Z617

PDF page 723 / T3

UROGENITAL AND URINARY SURGICAL PROCEDURES
 KIDNEY AND UPPER URINARY TRACT
                                                                                                     Asst    Surg     Anae
    PERCUTANEOUS PROCEDURES
# Z629 Percutaneous nephrostomy....................................................                          164.40    6
# Z623 Insertion of stent .....................................................................              101.95
# Z624 Dilatation of tract.....................................................................              105.25
# Z625 Selective catheterization of calyces (one or more) .................                                   55.35
# Z626 Nephroscopy, percutaneous or retrograde .............................                                 102.85    6
# Z627 Removal of renal calculi..........................................................             6      180.35    7
# E759    - if disintegrated by any method, to Z627..................... add                                 102.85
# E772    - percutaneous removal of staghorn calculus filling renal
            pelvis and extending into calyces .............................. add                             188.15
# Z636 Endoscopic ureterotomy or pyelotomy ...................................   293.00                                7
      [Commentary:
      Z636 is eligible for payment when rendered by percutaneous or retrograde route.]
# Z637 Percutaneous ablation of calyceal diverticulum to include
         dilation of communication with calyx and fulguration .........                                      262.75    6
# Z600 Change of nephrostomy tube .................................................                           44.00
       RENAL TRANSPLANTATION PROCEDURES
      Note:
      Submit on recipient’s claim. These fees do not include immunosuppressive therapy which is on
      a fee-for-service basis.
# E762     - reconstruction or repair of renal artery done in addition
             torenal transplantation procedures ............................ add 307.20
# S435 Kidney transplant ....................................................................         9     1585.10    13
# E769   - team fee (not to be billed when assistant fees are billed)
           ................................................................................... add           260.05
# S434 Kidney re-transplant................................................................           9     1896.35    13
# E771   - team fee (not to be billed when assistant fees are billed)
           ................................................................................... add           350.45
# S436 Donor nephrectomy - unilateral or bilateral (to include renal
           perfusion with hypothermia when rendered by surgeon) ...                            7 700.30                8
# E753    - live donor ................................................................... add   430.35
# E792    - when performed laparoscopically, to S436 ........ add 25%
      Note:
      For nephrological components - see Diagnostic and Therapeutic Procedures.
# Z631 Fine needle aspiration of renal transplant...............................                  45.15
    ENDOSCOPIC PROCEDURES
# S470 Cystoscopy with manipulation and/or removal of calculus and
         retrograde pyelogram if required ........................................                           240.65    6
# Z638 Endoscopic treatment of vesicoureteral reflux by subureteral
         injection of agent, unilateral or bilateral..............................                    6      450.00    6
         Note:
         Z606, Z607, Z611, Z617 and Z628 are not eligible for payment with Z638.

PDF page 724 / T4

UROGENITAL AND URINARY SURGICAL PROCEDURES
KIDNEY AND UPPER URINARY TRACT
                                                                                                    Asst         Surg          Anae
    Cystoscopy and diagnostic Ureteroscopy
# Z628 - above intramural................................................................                        125.70          6
# E819   - diagnostic ureteroscopy of second ureter, to Z628 .... add                                             54.65
# E822   - ureteroscopy to upper third of ureter or renal pelvis, to
           Z628........................................................................... add                    39.60
# E760   - with removal of calculus............................................. add                             174.55
# E761   - intracorporeal lithotripsy by any method .................... add                                     100.75
# E820   - with biopsy of one or more sites in ureter and/or pelvis
           using ureteroscope .................................................... add                             53.35
# E823   - resection and fulgarization of one or more ureteral or renal
           pelvic tumours, to Z628.............................................. add                             250.50
      INCISION
    Ureterotomy, abdominal or vaginal exploratory or for drainage
      With removal of calculus
# S445 - upper 2/3 ............................................................................        6         376.80          7
# S446 - lower 1/3.............................................................................        6         482.40          7
      Where ureter has been previously opened
# S447 - upper 2/3 ............................................................................        6         437.20          6
# S448 - lower 1/3.............................................................................        6         522.50          7
      EXCISION
    Ureterectomy
# S449 - including ureterovesical junction ........................................                    6         477.50          7
# S450 - other e.g. partial .................................................................          6         355.60          7
    REPAIR
# S452 Ureteroileal conduit.................................................................           6         844.95          9
# S454 - with ureterectomy and ileal replacement ...........................                           6         957.85          9
# S457 Ureteroureterostomy...............................................................              6         592.05          8
# E792     - when performed laparoscopically, to S457 ........ add 25%
    Re-implantation
# S451 Ureterovesical anastomosis or re-implantation unilateral .......                                6         525.55          8
      Note:
      Not to be billed in addition to S482.
# S561 Re-implantation of ureter with extensive tapering with or
           without ureterolysis.............................................................           6         743.45          8
# S562 Re-implantation of bifid ureter.................................................                6         747.90          8
# E792     - when performed laparoscopically, to S451, S561 or S562
             ........................................................................... add 25%
# Z638 Endoscopic treatment of vesicoureteral reflux by subureteral
         injection of agent, unilateral or bilateral..............................                     6         450.00          6
         Note:
         Z606, Z607, Z611, Z617 and Z628 are not eligible for payment with Z638.

Master, record 7340. Record Layout PDF, page 1.

Z61720260401999999990000038050000000000000000000000000000095760000000957600

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.