E793

PDF page 691 / S9

DIGESTIVE SYSTEM SURGICAL PROCEDURES
 OESOPHAGUS
                                                                                                        Asst    Surg     Anae
# E683         - when performed thorascopically, by video-assisted
                 thoracic surgery (VATS), by robotic-assisted surgery, or by
                 uniportal approach, to S087, S089, S090, S093
                 ……................................................................... add 35%.
    REPAIR
# S161 Oesophageal myotomy, partial (below aortic arch)..................                                       584.15
# E758   - with oesophageal hiatus hernia repair ........................add                                    217.35
# S100 Total thoracic oesophageal myotomy (as sole procedure) ......                                            841.35
# E758    - with oesophageal hiatus hernia repair ........................add                                   217.35
# E683    - when performed thorascopically, by video-assisted
            thoracic surgery (VATS), by robotic-assisted surgery, or by
            uniportal approach, to S100, S161 .................. add 35%.
    REPAIR
    Oesophageal hiatus hernia
# S091 - abdominal or transthoracic approach with fundal plication..                                    10      750.00
# S092 - recurrent ..............................................................................       10     1100.00
# S079 - massive paraesophageal ....................................................                    10     1200.00
      Payment rules:
      S079 is only eligible for payment for surgical repair of
             a.a paraesophageal hernia with >50% intrathoracic herniation of the stomach with the
               fundus lying above the gastroesophageal junction, or
             b.a paraesophageal hernia with herniation of the stomach and any other abdominal
               organ(s) through the crus.
# E793         - laparoscopic, thoracoscopic, or laparoscopic/
                 thoracoscopic assisted, to S091, S092, or S079
                  ........................................................................... add 25%
# E744         - with gastroplasty, to either S091, S092, or S079 ........add                                   115.80
# E847         - with reconstruction of diaphragm requiring repair with
                 mesh or equivalent synthetic material, to S091, S092, or
                 S079 ...........................................................................add             75.00
# E742         - when S091, S092, or S079, with or without gastroplasty, is
                 done in conjunction with cholecystectomy, and/or
                 vagotomy with or without drainage procedures, add E742
                 to S091, S092, or S079 (with or without E744) for each
                 additional procedure performed. For any other
                 combination of surgical procedures with oesophageal
                 hiatus hernia repair (with the exception of S161 and S100),
                 see Surgical Preamble SP2 ........................................add                          217.35
# S095 Oesophageal stricture (Thal) - may include oesophageal hiatus
         hernia repair with or without gastroplasty............................                                 676.05
# S096 Ruptured oesophagus, suture and drainage ...........................                              10    1200.00
# S097 Oesophago-gastrostomy for bypass (as sole procedure)........                                             692.65

PDF page 695 / S13

DIGESTIVE SYSTEM SURGICAL PROCEDURES
 STOMACH
                                                                                              Asst   Surg     Anae
    Vagotomy
# S131 - truncal or selective .............................................................    7     375.80    7
# S124 - highly selective (as sole procedure without pyloroplasty or
         gastroenterostomy) ............................................................       7     572.85    7
# S121 Transabdominal vagotomy after previous vagotomy ..............                          7     416.50    8
      Note:
      For suture of duodenal ulcer, refer to S139 on next page.
# S120 Gastric bypass with Roux-en-Y anastomosis, for morbid
           obesity ................................................................................ 7 1350.00 10
# S115 Reversal of previous vertical banded gastroplasty .................                          7  820.00 10
# S114 Sleeve gastrectomy ................................................................          7  820.00 10
      Note:
      1.S114 Sleeve gastrectomy is only eligible for payment when:
          a.a Roux-en-Y gastric bypass is not possible due to small bowel disease/adhesions or
            previous surgery; or
          b.performed as a planned staged surgery in patients with a BMI > 60 to enable the patient
            to lose weight.
      2.S120 is an insured service only when all of the conditions set out in the Surgical Preamble
        are satisfied.
      3.S189 is not eligible for payment in conjunction with S120.
      4.S160 is not eligible for payment in conjunction with S120.
      5.Mini-gastric bypass (loop gastric bypass) does not constitute gastric bypass or partition for
        the purpose of S120.
         [Commentary:
         The second stage would be a gastric bypass with Roux-en-Y.]
# S113 Removal of gastric band ........................................................ 7 341.60               10
      Note:
      S113 is only eligible for payment when the gastric band requires removal due to:
      1.Complications related to the gastric band; or
      2.Conversion to gastric bypass.
# E793        - laparoscopic or laparoscopic assisted, to S113, S114,
                S115 or S120 ..................................................... add 25%
         [Commentary:
         1.S120 does not include the service described as adjustable gastric banding by laparoscopic
           or open surgical method. See section 37.1 of Regulation 552 under the Health Insurance
           Act.
         2.Morbid obesity refers to patients with a Body Mass Index (BMI) > 40.]

