MSP Billing Codes, Fees & Payment Schedule

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Code Description Fee

97008 Apb-form completion greater than 20 minutes $50.00
97009 Apb-form completion greater than 20 minutes $50.00
97010 Apb-form completion greater than 20 minutes $50.00
97011 Apb-form completion greater than 20 minutes $50.00
97012 Apb-form completion greater than 20 minutes $60.00
97013 Apb-form completion greater than 20 minutes $50.00
97014 Apb-form completion greater than 20 minutes $50.00
97015 Apb-form completion greater than 20 minutes $50.00
97016 Apb-form completion greater than 20 minutes $50.00
08710 Consult malignant haemopoietic/reproductive/etc. $57.89

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06184 Extensor - repair $232.45
09903 First additional area. physical therapy. $6.75
06183 Flexor - repair $369.80
96201 Gp 2nd medical opinion & form 12 - mental health $58.99
09908 Home visit - requires therapist to travel to home $28.70
10040 Immunization-patient < 19 yrs-mmr/v $5.43
10041 Immunization-patient < 19 yrs-mmr/v $14.00
10042 Immunization-patient < 19 yrs-mmr/v $5.45
10043 Immunization-patient < 19 yrs-mmr/v $14.00
10044 Immunization-patient < 19 yrs-mmr/v $17.62
10045 Immunization-patient < 19 yrs-mmr/v $17.62
10046 Immunization-patient < 19 yrs-mmr/v $43.50
10050 Immunization-patient < 19 yrs-mmr/v $60.00
09904 Initial visit - incl. evaluation & treatment - $25.20
09910 Initial visit - nursing home - physical therapy $23.85
96501 Msd form person with disabilities designation $130.00
96503 Msd med rprt - persons with persist multi barriers $50.00
96504 Msd medical report employability form $25.00
96505 Msd medical report, child $25.00
96400 Msd monthly nutritional supplement form part b $25.00
96502 Msd section 3 assessor report $75.00
09913 Multiple area treatment - second additional area $6.75
09914 Multiple area treatment - third additional area. $6.75
96223 Osmv - visual field test and exam visual functions $102.00
96222 Osmv diabetic driver report-sent out with dmer $30.00
96221 Osmv diabetic driver report-stand alone (no dmer) $75.00
96220 Osmv driver's medical examination report (dmer) $75.00
96224 Osmv examination of visual function (evf) by optom $70.00
96225 Osmv visual field test (vft) by optom-stand alone $42.00
96227 Osmv-examinatino of visual function(evf)-by ophth $91.51
96228 Osmv-vft-visual field test by oph-stand alone test $62.10
96226 Osmv-vft+evf(visual field+visual function)by ophth $153.61
09934 Prolonged visit - assessment,treatment,instruction $23.60
09935 Prolonged visit - cns, assessment,treatment of cns $35.90
09933 Prolonged visit -min 25 minutes of direct contact $23.60
09912 Prolonged visit at nursing home, therapy rendered $23.60
08711 Radiology consult for malignant lesion - w/ biopsy $43.58
08712 Radiology consult for malignant lesion of skin $29.09
99000 Sessional - GP visit $1,106.00
99001 Sessional - GP visit $3,842.00
99002 Sessional - GP visit $14,702.00
A00095 Sessional - GP visit $92.70
96302 Spec 2nd med op & form 12, follow up-mental health $81.31
96301 Spec 2nd med. op. & form 12, intl - mental health $177.10
10007 Specialist e-mail patient management-follow up $10.10
10008 Specialist e-mail patient management-follow up $60.00
10009 Specialist e-mail patient management-follow up $40.00
09902 Subsequent visit - short evaluation and either $17.65
09911 Subsequent visit at nursing home-therapy rendered $15.65
08770 Telehealth radiology consult for malignant lesion $57.89
08771 Telehealth radiology consult malignant w/biopsy $43.58
08772 Telehealth radiology consult/malignant lesion skin $29.09

Abdomen

08570 Abdomen x-ray $35.32
08648 Abdominal b-scan $110.10
08571 Abdominal multiple x-ray $53.41
08650 Guidance for biopsy or cyst puncture $126.67
08684 Prostate scan using rectal probe $110.08
08649 Renal b scan $86.68

Abdominal and Perineal Approach

72666 Altemeier transperineal excision of rectal procide $677.27
72667 Division of stricture of rectum $252.59
72664 Proctectomy, complete - subtotal/total colectomy $1,645.83
72665 Proctectomy, partial - without anastomosis $558.30
07580 Rectal tumor excision by posterior parasacral $800.00

Abdominal Operations

04208 Ectopic pregnancy $500.91
04217 Hemorrhage - post op (intra-abdominal management) $458.49
04228 Hysterectomy - total $736.94
04709 Hysterectomy-laparoscopic total/supracerv&/or lavh $980.80
04204 Hysterotomy - abdominal with/without sterilization $358.76
04707 Laparoscopic sacrocolpopexy $980.80
04001 Laparoscopy $229.25
04203 Myomectomy $500.91
04216 Neurectomy presacral $418.08
04003 Oophorectomy/salpingectomy $358.76
04201 Ovarian cystectomy $447.72
04229 Removal of complicated pelvic disease $754.70
04230 Sterilization - abdominal-open $356.60
04206 Suspension of uterus $240.19
04605 Vault prolapse $748.87

