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R 385
Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)Scale of FeesAnnual Increase in Medical Tariffs for Medical Service Providers - 2020DoctorsPart lll : Procedures3. Musculo-Skeletal System3.1 Bones |
Specialist |
General Practitioner |
Anaesthetic |
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R |
U |
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R T |
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3.1.1 |
Fractures |
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0383 |
Fracture (reduction under general anaesthetic): Scapula |
112.30 |
3 020.87 |
112.30 |
3 020.87 |
3 |
377.07 + T+M |
0384 |
Fracture: Scapula: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
284.2 |
7 644.98 |
227.36 |
6 115.98 |
3 |
377.07 +T+M |
0386 |
Fracture: Clavicle: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
209.4 |
5 632.86 |
167.52 |
4 506.29 |
3 |
377.07 +T+M |
0387 |
Fracture (reduction under general anaesthetic): Clavicle |
93.80 |
2 523.22 |
93.80 |
2 523.22 |
3 |
377.07 +T+M |
0388 |
Percutaneous pinning supracondylar fracture elbow - stand alone procedure |
175.70 |
4 726.33 |
140.56 |
3 781.06 |
3 |
377.07 +T+M |
0389 |
Fracture (reduction under general anaesthetic): Humerus |
129.60 |
3 486.24 |
129.60 |
3 486.24 |
3 |
377.07 +T+M |
0390 |
Fracture: Humerus: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
255.3 |
6 867.57 |
204.24 |
5 494.06 |
3 |
377.07 +T+M |
0391 |
Fracture (reduction under general anaesthetic): Radius and/or Ulna |
135.7 |
3 650.33 |
120 |
3 228.00 |
3 |
377.07 +T+M |
0392 |
Open reduction of both radius and ulna (Modifier 0051 not applicable) |
193.50 |
5 205.15 |
154.80 |
4 164.12 |
3 |
377.07 +T+M |
0401 |
Fracture: Carpal bone: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
208.7 |
5 614.03 |
166.96 |
4 491.22 |
3 |
377.07 +T+M |
0402 |
Fracture (reduction under general anaesthetic): Carpal bone |
64 |
1 721.60 |
64 |
1 721.60 |
3 |
377.07 +T+M |
0403 |
Bennett's fracture-dislocation |
84.50 |
2 273.05 |
84.50 |
2 273.05 |
3 |
377.07 +T+M |
0405 |
Fracture reduction under general anaesthetic: Open treatment of Metacarpal: Simple |
75.40 |
2 028.26 |
75.40 |
2 028.26 |
3 |
377.07 +T+M |
0409 |
Fracture (reduction under general anaesthetic): Finger phalanx: Distal: Simple |
77 |
2 071.30 |
77 |
2 071.30 |
3 |
377.07 +T+M |
0411 |
Fracture (reduction under general anaesthetic): Finger phalanx: Distal: Compound (open) [Discontinued] Refer to item 0414 |
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0413 |
Fracture (reduction under general anaesthetic): Finger phalanx: Proximal or middle |
50.50 |
1 358.45 |
50.50 |
1 358.45 |
3 |
377.07 +T |
0414 |
Fracture: Finger phalanx, proximal or middle: Open reduction and internal fixation (modifier 0052 not applicable) |
169.90 |
4 570.31 |
135.92 |
3 656.25 |
3 |
377.07 +T |
0415 |
Fracture (reduction under general anaesthetic): Finger phalanx: Proximal or middle: Compound (open) [Discontinued] Refer to item 0413 |
102 |
2 743.80 |
102 |
2 743.80 |
3 |
377.07 +T+M |
0417 |
Fracture (reduction under general anaesthetic): Pelvis fracture: Closed (modifier 0051 is applicable_ |
137.20 |
3 690.68 |
120 |
3 228.00 |
3 |
377.07 +T |
0419 |
Fracture (reduction under general anaesthetic): Pelvis:Open reduction and internal fixation (modifier 0051 not applicable) |
354.49 |
9 535.78 |
283.59 |
7 628.57 |
3 |
377.07 +T+M |
0420 |
Fracture: Acetabulum: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
560 |
15 064.00 |
448 |
12 051.20 |
3 |
377.07 +T+M |
0421 |
Fracture (reduction under general anaesthetic): Femur: Neck or Shaft |
279.10 |
7 507.79 |
223.28 |
6 006.23 |
3 |
377.07 +T+M |
0422 |
Fracture: Femur neck or shaft: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
392.3 |
10 552.87 |
313.84 |
8 442.30 |
3 |
377.07 +T+M |
0425 |
Fracture (reduction under general anaesthetic) Patella |
82.50 |
2 219.25 |
82.50 |
2 219.25 |
3 |
377.07 +T+M |
0426 |
Fracture: Patella: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
219.5 |
5 904.55 |
175.6 |
4 723.64 |
3 |
377.07 +T+M |
0429 |
Fracture (reduction under general anaesthetic) Tibia with or without Fibula |
128 |
3 443.20 |
120 |
3 228.00 |
3 |
377.07 +T+M |
0430 |
Fracture: Tibia, with or without fibula: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
293.2 |
7 887.08 |
234.56 |
6 309.66 |
3 |
377.07 +T+M |
