Obstetrics & gynaecology MSP billing codes


Referred Cases

Code Description Amount
04005 EMERGENCY VISIT-OBSTETRICS & GYNECOLOGY $125.05
04007 VISIT, OFFICE, OB&G $46.59
04008 VISIT, HOSPITAL, OB&G $25.51
04009 VISIT, HOME, OB&G $105.85
04010 CONSULTATION, OB&G $137.07
04012 CONSULTATION, LIMITED, 0B&G $75.62
04070 TELEHEALTH CONSULTATION - OBSTETRICS & GYNECOLOGY $137.07
04072 TELEHEALTH REPEAT OR LIMITED CONSULT/OBS & GYN $69.64
04077 TELEHEALTH SUBSEQUENT OFFICE VISIT - OBS & GYN $46.59
04078 TELEHEALTH SUBSEQUENT HOSPITAL VISIT - OBS/GYN $25.51

Obstetrical Procedures

Code Description Amount
04000 COMPLICATED VAGINAL DELIVERY $312.15
04014 MIDCAVITY FORCEPS - DELIVERY $390.94
04017 MIDCAVITY ROTATION - SURGICAL DELIVERY $462.49
04018 BREECH VAGINAL BIRTH $462.49
04022 SPHINCTER REPAIR - EXTERNAL $196.54
04023 CERVICAL /VAGINAL LACERATIONS $196.54
04024 4TH DEGREE LACERATION - REPAIR $235.39
04025 C-SECTION - HIGH RISK $572.36
04026 RETAINED PLACENTA - MANUAL REMOVAL $196.54
04038 REPEAT INTRAPARTUM ASSESS BY CONSULTANT AT REQUEST $203.13
04039 MANAGEMENT OF COMPLICATED LABOUR BY OBSTETRICIAN $610.93
04049 EXTERNAL CEPHALIC VERSION $113.00
04050 CAESAREAN SECTION - ELECTIVE $442.69
04052 CAESAREAN SECTION - EMERGENCY $494.56
04080 INSERTION OF MULTIPLE OSMOTIC DILATORS WITH BLOCK $129.02
04092 MULTIPLE NATURAL BIRTHS - EACH ADDITIONAL CHILD $147.31
04093 CAESAREAN SECTION MULTIPLE BIRTHS, EACH ADDITIONAL $74.75
04106 CAESAREAN HYSTERECTOMY $676.05
04107 SUPERVISION OF LABOUR AND VAGINAL DELIVERY $121.37
04110 THERAPEUTIC ABORTION (VAGINAL) 14 - 18 WEEKS $183.59
04111 THERAPEUTIC ABORTION (VAGINAL) LESS THAN 14 WEEKS $131.77
04114 THERAPEUTIC ABORTION BY D&E, 18 WKS AND OVER $256.15
04116 CURETTAGE FOR POST-PARTUM HAEMORRHAGE (> 20 WEEKS) $161.87
04118 INDUC. OR STIM. OF LABOUR BY OXYTOCIN - 1ST HOUR $37.94
04119 INDUC. OR STIM. OF LABOUR BY OXYTOCIN - SUBS. HRS $27.96
14091 PRENATAL VISIT - SUBSEQUENT EXAMINATION $30.46
14094 POST-NATAL OFFICE VISIT $30.46
14104 DELIVERY AND POST-NATAL CARE (1-14 DAYS IN-HOSP) $563.02
14108 POST-NATAL CARE AFTER ELECTIVE C-SECTION $115.83
14109 DELIVERY - ATTENDANCE - EMERG C/S $468.97
14199 MNGMNT OF PRLNGD 2ND STG LABOUR - PER 30 MINS $82.27

Abdominal Operations

Code Description Amount
04003 OOPHORECTOMY/SALPINGECTOMY $320.99
04201 OVARIAN CYSTECTOMY $400.72
04203 MYOMECTOMY $400.72
04204 HYSTEROTOMY - ABDOMINAL WITH/WITHOUT STERILIZATION $320.99
04206 SUSPENSION OF UTERUS $214.73
04208 ECTOPIC PREGNANCY $399.39
04216 NEURECTOMY PRESACRAL $374.15
04217 HEMORRHAGE - POST OP (INTRA-ABDOMINAL MANAGEMENT) $320.99
04228 HYSTERECTOMY - TOTAL $586.67
04229 REMOVAL OF COMPLICATED PELVIC DISEASE $586.67
04230 STERILIZATION - ABDOMINAL-OPEN $267.84
04605 VAULT PROLAPSE $528.90

