S205

Appendectomy

S206

With gross perforation and peritonitis

C267

Subsequent visits-7th to 13th week inclusive

C269

Subsequent visits-after 13th week

G602

Neonatal intensive care-31st day onwards

Z819

Ventriculoscopy-External ventricular drainage

E032C

Anaesthesia service for Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499, Z555 or Z580

4

S207

Appendectomy with or without perforation

$458.60

6

7

E515

Incision of abscess or hematoma when performed as sole procedure under general anaesthetic in an operating room but not in an emergency department or emergency department equivalent. To Z102, Z172, Z105, Z107-increase the procedural fee(s) by.

100%

S152

Bowel lengthening procedure in a paediatric patient

$1700.00

9

10

E084

Saturday, Sunday or Holiday Subsequent visit by the MRP, to subsequent visits and C122, C123, C124, C142, C143, C882 or C982-add

45%

K229

Complex genetic test interpretation

$65.85

A/C/W682

Extended special neurological consultation

$401.30

G496

Electroencephalography (EEG) with time locked video recording

$120.00

E060

Post renal transplant assessment premium-add

25%

A631

Nuclear medicine minor assessment-cancellation or deferral

$17.75

A632

Nuclear medicine minor assessment-advisability of nuclear medicine procedure

$17.75

R766

In-situ saphenous vein arterial bypass-tibial-first vascular surgeon

$1303.00

10

17

R767

In-situ saphenous vein arterial bypass-tibial-second vascular surgeon

$1303.00

nil

nil

E986

Suprarenal or supraceliac aortic cross clamp, to R802, R817, R877, R783, R784, R785, R858 or R859-add

$250.00

R731

Tricuspid valvuloplasty

$770.55

18

28

A/C384

Consultation and Management for Acute Cerebral Vascular Syndrome (ACVS)

$200.00

K181

Management of Acute Cerebral Vascular Syndrome, after first 30 minutes, must include intravenous thrombolysis therapy and monitoring, per 30 minute unit (or major part thereof)

$90.00

A633

Nuclear medicine specific assessment

$60.00

E100C

Attendance at delivery. Allow 4 base units plus time units

S117

Pyloromyotomy-Allow only for newborns and infants

C262

Can be billed daily. All other conditions continue to apply

G601

Level A neonatal intensive care 2nd day onwards

E386

Extradural decompression-spinal cord or cauda equina, tumour or infection-Increase add-on percentage from 40% to 42%

E683

Lungs and pleura-excision-when performed thorascopically or by VATS-Increase add-on percentage from 25% to 28%

E023C

Anaesthesia service-Allow only with E137, E138, E139, E140, E141, E143, E144, E145, E146, E147, E149, Z432, Z606 or Z607

E676A/B

Obesity Premium-Add the following codes that E676A/B can be billed with: S089A, S090A, S207, M142A, M143A, M144A

G412

Nephrological component of renal transplantatation-1st day –only after kidney transplant

G408

Nephrological component of renal transplantatation-2nd to 10th day inclusive –only after kidney transplant

G409

Nephrological component of renal transplantatation-11th to 21st day inclusive –only after kidney transplant

E638

With transbronchial lung biopsy with or without image intensification , to Z327-add

S329

S329 may only be claimed for nonelective surgery admitted through the Emergency department

E525

After localization with mammographic wire or radioactive seeds, to R107-add

G804, G805

Hyperbaric oxygen therapy for idiopathic sudden sensorneural hearing loss-change treatment initiation time period from 14 to 30 days

R240B

Arthroplasty-revision total arthroscopy shoulder

8

9

R241B

Arthroscopy-revision total arthroscopy hip

8

9

N500B

Anterior spine decompression-disc excision

9

10

N501B

Anterior spine decompression-vertebrectomy

9

11

N177B

Sciatic nerve in buttock

6

7

N189B

Peripheral nerves-nerve graft-ulnar nerve

6

7

N190B

Peripheral nerves-nerve graft-exploration

6

7

N283B

Peripheral nerves-exploration, decompression

6

7

N285B

Decompression/denervation-major nerve

6

7

N286B

Tumour or neuroma-major nerve

6

7

N287B

Nerve suture-major

6

7

N289B

Nerve suture-minor

6

7

Z823B

Implantation or revision of stimulation pack

6

8

A001

GP/FP-Minor assessment

$21.70

$23.75

A003

GP/FP-General assessment

$77.20

$84.45

A005

GP/FP-Consultation

$77.20

$84.45

A007

GP/FP-Intermediate assessment/well baby care

$33.70

$36.85

A015

Anaesthesia-Consultation

$106.80

$107.25

A020

Complex dermatology assessment

$49.95

$60.00

A023

Dermatology-Specific assessment

$38.70

$43.00

A034

General Surgery-Partial assessment

$24.10

$26.85

A070

Consultation in association with special visit to a hospital in-patient, long-term care in-patient or emergency department patient

$185.00

$203.30

A071

Complex medical specific re-assessment

$70.90

$84.35

A073

Medical specific assessment

$79.85

$90.45

A074

Medical specific re-assessment

$61.25

$72.90

A075

Consultation

$175.00

$183.30

A078

Partial assessment

$38.05

$45.30

A083

Plastic Surgery-Specific assessment

$41.55

$44.95

A084

Plastic Surgery-Partial assessment

$26.55

$28.70

A085

Plastic Surgery-Consultation

$81.10

$87.70

A086

Plastic Surgery-Repeat consultation

$47.95

$51.85

A113

Complex neuromuscular assessment

$89.85

$91.00

A151

Endocrinology & Metabolism (15)-Complex medical specific re-assessment

$70.90

$73.45

A153

Endocrinology & Metabolism (15)-Medical specific assessment

$79.85

$82.75

A154

Endocrinology & Metabolism (15)-Medical specific re-assessment

$61.25

$61.85

A155

Endocrinology & Metabolism (15)-Consultation

$157.00

$162.65

A158

Endocrinology & Metabolism (15)-Partial assessment

$38.05

$38.45

A161

Nephrology (16)-Complex medical specific re-assessment

$70.90

$71.85

A163

Nephrology (16)-Medical specific assessment

$79.85

$80.95

A164

Nephrology (16)-Medical specific re-assessment

$61.25

$62.10

A165

Nephrology (16)-Nephrology-Consultation

$157.00

$162.90

A168

Nephrology (16)-Partial assessment

$38.05

$38.55

A181

Complex medical specific re-assessment

$71.90

$72.85

A183

Medical specific assessment

$78.80

$79.80

A184

Medical specific re-assessment

$62.10

$62.90

A185

Consultation

$176.35

$178.60

A188

Partial assessment

$37.65

$38.15

A191

Consultative interview with caregiver(s) of a patient at least 65 years of age, or a patient less than 65 years of age with a diagnosis of dementia

$212.65

$230.00

A192

Consultative interview with patient at least 65 years of age, or a patient less than 65 years of age with a diagnosis of dementia

$212.65

$230.00

A193

Specific assessment

$79.85

$86.35

A194

Partial assessment

$38.05

$41.15

A195

Consultation

$199.40

$215.65

A197

Consultative interview with parent(s) or patient representative(s) of patient less than age 22

$212.65

$230.00

A198

Consultative interview with patient less than age 22

$212.65

$230.00

A203

OB/GYN-Specific assessment

$47.45

$52.15

A204

OB/GYN-Partial assessment

$26.35

$33.70

A205

OB/GYN-Consultation

$101.70

$111.70

A206

OB/GYN-Repeat consultation

$54.10

$59.45

A223

Extended special genetic consultation

$395.65

$401.30

A225

Consultation

$165.00

$167.35

A235

Ophthalmology-Consultation

$82.30

$82.20

A244

Otolaryngology-Partial assessment

$24.55

$25.70

A245

Otolaryngology-Consultation

$77.90

$79.90

A253

Ophthalmology-Optometrist-Requested Assessment (ORA)

$82.30

$82.20

A262

Paediatrics-Level 2-Paediatric assessment

$42.15

$43.45

A263

Paediatrics-Medical specific assessment

$77.70

$80.05

A264

Paediatrics-Medical specific re-assessment

$59.45

$61.25

A265

Paediatrics-Consultation

$167.00

$175.40

A268

Paediatrics-Enhanced 18 month well baby visit

$62.40

$64.30

A315

Physical Medicine and Rehabilitation-Consultation

$172.85

$189.20

A348

Radiation Oncology-Partial assessment

$37.05

$36.25

A353

Urology-Specific assessment

$45.00

$45.55

A354

Urology-Partial assessment

$26.00

$26.70

A355

Urology-Consultation

$80.00

$83.15

A356

Urology-Repeat consultation

$55.75

$56.40

A461

Infectious Disease (46)-Complex medical specific re-assessment

$70.90

$80.70

A463

Infectious Disease (46)-Medical specific assessment

$79.85

$90.85

A464

Infectious Disease (46)-Medical specific re-assessment

$61.25

$69.70

A465

Infectious Disease (46)-Consultation

$157.00

$178.65

A468

Infectious Disease (46)-Partial assessment

$38.05

$43.30

A471

Respiratory Disease (47)-Complex medical specific re-assessment

$70.90

$73.75

A473

Respiratory Disease (47)-Medical specific assessment

$79.85

$84.65

A474

Respiratory Disease (47)-Medical specific re-assessment

$61.25

$63.70

A475

Respiratory Disease (47)-Consultation

$157.00

$169.65

A478

Respiratory Disease (47)-Partial assessment

$38.05

$38.25

A480

Rheumatology (48)-Complex rheumatology assessment

$89.85

$92.20

A481

Rheumatology (48)-Complex medical specific re-assessment

$70.90

$72.65

A483

Rheumatology (48)-Medical specific assessment

$79.85

$81.70

A484

Rheumatology (48)-Medical specific re-assessment

$61.25

$62.60

A485

Rheumatology (48)-Consultation

$157.00

$170.10

A486

Rheumatology (48)-Repeat consultation

$105.25

$109.35

A488

Rheumatology (48)-Partial assessment

$38.05

$39.10

A511

Physical Medicine and Rehabilitation-Complex physiatry assessment

$89.85

$98.35

A585

Laboratory medicine-Diagnostic consultation

$64.70

$68.60

A595

Rheumatology (48)-Limited consultation

$105.25

$109.35

A611

Haematology (61)-Complex medical specific re-assessment

$70.90

$76.20

A613

Haematology (61)-Medical specific assessment

$79.85

$85.80

A614

Haematology (61)-Medical specific re-assessment

$61.25

$65.85

A615

Haematology (61)-Consultation

$157.00

$168.75

A621

Clinical Immunology (62)-Complex medical specific re-assessment

$70.90

$71.80

A623

Clinical Immunology (62)-Medical specific assessment

$79.85

$80.90

A624

Clinical Immunology (62)-Medical specific re-assessment

$61.25

$62.05

A625

Clinical Immunology (62)-Consultation

$157.00

$159.00

A628

Clinical Immunology (62)-Partial assessment

$38.05

$38.55

A635

Nuclear Medicine-Consultation

$82.40

$157.00

A636

Repeat consultation

$57.25

$70.00

A638

Partial assessment

$35.35

$40.00

A645

General Thoracic Surgery (64)-Consultation

$90.30

$98.55

A661

Paediatrics-Complex medical specific re-assessment

$68.80

$72.25

A662

Paediatrics-Extended special paediatric consultation

$395.65

$401.30

A665

Paediatrics-Prenatal consultation

$91.35

$100.55

A667

Paediatrics-Neurodevelopmental consultation

$395.65

$401.30

A695

Neurodevelopmental consultation

$395.65

$401.30

A735

Nuclear Medicine-Diagnostic consultation

$33.70

$67.40

A760

Endocrinology & Metabolism (15)-Complex endocrine neoplastic disease assessment

$89.85

$90.75

A770

Extended comprehensive geriatric consultation

$395.65

$401.30

A777

GP/FP-Intermediate assessment-Pronouncement of death

$33.70

$36.85

A800

Midwife-requested genetic assessment

$165.00

$167.35

A802

Extended midwife-requested genetic assessment

$395.65

$401.30

A813

GP/FP-Midwife-Requested Assessment (MRA)

