 1.0 R
80
7.650 1.0 R
80
4.500 1.0 R
80 36.560 1.0 R
80
7.650 1.0 R
80
0.900 1.0 R
80 37.500 1.0 R
80 46.800 1.0 R
80 37.500 1.0 R
80 46.800 1.0 R
80
2.700 1.0 R
80 78.120 1.0 R
80
6.750 1.0 R
80
2.250 1.0 R
80
1.800 1.0 R
80 22.050 1.0 R
80 78.120 1.0 R
80 27.000 1.0 R
80
2.250 1.0 R
80
9.450 1.0 R
80 129.380 1.0 R
80 12.420 1.0 R
80
4.500 1.0 R
80
0.900 1.0 R
80
6.750 1.0 R
80 11.250 1.0 R
80 31.250 1.0 R
80 109.380 1.0 R
80
2.250 1.0 R
80 18.120 1.0 R
80 22.050 1.0 R
80
5.000 1.0 R
80 15.000 1.0 R
80
3.620 1.0 R
80
7.250 1.0 R
80
7.650 1.0 R
80
4.500 1.0 R

Page 77 of 84

10.800 1.0 R
15.300 1.0 R
18.120 1.0 R

116.44
164.84
195.35
16.13
48.54
48.54
841.95
194.03
55.88
195.35
24.20
29.04
38.86
78.17
39.01
269.41
161.61
393.33
24.20
24.20
38.86
101.05
24.20
77.58
394.06
39.01
82.42
48.54
394.06
82.42
9.69
404.18
504.35
404.18
504.35
29.04
841.95
72.74
24.20
19.36
237.58
841.95
290.97
24.20
101.78
1 394.40
133.90
48.54
9.69
72.74
121.28
336.87
1 178.82
24.20
195.35
237.58
53.82
161.61
39.01
78.17
82.42
48.54

Z
Z
Z
Z

80
80
80

7.200 1.0 R
10.200 1.0 R
12.080 1.0 R

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

1.000
3.000
3.000
52.080
12.000
3.450
12.080
1.500
1.800
2.400
4.830
2.410
16.700
10.000
24.330
1.500
1.500
2.400
6.250
1.500
4.800
24.370
2.410
5.100
3.000
24.370
5.100
0.600
25.000
31.200
25.000
31.200
1.800
52.080
4.500
1.500
1.200
14.700
52.080
18.000
1.500
6.300
86.250
8.280
3.000
0.600
4.500
7.500
20.830
72.920
1.500
12.080
14.700
3.330
10.000
2.410
4.830
5.100
3.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

77.58
109.99
130.23
10.78
32.26
32.26
561.25
129.35
37.25
130.23
16.13
19.36
25.81
52.06
25.96
179.95
107.79
262.22
16.13
16.13
25.81
67.32
16.13
51.77
262.66
25.96
55.00
32.26
262.66
55.00
6.47
269.41
336.28
269.41
336.28
19.36
561.25
48.54
16.13
12.94
158.39
561.25
194.03
16.13
67.90
929.65
89.17
32.26
6.47
48.54
80.81
224.53
785.93
16.13
130.23
158.39
35.93
107.79
25.96
52.06
55.00
32.26

Z
Z
Z
Z

4288
4293
4297
4298
4300
4301
4307
4309
4313
4315
4316
4319
4321
4322
4323
4325
4326
4327
4328
4335
4336
4337
21.8
4339
4343
4345
4347
4351
4352
4357
4358
4359
4361
4362
4363
4364
21.9
4366
4367
4368
4369
4370
4371
4372
4373
4374
4375
4376
4377
4378
4380
4381
4382
4386
4387
4388
4389
4390
4391
4392
4393
4394
4395