Abdominal Operations For Cancer

Code Description Amount
04011 CA OVARY/ FALLOPIAN TUBES $799.20
04029 OMENTECTOMY/REMOVAL OF SOFT-TISSUE MASS $320.99
04212 PELVIC LYMPHADENECTOMY $533.51
04218 HYSTERECTOMY - RADICAL $878.90
04219 PARA-AORTIC LYMPHADENECTOMY $533.51
04220 PARA-AORTIC LYMPHADENECTOMY - PARTIAL $235.99
04628 REMOVAL OF EXTRAPELVIC SOFT TISSUE MASS > 10 CM $427.25

Hysteroscopy Surgical

Code Description Amount
04221 HYSTEROSCOPIC DIV OF INTRAUTERINE ADHESIONS-SIMPLE $175.99
04222 HYSTEROSCOPIC DIV OF INTRAUTERINE ADHESIONS-COMP $293.95
04223 RESECTION OF MYOMA $407.42
04224 ENDOMETRIAL ABLATION $407.42
04225 HYSTEROSCOPIC DIVISION OF UTERINE SEPTUM $293.95
04226 HYSTEROSCOPIC TUBAL OCCLUSION (BILATERAL) $174.51

Laparoscopic Operations

Code Description Amount
04001 LAPAROSCOPY $188.18
04034 SALPINGOLYSIS VIA LAPAROSCOPY - UNILATERAL $63.31
04035 SALPINGOLYSIS VIA LAPAROSCOPE - BILATERAL $124.41
04036 SALPINGOSTOMY VIA LAPAROSCOPY - UNILATERAL $135.07
04037 SALPINGOSTOMY VIA LAPAROSCOPY - BILATERAL $267.85
04040 CAUTERY OF ENDOMETRIOSIS $55.32
04041 OOPHORECTOMY AND/OR SALPINGECTOMY-UNILATERAL $135.06
04042 OOPHORECTOMY AND/OR SALPINGECTOMY-BILATERAL $267.85
04043 OVARIAN CYSTECTOMY - UNILATERAL $214.76
04044 OVARIAN CYSTECTOMY-BILATERAL $400.74
04045 VENTRAL SUSPENSION OF UTERUS $135.07
04046 PRESACRAL NEURECTOMY $188.19
04047 EXCISION OF EXTENSIVE PERITONEAL ENDOMETRIOSIS $294.44
04048 REMOVAL OF COMPLICATED PELVIC DISEASE-LAPAROSCOPIC $400.73
04660 TUBAL INTERRUPTION (STERILIZATION ) $81.93
04662 LAPAROSCOPY - REMOVAL OF FOREIGN BODY $81.93
04664 ECTOPIC PREGNANCY - REMOVAL VIA SCOPE. $306.47

Micro Surgical Operations

Code Description Amount
04602 SALPINGOLYSIS - UNILATERAL/BILATERAL $400.72
04616 MICRO SALPINGOSTOMY -UNILATERAL $552.14
04617 MICRO SALPINGOSTOMY - BILATERAL $717.11
04626 TUBO-CORNUAL ANASTOMOSIS - UNILATERAL (MICRO) $799.19
04627 TUBO-CORNUAL ANASTOMOSIS - BILATERAL (MICRO) $1,038.27