Abdominal Operations for Cancer

04011 Ca ovary/ fallopian tubes $1,011.82
04218 Hysterectomy - radical $1,102.00
04029 Omentectomy/removal of soft-tissue mass $358.76
04219 Para-aortic lymphadenectomy $595.90
04220 Para-aortic lymphadenectomy - partial $263.91
04212 Pelvic lymphadenectomy $595.90
04628 Removal of extrapelvic soft tissue mass > 10 cm $509.44
04630 Removal of extrapelvic soft tissue mass > 10 cm $474.13
04631 Removal of extrapelvic soft tissue mass > 10 cm $711.19
04632 Removal of extrapelvic soft tissue mass > 10 cm $356.60
04633 Removal of extrapelvic soft tissue mass > 10 cm $407.55
04640 Removal of extrapelvic soft tissue mass > 10 cm $474.13
04641 Removal of extrapelvic soft tissue mass > 10 cm $711.19

Abdominal Surgery - Miscellaneous

07603 Abdominal wound evisceration - resuture $406.03
07597 Haemorrhage; intra-abdominal management - post ope $379.58
71280 Indwelling enteral tubes, removal - no anes $30.65
71282 Indwelling enteral tubes, removal- gen anaes $203.93
71281 Indwelling enteral tubes,removal-local/regional $63.06
71283 Indwelling entereal tubes, replacement - extra $30.65
07601 Intra-abdominal abscess excluding intrahepatic $434.19
07600 Laparotomy to include biopsy - exploratory $405.81
71292 Peritonectomy, with or without chemotherapy $662.77
71293 Peritonectomy, with/without chemotherapy add 15min $75.60
71291 Resection of soft issue tumour 10cmor >-add 15min $76.47
71290 Resection of soft tissue tumour 10cm or greater $662.77
72600 Temp or delayed abdominal closure with vac $376.25
07451 Thoracic extension of abdominal incision(extra) $285.69

Ablation

06114 Abrasive surgery - full face $523.79
06112 Abrasive surgery <1/4 of face $126.70
06113 Abrasive surgery 1/4 to 1/2 of face $246.18

Acute Pain Management

01075 Axillary indwelling catheter - repeat injection $60.85
01076 Axillary indwelling catheter - supervision $40.57
01007 Catheter insertion intrapleural for pain mgmt $83.54
01074 Catheter insertion-axillary for pain mgmt $72.55
01025 Epidural catheter insertion - lumbar or caudal $150.36
01026 Epidural catheter insertion - thoracic pain mgmt $228.03
01050 Epidural indwelling catheter repeat injection - 4 $60.85
01073 Epidural infusion - supervision $40.57
01019 Interpleural indwelling catheter repeat injections $60.85
01021 Intrapleural infusion - supervision $40.57
01187 Major peripheral nerve block - multiple $69.28
01186 Major peripheral nerve block - single $45.85
01013 Pain management - consultation for post-op pain $101.03
01012 Patient controlled analgesia - supervision $40.57
01011 Patient controlled analgesia (PCA) - first day $21.79

Adult and Pediatric Critical Care

01413 Comprehensive care (icu) - 1st day $507.54
01423 Comprehensive care (icu) - 2nd to 7th day (incl.) $256.61
01443 Comprehensive care (icu) - 31st day onward $147.80
01450 Comprehensive care (icu) - 31st day onward $42.87
01455 Comprehensive care (icu) - 31st day onward $7.26
01433 Comprehensive care (icu) - 8th to 30th day $142.11
01411 Critical care (icu) - 1st day $340.05
01421 Critical care (icu) - 2nd to 7th day (incl.) $170.52
01441 Critical care (icu) - 31st day onward $135.47
01431 Critical care (icu) - 8th to 30th day $117.75
01412 Ventilatory support (icu) - 1st day $294.96
01422 Ventilatory support (icu) - 2nd to 7th day (incl.) $161.06
01442 Ventilatory support (icu) - 31st day onward $110.89
01432 Ventilatory support (icu) - 8th to 30th day $123.38

Airway Surgery

02422 Broncho or microlaryngoscopy w f b removal- <3 yrs $380.57
02450 Broncho or microlaryngoscopy w removal of foreign body $255.15
79080 Closure of bronchopleural fistula $953.71
02420 Dilation of trachea $152.64
02421 Dilation of trachea - repeat within one month $152.43
02430 Micro-surgery w co2 laser for removal of-1st procedure $445.46
02435 Microsurgery w c02 laser for ..-subsequent proc $445.46
79085 Repair of ruptured bronchus $964.56
79065 Trachael resection $964.56
79075 Tracheal resection - with hilar release $476.11
79070 Tracheal resection - with laryngeal release $476.11