PDF page 703 / S21

DIGESTIVE SYSTEM SURGICAL PROCEDURES
 INTESTINES (EXCEPT RECTUM)
                                                                                                          Asst    Surg     Anae
# S173        - abdominal...........................................................................       9     1812.00    10
# S174        - perineal...............................................................................           533.80
# E738     - with continent ileostomy, to either S168, S169, S170,
             S173 or S174 ............................................................. add                       441.10
   E718    - bowel resection following previous resection with
             anastomosis, or following S217, S213, S214 or S215
             ................................................................................... add              162.15
       Note:
       E718 is not to be added to S181, S182, S185, S191, S192 or S193.
# S188 Bowel resection without anastomosis (colostomy and mucous
         fistula).................................................................................         6      877.40    6
# S189 Intestinal bypass for morbid obesity .......................................                        7      951.20    10
# E793    - laparoscopic or laparoscopic assisted, to S189 add 25%
         Note:
         1.S189 is an insured service only when all of the conditions set out in the Surgical Preamble
           are satisfied.
         2.Mini-gastric bypass (loop gastric bypass) does not constitute intestinal bypass for the
           purpose of S189.
    Intestinal obstruction (mechanical)
      One stage
# S175 - without resection ................................................................                6      814.95    7
# S176 - with entero-enterostomy.....................................................                      6     1023.75    7
# S177 - with resection .....................................................................              6     1207.25    7
# S180 - with enterotomy ..................................................................                6      943.60    7
      Note:
      If staged procedure, refer to Surgical Preamble SP2.
# S178 Intestinal atresia (newborn) ....................................................                   6     1722.55    7
# S179 Meconium ileus.......................................................................               6     1722.55    7
       REPAIR

PDF page 711 / S29

Hepatectomy
  # S269 - local excision of lesion (less than 5 cm) .............................                                                    7      350.65    7
  # S275 - partial lobectomy (excision greater than 5 cm)...................                                                          8      585.05    8
  # S270                                  - Hepatectomy, one or two liver segments............................                       12     1426.05    12
  # S267                                  - Hepatectomy, three or four liver segments.........................                       12     1885.55    12
  # S271                                  - Hepatectomy, five or more liver segments .........................                       12     2135.35    12
  # E812                                  - for repeat resection procedures, to S267, S270, S271
                                             ............................................................................. add 25%
  # E814                                  - with portal lymphadenectomy, to S267, S269, S270, S271,
                                            S275, S291................................................................... add                287.65
        Note:
        E814 is only eligible for payment when a formal portal lymphadenectomy has been performed
        and the operative record describes removal of all lymphatic tissue surrounding the common
        bile duct/ hepatic artery and portal vein.
  # S272 Laparotomy, cholangiogram and biopsy (neonatal jaundice) .              6   387.40    7
  # E793     - laparoscopic or laparoscopic assisted, to S267, S269,
               S270, S271, S272 or S275 ................................ add 25%
      Liver transplant
  # E765    - with reconstruction or repair of the hepatic artery (i.e. re-
              anastomosis or conduit), to liver transplant fee ......... add                                                                 342.10
  # S274 Deceased donor, liver removal ...............................................                                                6     1098.25    8
  # S294 Deceased donor, liver transplant ............................................                                                20    3129.95    30
  # S295 Repeat liver transplant............................................................                                          30    4299.90    40
  # S265 Living donor, hepatectomy...................................................... 20 4760.60 35
  # S266 Living donor, orthotopic liver transplant ..................................    25 6023.10 35
        Note:
        Cholecystectomy is not eligible for payment in conjunction with liver lobectomy involving liver
        segments #4 and/or #5, or formal anatomic resection involving liver segments #4 and/or #5.

PDF page 720 / S38

DIGESTIVE SYSTEM SURGICAL PROCEDURES
ABDOMEN, PERITONEUM AND OMENTUM
                                                                                                      Asst         Surg         Anae
    Omphalocele and gastroschisis
# S348 Primary or first stage repair ....................................................                7        1266.60          7
# E691    - requiring mobilization of abdominal wall musculature, to
            S348........................................................................... add                    178.40
# S349 Second or subsequent stage repair........................................                         7        1603.65          7
    Congenital diaphragmatic hernia
# S346 Primary or first stage repair ....................................................                9        1300.55         13
# S347 Second or subsequent stage repair........................................                         9         537.65         13
# E793          - laparoscopic or laparoscopic assisted, to S344. add 25%
# E726          - repeat recurrent inguinal hernia (more than 2 repairs), to
                  S322, S323, S326, S329 or S330.............................. add                       4         257.35
# S342 Epigastric ................................................................................       6         239.20          6
# E727   - hydrocele - extra - applicable to adults only............... add                                         75.05
    SUTURE
# S343 Secondary closure for evisceration - sole operative procedure
         in abdomen.........................................................................             6         350.00          7

Master, record 1488. Record Layout PDF, page 1.

E79320110901999999990000000010000000000000000000000000000000000000000000000

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.