Identification of drug: Quantitative

Urea clearance
Copper: Spectrophotometric
Copper: Atomic absorption
Indican or indole: Qualitative
Chloride
Ammonium chloride loading test
Urobilinogen: Quantitative
Phosphates
Potassium
Sodium
Urea
Uric acid
Fluoride
Total protein and protein electrophoresis
VMA: Quantitative
Catecholamines (HPLC)
Immunofixation: Total protein, IgG, IgA, IgM, Kappa, Lambda
Immunoglobulin D
Cystine: Quantitative
Dinitrophenol hydrazine test: Ketoacids
Hydroxyproline: Quantitative
Biochemical tests: Faeces
Chloride
Fat: Qualitative
Fat: Quantitative
Ph
Occult blood: Chemical test
Occult blood: Monoclonal antibodies
Potassium
Sodium
Secretory IgA
Stercobilin
Elastase quantitative ELISA
Stercobilinogen: Quantitative
Chymotrypsin determination: Enzymatic
Biochemical tests: Miscellaneous
Porphyrin screen qualitative: Urine, stool, red blood cells: Each
Porphyrin qualitative analysis by TLC: Urine, stool, red blood cells: Each
Porphyrin: Total quantisation: Urine, stool, red blood cells: Each
Porphyrin quantitative analysis by TLC/HPLC: Urine, stool, red blood cells: Each
Drug level in biological fluid: Monoclonal immunological
Amylase in exudate
Fluoride in biological fluids and water
Breast milk analysis
Trace metals in biological fluid: Atomic absorption
Calcium in fluid: Spectrophotometric
Calcium in fluid: Atomic absorption
Gallstone analysis: (Bilirubin, Ca, P, Oxalate, Cholesterol)
Urea breath test
Lecithin in amniotic fluid: L/S ratio
Lamellar body count in amniotic fluid
Bilirubin in amniotic fluid: Spectrophotometric essay
Oestrogen/Progesterone receptors: Fluorescent method
Oestrogen/Progesterone receptors: Cytosol radio-isotope technique
Gastric contents: Maximal stimulation test
Gastric fluid: Total acid per specimen
Foam test: Amniotic fluid
Renal calculus: Chemistry
Renal calculus: Crystallography
Saliva: Potassium
Saliva: Sodium
Sweat: Sodium

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.11
2004.00
2004.00
2004.00
2004.00

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

10.800
5.400
3.620
18.120
3.150
2.590
22.050
6.750
3.620
3.620
3.620
3.620
3.620
5.180
11.250
11.250
78.120
46.880
9.450
12.600
2.250
18.900

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

80
80
80
80
80
80
80
80
80
80
80
80
80

2.590
3.150
22.050
0.900
2.250
10.000
3.620
3.620
9.450
2.250
47.000
6.750
7.470

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.11
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

80
5.000 1.0 R
80 20.000 1.0 R
80 20.000 1.0 R
80 30.000 1.0 R
80 12.400 1.0 R
80
5.180 1.0 R
80 15.620 1.0 R
80
6.750 1.0 R
80 18.130 1.0 R
80
3.620 1.0 R
80
7.250 1.0 R
80 21.880 1.0 R
80 58.000 1.0 R
80 27.000 1.0 R
80 10.000 1.0 R
80
9.450 1.0 R
80 20.700 1.0 R
80 230.000 1.0 R
80 27.000 1.0 R
80
2.250 1.0 R
80
3.150 1.0 R
80
5.400 1.0 R
80 16.250 1.0 R
80
3.620 1.0 R
80
3.620 1.0 R
80
3.620 1.0 R

Page 78 of 84

116.44
58.22
39.01
195.35
33.88
27.86
237.58
72.74
39.01
39.01
39.01
39.01
39.01
55.88
121.28
121.28
841.95
505.23
101.78
135.80
24.20
203.70
27.86
33.88
237.58
9.69
24.20
107.79
39.01
39.01
101.78
24.20
506.55
72.74
80.51
53.82
215.58
215.58
323.38
133.60
55.88
168.36
72.74
195.35
39.01
78.17
235.82
625.05
290.97
107.79
101.78
223.06
2 478.92
290.97
24.20
33.88
58.22
175.11
39.01
39.01
39.01