$101.70

$111.70

A835

Nuclear Medicine-Special Nuclear Medicine consultation

$180.00

$300.70

A888

GP/FP-ED equivalent-Partial assessment

$33.70

$36.85

A895

Consultation in association with special visit to a hospital

$232.70

$251.70

A905

GP/FP-Limited consultation

$65.90

$72.10

A917

GP/FP-Focused Practice Assessment (FPA)-Sport medicine FPA

$33.70

$36.85

A921

Obstetrics-Medical management of early or ectopic pregnancy-Follow-Up visit

$33.70

$36.85

A927

GP/FP-Focused Practice Assessment (FPA)-Allergy FPA

$33.70

$36.85

A937

GP/FP-Focused Practice Assessment (FPA)-Pain management FPA

$33.70

$36.85

A945

GP/FP-Special palliative care consultation

$144.75

$159.20

A947

GP/FP-Focused Practice Assessment (FPA)-Sleep medicine FPA

$33.70

$36.85

A957

GP/FP-Focused Practice Assessment (FPA)-Addiction medicine FPA

$33.70

$36.85

A967

GP/FP-Care of the elderly FPA

$33.70

$36.85

B400

Community Palliative On-Call Program

$471.23

$487.93

C002

family & general practice-non-emergency hospital in-patient services-subsequent visits-up to five weeks-per visit

$31.00

$34.10

C003

GP/FP-Non-emergency hospital in-patient services-General assessment

$77.20

$84.45

C005

GP/FP-Non-emergency hospital in-patient services-Consultation

$77.20

$84.45

C015

Anaesthesia-Non-emergency hospital in-patient services-Consultation

$106.80

$107.25

C020

Complex dermatology assessment

$49.95

$60.00

C023

Dermatology-Non-emergency hospital in-patient services-Specific assessment

$38.70

$43.00

C034

Specific re-assessment

$25.95

$28.90

C071

Complex medical specific re-assessment

$70.90

$84.35

C072

geriatrics-non-emergency hospital in-patient services-subsequent visits-up to five weeks-per visit

$31.00

$34.10

C073

Medical specific assessment

$79.85

$90.45

C074

Medical specific re-assessment

$61.25

$72.90

C075

Consultation

$185.00

$203.30

C077

Geriatrics-non-emergency hospital in-patient services-subsequent visits-6th-13th wks inclusive (max. of 3/wk)-per visit

$31.00

$34.10

C078

Geriatrics-non-emergency hospital in-patient services-concurrent care, per visit

$31.00

$34.10

C079

Geriatrics-non-emergency hospital in-patient services-subsequent visits-after 13th wk (max. of 6/mth)-per visit

$31.00

$34.10

C083

Plastic Surgery-Non-emergency hospital in-patient services-Specific assessment

$41.55

$44.95

C084

Plastic Surgery-Non-emergency hospital in-patient services-Specific re-assessment

$27.80

$28.80

C085

Plastic Surgery-Non-emergency hospital in-patient services-Consultation

$81.10

$87.70

C086

Plastic Surgery-Non-emergency hospital in-patient services-Repeat consultation

$47.95

$51.85

C113

Complex neuromuscular assessment

$89.85

$91.00

C122

Subsequent visits-MRP-day following hospital admission assessment

$58.80

$61.15

C123

Subsequent visits-MRP-second day following hospital assessment

$58.80

$61.15

C124

Subsequent visits-MRP-day of discharge

$58.80

$61.15

C132

Internal medicine-non-emergency hospital in-patient services-subsequent visits-up to five weeks-per visit

$31.00

$32.65

C137

Internal medicine-non-emergency hospital in-patient services-subsequent visits-6th-13th wks inclusive (max. of 3/wk)-per visit

$31.00

$32.65

C138

Internal medicine-non-emergency hospital in-patient services-concurrent care, per visit

$31.00

$32.65

C139

Internal medicine-non-emergency hospital in-patient services-subsequent visits-after 13th week (max. of 6/mth)-per visit

$31.00

$32.65

C142

Subsequent visit-MRP-first subsequent visit following transfer from IC

$58.80

$61.15

C143

Subsequent visit-MRP-second subsequent visit following transfer from IC

$58.80

$61.15

C151

Endocrinology & Metabolism (15)-Complex medical specific re-assessment

$70.90

$73.45

C153

Endocrinology & Metabolism (15)-Medical specific assessment

$79.85

$82.75

C154

Endocrinology & Metabolism (15)-Medical specific re-assessment

$61.25

$61.85

C155

Endocrinology & Metabolism (15)-Consultation

$157.00

$162.65

C161

Nephrology (16)-Complex medical specific re-assessment

$70.90

$71.85

C162

Nephrology-non-emergency hospital in-patient services-subsequent visits-up to five weeks-per visit

$31.00

$33.95

C163

Nephrology (16)-Medical specific assessment

$79.85

$80.95

C164

Nephrology (16)-Medical specific re-assessment

$61.25

$62.10

C165

Nephrology (16)-Consultation

$157.00

$162.90

C167

Nephrology-non-emergency hospital in-patient services-subsequent visits-6th-13th wks inclusive (max. of 3/wk)-per visit

$31.00

$33.95

C169

Nephrology-non-emergency hospital in-patient services-subsequent visits-after 13th week (max. of 6/mth)-per visit

$31.00

$33.95

C181

Complex medical specific re-assessment

$71.90

$72.85

C183

Medical specific assessment

$78.80

$79.80

C184

Medical specific re-assessment

$62.10

$62.90

C185

Consultation

$176.35

$178.60

C193

Specific assessment

$79.85

$86.35

C194

Specific re-assessment

$61.25

$66.25

C203

OB/GYN-Specific assessment

$47.45

$52.15

C204

OB/GYN-Specific re-assessment

$29.65

$36.85

C205

OB/GYN-Consultation

$101.70

$111.70

C206

OB/GYN-Repeat consultation

$54.10

$59.45

C223

Extended special genetic consultation

$395.65

$401.30

C225

Consultation

$165.00

$167.35

C235

Ophthalmology-Non-emergency hospital in-patient services-Consultation

$82.30

$82.20

C245

Otolaryngology-Consultation

$77.90

$79.90

C263

Paediatrics-Medical specific assessment

$77.70

$80.05

C264

Paediatrics-Medical specific re-assessment

$59.45

$61.25

C265

Paediatrics-Consultation

$167.00

$175.40

C315

Physical Medicine and Rehabilitation-Non-emergency hospital in-patient services-Consultation

$182.85

$200.15

C352

Urology-non-emergency hospital in-patient services-subsequent visits-up to five weeks-per visit

$31.00

$31.60

C353

Urology-Specific assessment

$45.00

$45.55

C354

Urology-Specific re-assessment

$26.00

$26.70

C355

Urology-Consultation

$80.00

$83.15

C356

Urology-Repeat consultation

$55.75

$56.40

C357

Urology-non-emergency hospital in-patient services-subsequent visits-6th-13th wks inclusive (max. of 3/wk)-per visit

$31.00

$31.60

C358

Urology-non-emergency hospital in-patient services-concurrent care-per visit

$31.00

$31.60

C359

Urology-non-emergency hospital in-patient services-subsequent visits-after 13th week (max. of 6/mth)-per visit

$31.00

$31.60

C461

Infectious Disease (46)-Complex medical specific re-assessment

$70.90

$80.70

C463

Infectious Disease (46)-Medical specific assessment

$79.85

$90.85

C464

Infectious Disease (46)-Medical specific re-assessment

$61.25

$69.70

C465

Infectious Disease (46)-Consultation

$157.00

$178.65

C471

Respiratory Disease (47)-Complex medical specific re-assessment

$70.90

$73.75

C472

Respiratory disease-non-emergency hospital in-patient services-subsequent visits-up to five weeks-per visit

$31.00

$33.30

C473

Respiratory Disease (47)-Medical specific assessment

$79.85

$84.65

C474

Respiratory Disease (47)-Medical specific re-assessment

$61.25

$63.70

C475

Respiratory Disease (47)-Consultation

$157.00

$169.65

C477

Respiratory disease-non-emergency hospital in-patient services-subsequent visits-6th-13th wks inclusive (max. of 3/wk)-per visit

$31.00

$33.30

C478

Respiratory disease-non-emergency hospital in-patient services-concurrent care, per visit

$31.00

$34.10

C479

Respiratory disease-non-emergency hospital in-patient services-subsequent visits-after 13th wk (max. of 6/mth)-per visit

$31.00

$34.10

C480

Rheumatology (48)-Complex rheumatology assessment

$89.85

$92.20

C481

Rheumatology (48)-Complex medical specific re-assessment

$70.90

$72.65

C483

Rheumatology (48)-Medical specific assessment

$79.85

$81.70

C484

Rheumatology (48)-Complex medical specific re-assessment

$61.25

$62.60

C485

Rheumatology (48)-Consultation

$157.00

$170.10

C486

Rheumatology (48)-Repeat consultation

$105.25

$109.35

C511

Physical Medicine and Rehabilitation-Non-emergency hospital in-patient services-Complex physiatry assessment

$89.85

$98.35

C595

Rheumatology (48)-Limited consultation

$105.25

$109.35

C611

Haematology (61)-Complex medical specific re-assessment

$70.90

$76.20

C613

Haematology (61)-Medical specific assessment.

$79.85

$85.80

C614

Haematology (61)-Medical specific re-assessment

$61.25

$65.85

C615

Haematology (61)-Consultation

$157.00

$168.75

C621

Clinical Immunology (62)-Complex medical specific re-assessment

$70.90

$71.80

C623

Clinical Immunology (62)-Medical specific assessment

$79.85

$80.90

C624

Clinical Immunology (62)-Medical specific re-assessment

$61.25

$62.05

C625

Clinical Immunology (62)-Consultation

$157.00

$159.00

C635

Nuclear Medicine-Non-emergency hospital in-patient services-Consultation

$82.40

$157.00

C636

Repeat consultation

$57.25

$70.00

C645

General Thoracic Surgery-Non-emergency hospital in-patient services-Consultation

$90.30

$98.55

C661

Paediatrics-Complex medical specific re-assessment

$68.80

$72.25

C662

Paediatrics-Extended special paediatric consultation-Subject to the same conditions as A662

$395.65

$401.30

C665

Paediatrics-Prenatal consultation

$91.35

$100.55

C667

Paediatrics-Neurodevelopmental consultation

$395.65

$401.30

C695

Neurodevelopmental consultation

$395.65

$401.30

C735

Nuclear Medicine-Non-emergency hospital in-patient services-Diagnostic consultation

$33.70

$67.40

C760

Endocrinology & Metabolism (15)-Complex endocrine neoplastic disease assessment

$89.85

$90.75

C770

Extended comprehensive geriatric consultation

$395.65

$401.30

C777

GP/FP-Non-emergency hospital in-patient services-Intermediate assessment-Pronouncement of death

$33.70

$36.85

C800

Midwife-requested genetic assessment

$165.00

$167.35

C802

Extended midwife-requested genetic assessment

$395.65

$401.30

C813

GP/FP-Midwife-Requested Assessment

$101.70

$111.70

C835

Nuclear Medicine-Non-emergency hospital in-patient services-Special Nuclear Medicine consultation

$180.00

$300.70

C895

Consultation

$232.70

$251.70

C905

GP/FP-Non-emergency hospital in-patient services-Limited consultation

$65.90

$72.10

C945

GP/FP-Special palliative care consultation

$144.75

$159.20

C983B

Surgical Assistant-SVP-Saturdays, Sundays or Holidays, daytime and evenings (07:00h-24:00h), first patient seen

$75.00

$85.60

C998B

Surgical Assistant-SVP-Evenings (17:00h-24:00h) Monday to Friday, first patient seen

