Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)

Scale of Fees

Annual Increase in Medical Tariffs for Medical Service Providers - 2021

Doctors Gazette 2021

Part lll : Procedures

19. Radiology

Schedule

Purchase

This schedule must be used in conjunction with the Radiological Society of SA Guidelines. Please refer to the PET guidelines in Annexure D.

Code Structure Framework

(a)	The tariff code consists of 5 digits

(i)	1st digit indicates the main anatomical region or procedural category.

0 = General (non specific)

1 = Head

2 = Neck

3 = Thorax

4 = Abdomen and Pelvis (soft tissue)

5 = Spine, Pelvis and Hips

6 = Upper limbs

7 = Lower limbs

8 = Interventional

9 = Soft tissue regions (nuclear medicine)

eg "Head" = 1xxxx

(ii)	2nd digit indicates the sub region within a main region or category eg.

"Head/Skull and Brain" = 10xxx

(iii)

3rd digit indicates modality

1 = General (Black and White) x-ray

2 = Ultrasound

3 = Computed Tomography

4 = Magnetic Resonance Imaging

5 = Angiography

6 = Interventional radiology

9 = Nuclear Medicine (Isotopes)

eg:

Head/Skull and Brain/General x-ray 101xx

(iv)	4th and 5th digits are specific to a procedure/examination, eg

"Head/Skull and Brain/General/X-ray of the skull" = 10100.

Guidelines for use of coding structure

•	The vast majority of the codes describe complete procedures/examination and their use for the appropriate studies is self-explanatory.

•	Some codes may have multiple applications and their use is described in notes associated with each code

•	Codes 00510 to 00560 (Angiography machine codes) may only be used by owners of the equipment and who have registered such equipment with the Board of Healthcare Funders/RSSA.

•	The machine codes 00510, 00520, 00530, 00540, 00550, 00560 may not be added to 60540, 60550, 70530, 70535 (Antegrade Venography, upper and lower limbs)

•	Where public sector hospital equipment is used for a procedure, the units will be reduced by 33.33 %.

Consumables

Contrast Medium

o	Prior to the implementation of Act 90, contrast will be billed according to the official 2004 RSSA reimbursement price list, without mark up.

o	After the implementation of Act 90, contrast medium will be billed according to the suppliers' list price, without mark up.

o	Angiography catheters, angioplasty balloons, stents, coils and other embolisation materials, guide wires and drains are

General Comments on Procedural Codes

o	AII x-ray tomography codes are stand alone studies and may be used as a unique study or in combination with the appropriate regional study if done simultaneously. May not be added to 20130, 42110, 42115.

o	Setting of sterile tray is included in all appropriate procedure codes.

o	Where introduction of contrast is necessary eg. sialography, arthrography, angiography, etc, the codes used for the procedures are comprehensive and include the introduction of contrast or isotopes.

o	The use of Doppler or Colour Doppler as an adjunct to a study (eg small parts thyroid) is included in the code for that study.

o	CT Angiography (10330, 20330, 32300, 32310, 44300, 44310, 44320, 44330, 60310, 70310, 70320) are stand alone studies and may not be added to the regional contrasted studies (see 10335, 20340, 20350, 44325 for combined studies).

o	Angiography and interventional procedures include selective and super selective catheterization of vessels as are necessary to perform the procedures.

Codes 00230 (Ultrasound guidance), 00320 (CT guidance) and 00430 (MR guidance) are stand alone procedures that include the regional study and may not be added to any of the ultrasound, CT or MR regional studies

General Codes

Modifiers

00091

Radiology and nuclear medicine services rendered to hospital inpatients

00092

Radiology and nuclear medicine services rendered to outpatients

00093

A reduction of one third (33.33%) will apply to radiological examinations where hospital equipment it used

Equipment/Diagnostic

00090

Consumables used in radiology procedures: cost price PLUS 26% (up to a maximum of R26,00). (Where applicable, VAT should be added to the above).

Appropriate code to be provided. See separate codes for contrast and isotopes

00110 X-ray skeletal survey under five years

Other special/General Practitioner

Specialists

U/E

00090

Consumables used in radiology procedures

00091

Radiology and nuclear medicine services rendered to hospital inpatients

00092

Radiology and nuclear medicine services rendered to outpatients

00093

A reduction of one third (33.33%) will apply to radiological examinations where hospital equipment it used

00115

X-ray skeletal survey over five years

10.40

2 012.30

00120

X-ray sinogram any region

10.89

2 107.11

00130

X-ray with mobile unit in other facility

1.90

367.63

To be added to applicable procedure codes eg 30100.

00135

X-ray control view in theatre any region

5.26

1 017.76

00140

X-ray fluoroscopy any region

2.26

437.29

May only be added to the examination when fluoroscopy is not included in the standard procedure code. May not be added to:

•	any angiography, venography, lymphangiography or interventional codes

•	any contrasted fluoroscopy examination.

00145

X-ray fluoroscopy guidance for biopsy, any region

5.30

1 025.50

Add to the procedure eg. 80600, 80605, 80610

00150

X-ray C-Arm (equipment fee only, not procedure) per half hour

Only to be used if equipment is owned by the radiologist.

2.42

468.25

00155

X-ray C-arm fluoroscopy in theatre per half hour (procedure only)

2.30

445.03

00160

X-ray fixed theatre installation (equipment fee only)

2.26

437.29

Only to be used if equipment is owned by the radiologist.

00190

X-ray examination contrast material

Identification code for the use of contrast with a procedure.

Appropriate codes to be supplied.

00210

Ultrasound with mobile unit in other facility

1.84

356.02

Add to the relevant ultrasound examination codes eg 10200.

00220

Ultrasound intra-operative study

7.32

1 416.35

Covers all regions studied. Single code per operative procedure.

00230

Ultrasound guidance

12.10

2 341.23

guidance. Guided procedure code to be added eg. 80600, 80605, 80610.

00240

Ultrasound guidance for tissue ablation

11.24

2 174.83

Comprehensive ultrasound code including regional study and guidance Radiologist assistance (01030) may be added if procedure is performed by a non -radiologist. Guided procedure code to be added if performed by a radiologist. 80620 or 80630.

00250

Ultrasound limited Doppler study any region

6.50

1 257.69

Stand alone code may not be added to any other code.

00290

Ultrasound examination contrast material

Identification code for the use of contrast with a procedure.

Appropriate codes to be supplied.

00310

CT planning study for radiotherapy

21.37

4 134.88

00320

CT guidance (separate procedure)

16.92

3 273.65

Comprehensive CT code including regional study and guidance.

Guided procedure code to be added eg 80600, 80605, and 80610.

00330

CT guidance, with diagnostic procedure

8.46

1 636.93

To be added to the diagnostic procedure code. Guided procedure code to be added eg 80600, 80605, 80610.

00340

CT guidance and monitoring for tissue ablation

21.15

4 092.31

May only be used once per procedure for a region. Radiologist assistance (01030) may be added if procedure is performed by a non-radiologist. If performed by radiologist, add procedural code 80620, or 80630.

00390

CT examination contrast material

Identification code for the use of contrast with a procedure.

Appropriate codes to be supplied.

00420

MR Spectroscopy any region

28.90

5 591.86

May be added to the regional study, once only.

00430

MR guidance for needle replacement

42.56

8 234.93

Comprehensive MRI code including region studied and guidance.

Guided procedure code to be added eg 80600, 80605, 80610.

00440

MR low field strength imaging of peripheral joint any region

12.00

2 321.88

00450

MR planning study for radiotherapy or surgical procedure

38.00

7 352.62

00455

MR planning study for radiotherapy or surgical procedure, with contrast

47.00

9 094.03

00490

MR examination contrast material

Identification code for the use of contrast with a procedure.

Appropriate codes to be supplied.

00510

Analogue monoplane screening table

41.01

7 935.02

A machine code may be added once per complete procedure/patient visit

00520

Analogue monoplane table with DSA attachment

47.50

9 190.78

A machine code may be added once per complete procedure/patient visit.

00530

Dedicated angiography suite: Analogue monoplane unit. Once off charge per patient by owner of equipment.

47.50

9 190.78

A machine code may be added once per complete procedure/patient visit.

00540

Digital monoplane screening table

79.92

15 463.72

A machine code may be added once per complete procedure/patient visit.

00550

Dedicated angiography suite: Digital monoplane unit. Once off charge per patient by owner of equipment.

93.03

18 000.37

A machine code may be added once per complete procedure/patient visit.

00560

Dedicated angiography suite: Digital bi-plane unit. Once off charge per patient by owner of equipment

125.00

24 186.25

A machine code may be added once per complete procedure/patient visit.

00590

Angiography and interventional examination contrast material

Identification code for the use of contrast with a procedure.

Appropriate codes to be supplied.

00900

Nuclear Medicine study Bone, whole body, appendicular and axial skeleton

34.92

6 756.67

00903

Nuclear Medicine study - Bone, whole body, appendicular and axial skeleton and SPECT

48.33

9 351.37

00906

Nuclear Medicine study - Venous thrombosis regional

21.54

4 167.77

00909

Nuclear Medicine study - Tumour whole body

34.15

6 607.68

00912

Nuclear Medicine study - Tumour whole body multiple studies

47.56

9 202.38

00915

Nuclear Medicine study - Tumour whole body and SPECT

47.56

9 202.38

00918

Nuclear Medicine study - Tumour whole body multiple studies & SPECT

60.98

11 799.02

00921

Nuclear Medicine study - Infection whole body

31.45

6 085.26

00924

Nuclear Medicine study - infection whole body with SPECT

44.86

8 679.96

00927

Nuclear Medicine study - infection whole body multiple studies

44.86

8 679.96

00930

Nuclear Medicine study - infection whole body with SPECT multiple studies

58.27

11 274.66

00933

Nuclear Medicine study - Bone marrow imaging limited area

24.10

4 663.11

00936

Nuclear Medicine study - Bone marrow imaging whole body

37.51

7 257.81

00939

Nuclear Medicine study - Bone marrow imaging limited area multiple studies

37.51

7 257.81

00942

Nuclear Medicine study - Bone marrow imaging whole body multiple studies

50.92

9 852.51

00945

Nuclear Medicine study - Spleen imaging only - haematopoietic

24.10

4 663.11

00960

Nuclear Medicine therapy - Hyperthyroidism

11.99

2 319.95

00965

Nuclear Medicine therapy - Thyroid carcinoma and metastases

6.47

1 251.88

00970

Nuclear Medicine therapy - Intra-cavity radio-active colloid therapy

6.47

1 251.88

00975

Nuclear Medicine therapy - Interstitial radio-active colloid therapy

6.47

1 251.88

00980

Nuclear Medicine therapy - Intravascular radio pharmaceutical therapy particulate

6.47

1 251.88

00985

Nuclear Medicine therapy - Intra-articular radio pharmaceutical therapy

6.47

1 251.88

00990

Nuclear Medicine isotope

Identification code for the use of isotope with a procedure.

Appropriate codes to be supplied.

00991

Nuclear Medicine Substrate

00956

PET/CT scan whole body without contrast

165.13

31 951.00

00957

PET/CT scan whole body with contrast

163.19

31 575.63

00951

PET/CT local

120.00

23 218.80

00952

PET/CT local with contrast

124.68

24 124.33

Call and assistance

•	Emergency call out code 01010 only to be used if radiologist is called out to the rooms to report on an examination after normal working hours. May not be used for routine reporting during extended working hours.

•

Emergency call out code 01020 only to be used when a radiologist reports on subsequent cases after having been called out to the rooms to report an initial after hours procedure. This code may also be used for home tele-radiology reporting of an emergency procedure. May not be used for routine reporting during normal or extended working hours.

