What is an OHIP billing code?

An OHIP billing code is a fee code from the Schedule of Benefits. It identifies the insured service on a physician claim and carries the provider, specialist, assistant, and anaesthetic fees.

Where do APEX billing code fees come from?

Fees are the Ministry of Health Schedule of Benefits amounts used on Ontario physician claims, including provider fee and related role fees when they apply.

OHIP billing codes

Search the OHIP Schedule of Benefits for fee codes with provider, specialist, assistant, anaesthetist, and non-anaesthetist fees.

About OHIP billing codes

All OHIP fee codes in the Schedule of Benefits (April 2026), with fees and billing rules. Search this OHIP code lookup by code, words or service: A007, assessment, phone call.

OHIP billing codes end in a letter for the fee billed: A for the physician, B for an assistant, C for an anaesthetist.

Not sure which code to bill? Try the OHIP billing cheat sheet.

Look up OHIP billing codes by service

The OHIP billing code for common services, from the April 1, 2026 Schedule of Benefits. Each code links to its own page with fees, billing rules and common rejections.

Assessments and consultations

Well baby visit: The OHIP billing code for well-baby care under age 2 is A007A, the family practice intermediate assessment. A007A
Minor assessment: A brief history and exam of the affected part, or brief advice about a health issue. A001A
General assessment: A full history and exam of all body systems, once per patient per 12 months. A003A
Periodic health visit (annual physical): The periodic health visit OHIP billing code depends on age: K130A for 16 and 17, K131A for 18 to 64, K132A for 65 and older. K130A, K131A, K132A
Consultation: OHIP consultation codes for family practice: A005A for a consultation with a written report, A905A for a limited consultation. A005A, A905A
Pelvic exam: A pelvic exam with a speculum in the office is billed as the visit (A001A or A007A) plus the add-on E432A, $5.00. E432A can't be added when cervical screening (E430/E431) is billed that visit. In a general assessment the pelvic exam is part of the assessment, with no add-on. E432A, A007A, A001A, H264A
Palliative care: The main OHIP code for palliative care by a family physician is K023A, palliative care support, $85.25 per half-hour unit (20 minutes or more). The most responsible physician can also bill G512A ($67.75) once a week for palliative case management. Home visits add special visit premiums B998A (or B997A at night) and B966A for travel. K023A, G512A, A945A, B998A, B966A, G511A
Cognitive assessment: The OHIP billing code for a cognitive assessment is K032A, specific neurocognitive assessment, $80.00. It needs at least 20 minutes of testing memory, attention, language, visuospatial and executive function, done personally on one day. The Mini-Mental State Examination alone doesn't qualify. K032A, A007A, K002A, K035A

Counselling and mental health

Counselling: OHIP counselling codes: K013A for individual counselling and K040A for pre-booked group counselling, each per half-hour unit. K013A, K040A
Psychotherapy: The OHIP psychotherapy billing code is K007A, individual psychotherapy per half-hour unit. K007A
Primary mental health care: K005A is a family physician's individual assessment and treatment of mental or emotional problems, per half-hour unit. K005A
Form 1 (Mental Health Act): The OHIP code for Form 1, the application for psychiatric assessment, is K623A. Assessments billed the same day pay nil. K623A
Family meeting: Interview with relatives or the patient's substitute decision-maker, per half-hour unit. K002A
ADHD: There's no single OHIP fee code for ADHD. Bill the visit you provide, usually A007A (intermediate assessment), K005A (primary mental health care) or K013A (counselling) for 20 minutes or more, with diagnostic code 314, attention deficit disorder and ADHD. A007A, K005A, K013A, K008A, K002A
Bipolar disorder: Bill the visit you provide, usually K005A primary mental health care or K007A psychotherapy ($80.00 per half-hour unit) or A007A, with diagnostic code 296 (mood disorders, including bipolar affective disorder). FHO, FHN and other listed models add the tracking code Q020A for enrolled patients to count toward the serious mental illness premium. K005A, K007A, A007A, Q020A
Form 3: The OHIP billing code for a Form 3 is K624A, certification of involuntary admission under the Mental Health Act, $164.50; later re-certifications are K629A ($48.75). Form 3 is completed by the attending physician at the psychiatric facility, who can't be the physician who signed the Form 1, so a family physician bills it only when acting as that attending physician. K624A, K629A

Prevention and screening

Pap test: The OHIP billing code for a Pap test (cervical screening specimen) is G365A, for patients 25 and over. G365A
Flu shot: G590A for the influenza injection. Add G700A, or Q590A for FHO and FHN physicians, when the flu shot is the only reason for the visit. G590A, G700A
Other immunizations: OHIP immunization billing codes: G538A for a vaccine with no code of its own, plus G700A when the shot is the only reason for the visit. G538A, G700A
Smoking cessation: The OHIP code for smoking cessation: E079A for the first discussion, then K039A for up to 2 follow-up visits in 12 months. E079A, K039A
Diabetes management: K030A for a diabetic management assessment. Q040A is the yearly diabetes management incentive after at least three K030 visits. K030A, Q040A
FIT test: Family physicians bill Q150A ($7.00) for counselling a patient on colorectal cancer screening and sending the FIT requisition, and Q152A ($5.00) for reviewing the FIT result and telling the patient, each once every two years. FIT replaced the guaiac FOBT in Ontario's ColonCancerCheck program in 2019; the lab bills the test itself. Q150A, Q152A, Q133A, Q142A
Pneumonia vaccine: The OHIP billing code for the pneumonia (pneumococcal) vaccine is G846A, pneumococcal conjugate, $8.80; add G700A ($8.80) when the vaccine is the only reason for the visit. All of Ontario's publicly funded pneumococcal vaccines are now conjugate vaccines (Pneu-C-15, Pneu-C-20 and Pneu-C-21). G846A, G700A, G538A
RSV vaccine: The OHIP billing code for an RSV vaccine or the infant RSV antibody is G849A, respiratory syncytial virus, $8.80; add G700A ($8.80) when it is the only reason for the visit. The Ministry asks for diagnostic code 489 (RSV) on RSV immunization claims. G849A, G700A
Rotavirus vaccine: The OHIP billing code for the rotavirus vaccine is G462A, administration of oral polio or rotavirus vaccine, $8.80. Add G700A ($8.80) only when vaccines are the only reason for the visit; at a well-baby visit billed as A007A, leave G700A off. G462A, G700A
Shingles vaccine: There is no shingles-specific OHIP code, so bill G538A, other immunizing agents not listed above, $8.80, for each dose. Add G700A ($8.80) when the vaccine is the only reason for the visit. G538A, G700A
STI testing: There is no single OHIP code for STI testing. Bill the visit, usually A007A intermediate assessment, or K028A, the time-based STI management code ($80.00 per half-hour unit) for assessment and counselling of a patient suspected of having an STI; the lab bills for the tests themselves. K028A, A007A, E432A, G489A
Varicella vaccine: The OHIP billing code for the varicella (chickenpox) vaccine is G848A, $8.80. Add G700A ($8.80) when vaccines are the only reason for the visit; when you give it at a visit you bill as an assessment, leave G700A off. G848A, G700A

Procedures in the office

Joint injection: The OHIP billing code for a joint injection or aspiration is G370A, with G371A for each extra joint, up to 5. G370A, G371A
Skin biopsy: Skin or subcutaneous biopsy with no sutures. With sutures, bill Z116A. Z113A
Foreign body removal: Removal of a foreign body under local anaesthetic. Z114A
ECG: Interpretation of a 12-lead ECG with a written report. G313A
Ear wax removal: Ear syringing or curetting, insured for impacted wax with hearing loss or when needed to see the drum. G420A
Injection: Bill G373A ($7.90) for the first intramuscular, subcutaneous or intradermal injection when the injection is the only reason for the visit, and G372A ($4.55) for each extra injection. When you also bill an assessment, every injection is G372A. G700 doesn't apply to G372 or G373; it's for (+) procedures such as vaccines. G373A, G372A, G538A, G700A, G384A
Laceration repair: The OHIP billing code for laceration repair depends on length and complexity: Z176A ($21.90) for a laceration up to 5 cm, or Z154A ($39.35) if it is on the face or needs layered closure or tied bleeders, with longer repairs billed as Z175A/Z177A, Z179A/Z190A or Z191A/Z192A. Add E542A ($12.65) in the office; closure with tissue adhesive pays 50%. Z176A, Z154A, Z175A, Z177A, Z179A, Z190A, Z191A, Z192A, Z187A, Z188A, E542A
Urinalysis: The OHIP billing code for an office urine dipstick is G010A ($2.64), one or more parts of a routine urinalysis without microscopy; with microscopy of a centrifuged specimen, bill G009A ($4.90). Both are payable only when the test is done in your own office for your own patient and the result, interpretation and treatment decision are charted. G010A, G009A

Virtual care

Comprehensive virtual care: OHIP virtual care billing codes for existing patients: bill the visit code with K300A for video or K301A for phone. Phone pays 85% of the in-person fee. K300A, K301A
Limited virtual care: A101A by video and A102A by phone, for patients with no existing relationship with the physician. A101A, A102A
Telephone consultation: The OHIP code for a telephone consultation with another physician is K730A for the referring physician, at least 10 minutes. K730A
E-consultation: K738A when you send a secure electronic request for a specialist's opinion. K738A
Phone visit: For a patient you already have a relationship with, bill the usual visit code (for example A007A) with the telephone indicator K301A; OHIP pays 85% of the in-person fee (95% for K005, K007, K197 and K198). For a patient with no relationship, bill A102A, limited virtual care by telephone, $15.00. K301A, A007A, A001A, K005A, A102A

Premiums

After-hours premium: The OHIP after hours premium for enrolled patients seen in scheduled evening, weekend or holiday sessions. It rose from 30% to 50% for FHO physicians on April 1, 2026 (INFOBulletin 260308). Q012A
Special visit premium: OHIP special visit premiums pay extra for non-elective calls. B990A is the home special visit premium on a weekday daytime call. B990A
Holiday billing: OHIP holiday codes: on statutory holidays, special visit premiums and the Q012A after-hours premium apply to eligible visits. Q012A, B990A
Chronic disease premium: E078A adds 50% to an eligible specialist assessment for a chronic disease on the GP26 diagnostic list. E078A

FHO+ and roster

FHO+ hourly billing: FHO+ billing codes for time, in 15-minute units: Q310A direct care, Q311A phone care away from the clinic, Q312A indirect care, Q313A clinical administration. Q310A, Q311A, Q312A, Q313A
Roster code: The OHIP roster code Q200A tells the Ministry a patient enrolled with you. The service date is the date on the signed enrolment form. Q200A
Q codes: Q codes are OHIP's primary care premium, incentive and roster codes, such as Q012A, Q040A, Q200A and the FHO+ hourly codes. Q012A, Q040A, Q200A

Forms and uninsured services

Disability tax credit form: There is no OHIP billing code for the Disability Tax Credit Certificate (CRA form T2201). Completing it is an uninsured service, so you bill the patient directly, not OHIP. The OMA suggests charging your hourly rate, with a suggested minimum of $150.
Home care referral: The OHIP billing code for a home care (CCAC) referral is K070A, completion of the home care referral form, $34.75, paid in addition to the visit. CCAC is now Ontario Health atHome. Advice to home care staff afterwards is K071A (first 8 weeks) or K072A (after that), $21.95 each. K070A, K071A, K072A
ODSP forms: ODSP forms aren't OHIP-insured services, but you still claim them through OHIP: the Ministry of Health pays the Appendix F codes on behalf of the Ministry of Children, Community and Social Services. For an initial ODSP application, bill K050A ($116.15) for the Health Status Report and Activities of Daily Living Index together, or K051A ($92.90) or K052A ($23.20) when only one is completed. K050A, K051A, K052A, K057A, K058A, K059A, K060A, K054A, K055A, K056A

H409 and H410 were sessional codes for COVID-19 assessment centres (H409 weekday daytime; H410 evenings, nights, weekends and holidays), billed under the centre's group number. They are not in the April 1, 2026 Schedule of Benefits.