$60.00

$67.05

C999B

Surgical Assistant-SVP-Nights (00:00h-07:00h), first patient seen

$100.00

$117.65

D028

Foot and Ankle-Reduction-Dislocations-Tarso-Metatarsal-Open reduction, one joint

$300.00

$388.20

E079

GP/FP-Initial discussion with patient, to eligible services add

$15.40

$15.55

E080

Assessments-First visit by Primary Care Physician after hospital discharge premium, to other service listed in payment rule 5, add

$25.00

$25.25

E430

When Papanicolaou smear is performed outside of hospital, to G365,add

$11.55

$11.95

E431

When Papanicolaou smear is performed outside of hospital, to G394, add

$11.55

$11.95

E497

Hand and Wrist-Reconstruction-Bone-Pseudoarthrosis/non-union/avascular necrosis-Pedicled vascularized bone graft, to R322 or R345 add

$350.00

$526.40

E525

Operations of the Breast-Excision-After mammographic wire localization, to R107 R111 add

$41.55

$48.05

E542

When performed outside hospital, to G328, G378, G367, G370, R040, R041, R048, R049, R050, R094, R160, R161, R162, R163, R164, R165, S003, S006, Z080, Z081, Z082, Z083, Z084, Z085, Z096,Z101, Z103, Z104, Z106, Z114, Z116, Z122, Z123, Z124, Z125, Z126, Z127, Z128, Z129, Z173, Z174, Z130, Z131, Z141, Z154, Z156, Z157, Z158, Z162, Z163, Z164, Z

$11.15

$11.55

E545

Vasectomy-when performed outside hospital add

$11.15

$11.55

E608

Lungs and Pleura-each additional wedge resection of lung (to a maximum of 3), add

$75.00

$84.15

E645

Heart and Pericardium-Coronary artery repair-Off pump coronary artery bypass grafting, to R742or R743 add

$366.50

$371.00

E650

Heart and Pericardium-Pump bypass-Includes cannulating and decannulating heart or major vein, major artery, supervision of pump and pump run add

$366.50

$371.00

E652

Heart and Pericardium-Coronary artery repair-Use of Internal mammary or epigastric or radial artery for construction of bypass graft, to R742 or R743 add

$186.70

$187.85

E654

Heart and Pericardium-Coronary artery repair-Each additional add

$187.70

$188.85

E671

Heart and Pericardium-Re-operation involving open heart procedures with pump-Following previous sternotomy add

$337.00

$543.60

E691

Abdomen, Peritoneum and Omentum-Repair-Omphalocele and gastroschisis-requiring mobilization of abdominal wall musculature, to S348 add

$100.00

$178.40

E705

Intestines (except rectum)-Into terminal ileum, to Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 add

$30.50

$30.30

E730

Total thoracic oesophageal resection-with reconstruction, add

$678.85

$740.95

E740

Intestines (except rectum)-Colonoscopy-To splenic flexure, to Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 add

$51.95

$51.75

E741

Intestines (except rectum)-Colonoscopy-To hepatic flexure, to Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 add

$31.40

$31.15

E747

Intestines (except rectum)-Endoscopy/Colonoscopy-To cecum add to Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 add

$31.40

$31.15

E755

Male Genital-Penis-Repair-Hypospadias or Epispadia-With inflatable prosthesis add

$55.15

$69.30

E756

Abdomen, Peritoneum and Omentum-Repair-Herniotomy-Umbilical-With resection of strangulated contents add

$111.45

$24.50

E764

Abdomen, Peritoneum and Omentum-Repair-Herniotomy-Umbilical hernia repair when done in conjunction with other abdominal surgery, to other surgery add

$96.85

$24.20

E889

Skull Base Surgery-Resection of Lesion(s)-Endonasal Approach-Complex endonasal endoscopic resection of pituitary and non-pituitary lesion(s)-complex endonasal endoscopic resection from cranial nerves, to N114 or N116, add

$800.00

$520.00

E890

Skull Base Surgery-Resection of Lesion(s)-Endonasal Approach-Complex endonasal endoscopic resection of pituitary and non-pituitary lesion(s)-complex endonasal endoscopic resection from cavernous sinuses, to N114 or N116, add

$800.00

$520.00

E891

Skull Base Surgery-Resection of Lesion(s)-Endonasal Approach-Complex endonasal endoscopic resection of pituitary and non-pituitary lesion(s)-complex endonasal endoscopic resection from frontal or temporal lobe or brainstem, to N114 or N116, add

$800.00

$520.00

E898

Neurosurgery-Open Surgical Approach-Intracranial aneurysm repair-lesion greater than 2.5 cm, to N105 or N154, add

$229.55

$283.80

E919

Cranial-intracranial duroplasty (greater than 2 cm diameter) to any intracranial procedure, add

$244.80

$254.45

E921

Cranial-repeat cranial procedure-payable in addition to any intracranial procedure and N111, N114 and N116 but excluding N127, add

$252.20

$262.15

F023

Elbow and Forearm-Reduction-Fractures-Radius and ulna-Monteggia-Open reduction of ulna plus closed reduction radial head

$242.25

$416.65

F026

Elbow and Forearm-Reduction-Fractures-Radius and ulnar shaft-Open reduction

$368.40

$528.55

F030

Elbow and Forearm-Reduction-Fractures-Radius-Distal, e.g. Colles', Smith's, or Barton's fracture-Open reduction

$420.00

$499.40

F033

Elbow and Forearm-Reduction-Fractures-Radius or ulna-Open reduction

$274.00

$438.05

F036

Elbow and Forearm-Reduction-Fractures-Olecranon-Open reduction

$224.55

$414.60

F041

Elbow and Forearm-Reduction-Fractures-Transcondylar/condylar-open reduction

$375.80

$600.00

F044

Shoulder, Arm and Chest-Reduction-Fractures-Shaft-Open reduction

$323.05

$655.50

F052

Shoulder, Arm and Chest-Reduction-Fractures-Neck with dislocation of head-open reduction

$385.15

$521.75

F055

Shoulder, Arm and Chest-Reduction-Fractures-Neck without dislocation of head-Open reduction

$327.55

$514.95

F072

Foot and Ankle-Reduction-Fractures-Os calcis-Open reduction-With repair of both the subtalar and calcaneocuboid joints

$500.00

$588.20

F076

Foot and Ankle-Reduction-Fractures-Ankle-Open reduction-One malleolus

$237.50

$283.80

F077

Foot and Ankle-Reduction-Fractures-Ankle-Open reduction-Multiple malleoli or ligaments

$400.00

$523.50

F080

Fibula and Tibia-Reduction-Fractures-Tibia with or without fibula-Open reduction-Shaft

$356.40

$553.60

F081

Fibula and Tibia-Reduction-Fractures-Intramedullary nail with distal and proximal locking screws-Medial or lateral tibial plateau

$394.45

$558.10

F096

Femur-Reconstruction-Fractures-Closed reduction-Open reduction

$493.80

$613.95

F100

Pelvis and Hip-Reduction-Fractures-Femoral neck trochanteric, subtrochanteric-Open reduction-Pin and plate/screws (cannulated included)

$498.95

$614.55

F101

Pelvis and Hip-Reduction-Fractures-Femoral neck trochanteric, subtrochanteric open reduction-Primary prosthesis, Femur only (includes Moore, Thompson, Unipolar, Bipolar)

$490.95

$613.60

F108

Foot and Ankle-Reduction-Fractures-Ankle fracture with tibial Plafond burst-Open reduction

$362.95

$616.15

F118

Shoulder, Arm and Chest-Reduction-Fractures-Clavicle-Open reduction

$300.00

$458.75

F121

Shoulder, Arm and Chest-Reduction-Fractures-Scapula-Open reduction

$242.25

$381.40

G001

Laboratory Medicine-Miscellaneous-Cholesterol, total

$5.50

$5.70

G002

Laboratory Medicine-Miscellaneous-Glucose, quantitative or semi-quantitative

$2.18

$2.26

G004

Laboratory Medicine-Miscellaneous-Occult blood

$1.53

$1.58

G009

Laboratory Medicine-Miscellaneous-Urinalysis, routine (includes microscopic examination of centrifuged specimen plus any of SG, pH, protein, sugar, haemoglobin, ketones, urobilinogen, bilirubin)

$4.30

$4.45

G010

Laboratory Medicine-one or more parts of above without microscopy

$2.07

$2.14

G011

Laboratory Medicine-Miscellaneous-Fungus culture including KOH preparation and smear

$12.60

$13.05

G012

Laboratory Medicine-Miscellaneous-Wet preparation (for fungus, trichomonas, parasites)

$1.86

$1.93

G014

Laboratory Medicine-Miscellaneous-Rapid streptococcal test

$5.50

$5.70

G031

Laboratory Medicine-Miscellaneous-Prothrombin time

$6.20

$6.40

G112

ECG-Stress Testing-Dipyramidole Thallium stress test-professional component

$75.00

$74.25

G197

Skin testing-professional component

$0.19

$0.21

G208

Allergy-Provocation testing per unit

$15.00

$16.85

G262

Cardiovascular-Angiography-Transluminal coronary angioplasty-Each additional major vessel add

$212.45

$210.40

G263

Cardiovascular-Angiography-Selective coronary catheterization-With other drug interventional studies add

$97.40

$96.45

G297

Cardiovascular-Angiography-Angiography-Angiograms (only two angiograms may be billed-One per right heart catheterization and one per left heart catheterization) irrespective of the number of chambers injected.

$118.70

$117.55

G319

ECG-Stress Testing-Maximal stress ECG-professional component

$62.65

$62.05

G365

Gynaecology-Papanicolaou Smear-Periodic

$6.75

$8.65

G378

Gynaecology-Insertion of intrauterine contraceptive device

$25.50

$31.10

G382

Chemotherapy-Monthly telephone supervision-Supervision of chemotherapy (pharmacologic therapy of malignancy or autoimmune disease) by telephone, monthly

$13.30

$13.80

G388

Injections or Infusions-Management of special oral chemotherapy, for malignant disease

$20.50

$25.75

G394

Gynaecology-Additional-for follow-Up of abnormal or inadequate smears/annually in a patient who is immunocompromised, e.g. HIV-Positive or taking long-Term immunosuppressants; or a patient with a history of oncogenic HPV-Typing; or-Where the physician is of the opinion that the patient is a member of a vulnerable group that may have difficulty accessing the services within the specified time period

$6.75

$8.65

G405

Critical Care-Ventilatory support (ICA) physician-in-charge-1st day

$193.45

$183.80

G406

Critical Care-Ventilatory support (ICA) physician-in-charge- 2nd to 30th day, inclusive per diem

$101.55

$96.45

G407

Critical Care-Ventilatory support (ICA) physician-in-charge-31st day onwards per diem

$67.60

$64.20

G408

Nephrology-Nephrological component of renal transplantation-2nd to 10th day, inclusive per diem

$121.45

$139.65

G409

Nephrology-Nephrological component of renal transplantation-11th to 21st day, inclusive per diem

$60.70

$69.80

G412

Nephrology-Nephrological component of renal transplantation-1st day following transplantation

$242.90

$279.35

G418

Neurology-Routine EEG-professional component (16-21 channel EEG)

$50.00

$62.50

G420

Otolaryngology-Ear syringing and/or extensive curetting or debridement unilateral or bilateral

$11.25

$11.35

G473

Physical Medicine-Schedule C-professional component

$191.00

$275.00

G478

diagnostic & therapeutic procedures-physical medicine-psychiatry-electroconvulsive therapy (ect) cerebral-single or multiple-in-patient

$80.30

$86.85

G479

diagnostic & therapeutic procedures-physical medicine-psychiatry-electroconvulsive therapy (ect) cerebral-single or multiple-out-patient

$92.60

$100.15

G481

Laboratory Medicine-Miscellaneous-Haemoglobin screen and/or haematocrit (any method or instrument)