•	Radiologist assistance in theatre code 01030 only to be used if the radiologist is actively involved in assisting another radiologist or clinician with a procedure.

•	Radiographer assistance in theatre 01040 may not be used for procedures performed in facilities owned by the radiologist; ie only for attendance in hospital theatres etc. Does not apply to Bed Side Unit (BSU) examinations.

•	Second opinion consultations only to be used if a written report is provided as indicated in codes 01050, 01055, 01060. Not intended for ad hoc verbal consultations.

01010

Emergency call out fee, first case

3.00

580.47

01020

Emergency call out fee, subsequent cases same trip

2.00

386.98

01030

Radiologist assistance in theatre, per half hour

6.00

1 160.94

01040

Radiographer attendance in theatre, per half hour

1.60

309.58

01050

Written report on study done elsewhere, short

1.50

290.24

01055

Written report on study done elsewhere, extensive

4.20

812.66

01060

Written report for medico legal purposes, per hour

9.72

1 880.72

01070

Consultation for pre-assessment of interventional procedure

4.86

940.36

01100

X-ray procedure after hours, per procedure

2.00

386.98

01200

Ultrasound procedure after hours, per procedure

4.00

773.96

01300

CT procedure after hours, per procedure

10.00

1 934.90

01400

MR procedure after hours, per procedure

14.00

2 708.86

01500

Angiography procedure after hours, per procedure

20.00

3 869.80

01600

Interventional procedure after hours, per procedure

26.00

5 030.74

01970

Consultation for nuclear medicine study

2.20

425.68

Monitoring

ECG/Pulse oximetry monitoring (02010). Use for monitoring patients requiring conscious sedation during imaging procedure. Not to be used as a routine.

02010

ECG/pulse Oximeter monitoring

2.00

386.98

Head

Skull and Brain

Codes 10100 (skull) and 10110 (tomography) may be combined.

10100

X-ray of the skull

3.86

746.87

10110

X-ray tomography of the skull

4.30

832.01

10120

X-ray shuntogram for VP shunt

15.36

2 972.01

10200

Ultrasound of the brain - Neonatal

7.38

1 427.96

10210

Ultrasound of the brain including doppler

13.22

2 557.94

10220

Ultrasound of the intracranial vasculature, including B mode, pulse and colour doppler

15.04

2 910.09

10300

CT Brain uncontrasted

22.65

4 382.55

10310

CT Brain with contrast only

33.28

6 439.35

10320

CT Brain pre and post contrast

40.48

7 832.48

10325

CT brain pre and post contrast for perfusion studies

49.10

9 500.36

Stand alone code may not be added to any other CT studies of the brain, except for code 10330

10330

CT angiography of the brain

77.58

15 010.95

10335

CT of the brain pre and post contrast with angiography

97.91

18 944.61

10340

CT brain for cranio-stenosis including 3D

34.16

6 609.62

10350

CT Brain stereotactic localisation

19.36

3 745.97

10360

CT base of skull coronal high resolution study for CSF leak

34.90

6 752.80

10400

MR of the brain, limited study

43.56

8 428.42

10410

MR of the brain, uncontrasted

63.80

12 344.66

10420

MR of the brain with contrast

75.94

14 693.63

10430

MR of the brain pre and post contrast

104.04

20 130.70

10440

MR of the brain pre and post contrast, for perfusion studies

107.44

20 788.57

10450

MR of the brain plus angiography

92.20

17 839.78

10460

MR of the brain pre and post contrast plus angiography

121.23

23 456.79

10470

MR angiography of the brain uncontrasted

58.50

11 319.17

10480

MR angiography of the brain contrasted

74.02

14 322.13

10485

MR of the brain, with diffusion studies

79.00

15 285.71

10490

MR of the brain, pre and post contrast, with diffusion studies

110.64

21 407.73

10492

MR study of the brain plus angiography plus diffusion, uncontrasted

95.00

18 381.55

10495

MR of the brain pre and post contrast plus angiography and diffusion

125.44

24 271.39

10500

Arteriography of intracranial vessels: 1 - 2 vessels

48.60

9 403.61

10510

Arteriography of intracranial vessels: 3 - 4 vessels

82.33

15 930.03

10520

Arteriography of extra-cranial (non-cervical) vessels

48.44

9 372.66

10530

Arteriography of intracranial and extra-cranial (non-cervical) vessels

118.09

22 849.23

10540

Arteriography of intracranial vessels (4) plus 3 D rotational angiography

97.57

18 878.82

10550

Arteriography of intracranial vessels (1) plus 3D rotational angiography

37.29

7 215.24

10560

Venography of dural sinuses

52.23

10 105.98

10900

Nuclear Medicine study - Bone regional, static

21.50

4 160.04

10905

Nuclear Medicine study - Bone regional, static,with flow

27.53

5 326.78

10910

Nuclear Medicine study - Bone regional, static with SPECT

34.92

6 756.67

10915

Nuclear Medicine study - Bone regional, static, with flow, with SPECT

40.94

7 921.48

10920

Nuclear Medicine study - Brain, planar, complete, static

16.92

3 273.85

10925

Nuclear Medicine study - Brain complete static with vascular flow

22.95

4 440.60

10930

Nuclear Medicine study - Brain, planar, complete, static, with SPECT

30.33

5 868.55

10935

Nuclear Medicine study - Brain, planar, complete, static, with flow, with SPECT

36.36

7 035.30

10940

Nuclear Medicine study - CSF flow imaging cisternography

21.60

4 179.38

10945

Nuclear Medicine study - Ventriculography

13.41

2 594.70

10950

Nuclear Medicine study - Shunt evaluation static, planar

13.41

2 594.70

10955

Nuclear Medicine study - CFS leakage detection and localisation

13.41

2 594.70

10960

Nuclear medicine study - CSF SPECT

13.41

2 594.70

10971

PET/CT scan of the brain uncontrasted

110.12

21 307.12

10972

PET/CT of the brain contrasted

116.11

22 466.12

10981

PET/CT perfusion scan of the brain

131.07

25 360.73

Facial bones and nasal bones

Codes 11100 (facial bones) and 11110 (tomography) may be combined

11100

X-ray of the facial bones

3.93

760.42

11110

X-ray tomography of the facial bones

4.30

832.01

11120

X-ray of the nasal bones

2.39

462.44

11300

CT of the facial bones

20.96

4 055.55

11310

CT of the facial bones with 3D reconstructions

30.40

5 882.10

11320

CT of the facial bones/soft tissue, pre and post contrast

41.26

7 983.40

11400

MR of the facial soft tissue

62.40

12 073.78

11410

MR of the facial soft tissue pre and post contrast

100.60

19 465.09

11420

MR of the facial soft tissue plus angiography, with contrast

110.30

21 341.95

11430

MR angiography of the facial soft tissue

74.02

14 322.13

Orbits, lacrimal glands and tear ducts

Code 12130 (tomography) may be added to 12100 or 12110 or 12120 (orbits) or 12140 (dacrocystography).

12100

X-ray orbits less than three views

3.56

688.82

12110

X-ray of the orbits, three or more views, including foramina

5.30

1 025.50

12120

X-ray of the orbits for foreign body

3.56

688.82

12130

X-ray tomography of the orbits

4.30

832.01

12140

X-ray dacrocystography

11.20

2 167.09

12200

Ultrasound of the orbit/eye

5.13

992.60

12210

Ultrasound of the orbit/eye including doppler

10.97

2 122.59

12300

CT of the orbits single plane

15.70

3 037.79

12310

CT of the orbits, more than one plane

20.59

3 983.96

12320

CT of the orbits pre and post contrast single plane

36.03

6 971.44

12330

CT of the orbits pre and post contrast multiple planes

39.70

7 681.55

12400

MR of the orbits

62.46

12 085.39

12410

MR or the orbitae, pre and post contrast

100.64

19 472.83

12900

Nuclear Medicine study - Dacrocystography

20.77

4 018.79

Paranasal sinuses

Code 13120 (tomography) may be added to 13100, 13110 (paranasal sinuses), 13130 (nasopharyngeal)

13100

X-ray of the paranasal sinuses, single view

2.74

530.16

13110

X-ray of the paranasal sinuses, two or more views

3.66

708.17

13120

X-ray tomography of the paranasal sinuses

4.30

832.01

13130

X-ray of the naso-pharyngeal soft tissue

2.74

530.16

13300

CT of the paranasal sinuses single plane, limited study

7.20

1 393.13

13310

CT of the paranasal sinuses, two planes, limited study

12.40

2 399.28

13320

CT of the paranasal sinuses, any plane, complete study

15.42

2 983.62

13330

CT of the paranasal sinuses, more than one plane, complete study

20.77

4 018.79

13340

CT of the paranasal sinuses, any plane, complete study: pre and post contrast

34.74

6 721.84

13350

CT of the paranasal sinuses, more than one plane, complete study; pre and post contrast

41.01

7 935.02

13400

MR of the paranasal sinuses

60.27

11 661.64

13410

MR of the paranasal sinuses, pre and post contrast

96.59

18 689.20

Mandible, teeth and maxilla

Code 14110 (orthopantomogram) may be combined with 14100 (mandible) if two separate studies are performed.

Code 14110 (orthopantomogram) may be combined with 15100 and/or 15110 (TM joint) if complete separate studies are performed.

Code 14160 (tomography) may be combined with 14130 or 14140 or 14150 (teeth).

Code 14160 (tomography) may be combined with 15100 and/or 15110 (TM joint) if complete separate studies are performed.

Code 14330 and 14340 (Dental implants) may be combined if mandible and maxilla are examined at the same visit.

14100

X-ray of the mandible

3.66

708.17

14110

X-ray orthopantomogram of the jaws and teeth

4.06

785.57

14120

X-ray maxillofacial cephalometry

2.77

535.97

14130

X-ray of the teeth single quadrant

2.00

386.98

14140

X-ray of the teeth more than one quadrant

2.53

489.53

14150

X-ray of the teeth full mouth

3.62

700.43

14160

X-ray tomography of the teeth per side

3.23

624.97

14300

CT of the mandible

22.28

4 310.96

14310

CT of the mandible, pre and post contrast

41.26

7 983.40

14320

CT mandible with 3D reconstructions

30.40

5 882.10

14330

CT for dental implants in the mandible

27.45

5 311.30

14340

CT for dental implants in the maxilla

27.45

5 311.30

14400

MR of the mandible/maxilla

63.80

12 344.66

14410

MR of the mandible/maxilla, pre and post contrast

98.64

19 085.85

T M Joints

Code 15100 (TM joint) and 15120 (tomography) may be combined.

Code 15110 (TM joint) and 15130 (tomography) may be combined.

Code 15140 (arthrography) and 15120 (tomography) may be combined.

Code 15150 (arthrography) and 15130 (tomography)may be combined.

Codes 15320 (CT arthrogram) and 15420 (MR arthrogram) include introduction of contrast (00140 may not be added).

15100

X-ray tempero-mandibular joint, left

3.56

668.82

15100

X-ray tempero-mandibular joint, right

3.56

668.82

15120

X-ray tomography tempero-mandibular joint, left

4.30

832.01

15130

X-ray tomography tempero-mandibular joint, right

4.30

832.01

15140

X-ray arthrography of the tempero-mandibular joint, left

15.41

2 981.68

15150

X-ray arthrography of the tempero-mandibular joint, right

15.41

2 981.68

15200

Ultrasound tempero-mandibular joints, one or both sides

6.56

1 269.29

15300

CT of the tempero-mandibular joints

25.38

4 910.78

15310

CT of the tempero-mandibular joints plus 3D reconstructions

34.50

6 675.41

15320

CT arthrogram of the tempero-mandibular joints

35.96

6 957.90

15400

MR of the tempero-mandibular joints

63.80

12 344.66

15410

MR of the tempero-mandibular joints, pre and post contrast

100.84

19 511.53

15420

MR arthrogram of the tempero-mandibular joints

74.71

14 455.64

Mastoids and internal auditory canal

Code 16100 (mastoids) and 16120 (tomography) may be combined.

