Obstetrics & gynaecology MSP billing codes


Referred Cases

Code Description Amount
04005 EMERGENCY VISIT-OBSTETRICS & GYNECOLOGY $126.16
04007 VISIT, OFFICE, OB&G $47.76
04008 VISIT, HOSPITAL, OB&G $47.76
04009 VISIT, HOME, OB&G $114.98
04010 CONSULTATION, OB&G $139.36
04012 CONSULTATION, LIMITED, 0B&G $76.52
04070 TELEHEALTH CONSULTATION - OBSTETRICS & GYNECOLOGY $139.36
04072 TELEHEALTH REPEAT OR LIMITED CONSULT/OBS & GYN $76.52
04077 TELEHEALTH SUBSEQUENT OFFICE VISIT - OBS & GYN $47.76
04078 TELEHEALTH SUBSEQUENT HOSPITAL VISIT - OBS/GYN $47.76

Obstetrical Procedures

Code Description Amount
04000 COMPLICATED VAGINAL DELIVERY $337.93
04014 MIDCAVITY FORCEPS - DELIVERY $423.08
04017 MIDCAVITY ROTATION - SURGICAL DELIVERY $500.42
04018 BREECH VAGINAL BIRTH $500.42
04022 SPHINCTER REPAIR - EXTERNAL $212.99
04023 CERVICAL /VAGINAL LACERATIONS $212.99
04024 4TH DEGREE LACERATION - REPAIR $254.97
04025 C-SECTION - HIGH RISK $619.15
04026 RETAINED PLACENTA - MANUAL REMOVAL $212.99
04038 REPEAT INTRAPARTUM ASSESS BY CONSULTANT AT REQUEST $220.11
04039 MANAGEMENT OF COMPLICATED LABOUR BY OBSTETRICIAN $660.83
04049 EXTERNAL CEPHALIC VERSION $122.71
04050 CAESAREAN SECTION - ELECTIVE $479.01
04052 CAESAREAN SECTION - EMERGENCY $535.07
04080 INSERTION OF MULTIPLE OSMOTIC DILATORS WITH BLOCK $140.02
04092 MULTIPLE NATURAL BIRTHS - EACH ADDITIONAL CHILD $159.78
04093 CAESAREAN SECTION MULTIPLE BIRTHS, EACH ADDITIONAL $81.37
04106 CAESAREAN HYSTERECTOMY $731.22
04107 SUPERVISION OF LABOUR AND VAGINAL DELIVERY $131.75
04110 THERAPEUTIC ABORTION (VAGINAL) 14 - 18 WEEKS $199.00
04111 THERAPEUTIC ABORTION (VAGINAL) LESS THAN 14 WEEKS $142.99
04114 THERAPEUTIC ABORTION BY D&E, 18 WKS AND OVER $277.41
04116 CURETTAGE FOR POST-PARTUM HAEMORRHAGE (> 20 WEEKS) $175.52
04118 INDUC. OR STIM. OF LABOUR BY OXYTOCIN - 1ST HOUR $41.58
04119 INDUC. OR STIM. OF LABOUR BY OXYTOCIN - SUBS. HRS $28.66
14091 PRENATAL VISIT - SUBSEQUENT EXAMINATION $31.23
14094 POST-NATAL OFFICE VISIT $31.23
14104 DELIVERY AND POST-NATAL CARE (1-14 DAYS IN-HOSP) $577.54
14108 POST-NATAL CARE AFTER ELECTIVE C-SECTION $118.82
14109 DELIVERY - ATTENDANCE - EMERG C/S $481.07
14199 MNGMNT OF PRLNGD 2ND STG LABOUR - PER 30 MINS $83.89

Abdominal Operations

Code Description Amount
04003 OOPHORECTOMY/SALPINGECTOMY $355.36
04201 OVARIAN CYSTECTOMY $443.48
04203 MYOMECTOMY $443.48
04204 HYSTEROTOMY - ABDOMINAL WITH/WITHOUT STERILIZATION $355.36
04206 SUSPENSION OF UTERUS $237.92
04208 ECTOPIC PREGNANCY $442.01
04216 NEURECTOMY PRESACRAL $414.12
04217 HEMORRHAGE - POST OP (INTRA-ABDOMINAL MANAGEMENT) $355.36
04228 HYSTERECTOMY - TOTAL $649.00
04229 REMOVAL OF COMPLICATED PELVIC DISEASE $649.00
04230 STERILIZATION - ABDOMINAL-OPEN $296.61
04605 VAULT PROLAPSE $649.00