All

92520 1-amphetamine $70.92
92521 1-metamphetamine $70.92
92353 13c triolein breath test for malabsorption $67.91
91482 Acetaminophen (quantitative) $11.47
91480 Acetazolamide $46.68
91985 Albumin creatinine ratio (acr) $11.41
91484 Amikacin $45.99
91486 Amiodarone $46.53
91488 Amitryptyline $24.64
93065 Amniotic cell culture - analysis only $210.20
91490 Amoxapine $46.53
92503 Amphetamines $9.55
92522 Anileridine $70.92
90287 Anti-neutrophil cytoplasmic antibodies (anca) $114.26
90121 Anti-nuclear antibodies, by multiplex immunoassay $38.64
90288 Anti-parietal cell antibody (apca), immuno screen $23.82
92523 Antihistamines $70.92
90281 Antinuclear antibodies by sensitive eia $16.24
91220 B-glucosidase, fibroblasts $51.38
91221 B-glucosidase, white blood cells $51.38
91275 B-type natriuretic peptide(bnp or nt-probnp) $28.14
91226 Barbiturates - quantitative $35.61
92505 Benzodiazepines $8.39
91230 Beta - 2 - microglobulin $20.40
91231 Beta-glucuronidase, white blood cells $51.25
91232 Beta-mannosidase white blood cells $51.25
91235 Bicarbonate, serum/plasma $2.37
91236 Bicarbonate, urine $1.06
91241 Bile acids, total $32.36
91240 Bile pigments and salts, qualitative, urine $2.34
91245 Bilirubin total, serum/plasma $1.61
91246 Bilirubin total, transudate/exudate $1.05
91250 Bilirubin, direct $1.58
90620 Biochemical identification - micro-organism $9.55
92515 Blood methadone $46.42
91255 Blood, qualitative, gastric $2.44
91260 Bone gla protein (osteocalcin) $17.76
91270 Bromides, qualitative, urine $10.48
91265 Bromides, quantitative $16.29
91280 C - 1q esterase inhibitors $22.86
91285 C - 3 complement $9.61
91290 C - 4 complement $9.87
91295 C - peptide $47.42
91300 C - reactive protein $10.31
91310 Ca 125 $22.72
91305 Ca 15 - 3 $21.25
91315 Ca 19 -9 $20.88
91320 Calcitonin $50.63
91326 Calcium total, serum/plasma $1.55
91327 Calcium, 24 hours excretion, feces $19.73
91325 Calcium, timed urine collection $5.48
91328 Calcium, urine random $1.05
91330 Calculus analysis, urine $27.86
91335 Carbamazepine $15.32
91340 Carbon monoxide, quantitative $17.58
91345 Carotene $8.90
91350 Catecholamines $59.27
91351 Catecholamines fractions-separation/interpretation $40.79
91352 Catecholamines, total urine $46.45
91353 Cells count - examination for faeces $5.46
91360 Ceruloplasmin $10.15
91370 Chloride - iontophoresis, sweat $77.50
91365 Chloride, quantitative, csf/other fluids $7.21
91366 Chloride, serum/plasma $1.49
91367 Chloride, timed urine collection $10.06
91368 Chloride, urine random $3.26
91369 Chloride, whole blood $1.06
91492 Chlorpromazine $46.53
91375 Cholesterol, total $6.87
91380 Cholinesterase/dibucaine number $30.26
91386 Chromatography, keto acids $36.30
91387 Chromatography, reducing substances, urine $31.40
91388 Chromatography, thin layer (tlc) $32.65
93070 Chromosomal breakage $181.80
93080 Chromosome analysis - high resolution $123.82
93081 Chromosome analysis - high resolution $113.56
91494 Citrate, urine $24.66
91496 Clobazam $49.73
91498 Clomipramine $49.82
91500 Clonazepam $46.53
92524 Clonidine $70.92
91502 Clozapine $27.92
92507 Cocaine/cocaine metabolite $7.10
91390 Complement assay $19.63
91395 Complement, total haemolytic (ch 100) $43.71
92546 Comprehensive drug analysis $119.94
91400 Copper, serum $49.19
91401 Copper, tissue $49.77
91402 Copper, urine $49.78
91405 Cortisol $13.28
91406 Cortisol, late night salivary test $77.25
91415 Creatine kinase $1.88
91410 Creatine, timed urine collection $12.73
91420 Creatinine, random urine $5.10
91421 Creatinine, serum/plasma $1.52
91422 Creatinine, timed urine collection $5.80
91425 Cryofibrinogen $17.38
91440 Cryoglobulins $41.92
93010 Crystal identification synovial fluid $40.05
91445 Csf - albumin $20.16
91450 Csf - immunoglobulin g $20.40
91504 Cyanide $24.64
91435 Cyclic a.m.p., urine $45.46
91434 Cyclic amp, plasma/serum $44.73
91455 Cyclosporine $23.47
93045 Cytogenetic analysis $966.29
93047 Cytogenetic analysis $296.18
93048 Cytogenetic analysis $400.00
93049 Cytogenetic analysis $800.00
93020 Cytogenetic analysis - bone marrow $516.59
93025 Cytogenetic analysis - chorionic villus $727.15
93030 Cytogenetic analysis - cultured amniotic fluid $414.61
93035 Cytogenetic analysis - cultured tissue $414.49
93040 Cytogenetic analysis - foetal blood sample $392.46
93015 Cytogenetic analysis - short term blood $301.44