Code 16110 (mastoids bilat) and 16130 (tomography) may be combined

Code 16140 (IAM's) and 16150 (tomography) may be combined.

16100

X-ray of the mastoids, unilateral

3.59

694.63

16110

X-ray of the mastoids, bilateral

7.18

1 389.26

16120

X-ray tomography of the petro-temporal bone, unilateral

4.30

832.01

16130

X-ray tomography of the petro-temporal bone, bilateral

8.60

1 664.01

16140

X-ray internal auditory canal, bilateral

5.23

1 011.95

16150

X-ray tomography of the internal auditory canal, bilateral

4.30

832.01

16300

CT of the mastoids

12.60

2 437.97

16310

CT of the internal auditory canal

21.47

4 154.23

16320

CT of the internal auditory canal, pre and post contrast

34.20

6 617.36

16330

CT of the ear structure, limited study

13.40

2 592.77

16340

CT of the middle and inner ear structures, high definition including all reconstructions in various planes

43.35

8 387.79

16400

MR of the internal auditory canals, limited study

43.56

8 428.42

16410

MR of the internal auditory canals, pre and post contrast, limited study

68.93

13 337.27

16420

MR of the internal auditory canals, pre and post contrast, complete study

102.64

19 859.81

16430

MR of the ear structures

64.40

12 460.76

16440

MR of the ear structures, pre and post contrast

102.64

19 859.81

Sella turcica

Code 17100 (sella) and 17110 (tomography) may be combined.

17100

X-ray of the sella turcica

3.08

595.95

17110

X-ray tomography of the sella turcica

4.30

832.01

17300

CT of the sella turcica/hypophysis

17.45

3 376.40

17310

CT of the sella turcica/hypophysis, pre and post contrast

42.26

8 176.89

Salivary glands and floor of the mouth

Neck

Code 20120 (laryngography) includes fluoroscopy (00140 may not be added).

Code 20130 (speech) includes tomography and cinematography (00140 may not be added).

Code 20450 (MR Angiography) may be combined with 10410 (MR brain).

20100

X-ray of soft tissue of the neck

2.74

530.16

20110

X-ray of the larynx including tomography

9.39

1 816.37

20120

X-ray laryngography

8.28

1 602.10

20130

X-ray evaluation of pharyngeal movement and speech by screening and/or cine with or without video recording

8.30

1 605.97

20200

Ultrasound of the thyroid

6.56

1 269.29

20210

Ultrasound of soft tissue of the neck

6.56

1 269.29

20220

Ultrasound of the carotid arteries, bilateral including B mode, pulsed and colour doppler

15.00

2 902.35

20230

Ultrasound of the entire extracranial vascular tree including carotids, vertebral and subclavian vessels with B mode, pulse and colour doppler

21.84

4 225.82

20240

Ultrasound study of the venous system of the neck including pulse and colour Doppler

10.80

2 089.69

20300

CT of the soft tissues of the neck

18.25

3 531.19

20310

CT of the soft tissues of the neck, with contrast

38.15

7 381.64

20320

CT of the soft tissues of the neck, pre and post contrast

43.81

8 476.80

20330

CT angiography of the extracranial vessels in the neck

79.36

15 355.37

20340

Intracranial vessels of the brain

107.50

20 800.18

20350

CT angiography of the extracranial vessels in the neck and intracranial vessels of the brain plus a pre and post contrast study of the brain

124.43

24 075.96

20400

MR of the soft tissue of the neck

63.60

12 305.96

20410

MR of the soft tissue of the neck, pre and post contrast

102.04

19 743.72

20420

MR of the soft tissue of the neck and uncontrasted angiography

92.60

17 917.17

20430

MR angiography of the extracranial vessels in the neck, without contrast

59.60

11 532.00

20440

MR angiography of the extracranial vessels in the neck, with contrast

74.02

14 322.13

20450

MR angiography of the extra and intracranial vessels with contrast

116.05

22 454.51

20460

MR angiography of the intra and extra cranial vessels plus brain, without contrast

135.17

26 154.04

20470

MR angiography of the intra and extra cranial vessels plus brain, with contrast

156.05

30 194.11

20500

Arteriography of cervical vessels: carotid 1- 2 vessels

44.43

8 596.76

20510

Arteriography of cervical vessels: vertebral 1 - 2 vessels

50.73

9 815.75

20520

Arteriography of cervical vessels: carotid and vertebral

77.63

15 020.63

20530

Arteriography of aortic arch and cervical vessels

91.97

17 795.28

20540

Arteriography of aortic arch, cervical and intracranial vessels

108.87

21 065.26

20550

Venography of jugular and vertebral veins

48.95

9 471.34

Thyroid (Nuclear Medicine)

21900

Nuclear Medicine study - Thyroid, single uptake

9.68

1 872.98

21910

Nuclear medicine study - Thyroid, multiple uptake

14.69

2 842.37

21920

Nuclear medicine study - Thyroid imaging with uptake

17.72

3 428.64

21930

Nuclear medicine study - Thyroid imaging

12.72

2 461.19

21940

Nuclear medicine study - Thyroid imaging with vascular flow

18.74

3 626.00

21950

Nuclear medicine study - Thyroid suppression/stimulation

12.72

2 461.19

29961

PET/CT scan of the soft tissue of the neck uncontrasted

105.87

20 484.79

29962

PET/CT scan of the soft tissue of the neck contrasted

111.69

21 610.90

Thorax

Chest wall, pleura, lungs and mediastinum

Code 30140 (tomography) may be combined with 30100 or 30110 (chest) or 30150 or 30155 (ribs) or 30160 (thoracic inlet).

Codes 30170 (Sterno-clavicular) and 30175 (tomography) may be combined

Code 30180 (sternum) and 30185 (tomography) may be combined.

Code 30340 (CT limited high resolution) may be combined with 30310 or 30320 or 30330 (CT chest). Motivation may be required.

Code 30350 (high resolution) is a stand alone study.

Code 30360, (CT chest for pulmonary embolism) is a complete examination and includes the preceding uncontrasted CT scan of the chest, and may not be combined with 40330 or 40333 (CT abdomen and pelvis).

Code 30370 (CT pulmonary embolism plus CT venography) may not be combined with 70230 (Doppler).

30100

X-ray of the chest, single view

3.04

588.21

30110

X-ray of the chest two views, PA and lateral

3.84

743.00

30120

X-ray of the chest complete with additional views

4.24

820.40

30130

X-ray of the chest complete including fluoroscopy

4.48

866.84

30140

X-ray tomography of the chest

4.30

832.01

30150

X-ray of the ribs

4.79

926.82

30155

X-ray of the chest and ribs

6.42

1 242.21

30160

X-ray of the thoracic inlet

2.56

495.33

30170

X-ray of the sterno-clavicular joints

4.21

814.59

30175

X-ray tomography of the sterno-clavicular joint

4.30

832.01

30180

X-ray of the sternum

4.21

814.59

30185

X-ray tomography of the sternum

4.30

832.01

30200

Ultrasound of the chest wall, any region

6.56

1 269.29

30210

Ultrasound of the pleural space

6.56

1 269.29

30220

Ultrasound of the mediastinal structures

6.56

1 269.29

30300

CT of the chest, limited study

9.50

1 838.16

30310

CT of the chest uncontrasted

26.60

5 146.83

30320

CT of the chest contrasted

42.43

8 209.78

30330

CT of the chest, pre and post contrast

45.70

8 842.49

30340

CT of the chest, limited high resolution study

11.20

2 167.09

30350

CT of the chest, complete high resolution study

24.01

4 645.69

30355

prone and expiratory studies

33.30

6 443.22

30360

CT of the chest for pulmonary embolism

57.12

11 052.15

30370

CT of the chest for pulmonary embolism with CT venography of abdomen, pelvis and lower limbs

80.28

15 533.38

30400

MR of the chest

63.60

12 305.96

30410

MR of the chest with uncontrasted angiography

92.60

17 917.17

30420

MR of the chest, pre and post contrast

102.04

19 743.72

30900

Nuclear Medicine study - Lung perfusion

21.54

4 167.77

30910

Nuclear Medicine study - Lung ventilation, aerosol

21.50

4 160.04

30920

Nuclear Medicine study - Lung perfusion and ventilation

42.03

8 132.38

30930

Nuclear Medicine study - Lung ventilation using radio-active gas

14.17

2 741.75

30940

Nuclear Medicine study - Lung perfusion and ventilation using radio-active gas

34.69

6 712.17

30950

Nuclear medicine study - Muco-ciliary clearance study dynamic

26.51

5 129.42

30960

Nuclear medicine study - alveolar permeability

26.51

5 129.42

Stand alone code. Not to be combined with 30910.

30970

Nuclear medicine study - quantitative evaluation of lung perfusion and ventilation

6.02

1 164.81

Stand alone code. Not to be combined with 30920.

0.00

30981

PET/CT of the chest uncontrasted

111.44

21 562.53

30982

PET/CT scan of the chest contrasted

117.42

22 719.60

30983

PET/CT scan of the chest pre and post contrast

148.32

28 698.44

Oesophagus

may not be added)

31100

X-ray barium swallow

6.60

1 277.03

31105

X-ray 3 phase dynamic contrasted swallow

12.60

2 437.97

31110

X-ray barium swallow, double contrast

7.92

1 532.44

31120

X-ray barium swallow with cinematography

10.07

1 948.44

Aorta and large vessels

Codes 32210 and 32220 (Ivus) may be combined

32200

Intervention, once per complete procedure

4.20

812.66

32210

Ultrasound intravascular (IVUS) first vessel

8.44

1 633.06

32220

Ultrasound intravascular (IVUS) subsequent vessels

5.30

1 025.50

32300

CT angiography of the aorta and branches

79.08

15 301.19

32305

CT angiography of the thoracic and abdominal aorta and branches

105.50

20 413.20

32310

CT angiography of the pulmonary vasculature

79.08

15 301.19

32400

MR angiography of the aorta and branches

78.50

15 188.97

32410

MR angiography of the pulmonary vasculature

105.27

20 368.69

32500

Arteriography of thoracic aorta

28.26

5 468.03

32510

Arteriography of bronchial intercostal vessels alone

50.15

9 703.52

32520

Arteriography of thoracic aorta, bronchial and intercostal vessels

67.43

13 047.03

32530

Arteriography of pulmonary vessels

63.27

12 242.11

32540

Arteriography of heart chambers, coronary arteries

44.27

8 565.80

32550

Venography of thoracic vena cava

28.38

5 491.25

32560

Venography of vena cava, azygos system

56.31

10 895.42

32570

Venography patency of A-port or other central line

19.64

3 800.14

Heart

Codes 33300 (CT anatomy/function) and 33310 (CT Angiography) may be done as stand alone studies or as additive studies if both are performed at the same time.