Abdominal Operations For Cancer

Code Description Amount
04011 CA OVARY/ FALLOPIAN TUBES $883.90
04029 OMENTECTOMY/REMOVAL OF SOFT-TISSUE MASS $355.36
04212 PELVIC LYMPHADENECTOMY $590.25
04218 HYSTERECTOMY - RADICAL $971.99
04219 PARA-AORTIC LYMPHADENECTOMY $590.25
04220 PARA-AORTIC LYMPHADENECTOMY - PARTIAL $261.41
04628 REMOVAL OF EXTRAPELVIC SOFT TISSUE MASS > 10 CM $472.80

Hysteroscopy Surgical

Code Description Amount
04221 HYSTEROSCOPIC DIV OF INTRAUTERINE ADHESIONS-SIMPLE $195.09
04222 HYSTEROSCOPIC DIV OF INTRAUTERINE ADHESIONS-COMP $325.47
04223 RESECTION OF MYOMA $450.88
04224 ENDOMETRIAL ABLATION $450.88
04225 HYSTEROSCOPIC DIVISION OF UTERINE SEPTUM $325.47
04226 HYSTEROSCOPIC TUBAL OCCLUSION (BILATERAL) $193.46

Laparoscopic Operations

Code Description Amount
04001 LAPAROSCOPY $208.57
04034 SALPINGOLYSIS VIA LAPAROSCOPY - UNILATERAL $70.56
04035 SALPINGOLYSIS VIA LAPAROSCOPE - BILATERAL $138.09
04036 SALPINGOSTOMY VIA LAPAROSCOPY - UNILATERAL $149.86
04037 SALPINGOSTOMY VIA LAPAROSCOPY - BILATERAL $296.62
04040 CAUTERY OF ENDOMETRIOSIS $61.72
04041 OOPHORECTOMY AND/OR SALPINGECTOMY-UNILATERAL $149.85
04042 OOPHORECTOMY AND/OR SALPINGECTOMY-BILATERAL $296.62
04043 OVARIAN CYSTECTOMY - UNILATERAL $237.95
04044 OVARIAN CYSTECTOMY-BILATERAL $443.50
04045 VENTRAL SUSPENSION OF UTERUS $149.86
04046 PRESACRAL NEURECTOMY $208.58
04047 EXCISION OF EXTENSIVE PERITONEAL ENDOMETRIOSIS $326.01
04048 REMOVAL OF COMPLICATED PELVIC DISEASE-LAPAROSCOPIC $443.49
04660 TUBAL INTERRUPTION (STERILIZATION ) $91.13
04662 LAPAROSCOPY - REMOVAL OF FOREIGN BODY $91.13
04664 ECTOPIC PREGNANCY - REMOVAL VIA SCOPE. $339.31

Micro Surgical Operations

Code Description Amount
04602 SALPINGOLYSIS - UNILATERAL/BILATERAL $443.48
04616 MICRO SALPINGOSTOMY -UNILATERAL $610.83
04617 MICRO SALPINGOSTOMY - BILATERAL $793.18
04626 TUBO-CORNUAL ANASTOMOSIS - UNILATERAL (MICRO) $883.88
04627 TUBO-CORNUAL ANASTOMOSIS - BILATERAL (MICRO) $1,148.13