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

7.200
3.600
2.410
12.080
2.100
1.730
14.700
4.500
2.410
2.410
2.410
2.410
2.410
3.450
7.500
7.500
52.080
31.250
6.300
8.400
1.500
12.600

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

80
80
80
80
80
80
80
80
80
80
80
80
80

1.730
2.100
14.700
0.600
1.500
6.670
2.410
2.410
6.300
1.500
31.330
4.500
4.980

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R

80
3.330 1.0 R
80 13.330 1.0 R
80 13.330 1.0 R
80 20.000 1.0 R
80
8.270 1.0 R
80
3.450 1.0 R
80 10.410 1.0 R
80
4.500 1.0 R
80 12.090 1.0 R
80
2.410 1.0 R
80
4.830 1.0 R
80 14.590 1.0 R
80 38.670 1.0 R
80 18.000 1.0 R
80
6.700 1.0 R
80
6.300 1.0 R
80 13.800 1.0 R
80 153.000 1.0 R
80 18.000 1.0 R
80
1.500 1.0 R
80
2.100 1.0 R
80
3.600 1.0 R
80 10.800 1.0 R
80
2.410 1.0 R
80
2.410 1.0 R
80
2.410 1.0 R

77.58
38.86
25.96
130.23
22.58
18.63
158.39
48.54
25.96
25.96
25.96
25.96
25.96
37.25
80.81
80.81
561.25
336.87
67.90
90.49
16.13
135.80
18.63
22.58
158.39
6.47
16.13
71.86
25.96
25.96
67.90
16.13
337.60
48.54
53.68
35.93
143.72
143.72
215.58
89.17
37.25
112.19
48.54
130.23
25.96
52.06
157.22
416.80
194.03
72.15
67.90
148.71
1 649.00
194.03
16.13
22.58
38.86
116.44
25.96
25.96
25.96

4396 Sweat: Potassium

4397 Sweat: Chloride
4399 Sweat collection by iontophoresis (excluding collection material)
4400 Tryptophane loading test
21.10 Cerebrospinal fluid
4401 Cell count
4407 Cell count, protein, glucose and chloride
4409 Chloride
4415 Potassium
4416 Sodium
4417 Protein: Qualitative
4419 Protein: Quantitative
4421 Glucose
4423 Urea
4425 Protein electrophoresis
21.11 RNA/DNA based tests and andrology
21.11.1RNA/DNA based tests and andrology: RNA/DNA based tests
4424 HLA test for specific allele DNA-PCR
4426 HLA typing low resolution Class I DNA-PCR per locus
4427 HLA typing low resolution Class II DNA-PCR per locus
4428 HLA typing high resolution Class I or II DNA-PCR per locus
4429 Quantitative PCR (DNA/RNA)
4430 Recombinant DNA technique
4431 Ribosomal RNA targeting for bacteriological identification
4432 Ribosomal RNA amplification for bacteriological identification
4433 Bacteriological DNA identification (LCR)
4434 Bacteriological DNA identification (PCR)
4439 Quantitative PCR - viral load (not HIV) - hepatitis C, hepatitis B, CMV, etc.
21.11.2RNA/DNA based tests and andrology: Andrology
4435 Mixed antiglobulin reaction: Semen
4436 Friberg test: Semen
4437 Kremer test: Semen
4440 Semen analysis: Cell count
4441 Semen analysis: Cytology
4442 Semen analysis: Viability + motility - 6 hours
4443 Semen analysis: Supravital stain
4445 Seminal fluid: Alpha glucosidase
4446 Seminal fluid fructose
4447 Seminal fluid: Acid phosphatase
21.12 Immunology
4448 HCG: Latex agglutination: Qualitative (side room)
4449 HCG: Latex agglutination: Semi-quantitative (side room)
4450 HCG: Monoclonal immunological: Qualitative
4451 HCG: Monoclonal immunological: Quantitative
4452 Bone Specific Alk Phosphatase
4455 Anti IgE receptor antibody test (10 samples and dilution)
4456 Eosinophil cationic protein
4457 Mast cell tryptase
4458 Micro-albuminuria: Radio-isotope method
4459 Acetyl choline receptor antibody
4460 CA-199 tumour marker
4461 Nuclear Matrix Protein 22
4462 CA-125 tumour marker
4463 C6 complement functional essay
4464 House dust mite antigen ELIZA
4466 Beta-2-microglobulin
4467 Chromograqnin A
4468 CA-549
4469 Tumour markers: Monoclonal immunological (each)
4470 CA-195 tumour marker
4471 Carcino-embryonic antigen
4472 MCA antigen tumour marker
4473 TSH Receptor Ab