33205

Ultrasound study of the heart for foetal or paediatric cases including doppler

12.30

2 379.93

or 33210. This code is intended for paediatric and foetal cases only

33200

Ultrasound study of the heart, including Doppler

8.20

1 586.62

33210

Ultrasound study of the heart trans-oesophageal

10.52

2 035.51

33220

Ultrasound intravascular imaging to guide placement of 33220 intracoronary stent once per vessel

5.20

1 006.15

33300

CT anatomical/functional study of the heart

34.61

6 696.69

33310

CT angiography of heart vessels

81.28

15 726.87

33970

Nuclear Medicine study - Multi stage treadmill ECG test

6.66

1 288.64

Abdomen and Pelvis

Abdomen/stomach/bowel

Code 40120 (tomography) may be combined with 40100 or 40105 or 40110 (abdomen).

Codes 40140 to 40190 (barium studies) include fluoroscopy (00140 may not be added).

Code 40190 (intussusception) is a stand alone code and may not be combined with 40160 or 40165 (barium enema), (00140 may not be added).

40100

X-ray of the abdomen

3.32

642.39

40105

X-ray of the abdomen supine and erect, or decubitus

5.36

1 037.11

40110

X-ray of the abdomen multiple views including chest

8.10

1 567.27

40120

X-ray tomography of the abdomen

4.30

832.01

40140

X-ray barium meal single contrast

8.87

1 716.26

40143

X-ray barium meal double contrast

11.99

2 319.95

40147

X-ray barium meal double contrast with follow through

15.80

3 057.14

40150

X-ray small bowel enteroclysis (meal intubation) may be added

25.45

4 924.32

40153

X-ray small bowel meal follow through single contrast

19.55

3 782.73

40157

X-ray small bowel meal with pneumocolon

25.63

4 959.15

40160

X-ray large bowel enema single contrast

12.97

2 509.57

40165

X-ray large bowel enema double contrast

19.63

3 798.21

40170

X-ray guided gastro oesophageal intubation

1.60

309.58

40175

X-ray guided duodenal intubation

2.80

541.77

40180

X-ray defaecogram

12.97

2 509.57

40190

X-ray guided reduction of intussusception

16.27

3 148.08

40200

Ultrasound study of the abdominal wall

5.54

1 071.93

40210

Ultrasound study of the whole abdomen including the pelvis

8.24

1 594.36

40300

CT study of the abdomen

26.41

5 110.07

40310

CT study of the abdomen with contrast

44.82

8 672.22

40313

CT study of the abdomen pre and post contrast

52.99

10 253.04

40320

CT of the pelvis

26.13

5 055.89

40323

CT of the pelvis with contrast

47.48

9 186.91

40327

CT of the pelvis pre and post contrast

53.87

10 423.31

40330

CT of the abdomen and pelvis

38.50

7 449.37

40333

CT of the abdomen and pelvis with contrast

62.17

12 029.27

40337

CT of the abdomen and pelvis pre and post contrast

67.43

13 047.03

40340

CT triphasic study of the liver, abdomen and pelvis pre and post contrast

74.11

14 339.54

40345

CT of the chest, abdomen and pelvis without contrast

70.12

13 567.52

40350

CT of the chest, abdomen and pelvis with contrast

88.35

17 094.84

40355

CT of the chest triphasic of the liver, abdomen and pelvis with contrast

93.05

18 004.24

40360

CT of the base of skull to symphysis pubis with contrast

102.73

19 877.23

40365

CT colonoscopy

34.78

6 729.58

Stand alone study, may not be added to any code between 40300 and 40360

40400

MR of the abdomen

64.58

12 495.58

40410

MR of the abdomen pre and post contrast

100.84

19 511.53

40420

MR of the pelvis, soft tissue

64.58

12 495.58

40430

MR of the pelvis, soft tissue, pre and post contrast

102.04

19 743.72

40900

Nuclear Medicine study - Gastro oesophageal reflux and emptying

21.50

4 160.04

40905

Nuclear Medicine study - Gastro oesophageal reflux and emptying multiple studies

34.92

6 756.67

40910

Nuclear Medicine study - Gastro intestinal protein loss

21.50

4 160.04

40915

Nuclear Medicine study - Gastro intestinal protein loss multiple studies

34.92

6 756.67

40920

Nuclear Medicine study - Acute GIT bleed static/dynamic

21.50

4 160.04

40925

Nuclear medicine study - Acute GIT bleed multiple studies

34.92

6 756.67

40930

Nuclear medicine study - Meckel's localisation

20.77

4 018.79

40935

Nuclear medicine study - Gastric mucosa imaging

20.77

4 018.79

40940

Nuclear medicine study - colonic transit multiple studies

44.86

8 679.96

Stand alone code

40951

PET/CT scan of the abdomen and pelvis uncontrasted

119.53

23 127.86

40952

PET/CT scan of the abdomen and pelvis contrasted

129.31

25 020.19

40953

PET/CT scan of the abdomen and pelvis pre and post contrast

140.50

27 185.35

Liver, spleen, gall bladder and pancreas

Code 41110, 41120 and 41130 (cholangiography) include fluoroscopy (00140 may not be added).

41100

X-ray ERCP including screening

18.90

3 656.96

41105

X-ray ERCP reporting on images done in theatre

2.40

464.38

41110

X-ray cholangiography intra- operative

8.45

1 634.99

41120

X-ray T-tube cholangiography post operative

14.05

2 718.53

41130

X-ray transhepatic percutaneous cholangiography

32.34

6 257.47

41200

Ultrasound study of the upper abdomen

7.00

1 354.43

41210

Ultrasound doppler of the hepatic and splenic veins and interior vena cava in assessment of portal venous hypertension or thrombosis

9.80

1 896.20

Code 41210 is a stand alone study and may not be added to 40200, 40210, 41200 or 42200

41300

CT of the abdomen triphasic study - liver

54.90

10 622.60

41400

MR study of the liver/pancreas

64.78

12 534.28

41410

MR study of the liver/pancreas pre and post contrast

100.84

19 511.53

41420

MRCP

49.20

9 519.71

41430

MR study of the abdomen with MRCP

92.98

17 990.70

41440

MR study of the abdomen pre and post contrast with MRCP

133.60

25 850.26

41900

Nuclear Medicine study Liver and spleen, planar views only

21.50

4 160.04

41905

Nuclear Medicine study Liver and spleen, with flow study

27.53

5 326.78

41910

Nuclear Medicine study - Liver and spleen, planar views SPECT

34.92

6 756.67

41915

Nuclear Medicine study - Liver and spleen, with flow study and SPECT

40.94

7 921.48

41920

Nuclear Medicine study - Hepatobiliary system planar static/dynamic

21.50

4 160.04

41925

Nuclear Medicine study - hepatobiliary tract including flow

26.51

5 129.42

41930

Nuclear medicine study - Hepatobiliary system planar, static/dynamic multiple studies

34.92

6 756.67

41935

Nuclear medicine study - Hepatobiliary tract including flow multiple studies

39.92

7 724.12

41940

Nuclear medicine study - Gall bladder ejection fraction

6.02

1 164.81

41945

Nuclear medicine study - Biliary gastric reflux study

20.77

4 018.79

Renal tract

42100

X-ray tomography of the renal tract

4.30

832.01

Code 42100 (tomography) may not be added to 42110 or 42115 (IVP).

Codes 42115 (IVP), 42120 (cystography), 42130 (urethography), 42140 (MCU), 42150 (retrograde), and 42160 (prograde) include fluoroscopy (00140 may not be added).

42110

X-ray excretory urogram including tomography

24.86

4 810.16

42115

X-ray excretory urogram including tomography with micturating study

32.86

6 358.08

42120

X-ray cystography

15.05

2 912.02

42130

X-ray urethrography

15.37

2 973.94

42140

X-ray micturating cysto-urethrography

19.30

3 734.36

42150

X-ray retrograde/prograde pyelography

12.53

2 424.43

42155

X-ray retrograde/prograde pyelography reporting on images done in theatre

2.41

466.31

42160

X-ray prograde pyelogram - percutaneous

32.67

6 321.32

42200

Ultrasound study of the renal tract including bladder

7.42

1 435.70

42205

Ultrasound doppler for resistive index in vessels of transplanted kidney

3.80

735.26

Code 42205 is a stand alone study and may not be added to 42200

42210

Ultrasound study of the renal arteries including Doppler

10.60

2 050.99

42300

CT of the renal tract for a stone

25.15

4 866.27

42400

MR of the renal tract for obstruction

47.00

9 094.03

42410

MR of the kidneys without contrast

64.58

12 495.58

42420

MR of the kidneys pre and post contrast

102.24

19 782.42

42900

Nuclear Medicine study - Renal imaging, static (eg. DMSA)

21.94

4 245.17

42905

Nuclear Medicine study - Renal imaging, static (e.g. DMSA) with flow

27.96

5 409.98

42910

Nuclear Medicine study - Renal imaging, static (e.g. DMSA) with SPECT

35.35

6 839.87

42915

Nuclear Medicine study - Renal imaging, static (e.g. DMSA), with flow, with SPECT

41.37

8 004.68

42920

Nuclear Medicine study - Renal imaging dynamic (renogram) and vascular flow

26.51

5 129.42

42930

Nuclear Medicine study - Renovascular study, baseline

26.51

5 129.42

42940

Nuclear Medicine study - Renovascular study, with intervention

26.51

5 129.42

42950

Nuclear medicine study - indirect voiding cystogram

6.02

1 164.81

Aorta and vessels

Code 44400 (MR Angiography) may be combined with 40400 (MR abdomen)

44200

Ultrasound study of abdominal aorta and branches including doppler

18.32

3 544.74

44205

Ultrasound study of the IVC and pelvic veins including Doppler

14.00

2 708.86

This is a stand alone code and may not be added to 44200.

0.00

44300

CT angiography of abdominal aorta and branches

76.72

14 844.55

44305

CT angiography of the abdominal aorta and branches and pre and post contrast study of the upper abdomen

94.32

18 249.98

44310

CT angiography of the pelvis

78.64

15 216.05

44320

CT angiography of the abdominal aorta and pelvis

89.54

17 325.09

44325

CT angiography of the abdominal aorta and pelvis and pre and post contrast study of the upper abdomen and pelvis

119.15

23 054.33

44330

CT portogram

74.40

14 395.66

44400

MR angiography of abdominal aorta and branches

76.64

14 829.07

44500

Arteriography of abdominal aorta alone

28.12

5 440.94

44503

Arteriography of aorta plus coeliac, mesenteric branches

75.63

14 633.65

44505

Arteriography of aorta plus renal, adrenal branches

63.01

12 191.80

44507

Arteriography of aorta plus non-visceral branches

60.79

11 762.26

44510

Arteriography of coeliac, mesenteric vessels alone

64.35

12 451.08

44515

Arteriography of renal, adrenal vessels alone

49.49

9 575.82

44517

Arteriography of non-visceral abdominal vessels alone

54.91

10 624.54

44520

Arteriography of internal and external iliac vessels alone

56.72

10 974.75

44525

Venography of internal and external iliac veins alone

62.11

12 017.66

44530

Corpora cavernosography

25.06

4 848.86

44535

Vasography, vesciculography

29.19

5 647.97

44540

Venography of inferior vena cava

26.12

5 053.96

44543

Venography of hepatic veins alone

53.77

10 403.96

44545

Venography of inferior vena cava and hepatic veins

68.91

13 333.40

44550

Venography of lumbar azygos system alone

43.89

8 492.28

44555

Venography of inferior vena cava and lumbar azygos veins

65.46

12 665.86

44560

Venography of renal, adrenal veins alone

43.99

8 511.63

44565

Venography of inferior vena cava and renal/adrenal veins

68.39

13 232.78

44570

Venography of spermatic, ovarian veins alone

40.39

7 815.06

44573

Venography of inferior vena cava, renal, spermatic, ovarian veins

73.99

14 316.33

44580

Venography indirect splenoportogram

48.67

9 417.16

44583

Venography direct splenoportogram

31.59

6 112.35

44587

Venography transhepatic portogram

66.75

12 915.46

Soft Tissue

Spine, Pelvis and Hips

Code 51340 (CT myelography, cervical), 52330 (CT myelography thoracic) and 53340 (CT myelography lumbar) are stand alone studies and may not be combined with the conventianla myelography codes viz. 51160, 52150, 53160

General

Code 50130 (Lumbar puncture) and 50140 (cisternal puncture) include fluoroscopy and introduction of contrast (00140 may not be added).