93051 Cytogenetic analysis/fluorescence in situ, single $192.68
93052 Cytogenetic analysis/fluorescence, subtelomeric $515.49
93053 Cytogenetic analysis/fluorescence,uncultured $389.61
93050 Cytogenetic analysis/in-situ hybridization $466.46
93095 Cytologic interpretation - unscreened cytology $85.52
93090 Cytologic interpretation of pre-screened cytology $65.54
91460 Dehydroepiandrosterone, serum (dhea) $18.55
91506 Desipramine $24.35
91508 Desmethylclobazam $46.53
91510 Diazepam $46.53
91465 Digoxin $18.97
91470 Disaccharides, intestinal $62.40
91512 Disopyramide $46.53
91475 Dopamine, quantitative $61.91
91514 Doxepin $46.53
91599 Drug assay - multiple (2 or more) $53.46
92152 Drug assay (multiple) - pyridinium cross links $24.67
93100 Electron microscopy $384.40
91602 Electrophoresis, c.s.f. $31.21
91600 Electrophoresis, protein, qualitative $26.54
91601 Electrophoresis, protein, quantitative $34.58
91603 Electrophoresis, qualitative, urine $31.35
91605 Erythrocyte galactose 1 phosphate transferase $70.84
91610 Estradiol $22.43
91615 Estrogens $51.66
92508 Ethanol $6.92
91620 Ethosuximide $18.47
91628 Ethosuximide $26.00
91636 Fat, balance 3 day, feces $92.68
91631 Fat, microscopic exam-faeces $5.48
91640 Fatty acids, nonesterified (free), feces $22.79
91635 Fecal elastase $46.65
92006 Fecal immunochemical test (fit)-analysis only $11.29
92007 Fecal immunochemical test(fit)-collection only $6.57
91630 Fecal ph $3.92
92525 Fentanyl $70.92
92518 Fentanyl, urine screening immunoassay $13.10
91645 Ferritin, serum $10.12
91650 Fibrinogen, quantitative, chemical $28.68
93085 Fine needle aspirate - cytologic examination $94.24
91516 Fluoxetine $46.53
91518 Flupenthixol $46.53
91520 Fluphenazine $46.53
91522 Fluvoxamine $46.53
91660 Follicle stimulating hormone (fsh) $13.13
92330 Free t4 $12.12
92526 Furosemide $70.92
91523 Gabapentin $24.64
91665 Galactocerebrosidase, fibroblasts $51.38
91666 Galactocerebrosidase, white blood cells $51.38
91670 Galactose, qualitative, urine $17.13
91675 Gastric acidity determination, quantitative $3.52
91681 Gastric analysis, acid $0.92
91682 Gastric analysis, hollander insulin $89.43
91680 Gastric analysis, intubation $18.15
91685 Gastrin $63.32
90811 Gastrointestinal pathogen multiples(gpmp)& culture $105.04
92545 Gc/ms confirmation of positive screen $67.92
91524 Gentamycin $26.69
91720 Glucose phosphate isomerase $14.29
91705 Glucose quantitative, csf $6.45
91706 Glucose quantitative, joint fluid $6.45
91708 Glucose quantitative, transudate/exudate $6.45
91709 Glucose quantitative, urine $1.06
91700 Glucose semiquantitative $3.53
91716 Glucose tolerance test > 6 hours $39.40
91695 Glucose tolerance test-gestational protocol $15.84
91715 Glucose tolerance test, 2 - 5 hours $12.94
91717 Glucose tolerance test, intravenous $38.90
91690 Glucose, gestational assessment $10.03
91707 Glucose, quantitative serum/plasma $1.46
91710 Glucose, timed urine collection $7.13
91725 Glutamyl transpeptidase (gtp) $1.66
91730 Glutathione peroxidase $44.32
91735 Gold $43.91
91745 Haemoglobin, a1c $5.30
91526 Haloperidol $24.63
91740 Haptoglobin $19.77
91780 Hdl cholesterol $7.85
91760 Helicobacter pilori carbon 13 urea breath test $36.50
91761 Helicobacter pylori stool antigen (hpsa) $35.64
91750 Hemoglobin, qualitative, urine $2.28
91762 Heparan sulfamidase, white blood cells $93.71
93110 Hepatic glucose - 6 phosphatase $49.10
93105 Hepatic glycogen (tissue) $32.52
91765 Hepatitis b surface antigen $10.40
91777 Hexosaminidase white blood cells $99.30
91775 Hexosaminidase, serum $51.38
91770 Hexosaminidases $51.38
92080 Homocysteine - plasma $22.97
91785 Homocystine, screening test, urine $2.28
91790 Homovanillic acid (quantitative) urine $38.61
92527 Hydrocodone $70.92
92528 Hydromorphone $70.92
91796 Hydroxyindoleacetic acid, quantitative, urine $44.28
91795 Hydroxyindoleacetic acid, urine $9.28
90752 Id microorganisms maldi-tof-ms/non-stool specimen $6.84
90753 Id microorganisms maldi-tof-ms/stool specimen $6.84
91800 Iga anti-gliadin antibodies $32.58
91801 Iga quantitative, secretion $20.31
91802 Iga quantitative, serum/plasma $9.83
92170 Ige assay, quantitative (duplicate) $13.72
91805 Igf - i (somatomedin - c). $55.08
91840 Igg - quantitative serum $9.95
91163 Igg anti-deamidated gliadin peptide(anti-dgp)antib $18.24
91814 Igg blocking antibody $20.40
91803 Igg quantitative spinal fluid $20.06
