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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 - 2019Orthotists/ProsthetistsGuide to Fees for Orthotists/Prosthetists 2019ProsthetistsProsthetic Components and AccessoriesGeneral Prosthetic Accessories |
Item |
Code |
Cat |
Description |
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COIDA 2019 |
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GPA |
GENERAL PROSTHETIC ACCESSORIES |
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LA230 |
A22730 |
Patella buttons replaced |
ea |
240.37 |
|
LA235 |
A22735 |
Re-alignment (dynamic) of AK/TK modular prosthesis |
ea |
1092.68 |
|
LA236 |
A22736 |
Re-alignment (dynamic) of BK modular prosthesis |
ea |
1034.42 |
|
LA440 |
A22940 |
Stump care - Cleani-stump |
box |
1027.06 |
|
LA450 |
A22950 |
Stump care - Ampu-aid |
tube |
205.84 |
|
LA460 |
A22960 |
Stump care - talc |
tin |
278.65 |
|
LA461 |
A22961 |
Stump/skin lotion |
ea |
537.57 |
|
LA462 |
A22962 |
Stump lubricant |
ea |
426.08 |
|
LA463 |
A22963 |
Stump cleaner |
ea |
493.50 |
|
LA464 |
A22964 |
Stump moisturiser |
ea |
493.50 |
|
LA465 |
A22965 |
Stump ointment |
ea |
610.15 |
|
LA466 |
A22966 |
Stump moisturiser derma clean |
ea |
419.47 |
|
LA470 |
A22970 |
Stump care - balm |
tin |
493.48 |
|
LA480 |
A22980 |
Stump coning bandage 6cm |
ea |
402.51 |
|
LA481 |
A22981 |
Stump coning bandage 8cm |
ea |
508.04 |
|
LA482 |
A22982 |
Stump coning bandage 10cm |
ea |
681.16 |
|
LA483 |
A22983 |
Prosthetic sheath albert andre per pair |
ea |
743.02 |
|
LA484 |
A22984 |
Prosthetic sheath merit |
ea |
105.94 |
|
LA485 |
A22985 |
Fix prosthetic local 601 kneebrace |
ea |
440.96 |
|
LA486 |
A22986 |
Stump sock with hole for pin local |
ea |
317.43 |
|
LA487 |
A22987 |
Stump sock with pin imported |
ea |
425.42 |
|
LA488 |
A22988 |
Dermaseal residual limb stock 453D7 |
ea |
2057.42 |
|
LA490 |
A22990 |
Stump coning bandage 15cm |
ea |
743.02 |
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ADAPTORS |
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AD001 |
A24001 |
2R2 tube adaptor stainless steel |
ea |
1965.79 |
|
AD002 |
A24002 |
Bibr-003 hawk tube adaptor short E05S-BOSS |
ea |
895.95 |
|
AD003 |
A24003 |
2R3 tube adaptor stainless steel |
ea |
2086.35 |
|
AD004 |
A24004 |
Tube with adaptor 1907-13 |
ea |
1412.08 |
|
AD005 |
A24005 |
2R38 tube adaptor titanium |
ea |
4140.89 |
|
AD006 |
A24006 |
A-712010 tube adaptor aluminium short |
ea |
541.84 |
|
AD007 |
A24007 |
S-712020 tube adaptor aluminium long |
ea |
684.14 |
|
AD008 |
A24008 |
Bibr-004 hawk tube adaptor E05S-A SS |
ea |
1131.98 |
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FOOT ADAPTORS |
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AD009 |
A24009 |
2R8=10 sach foot adaptor 1907-14 |
ea |
1190.87 |
|
AD010 |
A24010 |
Sach foot adaptor 1907-14 |
ea |
1276.96 |
|
AD011 |
A24011 |
2R8=8 sach foot adaptor stainless |
ea |
1190.87 |
|
AD012 |
A24012 |
2R31 sach foot adaptor titanium |
ea |
2749.99 |
|
AD013 |
A24013 |
2R54 sach foot adaptor aluminium |
ea |
2265.17 |
|
AD014 |
A24014 |
Bibr-001 hawk sach foot adaptor E01S-M10SS |