Operations On The Vulva

Code Description Amount
04032 BIOPSY - VULVA (GREATER THAN OR EQUAL TO 2CM) $81.93
04300 HYMEN INCISION $39.44
04301 BARTHOLINS CYST/ABSCESS MARSUPIALIZATION $108.50
04303 HYDROCELE CANAL OF NUCK EXCISION $161.60
04304 URETHRAL CARUNCLE - CAUTERY OR EXCISION IN HOSP $55.33
04305 VENEREAL WARTS, CAUTERY OR EXCISION $34.07
04306 VENEREAL WARTS UNDER G.A., HOSPITAL $108.50
04307 VULVECTOMY - SIMPLE $347.58
04309 LABIUM VARICOCELE $119.10
04311 VULVAR ATRESIA OR ENLARGEMENT OF VAGINAL INTROITUS $119.10
04312 LABIA MINORA RESECTION $108.50
04316 VULVOVAGINOPLASTY $214.72
04317 BIOPSY - VULVA - < 2 CM $16.71
04318 VULVECTOMY - RADICAL $758.56
04320 LYMPHADENECTOMY - INGUINAL/FEMORAL - UNILATERAL $332.27
04322 LYMPHADENECTOMY - INGUINAL/FEMORAL - BILATERAL $552.27

Operations On The Vagina

Code Description Amount
04033 VAGINECTOMY-PARTIAL $320.99
04202 VAGINAL HYSTERECTOMY $586.67
04232 OOPHORECTOMY/OVARIAN CYSTECTOMY - VAG - UNILATERAL $79.44
04233 OOPHORECTOMY/OVARIAN CYSTECTOMY - VAG - BILATERAL $156.66
04401 FISTULA RECTO-VAGINAL REPAIR $480.40
04402 ABSCESS PELVIC COLPOTOMY DRAINAGE $135.08
04404 CYST VAGINAL INCLUSION $34.07
04405 CYST VAGINAL OTHER THAN INCLUSION $140.37
04406 SEPTUM VAGINAL REMOVAL $108.50
04408 VAULT PROLAPSE (VAGINAL APPROACH) $480.40
04410 POST-OP HAEMORRHAGE, VAGINAL MANAGEMENT W/ GA $140.37
04411 VAGINECTOMY - TOTAL $480.40

Plastic Operations For Genital Prolapse

Code Description Amount
04227 CYSTOCOELE/URETHROCOELE REPAIR $338.91
04421 RECTOCELE REPAIR $338.91
04422 ENTEROCELE REPAIR $413.08
04424 COMPLETE REPAIR OF PROLAPSE $528.91
04427 LEFORTS OPERATION $295.66
04429 PERINEAL LACERATION REPAIR OF OLD 3RD DEGREE $352.91
04432 REPEAT VAGINAL PLASTIC PROCEDURE - EXTRA $118.84

Vaginal Operations On The Cervix And Uterus

Code Description Amount
00770 PELVIC EXAMINATION UNDER ANESTHESIA $109.97
04500 CERVIX DILATION AND CURETTAGE $108.50
04502 CERVIX, REPAIR OF $108.50
04503 CRYOSURGERY - CERVIX $65.99
04508 BIOPSY CERVIX, UNDER G.A. $60.67
04509 POLYPECTOMY - CERVICAL $16.72
04510 BIOPSY CERVIX WITH D&C $108.50
04512 MYOMECTOMY VAGINAL $135.07
04515 CERVICAL LIGATURE, REMOVAL OF UNDER ANAESTHETIC $55.33
04516 CERVICAL INCOMPETENCE - EMERGENCY REPAIR $267.85
04517 CERVICAL INCOMPETENCE - ELECTIVE REPAIR $214.72
04530 CAUTERIZATION CERVIX, G.A. $55.33
04536 CONE BIOPSY CERVIX (INCLUDES D&C) $235.98
04545 ARTIFICIAL INSEMINATION - OPERATION ONLY $28.78
04551 CERVICAL STUMP REMOVAL $235.98
14540 INSERTION INTRAUTERINE CONTRACEPTIVE DEVICE $41.54

Laser Vaporization

Code Description Amount
04620 CERVICAL NEOPLASIA $138.39
04621 VAGINAL NEOPLASIA WITH OR WITHOUT G.A. $138.39
04622 VULVAR CONDYLOMATA $138.39
04623 EXTENSIVE VULVAR AND/OR VAGINAL CONDYL. UNDER G.A. $206.46
04624 VULVAR INTRAEPITHELIAL LESION DIFFUSE W/ PERIANAL $342.62
04625 VULVAR INTRAEPITHELIAL LESION/DIFFUSE MULTIFOCAL $274.55