2004.00
2004.00
2004.00
2004.00

80
80
80
80

3.620
2.590
4.500
22.050

1.0
1.0
1.0
1.0

R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

80
80
80
80
80
80
80
80
80
80

3.450
7.650
2.590
3.620
3.620
0.900
3.110
3.620
3.620
12.600

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2005.03

80 36.000 1.0 R
80 100.000 1.0 R
80 74.000 1.0 R
80 66.000 1.0 R
80 84.300 1.0 R
80 25.000 1.0 R
80 35.000 1.0 R
80 75.000 1.0 R
80 25.000 1.0 R
80 75.000 1.0 R
80 150.000 1.0 R

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

80
80
80
80
80
80
80
80
80
80

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

80
4.000 1.0 R
80
9.310 1.0 R
80 10.000 1.0 R
80 12.400 1.0 R
80 20.000 1.0 R
80 161.560 1.0 R
80 27.810 1.0 R
80 96.870 1.0 R
80 12.420 1.0 R
80 158.120 1.0 R
80 20.000 1.0 R
80 35.000 1.0 R
80 20.000 1.0 R
80 45.000 1.0 R
80 20.310 1.0 R
80 12.420 1.0 R
80 47.000 1.0 R
80 20.000 1.0 R
80 20.000 1.0 R
80 20.000 1.0 R
80 20.000 1.0 R
80 20.000 1.0 R
80 17.480 1.0 R

Page 79 of 84

6.600
14.500
3.600
7.650
7.200
6.000
5.440
20.000
3.150
5.180

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

39.01
27.86
48.54
237.58
37.25
82.42
27.86
39.01
39.01
9.69
33.58
39.01
39.01
135.80
388.05
1 077.77
797.51
711.28
908.53
269.41
377.20
808.37
269.41
808.37
1 616.73
71.13
156.34
38.86
82.42
77.58
64.68
58.66
215.58
33.88
55.88
43.12
100.31
107.79
133.60
215.58
1 741.24
299.76
1 044.04
133.90
1 704.14
215.58
377.20
215.58
484.99
218.96
133.90
506.55
215.58
215.58
215.58
215.58
215.58
188.45

80
80
80
80

2.410
1.730
3.000
14.700

1.0
1.0
1.0
1.0

R
R
R
R

80
80
80
80
80
80
80
80
80
80

2.300
5.100
1.730
2.410
2.410
0.600
2.070
2.410
2.410
8.400

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

80 24.000
80 67.000
80 49.300
80 44.000
80 56.200
80 16.670
80 23.330
80 50.000
80 16.670
80 50.000
80 100.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R

80
80
80
80
80
80
80
80
80
80

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R

4.400
9.670
2.400
5.100
4.800
4.000
3.630
13.330
2.100
3.450

80
2.670 1.0 R
80
6.210 1.0 R
80
6.670 1.0 R
80
8.270 1.0 R
80 13.330 1.0 R
80 107.710 1.0 R
80 18.540 1.0 R
80 64.580 1.0 R
80
8.300 1.0 R
80 105.410 1.0 R
80 13.330 1.0 R
80 23.330 1.0 R
80 13.330 1.0 R
80 30.000 1.0 R
80 13.540 1.0 R
80
8.280 1.0 R
80 31.330 1.0 R
80 13.300 1.0 R
80 13.330 1.0 R
80 13.330 1.0 R
80 13.330 1.0 R
80 13.330 1.0 R
80 11.650 1.0 R