ea |
534.68 |
|
AD015 |
A24015 |
2R10 single axis foot adaptor stainless steel |
ea |
2960.62 |
|
AD016 |
A24016 |
2R51 single axis foot adaptor titanium |
ea |
6489.51 |
|
AD017 |
A24017 |
2R33 single axis foot adaptor titanium |
ea |
8618.23 |
|
AD018 |
A24018 |
2R14 connection plate for each foot |
ea |
161.60 |
|
AD019 |
A24019 |
Sach foam connector |
ea |
161.60 |
|
AD020 |
A24020 |
2R22 connection cap for single axis foot |
ea |
337.78 |
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TUBE CLAMP ADAPTORS |
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AD021 |
A24021 |
4R21 tube clamp adaptor stainless |
ea |
1854.52 |
|
AD022 |
A24022 |
Tube clamp connector 1907-22 |
ea |
1291.55 |
|
AD023 |
A24023 |
4R82 tube clamp adaptor titanium |
ea |
5052.26 |
|
AD024 |
A24024 |
A-342100 tube clamp adaptor female pyramid |
ea |
1364.10 |
|
AD025 |
A24025 |
409054-BI tube clamp adaptor |
ea |
1981.03 |
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SOCKET ADAPTORS |
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AD026 |
A24026 |
Bibr-005 hawk clamp adaptor EO7S SS |
ea |
1004.34 |
|
AD027 |
A24027 |
4G70 TK lamination anchor |
ea |
5085.41 |
|
AD028 |
A24028 |
4R116 lamination anchor |
ea |
4193.88 |
|
AD029 |
A24029 |
4R41 lamination anchor/socket with rotate |
ea |
4024.32 |
|
AD030 |
A24030 |
4R43 lamination anchor |
ea |
2344.64 |
|
AD031 |
A24031 |
Rotating socket adaptor 1907-40 |
ea |
3469.29 |
|
AD032 |
A24032 |
4R51 socket adaptor with rotation |
ea |
4845.60 |
|
AD033 |
A24033 |
4R37 socket adaptor with rotation |
ea |
2466.52 |
|
AD034 |
A24034 |
4R89 socket adaptor with rotation |
ea |
3946.16 |
|
AD035 |
A24035 |
Bibr-006 hawk 3 prong socket adaptor with rotation |
ea |
1423.40 |
|
AD036 |
A24036 |
Bibr-007 hawk 3 pyramid adaptor with rotation |
ea |
1327.06 |
|
AD037 |
A24037 |
4R100 socket adaptor titanium Bk |
ea |
3772.63 |
|
AD038 |
A24038 |
4R68 socket adaptor titanium Bk |
ea |
2592.36 |
|
AD039 |
A24039 |
4R55 socket adaptor titanium |
ea |
3218.93 |
|
AD040 |
A24040 |
4R95 socket adaptor aluminium |
ea |
1865.12 |
|
AD041 |
A24041 |
4R22 socket adaptor stainless steel |
ea |
1376.33 |
|
AD042 |
A24042 |
2R63 socket adaptor stainless |
ea |
1675.68 |
|
AD043 |
A24043 |
BK socket adaptor with pyramid |
ea |
1453.14 |
|
AD044 |
A24044 |
4R42 socket adaptor stainless |
ea |
2302.25 |
|
AD045 |
A24045 |
3 prong socket adaptor |
ea |
1870.29 |
|
AD046 |
A24046 |
A-1104040 4 prong socket adaptor |
ea |
2047.92 |
|
AD047 |
A24047 |
Bibr-008 3 prong fixed pyramid adaptor E11S SS |
ea |
1391.94 |
|
AD048 |
A24048 |
Bibr-009 4 prong socket adaptor E12S SS |
ea |
818.88 |
|
AD249 |
A24049 |
5R1 socket attachment block |
ea |
1659.80 |
|
AD250 |
A24050 |
6PC599 socket lamination platform |
ea |
5023.32 |
|
AD251 |
A24051 |
Boww-037 laminating socket attachment Block 70020 |
ea |
1071.78 |
|
AD252 |
A24052 |
Boww-240 laminating socket attachment block |
ea |
1119.95 |
|
AD253 |
A24053 |
4R98 Sliding adaptor |
ea |
4646.91 |
|
AD254 |
A24054 |
Boww-200 pyramid sliding adaptor |
ea |
5975.43 |