All OHIP billing codes by service

OHIP billing codes with a guide

A001A: Minor Assessment — $26.80
A002A: 18 month Developmental Assessment — $73.95
A003A: General Assessment with diagnosis other than 917, all ages — $95.60
A004A: General Reassessment — $39.35
A005A: Consultation family practice & practice in general — $95.60
A006A: Repeat Consultation — $47.10
A007A: Intermediate Assessment — $44.55
A008A: Mini Assessment - Billed with WSIB minor Assessment — $13.40
A020A: Complex Dermatology Assessment — $60.00
A021A: Advanced Dermatology Consultation — $164.90
A023A: Dermatology specific assessment — $46.15
A024A: Dermatology partial assessment — $23.50
A025A: Dermatology consultation — $77.50
A026A: Dermatology repeat consultation — $47.75
A027A: Dermatology consultation with special visit (in-patient, LTC or ED) — $158.15
A033A: Specific Assessment — $56.40
A034A: Partial Assessment — $34.10
A035A: Consultation — $114.75
A036A: Repeat Consultation — $76.45
A063A: Orthopaedic surgery specific assessment — $45.55
A064A: Orthopaedic surgery partial assessment — $25.95
A065A: Orthopaedic surgery consultation — $89.80
A066A: Orthopaedic surgery repeat consultation — $55.35
A070A: Consultation In Association With Special Visit To A Hospital In-patient, Long-term Care In-patient Or Emergency Department Patient — $255.85
A071A: Geriatric complex medical specific re-assessment — $103.80
A073A: Geriatric medical specific assessment — $99.05
A074A: Geriatric medical specific re-assessment — $79.85
A075A: Geriatric consultation — $223.30
A076A: Geriatric repeat consultation — $113.35
A078A: Geriatric partial assessment — $49.65
A083A: Specific assessment – plastic surgery — $54.40
A084A: Partial assessment – plastic surgery — $34.75
A085A: Consultation — $106.25
A086A: Repeat Consultation — $62.80
A100A: Family Physician ER Department Assessment — $78.95
A101A: Limited Virtual Care by Video — $20.00
A102A: Limited Virtual Care by Telephone — $15.00
A112A: Periodic Oculo-visual Assessment - Aged 65 Years And Above — $48.90
A113A: Complex Neurological Assessment — $120.00
A115A: Major Eye Examination — $53.60
A118A: Critical care medicine partial assessment — $44.75
A120A: Colonoscopy Assessment, Same Day As Colonoscopy — $18.85
A130A: Comprehensive Internal Medicine Consultation — $342.25
A131A: Internal medicine complex medical specific re-assessment — $83.40
A133A: Internal medicine medical specific assessment — $95.95
A134A: Internal medicine medical specific re-assessment — $72.00
A135A: Internal medicine consultation — $192.85
A136A: Internal medicine repeat consultation — $123.10
A138A: Internal medicine partial assessment — $44.75
A150A: Comprehensive Endocrinology Consultation — $342.25
A151A: Complex Medical Specific Re-assessment — $83.40
A153A: Medical Specific Assessment — $95.95
A154A: Medical Specific Re-assessment — $72.00
A155A: Consultation — $172.95
A156A: Repeat Consultation — $110.15
A158A: Partial Assessment — $44.75
A160A: Comprehensive Nephrology Consultation — $342.25
A161A: Nephrology complex medical specific re-assessment — $83.40
A163A: Nephrology medical specific assessment — $95.95
A164A: Medical Specific Re-assessment — $72.00
A165A: Nephrology consultation — $180.75
A166A: Nephrology repeat consultation — $116.75
A168A: Partial Assessment — $44.75
A173A: Vascular surgery specific assessment — $49.30
A174A: Vascular surgery partial assessment — $26.75
A175A: Vascular surgery consultation — $125.15
A176A: Vascular surgery repeat consultation — $66.60
A180A: Special Neurology Consultation — $342.25
A181A: Complex Medical Specific Re-assessment — $75.20
A183A: Medical Specific Assessment — $82.40
A184A: Medical Specific Re-assessment — $64.95
A185A: Neurology consultation — $225.55
A186A: Neurology repeat consultation — $125.50
A188A: Partial assessment (neurology) — $39.40
A190A: Special Psychiatric Consultation — $342.25
A191A: Consultative interview – caregiver of patient 65+ or with dementia — $271.35
A192A: Consultative interview – patient 65+ or with dementia — $271.35
A193A: Specific assessment – psychiatry — $98.70
A194A: Partial assessment – psychiatry — $47.05
A195A: Consultation — $254.30
A196A: Repeat Consultation — $120.30
A197A: Consultative Interview On Behalf Of Disturbed Patient (including Report) - Consultative Interview With Parent(s) Or Patient Representative(s) Of Patient Less Than Age 22 — $271.35
A198A: Consultative Interview On Behalf Of Disturbed Patient (including Report) - Consultative Interview With Patient Less Than Age 22 — $271.35
A199A: Initiation of rTMS for treatment-resistant depression — $159.80
A203A: Obstetrics and gynaecology specific assessment — $62.65
A204A: Obstetrics and gynaecology partial assessment — $40.50
A205A: Obstetrics and gynaecology consultation — $134.25
A206A: Obstetrics and gynaecology repeat consultation — $71.45
A226A: Repeat Consultation — $119.40
A230A: Orthoptic Assessment — $26.20
A231A: Neuro-ophthalmology consultation — $155.45
A233A: Ophthalmology specific assessment — $60.50
A234A: Ophthalmology partial assessment — $31.95
A235A: Ophthalmology consultation — $86.25
A236A: Ophthalmology repeat consultation — $48.00
A237A: Periodic Oculo-visual Assessment - Aged 19 Years And Below — $59.35
A239A: Periodic Oculo-visual Assessment - Aged 65 Years And Above — $59.35
A241A: $155.45
A243A: Otolaryngology specific assessment — $44.75
A244A: Otolaryngology partial assessment — $30.45
A245A: Otolaryngology consultation — $92.70
A246A: Otolaryngology repeat consultation — $53.65
A250A: Retinopathy of prematurity (ROP) assessment — $125.80
A251A: Special ophthalmologic assessment — $125.80
A252A: Initial vision rehabilitation assessment — $251.65
A253A: Optometrist-requested Assessment (ora) — $86.25
A254A: Follow-up Vision Rehabilitation Assessment — $125.80
A255A: Endocrinology limited consultation — $110.15
A256A: Special Optometrist-requested Assessment — $194.65
A260A: Special paediatric consultation — $342.25
A261A: Level 1 - Paediatric Assessment — $24.85
A262A: Level 2 - Paediatric Assessment — $50.20
A263A: Medical Specific Assessment — $95.75
A264A: Medical Specific Re-assessment — $70.75
A265A: Consultation — $190.35
A266A: Repeat Consultation — $104.70
A268A: Enhanced 18 Month Well Baby Visit (see General Preamble Gp34) — $74.25
A310A: Physical medicine and rehabilitation medical specific re-assessment — $75.90
A311A: Physical medicine and rehabilitation complex medical specific re-assessment — $82.75
A313A: Physical medicine and rehabilitation medical specific assessment — $86.40
A315A: Physical medicine and rehabilitation consultation — $220.80
A316A: Physical medicine and rehabilitation repeat consultation — $106.60
A318A: Physical medicine and rehabilitation partial assessment — $44.45
A353A: Urology specific assessment — $51.45
A354A: Urology partial assessment — $30.60
A355A: Urology consultation — $93.15
A356A: Urology repeat consultation — $64.90
A375A: Geriatric limited consultation — $113.35
A384A: Consultation And Management For Acute Cerebral Vascular Syndrome (acvs) — $275.95
A385A: Neurology limited consultation — $125.50
A395A: Limited consultation – psychiatry — $120.30
A411A: Complex Medical Specific Re-assessment — $83.40
A413A: Medical Specific Assessment — $95.95
A414A: Medical Specific Re-assessment — $72.00
A415A: Gastroenterology consultation — $159.45
A416A: Gastroenterology repeat consultation — $106.90
A418A: Gastroenterology partial assessment — $44.75
A425A: Comprehensive Physical Medicine And Rehabilitation Consultation — $342.25
A435A: Internal medicine limited consultation — $123.10
A470A: Comprehensive Respiratory Disease Consultation — $342.25
A471A: Respiratory complex medical specific re-assessment — $89.40
A473A: Respiratory medical specific assessment — $102.60
A474A: Respiratory medical specific re-assessment — $75.30
A475A: Respiratory disease consultation — $192.30
A476A: Respiratory disease repeat consultation — $119.35
A478A: Respiratory disease partial assessment — $45.25
A480A: Complex Rheumatology Assessment — $113.85
A481A: Rheumatology complex medical specific re-assessment — $83.40
A483A: Rheumatology medical specific assessment — $95.95
A484A: Rheumatology medical specific re-assessment — $72.00
A485A: Rheumatology consultation — $202.40
A486A: Rheumatology repeat consultation — $125.10
A488A: Rheumatology partial assessment — $44.75
A510A: Complex Neuromuscular Assessment — $104.85
A511A: Complex Physiatry Assessment — $114.80
A515A: Physical medicine and rehabilitation limited consultation — $106.60
A545A: Gastroenterology limited consultation — $106.90
A570A: Complex Respiratory Assessment — $108.95
A575A: Respiratory disease limited consultation — $119.35
A590A: Comprehensive Rheumatology Consultation — $342.25
A595A: Rheumatology limited consultation — $124.50
A600A: Comprehensive Cardiology Consultation — $342.25
A601A: Cardiology complex medical specific re-assessment — $84.10
A603A: Cardiology medical specific assessment — $96.70
A604A: Cardiology medical specific re-assessment — $72.65
A605A: Cardiology consultation — $188.45
A606A: Cardiology repeat consultation — $105.25
A608A: Cardiology partial assessment — $49.80
A621A: Complex Medical Specific Re-assessment — $83.40
A623A: Medical Specific Assessment — $95.95
A624A: Medical Specific Re-assessment — $72.00
A625A: Consultation — $160.30
A626A: Repeat Consultation — $105.25
A628A: Partial Assessment — $44.75
A661A: Complex Medical Specific Re-assessment — $86.35
A662A: Extended Special Paediatric Consultation — $442.40
A665A: Paediatric prenatal consultation — $105.50
A667A: Paediatric neurodevelopmental consultation — $456.80
A675A: Cardiology limited consultation — $105.25
A680A: Initial Assessment - Substance Abuse — $164.95
A682A: Extended Special Neurology Consultation — $442.40
A695A: Neurodevelopmental Consultation — $456.80
A760A: Complex Endocrine Neoplastic Disease Assessment — $102.95
A770A: Extended Comprehensive Geriatric Consultation — $442.40
A771A: Certification of death (Completion of death certificate alone) — $24.20
A775A: Comprehensive Geriatric Consultation — $342.25
A777A: Pronouncement of Death other than patient's home (incl. Death Certificate) — $44.55
A795A: Geriatric Psychiatric Consultation — $342.25
A865A: Nephrology limited consultation — $116.75
A888A: Emergency Department Equivalent — $44.55
A895A: Consultation In Association With Special Visit To A Hospital In-patient, Long-term Care In-patient Or Emergency Department Patient — $297.00
A900A: Complex House call Assessment — $64.80
A902A: Pronouncement of Death in the home (incl. Death Certificate) — $64.80
A905A: Limited consultation — $80.15
A920A: Medical Management Of Early Pregnancy Initial Service — $193.70
A921A: Medical Management Of Early Or Ectopic Pregnancy Followup Visit — $44.55
A922A: Medical Management Of Ectopic Pregnancy Initial Service — $249.75
A930A: Uveitis and ocular inflammatory disease consultation — $157.00
A931A: $157.00
A933A: On-call Admission Assessment — $82.00
A935A: Special Surgical Consultation (see General Preamble Gp19) — $194.65
A945A: Special Palliative Care Consultation (office, home, OPD) — $174.25
A957A: Addiction Medicine - focused practice assessment — $44.55
A960A: Weekday daytime office travel premium — $37.40
A990A: Weekday daytime office special visit premium, first patient — $20.55
A994A: Weekday evening office special visit premium, first patient — $61.70
A998A: Weekend/holiday office special visit premium, first patient — $77.10
B960A: Weekday daytime or elective home travel premium — $37.40
B961A: Home visit travel premium – weekday daytime, sacrifice of office hours — $37.40
B962A: Weekday evening home travel premium — $37.40
B963A: Home visit travel premium – weekend or holiday — $37.40
B964A: Home visit travel premium – night — $37.40
B966A: Palliative care home visit travel premium — $37.40
B986A: Geriatric home visit – travel premium — $37.40
B987A: Geriatric home visit – first person seen – night — $113.10
B988A: Geriatric home visit – first person seen (day, evening, weekend) — $91.80
B990A: Weekday daytime or elective home special visit premium, first patient — $28.25
B992A: Home visit first person seen – weekday daytime, sacrifice of office hours — $45.25
B993A: Home special visit premium – first person seen – weekend or holiday daytime and evening — $84.80
B994A: Weekday evening home special visit premium, first patient — $67.85
B996A: Home special visit premium – first person seen – night — $113.10
B997A: First Person Seen - Nights (00:00 - 07:00) , Palliative Care Home Visit — $113.10
B998A: Palliative home special visit premium, first patient (not nights) — $91.80
C002A: Hospital subsequent visit – first five weeks — $40.05
C003A: General Assessment — $89.65
C004A: General Re-assessment — $38.35
C005A: Hospital in-patient consultation (family practice) — $95.60
C007A: Hospital subsequent visit – weeks 6 to 13 — $40.05
C008A: Hospital concurrent care visit — $40.05
C009A: Hospital subsequent visit – after week 13 — $40.05
C010A: Hospital supportive care visit — $40.05
C020A: Complex dermatology assessment — hospital in-patient — $60.00
C022A: Dermatology hospital subsequent visit — first five weeks — $40.05
C023A: Dermatology in-patient specific assessment — $46.15
C024A: Dermatology in-patient specific re-assessment — $27.25
C025A: Dermatology in-patient consultation — $158.15
C026A: Dermatology in-patient repeat consultation — $47.75
C027A: Dermatology hospital subsequent visit — weeks 6 to 13 — $40.05
C028A: Dermatology concurrent care visit — $40.05
C029A: Dermatology hospital subsequent visit — after week 13 — $40.05
C032A: General surgery in-patient subsequent visit – first five weeks — $34.10
C033A: Specific Assessment — $56.40
C034A: Specific Re-assessment — $36.75
C035A: Consultation — $114.75
C036A: Repeat Consultation — $76.45
C037A: General surgery in-patient subsequent visit – weeks 6 to 13 — $34.10
C038A: Concurrent Care - Per Visit — $34.10
C039A: General surgery in-patient subsequent visit – after week 13 — $34.10
C062A: Orthopaedic in-patient subsequent visit – first 5 weeks — $31.00
C063A: Orthopaedic surgery in-patient specific assessment — $45.55
C064A: Orthopaedic surgery in-patient specific re-assessment — $27.30
C065A: Orthopaedic surgery in-patient consultation — $89.80
C066A: Orthopaedic surgery in-patient repeat consultation — $55.35
C067A: Orthopaedic in-patient subsequent visit – weeks 6 to 13 — $31.00
C068A: Orthopaedic in-patient concurrent care visit — $31.00
C069A: Orthopaedic in-patient subsequent visit – after week 13 — $31.00
C071A: Geriatric in-patient complex medical specific re-assessment — $103.80
C072A: Geriatric in-patient subsequent visit – first 5 weeks — $40.05
C073A: Geriatric in-patient medical specific assessment — $99.05
C074A: Geriatric in-patient medical specific re-assessment — $79.85
C075A: Geriatric in-patient consultation — $255.85
C076A: Geriatric in-patient repeat consultation — $113.35
C077A: Geriatric in-patient subsequent visit – weeks 6 to 13 — $40.05
C078A: Geriatric in-patient concurrent care — $40.05
C079A: Geriatric in-patient subsequent visit – after week 13 — $40.05
C082A: Subsequent hospital visit – plastic surgery, first five weeks — $31.00
C083A: In-patient specific assessment – plastic surgery — $54.40
C084A: In-patient specific re-assessment – plastic surgery — $34.90
C085A: In-patient consultation – plastic surgery — $106.25
C086A: In-patient repeat consultation – plastic surgery — $62.80
C087A: Subsequent hospital visit – plastic surgery, sixth to thirteenth week — $31.00
C088A: Concurrent care – plastic surgery — $31.00
C089A: Subsequent hospital visit – plastic surgery, after the thirteenth week — $31.00
C101A: Intensive Or Coronary Care Unit Premium — $9.10
C113A: Complex Neurological Assessment - Subject To The Same Conditions As A113 — $120.00
C121A: Hospital visit for acute intercurrent illness — $40.05
C122A: MRP subsequent visit, day after admission assessment — $71.80
C123A: MRP subsequent visit, second day after admission — $71.80
C124A: MRP hospital visit – day of discharge — $71.80
C126A: MRP hospital visit – day of discharge, medically complex patient — $95.10
C130A: Comprehensive Internal Medicine Consultation — $342.25
C131A: Internal medicine complex medical specific re-assessment – hospital in-patient — $83.40
C132A: Internal medicine in-patient subsequent visit – first 5 weeks — $40.05
C133A: Internal medicine in-patient medical specific assessment — $95.95
C134A: Internal medicine in-patient medical specific re-assessment — $72.00
C135A: Internal medicine in-patient consultation — $192.85
C136A: Internal medicine in-patient repeat consultation — $123.10
C137A: Internal medicine in-patient subsequent visit – weeks 6 to 13 — $40.05
C138A: Internal medicine in-patient concurrent care — $40.05
C139A: Internal medicine in-patient subsequent visit – after week 13 — $40.05
C142A: Subsequent Visit By The Mrp, To Subsequent Visits And C122, C123, C124, C142, C143, C882 Or C982. Add 30% — $71.80
C143A: Subsequent Visit By The Mrp, To Subsequent Visits And C122, C123, C124, C142, C143, C882 Or C982. Add 30% — $71.80
C150A: Comprehensive Endocrinology Consultation - Subject To The Same Conditions As A150 — $342.25
C151A: Endocrinology complex medical specific re-assessment – hospital in-patient — $83.40
C152A: Endocrinology subsequent hospital visit – first five weeks — $40.05
C153A: Endocrinology medical specific assessment – hospital in-patient — $95.95
C154A: Endocrinology medical specific re-assessment – hospital in-patient — $72.00