25.96
18.63
32.26
158.39
24.78
55.00
18.63
25.96
25.96
6.47
22.29
25.96
25.96
90.49
258.70
722.13
531.33
474.28
605.69
179.65
251.51
538.96
179.65
538.96
1 077.77
47.37
104.27
25.81
55.00
51.77
43.12
39.16
143.72
22.58
37.25
28.74
66.88
71.86
89.17
143.72
1 160.93
199.89
696.03
89.46
1 136.14
143.72
251.51
143.72
323.38
145.92
89.17
337.60
143.28
143.72
143.72
143.72
143.72
125.54

4474
4475
4476
4477
4478
4479
4480
4482
4484
4485
4486
4487
4488
4490
4491
4492
4493
4494
4495
4496
4497
4499
4500
4501
4502
4503
4505
4506
4507
4508
4509
4511
4512
4513
4514
4515
4516
4517
4518
4519
4520
4521
4522
4523
4524
4526
4527
4528
4529
4530
4531
4532
4533
4534
4536
4537
4538
4539
4540
4546
4552
4553
4554

Cast Per Allergen

CA-724
Neopterin
Neuron specific enolase
Osteocalcin
Vitamin B12-absorption: Shilling test
Serotonin
Free thyroxine (FT4)
Thyrotropin (TSH) + Free Thyroxine (FT4)
Insulin
C-Peptide
Calcitonin
B-Type Natriuretic Peptide
Releasing hormone response
Vitamin B12
Vitamin D3: Calcitroil (RIA)
Drug concentration: Quantitative
Free hormone assay
Growth hormone
Hormone concentration: Quantitative
Carbohydrate deficient transferrin
Cortisol
DHEA sulphate
Testosterone
Free testosterone
Oestradiol
Oestriol
Multiple antigen specific IgE screening test for Atopy
Thyrotropin (TSH)
Combined antigen specific IgE
Free tri-iodothyronine (FT3)
Renin activity
Parathormone
IgE: Total
Antigen specific IgE
Aldosterone
Follitropin (FSH)
Lutropin (LH)
Soluble transferrin receptor
Prostate specific antigen
17 Hydroxy progesterone
Progesterone
Alpha-feto protein
ACTH
Free PSA
Sex hormone binding globulin
Gastrin
Ferritin
Anti-DNA antibodies
Antiplatelet antibodies
Hepatitis: Per antigen or antibody
Transcobalamine
Folic acid
Prostatic acid phosphatase
Erythrocyte folate
Prolactin
Procalcitonin: Semi-quantitative
Procalcitonin: Quantitative
HCG: Quantitative as used for Down's screen
First trimester Downs screen
Second Trimester Down's screen
Thyroglubulin
SCC marker

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

Page 80 of 84

27.810
20.000
20.000
20.000
31.400
11.700
18.750
17.480
37.080
12.420
12.420
18.900
47.040
50.000
12.420
75.000
12.420
17.480
12.420
12.420
29.060
12.420
12.420
12.420
17.480
12.420
10.800
37.260
19.600
24.480
17.480
18.900
17.080
12.420
12.420
12.420
12.420
12.420
11.250
14.490
12.420
12.420
12.420
21.740
20.000
12.420
12.420
12.420
12.420
15.300
14.490
12.420
12.420
12.420
17.480
12.420
32.000
46.000
15.000
53.500
33.620
20.000
20.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

299.76
215.58
215.58
215.58
338.48
126.12
202.09
188.45
399.64
133.90
133.90
203.70
506.99
538.96
133.90
808.37
133.90
188.45
133.90
133.90
313.26
133.90
133.90
133.90
188.45
133.90
116.44
401.54
211.18
263.83
188.45
203.70
184.05
133.90
133.90
133.90
133.90
133.90
121.28
156.19
133.90
133.90
133.90
234.36
215.58
133.90
133.90
133.90
133.90
164.84
156.19
133.90
133.90
133.90
188.45
133.90
344.93
495.84
161.61
576.65
362.39
215.58
215.58