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SILICONE SLEEVE |
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SS001 |
A24001 |
6Y42 silicone sleeve without pin |
ea |
5936.50 |
|
SS002 |
A25002 |
6Y70 silicone gel liner |
ea |
8551.50 |
|
SS003 |
A25003 |
6Y80 sleeve transfemoral |
ea |
9622.83 |
|
SS004 |
A25004 |
14Y1 silicone arm liner |
ea |
10800.95 |
|
SS006 |
A25006 |
I-0104 original icecross sleeve without cover |
ea |
6723.46 |
|
SS008 |
A25008 |
I-4013 derma lock in sleeve |
ea |
9121.39 |
|
SS009 |
A25009 |
I-5006 icecross comfort locking/Cushion liner |
ea |
8690.76 |
|
SS010 |
A25010 |
I-6003 icecross synergy locking |
ea |
10407.03 |
|
SS011 |
A25011 |
I-7132 icecross transfemoral locking/cushion liner |
ea |
11510.42 |
|
SS014 |
A25014 |
GPDT general purpose liner |
ea |
12106.40 |
|
SS015 |
A25015 |
GPFR general purpose liner |
ea |
12106.40 |
|
SS016 |
A25016 |
AKDT alps locking liner |
ea |
12133.61 |
|
SS017 |
A25017 |
AKFR alps cushion liner |
ea |
12133.61 |
|
SS018 |
A25018 |
Boww-016 alpha spirit cushion liner SP ALC5366 |
ea |
9706.14 |
|
SS019 |
A25019 |
Boww-006 alpha original lock liner |
ea |
11681.09 |
|
SS020 |
A25020 |
Boww-221 alpha AK Lock in liner |
ea |
11909.90 |
|
SS021 |
A25021 |
Boww 225 alpha AK cushion AKL |
ea |
9706.14 |
|
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SEAL IN SLEEVES |
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SS022 |
A25022 |
I-4613 icecross dermo seal in sleeve |
ea |
10243.63 |
|
SS023 |
A25023 |
I-7532 icecross transfemoral seal in sleeve |
ea |
13033.54 |
|
SS024 |
A25024 |
I-7632 icecross transfemoral seal in conical |
ea |
13033.54 |
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SEAL IN SOCKS |
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SS025 |
A25025 |
K5313 seal in liner socks 3 ply |
ea |
307.76 |
|
SS026 |
A25026 |
K5311 seal in liner sock 1 ply |
ea |
204.30 |
|
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KNEE SLEEVES |
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SS027 |
A25027 |
453A2=1-4 derma comfort ORT knee sleeve |
ea |
2769.71 |
|
SS028 |
A25028 |
453A3=1-3 profelex knee sleeve |
ea |
3359.34 |
|
SS029 |
A25029 |
453A-4=1-3 profelex knee sleeve short |
ea |
2986.08 |
|
SS030 |
A25030 |
F-2011 icecross knee sleeve = 35-62 |
ea |
2754.68 |
|
SS031 |
A25031 |
BDAW-301 daw G-sleeve |
ea |
1546.24 |
|
SS032 |
A25032 |
BDMI-182 medi genu sleeve Mk00203000 |
ea |
1890.66 |
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DISTAL CUPS |
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SS033 |
A25033 |
I-3000 distal cup |
ea |
2441.47 |
|
SS034 |
A25034 |
Boww-042 gel cups |
ea |
1168.12 |
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VOLUME MANAGE PADS |
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SS035 |
A25035 |
Boww-045 volume manage pads X3 |
ea |
826.45 |
|
SS036 |
A25036 |
BPRO-002 1K10 protector pad |
ea |
4400.27 |
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PINS |
|
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SS037 |
A25037 |
6Y13=3 long pin only |
ea |
1749.87 |
|
SS038 |
A25038 |
L-192000 attachment pin standard |
