Obstetrics & gynaecology MSP billing codes


Referred Cases

Code Description Amount
04005 EMERGENCY VISIT-OBSTETRICS & GYNECOLOGY $127.37
04007 VISIT, OFFICE, OB&G $48.22
04008 VISIT, HOSPITAL, OB&G $48.22
04009 VISIT, HOME, OB&G $116.08
04010 CONSULTATION, OB&G $140.70
04012 CONSULTATION, LIMITED, 0B&G $77.25
04070 TELEHEALTH CONSULTATION - OBSTETRICS & GYNECOLOGY $140.70
04072 TELEHEALTH REPEAT OR LIMITED CONSULT/OBS & GYN $77.25
04077 TELEHEALTH SUBSEQUENT OFFICE VISIT - OBS & GYN $48.22
04078 TELEHEALTH SUBSEQUENT HOSPITAL VISIT - OBS/GYN $48.22

Obstetrical Procedures

Code Description Amount
04000 COMPLICATED VAGINAL DELIVERY $375.70
04014 MIDCAVITY FORCEPS - DELIVERY $450.87
04017 MIDCAVITY ROTATION - SURGICAL DELIVERY $551.03
04018 BREECH VAGINAL BIRTH $585.77
04022 SPHINCTER REPAIR - EXTERNAL $240.44
04023 CERVICAL /VAGINAL LACERATIONS $240.44
04024 4TH DEGREE LACERATION - REPAIR $290.53
04025 C-SECTION - HIGH RISK $651.28
04026 RETAINED PLACENTA - MANUAL REMOVAL $240.44
04038 REPEAT INTRAPARTUM ASSESS BY CONSULTANT AT REQUEST $222.21
04039 MANAGEMENT OF COMPLICATED LABOUR BY OBSTETRICIAN $667.15
04049 EXTERNAL CEPHALIC VERSION $127.10
04050 CAESAREAN SECTION - ELECTIVE $500.99
04052 CAESAREAN SECTION - EMERGENCY $561.10
04080 INSERTION OF MULTIPLE OSMOTIC DILATORS WITH BLOCK $141.36
04092 MULTIPLE NATURAL BIRTHS - EACH ADDITIONAL CHILD $161.31
04093 CAESAREAN SECTION MULTIPLE BIRTHS, EACH ADDITIONAL $82.15
04106 CAESAREAN HYSTERECTOMY $742.68
04107 SUPERVISION OF LABOUR AND VAGINAL DELIVERY $200.27
04110 THERAPEUTIC ABORTION (VAGINAL) 14 - 18 WEEKS $250.41
04111 THERAPEUTIC ABORTION (VAGINAL) LESS THAN 14 WEEKS $150.00
04114 THERAPEUTIC ABORTION BY D&E, 18 WKS AND OVER $300.57
04116 CURETTAGE FOR POST-PARTUM HAEMORRHAGE (> 20 WEEKS) $200.36
04118 INDUC. OR STIM. OF LABOUR BY OXYTOCIN - 1ST HOUR $41.98
04119 INDUC. OR STIM. OF LABOUR BY OXYTOCIN - SUBS. HRS $28.93
14091 PRENATAL VISIT - SUBSEQUENT EXAMINATION $31.62
14094 POST-NATAL OFFICE VISIT $31.62
14104 DELIVERY AND POST-NATAL CARE (1-14 DAYS IN-HOSP) $584.78
14108 POST-NATAL CARE AFTER ELECTIVE C-SECTION $120.31
14109 DELIVERY - ATTENDANCE - EMERG C/S $487.10
14199 MNGMNT OF PRLNGD 2ND STG LABOUR - PER 30 MINS $84.94

Abdominal Operations

Code Description Amount
04003 OOPHORECTOMY/SALPINGECTOMY $358.76
04201 OVARIAN CYSTECTOMY $447.72
04203 MYOMECTOMY $500.91
04204 HYSTEROTOMY - ABDOMINAL WITH/WITHOUT STERILIZATION $358.76
04206 SUSPENSION OF UTERUS $240.19
04208 ECTOPIC PREGNANCY $500.91
04216 NEURECTOMY PRESACRAL $418.08
04217 HEMORRHAGE - POST OP (INTRA-ABDOMINAL MANAGEMENT) $358.76
04228 HYSTERECTOMY - TOTAL $736.94
04229 REMOVAL OF COMPLICATED PELVIC DISEASE $655.21
04230 STERILIZATION - ABDOMINAL-OPEN $299.44
04605 VAULT PROLAPSE $655.21

Abdominal Operations For Cancer

Code Description Amount
04011 CA OVARY/ FALLOPIAN TUBES $1,011.82
04029 OMENTECTOMY/REMOVAL OF SOFT-TISSUE MASS $358.76
04212 PELVIC LYMPHADENECTOMY $595.90
04218 HYSTERECTOMY - RADICAL $1,102.00
04219 PARA-AORTIC LYMPHADENECTOMY $595.90
04220 PARA-AORTIC LYMPHADENECTOMY - PARTIAL $263.91
04628 REMOVAL OF EXTRAPELVIC SOFT TISSUE MASS > 10 CM $477.33

