S815

PDF page 730 / T10

# S544 Urethrectomy - radical ............................................................              6         318.35          6
    REPAIR
# S548 Urethral sling...........................................................................        6         409.10          6
# 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 or S548 unless the cystoscopy is
         rendered for suspicion of disease.
    Retropubic urethropexy for stress incontinence
# 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%
      Note:
      See also procedures for stress incontinence in Female Genital Surgical Procedures.
# S539 Insertion of artificial urinary sphincter .....................................                  6         832.65          6
# S540 Revision or removal of artificial urinary sphincter ...................                          6         257.05          7

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.

Master, record 5731. Record Layout PDF, page 1.

S81520260401999999990000421650000000774600000000000000000095760000000957600

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.