ea |
783.95 |
|
SS039 |
A25039 |
Boww-074 alpha lock pin |
ea |
903.18 |
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SHUTTLE LOCKS |
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SL651 |
A36651 |
Shuttle lock fit |
ea |
3318.11 |
|
SL040 |
A25040 |
6A20 shuttle lock with distal adjustment pyramid |
ea |
12166.01 |
|
SL041 |
A25041 |
6A30=20 and 10 shuttle lock |
ea |
9961.44 |
|
SL042 |
A25042 |
14A1 shuttle lock to attach 14Y1 Silicone liner |
ea |
9443.49 |
|
SL043 |
A25043 |
L-621000 ice ratchet |
ea |
2826.72 |
|
SL044 |
A25044 |
109108 blatchfordshuttle lock |
ea |
9012.98 |
|
SL045 |
A25045 |
Alps shuttle lock with pyramid S498-P |
ea |
7049.64 |
|
SL047 |
A25047 |
Boww-061 alpha lock kit |
ea |
5977.83 |
|
SL048 |
A25048 |
Boww-062 lanyard lock kit |
ea |
6358.37 |
|
SL049 |
A25049 |
Bibr-040 hawk shuttle lock E70 |
ea |
5539.49 |
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VALVES |
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VL050 |
A25050 |
21Y12 screw valve kit |
ea |
3963.38 |
|
VL051 |
A25051 |
21Y40 suction valve |
ea |
573.57 |
|
VL052 |
A25052 |
21Y41 seat ring for 21Y40 valve |
ea |
164.25 |
|
VL053 |
A25053 |
21Y105 valve kit for flexible sockets |
ea |
2055.87 |
|
VL054 |
A25054 |
4R140 one way valve for knee sleeves |
ea |
1649.20 |
|
VL055 |
A25055 |
L-552000 ice lock expulsion valve TF AK valve |
ea |
1653.04 |
|
VL056 |
A25056 |
L-551002 ice lock expulsion valve TF BK valve |
ea |
1483.94 |
|
VL057 |
A25057 |
BMDI-240 medi vacu valve-1810723000 |
ea |
696.06 |
|
VL058 |
A25058 |
BUSN-001 green dot valve plastic |
ea |
1507.29 |
|
VL059 |
A25059 |
BUSN-002 green dot valve stainless steel |
ea |
1111.00 |
|
LA510 |
A25060 |
Suction valve standard |
ea |
786.19 |
|
LA520 |
A25061 |
Suction valve total contact |
ea |
1438.20 |
|
LA530 |
A25062 |
Suction valve Green dot standard |
ea |
1438.20 |
|
LA540 |
A25063 |
Suction valve Green dot total contact |
ea |
1438.20 |
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REPAIR KITS |
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RK001 |
A26001 |
2D2 single component pack for 1A6 and 1A29 |
ea |
1250.97 |
|
RK002 |
A26002 |
2D3 for 1A20 foot |
ea |
764.87 |
|
RK003 |
A26003 |
2D5 service pack for 2R10 ankle |
ea |
392.18 |
|
RK004 |
A26004 |
3D4 service kit for 3P23 knee |
ea |
1861.89 |
|
RK005 |
A26005 |
2D1 Service for 3R15/3R46/3R42 knees |
ea |
883.31 |
|
RK006 |
A26006 |
4D13 service kit for 3R36/R20 |
ea |
1534.79 |
|
RK007 |
A26007 |
4D18 service kit for 3R46 knee |
ea |
1328.62 |
|
RK008 |
A26008 |
4D19 repair kit for 3R55 |
ea |
1114.21 |
|
RK009 |
A26009 |
4V34 declaration bumper |
ea |
516.79 |
|
RK010 |
A26010 |
4H5=26 knee extension stop rubber |
ea |
125.78 |
|
RK011 |
A26011 |
4H21 shin extension stop rubber |
ea |
104.37 |
|
RK012 |
A26012 |
7U25 joint bearing 509K 11X5X16X5 |
ea |
215.33 |
|
RK013 |
A26013 |
7U25 joint big screw 501A22 |
ea |
109.95 |
|
RK014 |
A26014 |
7U25 small joint screw 501S6X8XM3.5 |
ea |
33.67 |
|
RK015 |
A26015 |
4B52 swinging block |
ea |
1874.04 |
|
RK016 |
A26016 |
4D7 repair kit for 3R21/3R30 |
ea |