0433 |
Fracture (reduction under general anaesthetic) Fibula shaft |
112.40 |
3 023.56 |
112.40 |
3 023.56 |
3 |
377.07 +T+M |
0434 |
Fracture: Fibula shaft: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
207 |
5 568.30 |
165.6 |
4 454.64 |
3 |
377.07 +T+M |
0435 |
Fracture (reduction under general anaesthetic): Malleolus of ankle |
126.80 |
3 410.92 |
120 |
3 228.00 |
3 |
377.07 +T+M |
0436 |
Fracture: Ankle malleolus: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
207.1 |
5 570.99 |
165.68 |
4 456.79 |
3 |
377.07 +T+M |
0437 |
Fracture-dislocation of ankle |
128 |
3 443.20 |
120 |
3 228.00 |
3 |
377.07 +T+M |
0438 |
Open reduction Talus fracture (Modifier 0051 not applicable) |
311.60 |
8 382.04 |
249.28 |
6 705.63 |
3 |
377.07 +T+M |
0439 |
Fracture (reduction under general anaesthetic): Tarsal bones (excluding talus and calcaneus) |
76.60 |
2 060.54 |
76.60 |
2 060.54 |
3 |
377.07 +T+M |
0440 |
Open reduction: Calcaneus fracture (Modifiers 0051, 0052 not applicable) |
403.50 |
10 854.15 |
322.5 |
8 675.25 |
3 |
377.07 +T+M |
0441 |
Fracture (reduction under general anaesthetic): Metatarsal |
66.80 |
1 796.92 |
66.80 |
1 796.92 |
3 |
377.07 +T+M |
0442 |
Fracture: Metatarsal bones: Open reduction with internal fixation (modifiers 0051, 0052 not applicable) |
154.7 |
4 161.43 |
123.76 |
3 329.14 |
3 |
377.07 +T+M |
0443 |
Fracture (reduction under general anaesthetic): Toe phalanx: Distal: Simple |
66.8 |
1 796.92 |
66.80 |
1 796.92 |
3 |
377.07 +T |
0444 |
Fracture: Toe phalanx, distal: Open reduction with internal fixation (modifier 0052 not applicable) |
144.5 |
3 887.05 |
120 |
3 228.00 |
3 |
377.07 +T |
0445 |
Fracture (reduction under general anaesthetic): Toe phalanx: Compound (Discontinued) Refer to item 0444 |
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0446 |
Fracture: Tarsal bones (excluding talus and calcaneus): Open reduction with internal fixation (modifiers 0051, 0052 not applicable) |
178.2 |
4 793.58 |
142.56 |
3 834.86 |
3 |
377.07 +T+M |
0447 |
Fracture (reduction under general anaesthetic): Other: Simple |
26 |
699.40 |
26 |
699.40 |
3 |
377.07 +T |
0448 |
Fracture: Calcaneus (reduction under general anaesthetic) |
103.3 |
2 778.77 |
103.3 |
2 778.77 |
3 |
377.07 +T+M |
0449 |
Fracture (reduction under general anaesthetic): Other: Compound [Discontinued] Refer to dedicated codes |
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0451 |
Fracture (reduction under general anaesthetic): Sternum and/or ribs: Closed [Discontinued 2020] Refer to item 0452 |
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0452 |
Fracture (reduction under general anaesthetic): Sternum and/or ribs: Open reduction and fixation of multiple fractured ribs for flail chest |
230 |
6 187.00 |
184 |
4 949.60 |
3 |
377.07 +T+M |
0455 |
Fracture (reduction under general anaesthetic): Spine: With or without paralysis: Cervical [Discontinued 2020] |
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0456 |
Fracture (reduction under general anaesthetic): Spine: With or without paralysis: Rest [Discontinued 2020] |
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0461 |
Fracture (reduction under general anaesthetic): Compression fracture: Cervical [Discontinued 2020] |
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0462 |
Fracture (reduction under general anaesthetic): Compression fracture: Rest[Discontinued 2020] |
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0463 |
Fracture (reduction under general anaesthetic): Spinous or transversa processes: Cervical [Discontinued 2020] |
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0464 |
Fracture (reduction under general anaesthetic): Spinous or transverse processes: Rest [Discontinued 2020] |
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3.1.1.1 |
Operations for fractures |
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0465 |
Fractures involving large joints (includes the item for the relative bone). This item may not be used as a modifier |
288 |
7 747.20 |
230.4 |
6 197.76 |
3 |
377.07 +T+M |
0473 |
Percutaneous insertion plus subsequent removal of Kirschner wires or Steinmann pin (Not subject to rite G) (Modifier 0005 not applicable) |
43 |
1 156.70 |
43 |
1 156.70 |
3 |
377.07 +T |
0475 |
Bonegrafting or internal fixation for malunion or non-union: Femur, Tibia, Humerus, Radius and Ulna |
328.20 |
8 828.58 |
262.56 |
7 062.86 |
3 |