Hysteroscopy Surgical

Code Description Amount
04221 HYSTEROSCOPIC DIV OF INTRAUTERINE ADHESIONS-SIMPLE $196.95
04222 HYSTEROSCOPIC DIV OF INTRAUTERINE ADHESIONS-COMP $328.58
04223 RESECTION OF MYOMA $455.19
04224 ENDOMETRIAL ABLATION $455.19
04225 HYSTEROSCOPIC DIVISION OF UTERINE SEPTUM $328.58
04226 HYSTEROSCOPIC TUBAL OCCLUSION (BILATERAL) $195.31

Laparoscopic Operations

Code Description Amount
04001 LAPAROSCOPY $210.56
04034 SALPINGOLYSIS VIA LAPAROSCOPY - UNILATERAL $71.24
04035 SALPINGOLYSIS VIA LAPAROSCOPE - BILATERAL $139.41
04036 SALPINGOSTOMY VIA LAPAROSCOPY - UNILATERAL $151.29
04037 SALPINGOSTOMY VIA LAPAROSCOPY - BILATERAL $299.45
04040 CAUTERY OF ENDOMETRIOSIS $62.31
04041 OOPHORECTOMY AND/OR SALPINGECTOMY-UNILATERAL $151.28
04042 OOPHORECTOMY AND/OR SALPINGECTOMY-BILATERAL $299.45
04043 OVARIAN CYSTECTOMY - UNILATERAL $240.22
04044 OVARIAN CYSTECTOMY-BILATERAL $447.74
04045 VENTRAL SUSPENSION OF UTERUS $151.29
04046 PRESACRAL NEURECTOMY $208.58
04047 EXCISION OF EXTENSIVE PERITONEAL ENDOMETRIOSIS $329.13
04048 REMOVAL OF COMPLICATED PELVIC DISEASE-LAPAROSCOPIC $447.73
04660 TUBAL INTERRUPTION (STERILIZATION ) $92.00
04662 LAPAROSCOPY - REMOVAL OF FOREIGN BODY $92.00
04664 ECTOPIC PREGNANCY - REMOVAL VIA SCOPE. $342.55

Micro Surgical Operations

Code Description Amount
04602 SALPINGOLYSIS - UNILATERAL/BILATERAL $447.72
04616 MICRO SALPINGOSTOMY -UNILATERAL $616.67
04617 MICRO SALPINGOSTOMY - BILATERAL $800.77
04626 TUBO-CORNUAL ANASTOMOSIS - UNILATERAL (MICRO) $892.33
04627 TUBO-CORNUAL ANASTOMOSIS - BILATERAL (MICRO) $1,159.11

Operations On The Vulva

Code Description Amount
04032 BIOPSY - VULVA (GREATER THAN OR EQUAL TO 2CM) $92.00
04300 HYMEN INCISION $150.00
04301 BARTHOLINS CYST/ABSCESS MARSUPIALIZATION $150.00
04303 HYDROCELE CANAL OF NUCK EXCISION $180.90
04304 URETHRAL CARUNCLE - CAUTERY OR EXCISION IN HOSP $62.32
04305 VENEREAL WARTS, CAUTERY OR EXCISION $38.61
04306 VENEREAL WARTS UNDER G.A., HOSPITAL $150.00
04307 VULVECTOMY - SIMPLE $388.42
04309 LABIUM VARICOCELE $133.47
04311 VULVAR ATRESIA OR ENLARGEMENT OF VAGINAL INTROITUS $150.00
04312 LABIA MINORA RESECTION $150.00
04316 VULVOVAGINOPLASTY $240.18
04317 BIOPSY - VULVA - < 2 CM $30.04
04318 VULVECTOMY - RADICAL $901.73
04320 LYMPHADENECTOMY - INGUINAL/FEMORAL - UNILATERAL $400.76
04322 LYMPHADENECTOMY - INGUINAL/FEMORAL - BILATERAL $701.26

Operations On The Vagina

Code Description Amount
04033 VAGINECTOMY-PARTIAL $358.76
04202 VAGINAL HYSTERECTOMY $736.94
04232 OOPHORECTOMY/OVARIAN CYSTECTOMY - VAG - UNILATERAL $89.21
04233 OOPHORECTOMY/OVARIAN CYSTECTOMY - VAG - BILATERAL $175.40
04401 FISTULA RECTO-VAGINAL REPAIR $596.40
04402 ABSCESS PELVIC COLPOTOMY DRAINAGE $151.30
04404 CYST VAGINAL INCLUSION $150.00
04405 CYST VAGINAL OTHER THAN INCLUSION $157.22
04406 SEPTUM VAGINAL REMOVAL $150.00
04408 VAULT PROLAPSE (VAGINAL APPROACH) $536.63
04410 POST-OP HAEMORRHAGE, VAGINAL MANAGEMENT W/ GA $157.22
04411 VAGINECTOMY - TOTAL $536.63