3038.42 |
|
RK017 |
A26017 |
4F34 lock control unit AK (3R17/3R33/3R40/3R41) KNEE |
ea |
1119.73 |
|
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PARTIAL HAND PROSTHESIS |
|
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|
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PH010 |
A30010 |
Partial hand passive |
ea |
24016.95 |
|
PH020 |
A30020 |
Partial hand functional |
ea |
33973.08 |
|
PH030 |
A30030 |
Partial opposition post |
ea |
16754.36 |
|
|
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PARTIAL HAND REPAIRS |
|
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|
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PH050 |
A30050 |
Partial new silicone socket |
ea |
7672.46 |
|
PH060 |
A30060 |
Partial hand - cosmetic glove replaced |
ea |
5776.56 |
|
PH070 |
A30070 |
Partial hand - replace zip to glove |
ea |
5 339.51 |
|
|
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WD |
WRIST DISARTICULATION PROSTHESIS |
|
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|
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WD010 |
A30510 |
Wrist disarticulation - passive |
ea |
46748.29 |
|
WD020 |
A30520 |
Wrist disarticulation - functional |
ea |
61692.50 |
|
WD021 |
A30521 |
Refit Wrist Disarticulation |
ea |
13961.17 |
|
|
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BE |
BELOW ELBOW PROSTHESIS |
|
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|
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BE010 |
A31010 |
Below elbow prosthesis - passive hand & cosmetic cover |
ea |
46748.29 |
|
BE020 |
A31020 |
Below elbow prosthesis - functional hand & cosmetic cover |
ea |
61692.50 |
|
BE040 |
A31040 |
BE test socket - diagnostic |
ea |
2622.39 |
|
|
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ED |
ELBOW DISARTICULATION PROSTHESIS |
|
|||
|
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ED010 |
A31510 |
Elbow disarticulation prosthesis - passive hand and cosmetic cover |
ea |
69654.38 |
|
ED020 |
A31520 |
Elbow disarticulation prosthesis - functional hand and cosmetic cover |
ea |
90777.65 |
|
ED030 |
A31530 |
ED test socket - diagnostic |
ea |
2622.39 |
|
ED031 |
A31531 |
Refit ED |
ea |
28594.95 |
|
|
|||||
ABOVE ELBOW PROSTHESIS |
|
||||
|
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AE010 |
A32010 |
Above elbow prosthesis - passive hand & cosmetic cover incl |
54795.93 |
||
AE020 |
A32020 |
Above elbow prosthesis - functional hand & cosmetic cover incl |
72424.36 |
||
AE040 |
A32040 |
AE test socket - diagnostic |
2622.39 |
||
|
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ADDITIONAL CHARGES |
|
||||
|
|||||
AE060 |
A32060 |
Automatic locking elbow 12K4 |
ea |
25506.73 |
|
AE065 |
A32065 |
Elbow joint with cable lock |
ea |
17896.28 |
|
AE067 |
A32067 |
Step-up joints for short BE or TE |
ea |
20132.53 |
|
|
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Notes
Manual locking elbows 12K5 are supplied as standard. Prosthetist may supply an automatic elbow on request and adjust the fee accordingly.
The cost of the standard elbow must be deducted and the automatic elbow added.