C155A: Endocrinology consultation – hospital in-patient — $172.95
C156A: Endocrinology repeat consultation – hospital in-patient — $110.15
C157A: Endocrinology subsequent hospital visit – weeks 6 to 13 — $40.05
C158A: Concurrent Care — $40.05
C159A: Endocrinology subsequent hospital visit – after week 13 — $40.05
C160A: Comprehensive nephrology consultation – hospital in-patient — $342.25
C161A: Nephrology complex medical specific re-assessment – hospital in-patient — $83.40
C162A: Nephrology hospital subsequent visit – first five weeks — $40.05
C163A: Nephrology medical specific assessment – hospital in-patient — $95.95
C164A: Nephrology medical specific re-assessment – hospital in-patient — $72.00
C165A: Nephrology consultation – hospital in-patient — $180.75
C166A: Nephrology repeat consultation – hospital in-patient — $116.75
C167A: Nephrology hospital subsequent visit – weeks 6 to 13 — $40.05
C168A: Nephrology concurrent care – hospital in-patient — $40.05
C169A: Nephrology hospital subsequent visit – after week 13 — $40.05
C180A: Special Neurology Consultation - Subject To The Same Conditions As A180 — $342.25
C181A: Complex Medical Specific Re-assessment — $75.20
C182A: Hospital subsequent visit – first five weeks (neurology) — $40.05
C183A: Medical Specific Assessment — $82.40
C184A: Medical Specific Re-assessment — $64.95
C185A: Neurology consultation – hospital in-patient — $225.55
C187A: Hospital subsequent visit – weeks 6 to 13 (neurology) — $40.05
C188A: Concurrent Care - Per Visit — $40.05
C189A: Hospital subsequent visit – after week 13 (neurology) — $40.05
C190A: Special psychiatric consultation – hospital in-patient — $342.25
C192A: Psychiatry subsequent visit – weeks 1 to 5 — $40.05
C193A: Psychiatry specific assessment – hospital in-patient — $98.70
C194A: Psychiatry specific re-assessment – hospital in-patient — $75.70
C196A: Psychiatry repeat consultation – hospital in-patient — $120.30
C197A: Psychiatry subsequent visit – weeks 6 to 13 — $40.05
C198A: Psychiatry concurrent care visit — $40.05
C199A: Psychiatry subsequent visit – after week 13 — $40.05
C202A: Obstetrics and gynaecology subsequent hospital visit – first five weeks — $31.00
C203A: Obstetrics and gynaecology specific assessment – hospital in-patient — $62.65
C204A: Obstetrics and gynaecology specific re-assessment – hospital in-patient — $44.30
C205A: Obstetrics and gynaecology consultation – hospital in-patient — $134.25
C206A: Obstetrics and gynaecology repeat consultation – hospital in-patient — $71.45
C207A: Obstetrics and gynaecology subsequent hospital visit – weeks 6 to 13 — $31.00
C208A: Obstetrics and gynaecology concurrent care – hospital in-patient — $31.00
C209A: Obstetrics and gynaecology subsequent hospital visit – after week 13 — $31.00
C231A: Neuro-ophthalmology consultation – hospital in-patient — $155.45
C232A: Ophthalmology subsequent hospital visit – first five weeks — $31.00
C233A: Ophthalmology specific assessment – hospital in-patient — $60.50
C234A: Ophthalmology specific re-assessment – hospital in-patient — $30.75
C235A: Ophthalmology consultation – hospital in-patient — $85.95
C236A: Ophthalmology repeat consultation – hospital in-patient — $48.00
C237A: Ophthalmology subsequent hospital visit – weeks 6 to 13 — $31.00
C238A: Ophthalmology concurrent care visit — $31.00
C239A: Ophthalmology subsequent hospital visit – after week 13 — $31.00
C242A: Otolaryngology in-patient subsequent visit – first 5 weeks — $31.00
C243A: Otolaryngology in-patient specific assessment — $44.75
C244A: Otolaryngology in-patient specific re-assessment — $31.00
C245A: Otolaryngology in-patient consultation — $92.70
C246A: Otolaryngology in-patient repeat consultation — $53.65
C247A: Otolaryngology in-patient subsequent visit – weeks 6 to 13 — $31.00
C248A: Otolaryngology concurrent care (in-patient) — $31.00
C249A: Otolaryngology in-patient subsequent visit – after week 13 — $31.00
C250A: Retinopathy of prematurity assessment – hospital in-patient — $125.80
C255A: Endocrinology limited consultation – hospital in-patient — $110.15
C260A: Special paediatric consultation – hospital in-patient — $342.25
C262A: Paediatric subsequent hospital visit — $40.05
C263A: Paediatric in-patient medical specific assessment — $95.75
C264A: Paediatric medical specific re-assessment – hospital in-patient — $70.75
C265A: Paediatric consultation – hospital in-patient — $190.35
C266A: Paediatric repeat consultation – hospital in-patient — $104.70
C268A: Paediatric concurrent care – hospital in-patient — $40.05
C311A: Physiatry complex medical specific re-assessment – hospital in-patient — $82.75
C312A: Physiatry subsequent hospital visit – first five weeks — $40.05
C313A: Physical medicine and rehabilitation medical specific assessment – hospital in-patient — $86.40
C315A: Physical medicine and rehabilitation consultation – hospital in-patient — $233.65
C316A: Physical medicine and rehabilitation repeat consultation – hospital in-patient — $106.60
C317A: Physiatry subsequent hospital visit – weeks 6 to 13 — $40.05
C318A: Physiatry concurrent care – hospital in-patient — $40.05
C319A: Physiatry subsequent hospital visit – after week 13 — $40.05
C352A: Urology subsequent hospital visit – first five weeks — $31.60
C353A: Urology specific assessment – hospital in-patient — $51.45
C354A: Urology specific re-assessment – hospital in-patient — $29.35
C355A: Urology consultation – hospital in-patient — $93.15
C356A: Urology repeat consultation – hospital in-patient — $64.90
C357A: Urology subsequent hospital visit – weeks 6 to 13 — $31.60
C358A: Urology concurrent care visit – hospital in-patient — $31.60
C359A: Urology subsequent hospital visit – after week 13 — $31.60
C384A: Consultation And Management For Acvs — $275.95
C395A: Psychiatry limited consultation – hospital in-patient — $120.30
C411A: Gastroenterology in-patient complex medical specific re-assessment — $83.40
C412A: Gastroenterology hospital subsequent visit – first five weeks — $40.05
C413A: Gastroenterology in-patient medical specific assessment — $95.95
C414A: Medical Specific Re-assessment — $72.00
C415A: Gastroenterology in-patient consultation — $159.45
C416A: Gastroenterology in-patient repeat consultation — $106.90
C417A: Gastroenterology hospital subsequent visit – weeks 6 to 13 — $40.05
C418A: Gastroenterology concurrent care visit — $40.05
C419A: Gastroenterology hospital subsequent visit – after week 13 — $40.05
C425A: Comprehensive physiatry consultation – hospital in-patient — $342.25
C435A: Internal medicine in-patient limited consultation — $123.10
C470A: Comprehensive respiratory disease consultation – hospital in-patient — $342.25
C471A: Respiratory complex medical specific re-assessment – hospital in-patient — $86.40
C472A: Respiratory subsequent visit – weeks 1 to 5 — $40.05
C473A: Respiratory medical specific assessment – hospital in-patient — $99.15
C474A: Respiratory medical specific re-assessment – hospital in-patient — $72.80
C475A: Respiratory disease consultation – hospital in-patient — $185.80
C476A: Respiratory disease repeat consultation – hospital in-patient — $115.30
C477A: Respiratory subsequent visit – weeks 6 to 13 — $40.05
C478A: Respiratory concurrent care visit — $40.05
C479A: Respiratory subsequent visit – after week 13 — $40.05
C480A: Complex rheumatology assessment – hospital in-patient — $112.00
C481A: Rheumatology complex medical specific re-assessment – hospital in-patient — $83.40
C482A: Rheumatology subsequent hospital visit – first five weeks — $40.05
C483A: Rheumatology medical specific assessment – hospital in-patient — $95.95
C484A: Rheumatology medical specific re-assessment – hospital in-patient — $72.00
C485A: Rheumatology consultation – hospital in-patient — $201.95
C486A: Rheumatology repeat consultation – hospital in-patient — $124.50
C487A: Rheumatology subsequent hospital visit – weeks 6 to 13 — $40.05
C488A: Rheumatology concurrent care visit – hospital in-patient — $40.05
C489A: Rheumatology subsequent hospital visit – after week 13 — $40.05
C510A: Complex Neuromuscular Assessment - Subject To The Same Conditions As A510 — $104.85
C511A: Complex physiatry assessment – hospital in-patient — $114.80
C515A: Physical medicine and rehabilitation limited consultation – hospital in-patient — $106.60
C545A: Gastroenterology in-patient limited consultation — $106.90
C570A: Complex respiratory assessment – hospital in-patient — $105.25
C575A: Respiratory disease limited consultation – hospital in-patient — $115.30
C590A: Comprehensive rheumatology consultation – hospital in-patient — $342.25
C595A: Rheumatology limited consultation – hospital in-patient — $124.50
C600A: Comprehensive Cardiology Consultation - Subject To The Same Conditions As A600 — $342.25
C601A: Complex Medical Specific Re-assessment — $84.10
C602A: Cardiology in-patient subsequent visit – first five weeks — $40.05
C603A: Medical Specific Assessment — $96.70
C604A: Medical Specific Re-assessment — $72.65
C605A: Cardiology in-patient consultation — $188.45
C606A: Repeat Consultation — $105.25
C607A: Cardiology in-patient subsequent visit – weeks 6 to 13 — $40.05
C608A: Concurrent Care - Per Visit — $40.05
C609A: Cardiology in-patient subsequent visit – after week 13 — $40.05
C661A: Paediatric complex medical specific re-assessment – hospital in-patient — $86.35
C662A: Extended special paediatric consultation – hospital in-patient — $442.40
C667A: Neurodevelopmental consultation – hospital in-patient — $456.80
C675A: Limited Consultation — $105.25
C695A: Neurodevelopmental consultation – hospital in-patient — $456.80
C760A: Complex Endocrine Neoplastic Disease Assessment - Subject To The Same Conditions As A760 — $102.95
C770A: Extended Comprehensive Geriatric Consultation - Subject To The Same Conditions As A770 — $442.40
C771A: Certification of death (Subject to same conditions as A771) — $24.20
C775A: Comprehensive Geriatric Consultation - Subject To The Same Conditions As A775 — $342.25
C777A: Hospital Pronouncement of Death - subject to the same conditions as A777 (incl. Certificate) — $44.55
C795A: Geriatric psychiatric consultation – hospital in-patient — $342.25
C865A: Nephrology limited consultation – hospital in-patient — $116.75
C882A: Hospital palliative care visit — $40.05
C895A: In-patient consultation – psychiatry — $297.00
C930A: Uveitis and ocular inflammatory disease consultation – hospital in-patient — $157.00
C933A: On-Call Admission Assessment — $82.00
C935A: Special Surgical Consultation (see General Preamble Gp19) — $194.65
C945A: Special Palliative Care Consultation (hospital) — $174.25
C982A: Hospital palliative care visit (specialist listing) — $40.05
C986A: Weekend/holiday in-patient special visit premium, first patient — $77.10
C987A: Weekend/holiday in-patient special visit premium, additional patients — $77.10
C989A: Special visit premium – first obstetrical delivery with sacrifice of office hours — $78.55
C990A: Weekday daytime in-patient special visit premium, first patient — $20.55
C991A: Weekday daytime in-patient special visit premium, additional patients — $20.55
C994A: Weekday evening in-patient special visit premium, first patient — $61.70
C995A: Weekday evening in-patient special visit premium, additional patients — $61.70
C996A: Night in-patient special visit premium, first patient — $102.80
C997A: Night in-patient special visit premium, additional patients — $102.80
C998C: Special visit, assistant or anaesthesia, weekday evenings — $60.00
D001A: Finger dislocation – closed reduction — $57.50
D003A: Finger dislocation – open reduction — $288.35
D004A: Metacarpal/phalangeal dislocation – closed reduction — $57.50
D007A: Carpal dislocation – closed reduction — $128.05
D009A: Elbow dislocation – closed reduction — $84.45
D010A: Dislocations - Elbow Joint - Open Reduction Acute — $252.45
D012A: Radial head dislocation (pulled elbow) – closed reduction — $39.00
D014A: Acromio-clavicular or sterno-clavicular dislocation – no reduction — $67.80
D015A: Shoulder (glenohumeral) dislocation – closed reduction without anaesthetic — $49.20
D016A: Shoulder (glenohumeral) dislocation – closed reduction with anaesthetic — $111.40
D017A: Shoulder dislocation – open reduction, early — $323.85
D025A: AC or SC joint dislocation – closed reduction with anaesthetic — $134.55
D027A: Toe interphalangeal dislocation – closed reduction — $57.50
D030A: Metatarsophalangeal joint dislocation – closed reduction — $57.50
D031A: Patellar dislocation – closed reduction with anaesthetic — $97.35
D035A: Ankle dislocation – closed reduction — $111.35
D036A: Ankle dislocation – open reduction — $252.45
D038A: Knee dislocation – closed reduction — $207.90
D040A: Patellar dislocation – closed reduction without anaesthetic — $62.20
D041A: Patellar dislocation – open reduction, early — $335.65
D042A: Hip dislocation – closed reduction — $268.25
D062A: Temporomandibular joint dislocation – closed reduction — $51.65
E006C: When A Anaesthesiologist Or Surgical Assistant Procedure Is Cancelled — $95.76
E014A: Anaesthesia extra units, newborn to 28 days
E030C: Procedural Sedation — $63.84
E032C: Anaesthesia Service For Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499, Z555 Or Z580 — $63.84
E050A: Tenoplasty, each additional tendon — $77.05
E060A: - Post Renal Transplant Assessment Premium - Add 25%
E063A
E077A: Request for Major Eye Examination — $10.25
E078A: Chronic disease assessment premium — 50% premium
E079A: Smoking Cessation Premium — $15.95
E080A: First Post Hospital Premium - within 2 weeks — $25.90
E082A: Admission assessment by the MRP, to admission assessment add
E083A: MRP subsequent and palliative care visit premium
E084A: Saturday, Sunday Or Holiday Subsequent Visit By The Mrp, To Subsequent Visits And - Add 45%
E088A: Congestive Heart Failure Premium - Add 50% For Virutal Services
E089A: Periodic health visit premium — 20% premium
E090A: Removal of ovaries with moderate or severe endometriosis (add-on) — $260.80
E098A: Gastroenterology Chronic Disease Assessment Premium - Add 50% For Virutal Services
E104A: Removal Of Intraocular Foreign Body — $542.00
E110A: Glaucoma surgery with cataract extraction (add-on) — $271.50
E115A: $350.00
E117A: Pterygium - Keratectomy Or Relaxing Incisions Post Penetrating Keratoplasty Or Post Traumatic Corneal Scar (non Cosmetic) — $308.30
E131A: Laser iridotomy — $161.75
E134A: Laser Angle Surgery Or Trans-scleral Or Endoscopic Cyclophotocoagulation Of The Ciliary Body — $205.55
E139A: Capsulotomy Or Primary Or Subsequent Needling — $161.75
E140A: Cataract - All Types Of, By Any Procedure, Includes Insertion Of Intraocular Lens — $397.75
E141A: Dislocated lens extraction — $505.45
E149A: Anterior Vitrectomy - Vitreous Injection Or Aspiration, Posterior With Needle For Culture And/or Injection Of Medication, Other Than For Macular Degeneration — $90.00
E150A: Criticall Review Of Complex Neuroimaging - Add — $44.00
E154A: Photocoagulation (xenon, Argon Laser, Etc.) - One Eye — $182.75
E156A: Intraocular Suturing Of Iris/pupillary Defect — $350.00
E157A: Placement And Suturing Of Iris Prosthetic Device With Or Without Suturing Of Iris/pupillary Defect — $550.00
E175A: Therapeutic paracentesis with intravitreal injection — $20.00
E186A: $90.00
E187A: $90.00
E202A: Corneal cross-linking — $200.00
E234A: Lateral canthotomy — $51.45
E250A: Double balloon enteroscopy – surgical time (per 15 minutes) — $100.00
E318A: Incision And Drainage Of Extensive Haematoma Of Pinna With Packing Of Ear And External Compression Dressing - Local Anaesthetic — $92.40
E323A: Myringoplasty — $209.05
E400C: Evenings (17:00h 24:00h) Monday To Friday Or Daytime And Evenings On Saturdays, Sundays Or Holidays - Add 50% — $7.98
E401C: Nights (00:00 - 07:00) - Add 75% — $11.97
E409A: After-hours procedure premium, evening/weekend/holiday
E410A: Premium nights (midnight - 0700)
E411A: Sole Delivery Premium
E412A: After-hours procedure premium — ED physician — evenings, weekends and holidays
E413A: After-hours procedure premium – ED physician – nights
E414A: High risk obstetrical premium — $62.05
E420A: Trauma Premium - Add 50%
E423A: Manual cycloplegic refraction premium — $25.00
E424A: Paediatric amblyopia assessment premium — $50.00
E430A: Pap Smear Tray Fee (G365) — $11.95
E431A: Pap Smear Tray Fee (G394) — $11.95
E432A: Pelvic exam with speculum outside hospital or ICHSC — $5.00
E440A: $30.00
E442A: $20.00
E446A: Injection joint with image guidance (foll. A failed attempt without imaging) add to G370/G371 — $30.00
E494A: Arthroscopic debridement of degenerative cartilage – knee — $299.00
E495A: Arthroscopic meniscectomy – knee — $240.45
E496A: Arthroscopic meniscal repair – knee — $336.65
E499A: Second caesarean delivery in a multiple birth (add-on) — $397.75
E500A: Third and each later delivery in a multiple birth (add-on) — $148.60
E502A: Vaginal birth after caesarean section (VBAC) premium — $51.00
E504A: Metacarpal fracture – each additional — $22.20
E505A: Limited axillary node sampling, add-on to breast surgery — $178.05
E515A: - Incision Of Abscess Or Hematoma When Performed As Sole Procedure Under General Anaesthetic In An Operating Room But Not In An Emergency Department Or Emergency Department Equivalent - Add 100%
E518A: Colonoscopic polypectomy – each additional polyp (20–29 mm) — $77.50
E519A: Colonoscopic polypectomy – each additional polyp (10–19 mm) — $77.50
E520A: - Each Additional Polyp (6 Mm - 9 Mm) - Add — $77.50
E524A: Mohs micrographic surgery — additional cuts — $273.45
E525A: Breast excision after wire or seed localization (add-on) — $48.05
E541A: Percutaneous inflation of tissue expander – each additional expander — $11.55