Plastic Operations For Genital Prolapse

Code Description Amount
04227 CYSTOCOELE/URETHROCOELE REPAIR $378.73
04421 RECTOCELE REPAIR $378.73
04422 ENTEROCELE REPAIR $461.51
04424 COMPLETE REPAIR OF PROLAPSE $590.76
04427 LEFORTS OPERATION $330.50
04429 PERINEAL LACERATION REPAIR OF OLD 3RD DEGREE $394.37
04432 REPEAT VAGINAL PLASTIC PROCEDURE - EXTRA $133.19

Vaginal Operations On The Cervix And Uterus

Code Description Amount
00770 PELVIC EXAMINATION UNDER ANESTHESIA $150.00
04500 CERVIX DILATION AND CURETTAGE $150.00
04502 CERVIX, REPAIR OF $150.00
04503 CRYOSURGERY - CERVIX $74.22
04508 BIOPSY CERVIX, UNDER G.A. $150.00
04509 POLYPECTOMY - CERVICAL $21.23
04510 BIOPSY CERVIX WITH D&C $150.00
04512 MYOMECTOMY VAGINAL $151.29
04515 CERVICAL LIGATURE, REMOVAL OF UNDER ANAESTHETIC $150.00
04516 CERVICAL INCOMPETENCE - EMERGENCY REPAIR $299.45
04517 CERVICAL INCOMPETENCE - ELECTIVE REPAIR $240.18
04530 CAUTERIZATION CERVIX, G.A. $150.00
04536 CONE BIOPSY CERVIX (INCLUDES D&C) $263.90
04545 ARTIFICIAL INSEMINATION - OPERATION ONLY $32.71
04551 CERVICAL STUMP REMOVAL $263.90
14540 INSERTION INTRAUTERINE CONTRACEPTIVE DEVICE $43.15

Laser Vaporization

Code Description Amount
04620 CERVICAL NEOPLASIA $155.00
04621 VAGINAL NEOPLASIA WITH OR WITHOUT G.A. $155.00
04622 VULVAR CONDYLOMATA $155.00
04623 EXTENSIVE VULVAR AND/OR VAGINAL CONDYL. UNDER G.A. $230.97
04624 VULVAR INTRAEPITHELIAL LESION DIFFUSE W/ PERIANAL $382.87
04625 VULVAR INTRAEPITHELIAL LESION/DIFFUSE MULTIFOCAL $306.95

Surgical Assistance

Code Description Amount
00195 SURGICAL ASSIST-LESS THAN $317.00 INCLUSIVE $134.22
00196 SURGICAL ASSIST $317.01 TO 529.00 INCLUSIVE $189.24
00197 SURGICAL ASSISTANCE - OPERATIONS OVER $529.00 $260.35
00198 SURGICAL ASSIST TIME AFTER 3 HRS - PER 15 MINS $28.52
70019 CERTIFIED SURGICAL ASSIST $256.63
70020 CERTIFIED SURGICAL ASSIST - TIME FROM 1-3 HOURS $32.23

Laboratory Procedures

Code Description Amount
04699 FERN TEST $9.51
15000 HAEMOGLOBIN -OTHER METHODS (IN PHYSICIANS OFFICE) $1.62
15120 PREGNANCY TEST, IMMUNOLOGIC, URINE $11.65
15136 FUNGUS, DIRECT EXAMINATION, KOH PREPARATION $8.33
15137 HAEMOGLOBIN - CYANMETHAEMOGLOBIN $3.12
15139 SPERM, SEMINAL EXAMINATION FOR PRESENCE OR ABSENCE $14.78
15141 TRICHOMONAS AND / OR CANDIDA, DIRECT EXAMINATION $5.65
15142 URINALYSIS-COMPLETE DIAGNOSTIC, SEMI-QUANT & MICRO $5.62

Diagnostic Ultrasound

Code Description Amount
04680 GUIDED AMNIOCENTESIS $131.25
08651 OBS. - B-SCAN - 14 WKS. OR MORE FOR SINGLES $109.70
08652 B SCAN I.U.D. LOCALIZATION $55.12
08653 PELVIC B SCAN - NON-OBSTETRICAL $109.70
08655 OBS. B-SCAN - LESS THAN 14 WKS. $82.30
08657 CHORIONIC VILLUS SAMPLING FOR ULTRASONIC GUIDANCE $110.30
86051 OBS B SCAN (14 WKS GESTATION OR OVER)- ADD FETUSES $81.63

Other

Code Description Amount
04531 CAUTERIZATION OF CERVIX TO INCLUDE D&C IF DONE $150.00
04533 CAUTERIZATION CERVIX, ELECTRIC, IN OFFICE $38.61
04701 REPEAT URINARY INCONTINENCE PROCEDURE $420.25
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 $980.80
04708 PROLONGED LAPAROSCOPIC SURGERY, PER 15 MIN (EXTRA) $71.72
04709 HYSTERECTOMY-LAPAROSCOPIC TOTAL/SUPRACERV&/OR LAVH $980.80
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