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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 - 2019DoctorsPart III : Procedures3. Musculo-Skeletal System3.1 Bones |
Specialist |
General Practitioner |
Anaesthetic |
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U/E |
R |
U/E |
R |
U/E |
R T/M |
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3.1.1 |
Fractures |
|
|
|
|
|
|
0383 |
Fracture (reduction under general anaesthetic): Scapula |
|
s |
|
s |
3 |
357.06 + T+M |
0384 |
Fracture: Scapula: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
284.20 |
7 238.57 |
227.38 |
5 790.86 |
3 |
357.06 +T+M |
0386 |
Fracture: Clavicle: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
209.4 |
5 333.42 |
167.52 |
4 266.73 |
3 |
357.06 +T+M |
0387 |
Fracture (reduction under general anaesthetic): Clavicle |
77 |
1 961.19 |
77 |
1 961.19 |
3 |
357.06 +T+M |
0388 |
Percutaneous pinning supracondylar fracture elbow - stand alone procedure |
175.70 |
4 475.08 |
140.56 |
3 580.06 |
3 |
357.06 +T+M |
0389 |
Fracture (reduction under general anaesthetic): Humerus |
111.60 |
2 842.45 |
111.60 |
2 842.45 |
3 |
357.06 +T+M |
0390 |
Fracture: Humerus: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
255.3 |
6 502.49 |
204.24 |
5 201.99 |
3 |
357.06 +T+M |
0391 |
Fracture (reduction under general anaesthetic): Radius and/or Ulna |
77 |
1 961.19 |
77 |
1 961.19 |
3 |
357.06 +T+M |
0392 |
Open reduction of both radius and ulna (Modifier 0051 not applicable) |
210 |
5 348.70 |
168 |
4 278.96 |
3 |
357.06 +T+M |
0401 |
Fracture: Carpal bone: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
206.7 |
5 315.59 |
166.96 |
4 252.47 |
3 |
357.06 +T+M |
0402 |
Fracture (reduction under general anaesthetic): Carpal bone |
64 |
1 630.08 |
64 |
1 630.08 |
3 |
357.06 +T+M |
0403 |
Bennett's fracture-dislocation |
51 |
1 298.97 |
51 |
1 298.97 |
3 |
357.06 +T+M |
0405 |
Fracture reduction under general anaesthetic: Open treatment of Metacarpal: Simple |
118.3 |
3 013.10 |
118.3 |
3 013.10 |
3 |
357.06 +T+M |
0409 |
Fracture (reduction under general anaesthetic): Finger phalanx: Distal: Simple |
|
β |
|
β |
3 |
357.06 +T+M |
0411 |
Fracture (reduction under general anaesthetic): Finger phalanx: Distal: Compound (open) |
52 |
1 324.44 |
52 |
1 324.44 |
3 |
357.06 +T+M |
0413 |
Fracture (reduction under general anaesthetic): Finger phalanx: Proximal or middle: simple |
48 |
1 222.56 |
48 |
1 222.56 |
3 |
357.06 +T |
0415 |
Fracture (reduction under general anaesthetic): Finger phalanx: Proximal or middle: Compound (open) |
102 |
2 597.94 |
102 |
2 597.94 |
3 |
357.06 +T+M |
0417 |
Fracture (reduction under general anaesthetic): Pelvis fracture: Closed (modifier 0051 is applicable_ |
|
β |
|
β |
|
357.06 +T |
0419 |
Fracture (reduction under general anaesthetic): Pelvis: Operative reduction and fixation |
320 |
8 150.40 |
256 |
6 520.32 |
3 |
357.06 +T+M |
0420 |