50100

X-ray of the spine scoliosis view AP only

7.00

1 354.43

50105

X-ray of the spine scoliosis view AP and lateral

12.00

2 321.88

50110

X-ray of the spine scoliosis view AP and lateral including stress views

18.54

3 587.30

50120

X-ray bone densitometry

11.52

2 229.00

50130

X-ray guided lumbar puncture

4.80

928.75

50140

X-ray guided cisternal puncture cisternogram

22.98

4 446.40

50300

CT quantitive bone mineral density

11.83

2 288.99

50500

Arteriogram of the spinal column and cord, all vessels

127.23

24 617.73

50510

Venography of the spinal, paraspinal veins

58.45

11 309.49

Cervical

Code 51100 (stress) is a stand alone study and may not be added to 51110, 51120 (cervical spine), 51160 (myelography) and 51170 (discography).

Code 51140 (tomography) may be combined with 51110 or 51120 (spine).

Code 51160s (myelography) and 51170 (discography) include fluoroscopy and introduction of contrast (00140 may not be added).

Code 51300 (CT) limited - limited to a single cervical vertebral body.

Code 51310 (CT) regional study - 2 vertebral bodies and intervertebral disc spaces.

Code 51320 (CT) complete study - an extensive study of the cervical spine.

Code 51340 (CT myelography) - post myelographic study and includes all disc levels, includes fluoroscopy and introduction of contrast (00140 may not be added).

51100

X-ray of the cervical spine, stress views only

4.14

801.05

51110

X-ray of the cervical spine, one or two views

3.01

582.40

51120

X-ray of the cervical spine, more than two views

4.28

828.14

51130

X-ray of the cervical spine, more than two views including stress views

7.58

1 466.65

51140

X-ray Tomography cervical spine

4.30

832.01

51160

X-ray myelography of the cervical spine

27.46

5 313.24

51170

X-ray discography cervical spine per level

25.17

4 870.14

51300

CT of the cervical spine limited study

9.50

1 838.16

51310

CT of the cervical spine - regional study

13.91

2 691.45

51320

CT of the cervical spine - complete study

37.13

7 184.28

51330

CT of the cervical spine pre and post contrast

58.85

11 386.89

51340

CT myelography of the cervical spine

47.19

9 130.79

51350

CT myelography of the cervical spine following myelogram

21.69

4 196.80

51400

MR of the cervical spine, limited study

44.40

8 590.96

51410

MR of the cervical spine and cranio-cervical junction

64.82

12 542.02

51420

MR of the cervical spine and cranio-cervical junction pre and post contrast

102.14

19 763.07

51900

Nuclear Medicine study - Bone regional cervical

21.50

4 160.04

51910

Nuclear Medicine study - Bone tomography regional cervical

13.41

2 594.70

51920

Nuclear Medicine study - with flow

6.02

1 164.81

Thoracic

Code 52120 (tomography) may be combined with 52100 or 52110 (spine).

Code 52150 (myelography) includes fluoroscopy and introduction of contrast (00140 may not be added).

Code 52300 (CT) limited study - limited to a single thoracic vertebral body.

Code 52305 (CT) regional study - 2 vertebral bodies and intervertebral disc paces.

Code 52310 (CT) complete study - an extensive study of the thoracic spine.

Code 52330 (CT myelography) - post myelographic study and includes all disc levels, fluoroscopy and introduction of contrast (00140 may not be added).

52100

X-ray of the thoracic spine, one or two views

3.21

621.10

52110

X-ray of the thoracic spine, more than two views

4.00

773.96

52120

X-ray tomography thoracic spine

4.30

832.01

52140

X-ray of the thoracic spine, more that two views including stress views

6.64

1 284.77

52150

X-ray myelography of the thoracic spine

18.62

3 602.78

52300

CT of the thoracic spine limited study

9.50

1 838.16

52305

CT of the thoracic spine - regional study

13.91

2 691.45

52310

CT of the thoracic spine complete study

35.78

6 923.07

52320

CT of the thoracic spine pre and post contrast

58.85

11 386.89

52330

CT myelography of the thoracic spine

48.09

9 304.93

52340

CT myelography of the thoracic spine following myelogram

20.37

3 941.39

52400

MR of the thoracic spine, limited study

46.60

9 016.63

52410

MR of the thoracic spine

64.34

12 449.15

52420

MR of the thoracic spine pre and post contrast

101.42

19 623.76

52900

Nuclear Medicine study - Bone regional dorsal

21.50

4 160.04

52910

Nuclear Medicine study - Bone tomography regional dorsal

13.41

2 594.70

52920

Nuclear Medicine study - with flow

6.02

1 164.81

Lumbar

Code 53100 (stress) is a stand alone study and may not be added to 53110, 53120 (lumbar spine), 53160 (myelography) and 53170 (discography).

Code 53140 (tomography) may be combined with 53110 or 53120 (spine).

Codes 53160 (myelography) and 53170 (discography) include fluoroscopy and introduction of contrast (00140 may not be added).

Code 53300 (CT) limited study - limited to a single lumbar vertebral body.

Code 53310 (CT) regional study - 2 vertebral bodies and intervertebral disc spaces.

Code 53320 (CT) complete study - an extensive study of the lumbar spine.

Code 53340 (CT myelography) - post myelographic study and includes all disc levels, fluoroscopy and introduction of contrast (00140 may not be added).

53100

X-ray of the lumbar spine - stress study only

4.14

801.05

53110

X-ray of the lumbar spine, one or two views

3.56

688.82

53120

X-ray of the lumbar spine, more than two views

4.46

862.97

53130

X-ray of the lumbar spine, more that two views including stress views

7.52

1 455.04

53140

X-ray tomography lumbar spine

4.30

832.01

53160

X-ray myelography of the lumbar spine

23.94

4 632.15

53170

X-ray discography lumbar spine per level

25.17

4 870.14

53300

CT of the lumbar spine limited study

9.50

1 838.16

53310

CT of the lumbar spine - regional study

13.91

2 691.45

53320

CT of the lumbar spine complete study

37.64

7 282.96

53330

CT of the lumbar spine pre and post contrast

58.85

11 386.89

53340

CT myelography of the lumbar spine

49.11

9 502.29

53350

CT myelography of the lumbar spine following myelogram

23.46

4 539.28

53400

MR of the lumbar spine, limited study

46.20

8 939.24

53410

MR of the lumbar spine

64.32

12 445.28

53420

MR of the lumbar spine pre and post contrast

103.29

19 985.58

53900

Nuclear medicine study - Bone regional lumbar

21.50

4 160.04

53910

Nuclear medicine study - Bone tomography regional lumbar

13.41

2 594.70

53920

Nuclear medicine study - with flow

6.02

1 164.81

Sacrum

Code 54120 (tomography) may be combined with 54100 (sacrum) or 54110 (Sl joints).

Code 54300 (CT) limited study - limited to single sacral vertebral body.

Code 54310 (CT) complete study an extensive study of the sacral spine.

54100

X-ray of the sacrum and coccyx

3.58

692.69

54110

X-ray of the sacro - iliac joints

4.10

793.31

54120

X-ray tomography - sacrum and/or coccyx

4.30

832.01

54300

CT of the sacrum - limited study

7.60

1 470.52

54310

CT of the sacrum - complete study - uncontrasted

25.61

4 955.28

54320

CT of the sacrum with contrast

46.93

9 080.49

54330

CT of the sacrum pre and post contrast

52.97

10 249.17

54400

MR of the sacrum

65.00

12 576.85

54410

MR of the sacrum pre and post contrast

101.04

19 550.23

Pelvis

Codes 55110 (tomography) and 55100 (pelvis) may be combined.

Code 55300 (CT) limited study - limited to a small region of interest of the pelvis eg. ascetabular roof or pubic ramus.

55100

X-ray of the pelvis

3.66

708.17

55110

X-ray tomography - pelvis

4.30

832.01

55300

CT of the bony pelvis limited

9.50

1 838.16

55310

CT of the bony pelvis complete uncontrasted

25.61

4 955.28

55320

CT of the bony pelvis complete 3D recon

37.47

7 250.07

55330

CT of the bony pelvis with contrast

46.93

9 080.49

55340

CT of the bony pelvis - pre and post contrast

52.97

10 249.17

55400

MR of the bony pelvis

65.00

12 576.85

55410

MR of the bony pelvis pre and post contrast

102.24

19 782.42

55900

Nuclear medicine study - Bone regional pelvis

21.50

4 160.04

55910

Nuclear medicine study - Bone tomography regional pelvis

13.41

2 594.70

55920

Nuclear medicine study - with flow

6.02

1 164.81

Hips

Code 56130 (tomography) may be combined with 56100 or 56110 or 56120 (hip).

Code 56140 (stress) may be combined with 56100 or 56110 or 56120 (hip).

Code 56150 (arthrography) includes fluoroscopy and introduction of contrast (00140 may not be added).

Code 56160 (introduction of contrast into hip joint) to be used with 56310 (CT hip) and 56410 (MR hip) and includes fluoroscopy. The combination of 56150 and 56310 and 56410 is not supported except in exceptional circumstances with motivation.

Code 56300 (CT) study limited to small region of interest eg part of femur head.

56100

X-ray of the left hip

3.18

615.30

56110

X-ray of the right hip

3.18

615.30

56120

X-ray pelvis and hips

6.02

1 164.81

56130

X-ray tomography - hip

4.30

832.01

56140

X-ray of the hip/s - stress study

4.38

847.49

56150

X-ray arthrography of the hip joint including introduction contrast

15.75

3 047.47

56160

X-ray guidance and introduction of contrast into hip joint only

7.41

1 433.76

56200

Ultrasound of the hip joints

6.50

1 257.69

56300

CT of hip - limited

9.50

1 838.16

56310

CT of hip - complete

27.37

5 295.82

56320

CT of hip - complete with 3D recon

39.78

7 697.03

56330

CT of hip with contrast

43.26

8 370.38

56340

CT of hip pre and post contrast

47.88

9 264.30

56400

MR of the hip joints, limited study

44.90

8 687.70

56410

MR of the hip joint/s

64.10

12 402.71

56420

MR of the hip joint/s, pre and post contrast

101.64

19 666.32

56900

Nuclear medicine study - Bone regional pelvis

21.50

4 160.04

56910

Nuclear medicine study - Bone limited static plus flow

27.53

5 326.78

56920

Nuclear medicine study - Bone tomography regional

13.41

2 594.70

Upper limbs

General

combined with other codes.

Code 60110 (tomography) may be combined with any one of the defined regional x-ray studies of the upper limb. Motivation may be required for more than one regional tomographic study per visit.

Code 60200 (U/S) may only be used once per visit.

Code 60300 (CT) limited study - limited to a small region of interest eg. part of humeral head.

Code 60400 (MR limited) may only be used once per visit.

