Obstetrics & gynaecology MSP billing codes


Referred Cases

Code Description Amount
04005 EMERGENCY VISIT-OBSTETRICS & GYNECOLOGY $115.68
04007 VISIT, OFFICE, OB&G $46.38
04008 VISIT, HOSPITAL, OB&G $25.40
04009 VISIT, HOME, OB&G $105.38
04010 CONSULTATION, OB&G $136.46
04012 CONSULTATION, LIMITED, 0B&G $69.33
04070 TELEHEALTH CONSULTATION - OBSTETRICS & GYNECOLOGY $136.46
04072 TELEHEALTH REPEAT OR LIMITED CONSULT/OBS & GYN $69.33
04077 TELEHEALTH SUBSEQUENT OFFICE VISIT - OBS & GYN $46.38
04078 TELEHEALTH SUBSEQUENT HOSPITAL VISIT - OBS/GYN $25.40

Obstetrical Procedures

Code Description Amount
04000 COMPLICATED VAGINAL DELIVERY $310.75
04014 MIDCAVITY FORCEPS - DELIVERY $389.19
04017 MIDCAVITY ROTATION - SURGICAL DELIVERY $460.42
04018 BREECH VAGINAL BIRTH $460.42
04022 SPHINCTER REPAIR - EXTERNAL $195.66
04023 CERVICAL /VAGINAL LACERATIONS $195.66
04024 4TH DEGREE LACERATION - REPAIR $234.34
04025 C-SECTION - HIGH RISK $569.80
04026 RETAINED PLACENTA - MANUAL REMOVAL $195.66
04038 REPEAT INTRAPARTUM ASSESS BY CONSULTANT AT REQUEST $202.22
04039 MANAGEMENT OF COMPLICATED LABOUR BY OBSTETRICIAN $608.19
04049 EXTERNAL CEPHALIC VERSION $112.49
04050 CAESAREAN SECTION - ELECTIVE $440.71
04052 CAESAREAN SECTION - EMERGENCY $492.34
04080 INSERTION OF MULTIPLE OSMOTIC DILATORS WITH BLOCK $128.44
04092 MULTIPLE NATURAL BIRTHS - EACH ADDITIONAL CHILD $146.65
04093 CAESAREAN SECTION MULTIPLE BIRTHS, EACH ADDITIONAL $74.42
04106 CAESAREAN HYSTERECTOMY $673.02
04107 SUPERVISION OF LABOUR AND VAGINAL DELIVERY $120.83
04110 THERAPEUTIC ABORTION (VAGINAL) 14 - 18 WEEKS $182.77
04111 THERAPEUTIC ABORTION (VAGINAL) LESS THAN 14 WEEKS $131.18
04114 THERAPEUTIC ABORTION BY D&E, 18 WKS AND OVER $255.00
04116 CURETTAGE FOR POST-PARTUM HAEMORRHAGE (> 20 WEEKS) $161.14
04118 INDUC. OR STIM. OF LABOUR BY OXYTOCIN - 1ST HOUR $37.77
04119 INDUC. OR STIM. OF LABOUR BY OXYTOCIN - SUBS. HRS $25.87
14091 PRENATAL VISIT - SUBSEQUENT EXAMINATION $30.32
14094 POST-NATAL OFFICE VISIT $30.32
14104 DELIVERY AND POST-NATAL CARE (1-14 DAYS IN-HOSP) $560.50
14108 POST-NATAL CARE AFTER ELECTIVE C-SECTION $115.31
14109 DELIVERY - ATTENDANCE - EMERG C/S $466.87
14199 MNGMNT OF PRLNGD 2ND STG LABOUR - PER 30 MINS $81.41

Abdominal Operations

Code Description Amount
04003 OOPHORECTOMY/SALPINGECTOMY $319.55
04201 OVARIAN CYSTECTOMY $398.92
04203 MYOMECTOMY $398.92
04204 HYSTEROTOMY - ABDOMINAL WITH/WITHOUT STERILIZATION $319.55
04206 SUSPENSION OF UTERUS $213.77
04208 ECTOPIC PREGNANCY $397.60
04216 NEURECTOMY PRESACRAL $372.47
04217 HEMORRHAGE - POST OP (INTRA-ABDOMINAL MANAGEMENT) $319.55
04228 HYSTERECTOMY - TOTAL $584.04
04229 REMOVAL OF COMPLICATED PELVIC DISEASE $600.87
04230 STERILIZATION - ABDOMINAL-OPEN $266.64
04605 VAULT PROLAPSE $526.53

Abdominal Operations For Cancer

Code Description Amount
04011 CA OVARY/ FALLOPIAN TUBES $795.62
04029 OMENTECTOMY/REMOVAL OF SOFT-TISSUE MASS $319.55
04212 PELVIC LYMPHADENECTOMY $531.12
04218 HYSTERECTOMY - RADICAL $874.96
04219 PARA-AORTIC LYMPHADENECTOMY $531.12
04220 PARA-AORTIC LYMPHADENECTOMY - PARTIAL $234.93
04628 REMOVAL OF EXTRAPELVIC SOFT TISSUE MASS > 10 CM $425.34