91810 Igg1 $24.85
91811 Igg2 $24.85
91812 Igg3 $24.85
91813 Igg4 $24.85
91845 Igm - quantitative $10.05
91528 Imipramine $46.53
91815 Immune complex detection by c1q binding method $44.66
91820 Immunofixation, csf $105.31
91821 Immunofixation, serum/plasma $104.12
91822 Immunofixation, urine $104.12
91830 Immunoglobulin + specific protein assays $20.40
91825 Immunoglobulin d $20.40
91831 Immunoglobulin, additional assay $12.53
91835 Immunoreactive trypsin $18.80
91850 Inclusion bodies, (cytomegalic) urine $7.77
91857 Insulin tolerance test, per specimen $6.29
91856 Insulin, additional specimen $19.49
91855 Insulin, first specimen $27.55
91858 Interferon beta, neutralizing antibodies $205.52
93075 Investigation - chromosomal mosaicism $114.52
91860 Ionized calcium. $14.02
91865 Iron, total and binding capacity, protein $7.56
91870 Isoenzymes by electrophoresis $25.53
91882 Keto acids chromatography - screening tests - urin $5.44
91881 Keto acids chromatography - total, chemical - urin $10.99
91880 Keto acids, chromatography - urine $36.90
91885 Ketogenic steroids - urine $39.47
91890 Ketosteroids, total neutral - urine $50.17
91900 Lactate dehydrogenase, csf $1.06
91901 Lactate dehydrogenase, serum/plasma $1.62
91902 Lactate dehydrogenase, transudate/exudate $1.05
91895 Lactate, serum/plasma $7.64
91896 Lactate, whole blood $17.89
91905 Lactose, qualitative, urine $9.81
91529 Lamotrigine $24.64
91910 Lead $130.68
91912 Lead, porphyrin screening test, urine $6.22
91911 Lead, timed urine collection $40.68
91915 Lecithin sphingomyelin ratio $232.26
91920 Lhrh stimulation test $46.22
91530 Lidocaine $44.73
91925 Light chains, free kappa and lambda $78.99
91930 Lipase $6.62
91936 Lipoprotein (a) isoforms $25.92
91940 Lipoprotein electrophoresis $56.04
91941 Lipoprotein, sizing $25.92
91935 Lipoprotein(a) $29.61
91945 Lithium, serum/plasma $14.94
91946 Lithium, whole blood $11.23
90286 Liver autoantibodies (liaa), immunofluorescence $23.82
91532 Lorazepam $46.53
91534 Loxapine $46.53
91950 Luteinizing hormone (lh) $12.41
91955 Magnesium, fecal $25.15
91956 Magnesium, red blood cell $29.51
91957 Magnesium, serum/plasma $6.79
91958 Magnesium, urine $10.06
91959 Magnesium, whole blood $23.97
91536 Maprotiline $46.53
91960 Melanin, qualitative, urine $2.35
92529 Meperidine $70.92
92530 Meprobamate $70.92
91965 Mercury $52.42
91970 Metachromatic granules, urine $16.13
91975 Metanephrines, quantitative $155.77
92513 Methadone $3.50
92510 Methadone metabolite $6.80
92532 Methaqualone $70.92
92533 Methocarbamol $70.92
91538 Methotrexate $46.53
91540 Methotrimeprazine $46.53
92534 Methylenedioxyamphetamine $70.92
92535 Methylenedioxymethamphetamine $70.92
91542 Methylphenidate $46.53
92396 Microalbumin, semiquantative - by urine dipstick $6.68
91990 Microscopic examination of feces $5.08
36079 Midwife consultative care and assessment-phase 1 $40.76
36080 Midwife consultative care and assessment-phase 2 $40.76
36081 Midwife consultative care and assessment-phase 3 $41.37
36082 Midwife consultative care and assessment-phase 4 $41.37
36083 Midwife consultative care and assessment-phase 5 $41.37
36084 Midwife consultative care/assessment by phone $41.37
36085 Midwife consultative care/assessment call-out-day $72.41
36086 Midwife consultative care/assessment callout-night $116.89
36091 Midwife consultative care/assessment callout-night $10.15
36092 Midwife consultative care/assessment callout-night $4.06
36093 Midwife consultative care/assessment callout-night $35.53
36021 Midwife phase 1 (1st trimest) 1st visit is in ph 2 $268.98
36010 Midwife phase 1 (1st trimester) - total care $268.98
36016 Midwife phase 1 (1st trimester)-trans frm othr 60% $161.36
36014 Midwife phase 1 (1st trimester)-trans to othr 40% $107.58
36020 Midwife phase 2 (2nd trimester) - total care $268.98
36026 Midwife phase 2 (2nd trimester)-trans frm othr 60% $161.36
36024 Midwife phase 2 (2nd trimester)-trans to othr 40% $107.58
36036 Midwife phase 3 (3nd trimester)-trans frm othr 60% $322.82
36034 Midwife phase 3 (3nd trimester)-trans to othr 40% $215.22
36030 Midwife phase 3 (3rd trimester) - total care $538.05
36031 Midwife phase 3 (third trimester) phase 3 services $538.05
36046 Midwife phase 4 - home birth medications $50.73
36047 Midwife phase 4 - home birth supplies $101.45
36040 Midwife phase 4 (l & d) - first contact prior 34 w $1,075.91