$1.32

$1.37

G512

Palliative Care-Palliative Care case management fee

$62.75

$67.75

G526

Otolaryngology-Basic diagnostic hearing tests-Pure tone threshold audiometry (with or without bone conduction) and speech reception threshold and/or speech discrimination scores-professional component

$15.70

$16.45

G538

Immunization-Other immunizing agents not listed above

$4.50

$4.95

G543

Neurology-Electroencephalography-Sleep-deprived/induced EEG-professional component

$60.00

$120.00

G557

Critical Care-Comprehensive Care (Intensive Care Area)-Physician-in-charge-1st day

$325.40

$374.35

G558

Critical Care-Comprehensive Care (Intensive Care Area)-Physician-in-charge-2nd to 30th day, inclusive per diem

$213.50

$223.50

G559

Critical Care-Comprehensive Care (Intensive Care Area)-Physician-in-charge-31st day onwards per diem

$85.35

$113.00

G590

Immunization-Influenza agent

$4.50

$4.95

G600

Critical Care-Neonatal intensive care-Level A-1st day

$358.00

$376.05

G601

Critical Care-Neonatal intensive care-Level A-2nd to 30th day, inclusive per diem

$178.95

$187.95

G603

Critical Care-Neonatal intensive care-Level A-Neonatal low volume intensive care-Payable in lieu of G600 or G604 if sole newborn to maximum of 25 services per physician per fiscal year

$536.95

$564.00

G610

Critical Care-Neonatal intensive care-Level B-1st day

$245.65

$258.05

G611

Critical Care-Neonatal intensive care-Level B-2nd day onwards, per diem

$122.80

$129.00

G620

Critical Care-Neonatal intensive care-Level C-1st day

$155.20

$162.95

G621

Critical Care-Neonatal intensive care-Level C-2nd day onwards, per diem

$77.60

$81.50

G700

Basic fee-Per-Visit premium for procedures marked (+)

$5.10

$5.60

G840

Injections and Infusions-Immunization-Diphtheria, Tetanus, and acellular Pertussis vaccine/ Inactivated Poliovirus vaccine (DTaP/IPV)-Paediatric

$4.50

$5.40

G841

Injections and Infusions-Immunization-Diphtheria, Tetanus, acellular Pertussis, Inactivated Polio Virus, Haemophilus influenza type b (DTaP-IPV-Hib)-Paediatric

$4.50

$5.40

G842

Injections and Infusions-Immunization-Hepatitis B (HB)

$4.50

$5.40

G843

Injections and Infusions-Immunization-Human Papillomavirus (HPV)

$4.50

$5.40

G844

Injections and Infusions-Immunization-Meningococcal C Conjugate (Men-C)

$4.50

$5.40

G845

Injections and Infusions-Immunization-Measles, mumps, rubella (MMR)

$4.50

$5.40

G846

Injections and Infusions-Immunization-Pneumococcal conjugate

$4.50

$5.40

G847

Injections and Infusions-Immunization-Diphtheria, Tetanus, acellular Pertussis (Tdap)-Adult

$4.50

$5.40

G848

Injections and Infusions-Immunization-Varicella (VAR)

$4.50

$5.40

H055

GP/FP-Emergency Medicine-ED-Physician on Duty-Consultation

$97.60

$106.80

H065

GP/FP-Consultation in Emergency Medicine

$74.25

$81.25

H101

GP/FP-Monday to Friday-Daytime (08:00h to 17:00h)-Minor assessment

$15.00

$16.55

H102

GP/FP-Monday to Friday-Daytime (08:00h to 17:00h)-Comprehensive assessment and care

$37.20

$41.65

H103

GP/FP-Monday to Friday-Daytime (08:00h to 17:00h)-Multiple systems assessment

$35.65

$39.35

H104

GP/FP-Monday to Friday-Daytime (08:00h to 17:00h)-Re-assessment

$15.00

$16.55

H112

GP/FP-Nights (00:00h to 08:00h)

$34.20

$35.15

H113

GP/FP-Daytime and evenings (08:00h to 24:00h) on Saturdays, Sundays or Holidays

$19.80

$20.35

H121

GP/FP-Nights (00:00h to 08:00h)-Minor assessment

$29.80

$30.60

H122

GP/FP-Nights (00:00h to 08:00h)-Comprehensive assessment and care

$73.90

$76.70

H123

GP/FP-Nights (00:00h to 08:00h)-Multiple systems assessment

$65.95

$67.75

H124

GP/FP-Nights (00:00h to 08:00h)-Re-assessment

$29.80

$30.60

H131

GP/FP-Monday to Friday-Evenings (17:00h to 24:00h)-Minor assessment

$18.70

$20.65

H132

GP/FP-Monday to Friday-Evenings (17:00h to 24:00h)-Comprehensive assessment and care

$46.30

$51.85

H133

GP/FP-Monday to Friday-Evenings (17:00h to 24:00h)-Multiple systems assessment

$42.40

$46.80

H134

GP/FP-Monday to Friday-Evenings (17:00h to 24:00h)-Re-assessment

$18.70

$20.65

H151

GP/FP-Saturdays, Sundays and Holidays-Daytime and Evenings (08:00h to 24:00h)-Minor assessment

$25.50

$26.20

H152

GP/FP-Saturdays, Sundays and Holidays-Daytime and Evenings (08:00h to 24:00h)-Comprehensive assessment and care

$63.30

$65.70

H153

GP/FP-Saturdays, Sundays and Holidays-Daytime and Evenings (08:00h to 24:00h)-Multiple systems assessment

$56.95

$58.50

H154

GP/FP-Saturdays, Sundays and Holidays-Daytime and Evenings (08:00h to 24:00h)-Re-assessment

$25.50

$26.20

H261

Paediatrics-Newborn care in hospital or home

$57.90

$60.80

H312

-first twelve weeks per visit

$39.00

$42.70

H313

Physical Medicine and Rehabilitation-Rehabilitation counselling-Per unit

$76.95

$84.20

H317

-From thirteenth to twenty-sixth week (maximum)

$39.00

$42.70

H319

-Twenty-seventh week onwards (maximum 6 per

$39.00

$42.70

J135

Diagnostic Ultrasound-Thorax, abdomen and retroperitoneum-Abdominal scan-Complete

$26.55

$26.45

J138

Diagnostic Ultrasound-Pelvis-Intracavitary ultrasound* (e.g. transrectal, transvaginal)

$26.55

$26.50

J304

Pulmonary Function Studies-Flow volume loop-Volume versus flow study-From which an expiratory limb, and inspiratory limb if indicated, are generated. A flow volume loop may include derivation of FEV1, VC, V50, V25

$10.75

$11.30

J306

Pulmonary Function Studies-Functional residual capacity-Airways resistance by plethysmography or estimated using oesophageal catheter

$16.05

$16.85

J307

Pulmonary Function Studies-Functional residual capacity-By body plethysmography

$17.85

$18.75

J310

Pulmonary Function Studies-Functional residual capacity-Carbon monoxide diffusing capacity by single breath method

$18.00

$18.90

J311

Pulmonary Function Studies-Functional residual capacity-By gas dilution method

$17.55

$18.45

J327

Pulmonary Function Studies-Flow volume loop-Repeat after bronchodilator

$6.45

$6.75

J332

Pulmonary Function Studies-Oxygen saturation-By oximetry at rest and exercise, or during sleep with or without O2

$10.80

$11.35

J333

Pulmonary Function Studies-Oxygen saturation-Non-Specific bronchial provocative test (histamine, methacholine, thermal challenge)

$34.70

$36.45

J334

Pulmonary Function Studies-Oxygen saturation-J332 with at least two levels of supplemental O2

$16.05

$16.85

J336

Pulmonary Function Studies-Oxygen saturation-With single blind assessment of exercise on room air and with supplemental oxygen

$16.05

$16.85

J802

Nuclear Medicine-IN VIVO-Cardiovascular system-Venography-Peripheral and superior vena cava

$38.70

$40.30

J804

Nuclear Medicine-IN VIVO-Cardiovascular system-First transit-Without blood pool images

$15.90

$16.55

J815

Nuclear Medicine-IN VIVO-Cardiovascular system-Myocardial wall motion-Detection of venous thrombosis using radioiodinated fibrinogen up to ten days

$38.70

$40.30

J816

Nuclear Medicine-IN VIVO-Endocrine system-Adrenal scintigraphy-With iodocholesterol

$38.70

$40.30

J817

Nuclear Medicine-IN VIVO-Endocrine system-Thyroid-Uptake

$17.50

$18.25

J818

Nuclear Medicine-IN VIVO-Endocrine system-Thyroid scintigraphy with Tc99m or I-131

$38.70

$40.30

J819

Nuclear Medicine-IN VIVO-Musculoskeletal system-Application of Tomography (SPECT)-Where each SPECT image represents a different organ or body area, to J852, J652, maximum 3 images per examination add

$23.65

$24.65

J820

Nuclear Medicine-IN VIVO-Endocrine system-Parathyroid scintigraphy-Dual isotope technique with T1201 and Tc99m Iodine

$53.10

$55.30

J824

Nuclear Medicine-IN VIVO-Gastrointestinal system-Malabsorption test-With C14 substrate

$9.95

$10.35

J827

Nuclear Medicine-IN VIVO-Gastrointestinal system-Calcium absorption-Oesophageal motility studies-one or more

$38.70

$40.30

J829

Nuclear Medicine-IN VIVO-Gastrointestinal system-Gastrointestinal-Transit

$38.70

$40.30

J830

Nuclear Medicine-IN VIVO-Gastrointestinal system-Abdominal scintigraphy for gastrointestinal bleed-Tc99m sulphur colloid or Tc04

$38.70

$40.30

J831

Nuclear Medicine-IN VIVO-Gastrointestinal system-Abdominal scintigraphy for gastrointestinal bleed-Biliary scintigraphy

$38.70

$40.30

J832

Nuclear Medicine-IN VIVO-Gastrointestinal system-Abdominal scintigraphy for gastrointestinal bleed-Liver/spleen scintigraphy

$38.70

$40.30

J833

Nuclear Medicine-IN VIVO-Gastrointestinal system-Abdominal scintigraphy for gastrointestinal bleed-Salivary gland scintigraphy

$38.70

$40.30

J834

Nuclear Medicine-IN VIVO-Gastrointestinal system-Abdominal scintigraphy for gastrointestinal bleed-Dynamic renal imaging

$31.30

$32.60

J835

Nuclear Medicine-IN VIVO-Genitourinary system-Computer assessed renal function-Includes first transit

$55.50

$57.80

J836

Nuclear Medicine-IN VIVO-Genitourinary system-Computer assessed renal function-Static renal scintigraphy

$38.70

$40.30

J837

Nuclear Medicine-IN VIVO-Genitourinary system-Computer assessed renal function-ERPF by blood sample method

$9.95

$10.35

J838

Nuclear Medicine-IN VIVO-Genitourinary system-Computer assessed renal function-GFR by blood sample method

$9.95

$10.35

J839

Nuclear Medicine-IN VIVO-Genitourinary system-Computer assessed renal function-Cystography for vesicoureteric reflux

$38.70

$40.30

J840

Nuclear Medicine-IN VIVO-Genitourinary system-Testicular and scrotal scintigraphy-Includes first transit

$38.70

$40.30

J841

Nuclear Medicine-IN VIVO-Hematopoietic system-Plasma volume

$11.40

$11.85

J843

Nuclear Medicine-IN VIVO-Hematopoietic system-Red cell volume

$11.40

$11.85

J850

Nuclear Medicine-IN VIVO-Musculoskeletal system-Bone scintigraphy-General survey

$47.70

$49.70

J851

Nuclear Medicine-IN VIVO-Musculoskeletal system-Bone scintigraphy-Single site

$38.70

$40.30

J852

Nuclear Medicine-IN VIVO-Musculoskeletal system-Gallium scintigraphy-General survey

