R064

PDF page 104 / GP90

SECOND ASSISTANT
Payment rules:
When more than one assistant was required for a surgical procedure, unless the service is listed
below, the second assistant’s service is only eligible for payment following authorization by a medical
consultant and requires submission of a letter from the surgeon outlining the reason the second
assistant was required. The amount payable for the second assistant is calculated in the same
manner as the amount payable for the first assistant.
Services where a second assistant's services are payable and authorization is not required:
D043, D046, D047, D052, D060, E645, F135, M112, M117, M134, M142, N539, N540, P042, P051,
P052, P056, P059, R008, R009, R013, R014, R015, R016, R055, R056, R064, R065, R067, R069,
R134, R135, R136, R140, R182, R240, R241, R244, R326, R327, R334, R393, R438, R440, R441,
R483, R487, R545, R553, R568, R593, R594, R617, R645, R701, R702, R704, R712, R713, R714,
R715, R718, R726, R727, R728, R729, R732, R733, R734, R735, R737, R739, R742, R743, R746,
R747, R749, R764, R770, R771, R772, R773, R774, R786, R799, R800, R801, R802, R803, R804,
R811, R815, R817, R818, R830, R832, R858, R863, R870, R872, R874, R876, R927, R929, R920,
R930, S005, S007, S079, S090, S091, S092, S096, S098, S099, S120, S125, S189, S210, S211,
S213, S214, S267, S270, S271, S274, S275, S294, S295, S298, S300, S321, S416, S429, S440,
S441, S453, S454, S462, S484, S750, S757, S758, S759, S816
       [Commentary:
       E003B is not eligible for payment for second assistant services.]

PDF page 571 / M21

INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
 SKIN AND SUBCUTANEOUS TISSUE
\                                                                                                    Asst    Surg     Anae
       FREE ISLAND FLAPS
         Note:
         When excision of the lesion and preparation of the recipient site are carried out by different
         surgeons, the preparation fees should be reduced by 15%.
# R013 Free jejunum artery and vein for transplantation ....................                         10      338.85    10
# R014 Preparation of microvascular recipient site for free jejunum
          artery and vein....................................................................        10      925.85    10
# R016 Preparation of microvascular recipient site for jejunum artery
          and vein immediately following ablative surgery, and when
          recipient vessels are in site of the ablation.........................                     10      544.95    10
# R015 Transplantation of free jejunum artery and vein with
          microvascular anastomosis ................................................                 10      925.85    10
# R064 Elevation of free island skin and subcutaneous flap and
          closure of defect .................................................................        10      874.60    10
# R065 Preparation of microvascular recipient site for free island skin
          subcutaneous flap ..............................................................           10      925.85    10
# R055 Preparation of microvascular recipient site for free island flap
          and subcutaneous flap immediately following ablative
          surgery and when recipient vessels are in site of the
          ablation...............................................................................    10      544.95    10
# R066 Transplantation of free island skin and subcutaneous flap with
          microvascular anastomosis(es)..........................................                    10      925.85    10
# R067 Elevation of innervated free island skin and subcutaneous flap
          and closure of defect ..........................................................           10     1028.20    10
# R068 Preparation of microvascular recipient site for innervated free
          island skin and subcutaneous flap .....................................                    10     1028.20    10
# R056 Preparation of microvascular recipient site for innervated free
          island skin and subcutaneous flap immediately following
          ablative surgery and when recipient vessels are in the site
          of ablation...........................................................................     10      605.15    10
# R069 Transplantation of innervated free island skin and
          subcutaneous flap with microvascular anastomosis(es) and
          nerve repair ........................................................................      10      961.60    10
# R125 Elevation of free island skin and muscle flap and closure of
          defect..................................................................................   10      874.60    10
# R126 Preparation of microvascular recipient site for free island skin
          and muscle flap ..................................................................          10     925.85    10
# R122 Preparation of microvascular recipient site for free island skin
          and muscle flap immediately following ablative surgery and
          when recipient vessels are in the site of the ablation .........                            10     544.95    10
# R127 Transplantation of free island skin and muscle flap with
          microvascular anastomosis(es)..........................................                     10     874.60    10

PDF page 578 / M28

Post-mastectomy breast reconstruction
  # R119 Breast mound creation by prosthesis as sole procedure........                                         6         350.00          7
  # R118 Breast skin reconstruction by local flaps or grafts, includes
           Wise pattern skin flaps and de-epithelialized skin flaps .....                                      6         405.60          6
  # E529   - with breast mound creation by prosthesis, to R118 ... add                                                   102.45
  # R156 Breast mound creation by insertion of tissue expander,
           includes creation of submuscular pocket ...........................                                 6         425.00          6
  # E513   - breast mound creation by soft tissue, includes flap
             insetting and shaping for autogenous reconstruction, to
             R118, R125, R064, R008 or R155 ............................. add                                            297.50
  # E514   - immediate breast reconstruction following mastectomy, to
             R125, R064, R156, R008, R118, or R155 ................. add                                                 200.00
                                          Note:
                                          1.Z132 is not eligible for payment with R156.
                                          2.E513 is not eligible for payment with E529.
                                          3.E514 is only eligible for payment if post-mastectomy breast reconstruction is performed
                                            immediately following mastectomy during the same anaesthesia.
  # R114 Revision of breast mound .......................................................                     6          230.30          7
  # R120 Nipple-areola reconstruction by grafts and/or flaps ................                                 6          300.00          7
  # R142 Nipple-areola tattooing - unilateral..........................................                       nil        175.00          nil
  # R143 Contralateral balancing mastopexy or reduction, to include
           nipple transplantation or grafting, if rendered.....................                                6         472.15          6
  # R144 Contralateral balancing augmentation mammoplasty.............       6        350.00       6
       Note:
       1.R143 and R144 are only eligible for payment when performed for post-mastectomy breast
         reconstruction. Prior authorization of payment from the Ministry of Health is not required.
                                          2.R110 and R112 are not eligible for payment with R143 or R144.
                                          [Commentary:
                                          1.For reduction or augmentation mammoplasty performed for reasons other than a balancing
                                            procedure related to post-mastectomy breast reconstruction, see R110 and R112
                                            respectively. Prior authorization of payment from the ministry is required.
                                          2.See the applicable service for post-mastectomy breast reconstruction by myocutaneous
                                            flaps or free flaps.]
      Reduction mammoplasty and augmentation mammoplasty (other than post-mastectomy
      breast reconstruction)
  # R110 Reduction mammoplasty (female, to include nipple
            transplantation or grafting, if rendered) - unilateral ............ 6 472.15 7
  # R112 Augmentation mammoplasty - unilateral ................................ 6 350.00 7

Master, record 4321. Record Layout PDF, page 1.

R06420260401999999990000874600000001291000000000000000000159600000001596000

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.