S813

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 744 / V4

FEMALE GENITAL SURGICAL PROCEDURES
VAGINA
                                                                                                        Asst          Surg         Anae
# E862         - when performed laparoscopically, to S760, S813 or S761
                 ........................................................................... add 25%
# S724 Perineorrhaphy (not eligible for payment with delivery or other
         vaginal surgery procedures)...............................................                        8         127.35           8
# S725 Colpocleisis (LeFort or modification) ......................................                        8         300.35           8
# S726 Construction of artificial vagina (see General Preamble GP12)                                       6          I.C             6
    Closure of fistula
# S523 Vesicovaginal..........................................................................             6         848.90           6
# S231 Rectovaginal (any repair)........................................................                   6         338.55           6
# S729 Ureterovaginal ........................................................................             6         560.95           6
# S709 Urethrovaginal ........................................................................             6         374.85           6
    Retropubic Urethropexy
# S549 Primary procedure ..................................................................                6         419.75           6
# S546 Repeat procedure for failed retropubic or vaginal surgery for
          stress incontinence.............................................................                 6         532.00           7
# E862    - when performed laparoscopically, to S549 or S546
            ........................................................................... add 25%
# S815 Tension free vaginal tape mid-urethral sling by any method/
          approach ............................................................................ 6 421.65 6
      Payment rules:
      Cystoscopy (Z606) is not eligible for payment with S815 unless the cystoscopy is rendered for
      suspicion of disease.

PDF page 748 / V8

FEMALE GENITAL SURGICAL PROCEDURES
CORPUS UTERI
                                                                                              Asst        Surg          Anae
# S783       - hysterotomy with tubal interruption.....................................        6          257.05         6
# S754 Diagnostic curettage (with or without cauterization, biopsy of
         cervix removal of polyps, or hysterosalpingography) .........                                     97.20          6
# S764 Myomectomy by any technique except hysteroscopic............                             8         406.90          8
    INCISION OR EXCISION
    Hysterectomy - with or without adnexa (unless otherwise specified)
# S757 - abdominal - total or subtotal ...............................................            8       643.35          8
# S816 - vaginal ................................................................................ 8       643.35          8
# S758       - with anterior and posterior vaginal repair and including
               enterocoele and/or vault prolapse repair when rendered...                        8         733.45          8
# S759       - with anterior or posterior vaginal repair and including
               enterocoele and/or vault prolapse repair when rendered...                        8         655.05          8
# E090        - removal of one or both ovaries with moderate or severe
                endometrosis, to S757, S758 or S759 ....................... add                           260.80
# E862        - when hysterectomy is performed laparoscopically, or with
                laparoscopic assistance, abdominal or vaginal, to S757,
                S758, S759 or S816........................................... add 25%
# S710     - with omentectomy for malignancy ......................................                8  820.40 8
# S763     - radical (Wertheim or Schauta) - includes node dissection .                            8 1081.80 8
# S762     - radical trachelectomy - excluding node dissection .............                       8  801.10 8
# E862       - when performed laparoscopically, to S710, S763, S762
               ........................................................................... add 25%
        Note:
        S722, S760, S812, S813, S738, S741, S745, S747, S780, S781 and S782 are not eligible for
        payment when rendered with S757, S816, S758, S759, S710, S763 or S762.
      [Commentary:
      Hysterectomy (S757, S816) for benign conditions should only be performed when less invasive
      treatments have been found to be unsuccessful or are declined by the patient.]
# S776 Staging pelvic lymphadenectomy for carcinoma (laparoscopic
           or open) .............................................................................. 8 462.30 8
# S781 Staging Para-aortic lymphadenectomy for carcinoma
           (laparoscopic or open) (not eligible for payment when
           rendered with Z578 and/or S776).......................................                  8 431.20 8

Master, record 5730. Record Layout PDF, page 1.

S81320260401999999990000515050000001032800000000000000000127680000001276800

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.