E542A: Office Premium (Tray Fee) — $12.65
E543A: $30.60
E545A: Vasectomy outside hospital add-on — $13.75
E546A: $388.75
E550A: Closed irrigation system insertion (wound care) — $63.15
E558A: Phalanx (finger) fracture – each additional — $22.25
E576A: Finger dislocation – each additional (add-on to D001) — $10.25
E577A: Metacarpal/phalangeal dislocation – each additional (add-on to D004) — $10.25
E584A: Cast applied outside hospital or ICHSC (add-on) — $11.15
E600A: Operating microscope add-on – laryngoscopy — $33.60
E629A: Endoscopic placement of stent in duodenum — $137.05
E630A: Colonoscopy – endoscopic placement of stent in colon — $137.05
E632A: Bronchoscopy with removal of foreign body, add-on — $68.40
E636A: $50.00
E638A: $81.90
E641A: Sigmoidoscopy – endoscopic placement of stent in rectum — $137.05
E643A: Laser microlaryngoscopy add-on – benign disease — $121.65
E662A: $49.75
E666A: $52.30
E668A: $93.80
E669A: $102.75
E673A: Lysis Of Extensive Intra-abdominal Adhesions - Add — $124.10
E674A: - With Snare Polypectomy - 1st Polyp > 1 Cm (maximum 1) - Add — $142.40
E675A: - With Snare Polypectomy Each Additional Polyp > 1 Cm (maximum 2) - Add — $73.50
E676A: Morbidly obese patient premium, surgeon or assistant — $77.46
E677A: $104.00
E678A: Bronchoscopy add-on – TBNA of lung mass — $104.00
E680A: - With Insertion Of First Endobiliary Prosthesis And/or Pancreatic Stent (maximum 1) - Add — $82.35
E681A: - With Insertion Of Each Additional Endobiliary Prosthesis And/or Pancreatic Stent (maximum 3) - Add — $43.60
E685A: Colonoscopic excision of very large sessile polyp (> 3 cm) — $227.65
E686A: $144.10
E687A: Colonoscopic excision of obstructive tumour or stricture – laser debulking — $69.80
E690A: $43.85
E692A: $69.70
E696A: $30.65
E698A: $69.70
E702A: - With Multiple (3 Or More) Biopsies Of Specific Lesion - Add — $15.10
E703A: - With Snare Polypectomy First Polyp (> 1 Cm) - Add — $50.50
E705A: Colonoscopy to terminal ileum (add-on) — $30.30
E717A: Biopsy and/or angiodysplasia coagulation (add-on) — $27.05
E720A: Each additional polyp excised, 3 mm to 5 mm (add-on) — $77.50
E723A: $325.85
E725A: Recurrent hernia repair (add-on) — $130.00
E726A: Repeat recurrent inguinal hernia repair (more than 2 repairs) — $257.35
E732A: Small intestine intubation with biopsy (add-on) — $29.10
E733A: $162.90
E734A: $241.55
E735A: $325.80
E736A: $214.95
E740A: Colonoscopy to splenic flexure (add-on) — $51.75
E741A: Colonoscopy to hepatic flexure (add-on) — $31.15
E746A: Sigmoidoscopy outside hospital – premium — $5.85
E747A: Endoscopy to cecum (add-on) — $31.15
E748A: $122.05
E749A: Colonoscopy or sigmoidoscopy in a private office – premium — $22.35
E751A: Cystoscopy add-on – instillation of chemotherapeutic agent — $58.65
E760A: Ureteroscopy add-on – removal of calculus — $174.55
E761A: Ureteroscopy add-on – intracorporeal lithotripsy — $100.75
E764A: $27.55
E766A: Nephrectomy add-on – gland dissection — $29.70
E770A: Duodenoscopy with bile drainage after IV CCK stimulation — $23.10
E773A: Cystoscopy add-on – stent past obstructing lesion — $53.50
E775A: Cystoscopy add-on – ureteric catheterization with specimen — $16.45
E776A: Cystoscopy with brush biopsy of renal pelvis/ureter or bladder biopsy (add-on) — $26.70
E777A: Cystoscopy add-on – cystometrogram — $12.35
E781A: Cystoscopy with electrocoagulation of bladder tumour(s) (add-on) — $53.50
E782A: Cystoscopy add-on – electrocoagulation of Hunner ulcer — $53.50
E783A: Cystoscopy add-on – evacuation of bladder clots and control of haemorrhage — $106.80
E784A: Cystoscopy add-on – hydrodistention of bladder under general anaesthetic — $53.45
E785A: Colonoscopy – multiple biopsies for IBD surveillance — $54.25
E789A: Cystoscopy with removal of foreign body or calculus (add-on) — $106.85
E790A: Cystoscopy add-on – removal of ureteric catheter — $9.45
E791A: Cystoscopy add-on – periurethral bulking agent injection — $50.70
E792A: Laparoscopic approach premium – urology
E793A: - Laparoscopic Or Laparoscopic Assisted - Add 25%
E794A: $40.80
E795A: $46.30
E796A: $117.15
E797A: Endoscopic management of uncomplicated GI bleeding (add-on) — $46.30
E798A: $69.70
E799A: - Each Additional Polyp, By Snare Polypectomy (> 1 Cm) (to A Maximum Of 2) - Add — $25.25
E800A: Endoscopic ultrasound – radial or linear probe through endoscope — $101.50
E801A: Endoscopic ultrasound probe through endoscope – with biliary/pancreatic exam — $152.30
E802A: Endoscopic ultrasound – biopsy or fine needle aspiration — $50.75
E803A: Endoscopic ultrasound – dilation of stricture — $30.65
E804A: Endoscopic ultrasound – injection (metastases, nodes, masses, celiac plexus) — $145.05
E805A: Endoscopic ultrasound – drainage of pseudocyst — $203.05
E813A: Radiofrequency ablation of dysplastic Barrett's oesophagus — $215.00
E816A: $50.00
E817A: Cystoscopy with ureteric catheterization and retrograde pyelogram (add-on) — $16.45
E818A: Cystoscopy add-on – ureteric stent insertion — $26.70
E819A: Ureteroscopy add-on – second ureter — $54.65
E820A: Ureteroscopy add-on – biopsy of ureter or renal pelvis — $53.35
E821A: Prostate needle biopsy – transperineal method (add-on) — $20.00
E822A: Ureteroscopy add-on – upper third of ureter or renal pelvis — $39.60
E823A: Ureteroscopy add-on – resection of ureteral or renal pelvic tumours — $250.50
E824A: Cystoscopy add-on – bladder biopsy under general anaesthetic — $53.45
E827A: - Repair Of Defect (> 10 Cm) With Component Separation - Add — $683.20
E829A: - Repair Of Defect (5-10 Cm) With Component Separation - Add — $341.60
E836A: Upper GI endoscopic mucosal resection (EMR) of very large polyp or lesion — $227.65
E837A: EBUS add-on – additional biopsies — $50.75
E839A: Flexible endoscope add-on (nose, epistaxis, tonsils/adenoids) — $35.25
E844A: Bilateral ethmoidectomy/antrostomy add-on — $200.00
E854A: Ureterolysis, unilateral (add-on) — $170.00
E860A: $131.45
E861A: Paracervical block (add-on) — $9.00
E862A: Laparoscopic approach premium (+25%)
E950A: Intraocular lens insertion (add-on) — $92.50
F004A: Phalanx (finger) fracture – no reduction, rigid immobilization — $49.20
F005A: Phalanx fracture – closed reduction — $99.25
F006A: Intra-articular hand fracture – closed reduction — $119.75
F007A: Finger phalanx fracture – open reduction — $346.50
F008A: Metacarpal fracture(s) – no reduction, rigid immobilization — $49.20
F009A: Metacarpal fracture – closed reduction — $99.25
F011A: Metacarpal fracture – open reduction — $320.80
F016A: Carpal fracture – closed reduction — $115.10
F018A: Scaphoid fracture – no reduction, rigid immobilization — $49.20
F019A: Scaphoid fracture – open reduction — $637.30
F021A: Fractures - Osteochondral - Open Reduction — $392.40
F024A: Radius and ulnar shaft fracture – no reduction, rigid immobilization — $67.75
F025A: Radius and ulnar shaft fracture – closed reduction — $148.50
F026A: Radius and ulna shaft fracture – open reduction — $854.65
F027A: Distal radius fracture – no reduction, rigid immobilization — $67.75
F028A: Distal radius fracture – closed reduction under local anaesthetic — $109.45
F029A: Epicondyle fracture – no reduction — $67.75
F030A: Distal radius fracture – open reduction — $682.00
F031A: Radius or ulna fracture – no reduction, rigid immobilization — $81.30
F032A: Radius or ulna fracture – closed reduction — $117.85
F033A: Radius or ulna fracture – open reduction — $660.10
F034A: Olecranon fracture – no reduction, rigid immobilization — $126.25
F035A: Olecranon fracture – closed reduction — $129.00
F036A: Olecranon fracture – open reduction — $705.35
F042A: Humeral shaft fracture – no reduction — $67.80
F043A: Humeral shaft fracture – closed reduction — $147.60
F044A: Humeral shaft fracture – open reduction — $904.15
F046A: Distal radius fracture – closed reduction under general anaesthetic — $149.35
F047A: Humeral tuberosity fracture – no reduction — $67.80
F053A: Humeral neck fracture (no head dislocation) – no reduction — $67.80
F054A: Humeral neck fracture without dislocation of the head – closed reduction — $133.60
F055A: Humeral neck fracture (no head dislocation) – open reduction — $775.95
F056A: Toe (phalanx) fracture – no reduction, rigid immobilization — $49.20
F058A: Toe (phalanx) fracture – closed reduction, one — $72.35
F061A: Metatarsal fracture(s) – one or more — $49.20
F062A: Metatarsal fracture – rigid immobilization — $67.75
F063A: Metatarsal fracture(s) – closed reduction, one or more — $98.35
F064A: Metatarsal fracture – open reduction, one — $358.05
F066A: Tarsus fracture – no reduction, rigid immobilization — $98.10
F070A: Os calcis or talar neck/body fracture – no reduction, rigid immobilization — $97.35
F071A: Os calcis or talar neck fracture – closed reduction — $161.45
F072A: Os calcis or talus fracture – open reduction — $746.10
F074A: Ankle fracture – no reduction, rigid immobilization — $67.75
F075A: Ankle fracture – closed reduction — $144.80
F076A: Ankle fracture – open reduction, one malleolus — $466.70
F077A: Ankle fracture – open reduction, multiple malleoli or ligaments — $746.10
F078A: Tibia fracture (with or without fibula) – no reduction, rigid immobilization — $115.95
F079A: Tibia fracture – closed reduction — $180.05
F080A: Tibial shaft fracture – open reduction — $789.00
F081A: Tibial plateau fracture – medial or lateral — $813.55
F082A: Fibula fracture – no reduction, rigid immobilization — $67.75
F083A: Fibula fracture – closed reduction — $101.25
F084A: Fibula fracture – open reduction — $653.05
F085A: Patella fracture – no reduction — $67.75
F087A: Patella fracture – open reduction or excision — $504.45
F096A: Femur fracture – open reduction — $774.05
F100A: Open reduction of hip fracture – screws, plate or locked nail — $771.75
F101A: Primary femoral head prosthesis (hemiarthroplasty) for hip fracture — $672.65
F102A: Carpal fracture – no reduction, rigid immobilization — $49.20
F110A: Clavicle fracture – closed reduction with anaesthetic — $62.20
F118A: Clavicle fracture – open reduction — $691.30
F136A: Nasal bone fracture – closed reduction — $102.35
G002A: Glucose — $2.26
G004A: Stool for O.B. — $1.58
G005A: Pregnancy Test (only insured & payable when an immediate determination of pregnancy is required) — $3.88
G009A: Urinalysis, Routine (includes Microscopic Examination Of Centrifuged Specimen Plus Any Of Sg, Ph, Protein, Sugar, Haemoglobin, Ketones, Urobilinogen, Bilirubin)- — $4.90
G010A: Urinalysis — $2.64
G012A: Wet Prep — $1.93
G014A: Rapid Strep — $6.80
G015A: Fsh (pituitary Gonadotrophins) — $11.35
G019A: Lh (luteinizing Hormone) — $9.30
G021A: Hcg (human Chorionic Gonadotrophins) Quantitative — $15.50
G022A: Testosterone — $14.50
G031A: Prothrombin Time — $6.40
G050A: Bronchoscopy - Endobronchial Ultrasound (ebus), For Guided Biopsy Of Hilar And/or Mediastinal Lymph Nodes — $203.05
G060A: Peripheral Nerve Block, Major — $55.00
G061A: Peripheral Nerve Block, Minor — $30.00
G082A: Continuous Haemodiafiltration - Continuous Venovenous Haemodiafiltration - Initial And Acute (for The First 3 Services) — $397.30
G083A: Haemodialysis - Continuous Venovenous Haemodialysis - Initial And Acute (for The First 3 Services) — $397.30
G085A: Haemodialysis - Continuous Venovenous Haemofiltration - Initial And Acute (for The First 3 Services) — $385.75
G090A: Slow Continuous Ultrafiltration - Venovenous Slow Continuous Ultrafiltration - Initial And Acute (for The First 3 Services) — $331.05
G094A: Continuous Haemodiafiltration - Chronic, Continuous Haemodiafiltration — $69.90
G096A: Slow Continuous Ultrafiltration - Chronic, Slow Continuous Ultrafiltration — $69.90
G099A: Subclavian Or External Jugular Catheter For Haemodialysis - Percutaneous Insertion Of Permanent Jugular/femoral Dialysis Catheter (including Subcutaneous Positioning) — $168.40
G112A: Dipyramidole Thallium Stress Test - Professional Component — $74.25
G115A: External Cardiac Pacing (temporary Transthoracic) Once Per 24-hour Period — $46.30
G117A: Thoracic — $170.00
G119A: Cervical — $190.00
G138A: Evoked potentials – upper or lower limbs – professional component — $71.65
G166A: Hydrogen breath test – professional component — $10.45
G167A: Hydrogen Breath Test - Technical Component — $7.70
G180A: Dual Chamber Reprogramming Including Electrocardiography - Professional Component — $16.95
G181A: Dual Chamber Reprogramming Including Electrocardiography - Technical Component — $13.40
G192A: Video Fluoroscopic Multichannel Urodynamic Assessment To Include Monitoring Of Intravesicular, Intra-abdominal, And Urethral Pressures, With Simultaneousfluoroscope Imaging And Recording Of Filling And Voiding Phases Including Interpretation — $73.65
G193A: Complete Multichannel Urodynamic Assessment - To Include Monitoring Ofintravesicular, Intra-abdominal, And Urethral Pressures, With Or Without Pressure-flow Studies — $43.85
G194A: Urodynamic assessment add-on – with EMG — $8.35
G196A: Hypersensitivity Skin Test For Validated Drugs Or Agents Excluding Foods And Inhalants, Maximum Of 3 Per Patient Per Physician Per 12 Month Period — $17.00
G197A: Skin Testing - Professional Component, To A Maximum Of 50 Per Year - Per Test — $0.39
G198A: Patch Test - For Industrial Or Occupational Dermatoses, To A Maximum Of 125 Per Patient, Per Year - Per Test — $2.39
G200A: Acute Desensitisation, E.g. Ats, Penicillin — $8.65
G202A: Allergy inj. (1 or more) with visit — $7.15
G205A: Insect Venom Desensitisation (immunotherapy) - Per Injection (maximum Of 5 Per Day). In Addition To G205, After The Initial Major Assessment Only, A Minor Or Partial Assessment May Be Claimed Once Per Day If Rendered — $13.15
G206A: Patch test (per test) — $2.39
G208A: Provocation Testing - Per Unit — $21.90
G209A: Skin Testing - Technical Component, To A Maximum Of 50 Per Year - Per Test — $0.80
G211A: Endotracheal Intubation For Resuscitation (not To Be Claimed When Followed By A Surgical Procedure At Which Time It Is Included In The Anaesthetic Procedure) — $38.35
G212A: Hyposensitisation injection, sole reason for visit — $12.85
G213A: Physical Urticaria Challenges — $13.80
G214A: Brachial plexus nerve block — $54.65
G223A: Somatic or peripheral nerve, nerve(s) or site(s), additional — $17.10
G224A: Nerve Block By Same Physician Performing The Procedure — $15.55
G227A: Cranial Nerve Block — $54.65
G228A: Spinal: paravertebral, cervical, thoracic, lumbar, sacral, coccygeal — $34.10
G231A: Somatic or peripheral nerve, one nerve or site, NOS — $34.10
G232A: Percutaneous Spheno-palatine Ganglion Block With Fluoroscopic Guidance — $150.00
G234A: Percutaneous Cervical Sympathetic Nerve Block Or Stellate Ganglion Block - Without Ultrasound Or Fluoroscopic Guidance, Unilateral — $55.10
G235A: Supraorbital nerve block — $34.10
G236A: Percutaneous Lumbar, Thoracic Or Sacral Sympathetic Nerve Block With Fluoroscopic Guidance - Unilateral Or Bilateral — $150.00
G238A: Transverse scapular nerve block — $34.10
G243A: Femoral nerve block – unilateral — $54.65
G244A: Femoral nerve block – bilateral — $81.95
G246A: Lumbar — $150.00
G254A: Management Of Post Liver, Lung Or Pancreas Transplant Immunosuppression - In Lieu Of Non-emergency Hospital Visits In-patient Visits - Per Visit — $39.50
G259A: Arrhythmia induction – ventricular — $383.30
G260A: Major Plexus Block — $80.00
G261A: Arrhythmia induction – atrial — $331.05
G262A: $210.40
G263A: $96.45
G264A: Occipital nerve first block per day — $34.10
G265A: Occipital nerve, each additional per spinal level, max 3/day — $17.10
G268A: Vascular Cannulation - Cannulation Of Artery For Pressure Measurements Including Cut Down As Necessary — $31.25
G269A: Vascular Cannulation - Cannulation Of Central Vein For Pressure Measurements Or For Feeding Line - Not To Be Billed With Right Heart Catheterization (z439) Or With Swan-ganz Catheter Insertion — $31.25
G270A: Vascular Cannulation - Intraosseous Infusion — $23.90
G271A: Anticoagulant supervision, long-term telephone advice — $13.10
G275A: Exchange transfusion — $205.45
G277A: Therapeutic Plasma Exchange - Initial And Repeat, To A Maximum Of 5 Per Year - Each — $82.00
G278A: Therapeutic Plasma Exchange - More Than 5 Per Year - Each — $41.80
G282A: Venipuncture - Umbilical Vein Catheterization (including Obtaining Of Blood Sample) — $43.60
G283A: Single Chamber Reprogramming Including Electrocardiography - Professional Component — $11.30
G284A: Single Chamber Reprogramming Including Electrocardiography - Technical Component — $10.25
G291A: - Each Additional Unilateral Block Following G291 Per Spinal Level Per Day When G291 Is Payable In Full (maximum 3 Per Day) — $19.85
G292A: - Each Additional Unilateral Block Following G291 Per Spinal Level Per Day When G291 Is Payable In Full (maximum 3 Per Day) — $10.00
G297A: Angiograms (only Two Angiograms May Be Billed - One Per Right Heart Catheterization And One Per Left Heart Catheterization) Irrespective Of The Number Of Chambers Injected — $117.55
G303A: Transthoracic Pacemaker - Insertion — $51.25
G307A: Pacemaker Pulse Wave Analysis Including Electrocardiography - Professional Component — $9.55
G308A: Pacemaker Pulse Wave Analysis Including Electrocardiography - Technical Component — $10.25
G309A: Vascular Cannulation - Umbilical Artery Catheterization (including Obtaining Of Blood Sample) — $45.55
G310A: Electrocardiogram - Twelve Lead - Technical Component — $7.70
G311A: Interpretation Of Telephone Transmitted Ecg Rhythm Strip - Technical Component — $2.25
G312A: Subclavian Or External Jugular Catheter For Haemodialysis - Thrombolytic Instillation Into Temporary And Permanent Percutaneous Catheters — $15.40
G313A: Electrocardiogram - Twelve Lead - Professional Component - Must Include Written Interpretation — $4.55