$51.70

$49.70

J853

Nuclear Medicine-IN VIVO-Musculoskeletal system-Gallium scintigraphy-Single survey

$38.70

$40.30

J857

Nuclear Medicine-IN VIVO-Nervous system and respiratory system-CSF circulation-With Tc99m or I-131 HSA

$43.95

$45.75

J858

Nuclear Medicine-IN VIVO-Nervous system and respiratory system-CSF circulation-Brain scintigraphy

$38.70

$40.30

J859

Nuclear Medicine-IN VIVO-Nervous system and respiratory system-Respiratory system-Perfusion lung scintigraphy

$34.60

$36.05

J860

Nuclear Medicine-IN VIVO-Nervous system and respiratory system-Respiratory system-Perfusion and ventilation scintigraphy-Same day

$47.70

$49.70

J861

Nuclear Medicine-IN VIVO-Miscellaneous-Radionuclide lymphangiogram

$52.60

$54.80

J863

Nuclear Medicine-IN VIVO-Miscellaneous-Scintimammography-Unilateral or bilateral

$38.70

$40.30

J864

Nuclear Medicine-IN VIVO-Miscellaneous-Tear duct scintigraphy

$41.25

$42.95

J865

Nuclear Medicine-IN VIVO-Miscellaneous-Total body counting

$38.70

$49.70

J867

Nuclear Medicine-IN VIVO-Cardiovascular system-First transit-With blood pool images

$22.30

$23.25

J869

Nuclear Medicine-IN VIVO-Endocrine system-Adrenal scintigraphy-With MIBG

$44.45

$49.70

J870

Nuclear Medicine-IN VIVO-Endocrine system-Thyroid-Repeat

$10.30

$10.75

J871

Nuclear Medicine-IN VIVO-Endocrine system-Thyroid scintigraphy-With I-123

$38.70

$40.30

J872

Nuclear Medicine-IN VIVO-Endocrine system-Parathyroid scintigraphy-Metastatic survey with I-131

$44.45

$49.70

J876

Nuclear Medicine-IN VIVO-Gastrointestinal system-Gastro-oesophageal-reflux

$38.70

$40.30

J877

Nuclear Medicine-IN VIVO-Gastrointestinal system-Gastro-oesophageal-Aspiration

$38.70

$40.30

J878

Nuclear Medicine-IN VIVO-Gastrointestinal system-Abdominal scintigraphy for gastrointestinal bleed-Labelled RBCs

$38.70

$40.30

J880

Nuclear Medicine-IN VIVO-Genitourinary system-Computer assessed renal function-Repeat after pharmacological intervention

$17.10

$17.80

J881

Nuclear Medicine-IN VIVO-Hematopoietic system-Bone marrow scintigraphy-Whole body

$47.70

$49.70

J882

Nuclear Medicine-IN VIVO-Hematopoietic system-Bone marrow scintigraphy-Single site

$38.70

$40.30

J883

Nuclear Medicine-IN VIVO-Hematopoietic system-In-111 leukocyte scintigraphy-Whole body

$46.75

$49.70

J884

Nuclear Medicine-IN VIVO-Hematopoietic system-In-111 leukocyte scintigraphy-Single site

$38.70

$40.30

J885

Nuclear Medicine-IN VIVO-Nervous system and respiratory system-CSF circulation-With In-111

$43.95

$45.75

J886

Nuclear Medicine-IN VIVO-Nervous system and respiratory system-CSF circulation-Via shunt puncture

$42.70

$44.45

J887

Nuclear Medicine-IN VIVO-Nervous system and respiratory system-Respiratory system-Ventilation lung scintigraphy

$34.60

$36.05

K002

Interviews-with relatives or a person who is authorized to make a treatment decision on behalf of the patient in accordance with the health care consent act, conducted for a purpose other than to obtain consent

$62.75

$67.75

K003

Interviews-interviews with C.A.S. or legal guardian or a person who is authorized to make a treatment decision on behalf of the patient in accordance with the health care consent act, conducted for a purpose other than to obtain consent

$62.75

$67.75

K004

Psychotherapy-family-2 or more family members in attendance at the same time-per ½ hour or major part thereof

$68.10

$73.55

K005

Primary mental health care-individual care-per ½ hour or major part thereof

$62.75

$67.75

K006

Hypnotherapy-individual-per ½ hour or major part thereof

$62.75

$67.75

K007

Psychotherapy-individual care-per ½ hour or major part thereof

$62.75

$67.75

K008

Interviews-diagnostic interview and/or counselling with child and/or parent-for psychological problem or for learning disabilities-per ½ hour or major part thereof

$62.75

$67.75

K010

Psychotherapy-group-per ½ hour or major part thereof-per member (seventh hour onward per day to a maximum of six services)

$10.00

$10.80

K012

Psychotherapy-group-per ½ hour or major part thereof-per member (up to six hours per day)-four people

$15.80

$17.05

K013

Counselling-individual care-per ½ hour or major part thereof

$62.75

$67.75

K014

Counselling-counselling for transplant recipients, donors or families of recipients and donors-one or more persons-per ½ hour or major part thereof

$62.75

$67.75

K015

Counselling relatives on behalf of catastrophically or terminally ill patient-1 or more persons-per ½ hour or major part thereof

$62.75

$67.75

K019

Psychotherapy-group-2 people

$31.40

$33.90

K020

Psychotherapy-group-3 people

$20.90

$22.55

K022

HIV primary care-primary care of patients infected with hiv-time-based all-inclusive visit fee per patient per day-per unit (½ hour or major part thereof)

$62.75

$67.75

K023

Palliative care support-time-based all-inclusive visit fee per patient per day for the purpose of providing pain and symptom management, emotional support and counselling to patients with terminal disease in the final year of

$62.75

$72.15

K024

Psychotherapy-group-per ½ hour or major part thereof-per member (up to six hours per day)-five people

$13.00

$14.05

K025

Psychotherapy-group-per ½ hour or major part thereof-per member (up to six hours per day)-six to twelve people

$11.05

$11.95

K028

Sexually Transmitted Disease (STD) management-per ½ hour or major part thereof

$62.75

$67.75

K029

Insulin therapy support (its)-per ½ hour or major part thereof

$62.75

$67.75

K030

GP/FP-Diabetic Management Assessment

$39.20

$40.55

K032

Specific neurocognitive assessment-diagnosis of dementia

$62.75

$67.75

K033

Counselling-individual care-additional units per patient per provider per year, per ½ hour or major part thereof

$38.15

$47.70

K037

Fibromyalgia/chronic fatigue syndrome care-Fibromyalgia/chronic fatigue syndrome care

$62.75

$67.75

K040

Group counselling-two or more persons-where no group members have received more than 3 units of any counselling paid under codes k013 and k040 combined per provider per year, per unit

$62.75

$67.75

K041

Group counselling-two or more persons-additional units where any group member has received 3 or more units of any counselling paid under codes k013 and k040 combined per provider per year, per unit

$38.80

$48.50

K077

Geriatrics-Geriatric telephone support per unit

$35.45

$40.05

K119

Paediatrics-Paediatric developmental assessment incentive

$100.00

$115.10

K122

Developmental and/or behavioural care-individual developmental and/or behavioural care

$80.30

$86.85

K123

Developmental and/or behavioural care-family developmental and/or behavioural care

$91.10

$98.55

K131

GP/FP-Periodic health visit-Adult age 18 to 64 inclusive

$50.00

$54.00

K140

Chronic disease shared appointment-per patient-maximum 8 units per patient per day-2 patients-per unit

$31.40

$33.90

K141

Chronic disease shared appointment-per patient-maximum 8 units per patient per day-3 patients-per unit

$20.90

$22.55

K142

Chronic disease shared appointment-per patient-maximum 8 units per patient per day-4 patients-per unit

$15.80

$17.05

K143

Chronic disease shared appointment-per patient-maximum 8 units per patient per day-5 patients-per unit

$13.00

$14.05

K144

Chronic disease shared appointment-per patient-maximum 8 units per patient per day 6 to 12 patients-per unit

$11.05

$11.95

K189

Urgent community psychiatric follow-up, to A190, A195, A695 or A795 add

$200.00

$216.30

K190

Psychiatry-office/clinic-individual in-patient psychotherapy (including aversive conditioning, narcoanalysis, psychoanalysis)-per ½ hour or major part thereof

$84.15

$91.00

K191

Psychiatry-family psychiatric care, in-patient, per ½ hour or major part thereof

$105.10

$113.70

K192

Psychiatry-hypnotherapy-individual-per ½ hour or major part thereof

$80.30

$86.85

K193

Psychiatry-family psychotherapy-in-patients (two or more family members) per ½ hour or major part thereof

$95.45

$103.25

K194

Psychiatry-hypnotherapy-group-for induction and training for hypnosis (up to eight people) per ½ hour or major part thereof-per member

$14.60

$15.80

K195

Psychiatry-family psychotherapy-out-patients (two or more family members) per ½ hour or major part thereof

$91.10

$98.55

K196

Psychiatry-family psychiatric care, out-patient, per ½ hour or major part thereof

$91.10

$98.55

K197

Psychiatry-office/clinic-individual out-patient psychotherapy (including aversive conditioning, narcoanalysis, psychoanalysis)-per ½ hour or major part thereof

$80.30

$86.85

K198

Psychiatry-psychiatric care, out-patient, per ½ hour or major part thereof

$80.30

$86.85

K199

Psychiatry-psychiatric care, in-patient, per ½ hour or major part thereof

$92.60

$100.15

K200

Psychiatry-group psychotherapy, in-patients-per member, per ½ hour or major part thereof-up to six hours per day-4 people

$21.00

$22.70

K201

Psychiatry-group psychotherapy-in-patients-per member-per unit (½ hr or major part thereof-first 12 units per day)-5 people

$16.80

$18.15

K202

Psychiatry-group psychotherapy-in-patients-per member-per unit (½ hr or major part thereof-first 12 units per day)-6 to 12 people

$15.15

$16.40

K203

Psychiatry-group psychotherapy-out-patients-per member-per unit (½ hr or major part thereof-first 12 units per day)-4 people

$20.10

$21.75

K204

Psychiatry-group psychotherapy-out-patients-per member-per unit (½ hr or major part thereof-first 12 units per day)-5 people

$16.05

$17.35

K205

Psychiatry-group psychotherapy-out-patients-per member-per unit (½ hr or major part thereof-first 12 units per day)-6 to 12 people

$14.45

$15.65

K206

Psychiatry-group psychotherapy, out-patients-per member, per ½ hour-(seventh hour onward, to a maximum of 3 hours)

$12.85

$13.90

K207

Outpatient psychotherapy-group-add'l units

$12.85

$13.90

K208

Psychiatry-Psychotherapy, Family Psychotherapy, Hypnotherapy and Psychiatric Care-Group psychotherapy, out-patients-per member-first 12 units per day

$40.15

$43.45

K209

Psychiatry (19)-Group psychotherapy, out-patients-per member-first 12 units per day- 3 people…per unit

$26.75

$28.95

K210

Psychiatry (19)-Group psychotherapy, in-patients-per member-first 12 units per day-2 people…per unit

$42.10

$45.55

K211

Psychiatry (19)-Group psychotherapy, in-patients-per member-first 12 units per day-3 people…per unit

$28.05

$30.35

K222

Genetic care, patient or family, per unit

$74.70

$75.75

K223

Clinical interpretation by a geneticist

$37.65

$38.20

K224

Clinical interpretation requested by a midwife

$37.65

$38.20

K620

Psychiatry-assessments under the mental health act-consultation for involuntary psychiatric treatment (as mandated by section 35a (2) of the mental health act)-per ½ hour or major part thereof

$85.00

$91.95

K623

Family & general practice-assessments under the mental health act-application for psychiatric assessment-form 1

$104.80

$113.35

K624

Family & general practice-assessments under the mental health act-certification of involuntary admission-form 3