Hysteroscopy Surgical

Code Description Amount
04221 HYSTEROSCOPIC DIV OF INTRAUTERINE ADHESIONS-SIMPLE $175.20
04222 HYSTEROSCOPIC DIV OF INTRAUTERINE ADHESIONS-COMP $292.63
04223 RESECTION OF MYOMA $405.59
04224 ENDOMETRIAL ABLATION $405.59
04225 HYSTEROSCOPIC DIVISION OF UTERINE SEPTUM $292.63
04226 HYSTEROSCOPIC TUBAL OCCLUSION (BILATERAL) $173.73

Laparoscopic Operations

Code Description Amount
04001 LAPAROSCOPY $187.34
04034 SALPINGOLYSIS VIA LAPAROSCOPY - UNILATERAL $63.03
04035 SALPINGOLYSIS VIA LAPAROSCOPE - BILATERAL $123.85
04036 SALPINGOSTOMY VIA LAPAROSCOPY - UNILATERAL $134.46
04037 SALPINGOSTOMY VIA LAPAROSCOPY - BILATERAL $266.65
04040 CAUTERY OF ENDOMETRIOSIS $55.07
04041 OOPHORECTOMY AND/OR SALPINGECTOMY-UNILATERAL $134.45
04042 OOPHORECTOMY AND/OR SALPINGECTOMY-BILATERAL $266.65
04043 OVARIAN CYSTECTOMY - UNILATERAL $213.80
04044 OVARIAN CYSTECTOMY-BILATERAL $398.94
04045 VENTRAL SUSPENSION OF UTERUS $134.46
04046 PRESACRAL NEURECTOMY $187.35
04047 EXCISION OF EXTENSIVE PERITONEAL ENDOMETRIOSIS $293.12
04048 REMOVAL OF COMPLICATED PELVIC DISEASE-LAPAROSCOPIC $398.93
04660 TUBAL INTERRUPTION (STERILIZATION ) $81.56
04662 LAPAROSCOPY - REMOVAL OF FOREIGN BODY $81.56
04664 ECTOPIC PREGNANCY - REMOVAL VIA SCOPE. $305.10

Micro Surgical Operations

Code Description Amount
04602 SALPINGOLYSIS - UNILATERAL/BILATERAL $398.92
04616 MICRO SALPINGOSTOMY -UNILATERAL $549.67
04617 MICRO SALPINGOSTOMY - BILATERAL $713.90
04626 TUBO-CORNUAL ANASTOMOSIS - UNILATERAL (MICRO) $795.61
04627 TUBO-CORNUAL ANASTOMOSIS - BILATERAL (MICRO) $1,033.62

Operations On The Vulva

Code Description Amount
04032 BIOPSY - VULVA (GREATER THAN OR EQUAL TO 2CM) $81.56
04300 HYMEN INCISION $39.26
04301 BARTHOLINS CYST/ABSCESS MARSUPIALIZATION $108.01
04303 HYDROCELE CANAL OF NUCK EXCISION $160.88
04304 URETHRAL CARUNCLE - CAUTERY OR EXCISION IN HOSP $55.08
04305 VENEREAL WARTS, CAUTERY OR EXCISION $33.92
04306 VENEREAL WARTS UNDER G.A., HOSPITAL $108.01
04307 VULVECTOMY - SIMPLE $346.02
04309 LABIUM VARICOCELE $118.57
04311 VULVAR ATRESIA OR ENLARGEMENT OF VAGINAL INTROITUS $118.57
04312 LABIA MINORA RESECTION $108.01
04316 VULVOVAGINOPLASTY $213.76
04317 BIOPSY - VULVA - < 2 CM $16.64
04318 VULVECTOMY - RADICAL $755.16
04320 LYMPHADENECTOMY - INGUINAL/FEMORAL - UNILATERAL $330.78
04322 LYMPHADENECTOMY - INGUINAL/FEMORAL - BILATERAL $549.80

Operations On The Vagina

Code Description Amount
04033 VAGINECTOMY-PARTIAL $319.55
04202 VAGINAL HYSTERECTOMY $584.04
04232 OOPHORECTOMY/OVARIAN CYSTECTOMY - VAG - UNILATERAL $79.08
04233 OOPHORECTOMY/OVARIAN CYSTECTOMY - VAG - BILATERAL $155.96
04401 FISTULA RECTO-VAGINAL REPAIR $478.25
04402 ABSCESS PELVIC COLPOTOMY DRAINAGE $134.47
04404 CYST VAGINAL INCLUSION $33.92
04405 CYST VAGINAL OTHER THAN INCLUSION $139.74
04406 SEPTUM VAGINAL REMOVAL $108.01
04408 VAULT PROLAPSE (VAGINAL APPROACH) $478.25
04410 POST-OP HAEMORRHAGE, VAGINAL MANAGEMENT W/ GA $139.74
04411 VAGINECTOMY - TOTAL $478.25

