E593

PDF page 548 / SP6

SURGICAL PREAMBLE
PREAMBLE
 24. Morbidly obese patients
     E676 is eligible for payment once per patient per physician in addition to the amount eligible for
     payment for the major surgical procedure(s) where a morbidly obese patient undergoes major
     surgery to the neck, thorax, peritoneal cavity, retroperitoneum, pelvis, or hip and:
    a. the patient has a Body Mass Index (BMI) greater than 40
    b. the surgery is rendered under general anaesthesia using either an open technique for the
       neck, thorax, or hip, or an open or laparoscopic technique for the peritoneal cavity, pelvis,
       retroperitoneum; and
    c. the principal surgical technique is neither aspiration, core or fine needle biopsy, dilation,
       endoscopy, mediastinoscopy, thoracoscopy, cautery, ablation nor catheterization.
E676A Morbidly obese patient, surgeon, to procedural fee(s)...... add                      25%
E676B Morbidly obese patient, surgical assistant, to major procedure
        add                                                                               6 units
     Note:
     E676A/B is only payable with the following procedures: D043, D046, D047, D052, E090, E499,
     E500, E505, E546, E589, E593, E626, E627, E655, E664, E673, E686, E697, E704, E706,
     E707, E708, E709, E711, E712, E713, E714, E718, E721, E722, E725, E728, E729, E731,
     E733, E734, E735, E736, E737, E738, E739, E743, E745, E748, E752, E754, E762, E764,
     E765, E766, E767, E768, E769, E771, E794, E796, E852, E853, E854, E855, E857, E860,
     E880, E882, E883, E884, E885, F100, F101, F135, M081, M082, M084, M090, M099, M100,
     M142, M143, M144, P018, P041, P042, P050, P055, P056, P057, P058, P059, P060, R108,
     R109, R216, R241, R269, R330, R423, R439, R440, R443, R470, R481, R488, R491, R553,
     R569, R590, R627, R628, R639, R686, R786, R800, R802, R803, R805, R806, R807, R811,
     R814, R815, R817, R823, R825, R826, R834, R839, R852, R855, R856, R858, R860, R861,
     R910, R885, R905, R913, R914, R915, R932, R933, R934, R935, R936, R937, S089, S090,
     S114, S115, S116, S117, S118, S120, S121, S122, S123, S124, S125, S128, S129, S131,
     S132, S133, S134, S137, S138, S139, S140, S149, S150, S154, S157, S158, S159, S160,
     S162, S164, S165, S166, S167, S168, S169, S170, S171, S172, S173, S175, S176, S177,
     S180, S182, S183, S184, S185, S187, S188, S189, S191, S192, S193, S194, S195, S196,
     S197, S199, S204, S207, S213, S214, S215, S217, S218, S222, S227, S265, S266, S267,
     S269, S270, S271, S274, S275, S276, S278, S280, S281, S282, S285, S287, S291, S292,
     S294, S295, S297, S298, S299, S300, S301, S302, S303, S304, S305, S306, S307, S308,
     S309, S310, S311, S312, S313, S314, S315, S318, S319, S321, S323, S325, S329, S332,
     S340, S342, S343, S344, S345, S405, S411, S416, S420, S422, S424, S427, S431, S432,
     S433, S434, S435, S436, S438, S440, S441, S445, S446, S447, S448, S449, S450, S451,
     S452, S453, S454, S455, S457, S460, S461, S462, S465, S466, S467, S468, S471, S482,
     S483, S488, S490, S491, S512, S513, S546, S549, S561, S590, S650, S651, S652, S710,
     S714, S727, S728, S729, S731, S733, S735, S736, S738, S739, S740, S741, S743, S745,
     S747, S748, S750, S751, S757, S758, S759, S760, S761, S763, S764, S766, S775, S776,
     S778, S780, S781, S782, S784, S788, S789, S790, S792, S793, S795, S798, S799, S800,
     S813, Z427, Z526, Z552, Z553, Z564, Z569, Z577, Z594, Z737, Z738

PDF page 616 / N36

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
PELVIS AND HIP
                                                                                                         Asst         Surg         Anae
    AMPUTATION
# R631 Hemipelvectomy - hindquarter................................................                        10         796.20         15
# R630 Hip disarticulation ...................................................................             10         753.50         10
    ARTHRODESIS
# R469 Sacro-iliac joint .......................................................................            6         395.25          7
# R514 Symphysis pubis.....................................................................                 6         387.00          7
# R470 Hip ..........................................................................................       6         703.45          8
    ARTHROPLASTY
# R439 Unipolar ..................................................................................          6         641.15         10
# R440 Total hip replacement - acetabulum and femur.......................                                  8         708.70         10
# R553 Total hip replacement with take down of fusion ......................                                8         972.90         15
    Revision total arthroplasty hip - one or both components
# R241 - acetabular or femoral .........................................................                    9        1304.80         15
# E589    - bone graft to acetabulum ........................................... add                                  101.25
# E593    - acetabular reconstruction (extensive, including bone
            grafts)......................................................................... add                      194.00
# R481 Reattachment of greater trochanter (late)...............................                             6         290.55          8
    Removal only
# R443 - non-cemented ....................................................................                  6         447.30          8
# R488 - cemented............................................................................               6         557.75          8
# R491 Replacement acetabular liner and/or femoral head................                                     8         532.30         10
    ARTHROSCOPY
# R686 Hip arthroscopy set up, includes when rendered debridement,
         synovectomy, removal of loose body(ies) and/or screw,
         drilling of defect, microfracture, abrasion arthroplasty, and/
         or synovial biopsy...............................................................                  6         669.80         10
# E487 Resection of labrum, to R686 ........................................... add                                   240.00
# E488 Repair of labrum, to R686................................................. add                                 350.00
# E482 Soft tissue capsular release without bone procedure, to R686
          ..................................................................................... add                   251.55
# E490 Osteochondroplasty (extensive bone and arthrofibrotic tissue
         removal requiring a minimum of 2 hours to resect), to R686
          ..................................................................................... add                   500.00
         Payment rules:
         1.E487 is not eligible for payment in addition to E488.
         2.Only one of E482 or E490 is eligible for payment same patient same day.
         3.Osteochondroplasty requiring less than 2 hours is included in R686.

Master, record 1289. Record Layout PDF, page 1.

E59320250401999999990000194000000000000000000000000000000000000000000000000

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.