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Doctors Gazette 2022

Part lll : Procedures

3. Musculo-Skeletal System

3.1 Bones

 



Specialist

General Practitioner

Anaesthetic

U

R

U

R

U

R          T

3.1.1

Fractures

 

 

 

 

 

 

0383

Fracture (reduction under general anaesthetic): Scapula

112.30

3 185.95

112.30

3 185.95

3

397.68 +T+M

0384

Fracture: Scapula: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

284.2

8 062.75

227.36

6 450.20

3

397.68 +T+M

0386

Fracture: Clavicle: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

209.4

5 940.68

167.52

4 752.54

3

397.68 +T+M

0387

Fracture (reduction under general anaesthetic): Clavicle

93.80

2 661.11

93.80

2 661.11

3

397.68 +T+M

0388

Percutaneous pinning supracondylar fracture elbow - stand alone procedure

175.70

4 984.61

140.56

3 987.69

3

397.68 +T+M

0389

Fracture (reduction under general anaesthetic): Humerus

129.60

3 676.75

129.60

3 676.75

3

397.68 +T+M

0390

Fracture: Humerus: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

255.3

7 242.86

204.24

5 794.29

3

397.68 +T+M

0391

Fracture (reduction under general anaesthetic): Radius and/or Ulna

135.7

3 849.81

120

3 404.40

3

397.68 +T+M

0392

Open reduction of both radius and ulna (Modifier 0051 not applicable)

193.50

5 489.60

154.80

4 391.68

3

397.68 +T+M

0401

Fracture: Carpal bone: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

208.7

5 920.82

166.96

4 736.66

3

397.68 +T+M

0402

Fracture (reduction under general anaesthetic): Carpal bone

64

1 815.68

64

1 815.68

3

397.68 +T+M

0403

Bennett's fracture-dislocation

84.50

2 397.27

84.50

2 397.27

3

397.68 +T+M

0404

Fracture: Bennett fracture/dislocation: Open reduction and internal fixation (modifiers 0051, 0052, 0055 not applicable)

179.80

5 100.93

143.84

4 080.74

3

397.68 +T+M

0405

Fracture reduction under general anaesthetic: Open treatment of Metacarpal: Simple

75.40

2 139.10

75.40

2 139.10

3

397.68 +T+M

0406

Fracture: Metacarpal bone: Open reduction and internal fixation (modifier 0052 not applicable)

163.60

4 641.33

130.88

3 713.07

3

397.68 +T+M

0409

Fracture (reduction under general anaesthetic): Finger phalanx: Distal: Simple

77

2 184.49

77

2 184.49

3

397.68 +T+M

0410

Fracture: Finger phalanx, distal, simple: Open reduction and internal fixation (modifier 0052 not applicable)

141.10

4 003.01

120

3 404.40

3

397.68 +T+M

0413

Fracture (reduction under general anaesthetic): Finger phalanx: Proximal or middle

50.50

1 432.69

50.50

1 432.69

3

397.68 +T

0414

Fracture: Finger phalanx, proximal or middle: Open reduction and internal fixation (modifier 0052 not applicable)

169.90

4 820.06

135.92

3 856.05

3

397.68 +T

0417

Fracture (reduction under general anaesthetic): Pelvis fracture: Closed (modifier 0051 is applicable_

137.20

3 892.36

120

3 404.40

3

397.68 +T

0419

Fracture (reduction under general anaesthetic): Pelvis:Open reduction and internal fixation (modifier 0051 not applicable)

354.49

10 056.88

283.59

8 045.45

3

397.68 +T+M

0420

Fracture: Acetabulum: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

560

15 887.20

448

12 709.76

3

397.68 +T+M

0421

Fracture (reduction under general anaesthetic): Femur: Neck or Shaft

279.10

7 918.07

223.28

6 334.45

3

397.68 +T+M

0422

Fracture: Femur neck or shaft: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

392.3

11 129.55

313.84

8 903.64

3

397.68 +T+M

0425

Fracture (reduction under general anaesthetic) Patella

82.50

2 340.53

82.50

2 340.53

3

397.68 +T+M

0426

Fracture: Patella: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

219.5

6 227.22

175.6

4 981.77

3

397.68 +T+M

0429

Fracture (reduction under general anaesthetic) Tibia with or without Fibula

128

3 631.36

120

3 404.40

3

397.68 +T+M

0430

Fracture: Tibia, with or without fibula: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

293.2

8 318.08

234.56

6 654.47

3

397.68 +T+M

0433

Fracture (reduction under general anaesthetic) Fibula shaft

112.40

3 188.79

112.40

3 188.79

3

397.68 +T+M

0434

Fracture: Fibula shaft: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

207

5 872.59

165.6

4 698.07

3

397.68 +T+M

0435

Fracture (reduction under general anaesthetic): Malleolus of ankle

126.80

3 597.32

120

3 404.40

3

397.68 +T+M

0436

Fracture: Ankle malleolus: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

207.1

5 875.43

165.68

4 700.34

3

397.68 +T+M

0437

Fracture-dislocation of ankle

128

3 631.36

120

3404.40

3

397.68 +T+M

0438

Open reduction Talus fracture (Modifier 0051 not applicable)

311.60

8 840.09

249.28

7 072.07

3

397.68 +T+M

0439

Fracture (reduction under general anaesthetic): Tarsal bones (excluding talus and calcaneus)