G315A: Maximal Stress Ecg - Technical Component — $50.55
G317A: Automatic Implantable Defibrillator - Nonprogrammable Including Electrocardiography, Interrogation And Analysis - Professional Component — $27.80
G318A: Non-biodegradable subcutaneous medication implant insertion — $42.00
G319A: Maximal Stress Ecg - Professional Component — $62.05
G320A: Interpretation Of Telephone Transmitted Ecg Rhythm Strip - Professional Component — $4.30
G321A: Automatic Implantable Defibrillator - Programmable Including Electrocardiography, Interrogation And Reprogramming - Professional Component — $47.65
G323A: Acute haemodialysis – repeat treatment (first 3 services) — $184.80
G324A: Subclavian Or External Jugular Catheter For Haemodialysis - Insertion — $102.95
G325A: Acute haemodialysis – initial treatment — $369.60
G327A: Subclavian Or External Jugular Catheter For Haemodialysis - Insertion Of Femoral Catheter For Dialysis — $77.30
G328A: Aspiration bursa or complex joint, with or without injection — $39.80
G329A: each additional bursa/complex joint up to 2 — $20.25
G330A: Acute peritoneal dialysis (up to 48 hours) — $247.70
G331A: Repeat acute peritoneal dialysis (up to 48 hours) — $223.00
G332A: Capsule endoscopy — $185.00
G336A: Subclavian Or External Jugular Catheter For Haemodialysis - Revision — $17.65
G337A: Antidiuretic Hormone Response Test Including The 8 Hour Water Deprivation Test — $16.95
G338A: Clonidine Suppression Test (for The Investigation Of Pheochromocytoma) - With Physician Present - Includes Venipunctures — $24.90
G341A: Glucagon Test - Hypertonic Saline Infusion Test — $16.95
G344A: Phentolamine Test — $42.30
G345A: Complex Single Agent Or Multi-agent Therapy Chemotherapy And/or Biologic Agent(s) That Can Cause Vesicant Damage, Infusion Reactions, Cardiac, Neurologic, Marrow Or Renal Toxicities That May Require Immediate Intervention By The Physician — $75.00
G349A: Oesophageal Tamponade (blakemore Bag) - Insertion — $45.30
G350A: Esophageal motility study with manometry and/or impedance planimetry — $97.85
G351A: Esophageal reflux monitoring study (24 hours or longer) — $51.50
G353A: Esophageal provocation testing — $35.00
G354A: Oesophageal Studies - Anal-rectal Manometry — $61.80
G356A: Gastric Lavage - Therapeutic - With Or Without Ice Water Lavage — $33.80
G358A: Growth hormone exercise stimulation test — $24.90
G359A: Special Single Agent Or Multi-agent Therapy Chemotherapy And/or Biologic Agent(s) With Major Toxicity That Require Frequent Monitoring And Prolonged Administration Periods And May Require Immediate Intervention By The Physician — $105.15
G362A: Insertion Of Laminaria Tent — $6.25
G363A: Cervical Mucous Penetration Test — $22.00
G365A: Pap Smear - periodic (25-69 yo) — $12.00
G369A: B.c.g. Inoculation, Following Tuberculin Tests — $5.30
G370A: Injection Bursa, Aspiration joint, ganglion, tendon sheath — $20.25
G371A: each additional injection, aspiration up to 5 — $19.90
G372A: Injection IM, SC, intradermal, with visit OR each additional injection — $4.55
G373A: Injection, sole reason — $7.90
G375A: Intralesional infiltration — one or two lesions — $10.50
G376A: Intravenous injection or infusion, newborn or infant — $10.20
G377A: Intralesional infiltration — three or more lesions — $15.80
G378A: I.U.D. Insertion — $47.50
G379A: Intravenous injection or infusion, child, adolescent or adult — $6.15
G380A: Cutdown Including Cannulation As Necessary — $27.05
G381A: Standard Chemotherapy - Agents With Minor Toxicity That Require Physician Monitoring, Including Any Additional Standard Chemotherapy Other Than The Initial Agent — $54.50
G382A: Supervision Of Chemotherapy (pharmacologic Therapy Of Malignancy Or Autoimmune Disease) By Telephone, Monthly — $13.95
G384A: Infiltration of tissue for trigger point — $8.85
G385A: Infiltration of tissue for trigger point, each add site, max 2, add — $4.55
G389A: Infusion Of Gamma Globulin, Initiated By Physician, Including Preparation Per Patient, Per Day — $13.90
G391A: Other resuscitation after first 1/4 hour — $34.35
G394A: Additional cervical cancer screening specimen — $12.00
G395A: Other resuscitation first 1/4 hour — $64.70
G396A: Injections Of Extensive Keloids — $24.90
G398A: Pessary fitting - initial or re-fitting (1 per 12 month per patient) — $65.35
G400A: Critical care (intensive care area) – physician-in-charge – 1st day — $223.10
G401A: Critical care (intensive care area) – physician-in-charge – 2nd to 30th day (per diem) — $146.45
G402A: Critical care (intensive care area) – physician-in-charge – 31st day onwards (per diem) — $58.60
G403A: Epley (BPPV) Particle repositioning — $21.70
G404A: Chronic Ventilatory Care Outside An Intensive Care Unit — $61.00
G405A: Ventilatory support (intensive care area) – physician-in-charge – 1st day — $183.80
G406A: Ventilatory support (intensive care area) – physician-in-charge – 2nd to 30th day (per diem) — $96.45
G407A: Ventilatory support (intensive care area) – physician-in-charge – 31st day onwards (per diem) — $64.20
G408A: Nephrological care after renal transplant – days 2 to 10 — $177.10
G409A: Nephrological care after renal transplant – days 11 to 21 — $88.55
G411A: Nephrological Management Of Donor Procurement — $213.00
G412A: Nephrological care after renal transplant – day 1 — $354.30
G414A: Routine Eeg - Technical Component — $28.30
G415A: Routine Eeg - Professional Component — $23.15
G418A: Routine Eeg - Professional Component (16 - 21 Channel Eeg) — $62.50
G420A: Ear Syringe, curette (only payable when medically necessary) — $13.15
G421A: Subconjunctival Or Sub-tenons Capsule Injection — $27.70
G425A: Fluorescein angiography – professional component — $44.40
G432A: Static visual fields – professional component — $26.95
G435A: Tonometry — $5.10
G436A: Kinetic visual fields – professional component — $14.50
G438A: Colour vision detailed assessment – professional component — $22.15
G440A: Pure tone audiometry – technical component — $11.95
G441A: Pure tone and speech audiometry – technical component — $20.80
G442A: Impedance audiometry – technical component — $3.80
G454A: Stroboscopy — $16.80
G455A: EMG/nerve conduction Schedule A (complete) – technical component — $31.80
G456A: EMG/nerve conduction Schedule A (complete) – professional component — $120.00
G457A: EMG/nerve conduction Schedule B (limited) – professional component — $74.40
G458A: Single Fibre Electromyography — $275.00
G460A: Ocular photodynamic therapy – unilateral — $330.00
G461A: Ocular photodynamic therapy – bilateral — $500.00
G462A: Oral polio or rotavirus vaccine administration — $8.80
G466A: EMG/nerve conduction Schedule B (limited) – technical component — $21.40
G470A: Ultraviolet Light Therapy — $7.85
G471A: EMG/nerve conduction Schedule C (complex) – technical component — $31.80
G473A: EMG/nerve conduction Schedule C (complex) – professional component — $275.00
G475A: Cystometrogram And/or Voiding Pressure Studies And/or Flow Rate With Or Withoutpostural Studies And/or Urethral Pressure Profile Including Interpretation — $23.75
G476A: Prostatic Massage — $5.40
G478A: Electroconvulsive Therapy (ect) Cerebral - Single Or Multiple - In-patient — $102.35
G479A: Electroconvulsive Therapy (ect) Cerebral - Single Or Multiple - Out-patient — $118.00
G480A: Venipuncture - Infant - < 2 years — $9.90
G482A: Venipuncture - Child 2 - 15 years — $7.35
G483A: Venipuncture - Therapeutic Venisection — $9.70
G485A: Chemodenervation injection – first major nerve and/or branches — $45.45
G486A: Chemodenervation injection – each additional major nerve, same day — $28.50
G487A: Repeat Or Additional Procedure Within 30 Days Of Previous Chemodenervation Injection - First Major Nerve And/or Its Branches — $28.50
G488A: $18.80
G489A: Venipuncture - Adult - 16+ years — $3.54
G493A: Acth Test - Single Or Multiple, Per Injection — $6.25
G494A: Glucagon Test - (type A) For Carbohydrate Response — $10.20
G495A: Glucagon Test - (type B) For Hypertension, Pheochromocytoma And Insulinoma Provocative Test (including Cold Pressor Test) — $42.30
G496A: Sleep-deprived/induced Eeg - Professional Component — $120.00
G497A: Glucagon Test - Insulin Hypoglycemia Pituitary Function Test With Or Without Trh And Lhrh Alone Or In Combination — $49.80
G498A: Intravenous Glucose Tolerance Test — $10.20
G500A: Month In Which Insulin Injections (2 Or More Daily) Or Insulin By Pump Is Initiated; Or Month In Which Initial Assessment By A Specialist Of A Diabetic Patient Treated With Insulin Injections (2 Or More Daily) Or Insulin By Pump Occurs, 1 Or More Contacts — $31.80
G501A: Trh Or Lhrh Test, Per Injection — $6.25
G511A: Telephone Management of Palliative Care (per call) — $18.20
G512A: Palliative Care Case Management (weekly) — $67.75
G513A: Pentagastrin Stimulation For Calcitonin — $42.30
G514A: Diabetes Monthly Management - Each Additional Month, 1 To 3 Contacts — $10.60
G515A: Open Circuit Indirect Calorimetry — $46.30
G517A: Ankle Pressure Determination, Includes Calculation Of The Ankle-arm Index Systolic Pressure Ratio — $10.05
G520A: Diabetes monthly management – each additional month, 4 or more contacts — $21.20
G521A: Life Threatening emergency situation - first 1/4 hour — $125.10
G522A: Life Threatening emergency situation - after 1st half hour per 1/4 hour — $42.50
G523A: Life Threatening emergency situation - 2nd 1/4 hour — $64.50
G525A: Pure tone audiometry – professional component — $5.85
G526A: Pure tone and speech audiometry – professional component — $16.45
G529A: Impedance audiometry – professional component — $1.86
G537A: Repeat Sclerotherapy, Unilateral — $26.05
G538A: Other Immunizing Agents — $8.80
G541A: Sleep-deprived/induced Eeg - Technical Component — $45.30
G543A: Sleep-deprived/induced Eeg - Professional Component — $120.00
G545A: Professional Component ... Per Unit — $14.70
G546A: Radiotelemetry or portable EEG recording (freely moving patient) – professional component — $30.45
G547A: Clinical Programming Of Deep Brain Stimulator (dbs) Includes One Or More Visits For Dbs Checking, Minor And Major Dbs Adjustments, And Intensive Programming. First Implantation Site (maximum 1 Per Patient) — $185.70
G550A: Pessary care - removal, care & reinsertion (up to 6X per 12 months per pt.) — $10.00
G552A: Removal of IUD — $23.80
G555A: Ambulatory Eeg Monitoring - Professional Component — $120.00
G557A: Comprehensive care (intensive care area) – physician-in-charge – 1st day — $429.30
G558A: Comprehensive care (intensive care area) – physician-in-charge – 2nd to 30th day (per diem) — $256.25
G559A: Comprehensive care (intensive care area) – physician-in-charge – 31st day onwards (per diem) — $122.80
G570A: Echocardiography – complete study (1 and 2 dimensions) – technical component — $130.80
G571A: Echocardiography – complete study (1 and 2 dimensions) – professional component — $96.20
G574A: Echocardiography – focused study – technical component — $18.65
G575A: Echocardiography – focused study – professional component — $13.95
G579A: $11.35
G580A: Insertion Of Oesophageal Transducer — $45.00
G581A: Transoesophageal Echocardiography - Professional Component — $25.00
G582A: Echocardiography – stress study – technical component — $148.50
G583A: Stress echocardiogram, professional component — $110.15
G585A: $147.25
G590A: Influenza — $8.80
G593A: Covid-19 Vaccine — $13.00
G600A: Neonatal intensive care, Level A – first day — $376.05
G601A: Neonatal intensive care, Level A – day 2 onwards — $187.95
G603A: Neonatal Low Birth Weight Intensive Care - Payable In Lieu Of G600 Or G603 For Newborn Less Than 750 Grams In Weight Or 26 Weeks Gestational Age — $564.00
G604A: Neonatal Low Birth Weight Intensive Care - Payable In Lieu Of G600 Or G603 For Newborn Less Than 750 Grams In Weight Or 26 Weeks Gestational Age — $536.95
G610A: Neonatal intensive care, Level B – 1st day — $258.05
G611A: Neonatal intensive care, Level B – 2nd day onwards — $129.00
G620A: Neonatal intermediate care, Level C – 1st day — $162.95
G621A: Neonatal intermediate care, Level C – 2nd day onwards — $81.50
G647A: Continuous ECG monitoring (Holter) Level 1 – technical component (recording) – 14 or more days — $130.85
G648A: Continuous ECG monitoring (Holter) Level 1 – technical component (scanning) – 14 or more days — $190.45
G649A: Continuous ECG monitoring (Holter) Level 1 – professional component – 14 or more days — $122.25
G650A: Continuous ECG monitoring (Holter) Level 1 – professional component – 12 to 35 hours — $47.90
G651A: Continuous ECG monitoring (Holter) Level 1 – technical component (recording) – 12 to 35 hours — $27.75
G652A: Continuous ECG monitoring (Holter) Level 1 – technical component (scanning) – 12 to 35 hours — $38.00
G653A: Continuous ECG monitoring (Holter) Level 2 – professional component – 12 to 35 hours — $34.10
G656A: Continuous ECG monitoring (Holter) Level 2 – professional component – 36 to 59 hours — $51.15
G657A: Continuous ECG monitoring (Holter) Level 2 – professional component – 60 hours to 13 days — $68.20
G658A: Continuous ECG monitoring (Holter) Level 1 – professional component – 36 to 59 hours — $75.45
G659A: Continuous ECG monitoring (Holter) Level 1 – professional component – 60 hours to 13 days — $95.85
G682A: Continuous ECG monitoring (Holter) Level 1 – technical component (recording) – 36 to 59 hours — $55.55
G683A: Continuous ECG monitoring (Holter) Level 1 – technical component (scanning) – 36 to 59 hours — $75.95
G684A: Continuous ECG monitoring (Holter) Level 1 – technical component (recording) – 60 hours to 13 days — $83.25
G685A: Continuous ECG monitoring (Holter) Level 1 – technical component (scanning) – 60 hours to 13 days — $113.90
G694A: Continuous ECG monitoring (Holter) Level 2 – technical component (recording) – 14 or more days — $124.30
G695A: Continuous ECG monitoring (Holter) Level 2 – technical component (scanning) – 14 or more days — $91.45
G696A: Continuous ECG monitoring (Holter) Level 2 – professional component – 14 or more days — $86.80
G700A: Basic fee per visit Premium if sole reason for procedure/immunization — $8.80
G810A: Corneal Topography - Professional Component — $4.80
G811A: Keratometry - Professional Component — $4.80
G812A: Specular Photomicroscopy - Professional Component — $4.80
G813A: Corneal Pachymetry - Professional Component — $5.10
G814A: Orthoptic Examination — $25.00
G818A: Oct Unilateral Or Bilateral - Retinal Disease, When The Physician Interprets The Results And Either Performs The Procedure Or Supervises The Performance Of The Procedure — $35.00
G820A: Oct Unilateral Or Bilateral - Glaucoma, When The Physician Interprets The Results And Either Performs The Procedure Or Supervises The Performance Of The Procedure — $35.00
G821A: Oct Unilateral Or Bilateral - Active Management Of Retinal Disease With Laser Or Intravitreal Injections When The Physician Interprets The Results And Either Performs The Procedure Or Supervises The Performance Of The Procedure — $35.00
G822A: Oct Unilateral Or Bilateral - Active Management With Laser Or Intravitreal Injections — $25.00
G823A: Oct Unilateral Or Bilateral - Evaluation Of An Infant/child/adolescent With Retinal Disease And/or Glaucoma (including Genetic Retinal Anomalies And Cancer) — $35.00
G840A: DTaP-IPV (Adacel-Polio) — $8.80
G841A: DTaP-IPV-Hib (Pediacel) — $8.80
G842A: Hepatitis B (Engerix) — $8.80
G843A: Human Papilloma Virus (HPV) (Gardasil-9) — $8.80
G844A: Meningococcal C Conjugate (Men-C) (Menjugate, NeisVac-C, Meningitec) — $8.80
G845A: Measles, Mumps, Rubella (MMR, Priorix) — $8.80
G846A: Pneumococcal Conjugate (Prevnar-13) — $8.80
G847A: Tdap (Adacel, Boostrix) — $8.80
G848A: Varicella (var) — $8.80
G849A: Respiratory syncytial virus (RSV) immunization — $8.80
G850A: Colour vision detailed assessment – technical component — $23.65
G853A: Fluorescein angiography – technical component — $25.50
G857A: Kinetic visual fields – technical component — $5.10
G858A: Static visual fields – technical component — $15.45
G860A: Chronic dialysis weekly team fee – hospital haemodialysis or haemodiafiltration — $135.80
G861A: Chronic dialysis weekly team fee – hospital peritoneal dialysis — $135.80
G862A: Chronic dialysis weekly team fee – self-care or satellite haemodialysis — $135.80
G863A: Chronic Dialysis Weekly Team Fee - Independent Health Facility Haemodialysis — $135.80
G864A: Chronic dialysis weekly team fee – home peritoneal dialysis — $135.80
G865A: Chronic Dialysis Weekly Team Fee - Home Haemodialysis — $135.80
G866A: Chronic Dialysis Weekly Team Fee - Intermittent Haemodialysis - At An Auxiliary Treatment Centre (per Treatment, Maximum 2 Per Patient Per 7-day Period Referred To Above) — $73.45
G869A: Botulinum Toxin Injection(s) Of Bladder Detrusor Muscle — $150.00
G871A: Botulinum Toxin Injection(s) For Blepharospasm, (unilateral Or Bilateral) — $120.00
G872A: Botulinum Toxin Injection(s) For Hemifacial Spasm, (unilateral Or Bilateral) — $120.00
G873A: Botulinum Toxin Injection(s) For Spasmodic Dysphonia — $120.00
G874A: Botulinum Toxin Injection(s) For Sialorrhea Or Epiphora (unilateral Or Bilateral) — $120.00
G875A: Botulinum Toxin Injection For The Following Conditions: Oromandibular Dystonia, Limb Dystonia, Cervical Dystonia Or Spasticity - First Injection — $40.00
G876A: - Each Additional Injection To A Maximum Of 11 - Add — $10.00
G877A: $18.85
G878A: $28.10
G900A: Residual Urine Measurement By Ultrasound — $12.70
G912A: Lumbar/sacral facet injection – first site — $80.00
G913A: Vertebral facet injection – each additional site — $20.00
G914A: Percutaneous Diagnostic Lumbar Facet Medial Branch Block With Ultrasound Guidance - First Site — $56.00