36045 Midwife phase 4 home birth: second attendance fees $371.35
36048 Midwife phase 4 supp care-scheduld c-section in or $106.10
36070 Midwife phase 4 surgical assist caesarean schedule $192.08
36071 Midwife phase 4 surgical assistance-caesarean emer $260.35
36076 Midwife phase 4-caesarean night surcharge $185.94
36075 Midwife phase 4-caesarean-evening surcharge $115.83
36077 Midwife phase 4-caesarean-weekend/stat surcharge $115.83
36078 Midwife phase 4-call out-emergency caesarean sect $115.98
36073 Midwife phase 4-first surgical assist of the day $88.16
36056 Midwife phase 5 (post part care) - trnsfr to other $645.56
36054 Midwife phase 5 (post part care) -trnsfr frm other $430.37
36050 Midwife phase 5 (post partum care) - total care $1,075.91
36049 Midwife phase4 supp care-scheduled c-sect recovery $106.10
36064 Midwife supervision of 11-15 full courses of care $12,290.45
36065 Midwife supervision of 16-30 full courses of care $15,363.06
36062 Midwife supervision of 5 full courses of care $6,145.22
36063 Midwife supervision of 6 - 10 full courses of care $9,217.84
36061 Midwife supervision of up to 5 births or 4 full cs $3,072.61
36074 Midwife surgical assistance-fs delivery incentive $244.14
36072 Midwife-attendance at caesarean as mrp for baby $91.44
36041 Midwife-phase4 (labour/delivery) trans to (40%) $430.37
36042 Midwife-phase4 (labour/delivery) transfer (60%) $645.56
91992 Mitochondrial preparation-muscle $90.55
91995 Mucopolysaccharides, urine $59.55
93115 Muscle biopsy enzyme studies $195.44
91022 Muscle-specific tyrosine kinase antibody (musk ab) $245.60
91544 N - acetyl procainamide $46.53
92536 N-acetyl morphine $70.92
91997 N-acetyl-galactosamine-6-sulfate sulfatase, wbc $93.71
92537 Naloxone $70.92
91546 Netilmicin $46.53
91548 Nitrazepam $46.53
92001 Nitrogen - 24 hr. excretion - urine $6.43
92000 Nitrogen, 24 hr. excretion - feces $19.79
91550 Nortriptyline $24.35
92005 Occult blood-feces $6.02
91551 Olanzapine $24.64
92511 Opiates $7.16
92010 Organic acids $105.41
92015 Osmolar concentration, serum $49.25
92016 Osmolar concentration, urine $49.41
92020 Oxalate, timed urine collection $58.00
92538 Oxycodone $70.92
92514 Oxycodone, screening assay $12.82
92025 Oxygen capacity or content $20.06
92026 Oxygen, saturation (photometric) $10.93
92539 Oxymorphone $70.92
92030 Parathyroid hormone (intact) $17.52
92031 Parathyroid hormone (mid molecule/carboxyl termina $25.18
91552 Paroxetine $46.53
92035 Pentagastrin test, gastric $67.51
92540 Pentazocine $70.92
92040 Peptide hormones $25.18
91554 Perphenazine $46.53
92045 Ph, pc02 and p02 $36.18
92050 Phenothiazine screen $7.24
92541 Phentermine $70.92
92056 Phenylalanine, quantitative $20.56
92055 Phenylalanine, screening test (guthrie) $4.04
92542 Phenylpropanolamine $70.92
92065 Phenylpyruvic acid, qualitative, urine $2.35
92060 Phenytoin $17.13
92072 Phosphate, timed urine collection $3.95
92070 Phosphates, random urine $2.24
92071 Phosphates, serum/plasma $1.62
92075 Pigments, abnormal (spectroscopic) $14.06
90415 Plasma preparation $16.19
92085 Porphobilinogen, qualitative, urine $9.70
92090 Porphyrins, qualitative, urine $7.62
92095 Porphyrins, quantitative - blood $21.76
92092 Porphyrins, quantitative - feces $132.71
92091 Porphyrins, quantitative - urine $56.74
92100 Potassium, serum/plasma $1.39
92101 Potassium, timed urine collection $5.57
92102 Potassium, urine random $2.84
92103 Potassium, whole blood $1.05
92105 Pre albumin $20.16
92110 Pregnancy test - serum $14.74
92108 Pregnancy test, immunologic - urine $15.50
92115 Pregnanediol, urine $45.07
92120 Pregnanetriol, urine $53.20
92125 Primidone (mysolene) $18.49
91556 Procainamide $46.53
92130 Progesterone, serum/plasma $14.86
92131 Progesterone, serum/plasma 17-oh $41.71
92135 Prolactin $13.49
92543 Propoxyphene $70.92
91558 Propranolol $46.53
90710 Prostatic specific antigen (psa) $14.35
92150 Protease inhibitor $32.95
92397 Protein creatinine ratio, urine $7.67
92147 Protein total, joint fluid $1.05
92148 Protein total, serum or plasma $1.60
92149 Protein total, transudate/exudate $1.05
92146 Protein, timed urine collection $5.95
92145 Proteins, total quantitative, c.s.f. $7.14
92156 Pryruvate carboxylase, fibroblasts $93.71
92544 Pseudoephedrine $70.92
92151 Purine, pyrimidine and creatine disorder screen $63.34
92157 Pyruvate dehydrogenase, fibroblasts $93.71
92155 Pyruvates $17.98