76.60

2 173.14

76.60

2 173.14

3

397.68 +T+M

0440

Open reduction: Calcaneus fracture (Modifiers  0051, 0052 not applicable)

403.50

11 447.30

322.5

9 149.33

3

397.68 +T+M

0441

Fracture (reduction under general anaesthetic): Metatarsal

66.80

1 895.12

66.80

1 895.12

3

397.68 +T+M

0442

Fracture: Metatarsal bones: Open reduction with internal fixation (modifiers 0051, 0052 not applicable)

154.7

4 388.84

123.76

3 511.07

3

397.68 +T+M

0443

Fracture (reduction under general anaesthetic): Toe phalanx: Distal: Simple

66.8

1 895.12

66.80

1 895.12

3

397.68 +T

0444

Fracture: Toe phalanx, distal: Open reduction with internal fixation (modifier 0052 not applicable)

144.5

4 099.47

120

3 404.40

3

397.68 +T

0446

Fracture: Tarsal bones (excluding talus and calcaneus): Open reduction with internal fixation (modifiers 0051, 0052 not applicable)

178.2

5 055.53

142.56

4 044.43

3

397.68 +T+M

0447

Fracture (reduction under general anaesthetic): Other: Simple

26

737.62

26

737.62

3

397.68 +T

0448

Fracture: Calcaneus (reduction under general anaesthetic)

103.3

2 930.62

103.3

2 930.62

3

397.68 +T+M

0452

Fracture (reduction under general anaesthetic): Sternum and/or ribs: Open reduction and fixation of multiple fractured ribs for flail chest

230

6 525.10

184

5 220.08

3

397.68  +T+M



 

 

 

 

 

 

3.1.1.1

Operations for fractures

 

 

 

 

 

 

0465

Fractures involving large joints (includes the item for the relative bone). This item may not be used as a modifier

288

8 170.56

230.4

6 536.45

3

397.68 +T+M

0466

Fratures involving digital joints: Includes the metaphysis of the relative bone. Open reduction and internal fixation (modifier 0052 not applicable)

210.90

5 983.23

168.72

4 786.59

3

397.68 +T+M

0473

Percutaneous insertion plus subsequent removal of Kirschner wires or Steinmann pin (Not subject to rite G) (Modifier 0005 not applicable)

43

1 219.91

43

1 219.91

3

397.68 +T    

0475

Bonegrafting or internal fixation for malunion or non-union: Femur, Tibia, Humerus, Radius and Ulna

326.20

9 311.03

262.56

7 448.83

3

397.68 +T+M

0479

Bonegrafting or internal fixation for malunion or non-union: Other bones (not applicable to fingers and toes)

154

4 368.98

123.2

3 495.18

3

397.68 +T+M



 

 

 

 

 

 

3.1.2

Bony operations

 

 

 

 

 

 

3.1.2.1

Bone grafting

 

 

 

 

 

 

0499

Grafts to cysts: Large bones

192

5 447.04

153.6

4 357.63

3

397.68 +T+M

0501

Grafts to cysts: Small bones

128

3 631.36

120

3 404.40

3

397.68 +T+M

0503

Grafts to cysts: Cartilage graft

206

5 844.22

164.8

4 675.38

3

397.68 +T+M

0505

Grafts to cysts: Inter-metacarpal bone graft

147

4 170.39

120

3 404.40

3

397.68 +T+M

0506

Harvesting of graft: Cartilage graft, costochondral

91.1

2 584.51

91.1

2 584.51

6

795.36 +T    

0507

Removal of autogenous bone for grafting (not subject to modifier 0005)

50

1 418.50

50

1 418.50

3

397.68 +T+M



 

 

 

 

 

 

3.1.2.2

Acute/chronic osteomyelitis

 

 

 

 

 

 

0512

Sternum sequestrectomy and drainage: Including FOUR weeks after care

128

3 631.36

120

3 404.40

3

397.68 +T+M



 

 

 

 

 

 

3.1.2.3

Osteotomy

 

 

 

 

 

 

0516

Osteotomy: Pelvic

320

9 078.40

256

7 262.72

3

397.68 +T+M

0521

Osteotomy: Femoral: Proximal (Modifier 0051 is applicable)

320

9 078.40

256

7 262.72

3

397.68 +T+M

0527

Osteotomy: Knee region (Modifier 0051 is applicable)

320

9 078.40

256

7 262.72

3

397.68 +T+M

0528

Osteotomy: Os Calcis (Dwyer operation) (Modifier 0051 is applicable)

115

3 262.55

115

3 262.55

3

397.68 +T+M

0530

Osteotomy: Metacarpal and phalanx: Corrective for mal-union or rotation (Modifier 0051 is applicable)

120

3 404.40

120

3 404.40

3

397.68 +T+M

0531

Rotational osteotomy tibia and fibula - stand alone procedure

278.90

7 912.39

223.12

6 329.91

3

397.68 +T+M

0532

Rotation osteotomy of the Radius. Ulna or Humerus (modifier 0051 is applicable)

160

4 539.20

128

3 631.36

3

397.68 +T+M

0533

Osteotomy single metatarsal (modifier 0051 Is applicable)

60

1 702.20

60

1 702.20

3

397.68 +T+M

0534

Multiple metatarsal osteotomies (modifier 0051 is applicable

150

4 255.50

120

3 404.40

3

397.68 +T+M