377.07 +T+M |
0479 |
Bonegrafting or internal fixation for malunion or non-union: Other bones (not applicable to fingers and toes) |
154 |
4 142.60 |
123.2 |
3 314.08 |
3 |
377.07 +T+M |
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3.1.2 |
Bony operations |
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3.1.2.1 |
Bone grafting |
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0497 |
Resection of bone with or without grafting (benign) |
282 |
7 585.80 |
225.6 |
6 068.64 |
3 |
377.07 +T+M |
0498 |
Resection of bone or tumour (malignant) with or without grafting (does not include digits) |
340 |
9 146.00 |
272 |
7 316.80 |
3 |
377.07 +T+M |
0499 |
Grafts to cysts: Large bones |
192 |
5 164.80 |
153.6 |
4 131.84 |
3 |
377.07 +T+M |
0501 |
Grafts to cysts: Small bones |
128 |
3 443.20 |
120 |
3 228.00 |
3 |
377.07 +T+M |
0503 |
Grafts to cysts: Cartilage graft |
206 |
5 541.40 |
164.8 |
4 433.12 |
3 |
377.07 +T+M |
0505 |
Grafts to cysts: Inter-metacarpal bone graft |
147 |
3 954.30 |
120 |
3 228.00 |
3 |
377.07 +T+M |
0506 |
Harvesting of graft: Cartilage graft, costochondral |
91.1 |
2 450.59 |
91.1 |
2 450.59 |
6 |
754.14 +T |
0507 |
Removal of autogenous bone for grafting (not subject to modifier 0005) |
50 |
1 345.00 |
50 |
1 345.00 |
3 |
377.07 +T+M |
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3.1.2.2 |
Acute/chronic osteomyelitis |
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0509 |
Conservative treatment [Discontinued 2020] |
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0511 |
Operation: Tariff which would be applicable for compound (open) fracture of the bone involved, including six weeks post-operative care [Discontinued 2020] |
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0512 |
Sternum sequestrectomy and drainage: Including FOUR weeks after care |
128 |
3 443.20 |
120 |
3 228.00 |
3 |
377.07 +T+M |
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3.1.2.3 |
Osteotomy |
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0514 |
Osteotomy: Sternum: Repair of pectus-excavatum |
330 |
8 877.00 |
264 |
7 101.60 |
3 |
377.07 +T+M |
0515 |
Osteotomy: sternum: Repair of pectus carinatum |
330 |
8 877.00 |
264 |
7 101.60 |
3 |
377.07 +T+M |
0516 |
Osteotomy: Pelvic |
320 |
8 608.00 |
256 |
6 886.40 |
3 |
377.07 +T+M |
0521 |
Osteotomy: Femoral: Proximal (Modifier 0051 is applicable) |
320 |
8 608.00 |
256 |
6 886.40 |
3 |
377.07 +T+M |
0527 |
Osteotomy: Knee region (Modifier 0051 is applicable) |
320 |
8 608.00 |
256 |
6 886.40 |
3 |
377.07 +T+M |
0528 |
Osteotomy: Os Calcis (Dwyer operation) (Modifier 0051 is applicable) |
115 |
3 093.50 |
115 |
3 093.50 |
3 |
377.07 +T+M |
0530 |
Osteotomy: Metacarpal and phalanx: Corrective for mal-union or rotation (Modifier 0051 is applicable) |
120 |
3 228.00 |
120 |
3 228.00 |
3 |
377.07 +T+M |
0531 |
Rotational osteotomy tibia and fibula - stand alone procedure |
278.90 |
7 502.41 |
223.12 |
6 001.93 |
3 |
377.07 +T+M |
0532 |
Rotation osteotomy of the Radius. Ulna or Humerus (modifier 0051 is applicable) |
160 |
4 304.00 |
128 |
3 443.20 |
3 |
377.07 +T+M |
0533 |
Osteotomy single metatarsal (modifier 0051 Is applicable) |
60 |
1 614.00 |
60 |
1 614.00 |
3 |
377.07 +T+M |
0534 |
Multiple metatarsal osteotomies (modifier 0051 is applicable |
150 |
4 035.00 |
120 |
3 228.00 |
3 |
377.07 +T+M |
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3.1.2.4 |
Exostosis |
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0535 |
Exostosis: Excision: Readily accessible sites |
60 |
1 614.00 |
60 |
1 614.00 |
3 |
377.07 +T+M |
0537 |
Exostosis: Excision: Less accessible sites |
96 |
2 582.40 |
96 |
2 582.40 |
3 |
377.07 +T+M |
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3.1.2.5 |
Biopsy |
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0539 |
Needle Biopsy: Spine (no after-care). Modifier 0005 not applicable |
50 |
1 345.00 |
50 |
1 345.00 |
4 |
502.76 +T |
0541 |
Needle Biopsy: Other sites (no after-care). Modifier 0005 not applicable |
32 |
860.80 |
32 |
860.80 |
4 |
502.76 +T |
0543 |
Biopsy: Open (modifier 0005 is not applicable): Readily accessible site |
64 |
1 721.60 |
64 |
1 721.60 |
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As per bone |
0545 |
Biopsy: Open (modifier 0005 is not applicable): Less accessible site |
96 |
2 582.40 |
96 |
2 582.40 |
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As per bone |