$129.05

$139.60

K629

Family & general practice-assessments under the mental health act-all other re-certification(s) of involuntary admission including completion of appropriate forms

$38.25

$41.35

K630

Psychiatry-Psychiatric consultation extension-per unit

$105.10

$113.70

K680

Substance abuse-extended assessment

$62.75

$67.75

K887

Family & general practice-community treatment order (CTO)-CTO initiation-including completion of the CTO form and all preceding CTO services directly related to CTO initiation-per unit

$84.70

$91.60

K888

Family & general practice-community treatment order (CTO)-CTO supervision-including all associated CTO services except those related to initiation or renewal-per unit

$84.70

$91.60

K889

Family & general practice-community treatment order (CTO)-CTO renewal-including completion of the CTO form and all preceding CTO services directly related to CTO renewal-per unit

$84.70

$91.60

L800

Laboratory Medicine-Haematopathology-Blood film interpretation (Romanowsky stain)

$20.85

$21.70

L805

Laboratory Medicine-Anatomic Pathology-Cytopathology-Aspiration biopsy e.g. Lung, breast, thyroid, prostate

$79.00

$81.20

L806

Laboratory Medicine-Anatomic Pathology-Bronchial, oesophageal, gastric, endometrial or other brushings and washings

$35.45

$35.80

L810

Laboratory Medicine-Anatomic Pathology-Cytopathology-Fluids e.g. pleural, ascitic cyst, pericardial, C.S.F., urine and joint

$22.05

$23.40

L820

Laboratory Medicine-Anatomic Pathology-Cytopathology-Smear for spermatozoa

$6.05

$7.00

L826

Laboratory Medicine-Haematopathology-Blood film interpretation (special stain)

$11.85

$13.35

L829

Laboratory Medicine-Haematopathology-Haemoglobinopathy interpretation (payable for abnormal results only)

$12.90

$13.70

L834

Laboratory Medicine-Special Procedures and Interpretation-Histology or Cytology-Histochemistry of muscle-1 to 3 enzymes

$11.85

$13.35

L835

Laboratory Medicine-Special Procedures and Interpretation-Each additional enzyme, add

$11.85

$13.35

L841

Laboratory Medicine-Special Procedures and Interpretation-Enzyme histochemistry and interpretation-Per enzyme

$11.85

$13.35

L843

Laboratory Medicine-Special Procedures and Interpretation-Special microscopy of tissues including polarization, interference phase contrast, dark field, autofluorescence or other microscopy and interpretation

$19.80

$21.50

L844

Laboratory Medicine-Special Procedures and Interpretation-Special microscopy of fluids (polarization, interference, phase contrast, dark field, autofluorescence or other microscopy and interpretation)

$12.80

$13.60

L846

Laboratory Medicine-Special Procedures and Interpretation-Flow cell cytometry and interpretation-Per marker

$11.85

$12.20

L849

Laboratory Medicine-Special Procedures and Interpretation-Interpretation and handling of decalcified tissue

$12.80

$13.90

M135

Major decortication of lung for empyema or tumour

$800.00

$848.80

M142

Pneumonectomy, may include radical mediastinal node dissection, sampling or pericardial resection requiring repair

$1,400.00

$1,485.40

M143

Lobectomy, may include radical mediastinal node dissection or sampling

$1,285.00

$1,402.60

M144

Segmental resection, including segmental bronchus and artery

$1,285.00

$1,441.75

M145

Wedge resection of lung

$818.45

$843.40

N102

Meningioma and other tumourous lesions, including pituitary tumours-supratentorial

$1,726.80

$1,862.85

N103

Craniotomy plus excision-Astrocytoma, oligodendroglioma, glioblastoma or metastatic tumour-supratentorial

$1,562.90

$1,686.05

N104

Spontaneous Intracerebral Haemorrhage-Craniotomy plus removal-supratentorial

$1,100.00

$1,230.00

N105

Neurosurgery-Open Surgical Approach-Intracranial aneurysm repair-Craniotomy approaches-Carotid circulation-per vessel

$2,140.15

$2,477.45

N106

Neurosurgery-Open Surgical Approach-Cerebral vascular malformation-Craniotomy-supratentorial

$1,622.50

$2,006.05

N113

Intracranial Abscess-Craniotomy for brain Biopsy (other than for tumour)

$774.90

$1,019.15

N119

Intracranial Abscess-Functional stereotaxy-Intracranial implantation of chronic surface electrodes

$901.25

$1,185.30

N123

Intracranial Abscess-Stereotaxis-intracranial (to include ventriculography)

$538.40

$559.60

N124

Intracranial Abscess-Functional stereotaxy

$1,551.20

$2,040.15

N128

Intracranial Abscess-Repair of encephalocoele

$798.80

$924.70

N129

Intracranial Abscess-Posterior fossa decompression for Arnold Chiari malformation

$1,110.00

$1,284.95

N140

Cranial-Reduction of skull fracture-compound

$773.15

$895.00

N143

Cranial-Extracerebral haematoma and/or hygroma-Drainage by burr hole(s)-unilateral

$559.60

$647.80

N144

Cranial-Extracerebral haematoma and/or hygroma-Drainage and/or removal by craniotomy

$863.25

$999.30

N148

Cranial-Removal of intracerebral haematoma and/or debridement of traumatized brain (includes management of any skull fracture)

$1,040.65

$1,204.65

N151

Craniotomy plus excision-Astrocytoma, oligodendroglioma, glioblastoma or metastatic tumour-infratentorial

$1,726.80

$1,862.85

N153

Meningioma and other tumourous lesions, including pituitary tumours-infratentorial or basal

$2,345.00

$2,529.80

N154

Neurosurgery-Open Surgical Approach-Intracranial aneurysm repair-Craniotomy approaches-Vertebrobasilar circulation, including aneurysm of vein of Galen

$2,140.15

$2,477.45

N155

Neurosurgery-Open Surgical Approach-Cerebral vascular malformation-Craniotomy-infratentorial

$1,532.10

$2,015.00

N157

Spontaneous Intracerebral Haemorrhage-Craniotomy plus removal-infratentorial

$1,241.65

$1,388.40

N174

Cranial-Conversion of shunt (e.g. ventriculoperitoneal to ventriculoatrial)-includes removal of existing shunt

$420.30

$585.90

N200

Cranial-Decompressive craniectomy (frontal, sub-temporal)

$638.05

$738.60

N218

Neurosurgery-Open Surgical Approach-Extracranial-intracranial microvascular anastomosis superficial temporal artery

$1,178.35

$1,364.05

N230

Cranial-CSF shunting procedures-all types

$737.00

$1,027.40

N245

Cranial-Revision of CSF shunt-operative-all types

$420.70

$585.90

N249

Cranial-Conversion of shunt (e.g. ventriculoperitoneal to ventriculoatrial)-Third ventriculostomy

$777.80

$1,084.25

N259

Cranial-V-Decompression or rhizotomy (partial or complete) trigeminal nerve

$481.90

$671.75

N267

Cranial-Occipital and/or suboccipital craniectomy for compression, decompression or section of cranial nerves

$1,232.35

$1,280.90

N501

Anterior Spinal Decompression-Cervical-Vertebrectomy (removal of vertebral body and excision of adjacent discs)

$1,020.00

$1,100.40

N523

AV malformation of cord-excision/obliteration

$1,530.00

$1,891.70

N530

Implantation of spinal cord stimulating electrode by laminectomy

$816.00

$1,008.90

N536

Repair of myelomeningocoele (one surgeon)

$765.00

$1,217.10

N538

Repair of myelomeningocoele (two surgeons)-reconstructive surgeon

$632.40

$881.55

N555

Insertion / revision of implantable infusion pump

$510.00

$590.40

N560

Intradural extramedullary spinal tumour(s)-partial or total removal

$1,530.00

$2,132.80

N561

Intradural intramedullary spinal tumour(s)-partial or total removal

$1,765.75

$2,461.45

N565

Repair of lipomeningocoele including release of tethered cord

$1,020.00

$1,622.80

N577

Intradural rhizotomy anterior/posterior (uni/bilateral)-any number of roots.

$714.00

$1,276.65

P004

Obstetrics-Prenatal care-Minor prenatal assessment

$33.70

$36.85

P008

Obstetrics-Labour-Delivery-Postnatal care in office

$33.70

$36.85

R261

Elbow and Forearm-Reconstruction-Bone-Deformity-Osteotomy-radius with or without ulna

$411.20

$577.70

R322

Hand and Wrist-Reconstruction-Bone-Pseudoarthrosis/non-Union/avascular necrosis-Scaphoid

$500.00

$588.20

R352

Chest Wall and Mediastinum-Repair-Chest wall-Pleura-Pectus excavatum or carinatum repair (by reconstruction, not implant)

$750.00

$832.30

R401

Shoulder, Arm and Chest-Reduction-Dislocations-Glenohumeral joint-Open reduction, recurrent

$379.50

$419.65

R421

Elbow and Forearm-Excision-Joint contents-Synovectomy/capsulectomy/debridement, etc.

$311.85

$407.25

R465

Hand and Wrist-Arthrodesis-Finger-Thumb

$256.15

$321.30

R466

Hand and Wrist/Elbow and Forearm/Foot and Ankle-Arthrodesis-Wrist/Elbow/Ankle

$400.00

$461.75

R475

Foot and Ankle-Arthrodesis-Pan-Talar, one stage

$626.45

$779.50

R477

Foot and Ankle-Arthrodesis-Metatarsophalangeal

$247.25

$302.60

R485

Hand and Wrist-Arthroplasty-Wrist-Total

$426.90

$667.75

R486

Elbow and Forearm-Arthroplasty-Complete arthroplasty replacement

$619.90

$911.05

R487

Shoulder, Arm and Chest-Arthroplasty-Total prosthesis

$695.10

$770.00

R695

Foot and Ankle-Arthrodesis-Subtalar

$450.00

$599.95

R720

Heart and Pericardium-Repair-Total repair Tetralogy of Fallot-With or without previous arterial shunt

$1,261.80

$1,285.00

R721

Heart and Pericardium-Repair-Arterial repair of transposition

$1,687.50

$1,739.20

R722

Heart and Pericardium-Repair-Total anomalous pulmonary venous drainage

$1,124.70

$1,152.30

R723

Heart and Pericardium-Repair-Total correction transposition of great vessels

$1,124.70

$1,152.30

R727

Valves-Tricuspid annuloplasty

$662.55

$678.80

R728

Valves-Tricuspid valve replacement

$758.80

$777.40

R734

Valves-Mitral annuloplasty

$770.70

$789.60

R735

Valves-Mitral replacement

$948.70

$960.35

R738

Valves-Mitral valve reconstruction-Aortic valve replacement

$1,036.50

$1,049.20

R743

Heart and Pericardium-Excision-Coronary artery repair-Two

$1,255.00

$1,278.10

R758

Heart and Pericardium-Resection coarctation-Adolescent or adult

$967.00

$984.90

R759

Heart and Pericardium-Resection coarctation-Congenital heart procedures-E.g. Blalock, Glenn, Potts, Waterston or Central

$755.80

$774.35

R770

Heart and Pericardium-Repair-Correction of cor triatriatum

$864.40

$885.60

R773

Valves-Mitral valve reconstruction-Simple (includes annuloplasty)

$1,618.50

$1,648.25

R774

Valves-Mitral valve reconstruction-Complex (includes annuloplasty and repair of both the anterior and posterior leaflets)

$2,021.05

$2,058.20

R785

Arteries-Aorto-Iliac repair-Plus bilateral common femoral repair

$2,202.00

$2,327.50

R787

Arteries-Femoro-Anterior/posterial tibial/peroneal bypass graft-With saphenous vein

$1,006.75

$1,265.00

R791

Arteries-Femoro-Popliteal-With saphenous vein

$857.35

$1,077.25

R799

Arteries-Thoracic aorta aneurysm-Repair or excision with graft-Ascending

$1,455.30

$1,473.15

R800

Arteries-Thoracic aorta aneurysm-Repair or excision with graft-Arch

$1,807.10

$1,840.35

R802

Arteries-Abdominal aorta-Repair or excision with graft-Aneurysm repair alone or including unilateral common femoral repair