92160 Quantitative beta hcg $16.30
92165 Quantitative hcg (intact) $25.18
91559 Quetiapine $24.64
92180 Quinidine $27.36
92185 Renin, single determination $63.87
92190 Renin, two or more determinations $98.11
92195 Respiratory chain enzymes-muscle $274.56
92197 Retinol binding protein $27.82
91561 Risperidone $26.46
92201 Salicylates, qualitative, gastric $2.88
92200 Salicylates, qualitative, serum $5.24
92202 Salicylates, qualitative, urine $3.01
92203 Salicylates, quantitative, serum $9.26
92204 Salicylates, quantitative, urine $9.77
92205 Scc $20.40
92210 Secretin - pancreozymin test $462.10
92215 Selenium $49.77
93160 Semen - examination - complete $82.34
93170 Seminal examination $26.98
92220 Seminal fructose $7.32
91560 Sertraline $52.35
92225 Serum viscosity $23.17
92267 Sex hormone binding globulig (shbg) $13.56
92227 Sirolimus $43.01
91430 Skin fibroblasts-culturing/biochemical/dna $603.88
92230 Sodium, random urine $2.72
92231 Sodium, serum/plasma $1.38
92232 Sodium, timed urine collection $4.60
92233 Sodium, whole blood $1.05
92236 Somatotropin, additional specimen $19.36
92235 Somatotropin, one specimen $30.38
93060 Special banding (q-, r-, c-) $29.48
93055 Special staining (giemsa ii, dapi, sce, nor) $30.78
92240 Specific protein analysis/preparative ultracentrif $141.14
92250 Sphingomyelinase, fibroblasts $51.38
92251 Sphingomyelinase, white blood cells $51.38
91010 Split base fee (referral facility) $7.02
90810 Stool examination - amoebae $46.93
92255 Sulfonamides, quantitative, urine $3.77
36067 Supervised labour and delivery-conditional midwive $131.32
36066 Supervision of continuity of care-conditional midw $315.15
36068 Supervision of in-office competency-based skills $15.75
36069 Supervision of out-of-office competency-based $26.26
92260 Sweat test (mucoviscidosis) chemical $10.20
92311 T3 - free $9.35
92263 Tacrolimus $23.47
92266 Testosterone total $15.81
92506 Tetrahydrocannabinoids (thc) $10.92
92270 Thallium $43.91
92275 Theophylline $42.33
92277 Thiopurine metabolites $50.46
92278 Thiopurine metabolites $54.49
91562 Thioridazine $48.47
90545 Thrombin time $8.31
92280 Thyroglobulin $27.90
92285 Thyroglobulin antibodies $20.40
92290 Thyroid binding globulin $20.40
92305 Thyroid receptor ab $22.48
92320 Thyroid releasing hormone (trh) stimulation test $55.91
92325 Thyroid stimulating hormone, tsh $9.90
92332 Thyroperoxidase antibodies $20.22
92315 Thyroxine ratio, t4 or total $12.12
92335 Tissue iron $43.91
91564 Tobramycin $26.17
91565 Topiramate $24.64
92310 Total t3 $12.12
92340 Transcobalamine ii $20.40
92345 Transferrin $7.56
92346 Transferrin isoelectric focusing(qualitive) $90.49
91566 Trazodone $46.53
91568 Trifluoperazine $46.53
92350 Triglycerides, serum/plasma $6.59
92351 Triglycerides, transudate/exudate $9.05
91570 Trimipramine $46.53
92355 Troponin $15.05
92360 Trypsin, qualitative, feces $2.24
92361 Trypsin, quantitative, feces $3.96
92362 Trypsin, quantitative, gastric $3.96
92365 Urea, amniotic fluid $1.06
92366 Urea, csf $1.06
92367 Urea, nitrogen quantitative, urine $7.42
92368 Urea, serum/plasma $1.57
92369 Urea, urine random $1.76
92370 Urea, whole blood $1.06
92375 Uric acid, random urine $1.06
92376 Uric acid, serum/plasma $1.70
92377 Uric acid, synovial fluid $1.58
92378 Uric acid, timed urine collection $4.56
92385 Urinalysis - or any part of (screening) $2.05
92391 Urinalysis-microscopic exam of centrifuged deposit $4.19
92390 Urinalysis, macroscopic $7.42
92395 Urinalysis, microscopic $7.17
92382 Urinalysis, screening and microscopic $5.63
92550 Urine, drugs of abuse screen - per analyte $6.95
92400 Urobilin, qualitative, urine $2.35
92405 Urobilinogen, qualitative, urine $4.09
92406 Urobilinogen, timed urine collection $13.58
91572 Valproic acid $16.55
91573 Vancomycin $15.57
92420 Vanillylmandelic acid $38.61
90000 Venepuncture $7.65
92425 Very long chain fatty acids $91.69
91576 Vigabatrin $26.68
92430 Vitamin a $47.86
92435 Vitamin b1 $54.30
92450 Vitamin b12 $14.38
92440 Vitamin b2 $54.30
92445 Vitamin b6 $54.30
92455 Vitamin d (1,25 dihydroxy) $94.49
92460 Vitamin d (25 hydroxy-cholecalciferol) $61.32
92465 Vitamin e $53.94
91861 Voltage-gated calcium channel antibody (vgcc ab) $281.78
92467 White blood cell preparation for lysosomal enzyme $42.36
92470 Xylose tolerance $106.16
92475 Zinc $102.44
91574 Zopiclone $24.64
91575 Zuclopenthixol $24.64