G916A: Sacroiliac Joint Injections - Percutaneous Diagnostic And/or Corticosteroid Sacroiliac Joint Injection With Fluoroscopic Guidance, Unilateral — $75.00
G918A: Caudal — $74.20
G920A: Percutaneous Cervical Sympathetic Nerve Block Or Stellate Ganglion Block - With Ultrasound Or Fluoroscopic Guidance, Unilateral — $80.00
G921A: Spheno-palatine Ganglion Block, Transnasal Topical, Uni Or Bilateral — $12.50
H001A: Newborn Care (in hospital or in home) — $71.15
H007A: Attendance At Maternal Delivery For Care Of High Risk Baby(ies) — $61.65
H055A: Emergency medicine specialist consultation in the ED — $125.65
H065A: Consultation In Emergency Medicine — $95.60
H100A: Emergency Department Investigative Ultrasound — $19.65
H101A: Minor Assessment (Day) — $22.65
H102A: ED comprehensive assessment and care – weekday daytime — $56.70
H103A: ED multiple systems assessment – weekday daytime — $46.65
H104A: Reassess (Day) — $22.75
H105A: Inpatient interim orders — $29.05
H112A: ED premium – nights, service without an assessment — $50.95
H113A: ED premium – weekend, holiday or Friday evening, service without an assessment — $32.20
H114A: ED premium – Monday to Thursday evening, service without an assessment — $23.65
H121A: Minor Assessment (Night) — $39.85
H122A: ED comprehensive assessment and care – night — $99.60
H123A: ED multiple systems assessment – night — $80.95
H124A: Reassess (Night) — $39.80
H131A: Minor Assessment (Evening) — $30.05
H132A: ED comprehensive assessment and care – Monday to Thursday evening — $75.40
H133A: ED multiple systems assessment – Monday to Thursday evening — $61.50
H134A: Reassess (Evening) — $30.05
H151A: ED minor assessment – Friday evening, weekend or holiday — $34.15
H152A: ED comprehensive assessment and care – Friday evening, weekend or holiday — $85.70
H153A: ED multiple systems assessment – Friday evening, weekend or holiday — $69.60
H154A: ED re-assessment – Friday evening, weekend or holiday — $34.15
H261A: Newborn care by a paediatrician – hospital or home — $82.90
H264A: $12.00
H267A: Paediatric attendance at maternal delivery — $63.45
H312A: Rehabilitation unit team management – first 12 weeks — $50.15
H313A: Rehabilitation Counselling — $84.20
H317A: Rehabilitation unit team management – weeks 13 to 26 — $50.15
H319A: Rehabilitation unit team management – week 27 onwards — $50.15
H960A: Weekdays Daytime (07:00- 17:00) — $37.40
H962A: Evenings (17:00h 24:00h) Monday To Friday — $37.40
H963A: Sat., Sun. And Holidays (07:00 - 24:00) — $37.40
H964A: Nights (00:00 - 07:00) — $37.40
H980A: Weekdays Daytime (07:00- 17:00) — $20.55
H981A: Weekdays Daytime (07:00- 17:00) — $20.55
H984A: Evenings (17:00h 24:00h) Monday To Friday — $61.70
H985A: Evenings (17:00h 24:00h) Monday To Friday — $61.70
H986A: Nights (00:00 - 07:00) — $102.80
H987A: Nights (00:00 - 07:00) — $102.80
H988A: Sat., Sun. And Holidays (07:00 - 24:00) — $77.10
H989A: Sat., Sun. And Holidays (07:00 - 24:00) — $77.10
J013A: Percutaneous Trans-hepatic Cholangiogram — $185.90
J102C: Echogr.-ophthalmic-quant.,a-mode — $28.50
J103C: Ophthalmic echography – B-scan immersion — $38.05
J105C: Ultrasound – face and/or neck (excluding vascular study) — $23.70
J107C: B-scan Contact — $18.85
J108C: Biometry (axial Length- A-mode) — $19.70
J138C: Intracavitary ultrasound (transvaginal or transrectal) — $26.50
J149C: Ultrasonic Guidance Of Biopsy, Aspiration, Amniocentesis Or Drainage Procedures (one Physician Only) — $56.45
J157C: Gestational age ultrasound for Maternal Serum Screening (before 16 weeks) — $17.55
J158C: Limited pregnancy ultrasound – high risk or complications — $17.55
J159C: Complete pregnancy ultrasound – 16 weeks or later — $33.80
J160C: Complete pregnancy ultrasound – high risk or complications — $32.25
J161C: Limited intracavitary ultrasound – other than pregnancy — $16.25
J162C: Complete pelvic ultrasound — $26.55
J163C: Limited pelvic ultrasound – other than pregnancy — $17.55
J164C: Follicle monitoring ultrasound — $12.30
J165C: Transvaginal sonohysterography — $33.15
J168C: Nuchal translucency ultrasound (prenatal genetic screening) — $20.85
J301C: Simple Spirometry T — $7.85
J303C: Extra Pulmonary Airways Resistance By Plethysmography — $16.05
J304C: Flow Volume Loop T — $12.85
J305C: Lung Compliance — $48.15
J306C: Airways Resistance By Plethysmography Or Estimated Using — $19.20
J307C: Functional Residual Capacity By Body Plethysmography Method — $21.35
J308C: Carbon Dioxide Ventilatory Response — $14.60
J310C: Carbon Monoxide Diffusing Capacity By Single Breath Method — $21.55
J311C: Functional Residual Capacity - By Gas Dilution Method — $21.00
J315C: - J315 Plus 12 Lead E.c.g. Done At Rest, Used For Monitoring - Add — $56.45
J316C: Stage Ii: Repeated Steady State Graded Exercise(must Include — $72.70
J323B: Oxygen Saturation - By Oximetry At Rest, With Or Without O2 — $4.90
J324C: Repeat After Bronchodilator T — $4.20
J327C: Repeat After Bronchodilator T — $7.65
J330C: Assessment Of Exercise Induced Asthma (workload Sufficient To Achieve Heart Rate 85% Of Predicted Maximum; Performance Of J301 Or J304 Before Exercise And 5-10 Minutes Post Exercise) — $27.25
J332C: J332 With At Least Two Levels Of Supplemental O2 — $11.35
J333C: Non-specific Bronchial Provocation Test(histamine) — $41.55
J334C: J332 With At Least Two Levels Of Supplemental O2 — $16.85
J335C: Antigen Challenge Test — $30.95
J336C: Oxygen Saturation - With Single Blind Assessment Of Exercise On Room Air And With Supplemental Oxygen — $16.85
J340C: Maximum Inspiratory & Expiratory Pressures — $3.81
J893C: Multiple Sleep Latency Test — $49.90
J894C: Maintenance Of Wakefulness Test — $49.90
J895C: Level 1 sleep study – therapeutic — $97.50
J896C: Level 1 sleep study – initial diagnostic — $97.50
J897C: Level 1 sleep study – repeat diagnostic — $97.50
K001A: Detention, per 15 minutes or major part thereof — $21.10
K002A: Interview with relatives or authorized decision-maker — $80.00
K003A: Interviews With Children's Aid Society (cas) Or Legal Guardian On Be Half Of The Patient In Accordance With The Health Care Consent Act Conducted For A Purpose Other Than To Obtain Consent (per Unit) — $80.00
K004A: Psychotherapy - Family (2 Or More Family Members In Attendance At The Same Time) Per Unit — $86.85
K005A: Primary Mental Health Care — $80.00
K006A: Hypnotherapy - Individual Care — $80.00
K007A: GP Psychotherapy — $80.00
K008A: Diagnostic Interview And/or Counselling With Child And/or Parent For Psychological Problem Or Learning Disabilities (per Unit) — $80.00
K012A: Group psychotherapy, 4 people - per member per unit — $20.15
K013A: Counselling - up to 3 units/yr — $80.00
K014A: Counselling For Transplant Recipients, Donors Or Families Of Recipients And Donors — $80.00
K015A: Counselling of Relatives (scheduled visit) — $80.00
K017A: Child (2 - 15 yo) Periodic Health Assessment — $49.55
K022A: HIV - Primary Care — $80.00
K023A: Palliative Care Support (>20 min) — $85.25
K028A: STD Management (max 2units/pt/doc/day & 4 units/pt/doc/yr) — $80.00
K029A: Diabetes – Insulin Therapy Support — $80.00
K030A: Diabetic Management Assessment (4/yr) — $45.75
K032A: Neurocognitive Assessment — $80.00
K033A: Counselling - When billing more than 3 units/yr (K013) — $56.30
K034A: Telephone Reporting - Specified Reportable Disease To A Moh — $36.00
K035A: MTO Mandatory Reporting Medical Condition — $36.25
K036A: Northern Travel Grant Application — $10.25
K037A: Chronic Fatigue/Fibromyalgia care — $80.00
K038A: Long Term Care Application — $46.35
K039A: Smoking Cessation Follow up — $39.25
K040A: Group counselling, per unit, where no group member received > 3 units K013 or K040 per 12 month period — $80.00
K041A: Group counselling, 2 or more persons - additional units — $57.30
K042A: Extended Specific Neurocognitive Assessment — $140.20
K045A: Diabetes Management By A Specialist — $80.25
K046A: Diabetes Team Management — $127.20
K050A: MCFSC HSR & ADL Amalgamated Form — $116.15
K051A: Health Status Report for initial ODSP application — $92.90
K052A: ADL Index (completed separately), initial ODSP application — $23.20
K053A: Ontario Works Program - Limitation to Participation — $17.45
K054A: MCFSC Mandatory Special Necessities Benefit Form — $29.05
K055A: MCFSC Special Diet Application Form — $23.20
K056A: MCFSC Pregnancy, Breastfeeding Allowance Application Form — $23.20
K057A: ODSP Completion of medical Form Part A — $40.70
K058A: ODSP Completion of medical Form Part B - Both HSR & ADLI — $145.15
K060A: ODSP Completion of medical Form Part B - ADLI — $29.05
K070A: Home Care Application — $34.75
K071A: Acute home care supervision (1 per pt per week per MD for 8 weeks) — $21.95
K072A: Chronic Home Care Supervision (2 per month per pt per MD after 8 weeks) — $21.95
K077A: Geriatric Telephone Support - Per Unit — $43.10
K119A: Paediatric developmental assessment incentive (PDAI) — $142.50
K121A: In-Hospital Case Conference - acute, chronic or rehab (per unit) — $37.05
K122A: Individual developmental and/or behavioural care (per unit) — $102.35
K123A: Developmental And/or Behavioural Care - Family Developmental And/or Behavioural Care - Per Unit — $116.15
K124A: LTC Case conf./10 min. unit max. 4/year — $37.05
K125A: Intellectual and developmental disability primary care — $80.00
K130A: Adolescent (16 - 17 yo) Periodic Health Assessment — $87.10
K131A: Adult (18 - 64 yo) Periodic Health Assessment — $64.25
K132A: Adult (>65 yo) Periodic Health Assessment — $91.35
K133A: Annual Exam Intellectual and Developmental Disability — $164.25
K180A: $125.00
K181A: Consultation And Management For Acute Cerebral Vascular Syndrome (acvs) - After First 30 Minutes, Must Include Intravenous Thrombolysis Therapy And Monitoring, Per 30 Minute Unit (or Major Part Thereof) — $90.00
K187A: - Acute Post-discharge Community Psychiatric Care - Add 15%
K188A: - High Risk Community Psychiatric Care - Add 15%
K189A: $216.30
K190A: Individual In-patient Psychotherapy - Per Unit — $107.25
K191A: Family psychiatric care – in-patient — $134.00
K192A: Individual hypnotherapy — $102.35
K193A: Family psychotherapy – in-patient — $121.65
K195A: Family psychotherapy – out-patient — $116.15
K196A: Family Psychiatric Care - Out-patient - Per Unit — $116.15
K197A: Individual psychotherapy – out-patient — $102.35
K198A: Psychiatric Care - Out-patient - Per Unit — $102.35
K199A: Psychiatric Care - In-patient - Per Unit — $118.00
K200A: Group psychotherapy – in-patient, 4 people — $26.75
K201A: Group psychotherapy – in-patient, 5 people — $21.40
K202A: Group psychotherapy – in-patient, 6 to 12 people — $19.35
K203A: Group psychotherapy – out-patient, 4 people — $25.60
K204A: Group psychotherapy – out-patient, 5 people — $20.45
K205A: Group psychotherapy – out-patient, 6 to 12 people — $18.45
K206A: Group psychotherapy – out-patient, additional units — $16.40
K208A: Group psychotherapy – out-patient, 2 people — $51.20
K209A: Group psychotherapy – out-patient, 3 people — $34.10
K210A: Group psychotherapy – in-patient, 2 people — $53.70
K211A: Group psychotherapy – in-patient, 3 people — $35.80
K267A: Paediatric periodic health visit – age 2 to 11 — $48.05
K269A: Paediatric periodic health visit – age 12 to 17 — $89.15
K300A: Video visit code add (existing/ongoing Patient-Physician Relationship)
K301A: Telephone visit code add on (ongoing Patient-Physician Relationship)
K313A: Physiatric Management — $8.10
K480A: Physician To Allied Professional Telephone Consultation — $31.35
K481A: Rheumatoid Arthritis Management By A Specialist — $85.35
K620A: Consultation For Involuntary Psychiatric Treatment - Per Unit — $108.35
K623A: Form 1 - Application for Psychiatric Assessment — $133.60
K624A: Certification Of Involuntary Admission — $164.50
K629A: All Other Re-certification(s) Of Involuntary Admission Including Completion Of Appropriate Forms — $48.75
K630A: Psychiatric Consultation Extension - Per Unit — $134.00
K700A: Outpatient Palliative Case Conference (per unit) — $37.05
K701A: Mental Health Out-patient Case Conference (per Unit) — $37.05
K703A: Geriatric Out-patient Case (per Unit) — $37.05
K704A: Paediatric Out-patient Case Conference (per Unit) — $37.05
K707A: Chronic Pain Out-patient Case Conference (per Unit) — $37.05
K708A: Multidisciplinary Cancer Conferences (per patient) — $37.05
K709A: Mcc Chairperson, Per Patient — $47.75
K710A: Mcc Radiologist Participant, Per Patient — $37.05
K711A: Mcc Nuclear Medicine Participant For Patients Requiring Pet Scan — $37.05
K730A: Referring Physician (Telephone Consultation) — $37.05
K731A: Consulting Physician (Telephone Consultation) — $47.75
K732A: CritiCall telephone consultation, referring physician — $37.05
K733A: Consulting Physician (Critical Consultation) — $47.75
K734A: Physician To Physician Telephone Consultation - Referring Physician (physician On Duty In An Emergency Department Or A Hospital Urgent Care Clinic) — $37.05
K735A: Physician To Physician Telephone Consultation - Consultant Physician (physician On Duty In An Emergency Department Or A Hospital Urgent Care Clinic) — $47.75
K736A: Criticall Telephone Consultation - Referring Physician (physician On Duty In An Emergency Department Or A Hospital Urgent Care Clinic) — $37.05
K738A: Referring Physician (E Consultation) — $16.45
K739A: Consulting Physician (E Consultation) — $20.50
K887A: Cto Initiation Including Completion Of The Cto Form And All Preceding Cto Services Directly Related To Cto Initiation (per Unit) — $107.90
K888A: Cto Supervision Including All Associated Cto Services Except Those Related To Initiation Or Renewal (per Unit) — $107.90
K889A: Cto Renewal Including Completion Of The Cto Form And All Preceding Cto Services Directly Related To Cto Renewal (per Unit) — $107.90
K960A: Weekdays Daytime (07:00 - 17:00) — $37.40
K990A: Weekdays Daytime (07:00 - 17:00) — $20.55
K992A: Weekdays Daytime (07:00 - 17:00) With Sacrifice Of Office Hours — $41.10
K994A: Evenings (17:00 - 24:00) Monday Thorugh Friday — $61.70
K996A: Nights (00:00 - 07:00) — $102.80
K998A: Sat., Sun And Holidays (07:00 - 24:00) — $77.10
M012A: Septoplasty — $293.95
M054A: Ethmoidectomy/antrostomy - Intranasal Ethmoidectomy Including Maxillary Antrostomy, With Endoscope Unilateral (not Eligible For Payment With M061 Or M054) — $123.70
M083A: Ethmoidectomy/antrostomy - Intranasal Ethmoidectomy Including Maxillary Antrostomy, With Endoscope Unilateral (not Eligible For Payment With M061 Or M054) — $350.00
N290A: Decompression Median Nerve At Wrist (carpal Tunnel Syndrome) — $197.15
P002A: High Risk Prenatal Assessment — $87.25
P003A: Major Prenatal — $93.85
P004A: Minor Prenatal Assessment — $44.55
P005A: Antenatal Preventative Assessment — $55.70
P006A: Vaginal Delivery — $512.65
P007A: Postnatal Care Hospital — $65.55
P008A: Postnatal Care Office — $43.80
P009A: Attendance At Labour And Delivery — $512.65
P010A: Attendance Of Obstetric Consultant(s) At Delivery — $211.20
P018A: Caesarean Section — $579.80
P020A: Operative Delivery — $535.60
P023A: Oxytocin Stimulation — $67.75
P025A: Non Stress Test — $9.65
P030A: Cervical Ripening (max 1 per pregnancy) — $58.60
P038A: Attendance at labour – patient transferred for delivery — $211.20
P041A: Caesarean Section Including Tubal Interruption — $609.20
P042A: Caesarean Section Including Hysterectomy — $1,004.60
P045A: Repair Of Third Degree Tear Or Episiotomy Extension, Must Include Repair Of Perianal Sphincter And Perineum — $82.15
P046A: Repair Of Fourth Degree Tear Or Episiotomy Extension, Must Include Repair Of Rectal Mucosa, Perianal Sphincter And Perineum — $200.00
Q011A: Pap Smear (25 - 69 years)
Q012A: After-hours premium — 50% premium
Q015A: Newborn Care Episodic Fee (FHO) (max 8 in first year of life) — $13.99
Q016A: After-hours premium (CCM) — 50% premium
Q020A: Bipolar for 10+ patients
Q021A: Serious mental illness premium: schizophrenia tracking code
Q023A: Unattached Patient Fee — $150.00
Q040A: Diabetes Management Incentive (Annual) Flow Sheet. Min K030 X 3 — $65.70
Q042A: Smoking Cessation Counselling Fee (2/yr) — $7.70
Q043A: New Patient Fee FIT Positive or increased colorectal risk — $150.00
Q050A: Heart Failure Management Incentive (Annual) — $125.00
Q053A: HCC Complex Vulnerable New Patient Fee — $350.00
Q100A: Preventive care bonus, influenza 60%
Q101A: Preventive care bonus, influenza 65%
Q104A: Preventive care bonus, influenza 80%
Q105A: Preventive care bonus, cervical screening 60%
Q106A: Preventive care bonus, cervical screening 65%
Q113A: Preventive care bonus, mammography 70%
Q114A: Preventive care bonus, mammography 75%
Q115A: Preventive care bonus, childhood immunizations 85%
Q116A: Preventive care bonus, childhood immunizations 90%
Q117A: Preventive care bonus, childhood immunizations 95%
Q119A: Preventive care bonus, colorectal screening 20%
Q120A: Preventive care bonus, colorectal screening 40%
Q130A: Influenza Vaccine (65 & over)
Q131A: Mammogram (50 - 74 years)
Q132A: Childhood immunizations tracking code
Q133A: Colorectal Screening (45 - 74 years)
Q140A: Pap smear exclusion code
Q141A: Mammography exclusion code
Q142A: Colorectal cancer screening exclusion code
Q150A: Colorectal Cancer Screening (Once per patient every 2 years) — $7.00
Q152A: Colorectal Cancer Screening Test Completion (Once per pt per 2 years) (if not met min. roster size - <650 in FHG & CCM) — $5.00
Q200A: Per Patient Rostering
Q202A: Long-term care per-patient rostering fee
Q310A: FHO+ hourly direct patient care — $20.00
Q311A: FHO+ hourly phone care away from the clinic — $17.00
Q312A: FHO+ hourly indirect patient care — $20.00
Q313A: FHO+ hourly clinical administration — $20.00
Q590A: FHO/FHN ONLY if influenza is sole reason add to G590 — $8.80