Operations On The Vulva

Code Description Amount
04032 BIOPSY - VULVA (GREATER THAN OR EQUAL TO 2CM) $91.13
04300 HYMEN INCISION $44.17
04301 BARTHOLINS CYST/ABSCESS MARSUPIALIZATION $120.51
04303 HYDROCELE CANAL OF NUCK EXCISION $179.19
04304 URETHRAL CARUNCLE - CAUTERY OR EXCISION IN HOSP $61.73
04305 VENEREAL WARTS, CAUTERY OR EXCISION $38.24
04306 VENEREAL WARTS UNDER G.A., HOSPITAL $120.51
04307 VULVECTOMY - SIMPLE $384.74
04309 LABIUM VARICOCELE $132.21
04311 VULVAR ATRESIA OR ENLARGEMENT OF VAGINAL INTROITUS $132.21
04312 LABIA MINORA RESECTION $120.51
04316 VULVOVAGINOPLASTY $237.91
04317 BIOPSY - VULVA - < 2 CM $19.04
04318 VULVECTOMY - RADICAL $838.98
04320 LYMPHADENECTOMY - INGUINAL/FEMORAL - UNILATERAL $367.82
04322 LYMPHADENECTOMY - INGUINAL/FEMORAL - BILATERAL $610.98

Operations On The Vagina

Code Description Amount
04033 VAGINECTOMY-PARTIAL $355.36
04202 VAGINAL HYSTERECTOMY $649.00
04232 OOPHORECTOMY/OVARIAN CYSTECTOMY - VAG - UNILATERAL $88.37
04233 OOPHORECTOMY/OVARIAN CYSTECTOMY - VAG - BILATERAL $173.74
04401 FISTULA RECTO-VAGINAL REPAIR $531.54
04402 ABSCESS PELVIC COLPOTOMY DRAINAGE $149.87
04404 CYST VAGINAL INCLUSION $38.24
04405 CYST VAGINAL OTHER THAN INCLUSION $155.73
04406 SEPTUM VAGINAL REMOVAL $120.51
04408 VAULT PROLAPSE (VAGINAL APPROACH) $531.54
04410 POST-OP HAEMORRHAGE, VAGINAL MANAGEMENT W/ GA $155.73
04411 VAGINECTOMY - TOTAL $531.54

Plastic Operations For Genital Prolapse

Code Description Amount
04227 CYSTOCOELE/URETHROCOELE REPAIR $375.15
04421 RECTOCELE REPAIR $375.15
04422 ENTEROCELE REPAIR $457.14
04424 COMPLETE REPAIR OF PROLAPSE $585.16
04427 LEFORTS OPERATION $327.36
04429 PERINEAL LACERATION REPAIR OF OLD 3RD DEGREE $390.63
04432 REPEAT VAGINAL PLASTIC PROCEDURE - EXTRA $131.93

Vaginal Operations On The Cervix And Uterus

Code Description Amount
00770 PELVIC EXAMINATION UNDER ANESTHESIA $122.12
04500 CERVIX DILATION AND CURETTAGE $120.51
04502 CERVIX, REPAIR OF $120.51
04503 CRYOSURGERY - CERVIX $73.52
04508 BIOPSY CERVIX, UNDER G.A. $67.64
04509 POLYPECTOMY - CERVICAL $19.05
04510 BIOPSY CERVIX WITH D&C $120.51
04512 MYOMECTOMY VAGINAL $149.86
04515 CERVICAL LIGATURE, REMOVAL OF UNDER ANAESTHETIC $61.73
04516 CERVICAL INCOMPETENCE - EMERGENCY REPAIR $296.62
04517 CERVICAL INCOMPETENCE - ELECTIVE REPAIR $237.91
04530 CAUTERIZATION CERVIX, G.A. $61.73
04536 CONE BIOPSY CERVIX (INCLUDES D&C) $261.40
04545 ARTIFICIAL INSEMINATION - OPERATION ONLY $32.40
04551 CERVICAL STUMP REMOVAL $261.40
14540 INSERTION INTRAUTERINE CONTRACEPTIVE DEVICE $42.62

Laser Vaporization

Code Description Amount
04620 CERVICAL NEOPLASIA $153.53
04621 VAGINAL NEOPLASIA WITH OR WITHOUT G.A. $153.53
04622 VULVAR CONDYLOMATA $153.53
04623 EXTENSIVE VULVAR AND/OR VAGINAL CONDYL. UNDER G.A. $228.78
04624 VULVAR INTRAEPITHELIAL LESION DIFFUSE W/ PERIANAL $379.25
04625 VULVAR INTRAEPITHELIAL LESION/DIFFUSE MULTIFOCAL $304.04

