S266

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 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.

Master, record 5370. Record Layout PDF, page 1.

S26620260401999999990006023100000003227500000000000000000558600000005586000

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.