Prosthetic hooks are not included with upper extremity prosthesis as standard. |
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SD |
SHOULDER DISARTICULATION PROSTHESIS |
|
|||
|
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SD010 |
A32510/1 |
Shoulder disarticulation prosthesis manual elbow (incl. passive hand & cosmetic cover) |
ea |
75871.74 |
|
A32510/2 |
Shoulder disarticulation prosthesis electric elbow (incl. passive hand & cosmetic cover) |
ea |
92094.33 |
||
SD020 |
A32520 |
Shoulder disarticulation - with electric elbow functional hand & cosmetic cover incl |
ea |
93498.38 |
|
A33155 |
Refit Shoulder disarticulation |
ea |
32724.42 |
||
|
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AA |
ACCESSORIES |
|
|||
|
|||||
AA010 |
A33010 |
Cable - AE |
ea |
2625.98 |
|
AA020 |
A33020 |
Cable - BE |
ea |
2400.15 |
|
AA030 |
A33030 |
Corset - BE |
ea |
2393.00 |
|
AA040 |
A33040 |
Passive hand |
ea |
11258.25 |
|
AA050 |
A33050 |
Felt hand |
ea |
11258.25 |
|
AA060 |
A33060 |
Functional hand |
ea |
14133.77 |
|
AA070 |
A33070 |
Harness - AE |
ea |
2400.20 |
|
AA080 |
A33080 |
Harness - BE |
ea |
2400.18 |
|
AA090 |
A33090 |
Hook elastics |
ea |
63.81 |
|
AA100 |
A33100 |
Prosthetic glove - cosmetic |
ea |
5731.08 |
|
AA110 |
A33110 |
Prosthetic glove - leather |
ea |
1198.38 |
|
AA120 |
A33120 |
Prosthetic hook - aluminium |
ea |
16437.42 |
|
AA130 |
A33130 |
Prosthetic hook - steel |
ea |
21032.14 |
|
AA140 |
A33140 |
Refit AE |
ea |
21289.03 |
|
AA150 |
A33150 |
Refit BE |
ea |
13283.25 |
|
AA160 |
A33160 |
Wrist insert - Only with repairs or when hook is required |
ea |
1546.07 |
|
AA165 |
A33165 |
Wrist Unit inclusive of wrist insert |
ea |
6013.32 |
|
AA170 |
A33170 |
Manual locking elbow 12K5 inclusive with new. Only charge separate with repairs |
ea |
9284.15 |
|
AA175 |
A33175 |
Re laminate BE |
ea |
1898.06 |
|
AA180 |
A33180 |
C708 Base Plate |
ea |
102.47 |
|
AA185 |
133185 |
21A29=25 Auxila Loop |
ea |
786.13 |
|
AA190 |
A33190 |
C711HD Hanger |
ea |
207.74 |
|
AA195 |
A33195 |
C711 Standard Hanger |
ea |
166.99 |
|
AA196 |
A33196 |
C713HD Ball Receiver |
ea |
314.36 |
|
AA197 |
A33197 |
C713 Standard Ball Receiver |
ea |
269.75 |
|
AA198 |
A33198 |
C703HD Ball Terminal |
ea |
107.04 |
|
AA199 |
A33199 |
C703 Standard Ball Terminal |
ea |
139.16 |
|
AA200 |
A33200 |
C701HD Triple Swivel |
ea |
309.49 |
|
AA201 |
A33201 |
C703 Standard Triple Swivel |
309.49 |
||
AA202 |
A33202 |
C709HD Retainer |
ea |
175.55 |
|
AA203 |
A33203 |
C709 Standard Retainer |
ea |
150.40 |
|
AA204 |
A33204 |
C710HD Cross Bar |
ea |
278.31 |
|
AA205 |
A33205 |
C710 Standard Cross Bar |
ea |
268.95 |
|
|
|||||
SS |
PROSTHETIC SOCKS |
|
|||
|
|||||
SS010 |
A35010 |
Stump sock - BK local |
ea |
429.84 |
|
SS020 |
A35020 |
Stump sock - AK local |
ea |
480.73 |
|
SS030 |
A35030 |
Stump sock - Arm local |
ea |
309.57 |
|
SS040 |
A35040 |
Stump sock - Symes local |
ea |
797.66 |
|
SS050 |
A35050 |
Stump sock - BK 5 ply - imported |
ea |
850.52 |
|
SS055 |
A35055 |
Stump sock - BK 3 ply - imported |
ea |
797.66 |
|
SS060 |
A35060 |
Stump sock - AK 5 ply - imported |
ea |
850.52 |
|
SS065 |
A35065 |
Stump sock AK 3 ply - imported |
ea |