80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80
80

18.540
13.330
13.330
13.330
20.930
7.800
12.500
11.650
24.720
8.280
8.280
12.600
31.360
33.350
8.280
50.000
8.280
11.650
8.280
8.280
19.370
8.280
8.280
8.280
11.650
8.280
7.200
24.800
13.070
16.600
11.650
12.600
11.390
8.280
8.280
8.280
8.280
8.280
7.500
9.660
8.280
8.280
8.280
14.490
13.330
8.280
8.280
8.280
8.280
10.200
9.660
8.280
8.280
8.280
11.650
8.280
21.330
30.670
10.000
35.670
22.410
13.330
13.330

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R
R

199.89
143.72
143.72
143.72
225.56
84.03
134.78
125.54
266.47
89.17
89.17
135.80
338.04
359.45
89.17
538.96
89.17
125.54
89.17
89.17
208.84
89.17
89.17
89.17
125.54
89.17
77.58
267.35
140.94
178.92
125.54
135.80
122.75
89.17
89.17
89.17
89.17
89.17
80.81
104.13
89.17
89.17
89.17
156.19
143.72
89.17
89.17
89.17
89.17
109.99
104.13
89.17
89.17
89.17
125.54
89.17
229.96
330.56
107.79
384.38
241.54
143.72
143.72

21.13 Clinical pathology: Miscellaneous

4544 Attendance in theatre
2004.00
4547 After-hours service: (Monday to Friday) 17:00 to 08:00, Saturday 13:00 to Monday 08:00 and public 2004.00
holidays - Refer to General Rule B.
4551 Unlisted pathology service: Fees for items not listed in the current Pathology schedule (sections 21, 2004.00
22 and 23) will be based on the fee for a comparable service in the coding structure. Please contact
the SA Medical Association (SAMA) Private Practice Unit via e-mail on coding@samedical.org to
obtain a comparable code for the unlisted pathology service which will be based on the fee for a
comparable service in the coding structure. New items for these unlisted services should be added
to the coding structure within six months or that specific unlisted pathology service should no longer
be performed. Please note General Rule C and item 6999 are not applicable to pathology services
(sections 21, 22 and 23)
4555 Where pharmacological preparations (hormones, etc.) are administered as part of metabolic function 2004.00
tests, the cost of such preparation shall be charged separately
Anatomical Pathology
22
Please note: The calculated amounts in this section are calculated according to the anatomical
2004.00
pathology unit values
22.1 Exfoliative cytology
4561 Sputum, all body fluids and tumour aspirates: First unit
2004.00
4563 Sputum, all body fluids and tumour aspirates: Each additional unit
2004.00
Performance
of
fine-needle
aspiration
for
cytology
4564
2004.00
4565 Examination of fine needle aspiration in theatre
2004.00
4566 Vaginal or cervical smears, each
2004.00
22.2 Histology
4567 Histology per sample
2004.00
4571 Histology per additional block, each
2004.00
4575 Histology and frozen section in laboratory
2004.00
4577 Histology and frozen section in theatre
2004.00
4578 Second and subsequent frozen sections, each
2004.00
4579 Attendance in theatre - no frozen section performed
2004.00
4582 Serial step sections (including item 4567)
2004.00
4584 Serial step sections per additional block, each
2004.00
4587 Histology consultation
2004.00
4589 Special stains
2004.00
4591 Immunofluorescence studies
2004.00
4592 Immunoperoxidase studies
2004.00
4593 Electron microscopy
2004.00
4595 Foetal autopsy excluding histology
2004.00
Human Genetics
23
Please note: The calculated amounts in this section are calculated according to the human genetics 2004.00
unit values
23.1 Cytogenitc
4750 Cell culture: Lymphocytes, cord blood
2004.00
4751 Cell culture: Amniotic fluid, fibroblasts, leukaemia bloods, bone marrow, other specialised cultures
2004.00