$1,500.00

$1,585.50

R803

Arteries-Thoracic aorta aneurysm-Repair or excision with graft-Thoraco-Abdominal aneurysm

$2,566.70

$2,859.30

R817

Arteries-Abdominal aorta-Repair or excision with graft-Aneurysm repair and bilateral common femoral repair

$2,202.00

$2,327.50

R827

Diagnostic and Therapeutic Procedures/Cardiovascular-Dialysis/veins-Revision of Scribner shunt/Anastomosis-Spleno-renal-Creation of A.V. fistula

$440.00

$490.15

R840

Dialysis-Bypass graft for haemodialysis-Autogenous vein

$424.10

$496.60

R851

Dialysis-Bypass graft for haemodialysis-Synthetic

$444.70

$482.70

R852

Dialysis-Peritoneal dialysis-Insertion of peritoneal cannula by laparotomy or laparoscopy

$256.10

$352.50

R863

Valves-Mitral valve reconstruction-Replacement of aortic valve, replacement of ascending aorta, and reimplantation of coronary Arteries (Modified Bentall)

$2,021.05

$2,070.60

R874

Heart and Pericardium-Percutaneous transluminal catheter assisted closure for Secundum arterial septal defect-Cardiopulmonary transplantation

$2,534.25

$2,565.30

R876

Valves-Mitral valve reconstruction-Valve sparing aortic root replacement or remodelling

$2,021.05

$2,144.95

R877

Arteries-Abdominal aorta-Repair or excision with graft-Aneurysm with repair of iliac artery aneurysm (unilateral or bilateral)

$2,002.75

$2,116.90

R923

Heart and Pericardium-Repair-Double outlet-Right/left ventricle

$1,480.40

$1,516.70

R924

Heart and Pericardium-Repair-Double outlet ventricle with transposition

$1,687.50

$1,728.90

R925

Heart and Pericardium-Repair-Truncus arteriosus

$1,687.50

$1,718.55

R926

Heart and Pericardium-Repair-Interrupted aortic arch

$1,480.40

$1,516.70

R927

Heart and Pericardium-Repair-Aorto-Pulmonary window

$948.75

$960.40

S089

Partial oesophageal resection and reconstruction (including intestinal transposition)

$1,081.55

$1,180.50

S090

Total thoracic oesophageal resection

$1,465.35

$1,912.30

S096

Ruptured oesophagus, suture and drainage

$507.00

$661.65

S104

Oesophagus-Suture-Repair of esophageal atresia with or without tracheal fistula

$1,153.85

$2,203.20

S117

Stomach-Incision-Gastrotomy-Pyloromyotomy (Ramstedt's)

$314.80

$536.90

S118

Stomach-Incision-Gastrostomy-Gastrostomy

$345.85

$467.85

S139

Stomach-Suture-Gastrorrhaphy (for perforated gastric or duodenal ulcer or wound)

$503.15

$672.75

S149

Intestines (except rectum) Incision-Enterotomy-Ileostomy

$406.85

$470.65

S157

Intestines (except rectum) Incision-Enterotomy-Colostomy

$406.85

$470.65

S160

Intestines (except rectum) Incision-Enterotomy-Entero-enterostomy

$406.85

$470.65

S164

Intestines (except rectum) Excision-Resection with anastomosis-Small intestine-Duodenum

$746.10

$1,015.15

S165

Intestines (except rectum) Excision-Resection with anastomosis-Small intestine-Other

$687.55

$741.45

S166

Intestines (except rectum) Excision-Resection with anastomosis-Small and large intestine terminal ileum, cecum and ascending colon (right hemicolectomy)

$799.55

$899.85

S167

Intestines (except rectum) Excision-Resection with anastomosis-Large intestine-any portion

$799.55

$877.95

S168

Intestines (except rectum) Excision-Ileostomy-Subtotal colectomy

$1,057.70

$1,260.40

S169

Intestines (except rectum) Excision-Resection with anastomosis-Total colectomy with ileo-rectal anastomosis

$1,242.90

$1,313.65

S170

Intestines (except rectum) Ileostomy-Plus total colectomy plus abdomino-perineal resection

$1,790.60

$2,183.65

S171

Intestines (except rectum) Excision-Resection with anastomosis-Left hemicolectomy with anterior resection or proctosigmoidectomy (anastomosis below peritoneal reflection & mobilization of splenic flexure)

$1,082.95

$1,128.10

S173

Intestines (except rectum)-Ileostomy-Two-Surgeon team-Abdominal

$1,632.80

$1,812.00

S174

Intestines (except rectum)-Ileostomy-Two-Surgeon team-Perineal

$481.00

$533.80

S175

Intestines (except rectum)-Intestinal obstruction (mechanical)-One stage-Without resection

$620.00

$712.35

S176

Intestines (except rectum)-Intestinal obstruction (mechanical)-One stage-With entero-enterostomy

$748.00

$894.85

S177

Intestines (except rectum)-Intestinal obstruction (mechanical)-One stage-With resection

$900.00

$1,055.25

S178

Intestines (except rectum)-Intestinal obstruction (mechanical)-Intestinal atresia (newborn)

$682.90

$1,512.75

S179

Intestines (except rectum)-Intestinal obstruction (mechanical)-Meconium ileus

$682.90

$1,512.75

S180

Intestines (except rectum)-Intestinal obstruction (mechanical)-One stage-With enterotomy

$672.00

$824.80

S182

Intestines (except rectum)-Repair-Revision of ileostomy or colostomy-Full thickness

$350.65

$467.90

S185

Intestines (except rectum)-Suture-Closure of colostomy or enterostomy-With or without resection and/or anastomosis

$406.85

$504.70

S188

Intestines (except rectum)-Ileostomy-Bowel resection without anastomosis (colostomy and mucous fistula)

$544.35

$770.55

S213

Rectum-Excision-Proctectomy-Anterior resection or proctosigmoidectomy (anastomosis below peritoneal reflection)

$1,100.00

$1,204.50

S214

Rectum-Excision-Proctectomy-Abdomino-Perineal resection or pull through

$1,300.00

$1,524.20

S215

Rectum-Excision-Two surgeon team-Abdominal surgeon

$1,009.85

$1,107.50

S217

Rectum-Excision-Two surgeon team-Hartmann procedure

$890.00

$1,063.60

S218

Rectum-Excision-Two surgeon team-Colon reconstruction following Hartmann procedure

$1,030.00

$1,086.75

S222

Rectum-Excision-Two surgeon team-Presacral or trans-sacral proctotomy and excision of lesion

$350.65

$474.35

S227

Rectum-Repair-Rectal prolapse-Abdominal approach

$554.10

$688.75

S229

Rectum-Suture of rectum, trauma-External approach

$239.20

$355.45

S249

Rectum-Excision-Local excision for malignancy

$153.05

$291.05

S270

Liver-Excision-Hepatectomy-Formal anatomical resection-one or two liver segments

$1,184.60

$1,426.05

S271

Liver-Excision-Hepatectomy-Formal anatomical resection-Five or more liver segments

$1,784.60

$1,938.50

S300

Pancreas-Excision-Pancreatectomy-"Whipple type" procedure

$1,785.45

$2,457.35

S312

Abdomen, Peritoneum and Omentum-Incision-Laparotomy, with or without biopsy or for Hirschsprung's disease (except biopsies of stomach, liver, pancreas and multiple para-Aortic lymph nodes

$330.00

$485.25

S321

Abdomen, Peritoneum and Omentum-Incision-Laparotomy-for acute trauma

$397.15

$587.10

S322

Abdomen, Peritoneum and Omentum-Repair-Herniotomy-Inguinal and/or femoral-Infants

$325.00

$487.50

S323

Abdomen, Peritoneum and Omentum-Repair-Herniotomy-Inguinal and/or femoral-Adolescents and adults

$331.80

$357.80

S326

Abdomen, Peritoneum and Omentum-Repair-Herniotomy-Inguinal and/or femoral-Children

$275.00

$412.50

S328

Unilateral with exploration of other side-infants and children

$329.30

$458.40

S345

Massive sliding inguinal hernia

$400.00

$431.35

S346

Abdomen, Peritoneum and Omentum-Repair-Congenital diaphragmatic hernia-Primary or first stage repair

$576.90

$1,300.55

S347

Abdomen, Peritoneum and Omentum-Repair-Congenital diaphragmatic hernia-Second or subsequent stage repair

$366.00

$472.15

S348

Abdomen, Peritoneum and Omentum-Repair-Omphalocele and gastroschisis-Primary or first stage repair

$375.80

$1,112.35

S349

Abdomen, Peritoneum and Omentum-Repair-Omphalocele and gastroschisis-Second or subsequent stage repair

$475.80

$1,408.35

S411

Kidney and Upper Urinary Tract-Excision-Partial or heminephrectomy

$875.00

$890.80

S416

Kidney and Upper Urinary Tract-Excision-Nephrectomy-Thoraco-Abdominal or radical nephrectomy

$875.00

$890.80

S422

Kidney and Upper Urinary Tract-Repair-Pyeloplasty (with or without nephropexy)

$679.25

$890.80

S424

Kidney and Upper Urinary Tract-Excision-Nephrectomy-Extrophy-Plastic closure of bladder with closure of abdominal wall and urethral lengthening with closure of pelvic floor with or without reimplantation of ureters

$939.70

$1,237.25

S428

Kidney and Upper Urinary Tract-Repair-Symphysiotomy for horseshoe kidney with or without nephropexy and associated procedures

$437.20

$494.90

S449

Kidney and Upper Urinary Tract-Excision-Ureterectomy-Including ureterovesical junction

$437.20

$445.40

S458

Kidney and Upper Urinary Tract-Repair-Ureterostomy-Cutaneous-Unilateral

$260.85

$494.90

S484

Bladder-Cystectomy-Complete cystectomy, without transplant

$657.75

$791.85

S512

Bladder-Repair of ruptured bladder

$330.90

$346.45

S513

Bladder-Repair-Cystoplasty, using intestine

$657.75

$692.85

S518

Bladder-Repair-Plastic repair of bladder neck-Child

$331.70

$494.90

S523

Urogenital and Urinary Surgical Procedures-Bladder/Female Genital Surg Procedures-Vagina-Suture/Repair-Closure of fistula/Vesicovaginal-Vaginal approach

$772.40

$791.85

S524

Bladder-Suture-Closure of fistula-Vesicovaginal-Transvesical approach (with or without omental flap)

$467.00

$544.40

S535

Urethra-Repair-Urethroplasty-First stage-One stage repair and may include skin grafting

$381.60

$445.40

S536

Urethra-Excision-Caruncle

$85.30

$118.80

S537

Urethra-Excision-Urethral papilloma, single or multiple

$85.30

$118.80

S543

Urethra-Excision-Prolapse urethra

$85.30

$118.80

S544

Urethra-Excision-Urethrectomy-Radical

$215.80

$296.95

S553

Urethra-Suture-Posterior urethra-Late repair

$552.30

$643.35

S569

Penis-Incision-Slit of prepuce (complete care)-Adult or child

$30.25

$39.60

S571

Penis-Repair-Hypospadias or Epispadia-One stage repair-With advancement of meatus into glans

$383.50

$420.65

S572

Penis-Repair-Hypospadias or Epispadia-One stage repair-Into glans using island flap pedicle (penoscrotal)

$662.45

$722.55

S573

Penis-Excision-Circumcision-for Physical symptomatology only-for patients aged one year or older

$179.40

$188.05

S574

Penis-Excision-Amputation-Partial

$170.65

$197.95

S577

Penis-Excision-Circumcision-for Physical symptomatology only-for infants less than one year of age