Surgical Assistance

Code Description Amount
00195 SURGICAL ASSIST-LESS THAN $317.00 INCLUSIVE $132.23
00196 SURGICAL ASSIST $317.01 TO 529.00 INCLUSIVE $186.43
00197 SURGICAL ASSISTANCE - OPERATIONS OVER $529.00 $246.57
00198 SURGICAL ASSIST TIME AFTER 3 HRS - PER 15 MINS $27.93
70019 CERTIFIED SURGICAL ASSIST $252.83
70020 CERTIFIED SURGICAL ASSIST - TIME FROM 1-3 HOURS $26.40

Laboratory Procedures

Code Description Amount
04699 FERN TEST $8.18
15000 HAEMOGLOBIN -OTHER METHODS (IN PHYSICIANS OFFICE) $1.58
15120 PREGNANCY TEST, IMMUNOLOGIC, URINE $11.19
15136 FUNGUS, DIRECT EXAMINATION, KOH PREPARATION $8.27
15137 HAEMOGLOBIN - CYANMETHAEMOGLOBIN $3.08
15139 SPERM, SEMINAL EXAMINATION FOR PRESENCE OR ABSENCE $14.56
15141 TRICHOMONAS AND / OR CANDIDA, DIRECT EXAMINATION $5.54
15142 URINALYSIS-COMPLETE DIAGNOSTIC, SEMI-QUANT & MICRO $5.42

Diagnostic Ultrasound

Code Description Amount
04680 GUIDED AMNIOCENTESIS $120.00
08651 OBS. - B-SCAN - 14 WKS. OR MORE FOR SINGLES $106.65
08652 B SCAN I.U.D. LOCALIZATION $53.58
08653 PELVIC B SCAN - NON-OBSTETRICAL $106.65
08655 OBS. B-SCAN - LESS THAN 14 WKS. $80.03
08657 CHORIONIC VILLUS SAMPLING FOR ULTRASONIC GUIDANCE $107.22
86051 OBS B SCAN (14 WKS GESTATION OR OVER)- ADD FETUSES $79.37

Other

Code Description Amount
04531 CAUTERIZATION OF CERVIX TO INCLUDE D&C IF DONE $108.50
04533 CAUTERIZATION CERVIX, ELECTRIC, IN OFFICE $34.07
04701 REPEAT URINARY INCONTINENCE PROCEDURE $413.19
04702 TRANSECTION OR REMOVAL OF SUBURETHRAL MESH SLING $413.19
04703 AUGMENTED ANTERIOR COMPARTMENT VAGINAL PROLAPSE $412.08
04704 AUGMENTED POSTERIOR COMPARTMENT VAGINAL PROLAPSE $412.08
04705 REMOVAL OF TRANS-VAGINAL PLACED SYNTHETIC MESH $494.49
04706 VAGINAL VAULT SUSPENSION-APICAL SUPPORT PROCEDURE $401.82
04707 LAPAROSCOPIC SACROCOLPOPEXY $775.56
04708 PROLONGED LAPAROSCOPIC SURGERY, PER 15 MIN (EXTRA) $71.05
04709 HYSTERECTOMY-LAPAROSCOPIC TOTAL/SUPRACERV&/OR LAVH $860.36
04710 GYNECOLOGICAL CERTIFIED SURGICAL ASSIST-UP TO 1 HR $255.49
04711 GYNECOLOGICAL CERTIFIED SURG ASSIST,TIME 1-3 HOURS $26.67
04712 GYNECOLOGICAL SURGICAL ASSISTANT(CERT/SECOND) >3HR $28.15
04713 LAPAROSCOPIC HYSTERECTOMY SECOND SURGICAL ASSISTNT $243.78
04714 PROLONGED SURGERY-OPEN PROCEDURE, PER 15 MIN(EXTRA $71.05
04715 OBSTETRICAL SURCHARGE TRERAPEUTIC ABORTION >18 WKS $81.20
04716 OBSTETRICAL SURCHARGE THERAPEUTIC ABORTION,14-18WK $60.90
04717 PRENATAL OFFICE VISIT -COMPLEX OBSTETRICAL PATIENT $46.45
04718 CARE OF COMPLEX ANTEPARTUM PATIENT PRIOR TO TRNSFR $277.89
04719 GYNECOLOGY SURGICAL SURCHARGE PATIENT 75YR + OLDER $63.45