60100

X-ray upper limbs - any region - stress studies only

4.52

874.57

60110

X-ray upper limbs - any region - tomography

4.30

832.01

60200

Ultrasound upper limb - soft tissue any region

7.38

1 427.96

60210

Ultrasound of the peripheral arterial system of the left arm including B mode, pulse and colour doppler

13.64

2 639.20

60220

Ultrasound of the peripheral arterial system of the right arm including B mode, pulse and colour doppler

13.64

2 639.20

60230

Ultrasound peripheral venous system upper limbs including pulse and colour doppler for deep vein thrombosis

12.54

2 426.36

60240

Ultrasound peripheral venous system upper limbs including pulse and colour doppler

17.26

3 339.64

60300

CT of the upper limbs limited study

9.50

1 838.16

60310

CT angiography of the upper limb

78.28

15 146.40

60400

MR of the upper limbs limited study, any region

44.80

8 668.35

60410

MR angiography of the upper limb

74.66

14 445.96

60500

Arteriogram of subclavian, upper limb arteries alone, unilateral

45.67

8 836.69

60510

Arteriogram of subclavian, upper limb arteries alone, bilateral

82.67

15 995.82

60520

Arteriogram of aortic arch, subclavian, upper limb, unilateral

56.75

10 980.56

60530

Arteriogram of aortic arch, subclavian, upper limb, bilateral

88.11

17 048.40

60540

Venography, antegrade of upper limb veins, unilateral

26.12

5 053.96

60550

Venography, antegrade of upper limb veins, bilateral

49.43

9 564.21

60560

Venography, retrograde of upper limb veins, unilateral

31.01

6 000.12

60570

Venography, retrograde of upper limb veins, bilateral

54.81

10 605.19

60580

Venography, shuntogram, dialysis access shunt

23.79

4 603.13

60900

Nuclear medicine study - Venogram upper limb

37.12

7 182.35

Shoulder

Code 61160 (arthrography) includes fluoroscopy and introduction of contrast (00140 may not be added).

Code 61170 (introduction of contrast into the shoulder joint) may be combined with 61300 and 61305 (CT), or 61400 and 61405 (MR).

The combination of 61160 (arthrography) and 61300 and 61305 (CT) or 61400 and 61405 (MR) is not supported except in exceptional circumstances with motivation.

61100

X-ray of the left clavicle

3.04

588.21

61105

X-ray of the right clavicle

3.04

588.21

61110

X-ray of the left scapula

3.04

588.21

61115

X-ray of the right scapula

3.04

588.21

61120

X-ray of the left acromio-clavicular joint

3.14

607.56

61125

X-ray of the right acromio-clavicular joint

3.14

607.56

61128

X-ray of acromio-clavicular joints plus stress studies bilateral

7.68

1 486.00

61130

X-ray of the left shoulder

3.48

673.35

61135

X-ray of the right shoulder

3.48

673.35

61140

X-ray of the left shoulder plus subacromial impingement views

5.92

1 145.46

61145

X-ray of the right shoulder plus subacromial impingement views

5.92

1 145.46

61150

X-ray of the left subacromial impingement views only

3.24

626.91

61155

X-ray of the right subacromial impingement views only

3.24

626.91

61160

X-ray arthrography shoulder joint including introduction of contrast

15.83

3 062.95

61170

X-ray guidance and introduction of contrast into shoulder joint only

7.41

1 433.76

61200

Ultrasound of the left shoulder joint

6.50

1 257.69

61210

Ultrasound of the right shoulder joint

6.50

1 257.69

61300

CT of the left shoulder joint - uncontrasted

24.36

4 713.42

61305

CT of the right shoulder joint - uncontrasted

24.36

4 713.42

61310

CT of the left shoulder - complete with 3D recon

37.66

7 286.83

61315

CT of the right shoulder - complete with 3D recon

37.66

7 286.83

61320

CT of the left shoulder joint - pre and post contrast

48.63

9 409.42

61325

CT of the right shoulder joint - pre and post contrast

48.63

9 409.42

61400

MR of the left shoulder

64.64

12 507.19

61405

MR of the right shoulder

64.64

12 507.19

61410

MR of the left shoulder pre and post contrast

101.04

19 550.23

61415

MR of the right shoulder pre and post contrast

101.04

19 550.23

Humerus

62100

X-ray of the left humerus

2.94

568.86

62105

X-ray of the right humerus

2.94

568.86

62300

CT of the left upper arm

24.36

4 713.42

62305

CT of the right upper arm

24.36

4 713.42

62310

CT of the left upper arm contrasted

39.97

7 733.80

62315

CT of the right upper arm contrasted

39.97

7 733.80

62320

CT of the left upper arm pre and post contrast

48.58

9 399.74

62325

CT of the right upper arm pre and post contrast

48.58

9 399.74

62400

MR of the left upper arm

64.20

12 422.06

62405

MR of the right upper arm

64.20

12 422.06

62410

MR of the left upper arm pre and post contrast

102.04

19 743.72

62415

MR of the right upper arm pre and post contrast

102.04

19 743.72

62900

Nuclear medicine study - Bone limited/regional static

21.50

4 160.04

62905

Nuclear medicine study - Bone limited static plus flow

27.53

5 326.78

62910

Nuclear medicine study - bone tomography regional

13.41

2 594.70

Elbow

Code 63120 (arthrography) includes fluoroscopy and introduction of contrast (00140 may not be added).

Code 63130 (introduction of contrast) may be combined with 63300 and 63305 (CT) or 63400 and 63405 (MR). The combination of 63120 (arthrography) and 63300 and 63305 or 63400 and 63405 (MR) is not supported except in exceptional circumstances with motivation.

63100

X-ray of the left elbow

3.14

607.56

63105

X-ray of the right elbow

3.14

607.56

63110

X-ray of the left elbow with stress

4.34

839.75

63115

X-ray of the right elbow with stress

4.34

839.75

63120

X-ray arthrography elbow joint including introduction of contrast

15.89

3 074.56

63130

X-ray guidance and introduction of contrast into elbow joint only

7.41

1 433.76

63200

Ultrasound of the left elbow joint

6.50

1 257.69

63205

Ultrasound of the right elbow joint

6.50

1 257.69

63300

CT of the left elbow

24.36

4 713.42

63305

CT of the right elbow

24.36

4 713.42

63310

CT of the left elbow - complete with 3D recon

37.66

7 286.83

63315

CT of the right elbow - complete with 3D recon

37.66

7 286.83

63320

CT of the left elbow contrasted

39.97

7 733.80

63325

CT of the right elbow contrasted

39.97

7 733.80

63330

CT of the left elbow pre and post contrast

48.63

9 409.42

63335

CT of the right elbow pre and post contrast

48.63

9 409.42

63400

MR of the left elbow

64.64

12 507.19

63405

MR of the right elbow

64.64

12 507.19

63410

MR of the left elbow pre and post contrast

101.04

19550.23'

63415

MR of the right elbow pre and post contrast

101.04

19550.23'

63905

Nuclear medicine study - Bone limited/regional static

21.50

4 160.04

63910

Nuclear medicine study - Bone limited static plus flow

27.53

5 326.78

63915

Nuclear medicine study - Bone tomography regional

13.41

2 594.70

Forearm

64100

X-ray of the left forearm

2.94

568.86

64105

X-ray of the right forearm

2.94

568.86

64110

X-ray peripheral bone densitometry

1.96

379.24

64300

CT of the left forearm

24.36

4 713.42

64305

CT of the right forearm

24.36

4 713.42

64310

CT of the left forearm contrasted

39.97

7 733.80

64315

CT of the right forearm contrasted

39.97

7 733.80

64320

CT of the left forearm pre and post contrast

48.58

9 399.74

64325

CT of the right forearm pre and post contrast

48.58

9 399.74

64400

MR of the left forearm

64.20

12 422.06

64405

MR of the right forearm

64.20

12 422.06

64410

MR of the left forearm pre and post contrast

98.04

18 969.76

64415

MR of the right forearm pre and post contrast

98.04

18 969.76

64900

Nuclear medicine study - Bone limited/regional static

21.50

4 160.04

64905

Nuclear medicine study - Bone limited static plus flow

27.53

5 326.78

64910

Nuclear medicine study - Bone tomography regional

13.41

2594.70

Hand and Wrist

Code 65120 (finger) may not be combined with 65100 or 65105 (hands).

Codes 65130 and 65135 (wrists) may be combined with 65140 or 65145 (scaphoid) respectively if requested and additional views done.

Code 65160 (arthrography) includes fluoroscopy and the introduction of contrast (00140 may not be added).

Code 65170 (contrast) may be combined with 65300 and 65305 (CT) or 65400 and 65405 (MR). The combination of 65160 (arthrography) and 65300 and 65305 or 65400 and 65405 is not supported except in exceptional circumstances with motivation.

65100

X-ray of the left hand

3.08

595.95

65105

X-ray of the right hand

3.08

595.95

65110

X-ray of the left hand - bone age

3.08

595.95

65120

X-ray of a finger

2.67

516.62

65130

X-ray of the left wrist

3.18

615.30

65135

X-ray of the right wrist

3.18

615.30

65140

X-ray of the left scaphoid

3.30

638.52

65145

X-ray of the right scaphoid

3.30

638.52

65150

X-ray of the left wrist, scaphoid and stress views

7.56

1 462.78

65155

X-ray of the right wrist, scaphoid and stress views

7.56

1 462.78

65160

X-ray arthrography wrist joint including introduction of contrast

15.93

3 082.30

65170

X-ray guidance and introduction of contrast into wrist joint only

7.41

1 433.76

65200

Ultrasound of the left wrist

6.50

1 257.69

65210

Ultrasound of the right wrist

6.50

1 257.69

65300

CT of the left wrist and hand

24.36

4 713.42

65305

CT of the right wrist and hand

24.36

4 713.42

65310

CT of the left wrist and hand - complete with 3D recon

37.66

7 286.83

65315

CT of the right wrist and hand - complete with 3D recon

37.66

7 286.83

65320

CT of the left wrist and hand contrasted

39.97

7 733.80

65325

CT of the right wrist and hand contrasted

39.97

7 733.80

65330

CT of the left wrist and hand pre and post contrast

48.63

9 409.42

65335

CT of the right wrist and hand pre and post contrast

48.63

9 409.42

65400

MR of the left wrist and hand

64.64

12 507.19

65405

MR of the right wrist and hand

64.64

12 507.19

65410

MR of the left wrist and hand pre and post contrast

101.04

19 550.23

65415

MR of the right wrist and hand pre and post contrast

101.04

19 550.23

65900

Nuclear Medicine study - bone limited/regional static

21.50

4 160.04

65905

Nuclear Medicine study - bone limited static plus flow

27.53

5 326.78

65910

Nuclear Medicine study - bone tomography regional

13.41

2 594.70

Soft Tissue

69900

Nuclear medicine study - Tumour localisation planar, static

20.74

4 012.98

69905

Nuclear medicine study - Tumour localisation planar, static, multiple studies

35.17

6 805.04

69910

Nuclear medicine study - Tumour localisation planar, static and SPECT

34.15

6 607.68

69915

Nuclear medicine study - Tumour localisation planar, static, multiple studies and SPECT

47.56

9 202.38

69920

Nuclear medicine study - Infection localisation planar, static

18.04

3 490.56

69925

Nuclear medicine study - Infection localisation planar, static, multiple studies

31.45

6 085.26

69930

Nuclear medicine study - Infection localisation planar, static and SPECT

31.45

6 085.26

69935

Nuclear medicine study - Infection localisation planar, static, multiple studies and SPECT

44.86

8 679.96

69940

Nuclear medicine study - Regional lymph node mapping dynamic

6.02

1 164.81

69945

Nuclear medicine study - Regional lymph node mapping, static, planar

24.10

4 663.11

69950

Nuclear medicine study - Regional lymph node mapping, static, planar,multiple

37.51

7 257.81

69955

Nuclear medicine study - Regional lymph node mapping SPECT

13.41

2 594.70

69960

Nuclear medicine study - Lymph node localisation with gamma probe

13.41

2 594.70

Lower Limbs

General

Code 70100 (stress) is a stand alone study and may not be combined with other codes.