Q593A: COVID-19 vaccine sole visit premium (patient enrolment models) — $8.80
Q888A: Weekend & Holiday Access for FHO Patients — $44.55
R002A: Advancement flap — defect 2.1 to 5 cm — other areas — $67.40
R010A: Malignant Melanoma - Wide Excision In Any Area And Must Include > 1 Cm Margins And Layered Closure — $135.95
R011A: Advancement flap — defect 2.1 to 5 cm — face, neck or scalp — $89.85
R018A: Malignant skin lesion — curettage, electrodesiccation or cryosurgery, face or neck — one lesion — $75.10
R019A: Malignant skin lesion — curettage, electrodesiccation or cryosurgery, face or neck — two lesions — $123.70
R020A: Malignant skin lesion — curettage, electrodesiccation or cryosurgery, face or neck — three or more lesions — $247.30
R021A: Scar revision – face or neck, up to 2.5 cm — $115.60
R022A: Scar revision – face or neck, 2.6 to 5 cm — $194.85
R023A: Scar revision – face or neck, 5.1 to 10 cm — $277.90
R024A: Repair Of Lacerations - Acute Laceration Earlobe, Unilateral — $110.25
R026A: Scar revision – other areas, up to 2.5 cm — $77.35
R031A: Malignant skin lesion — curettage, electrodesiccation or cryosurgery, other areas — one lesion — $60.35
R032A: Malignant skin lesion — curettage, electrodesiccation or cryosurgery, other areas — two lesions — $99.45
R033A: Malignant skin lesion — curettage, electrodesiccation or cryosurgery, other areas — three or more lesions — $199.05
R035A: Group 4 - Other Lesions - Pilonidal Cyst - Simple Excision Or Marsupialization — $219.10
R040A: Malignant skin lesion — simple excision, other areas — two lesions — $104.85
R041A: Malignant skin lesion — simple excision, other areas — three or more lesions — $209.70
R045A: Rotation, transposition or Z-plasty flap — defect under 2 cm — face, neck or scalp — $203.70
R046A: Rotation/transposition flap or Z-plasty – face, neck or scalp, 2.1 to 5 cm — $335.15
R048A: Malignant skin lesion, face or neck: single simple excision — $100.95
R049A: Malignant skin lesion — simple excision, face or neck — two lesions — $152.50
R050A: Malignant skin lesion — simple excision, face or neck — three or more lesions — $255.25
R072A: Rotation, transposition or Z-plasty flap — defect under 2 cm — other areas — $133.40
R075A: Rotation/transposition flap or Z-plasty – other areas, 2.1 to 5 cm — $223.35
R081A: Mohs micrographic surgery — initial cut — $315.45
R083A: Full-thickness skin graft – major (over 5 cm) — $280.15
R091A: Full-thickness skin graft – complex (eyelid, nose, lip, face) — $263.95
R092A: Full-thickness skin graft – minor (under 1 cm) — $116.65
R093A: Full-thickness skin graft – intermediate (1 to 5 cm) — $178.90
R094A: Malignant lesion Other - single, simple excision — $63.70
R102A: Oncoplastic Breast Surgery - Level 1 Oncoplastic Breast Conserving Lumpectomy Or Partial Mastectomy For Malignancy — $350.00
R107A: Tumour Or Tissue For Diagnostic Biopsy And/or Treatment, E.g. Carcinoma, Fibroadenoma Or Fibrocystic Disease (single Or Multiple Same Breast) — $169.95
R108A: Mastectomy - Female (with Or Without Biopsy) - Simple — $330.00
R111A: Partial Mastectomy Or Wedge Resection For Treatment Of Breast Disease, With Or Without Biopsy, E.g. Carcinoma Or Extensive Fibrocystic Disease — $306.75
R150A: Plastic surgery procedure – very minor — $92.30
R151A: Plastic surgery procedure – minor — $140.25
R152A: Plastic surgery procedure – intermediate — $259.20
R153A: Plastic surgery procedure – major — $388.00
R154A: Plastic surgery procedure – extensive major — $568.95
R160A: Pre-malignant skin lesion — simple excision, face or neck — one lesion — $58.30
R161A: Pre-malignant skin lesion — simple excision, face or neck — two lesions — $95.75
R162A: Pre-malignant skin lesion — simple excision, face or neck — three or more lesions — $191.45
R163A: Pre-malignant skin lesion — simple excision, other areas — one lesion — $47.75
R164A: Pre-malignant skin lesion — simple excision, other areas — two lesions — $78.65
R165A: Pre-malignant skin lesion — simple excision, other areas — three or more lesions — $157.35
R219A: Phalanx/metacarpal/carpus - Incision And Drainage — $182.90
R268A: Removal Of Internal Fixation Device - Local Anaesthetic — $54.85
R517A: Excision Of Foreign Body — $107.70
R522A: Muscle - Simple — $193.00
R591A: Tumours - Soft Tissues - Superficial — $196.05
R592A: Tumours - Soft Tissues - Deep — $484.35
R687A: Knee arthroscopy set-up – degenerative knee disease — $97.35
R853A: Tenckhoff Type Peritoneal Catheter - Insertion, Chronic By Trocar — $154.40
R854A: Tenckhoff Type Peritoneal Catheter - Removal — $63.10
R914A: Axillary Or Inguinal Lymph Nodes - Limited Resection, Unilateral — $310.95
S063A: Tonsillectomy, with or without adenoidectomy — $214.50
S065A: Adenoidectomy — $101.25
S165A: Small intestine resection with anastomosis – other than duodenum — $844.25
S166A: Resection With Anastomosis - Small And Large Intestine Terminal Ileum, Cecum And Ascending Colon (right Hemicolectomy) — $1,029.45
S167A: Resection With Anastomosis - Large Intestine Any Portion — $1,004.40
S171A: Resection With Anastomosis - Left Hemicolectomy With Anterior Resection Or Proctosigmoidectomy (anastomosis Below Peritoneal Reflection & Mobilization Of Splenic Flexure) — $1,290.55
S204A: Incision And Drainage Of Abscess — $273.60
S207A: Appendectomy With Or Without Perforation — $524.60
S236A: Linear Or Radial Echo-endoscope - Excluding Biliary Or Pancreatic Examination (scope Also Used For Therapeutic Procedures) — $203.05
S237A: Linear Or Radial Echo-endoscope - Including Biliary And/or Pancreatic Examination (scope Also Used For Therapeutic Procedures) — $253.80
S247A: Haemorrhoidectomy, With Or Without Sigmoidoscopy Or Repair Of Fissure(s) And/or Sphincterotomy And/or Anal Dilation — $260.15
S251A: Fistula-in-ano: Seton drain and/or fistulotomy — $234.45
S287A: Cholecystectomy — $544.30
S312A: Laparotomy, With Or Without Biopsy Or For Hirschsprung's Disease (except Biopsies Of Stomach, Liver, Pancreas And Multiple Paraaortic Lymph Nodes — $485.25
S313A: Peritoneal abscess drainage – subphrenic — $370.95
S314A: Peritoneal abscess drainage – abdominal — $301.10
S318A: Panniculectomy, Including Any Necessary Diastasis Repair — $500.00
S321A: Laparotomy - For Acute Trauma — $671.65
S322A: Herniotomy - Inguinal And/or Femoral - Infants — $522.60
S323A: Herniotomy - Inguinal And/or Femoral - Adolescents And Adults — $357.80
S326A: Herniotomy - Inguinal And/or Femoral - Children — $442.20
S329A: Herniotomy - Strangulated Or Incarcerated - Without Resection Of Bowel — $425.00
S330A: Strangulated or incarcerated inguinal/femoral hernia repair with bowel resection — $660.50
S332A: Herniotomy - Umbilical - Adolescent Or Adult, With Or Without Resection Of Incarcerated/strangulated Contents — $324.20
S340A: Ventral or incisional hernia, under 5 cm or primary closure — $370.95
S344A: Ventral or incisional hernia, defect 5 cm or more, with mesh — $569.35
S411A: Partial Or Heminephrectomy — $972.35
S416A: Nephrectomy — $972.35
S420A: Nephrectomy - Nephroureterectomy, Total, With Resection Of Ureterovesical Junction — $1,336.35
S460A: Ureterolysis For Periureteral Fibrosis - Unilateral — $480.25
S470A: Cystoscopy With Manipulation And/or Removal Of Calculus And Retrograde Pyelogram If Required — $240.65
S519A: Plastic Repair Of Bladder Neck - Adolescent Or Adult — $468.70
S565A: $500.00
S569A: Slit Of Prepuce (complete Care) - Adult Or Child — $65.30
S582A: $650.00
S595A: Ruptured testicle — $448.70
S600A: Orchidopexy - Reduction Of Torsion Of Testis Or Appendix Testis And Orchidopexy (one Or Both Sides) If Required — $456.95
S626A: Vasectomy - Uni - Or Bilateral - By Any Technique — $115.10
S636A: Vesiculectomy — $552.30
S639A: $550.00
S651A: Prostatectomy - Radical, With Or Without Removal Of Bladder Stones — $1,174.70
S654A: Repeat endoscopic prostate surgery within one year (residual or regrowth) — $440.85
S655A: Endoscopic Removal Or Destruction Of Prostatic Tissue — $483.05
S716A: Anterior or posterior vaginal repair — $250.65
S717A: Anterior and posterior vaginal repair — $396.80
S718A: Anterior and posterior repair with enterocoele and/or vault prolapse repair — $432.45
S719A: Posterior repair with enterocoele and/or vault prolapse repair — $366.55
S722A: Post-hysterectomy vault prolapse repair, vaginal approach — $432.45
S724A: Abdominal Approach To Vaginal Vault Prolapse - Perineorrhaphy (not Eligible For Payment With Delivery Or Other Vaginal Surgery Procedures) — $127.35
S738A: Ectopic Pregnancy - Salpingectomy Or Salpingooophorectomy (unior Bilateral) — $366.20
S741A: Ectopic Pregnancy - Tubal Occlusion Or Interruption For The Purpose Of Sterilization, By Any Method Or Approach — $155.70
S745A: Oophorectomy - And/or Oophorocystectomy — $366.20
S754A: Diagnostic curettage — $97.20
S757A: Abdominal hysterectomy, total or subtotal — $643.35
S758A: Hysterectomy with anterior and posterior vaginal repair — $733.45
S759A: Hysterectomy with anterior or posterior vaginal repair — $655.05
S768A: Spontaneous incomplete abortion, including D&C — $113.40
S772A: Endometrial Ablation By Any Method — $225.90
S784A: Ectopic pregnancy – surgical management — $462.20
S816A: Vaginal hysterectomy — $643.35
U021A: Dermatology minor e-assessment — $11.80
U023A: Dermatology repeat e-assessment — $31.15
U025A: Dermatology initial e-assessment — $47.75
U026A: Dermatology follow-up e-assessment — $23.50
U231A: Ophthalmology minor e-assessment — $15.75
U233A: Ophthalmology repeat e-assessment — $45.40
U235A: Ophthalmology initial e-assessment — $48.05
U236A: Ophthalmology follow-up e-assessment — $30.35
U990A: Weekday daytime out-patient special visit premium, first patient — $20.55
U991A: Weekday daytime out-patient special visit premium, additional patients — $20.55
U992A: Weekday out-patient special visit premium, office hours sacrificed, first patient — $41.10
U993A: Weekday out-patient special visit premium, office hours sacrificed, additional patients — $41.10
U994A: Weekday evening out-patient special visit premium, first patient — $61.70
U995A: Weekday evening out-patient special visit premium, additional patients — $61.70
U996A: Night out-patient special visit premium, first patient — $102.80
U997A: Night out-patient special visit premium, additional patients — $102.80
U998A: Weekend/holiday out-patient special visit premium, first patient — $77.10
U999A: Weekend/holiday out-patient special visit premium, additional patients — $77.10
W001A: Additional subsequent visits - 4/month — $40.05
W002A: First 4 visits/month — $40.05
W003A: First 2 visits/month — $40.05
W004A: General Re-assessment Of Patient In Nursing Home (per The Nursing Homes Act) — $38.35
W008A: Additional 2 subsequent visits/month — $40.05
W010A: Monthly Management Fee — $135.30
W031A: General surgery chronic care subsequent visit – additional visits — $40.05
W032A: General surgery chronic care subsequent visit – first 4 per month — $40.05
W033A: General surgery nursing home subsequent visit – first 2 per month — $40.05
W035A: Consultation — $114.75
W036A: Repeat Consultation — $76.45
W038A: General surgery nursing home subsequent visit – additional visits — $40.05
W061A: Chronic care subsequent visit – additional (orthopaedics) — $40.05
W062A: Chronic care subsequent visit – first 4 per month (orthopaedics) — $40.05
W063A: Nursing home subsequent visit – first 2 per month (orthopaedics) — $40.05
W065A: Orthopaedic surgery long-term care consultation — $89.80
W066A: Orthopaedic surgery long-term care repeat consultation — $55.35
W068A: Nursing home subsequent visit – additional (orthopaedics) — $40.05
W071A: Geriatric chronic care subsequent visit – additional — $40.05
W072A: Geriatric chronic care subsequent visit – first 4 per month — $40.05
W073A: Geriatric nursing home subsequent visit – first 2 per month — $40.05
W074A: Geriatric nursing home general re-assessment — $20.60
W075A: Geriatric long-term care consultation — $249.90
W078A: Geriatric nursing home subsequent visit – additional — $40.05
W102A: LTC admission assessment – Type 1 — $71.20
W104A: LTC admission assessment – Type 2 — $20.60
W105A: LTC consultation (family practice) — $95.60
W106A: LTC repeat consultation (family practice) — $45.90
W107A: LTC admission assessment – Type 3 — $30.70
W109A: LTC periodic health visit — $72.35
W121A: LTC visit for acute intercurrent illness — $40.05
W124A: LTC discharge-day visit — $71.80
W130A: Comprehensive internal medicine consultation – long-term care — $342.25
W131A: Internal medicine LTC subsequent visit – chronic care hospital, additional visits — $40.05
W132A: Internal medicine chronic care subsequent visit – first 4 per month — $40.05
W133A: Internal medicine LTC subsequent visit – nursing home, first 2 visits in the month — $40.05
W134A: Internal medicine nursing home general re-assessment — $20.60
W138A: Internal medicine LTC subsequent visit – nursing home, additional visits — $40.05
W150A: Comprehensive Endocrinology Consultation - Subject To The Same Conditions As A150 — $342.25
W151A: Endocrinology subsequent visit – chronic care or convalescent hospital, additional visits — $40.05
W152A: Endocrinology subsequent visit – chronic care or convalescent hospital, first 4 per month — $40.05
W153A: Endocrinology subsequent visit – nursing home, first 2 per month — $40.05
W154A: General Re-assessment Of Patient In Nursing Home (as Per The Nursing Homes Act)* — $20.60
W155A: Endocrinology consultation – long-term care — $172.95
W156A: Endocrinology repeat consultation – long-term care — $110.15
W158A: Endocrinology subsequent visit – nursing home, additional visits — $40.05
W161A: Nephrology LTC subsequent visit – chronic care hospital, additional visits — $40.05
W162A: Nephrology LTC subsequent visit – chronic care hospital, first 4 visits in the month — $40.05
W163A: Nephrology LTC subsequent visit – nursing home, first 2 visits in the month — $40.05
W168A: Nephrology LTC subsequent visit – nursing home, additional visits — $40.05
W232A: Internal medicine LTC admission assessment – Type 1 — $69.35
W234A: Internal medicine LTC admission assessment – Type 2 — $20.60
W235A: Internal medicine long-term care consultation — $192.85
W236A: Internal medicine repeat consultation – long-term care — $123.10
W237A: Internal medicine LTC admission assessment – Type 3 — $30.70
W239A: Internal medicine LTC periodic health visit — $65.05
W252A: Endocrinology long-term care admission assessment – Type 1 — $69.35
W254A: Endocrinology long-term care admission assessment – Type 2 — $20.60
W255A: Endocrinology limited consultation – long-term care — $110.15
W257A: Endocrinology long-term care admission assessment – Type 3 — $30.70
W259A: Endocrinology periodic health visit – long-term care — $65.05
W260A: Special paediatric consultation – long-term care — $342.25
W265A: Paediatric consultation – long-term care — $190.35
W266A: Paediatric repeat consultation – long-term care — $104.70
W272A: Geriatric LTC admission assessment – Type 1 — $74.65
W274A: Geriatric LTC admission assessment – Type 2 — $20.60
W277A: Geriatric LTC admission assessment – Type 3 — $30.70
W279A: Geriatric LTC periodic health visit — $65.05
W305A: Obstetrics and gynaecology consultation – long-term care — $134.25
W306A: Obstetrics and gynaecology repeat consultation – long-term care — $71.45
W311A: Physiatry chronic care visit – additional visits — $40.05
W312A: Physiatry chronic care visit – first 4 per month — $40.05
W313A: Physiatry nursing home visit – first 2 per month — $40.05
W314A: Physiatry general re-assessment – nursing home — $20.60
W318A: Physiatry nursing home visit – additional visits — $40.05
W419A: Physiatry periodic health visit – long-term care — $65.05
W435A: Internal medicine long-term care limited consultation — $123.10
W510A: Complex neuromuscular assessment – long-term care — $104.85
W511A: Complex physiatry assessment – long-term care — $114.80
W512A: Physiatry long-term care admission assessment – Type 1 — $69.35
W514A: Physiatry long-term care admission assessment – Type 2 — $20.60
W515A: Physical medicine and rehabilitation consultation – long-term care — $233.65
W517A: Physiatry long-term care admission assessment – Type 3 — $30.70
W565A: Paediatric limited consultation – long-term care — $104.70
W662A: Extended special paediatric consultation – long-term care — $442.40
W667A: Neurodevelopmental consultation – long-term care — $456.80
W760A: Complex Endocrine Neoplastic Disease Assessment - Subject To The Same Conditions As A760 — $102.95
W770A: Extended Comprehensive Geriatric Consultation - Subject To The Same Conditions As A770 — $442.40
W771A: Certification of death - subject to same conditions as A771 — $24.20
W775A: Comprehensive Geriatric Consultation - Subject To The Same Conditions As A775 — $342.25
W777A: LTC Pronouncement of death - subject to the same conditions as A777 (incl. death certificate) — $44.55
W872A: Palliative Care Assessment - GP, LTC — $40.05
W882A: Palliative Care Assessment - GP, chronic care/rehab — $40.05
W911A: Special Family And General Practice Consultation - Subject To The Same Conditions As A911 — $164.95
W912A: Comprehensive Family And General Practice Consultation - Subject To The Same Conditions As A912 — $247.40
W960A: Weekdays Daytime (07:00 - 17:00) — $37.40
W972A: Palliative Care Assessment - Specialist, LTC — $40.05
W982A: Palliative Care Assessment - Specialist, chronic care/rehab — $40.05
X048C: Shoulder - Two Views — $8.70
X054C: Hand - Two Or Three Views — $7.00
X065C: Knee Including Patella - Two Views — $7.00
X067C: Ankle - Two Or Three Views — $7.00
X069C: Foot - Two Or Three Views — $7.00
X090C: Chest - Single View — $6.95