Fracture: Acetabulum: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
560 |
14 263.20 |
448 |
11 410.56 |
3 |
357.06 +T+M |
0421 |
Fracture (reduction under general anaesthetic): Femur: Neck or shaft |
237 |
6 036.39 |
189.6 |
4 829.11 |
3 |
357.06 +T+M |
0422 |
Fracture: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
392.3 |
9 991.88 |
313.84 |
7 993.50 |
3 |
357.06 +T+M |
0425 |
Fracture (reduction under general anaesthetic Patella |
51 |
1 298.97 |
51 |
1 298.97 |
3 |
357.06 +T+M |
0426 |
Fracture: Patella: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
219.5 |
5 590.67 |
175.6 |
4 472.53 |
3 |
357.06 +T+M |
0429 |
Fracture (reduction under general anaesthetic) Tibia with or without Fibula |
128 |
3 260.16 |
120 |
3 056.40 |
3 |
357.06 +T+M |
0430 |
Fracture: Tibia, with or without fibula: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
293.2 |
7 467.80 |
234.56 |
5 974.24 |
3 |
357.06 +T+M |
0433 |
Fracture (reduction under general anaesthetic) Fibula shaft |
|
β |
|
β |
3 |
357.06 +T+M |
0434 |
Fracture: Fibula shaft: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
207 |
5 272.29 |
165.6 |
4 217.83 |
3 |
357.06 +T+M |
0435 |
Fracture (reduction under general anaesthetic): Malleolus of ankle |
58 |
1 477.26 |
58 |
1 477.26 |
3 |
357.06 +T+M |
0436 |
Fracture: Ankle malleolus: Open reduction and internal fixation (modifiers 0051, 0052 not applicable) |
207.10 |
5 274.84 |
165.68 |
4 219.87 |
3 |
357.06 +T+M |
0437 |
Fracture-dislocation of ankle |
128 |
3 260.16 |
120 |
3 056.40 |
3 |
357.06 +T+M |
0438 |
Open reduction Talus fracture (Modifier 0051 not applicable) |
198.7 |
5 060.89 |
158.96 |
4 048.71 |
3 |
357.06 +T+M |
0439 |
Fracture (reduction under general anaesthetic): Tarsal bones (excluding talus and calcaneus) |
64 |
1 630.08 |
64 |
1 630.08 |
3 |
357.06 +T+M |
0440 |
Open reduction: Calcaneus fracture (Modifier 0051 not applicable) |
403.50 |
10 277.15 |
322.5 |
8 214.08 |
3 |
357.06 +T+M |
0441 |
Fracture (reduction under general anaesthetic): Metatarsal |
41.8 |
1 064.65 |
41.8 |
1 064.65 |
3 |
357.06 +T+M |
0442 |
Fracture: Metatarsal bones: Open reduction with internal fixation (modifiers 0051, 0052 not applicable) |
154.7 |
3 940.21 |
123.76 |
3 152.17 |
3 |
357.06 +T+M |
0443 |
Fracture (reduction under general anaesthetic): Toe phalanx: Distal: Simple |
|
β |
|
β |
3 |
357.06 +T |
0444 |
Fracture: Toe phalanx, distal: Open reduction with internal fixation (modifiers 0051, 0052 not applicable) |
144.5 |
3 680.42 |
120 |
3 056.40 |
3 |
357.06 +T |
0445 |
Fracture (reduction under general anaesthetic): Toe phalanx: Compound |
32 |
815.04 |
32 |
815.04 |
3 |
357.06 +T+M |
0446 |
Fracture: Tarsal bones (excluding talus and calcaneus): Open reduction with internal fixation (modifiers 0051, 0052 not applicable) |
178.2 |
4 538.75 |
142.56 |
3 631.00 |
3 |
357.06 +T+M |
0447 |
Fracture (reduction under general anaesthetic): Other: Simple |