Code 70110 (tomography) may be combined with any one of the defined regional x-ray studies of the lower limb. Motivation may be required for more than one regional tomographic study per visit.

Code 70200 (U/S) may only be billed once per visit.

Code 70300 (CT) limited study - limited to a small region of interest eg part of condyle of the knee.

Codes 70310 and 70320 (CT angiography) may not be combined.

Code 70400 (MR limited) may only be used once per visit.

Code 70410 and 70420 (MR angiography) may not be combined.

70100

X-ray lower limbs - any region - stress studies only

4.52

874.57

70110

X-ray lower limbs - any region - tomography

4.30

832.01

70120

X-ray of the lower limbs full length study

6.46

1 249.95

70200

Ultrasound lower limb - soft tissue - any region

7.38

1 427.96

70210

Ultrasound of the peripheral arterial system of the left leg including B mode, pulse and colour Doppler

13.64

2 639.20

70220

Ultrasound of the peripheral arterial system of the right leg including B mode, pulse and colour Doppler

13.64

2 639.20

70230

Ultrasound peripheral venous system lower limbs including pulse and colour doppler for deep vein thrombosis

13.64

2 639.20

70240

Ultrasound peripheral venous system lower limbs including pulse and colour doppler in erect and supine position including all compression and reflux manoeuvres, deep and superficial systems bilaterally

19.66

3 804.01

70300

CT of the lower limbs limited study

9.50

1 838.16

70310

CT angiography of the lower limb

79.43

15 368.91

70320

CT angiography abdominal aorta and outflow lower limbs

98.34

19 027.81

70400

MR of the lower limbs limited study

46.40

8 977.94

70410

MR angiography of the lower limb

76.66

14 832.94

70420

MR angiography of the abdominal aorta and lower limbs

118.86

22 998.22

70500

Angiography of pelvic and lower limb arteries unilateral

40.59

7 853.76

70505

Angiography of pelvic and lower limb arteries bilateral

75.92

14 689.76

70510

Angiography of abdominal aorta, pelvic and lower limb vessels unilateral

61.23

11 847.39

70515

Angiography of abdominal aorta, pelvic and lower limb vessels bilateral

85.66

16 574.35

70520

Angiography translumbar aorta with full peripheral study

45.68

8 838.62

70530

Venography, antegrade of lower limb veins, unilateral

25.46

4 926.26

70535

Venography, antegrade of lower limb veins, bilateral

49.43

9 564.21

70540

Venography, retrograde of lower limb veins, unilateral

31.17

6 031.08

70545

Venography, retrograde of lower limb veins, bilateral

56.79

10 988.30

70560

Lymphangiography, lower limb, unilateral

51.04

9 875.73

70565

Lymphangiography, lower limb, bilateral

83.97

16 247.36

70900

Nuclear medicine study - Venogram lower limb

37.12

7 182.35

Femur

71100

X-ray of the left femur

2.94

568.86

71105

X-ray of the right femur

2.94

568.86

71300

CT of the left femur

24.52

4 744.37

71305

CT of the right femur

24.52

4 744.37

71310

CT of the left upper leg contrasted

41.83

8 093.69

71315

CT of the right upper leg contrasted

41.83

8 093.69

71320

CT of the left upper leg pre and post contrast

49.71

9 618.39

71325

CT of the right upper leg pre and post contrast

49.71

9 618.39

71400

MR of the left upper leg

64.80

12 538.15

71405

MR of the right upper leg

64.80

12 538.15

71410

MR of the left upper leg pre and post contrast

102.04

19 743.72

71415

MR of the right upper leg pre and post contrast

102.04

19 743.72

71900

Nuclear Medicine study - bone limited/regional static

21.50

4 160.04

71905

Nuclear Medicine study - Bone limited static plus flow

27.53

5 326.78

71910

Nuclear Medicine study - Bone tomography regional

13.41

2 594.70

Knee

Codes 72140 and 72145 (patella) may not be added to 72100, 72105, 72110, 72115, 72130, 72135 (knee views)

Code 72160 (arthrography) includes fluoroscopy and introduction of contrast (00140 may not be added).

Code 72170 (introduction of contrast) may be combined with 72300 and 72305 (CT) or 72400 and 72405 (MR). The combination of 72160 (arthrography) and 72300 and 72305 (CT) or 72400 and 72405 (MR) is not supported except in exceptional circumstances with motivation.

72100

X-ray of the left knee one or two views

2.77

535.97

72105

X-ray of the right knee one or two views

2.77

535.97

72110

X-ray of the left knee, more than two views

3.32

642.39

72115

X-ray of the right knee, more than two views

3.32

642.39

72120

X-ray of the left knee including patella

4.62

893.92

72125

X-ray of the right knee including patella

4.62

893.92

72130

X-ray of the left knee with stress views

5.82

1 126.11

72135

X-ray of the right knee with stress views

5.82

1 126.11

72140

X-ray of left patella

2.77

535.97

72145

X-ray of right patella

2.77

535.97

72150

X-ray both knees standing - single view

2.80

541.77

72160

X-ray arthrography knee joint including introduction of contrast

15.81

3 059.08

72170

X-ray guidance and introduction of contrast into knee joint only

7.41

1 433.76

72200

Ultrasound of the left knee joint

6.50

1 257.69

72205

Ultrasound of the right knee joint

6.50

1 257.69

72300

CT of the left knee

24.52

4 744.37

72305

CT of the right knee

24.52

4 744.37

72310

CT of the left knee complete study with 3D reconstructions

35.93

6 952.10

72315

CT of the right knee complete study with 3D reconstructions

35.93

6 952.10

72320

CT of the left knee contrasted

41.83

8 093.69

72325

CT of the right knee contrasted

41.83

8 093.69

72330

CT of the left knee pre and post contrast

49.76

9 628.06

72335

CT of the right knee pre and post contrast

49.76

9 628.06

72400

MR of the left knee

64.10

12 402.71

72405

MR of the right knee

64.10

12 402.71

72410

MR of the left knee pre and post contrast

100.84

19 511.53

72415

MR of the right knee pre and post contrast

100.84

19 511.53

72900

Nuclear Medicine study - Bone limited/regional static

21.50

4 160.04

72905

Nuclear Medicine study - Bone limited static plus flow

27.53

5 326.78

72910

Nuclear Medicine study - Bone tomography regional

13.41

2 594.70

Lower Leg

73100

X-ray of the left lower leg

2.94

568.86

73105

X-ray of the right lower leg

2.94

568.86

73300

CT of the left lower leg

24.52

4 744.37

73305

CT of the right lower leg

24.52

4 744.37

73310

CT of the left lower leg contrasted

41.83

8 093.69

73315

CT of the right lower leg contrasted

41.83

8 093.69

73320

CT of the left lower leg pre and post contrast

49.71

9 618.39

73325

CT of the right lower leg pre and post contrast

49.71

9 618.39

73400

MR of the left lower leg

64.20

12 422.06

73405

MR of the right lower leg

64.20

12 422.06

73410

MR of the left lower leg pre and post contrast

102.04

19 743.72

73415

MR of the right lower leg pre and post contrast

102.04

19 743.72

73900

Nuclear Medicine study - bone limited/regional static

21.50

4 160.04

73905

Nuclear Medicine study - bone limited static plus flow

27.53

5 326.78

73910

Nuclear Medicine study - bone tomography regional

13.41

2 594.70

Ankle and Foot

Code 74145 (toe) may not be combined with 74120 or 74125 (foot).

Code 71450 (sesamoid bones) may be combined with 74120 or 74125 (foot) if requested.

Codes 74120 and 74125 (foot) may only be combined with 74130 and 74135 (calcaneus) if specifically requested.

Code 74160 (arthrography) includes fluoroscopy and introduction of contrast (00140 may not be added).

Code 74170 (introduction of contrast) may be combined with 74300 and 74305 (CT) or 74400 and 74405 (MR). The combination of 74160 (arthrography) and 74300 and 74305 (CT) or 74400 and

74100

X-ray of the left ankle

3.32

642.39

74105

X-ray of the right ankle

3.32

642.39

74110

X-ray of the left ankle with stress views

4.52

874.57

74115

X-ray of the right ankle with stress views

4.52

874.57

74120

X-ray of the left foot

2.80

541.77

74125

X-ray of the right foot

2.80

541.77

74130

X-ray of the left calcaneus

2.74

530.16

74135

X-ray of the right calcaneus

2.74

530.16

74140

X-ray of both feet - standing - single view

2.80

541.77

74145

X-ray of a toe

2.67

516.62

74150

X-ray of the sesamoid bones one or both sides

2.80

541.77

74160

X-ray arthrography ankle joint including introduction of contrast

15.91

3 078.43

74170

X-ray guidance and introduction of contrast into ankle joint

7.41

1 433.76

74210

Ultrasound of the left ankle

6.50

1 257.69

74215

Ultrasound of the right ankle

6.50

1 257.69

74220

Ultrasound of the left foot

6.50

1 257.69

74225

Ultrasound of the right foot

6.50

1 257.69

74290

Ultrasound bone densitometry

2.04

394.72

74300

CT of the left ankle/foot

24.52

4 744.37

74305

CT of the right ankle/foot

24.52

4 744.37

74310

CT of the left ankle/foot - complete with 3D recon

37.81

7 315.86

74315

CT of the right ankle/foot- complete with 3D recon

37.81

7 315.86

74320

CT of the left ankle/foot contrasted

41.83

8 093.69

74325

CT of the right ankle/foot contrasted

41.83

8 093.69

74330

CT of the left ankle/foot pre and post contrast

49.71

9 618.39

74335

CT of the right ankle/foot pre and post contrast

49.71

9 618.39

74400

MR of the left ankle

64.10

12 402.71

74405

MR of the right ankle

64.10

12 402.71

74410

MR of the left ankle pre and post contrast

100.64

19 472.83

74415

MR of the right ankle pre and post contrast

100.64

19 472.83

74420

MR of the left foot

64.20

12 422.06

74425

MR of the right foot

64.20

12 422.06

74430

MR of the left foot pre and post contrast

102.04

19 743.72

74435

MR of the right foot pre and post contrast

102.04

19 743.72

74900

Nuclear Medicine study - Bone limited/regional static

21.50

4 160.04

74905

Nuclear Medicine study - Bone limited static plus flow

27.53

5 326.78

74910

Nuclear Medicine study - Bone tomography regional

13.41

2 594.70

Soft Tissue

79900

Nuclear Medicine study - Tumour localisation planar, static

20.74

4 012.98

79905

Nuclear Medicine study - Tumour localisation planar, static, multiple studies

35.17

6 805.04

79910

Nuclear Medicine study - Tumour localisation planar, static and SPECT

34.15

6 607.68

79915

Nuclear Medicine study - Tumour localisation planar, static, multiple studies & SPECT

47.56

9 202.38

79920

Nuclear Medicine study - Infection localisation planar, static

18.43

3 556.02

79925

Nuclear Medicine study - Infection localisation planar, static, multiple studies

31.84

6 160.72

79930

Nuclear Medicine study - Infection localisation planar, static and SPECT

31.84

6 160.72

79935

Nuclear Medicine study - Infection localisation planar, static, multiple studies and SPECT

45.25

8 755.42

79940

Nuclear Medicine study - Regional lymph node mapping dynamic

6.02

1 164.81

79945

Nuclear Medicine study - Regional lymph node mapping, static, planar

24.10

4 663.11

79950

Nuclear Medicine study - Regional lymph node mapping, static, planar, multiple studies

37.51

7 257.81

79955

Nuclear Medicine study - Regional lymph node mapping and SPECT

13.41

2 594.70

79960

Nuclear Medicine study - Lymph node localisation with gamma probe

13.41

2 594.70

Intervention

General

Codes 80600, 80605, 80610, 80620, 80630, 81660, 81680, 82600, 84660, 85640, 85645, 86610, 86615, 86620, 86630, (aspiration/biopsy/ablations etc) may be combined with the relevant guidance codes (fluoroscopy, ultrasound, CT, MR) as previously described.