80

27.000 1.0 R

90
90
90
90
90

13.400
7.800
15.000
90.000
11.000

1.0
1.0
1.0
1.0
1.0

95
95
95
95
95
95
95
95
95
95
95
95
95
95

20.000
11.600
22.700
90.000
20.000
45.000
23.300
13.500
10.100
6.700
20.700
40.000
94.000
73.000

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

100
100

290.97
-

110.58
64.68
745.74
86.97
156.48
90.63
177.60
706.00
157.66
353.00
183.61
105.89
78.90
52.94
162.35
313.84
741.20
572.69
-

165.57
496.72

R
166.60
R
96.94
R
186.40
R 1 118.69
R
136.68
R
235.38
R
136.54
R
267.06
R 1 059.00
R
235.38
R
529.43
R
274.10
R
158.83
R
118.79
R
78.90
R
243.60
R
470.62
R 1 106.08
R
858.96
-

15.000 1.0 R
45.000 1.0 R

165.57
496.72

90
90

8.900 1.0 R
5.200 1.0 R

90
90

60.000 1.0 R
7.000 1.0 R

95
95
95
95
95
95
95
95
95
95
95
95
95
95

13.300
7.700
15.100
60.000
13.400
30.000
15.600
9.000
6.700
4.500
13.800
26.670
63.000
48.670

100
100

1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0

R
R
R
R
R
R
R
R
R
R
R
R
R
R

15.000 1.0 R
45.000 1.0 R

2004.00
2004.00
2004.00

100 60.000 1.0 R

662.30
100 135.000 1.0 R 1 490.17
100 270.000 1.0 R 2 980.49

100 60.000 1.0 R

662.30
100 135.000 1.0 R 1 490.17
100 270.000 1.0 R 2 980.49

4757

Cell culture: Chorionic villi

Cytogenetic analysis: Lymphocytes: Idiograms, karyotyping, one staining technique
Cytogenetic analysis: Amniotic fluid, fibroblasts, chorionic villi, products of conception, bone marrow,
leukamia bloods: Idiograms, karyotyping, one straining technique
Specified additional analysis e.g. mosaicism, Fanconi anaemia, Fra X, additional staining techniques

2004.00

100

100

772.73

4760
4761
23.2
4763
4764
4765
4766
4767
4768
4769
IV.

FISH procedure, including cell culture

FISH analysis per probe system
DNA-testing
Blood: DNA extraction
Blood: Genotype per person: Southern blotting
Blood: Genotype per person: PCR
HIV Drug Resistance Testing
Prenatal diagnosis: Amniotic fluid or chorionic tissue: DNA extraction
Prenatal diagnosis: Amniotic fluid or chorionic tissue: Genotype per person: Southern blotting
Prenatal diagnosis: Amniotic fluid or chorionic tissue: Genotype per person: PCR
Travelling Expenses

2004.00
2004.00

100 115.000 1.0 R 1 269.45

100 35.000 1.0 R
386.29
100 45.000 1.0 R
496.72
100 89.000 1.0 R
982.45
100 60.000 1.0 R
662.30
100 513.000 1.0 R 5 662.97
100 90.000 1.0 R
993.45
100 188.000 1.0 R 2 075.33
100 120.000 1.0 R 1 324.60
-

100 115.000 1.0 R 1 269.45

100 35.000 1.0 R
386.29
100 45.000 1.0 R
496.72
100 89.000 1.0 R
982.45
100 60.000 1.0 R
662.30
100 342.000 1.0 R 3 775.21
100 90.000 1.0 R
993.45
100 188.000 1.0 R 2 075.33
100 120.000 1.0 R 1 324.60
-

4752
4754
4755

2004.00
2004.00
2004.00
2004.00
2004.00
2004.00
2004.00

Page 81 of 84

70.000 1.0 R

772.73

70.000 1.0 R

P.

5003

5005
5007
5013
V.

