R380

PDF page 613 / N33

Lateral canthoplasty
# R399 unilateral .................................................................................    6      204.80    6
# E930          - when done in conjunction with another procedure..... add                                    102.35
    Hypertelorism correction
# R376 - intracranial approach* ........................................................              12     2334.85    25
# R377 - subcranial U osteotomies*..................................................                  12     1950.15    25
# R678 - medial orbital wall osteotomies* .........................................                   10     1228.70    20
# R679 - medial and lateral orbital wall osteotomies* .......................                         10     1612.30    20
    Orbital dystopia*
# R391 - intracranial approach..........................................................              12     1950.15    25
# R392 - extracranial approach.........................................................               10     1485.10    20
    Orbital cranial osteotomy*
# R380 - intracranial approach..........................................................              12     1495.50    25
         Note:
         Claims for R380 with N153 rendered for the same patient should be submitted using the
         manual review indicator and accompanied by supporting documentation.
# R381        - extracranial approach.........................................................        10     1121.50    20
    Late correction traumatic enophthalmos
     Tessier Technique - total periorbital stripping and bone grafts.
# R680 - intracranial..........................................................................       12     1997.05    25
# R681 - extracranial.........................................................................        10     1443.95    20
    Harvesting of bone graft when not included
# Z263 Iliac bone graft ........................................................................              102.35
      Rib graft
# Z264 - one rib ................................................................................             154.00
# E975    - each subsequent rib................................................... add                         76.50
      Costochondral or chondral graft
# Z265 - one rib ................................................................................             230.65
# E976     - each subsequent rib................................................... add                       154.00
# Z266 - split cranial graft .................................................................                204.80
      Note:
      * Includes harvesting and grafting of bone or cartilage grafts.

PDF page 753 / X1

Neurologic al Surgical ProceduresJ uly 22, 2026 (effective July 1, 2026)
                                                                               NEUROLOGICAL SURGICAL PROCEDURES
      CRANIAL
                                                                                                                                                             Asst    Surg     Anae
               Z811 Intravenous drug test for pain .................................................                                                                  54.10    6
  # E919                                                                   - intracranial duroplasty (greater than 2 cm diameter) to any
                                                                             intracranial procedure ................................................ add             254.45
  # E921                                                                   - repeat cranial procedure - payable in addition to any open
                                                                             intracranial procedure and N111, N114 and N116 but
                                                                             excluding N127 .......................................................... add           262.15
      BRAIN
      Craniotomy plus excision
        Astrocytoma, oligodendroglioma, glioblastoma or metastatic tumour
  # N103 - supratentorial......................................................................   15                                                                1877.70    15
  # N151 - infratentorial........................................................................ 15                                                                2004.00    15
  # N152 Craniotomy plus lobectomy ....................................................           15                                                                1754.90    15
  # E901    - with operating microscope ......................................... add                                                                                252.40
        Meningioma and other tumourous lesions, including pituitary tumours
  # N102 - supratentorial...................................................................... 15 2004.00 15
  # N153 - infratentorial or basal ..........................................................   15 2817.30 15
  # E901    - with operating microscope ......................................... add               252.40
  # E902    - lesion greater than 2 cm diameter, to N102 or N153 . add                              454.15
  # E903    - team fee for acoustic neuroma, same approach........ add                              614.70
        Note:
        Claims for N200 or R380 with N153 rendered for the same patient should be submitted using
        the manual review indicator and accompanied by supporting documentation.

Master, record 4608. Record Layout PDF, page 1.

R38020260401999999990001495500000001549200000000000000000399000000003990000

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.