26 |
662.22 |
26 |
662.22 |
3 |
357.06 +T |
0448 |
Fracture: Calcaneus (reduction under general anaesthetic) |
103.3 |
2 631.05 |
103.3 |
2 631.05 |
3 |
357.06 +T+M |
0449 |
Fracture (reduction under general anaesthetic): Other: Compound |
52 |
1 324.44 |
52 |
1 324.44 |
3 |
357.06 +T+M |
0451 |
Fracture (reduction under general anaesthetic): Sternum and/or ribs: Closed |
|
β |
|
β |
3 |
357.06 +T |
0452 |
Fracture (reduction under general anaesthetic): Sternum and/or ribs: Open reduction and fixation of multiple fractured ribs for flail chest |
230 |
5 858.10 |
184 |
4 686.48 |
3 |
357.06 +T+M |
0455 |
Fracture (reduction under general anaesthetic): Spine: With or without paralysis: Cervical |
|
β |
|
β |
3 |
357.06 +T+M |
0456 |
Fracture (reduction under general anaesthetic): Spine: With or without paralysis: Rest |
|
β |
|
β |
|
357.06 +T+M |
0459 |
DELETED 2009: Open reduction and internal fixation for fracture and/or dislocation of spine |
|
|
|
|
|
|
0461 |
Fracture (reduction under general anaesthetic): Compression fracture: Cervical |
|
s |
|
s |
3 |
357.06 +T+M |
0462 |
Fracture (reduction under general anaesthetic): Compression fracture: Rest |
|
s |
|
s |
3 |
357.06 +T+M |
0463 |
Fracture (reduction under general anaesthetic): Spinous or transversa processes: Cervical |
|
s |
|
s |
3 |
357.06 +T+M |
0464 |
Fracture (reduction under general anaesthetic): Spinous or transverse processes: Rest |
|
s |
|
s |
3 |
357.06 +T+M |
|
|
|
|
|
|
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3.1.1.1 |
Operations for fractures |
|
|
|
|
|
|
0465 |
Fractures involving large joints (includes the item for the relative bone). This item may not be used as a modifier |
288 |
7 335.36 |
230.4 |
5 868.29 |
3 |
357.06 +T+M |
0473 |
Percutaneous insertion plus subsequent removal of Kirschner wires or Steinmann pin (Not subject to rite G) (Modifier 0005 not applicable) |
43 |
1 095.21 |
43 |
1 095.21 |
3 |
357.06 +T |
0475 |
Bonegrafting or internal fixation for malunion or non-union: Femur, Tibia, Humerus, Radius and Ulna |
282 |
7 182.54 |
225.6 |
5 746.03 |
3 |
357.06 +T+M |
0479 |
Bonegrafting or internal fixation for malunion or non-union: Other bones (not applicable to fingers and toes) |
154 |
3 922.38 |
123.2 |
3 137.90 |
3 |
357.06 +T+M |
|
|
|
|
|
|
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3.1.2 |
Bony operations |
|
|
|
|
|
|
3.1.2.1 |
Bone grafting |
|
|
|
|
|
|
0497 |
Resection of bone with or without grafting (benign) |
282 |
7 182.54 |
225.6 |
5 746.03 |
3 |
357.06 +T+M |
0498 |
Resection of bone or tumour (malignant) with or without grafting (does not include digits) |
340 |
8 659.80 |
272 |
6 927.84 |
3 |
357.06 +T+M |
0499 |
Grafts to cysts: Large bones |
192 |
4 890.24 |
153.6 |
3 912.19 |
3 |
357.06 +T+M |
0501 |
Grafts to cysts: Small bones |
128 |
3 260.16 |
120 |
3 056.40 |
3 |
357.06 +T+M |
0503 |