Travelling fees: (a) Where, in cases of emergency, a practitioner was called out from his residence 2004.00
or rooms to a patient's home or the hospital, travelling fees can be charged according to the section
on travelling expenses (section IV) if he had to travel more than 16 kilometres in total. (b) If more
than one patient would be attended to during the course of a trip, the full travelling expenses must be
divided between the relevant patients. (c) A practitioner is not entitled to charge for any travelling
expenses or travelling time to his rooms. (d) Where a practitioner's residence would be more than 8
kilometres away from a hospital, no travelling fees may be charged for services rendered at such
hospitals, except in cases of emergency (services not voluntarily scheduled). (e) Where a
practitioner conducts an itinerant practice, he is not entitled to charge fees for travelling expenses
except in cases of emergency (services not voluntarily scheduled). (f) For voluntarily scheduled
services, fees for travelling expenses may only be charged where the patient and the practitioner
have entered into an agreement to this effect. Medical scheme benefits will not be applicable in
such instances.
R6,67 for each kilometre in excess of 16 kilometres travelled in own car e.g. where a practitioner has 2004.00
to travel 19 kilometres in total to visit a patient, the fees shall be calculated as follows: 19-16=3 X
R6,67 = R20,01
Normal hours: Specialist: 18,00 clinical procedure units per hour or part thereof
2004.00
Normal hours: General practitioner: 18,00 clinical procedure units per hour or part thereof
2004.00
Travelling fees are not payable to practitioners who assisted at operations on cases referred to
2004.00
surgeons by them
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:
2004.00

20

All anaesthetic services

Section 19: Radiology
Section 20: Radiation Oncology
Section 21: Clinical Pathology (except for items 3719, 3720 and 3721 where modifier 0004 may be
applied)
Section 22: Anatomical Pathology
Section 23: Human Genetic
Please note : This is not a conclusive list and practitioners should not be penalised when patients
need to be admitted to hospital for these procedures.

Page 82 of 84

18.000 1.0 R

167.77
-

167.77
-

20

18.000 1.0 R

Medical Practitioners 2006

GUIDELINE TARIFFS FOR SERVICES BY MEDICAL PRACTITIONERS
Published in terms of Section 53 (3) (d) of the HEALTH PROFESSIONS ACT (56 OF 1974)

Code
10
11
12
20
30
40
50
60
70
75
80
90
95
100
130

Note that this schedule is based on the 2006 NHRPL which was inflated by 46.66%.
The 2006 NHRPL is available in database format at http://www.hpcsa.co.za
Rand Conversion Factors
Description
Consultative Services
Psychiatrists
Consultative Services (Paediatrics and Paediatric Cardiologists)
Clinical Procedures
Anaesthesiologists
Radiology
Radiation Oncology
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Clinical Pathology
Anatomical Pathology - Cytology
Anatomical Pathology - Histology
Human Genetics
GP Consultative Services (items 0190 - 0192, 0173-0175)

20 Feb 2006

Page 83 of 84

RCF
15.05422
17.95361
15.05422
9.322911
58.50835
13.20636
11.32916
8.885877
10.48736
10.05032
10.77774
12.42908
11.7662
11.03878
16.87569

Version 2006.06

Medical Practitioners 2006

Code
10000
10008
10099
11000
11200
11400
11600
11700
11800
11900
12000
12100
12200
12300
12400
12500
12600
12800
13000
13100
13200
13300
13400
13600
13800
14000
14200
14400
14600
15200
15300

Description
Specialists
Specialist Radiologist/Nuclear Physicians
General Practitioners / non-designated Specialists
Anaesthesiology
Dermatology
General Medical Practice
Obstetrics and Gynaecology
Pulmonology
Medicine (Specialist Physician)
Gastroenterology
Neurology
Cardiology
Psychiatry
Medical Oncology
Neurosurgery
Nuclear Medicine
Opthalmology
Orthopaedics
Otorhinolaryngology
Rheumatology
Paediatrics
Paediatric Cardiology
Physical Medicine
Plastic and Reconstructive Surgery
Radiology
Radiation Oncology
Surgery
Cardiothoracic Surgery
Urology
Pathology (Clinical)
Pathology (Anatomical)