R815

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 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 661 / Q3

CARDIOVASCULAR SURGICAL PROCEDURES
 HEART AND PERICARDIUM
                                                                                                     Asst   Surg     Anae
    Decannulation of circulatory assist device
# Z744 - open ...................................................................................           123.05    6
# Z781 - percutaneous......................................................................                  39.00
      Note:
      1.Includes repair of artery.
      2.R815 not to be claimed in addition to Z744.

PDF page 669 / Q11

Traumatic
# R790 Suture of lacerated major artery .............................................               6     316.85    10
# R795 Repair of lacerated major artery or microscopic repair of digital
         artery (including patch angioplasty)....................................                  10     598.40    10
# R862 - by bypass or interposition graft ..........................................               10     834.30    10
    LIGATION
# R781 Ligation of artery - as sole procedure .....................................                 6     170.10    8
# R788 Internal maxillary artery - Caldwell Luc approach...................                         7     408.10    10
# R789 Anterior ethmoid artery ...........................................................          6     299.85    7
# R708 Internal iliac artery (unilateral or bilateral)...............................               7     409.55    10
EXCISION AND/OR REPAIR
  1. Common femoral artery repair includes repair to the profunda femoris artery as far as the first
     major branch.
    2. If the repair extends beyond the first major branch of the profunda femoris artery, R815 may be
       claimed in addition.
    3. If the repair extends beyond the second major branch of the profunda femoris artery, R856
       instead of R815 may be claimed in addition.
    4. For procedures involving the application of a complete aortic cross clamp, the anaesthetic basic
       fee will depend on:
        a. the level of application of the cross clamp; and
        b. the surgical exposure and extent of the aortic repair
# E679         - with vein graft harvest remote from site of by-pass and
                 only when saphenous vein is unavailable.................. add                            124.10
# E649         - embolectomy and/or thrombectomy when done in
                 conjunction with other vascular procedures............... add                            112.45

PDF page 671 / Q13

CARDIOVASCULAR SURGICAL PROCEDURES
 ARTERIES
                                                                                                    Asst   Surg      Anae
# R875 Endovascular aneurysm repair using stent grafting ................                           10     1563.05    17
     Two Surgeon
# R888 - Endovascular aneurysm repair using stent grafting – first
         surgeon ...............................................................................    10     1172.30    17
# R889 - Endovascular aneurysm repair using stent grafting – second
         surgeon ...............................................................................     nil   1172.30    nil
# E627    - ruptured aneurysm, to R875 or R888 .........................add                          619.25
# E510    - for branched or fenestrated devices, to R875 or R888
             ....................................................................................add 926.85
# E509    - conduit to aorta or common iliac artery, to R875 or R888
             ....................................................................................add 805.65
      Note:
      1.These services include insertion of all catheters including access catheters, interpretation of
        any images which may be taken at the time of the procedures.
         2.E510 is not eligible for payment for branched or fenestrated devices to the common iliac
           artery(s).
         3.E510 is not eligible for payment with E627.
         [Commentary:
         1.Endovascular repair for abdominal aortic aneurysms is only recommended for patients who
           are at high-risk of perioperative morbidity or death from open surgical repair.
         2.For open repair of abdominal aorta aneurysms, see page Q14.]
    Abdominal surgical exposure
# R880 - supraceliac aortic cross clamp ............................................                         -        20
# R881 - infraceliac aortic cross clamp ..............................................                       -        17
# R882 Thoracic surgical exposure......................................................                      -        25
# R883 Thoraco-abdominal surgical exposure ....................................                              -        30
# R815 Arterioplasty with or without patch graft including microvascular
          anastomosis, arterial or venous (other than listed below) ...                             10      581.85    10
    Carotid
# R792 - endarterectomy, with or without bypass graft ......................                        10      982.95    10
# E665    - with patch graft, to R792 .............................................add                      419.00
      Note:
      R815 is not eligible for payment with R792.
# R796        - carotid - carotid body tumor / aneurysm repair....................                  10      950.80    10
    Aortic arch reconstruction
# R830 - innominate...........................................................................      10      910.70    10
# R831 - subclavian ...........................................................................     10      910.70    10
# R832 - vertebral ..............................................................................   10      867.35    10
# E659    - with thoracotomy.........................................................add            6       169.00
# E667    - ruptured ......................................................................add              266.60

Master, record 5036. Record Layout PDF, page 1.

R81520260401999999990000581850000001291000000000000000000159600000001596000

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.