X091C: Chest - Two Views — $11.70
X225C: Knee Including Patella - Five Or More Views — $12.70
Z080A: Debride wound or ulcer to s.c tissue 10 min 1 — $21.90
Z081A: Debride wound or ulcer to s.c tissue 10 min 2 — $32.90
Z082A: Debridement of wounds or ulcers into subcutaneous tissue — three — $49.30
Z083A: Debridement Of Wound(s) And/or Ulcer(s) Extending Into Subcutaneous Tissue - Four Or More — $65.75
Z084A: Debridement Of Wound(s) And/or Ulcer(s) Extending Into Any Of The Following Structures: Tendon, Ligament, Bursa And/or Bone - One — $65.75
Z085A: Debridement of wounds or ulcers into tendon, ligament, bursa or bone — two or more — $98.65
Z096A: Group 4 - Other Lesions - Lipoma 5 To 10 Cm — $87.65
Z097A: Group 4 - Other Lesions - Lipoma Over 10 Cm — $175.30
Z101A: Abscess, Haematoma I&D (one) — $28.20
Z102A: Abscess Or Haematoma - General Anaesthetic - Subcutaneous - One — $48.60
Z103A: Incision and drainage of palmar or plantar space abscess or haematoma – local anaesthetic — $48.60
Z104A: Incision and drainage of perianal abscess or haematoma – local anaesthetic — $33.25
Z105A: Abscess Or Haematoma - General Anaesthetic - Subcutaneous - Perianal — $72.30
Z106A: Abscess, Haematoma I&D ischiorectal/pilonidal — $48.60
Z107A: Abscess Or Haematoma - General Anaesthetic - Subcutaneous - Ischiorectal Or Pilonidal — $118.30
Z108A: Abscess Or Haematoma - General Anaesthetic - Subcutaneous - Palmar Or Plantar Spaces — $78.90
Z111A: Frenotomy - Simple Not Requiring General Anaesthetic — $20.00
Z113A: Biopsy(ies) - any method, when sutures are not used — $32.45
Z114A: Foreign body removal - local anaesthetic — $27.65
Z115A: Foreign Body Removal - General Anaesthetic — $97.30
Z116A: Biopsy(ies) - any method, when sutures are used — $32.45
Z117A: Chemical/Cryotherapy Rx wart (plantar, genital) — $12.75
Z118A: Aspiration of superficial lump for cytology — $30.95
Z119A: Cryotherapy of 5 or more actinic keratoses, same day — $31.80
Z122A: Group 3 - Cyst, Haemangioma, Lipoma - Face Or Neck Local Anaesthetic - Single Lesion — $42.20
Z123A: Cyst, haemangioma or lipoma (Group 3) — face or neck, local anaesthetic — two lesions — $74.30
Z124A: Cyst, haemangioma or lipoma (Group 3) — face or neck, local anaesthetic — three or more lesions — $85.45
Z125A: Group 3 - Cyst, Haemangioma, Lipoma - Other Areas - Local Anaesthetic - Single Lesion — $35.05
Z126A: Cyst, haemangioma or lipoma (Group 3) — other areas, local anaesthetic — two lesions — $49.30
Z127A: Cyst, haemangioma or lipoma (Group 3) — other areas, local anaesthetic — three or more lesions — $65.75
Z128A: Simple, partial or complete nail plate excision req. anaesthesia — $36.30
Z129A: Simple, Partial Or Complete, Nail Plate Excision Requiring Anaesthesia - Multiple — $39.20
Z130A: Radical, Including Destruction Of Nail Bed - One — $68.75
Z131A: Radical nail excision with nail bed destruction – multiple — $90.70
Z137A: Percutaneous Inflation Of First Tissue Expander — $23.05
Z139A: Breast Cyst Aspiration — $37.20
Z140A: Drainage Of Intramammary Abscess Or Haematoma - Single Or Multiloculated Local Anaesthetic — $33.00
Z141A: Breast needle biopsy, one or more — $37.20
Z142A: Removal Of Breast Prosthesis — $150.00
Z143A: Needle Biopsy - Large Core Breast Biopsy (14 Gauge Or Larger Bore Needle) — $144.85
Z149A: Group 3 - Cyst, Haemangioma, Lipoma - Other Areas General Anaesthetic - Single Lesion — $54.80
Z151A: Group 3 - Cyst, Haemangioma, Lipoma - Other Areas General Anaesthetic - Three Or More Lesions — $107.95
Z154A: Repair of lacerations - up to 5cm (face and/or requires tying of bleeders and/or closure in layers) — $39.35
Z156A: Group 1 - E.g. Keratosis, Pyogenic Granuloma - Removal By Excision And Suture - Single Lesion — $21.90
Z157A: Benign skin lesion (Group 1) — excision and suture — two lesions — $29.05
Z158A: Benign skin lesion (Group 1) — excision and suture — three or more lesions — $48.50
Z159A: Group 1 - E.g. Keratosis, Pyogenic Granuloma - Removal By Electrocoagulation And/or Curetting - Single Lesion — $11.55
Z160A: Group 1 - E.g. Keratosis, Pyogenic Granuloma - Removal By Electrocoagulation And/or Curetting - Two Lesions — $17.35
Z161A: Benign skin lesion (Group 1) — electrocoagulation and/or curetting — three or more lesions — $28.70
Z162A: Group 2 - Nevus - Removal By Excision And Suture - Single Lesion — $21.90
Z163A: Nevus (Group 2) — excision and suture — two lesions — $29.05
Z164A: Nevus (Group 2) — excision and suture — three or more lesions — $48.50
Z172A: Abscess Or Haematoma - General Anaesthetic - Subcutaneous - Two Or More — $72.95
Z173A: Abscess or haematoma, subcutaneous — local anaesthetic — two — $33.25
Z174A: Abscess or haematoma, subcutaneous — local anaesthetic — three or more — $44.70
Z175A: Repair Of Lacerations - 5.1 To 10 Cm — $39.35
Z176A: Repair of lacerations - up to 5cm — $21.90
Z177A: Laceration repair — 5.1 to 10 cm, face or layered/bleeders — $78.15
Z179A: Repair Of Lacerations - 10.1 To 15 Cm — $55.20
Z180A: Resuscitation - Major Burn, Initial Care - First Day — $106.25
Z187A: Complex Laceration Repair, Face — $101.15
Z188A: Complex Laceration Repair, Anatomical Area Other Than Face, (except Digit, Zone 1 Repair) — $101.15
Z189A: Complex Repair, Digit, Zone 1 Repair, Without Soft Tissue Loss, Per Digit — $101.15
Z190A: Repair Of Lacerations - 10.1 To 15 Cm If On Face And/or Requires Tying Of Bleeders And/or Closure In Layers — $111.20
Z191A: Repair Of Lacerations - More Than 15.1 Cm Other Than Face — $84.70
Z192A: Repair Of Lacerations - More Than 15.1 Cm On Face — $169.75
Z198A: Cast toes — $10.25
Z199A: Cast foot — $14.90
Z201A: Cast Finger — $10.25
Z202A: Cast Hand — $14.90
Z203A: Cast – arm, forearm or wrist — $24.10
Z204A: Cast removal — $10.25
Z208A: Shoulder spica cast — $97.35
Z211A: Cast – whole leg (mid-thigh to toes) — $28.80
Z213A: Cast – below knee or knee splint — $24.10
Z222A: Hand or wrist manipulation under general anaesthetic — $134.10
Z223A: Shoulder manipulation under general anaesthetic — $173.00
Z226A: Soft Tissue Or Bursa, Incision And Drainage — $97.35
Z292A: Direct laryngoscopy – without biopsy — $61.30
Z293A: Direct laryngoscopy – with biopsy — $61.30
Z296A: Flexible fiberoptic nasal endoscopy (sole procedure) — $33.25
Z301A: Drainage of nasal abscess or haematoma — $55.60
Z302A: Turbinate reduction — $55.60
Z304A: Nasal polypectomy – single — $21.00
Z309A: Nasal biopsy – single — $18.30
Z311A: Removal of foreign body from nose, local anaesthetic — $10.55
Z314A: Cauterization for epistaxis, unilateral — $11.50
Z315A: Epistaxis - unilateral anterior packing — $15.35
Z316A: Posterior nasal packing for epistaxis — $35.50
Z322A: Direct laryngoscopy – removal of foreign body — $106.45
Z323A: Direct laryngoscopy – removal of lesion(s) — $226.35
Z324A: Indirect laryngoscopy – biopsy or foreign body removal — $44.70
Z327A: Bronchoscopy - Flexible Or Rigid, With Or Without Bronchial Biopsy, Suction Or Injection Of Contrast Material — $124.90
Z332A: Thoracentesis – diagnostic or therapeutic — $104.40
Z336A: Biopsy Of Pleura, Needle Including Diagnostic Aspiration — $59.15
Z341A: Closed Drainage Effusion Or Pneumothorax — $76.80
Z360A: Bronchoscopy - Emergency Rigid Bronchoscopy For Obstructed Airway — $474.65
Z361A: Indwelling pleural catheter insertion — $200.00
Z362A: Indwelling pleural catheter removal — $200.00
Z363A: Removal Of Thoracostomy Tube (chest Tube) — $20.00
Z399A: Duodenoscopy (not To Be Claimed If Z399 And/or Z400 Performed On Same Patient Within 3 Months) — $92.50
Z400A: Duodenoscopy (not To Be Claimed If Z399 And/or Z400 Performed On Same Patient Within 3 Months) — $125.10
Z401A: Thoracotomy - Aspiration Of Pericardium — $131.70
Z403A: Bone Marrow Aspiration — $133.55
Z427A: Sentinel Node Biopsy, Per Draining Basin — $330.45
Z437A: Cardioversion (electrical And/or Chemical) - Maximum Of Three Sessions Per Patient, Per Day — $92.45
Z438A: Venipuncture - Insertion Of Swan-ganz Catheter (not Included In Respiratory Or Critical Care Benefits) — $162.50
Z439A: Right heart catheterization — pressures only — $166.90
Z440A: Left heart catheterization — retrograde aortic — $208.50
Z442A: Selective Coronary Catheterization - Both Arteries — $286.75
Z459A: Vascular Cannulation - Arterial Puncture For Blood Gas Analysis — $10.20
Z464A: Revision Or Repair Of Arterio-venous (av) Fistula Or Graft For Haemodialysis - Declotting By Cannula, Any Method — $150.00
Z477A: Vulvar biopsy – sole procedure, local anaesthetic — $39.60
Z491A: Follow Up Of Incomplete Polyp Resection — $51.95
Z492A: Follow Up Of Normal Colonoscopy (z499), Absence Of Intervening Signs Or Symptoms - Sigmoid To Descending — $51.95
Z493A: Follow Up Of Normal Colonoscopy (z497, Z555), Absence Of Intervening Signs Or Symptoms Sigmoid To Descending — $51.95
Z494A: Hereditary (e.g. Familial Adenomatous Polyposis Or Hereditary Nonpolyposis Colorectal Cancer) Or Other Bowel Disorders (e.g. Inflammatory Bowel Disease) Associated With Increased Risk Of Malignancy — $51.95
Z495A: Follow Up Of Unsatisfactory Colonoscopy — $51.95
Z496A: Colonoscopy - For Diagnosis Or Ongoing Management - Presence Of Signs Or Symptoms Sigmoid To Descending Colon — $51.95
Z497A: Confirmatory Colonoscopy - Sigmoid To Descending Colon — $51.95
Z498A: Follow Up Of Abnormal Colonoscopy Sigmoid To Descending Colon — $51.95
Z499A: Absence Of Signs Or Symptoms, Family History Associated With An Increased Risk Of Malignancy, In Accordance With Current Ontario Generally Accepted Clinical Practice Guidelines Sigmoid To Descending Colon — $51.95
Z506A: Drainage Of Oral Abscess Or Haematoma — $50.90
Z510A: Drainage Of Pharyngeal Abscess Or Haematoma — $91.10
Z512A: Endoscopy of ileostomy or colostomy — $36.80
Z513A: Colonoscopic hydrostatic/pneumatic dilatation of colon stricture — $107.50
Z514A: Endoscopy of ileostomy or colostomy with biopsy — $44.55
Z515A: Oesophagoscopy, With Or Without Biopsy(ies) — $68.25
Z516A: Colonoscopic excision of first polyp (20–29 mm) — $150.15
Z517A: Excision Of First Polyp (10 Mm To 19 Mm) — $150.15
Z518A: Excision of first polyp (6 mm to 9 mm) — $150.15
Z520A: Change Of Gastrostomy Tube — $10.65
Z527A: Gastroscopy - May Include Biopsies, Photography And Removal Of Polyps Less Than Or Equal To 1 Cm — $82.90
Z528A: Gastroscopy - Subsequent (within Three Months Following Previous Gastroscopy) — $67.85
Z532A: Percutaneous endoscopic gastrostomy (PEG) — $172.95
Z535A: Rigid sigmoidoscopy — $36.80
Z536A: Sigmoidoscopy with biopsy(ies) — $44.55
Z542A: Intubation of bile duct for obstruction — $85.25
Z543A: Proctoscopy — $8.70
Z545A: Incision of thrombosed haemorrhoid(s) — $25.25
Z546A: Barron Ligation(s) (not To Exceed 6 In Any One Year) — $39.40
Z547A: Gastroscopy - With Removal Of Foreign Body — $99.75
Z548A: Cauterization of anal fissure — $34.90
Z549A: Fulguration Of Condylomata - Local Anaesthetic — $30.95
Z551A: Liver biopsy – needle — $95.80
Z555A: Absence Of Signs Or Symptoms Or Risk Factors, 50 Years Of Age Or Older Sigmoid To Descending Colon — $51.95
Z558A: Endoscopic Retrograde Cholangiopancreatography (ercp) - Including Sphincterotomy And May Include Removal Of One Or More Bile Duct Stones — $300.25
Z560A: Duodenoscopy (not To Be Claimed If Z399 And/or Z400 Performed On Same Patient Within 3 Months) — $92.10
Z561A: Endoscopic Retrograde Cholangiopancreatography (ercp) - With Cannulation Of Common Bile Duct And/or Pancreatic Duct — $213.15
Z565A: Complete Haemorrhoidectomy Using Cryotherapy And/or Barron Ligation(s) Including Rectal Dilation — $99.60
Z571A: Excision of first polyp (3 mm to 5 mm) — $150.15
Z575A: Haemorrhoid injections — $27.05
Z576A: Injections for anal fissure — $35.90
Z580A: Sigmoidoscopy using 60 cm flexible endoscope — $57.70
Z582A: Hysteroscopy – diagnostic — $111.50
Z583A: Hysteroscopy with uterine biopsy and/or D&C — $133.70
Z584A: Small Bowel Push Enteroscopy — $185.15
Z587A: Hysteroscopy with resection of polyps or fibroids — $206.35
Z588A: $50.00
Z590A: Paracentesis – diagnostic sample — $31.30
Z591A: Paracentesis – therapeutic drainage — $57.65
Z592A: Sigmoidoscopy with decompression of volvulus — $49.40
Z593A: Nasobiliary Catheter Insertion — $55.25
Z594A: Peritoneal Abscess - Percutaneous Abdominal Abscess Drainage Including Daily Supervision, For One Or More Abscesses Within The Same Abdominal Quadrant Or The Pelvis — $508.80
Z600A: Change Of Nephrostomy Tube — $44.00
Z601A: Renal Biopsy, Needle — $153.85
Z603A: Bladder catheterization – home — $16.25
Z606A: Diagnostic cystoscopy — $77.00
Z607A: Repeat diagnostic cystoscopy within 30 days — $38.05
Z608A: Manual Catheter Declotting And Irrigation Of Bladder — $58.65
Z610A: Intravesical Instillation Of Bcg Or Immunotherapeutic Agent Or Chemotherapeutic Agent For The Treatment Of Bladder Cancer — $25.65
Z611A: Bladder catheterization – hospital or office — $9.15
Z615A: Filiform And Follower Urethral Dilation And May Include Bladder Catheterization — $64.05
Z616A: Biopsy Of Urethra (without Endoscopy) — $25.25
Z617A: Urethroscopy - Diagnostic — $38.05
Z618A: Urethroscopy - With Biopsy — $83.30
Z619A: Urethral stricture dilatation – male, general anaesthetic — $56.50
Z620A: Urethral dilatation – female, general anaesthetic — $44.65
Z621A: Urethral stricture dilatation – male, local anaesthetic — $20.60
Z622A: Urethral dilatation – female — $10.60
Z628A: Cystoscopy with diagnostic ureteroscopy above the intramural ureter — $125.70
Z631A: Fine Needle Aspiration Of Renal Transplant — $45.15
Z632A: Cystoscopic excision of bladder tumour – single, 1 to 2 cm — $290.90
Z633A: Cystoscopic excision of bladder tumour – single, over 2 cm — $468.70
Z634A: Cystoscopic excision of multiple bladder tumours — $468.70
Z700A: Hypospadias Or Epispadia - Intracorporeal Injection For Impotence — $27.80
Z701A: Condylomata - Local Anaesthetic — $34.95
Z702A: Biopsy of penis — $42.45
Z708A: Hydrocele aspiration — $21.20
Z709A: Scrotal abscess or haematocele – local anaesthetic — $42.45
Z712A: Prostate needle biopsy — $91.60
Z714A: Abscess Of Vulva, Bartholin Or Skene's Gland - Incision And Drainage - Local Anaesthetic — $25.40
Z720A: Biopsy of cervix, with or without fulguration — $20.00
Z722A: Vaginal biopsy – sole procedure, local anaesthetic — $39.60
Z724A: Electrocauterization of the cervix — $8.55
Z726A: Aspiration, Thyroid Cyst — $38.00
Z728A: Incision And Drainage Of Cyst, Abscess Or Haematoma — $97.20
Z729A: Cryoconization, Electroconization Or Co2 Laser Therapy With Or Without Curettage For Premalignant Lesion (dysplasia Or Carcinoma In Situ), Outpatient Procedure — $38.35
Z730A: Follow Up Colposcopy Without Biopsy With Or Without Endocervical Curetting — $28.35
Z731A: Initial Investigation Of Abnormal Cytology Of Vulva And/or Vagina Or Cervix Under Colposcopic Technique With Or Without Biopsy(ies) And/or Endocervical Curetting — $53.50
Z732A: Cauterization of cervix by cryotherapy — $17.30
Z733A: Condylomata – chemical and/or cryosurgery, one or more — $12.00
Z735A: Examination And/or Dilatation (may Include Insertion And/or Removal Of Iud) - General Anaesthetic As Sole Procedure — $56.70
Z736A: Condylomata – surgical excision, electrodesiccation or CO2 laser, local anaesthetic — $32.60
Z756A: Fecal disimpaction without anaesthetic — $46.00
Z757A: Excision Of Benign Anal Lesion(s) — $47.15
Z760A: Endoscopic Retrograde Cholangiopancreatography (ercp) - Through Gastrojejunostomy Following Previous Billroth Ii — $251.85
Z764A: Colonoscopic excision of obstructive tumour or stricture (< 2 cm) — $69.80
Z765A: Colonoscopic excision of obstructive tumour or stricture (2 cm or more) — $131.75
Z766A: Loop Electrosurgical Excision Procedure (leep) — $85.65
Z770A: Endometrial sampling — $38.85
Z771A: Aspiration Biopsy, Thyroid Gland Or Nodule Fine Needle Method — $38.00
Z774A: Postpartum Haemorrhage Exploration Of Vagina And Cervix, Uterine Curettage — $113.65
Z777A: Breech Presentation External Cephalic Version With Or Without Tocolysis To Be Claimed In Hospital After 35 Weeks, Once Per Pregnancy — $60.35
Z778A: Amniocentesis Diagnostic Or Genetic — $102.00
Z783A: Secondary Closure — $97.35
Z786A: $250.00
Z787A: Followup Colposcopy With Biopsy(ies) With Or Without Endocervical Curetting — $53.50
Z804A: Lumbar Puncture — $150.00
Z844A: Diagnostic paracentesis (eye) — $100.00
Z847A: Removal of one embedded corneal foreign body — $33.00
Z848A: Removal of two embedded corneal foreign bodies – local anaesthetic — $45.00
Z851A: Therapeutic paracentesis (anterior chamber) — $70.00
Z854A: Eyelid abscess drainage – local anaesthetic — $60.00
Z857A: Eyelid epilation – hyfrecator, electrolysis or cryopexy — $115.80
Z860A: Zeigler Punctures (for Entropion/ectropion) — $26.60
Z861A: Conjunctival biopsy — $26.60
Z866A: Removal Of Foreign Body - Complicated, General Anaesthetic — $50.90
Z871A: Corneal ulcer cautery – local anaesthetic — $26.60
Z873A: Application Of Cast Brace (must Include Hinge) — $67.75
Z874A: Chalazion, single or multiple – local anaesthetic — $70.00
Z901A: Irrigation Of Nasolacrimal System Per Eye — $27.00
Z902A: Nasolacrimal duct probing and dilation – local anaesthetic, unilateral — $27.00
Z904A: Ear polyp excision – office — $25.85
Z906A: Removal of ear drainage tube(s) under general anaesthetic – unilateral — $66.50
Z907A: Ear debridement under microscopy – unilateral — $27.40
Z908A: Ear debridement under general anaesthetic – unilateral — $50.90
Z909A: Biopsy of ear canal — $25.85
Z912A: Myringotomy – unilateral — $42.15
Z913A: Repair of small eardrum perforation under local – unilateral — $39.00
Z914A: Myringotomy with ventilation tube – unilateral — $78.60
Z915A: Removal Of Foreign Body - Simple — $10.55
Z916A: Intratympanic injection – unilateral — $75.90