Allergy, patch and photopatch tests

00765 Annual maximum (scratch or intracutaneous tests) $34.40
00767 Patch testing (extra) (annual maximum, 80 tests) per test $1.96
00769 Photopatch test, annual maximum $56.69
00768 Photopatch test, per test $5.66
00763 Scratch test - children under 5 years $2.32
00762 Scratch test, per antigen $1.06

Anesthesiology

01215 Anesthesia surcharge - nonoperative - evening $66.69
01216 Anesthesia surcharge - nonoperative - night $91.18
01217 Anesthesia surcharge - nonoperative -weekend, stat $66.69

Anesthestic Intensity / Complexity Levels

01180 Level 10 - per 15 mins-anaes. intensity / complexity $50.00
01181 Level 11 - per 15 mins-anaes. intensity / complexity $50.00
01172 Level 2 - per 15 mins-anaes. intensity / complexity $36.64
01173 Level 3 - per 15 mins-anaes. intensity / complexity $36.75
01174 Level 4 - per 15 mins-anaes. intensity / complexity $36.75
01175 Level 5 - per 15 mins-anaes. intensity / complexity $41.87
01176 Level 6 - per 15 mins-anaes. intensity / complexity $43.75
01177 Level 7 - per 15 mins-anaes. intensity / complexity $43.75
01178 Level 8 - per 15 mins-anaes. intensity / complexity $49.82
01179 Level 9 - per 15 mins-anaes. intensity / complexity $50.00

Anesthetic Procedural Fee Modifiers

01192 Awake intubation, any means, for difficult airway $61.13
01082 Catheter axillary - insertion during GA $24.26
01084 Catheter insertion - intrapleural, during GA $27.93
01072 Epidural catheter - lumbar insertion during GA $41.75
01071 Epidural catheter - thoracic insertion during GA $54.28
01070 Hypotension - controlled in neurosurgical anaesth $61.13
01168 Neonates-anaesthesia - < 42 gest wks and / or 4000 gr $122.20
01169 Neonates-anaesthesia - < 42 gest wks and / or 4000 gr $10.00
01065 Patients < one year - anaesthetic modifier $61.10
01164 Patients 70-79 years of age - anaesthesia $20.38
01165 Patients 80 years of age and over-anaesthesia $41.56
01059 Prone position $35.50
01077 Pulmonary artery catheterization $55.60
01096 Retrobulbar / peribulbar block with anaesthetic $34.04
01166 Sitting position - anaesthesia $61.13
01093 Spinal cord monitoring - interp of ssep during GA $40.76

Angiography

08626 Angiogram, thoracic or abdominal, mult non-select $137.74
08627 Angiogram, thoracic or abdominal, mult selective $135.56
08616 Angiography cerebral x-ray - bilateral $232.60
08615 Angiography cerebral x-ray - unilateral $135.56
08618 Angiography peripheral - bilateral $104.61
08617 Angiography peripheral - unilateral $70.17

Angioplasty

77114 Intraoperative open or percutaneous angioplasty $589.40
77113 Intraoperative open or percutaneous tibial artery angioplasty $697.42

Anus Excision

70676 Abscess - ischiorectal/ intramural - incision $389.95
07687 Anal fissure, excision $115.00
70675 Anal seton - removal $28.67
07691 Anus imperforate simple incision $303.06
71682 Botox injection for anal fissure $252.34
07675 Fistula-in-ano - subcutaneous or submucous $250.00
07677 Fistula-in-ano - multiple or horseshoe $451.50
07676 Fistula-in-ano - submuscular $337.72
71700 Fistula-in-ano; closure of congenital anal fistula $645.16
07666 Fistula-in-ano; second stage; division - sphincter $250.00
71689 Hemmorhoid(s); office procedure (eg band ligation) $80.58
71690 Hemorrhoid(s); office procedure-infrared photocoag $80.58
71691 Hemorrhoid(s); office procedure-infrared photocoag $16.82
07683 Hemorrhoidectomy $268.05
07678 Incision and drainage perianal abscess,superficial $91.43
07679 Incision/drain abscess - ischiorectal, intramural $203.01
71686 Papillectomy - multiple - extra $123.30
71684 Papillectomy - single - extra $67.87
71681 Sphincterotomy with/without fissurectomy $303.07

Anus Repair

07689 Anal dilation under general anaesthetic $152.67
70665 Anoplasty - adult $451.50
07690 Anoplasty for imperforate anus - peads $602.52
70674 Destruction - anal lesion $75.41
70680 Destruction of anal lesion - complicated $252.69
70683 Eua with or without sigmoidoscopy $152.95
07452 Extra-peritoneal rectum +/- colostomy - repair $962.78
70668 Graft - rectal incontinence/prolapse: $203.93
70671 Imbrication - levator muscle $451.50
70672 Implantation - artificial sphincter $1,009.32
70666 Sphincteroplasty - anal - adult $451.50
70670 Sphincteroplasty - anal - incontinence $702.52

Appendix

72658 Appendectomy - laparoscopic $480.30
72659 Appendectomy - laparoscopic - perforated $505.30