The machine codes 00510, 00520, 00530, 00540, 00550, 00560 may not be combined with these codes.

If ultrasound guidance (00230) is used for a procedure which also attracts one of the machine codes (00510, 00520, 00530, 00540, 00550, 00560), it may not be billed for separately.

Codes 80640, 80645, 87682, 87683 include fluoroscopy. Machine fees may not be added.

All other interventional procedures are complete unique procedures describing a whole comprehensive procedure and combinations of different codes will only be supported when motivated.

80600

Percutaneous abscess, cyst drainage, any region

9.37

1 813.00

80605

Fine needle aspiration biopsy, any region

4.22

816.53

80610

Cutting needle, trochar biopsy, any region

6.36

1 230.60

80620

Tumour/cyst ablation chemical

25.37

4 908.84

80630

Tumour ablation radio frequency, per lesion

21.21

4 103.92

80640

Insertion of CVP line in radiology suite

8.99

1 739.48

80645

Peripheral central venous line insertion

12.12

2 345.10

80650

Infiltration of a peripheral joint, any region

6.40

1 238.34

May be combined with relevant guidance (fluoroscopy, ultrasound, CT and MR). May not be combined with machine codes 00510, 00520, 00530, 00540, 00550, 00560 or 86610 (facet joint or SI joint) or arthrogram codes.

Neuro intervention

81600

Intracranial aneurysm occlusion, direct

214.52

41 507.47

81605

Intracranial arteriovenous shunt occlusion

254.82

49 305.12

81610

Dural sinus arteriovenous shunt occlusion

264.33

51 145.21

81615

Extracranial arteriovenous shunt occlusion

157.28

30 432.11

81620

Extracranial arterial embolisation (head and neck)

163.12

31 562.09

81625

Caroticocavernous fistula occlusion

192.29

37 206.19

81630

Intracranial angioplasty for stenosis, vasospasm

126.92

24 557.75

81632

Intracranial stent placement (including PTA)

133.72

25 873.48

81635

Temporary balloon occlusion test

83.42

16 140.94

Code 81635 does not include the relevant preceding diagnostic study and may be combined with codes 10500, 10510, 10530, 10540, 10550.

81640

Permanent carotid or vertebral artery occlusion (including occlusion test)

178.18

34 476.05

81645

Intracranial aneurysm occlusion with balloon remodelling

216.35

41 861.56

81650

Intracranial aneurysm occlusion with stent assistance

230.45

44 589.77

81655

Intracranial thrombolysis, catheter directed

58.94

11 404.30

Code 81655 may be combined with any of the other neuro interventional codes 81600 to 81650

81660

Nerve block, head and neck, per level

7.66

1 482.13

81665

Neurolysis, head and neck, per level

20.14

3 896.89

81670

Nerve block, head and neck, radio frequency, per level

19.04

3 684.05

81680

Nerve block, coeliac plexus or other regions, per level

9.28

1 795.59

Thorax

82600

Chest drain insertion

8.82

1 706.58

82605

Trachial, bronchial stent insertion

30.36

5 874.36

Gastrointestinal

83600

Oesophageal stent insertion

31.22

6 040.76

83605

GIT balloon dilation

24.36

4 713.42

83610

GIT stent insertion (non-oesophageal)

32.02

6 195.55

83615

Percutaneous gastrostomy, jejunostomy

25.36

4 906.91

Hepatobiliary

84600

Percutaneous biliary drainage, external

33.98

6 574.79

84605

Percutaneous external/internal biliary drainage

37.21

7 199.76

84610

Permanent biliary stent insertion

51.22

9 910.56

84615

Drainage tube replacement

20.22

3 912.37

84620

Percutaneous bile duct stone or foreign object removal

49.98

9 670.63

84625

Percutaneous gall bladder drainage

29.58

5 723.43

84630

Percutaneous gallstone removal, including drainage

69.25

13 399.18

84635

Transjugular liver biopsy

24.93

4 823.71

84640

Transjugular intrahepatic Portosystemic shunt

119.47

23 116.25

84645

Transhepatic Portogram including venous sampling, pressure studies

81.89

15 844.90

84650

Transhepatic Portogram with embolisation of varices

100.81

19 505.73

84655

Percutaneous hepatic tumour ablation

15.68

3 033.92

84660

Percutaneous hepatic abscess, cyst drainage

13.20

2 554.07

84665

Hepatic chemoembolisation

59.44

11 501.05

84670

Hepatic arterial infusion catheter placement

60.30

11 667.45

Urogenital

85600

Percutaneous nephrostomy, external drainage

29.97

5 798.90

85605

Percutaneous double J stent insertion including access

40.82

7 898.26

85610

Percutaneous renal stone, foreign body removal including access

66.79

12 923.20

85615

Percutaneous nephrostomy tract establishment

29.27

5 663.45

85620

Change of nephrostomy tube

15.90

3 076.49

85625

Percutaneous cystostomy

16.52

3 196.45

85630

Urethral balloon dilatation

14.24

2 755.30

85635

Urethral stent dilatation

31.22

6 040.76

85640

Renal cyst ablation

11.92

2 306.40

85645

Renal abscess, cyst drainage

15.16

2 933.31

85655

Fallopian tube recanalisation

45.06

8 718.66

Spinal

86600

Spinal vascular malformation embolisation

275.16

53 240.71

86605

Vertebroplasty per level

22.30

4 314.83

86610

Facet joint block per level, uni- or bilateral

9.54

1 845.89

Code 86610 may only be billed once per level, and not per left and right side per level

86615

Spinal nerve block per level, uni- or bilateral

8.16

1 578.88

86620

Epidural block

9.42

1 822.68

86625

Chemonucleolysis, including discogram

18.32

3 544.74

86630

Spinal nerve ablation per level

11.60

2 244.48

Vascular

Code 87654 (Thrombolysis follow up) may only be used on the days following the initial procedure, 87650 (thrombolysis).

If a balloon angioplasty and/or stent placement is performed at more that one defined anatomical site at the same sitting the relevant codes may be combined. However multiple balloon dilatations or stent placements at one defined site will only attract one procedure code

87600

Percutaneous transluminal angioplasty: aorta, IVC

56.56

10 943.79

87601

Percutaneous transluminal angioplasty: iliac

55.76

10 789.00

87602

Percutaneous transluminal angioplasty: femoropopliteal

60.16

11 640.36

87603

Percutaneous transluminal angioplasty: subpopliteal

73.34

14 190.56

87604

Percutaneous transluminal angioplasty: brachiocephalic

67.12

12 987.05

87605

Percutaneous transluminal angioplasty: subclavian, axillary

60.16

11 640.36

87606

Percutaneous transluminal angioplasty: extracranial carotid

71.62

13 857.75

87607

Percutaneous transluminal angioplasty: extracranial vertebral

73.30

14 182.82

87608

Percutaneous transluminal angioplasty: renal

87.69

16 967.14

87609

Percutaneous transluminal angioplasty: coeliac, mesenteric

87.69

16 967.14

87620

Aorta stent-graft placement

120.75

23 363.92

87621

Stent insertion (including PTA): aorta, IVC

73.87

14 293.11

87622

Stent insertion (including PTA): iliac

76.37

14 776.83

87623

Stent insertion (including PTA): femoropopliteal

77.97

15 086.42

87624

Stent insertion (including PTA): subpopliteal

84.55

16 359.58

87625

Stent insertion (including PTA): brachiocephalic

98.47

19 052.96

87626

Stent insertion (including PTA): subclavian, axillary

86.69

16 773.65

87627

Stent insertion (including PTA): extracranial carotid

106.99

20 701.50

87628

Stent insertion (including PTA): extracranial vertebral

100.55

19 455.42

87629

Stent insertion (including PTA): renal

98.59

19 076.18

87630

Stent insertion (including PTA): coeliac, mesenteric

98.59

19 076.18

87631

Stent-graft placement: iliac

76.37

14 776.83

87632

Stent-graft placement: femoropopliteal

77.97

15 086.42

87633

Stent-graft placement: brachiocephalic

98.47

19 052.96

87634

Stent-graft placement: subclavian, axillary

82.77

16 015.17

87635

Stent-graft placement: extracranial carotid

120.43

23 302.00

87636

Stent-graft placement: extracranial vertebral

114.73

22 199.11

87637

Stent-graft placement: renal

98.59

19 076.18

87638

Stent-graft placement: coeliac, mesenteric

98.59

19 076.18

87650

Thrombolysis in angiography suite, per 24 hours

45.82

8 865.71

Code 87650 may be combined with any of the relevant non neuro interventional angiography and interventional codes 10520, 20500, 20510, 20520, 20530, 20540,32500,32530,44500, 44503, 44505, 44507, 44510, 44515, 44517, 44520, 60500, 60510, 60520, 60530, 70500, 70505, 70510, 70515, 87600 to 87638.

87651

Aspiration, rheolytic thrombectomy

77.67

15 028.37

87652

Atherectomy, per vessel

91.89

17 779.80

87653

or other line insertion

28.15

5 446.74

87654

Thrombolysis follow-up

23.57

4 560.56

87655

Percutaneous sclerotherapy, vascular malformation

21.10

4 082.64

87660

Embolisation, mesenteric

100.43

19 432.20

87661

Embolisation, renal

99.36

19 225.17

87662

Embolisation, bronchial, intercostal

108.34

20 962.71

87663

Embolisation, pulmonary arteriovenous shunt

103.22

19 972.04

87664

Embolisation, abdominal, other vessels

101.44

19 627.63

87665

Embolisation, thoracic, other vessels

97.60

18 884.62

87666

Embolisation, upper limb

90.92

17 592.11

87667

Embolisation, lower limb

92.14

17 828.17

87668

Embolisation, pelvis, non-uterine

117.12

22 661.55

87669

Embolisation, uterus

113.88

22 034.64

87670

Embolisation, spermatic, ovaria veins

85.82

16 605.31

87680

Inferior vena cava filter placement

61.84

11 965.42

87681

Intravascular foreign body removal

85.03

16 452.45

87682

Revision of access port (tunnelled or implantable)

14.12

2 732.08

87683

Removal of access port (tunnelled or implantable)

11.12

2 151.61

87690

Superior petrosal venous sampling

73.01

14 126.70

87691

Pancreatic stimulation test

89.79

17 373.47

87692

Transportal venous sampling

76.95

14 889.06

87693

Adrenal venous sampling

55.01

10 643.88

87694

Parathyroid venous sampling

86.66

16 767.84

87695

Renal venous sampling

55.01

10 643.88

Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)

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Part lll : Procedures

19. Radiology

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