Surgical Assistance

Code Description Amount
00195 SURGICAL ASSIST-LESS THAN $317.00 INCLUSIVE $133.22
00196 SURGICAL ASSIST $317.01 TO 529.00 INCLUSIVE $187.83
00197 SURGICAL ASSISTANCE - OPERATIONS OVER $529.00 $256.18
00198 SURGICAL ASSIST TIME AFTER 3 HRS - PER 15 MINS $28.31
70019 CERTIFIED SURGICAL ASSIST $254.72
70020 CERTIFIED SURGICAL ASSIST - TIME FROM 1-3 HOURS $31.99

Laboratory Procedures

Code Description Amount
04699 FERN TEST $9.42
15000 HAEMOGLOBIN -OTHER METHODS (IN PHYSICIANS OFFICE) $1.61
15120 PREGNANCY TEST, IMMUNOLOGIC, URINE $11.50
15136 FUNGUS, DIRECT EXAMINATION, KOH PREPARATION $8.33
15137 HAEMOGLOBIN - CYANMETHAEMOGLOBIN $3.10
15139 SPERM, SEMINAL EXAMINATION FOR PRESENCE OR ABSENCE $14.67
15141 TRICHOMONAS AND / OR CANDIDA, DIRECT EXAMINATION $5.58
15142 URINALYSIS-COMPLETE DIAGNOSTIC, SEMI-QUANT & MICRO $5.55

Diagnostic Ultrasound

Code Description Amount
04680 GUIDED AMNIOCENTESIS $130.27
08651 OBS. - B-SCAN - 14 WKS. OR MORE FOR SINGLES $108.39
08652 B SCAN I.U.D. LOCALIZATION $54.46
08653 PELVIC B SCAN - NON-OBSTETRICAL $108.39
08655 OBS. B-SCAN - LESS THAN 14 WKS. $81.32
08657 CHORIONIC VILLUS SAMPLING FOR ULTRASONIC GUIDANCE $108.98
86051 OBS B SCAN (14 WKS GESTATION OR OVER)- ADD FETUSES $80.66

Other

Code Description Amount
04531 CAUTERIZATION OF CERVIX TO INCLUDE D&C IF DONE $120.51
04533 CAUTERIZATION CERVIX, ELECTRIC, IN OFFICE $38.24
04701 REPEAT URINARY INCONTINENCE PROCEDURE $417.12
04702 TRANSECTION OR REMOVAL OF SUBURETHRAL MESH SLING $417.12
04703 AUGMENTED ANTERIOR COMPARTMENT VAGINAL PROLAPSE $415.99
04704 AUGMENTED POSTERIOR COMPARTMENT VAGINAL PROLAPSE $415.99
04705 REMOVAL OF TRANS-VAGINAL PLACED SYNTHETIC MESH $499.19
04706 VAGINAL VAULT SUSPENSION-APICAL SUPPORT PROCEDURE $405.64
04707 LAPAROSCOPIC SACROCOLPOPEXY $782.93
04708 PROLONGED LAPAROSCOPIC SURGERY, PER 15 MIN (EXTRA) $71.72
04709 HYSTERECTOMY-LAPAROSCOPIC TOTAL/SUPRACERV&/OR LAVH $868.53
04710 GYNECOLOGICAL CERTIFIED SURGICAL ASSIST-UP TO 1 HR $257.92
04711 GYNECOLOGICAL CERTIFIED SURG ASSIST,TIME 1-3 HOURS $26.92
04712 GYNECOLOGICAL SURGICAL ASSISTANT(CERT/SECOND) >3HR $28.15
04713 LAPAROSCOPIC HYSTERECTOMY SECOND SURGICAL ASSISTNT $246.10
04714 PROLONGED SURGERY-OPEN PROCEDURE, PER 15 MIN(EXTRA $71.72
04715 OBSTETRICAL SURCHARGE TRERAPEUTIC ABORTION >18 WKS $81.97
04716 OBSTETRICAL SURCHARGE THERAPEUTIC ABORTION,14-18WK $61.48
04717 PRENATAL OFFICE VISIT -COMPLEX OBSTETRICAL PATIENT $46.89
04718 CARE OF COMPLEX ANTEPARTUM PATIENT PRIOR TO TRNSFR $280.53
04719 GYNECOLOGY SURGICAL SURCHARGE PATIENT 75YR + OLDER $64.05