$90.05

$188.05

S581

Penis-Repair-Hypospadias or Epispadia-Closure urethro-Cutaneous fistula

$92.10

$296.95

S588

Penis-Repair-Hypospadias or Epispadia-Surgical removal of prosthesis

$110.15

$148.45

S591

Testis-Repair-Orchidopexy-for undescended testis, any type, one or two stages to include hernia repair where required

$331.70

$346.45

S593

Testis-Repair-Orchidopexy-Exploration for undescended testicle, without orchidopexy

$260.85

$346.45

S595

Testis-Repair-Orchidopexy-Ruptured testicle

$170.65

$247.45

S596

Testis-Repair-Orchidopexy-Insertion of testicular prosthesis

$170.65

$197.95

S597

Penis-Repair-Hypospadias or Epispadia-Penile prosthesis for impotence

$306.85

$395.90

S598

Testis-Biopsy-Radical orchidectomy for malignancy-Unilateral

$235.35

$267.25

S600

Testis-Repair-Orchidopexy-Reduction of torsion of testis or appendix testis and orchidopexy (one or both sides) if required

$235.35

$296.95

S601

Epididymis and Tunica Vaginalis-Epididymis-Spermatocele or spermatic granuloma excision

$205.35

$207.85

S611

Epididymis and Tunica Vaginalis-Tunica Vaginalis-Hydrocele excision-Unilateral

$205.35

$207.85

S616

Scrotum-Incision-Abscess or haematocele-And exploration-Unilateral

$85.30

$99.00

S647

Prostate-Excision-Prostatectomy-Suprapubic-With or without removal of bladder stones

$600.75

$643.35

S650

Prostate-Excision-Retropubic-With or without removal of bladder stones-Simple

$600.75

$643.35

W075

Consultation

$185.00

$203.30

W085

Plastic Surgery-Non-emergency LTC in-patient Services-Consultation

$81.10

$87.70

W086

Plastic Surgery-Non-emergency hospital in-patient services-Repeat consultation

$47.95

$51.85

W113

Complex neuromuscular assessment

$89.85

$91.00

W155

Endocrinology & Metabolism (15) -Consultation

$157.00

$162.65

W165

Nephrology (16)-Consultation

$157.00

$162.90

W185

Consultation

$176.35

$178.60

W223

Extended special genetic consultation

$395.65

$401.30

W225

Consultation

$165.00

$167.35

W265

Paediatrics-Consultation

$167.00

$175.40

W305

OB/GYN-Consultation

$101.70

$111.70

W306

OB/GYN-Repeat consultation

$54.10

$59.45

W345

Otolaryngology-Non-emergency LTC in-patient Services-Consultation

$77.90

$79.90

W355

Urology-Non-emergency LTC in-patient Services-Consultation

$80.00

$83.15

W356

Urology-Non-emergency LTC in-patient Services-Repeat consultation

$55.75

$56.40

W465

Infectious Disease (46)-Consultation

$157.00

$178.65

W511

Physical Medicine and Rehabilitation-Non-emergency LTC in-patient Service-Complex physiatry assessment

$89.85

$98.35

W515

Physical Medicine and Rehabilitation-Non-emergency LTC in-patient Service-Consultation

$182.85

$200.15

W535

Ophthalmology-Non-emergency LTC in-patient Service-Consultation

$82.30

$82.20

W645

General Thoracic Surgery-Non-emergency hospital in-patient services-Consultation

$90.30

$98.55

W662

Paediatrics-Extended special paediatric consultation-Subject to the same conditions as A662

$395.65

$401.30

W667

Paediatrics-Neurodevelopmental consultation

$395.65

$401.30

W695

Neurodevelopmental consultation

$395.65

$401.30

W760

Endocrinology & Metabolism (15) -Complex endocrine neoplastic disease assessment

$89.85

$90.75

W770

Extended comprehensive geriatric consultation

$395.65

$401.30

W777

GP/FP-Non-emergency LTC in-patient Services-Admission assessment-Intermediate assessment-Pronouncement of death

$33.70

$36.85

W895

Consultation

$232.70

$251.70

X090

Diagnostic Radiology-Chest & Abdomen-Chest-Single view

$6.40

$6.35

X091

Diagnostic Radiology-Chest & Abdomen-Chest-Two views

$10.75

$10.70

X092

Diagnostic Radiology-Chest & Abdomen-Chest-Three or more views

$12.45

$12.40

Y820

Nuclear Medicine-IN VIVO-Parathyroid scintigraphy-Dual isotope technique with T1201 and Tc99m Iodine

$69.03

$71.89

Y827

Nuclear Medicine-IN VIVO-Calcium absorption-Oesophageal motility studies-one or more

$50.31

$52.40

Y829

Nuclear Medicine-IN VIVO-Gastrointestinal-Transit

$50.31

$52.40

Y831

Nuclear Medicine-IN VIVO-Abdominal scintigraphy-for gastrointestinal bleed-Biliary scintigraphy

$50.31

$52.40

Y832

Nuclear Medicine-IN VIVO-Abdominal scintigraphy-for gastrointestinal bleed-Liver/spleen scintigraphy

$50.31

$52.40

Y833

Nuclear Medicine-IN VIVO-Abdominal scintigraphy-for gastrointestinal bleed-Salivary gland scintigraphy

$50.31

$52.40

Y836

Nuclear Medicine-IN VIVO-Computer assessed renal function-Static renal scintigraphy

$50.31

$52.40

Y850

Nuclear Medicine-IN VIVO-Bone scintigraphy-General survey

$62.01

$64.58

Y851

Nuclear Medicine-IN VIVO-Bone scintigraphy-Single site

$50.31

$52.40

Y859

Nuclear Medicine-IN VIVO-Perfusion lung scintigraphy

$44.98

$46.85

Y860

Nuclear Medicine-IN VIVO-Perfusion and ventilation scintigraphy-Same day

$62.01

$64.58

Y876

Nuclear Medicine-IN VIVO-Gastroesophageal-Reflux

$50.31

$52.40

Y877

Nuclear Medicine-IN VIVO-Gastro-Oesophageal-Aspiration

$50.31

$52.40

Y887

Nuclear Medicine-IN VIVO-Ventilation lung scintigraphy

$44.98

$46.85

Z296

Nose-Endoscopy-Fiberoptic endoscopy of upper airway (nose, hypopharynx or larynx) (IOP)-With flexible endoscope-If only operative procedure performed

$19.20

$20.10

Z335

Thoracoscopy (pleuroscopy) with or without pleural biopsy, suction, etc.

$228.40

$242.35

Z341

Lungs and Pleura-Incision-Closed drainage effusion or pneumothorax

$69.80

$76.80

Z403

Diagnostic and Therapeutic Procedures/Haematic and Lymphatic Surgical Procedures-Laboratory medicine/spleen and marrow-Incision//Haematopathology-Bone marrow aspiration

$33.90

$42.40

Z408

Spleen and Marrow-Incision-Bone marrow core biopsy (with biopsy needle)

$63.35

$79.20

Z434

Cardiovascular-Angiography-Transluminal coronary angioplasty-one or more sites on a single major vessel

$471.60

$467.05

Z440

Cardiovascular-Haemodynamic/Flow/Metabolic Studies-Left heart-Retrograde aortic

$210.55

$208.50

Z442

Cardiovascular-Angiography-Selective coronary catheterization-Both arteries

$289.55

$286.75

Z604

Urethra-Incision-Urethrotomy-Meatotomy and Plastic repair

$31.60

$39.60

Z621

Urethra-Manipulation-Dilatation of stricture-Male, local anaesthetic

$13.65

$14.85

Z622

Urethra-Manipulation-Dilatation of urethra-Female

$5.65

$9.90

Z627

Kidney and Upper Urinary Tract-Percutaneous procedures-Removal of renal calculi

$167.85

$168.25

Z628

Kidney and Upper Urinary Tract-Endoscopic Procedures-Cystoscopy and diagnostic ureteroscopy-Above intramural

$125.65

$125.70

Z702

Penis-Excision-Biopsy

$23.55

$39.60

Z708

Epididymis and Tunica Vaginalis-Tunica Vaginalis-Hydrocele aspiration

$16.25

$19.80

Z709

Scrotum-Incision-Abscess or haematocele-Local anaesthetic

$20.10

$39.60

Z740

Operations of the Breast-Incision-Drainage of intramammary abscess or haematoma-Single or multiloculated-General anaesthetic

$75.00

$133.80

Z768

Scrotum-Incision-Abscess or haematocele-General anaesthetic

$55.15

$99.00

Z785

Rectum-Excision-Polyps or tumours of rectum or sigmoid-Excision and suture-Base over 5 cm

$329.65

$582.95

Z804

Neurology-Lumbar puncture

$67.60

$74.35

Z805

Neurology-Lumbar puncture-With instillation of medication or other therapeutic agent

$75.10

$86.35

Z809

Cranial-Conversion of shunt (e.g. ventriculoperitoneal to ventriculoatrial)-Insertion of CSF reservoir (Ommaya) including burr holes

$370.50

$428.90

Z813

Intracranial Abscess-Burr hole-plus needling of brain for biopsy

$453.60

$560.85

Z820

Intracranial Abscess-Ventriculoscopy-Insertion of intracranial catheter or transducer for purposes of monitoring

$317.85

$367.95

Z823

Neurological Surgical Procedures-Cranial/Peripheral Nerves-Functional stereotaxy-Implantation or revision of stimulation pack or leads (peripheral nerve, brain)

$307.40

$404.30

Z825

Intracranial Abscess-Ventriculoscopy-to include burr hole

$408.95

$731.20

Z943

Programming infusion pump or dorsal column stimulator

$102.00

$142.20

K018

Sexual assault examination-female

$308.70

$319.60

K021

Sexual assault examination-male

$243.50

$252.10

K061

Taking of blood samples in a hospital setting at the request of a police officer

$30.00

$31.05

K050

Health Status Report and Activities of Daily Living Index (amalgamated form)

$100.00

$103.55

K051

Health Status Report (completed separately)

$80.00

$82.85

K052

Activities of Daily Living Index (completed separately)

$20.00

$20.70

K057

Medical Form Part A for Medical Review process

$35.00

$36.25

K058

Medical Form Part B including both Health Status Report and Activities of Daily Living Index for Medical Review process

$125.00

$129.40

K059

Health Status Report of Part B (completed separately) for Medical Review process

$100.00

$103.55

K060

Activities of Daily Living Index of Part B (completed separately) for Medical Review process

$25.00

$25.90

K054

Mandatory Special Necessities Benefit Request Form

$25.00

$25.90

K055

Application for Special Diet Allowance

$20.00

$20.70

K056

Application for Pregnancy/Breast-feeding Nutritional Allowance

$20.00

$20.70

K053

A Limitation to Participation Form

$15.00

$15.55

K065

Periodic Oculo-Visual Assessment-ODSP

$48.90

$50.65

K066

Periodic Oculo-Visual Assessment-OW

$48.90

$50.65

G153

Cortical evoked audiometry, technical component

$9.75

$10.10

G154

Cortical evoked audiometry, professional component

$40.30

$41.70

00

GP Group 1: Capitated harmonized models

2.4629%

00

GP Group 2: Comprehensive Care models with CCM fee

6.7646%

00

GP Group 3: FFS and Other

8.9897%

01

Anaesthesiology

0.4542%

02

Dermatology

1.8232%

03

General Surgery

2.4806%

04

Neurosurgery

2.8042%

05

Community Medicine

3.5446%

06

Orthopaedic Surgery

2.2551%

07

Geriatrics

5.3367%

08

Plastic Surgery

3.1374%

09

Cardiac Surgery

1.6189%

13

Internal and Occupational Medicine

3.8628%

15

Endocrinology

2.8045%

16

Nephrology

1.4123%

17

Vascular Surgery

1.2025%

18

Neurology

4.5901%

19

Psychiatry

7.5602%

20

Obstetrics & Gynaecology

4.7519%

22

Genetics

3.6546%

23

Ophthalmology

0.0000%