Plastic Operations For Genital Prolapse

Code Description Amount
04227 CYSTOCOELE/URETHROCOELE REPAIR $337.39
04421 RECTOCELE REPAIR $337.39
04422 ENTEROCELE REPAIR $411.23
04424 COMPLETE REPAIR OF PROLAPSE $526.54
04427 LEFORTS OPERATION $294.34
04429 PERINEAL LACERATION REPAIR OF OLD 3RD DEGREE $351.33
04432 REPEAT VAGINAL PLASTIC PROCEDURE - EXTRA $118.31

Vaginal Operations On The Cervix And Uterus

Code Description Amount
00770 PELVIC EXAMINATION UNDER ANESTHESIA $109.48
04500 CERVIX DILATION AND CURETTAGE $108.01
04502 CERVIX, REPAIR OF $108.01
04503 CRYOSURGERY - CERVIX $65.69
04508 BIOPSY CERVIX, UNDER G.A. $60.40
04509 POLYPECTOMY - CERVICAL $16.65
04510 BIOPSY CERVIX WITH D&C $108.01
04512 MYOMECTOMY VAGINAL $134.46
04515 CERVICAL LIGATURE, REMOVAL OF UNDER ANAESTHETIC $55.08
04516 CERVICAL INCOMPETENCE - EMERGENCY REPAIR $266.65
04517 CERVICAL INCOMPETENCE - ELECTIVE REPAIR $213.76
04530 CAUTERIZATION CERVIX, G.A. $55.08
04536 CONE BIOPSY CERVIX (INCLUDES D&C) $234.92
04545 ARTIFICIAL INSEMINATION - OPERATION ONLY $28.65
04551 CERVICAL STUMP REMOVAL $234.92
14540 INSERTION INTRAUTERINE CONTRACEPTIVE DEVICE $41.35

Laser Vaporization

Code Description Amount
04620 CERVICAL NEOPLASIA $137.77
04621 VAGINAL NEOPLASIA WITH OR WITHOUT G.A. $137.77
04622 VULVAR CONDYLOMATA $137.77
04623 EXTENSIVE VULVAR AND/OR VAGINAL CONDYL. UNDER G.A. $205.54
04624 VULVAR INTRAEPITHELIAL LESION DIFFUSE W/ PERIANAL $341.09
04625 VULVAR INTRAEPITHELIAL LESION/DIFFUSE MULTIFOCAL $273.32

Surgical Assistance

Code Description Amount
00195 SURGICAL ASSIST-LESS THAN $317.00 INCLUSIVE $131.64
00196 SURGICAL ASSIST $317.01 TO 529.00 INCLUSIVE $185.59
00197 SURGICAL ASSISTANCE - OPERATIONS OVER $529.00 $245.47
00198 SURGICAL ASSIST TIME AFTER 3 HRS - PER 15 MINS $27.80
70019 CERTIFIED SURGICAL ASSIST $251.70
70020 CERTIFIED SURGICAL ASSIST - TIME FROM 1-3 HOURS $26.28

Laboratory Procedures

Code Description Amount
04699 FERN TEST $8.14
15000 HAEMOGLOBIN -OTHER METHODS (IN PHYSICIANS OFFICE) $1.57
15120 PREGNANCY TEST, IMMUNOLOGIC, URINE $11.14
15136 FUNGUS, DIRECT EXAMINATION, KOH PREPARATION $8.23
15137 HAEMOGLOBIN - CYANMETHAEMOGLOBIN $3.07
15139 SPERM, SEMINAL EXAMINATION FOR PRESENCE OR ABSENCE $14.49
15141 TRICHOMONAS AND / OR CANDIDA, DIRECT EXAMINATION $5.52
15142 URINALYSIS-COMPLETE DIAGNOSTIC, SEMI-QUANT & MICRO $5.40

Diagnostic Ultrasound

Code Description Amount
04680 GUIDED AMNIOCENTESIS $119.46
08651 OBS. - B-SCAN - 14 WKS. OR MORE FOR SINGLES $106.17
08652 B SCAN I.U.D. LOCALIZATION $53.34
08653 PELVIC B SCAN - NON-OBSTETRICAL $106.17
08655 OBS. B-SCAN - LESS THAN 14 WKS. $79.67
08657 CHORIONIC VILLUS SAMPLING FOR ULTRASONIC GUIDANCE $106.74
86051 OBS B SCAN (14 WKS GESTATION OR OVER)- ADD FETUSES $79.01

Other

Code Description Amount
04531 CAUTERIZATION OF CERVIX TO INCLUDE D&C IF DONE $108.01
04533 CAUTERIZATION CERVIX, ELECTRIC, IN OFFICE $33.92
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 $27.89
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