E232

PDF page 777 / Y11

Blepharoplasty
# E200 - excision of skin, with or without partial excision of the
          orbicularis oculi muscle - one lid ........................................           82.80 6
# E201 - same as E200 plus removal of orbital fat and/or major lid
          fold reconstruction - one lid ................................................     6 205.55 7
      Note:
      Blepharoplasty is only insured in those circumstances described in the Appendix D - prior
      approval of the Ministry of Health is required.
# E211 Lid lengthening procedure ......................................................      6 288.35 6
# E953    - with scleral graft ......................................................... add    80.90
# E222 Primary closure of full thickness lid defect..............................                 6      290.00      6
# E942    - with cantholysis.......................................................... add                53.20
# E943    - with releasing rotation flap including cantholysis ....... add                                89.45
# E223 Tarsoconjunctival flap and skin graft (Hughes) .......................                     6      484.35      7
# E224 - second stage ......................................................................             108.45      7
# E225 Lower or upper eyelid bridge flap ...........................................              6      484.35      6
# E226 - second stage ......................................................................             108.45      6
# E227 Temporal rotation flap .............................................................       6      514.80      6
# E944   - with free posterior lamellar graft................................. add                       175.15
# E228 Free tarsal, scleral or cartilage graft with local skin
         mobilization ........................................................................    6      535.80      7
# E229 Free composite eyelid graft ....................................................           6      535.80      7
# E230 Medial canthoplasty (skin and muscle)...................................                   6      257.90      6
    Medial canthal tendon
# E231 - tendon repair only...............................................................        6      267.35      7
# E232 - fixation to bone ...................................................................     6      412.05      6
# E233   - when done in conjunction with another procedure..... add                                      153.25
    Lateral canthal surgery
# E234 Canthotomy ............................................................................            51.45
      Note:
      Not to be claimed with E140 or E141.
6

Master, record 1052. Record Layout PDF, page 1.

E23220260401999999990000412050000000774600000000000000000095760000000957600

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.