797.67 |
|
SS070 |
A35070 |
Stump sock Arm 3 ply - imported |
ea |
429.84 |
|
SS075 |
A35075 |
Stump sock Arm 5 ply - imported |
ea |
509.85 |
|
SS080 |
A35080 |
Stump sock - Symes 3 ply - imported |
ea |
1178.26 |
|
SS085 |
A35085 |
Stump sock - Symes 5 ply - imported |
ea |
1283.95 |
|
SS090 |
A35090 |
Prosthetic sheath - imported |
ea |
482.52 |
|
SS096 |
A35096 |
Prosthetic sheath - Local |
ea |
105.94 |
|
SS093 |
A35093 |
Prosthetic sheath with hole for pin - local |
ea |
109.31 |
|
SS097 |
A35097 |
Stump sock with hole for pin - local |
ea |
317.43 |
|
SS095 |
A35095 |
Stump sock with hole for pin imported |
ea |
425.42 |
|
SS100 |
A35100 |
Protective sheath - American |
2385.63 |
||
SS105 |
A35105 |
Protective sheath - European (Derma seal) |
4022.84 |
||
SS106 |
A35106 |
Dermaseal residual limb sock 453D7 |
ea |
2163.16 |
|
SS110 |
A35110 |
Fix Prosthesis - European (Daw) |
ea |
1145.53 |
|
SS120 |
A35120 |
Fix Prosthesis - American (silicone suspension liner) |
ea |
564.50 |
|
SS121 |
A35121 |
Fix prosthesis local 601 kneebrace |
ea |
440.96 |
|
SS130 |
A35130 |
Stump shrinker BK |
ea |
910.22 |
|
SS140 |
A35140 |
Stump shrinker AK |
ea |
1209.73 |
|
|
|||||
SUSPENSION SYSTEMS |
|
||||
|
|||||
AK150 |
A21650 |
AK - hip-joint and pelvic band to prosthesis |
ea |
10373.05 |
|
AK700 |
A21700 |
AK - shoulder belt |
ea |
1050.74 |
|
AK701 |
A21701 |
AK - silesion belt |
ea |
962.35 |
|
AK704 |
A21704 |
AK - silesion strap |
ea |
291.77 |
|
AK708 |
A21708 |
AK - waist belt |
ea |
1011.90 |
|
AK712 |
A21712 |
AK - neoprene suspension belt |
ea |
2660.95 |
|
BK132 |
A20632 |
BK joints and thigh corset |
ea |
18641.80 |
|
BK133 |
A20633 |
BK joints and weightbearing corset |
ea |
20923.01 |
|
BK192 |
A20692 |
BK back check strap |
ea |
583.63 |
|
BK193 |
A20693 |
BK backlift |
ea |
605.03 |
|
BK194 |
A20694 |
BK crutch strap |
ea |
653.15 |
|
BK197 |
A20697 |
BK ptb strap |
ea |
1131.06 |
|
BK198 |
A20698 |
Front Control strap |
ea |
721.57 |
|
BK200 |
A20700 |
BK thigh corset |
ea |
3136.22 |
|
BK201 |
A20701 |
BK waistbelt leather |
ea |
1214.06 |
|
BK202 |
A20702 |
BK waistbelt webbing |
ea |
795.06 |
|
|
|
|
|
|
OCULAR PROSTHESIS |
|
||||
|
|||||
OCU |
A53015 |
Prosthesis Consultation (Not payable with A56000) |
701.90 |
||
OCU |
A53115 |
Impression for Ocular Prosthesis |
2833.59 |
||
OCU |
A53215 |
Iris Colour |
1171.36 |
||
OCU |
A53315 |
Model fitting |
5762.09 |
||
OCU |
A53415 |
Prosthetic manufacture and moulding |
6656.35 |
||
OCU |
A53515 |
Follow-up (Within 6 months of new or replacement prosthesis but included in item 56000) |
388.41 |
||
OCU |
A53715 |
Glass eye complete with consultation and fitting (attached motivation) |
5260.41 |
||
OCU |
A53815 |
Drill ball and socket (pegging to coral) "attached motivation" |
1136.19 |
||
OCU |
A53915 |
Trimming and Reshaping |
568.86 |
||
OCU |
A54015 |
Build up |
1683.64 |
||
OCU |
A54115 |
Veining |
793.65 |
||
OCU |
A54215 |
Polishing |
351.71 |
||
OCU |
A54315 |
Materials for custom eye |
2211.21 |
||
OCU |
A54415 |
Stock eye (every 5 years) |
1579.65 |
||
OCU |
A54515 |
Haptic Lens (every 5 years) |
3478.90 |
||
OCU |
A56000 |
Complete eye (includes consultation A53015) |
22067.72 |