Grafts to cysts: Cartilage graft |
206 |
5 246.82 |
164.8 |
4 197.46 |
3 |
357.06 +T+M |
0505 |
Grafts to cysts: Inter-metacarpal bone graft |
147 |
3 744.09 |
120 |
3 056.40 |
3 |
357.06 +T+M |
0506 |
Harvesting of graft: Cartilage graft, costochondral |
91.1 |
2 320.32 |
91.1 |
2 320.32 |
6 |
714.12 +T |
0507 |
Removal of autogenous bone for grafting (not subject to modifier 0005) |
50 |
1 273.50 |
50 |
1 273.50 |
3 |
357.06 +T+M |
|
|
|
|
|
|
||
3.1.2.2 |
Acute/chronic osteomyelitis |
|
|
|
|
|
|
0509 |
Conservative treatment |
|
s |
|
s |
|
|
0511 |
Operation: Tariff which would be applicable for compound (open) fracture of the bone involved, including six weeks post-operative care |
|
|
|
|
|
|
0512 |
Sternum sequestrectomy and drainage: Including six weeks after care |
128 |
3 260.16 |
120 |
3 056.40 |
3 |
357.06 +T+M |
|
|
|
|
|
|
||
3.1.2.3 |
Osteotomy |
|
|
|
|
|
|
0514 |
Osteotomy: Sternum: Repair of pectus-excavatum |
330 |
8 405.10 |
264 |
6 724.08 |
3 |
357.06 +T+M |
0515 |
Osteotomy: sternum: Repair of pectus carinatum |
330 |
8 405.10 |
264 |
6 724.08 |
3 |
357.06 +T+M |
0516 |
Osteotomy: Pelvic |
320 |
8 150.40 |
256 |
6 520.32 |
3 |
357.06 +T+M |
0521 |
Osteotomy: Femoral: Proximal (Modifier 0051 is applicable) |
320 |
8 150.40 |
256 |
6 520.32 |
3 |
357.06 +T+M |
0527 |
Osteotomy: Knee region (Modifier 0051 is applicable) |
320 |
8 150.40 |
256 |
6 520.32 |
3 |
357.06 +T+M |
0528 |
Osteotomy: Os Calcis (Dwyer operation) (Modifier 0051 is applicable) |
115 |
2 929.05 |
115 |
2 929.05 |
3 |
357.06 +T+M |
0530 |
Osteotomy: Metacarpal and phalanx: Corrective for mal-union or rotation (Modifier 0051 is applicable) |
120 |
3 056.40 |
120 |
3 056.40 |
3 |
357.06 +T+M |
0531 |
Rotational osteotomy tibia and fibula - stand alone procedure |
278.90 |
7 103.58 |
223.12 |
5 682.87 |
3 |
357.06 +T+M |
0532 |
Rotation osteotomy of the Radius. Ulna or Humerus (modifier 0051 is applicable) |
160 |
4 075.20 |
128 |
3 260.16 |
3 |
357.06 +T+M |
0533 |
Osteotomy single metatarsal (modifier 0051 Is applicable) |
60 |
1 528.20 |
60 |
1 528.20 |
3 |
357.06 +T+M |
0534 |
Multiple metatarsal osteotomies (modifier 0051 is applicable |
150 |
3 820.50 |
120 |
3 056.40 |
3 |
357.06 +T+M |
|
|
|
|
|
|
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3.1.2.4 |
Exostosis |
|
|
|
|
|
|
0535 |
Exostosis: Excision: Readily accessible sites |
60 |
1 528.20 |
60 |
1 528.20 |
3 |
357.06 +T+M |
0537 |
Exostosis: Excision: Less accessible sites |
96 |
2 445.12 |
96 |
2 445.12 |
3 |
357.06 +T+M |
|
|
|
|
|
|
||
3.1.2.5 |
Biopsy |
|
|
|
|
|
|
0539 |
Needle Biopsy: Spine (no after-care). Modifier 0005 not applicable |
50 |
1 273.50 |
50 |
1 273.50 |
4 |
476.08 +T |
0541 |
Needle Biopsy: Other sites (no after-care). Modifier 0005 not applicable |
32 |
815.04 |
32 |
815.04 |
4 |
476.08 +T |
0543 |
Biopsy: Open (modifier 0005 is not applicable): Readily accessible site |
64 |
1 630.08 |
64 |
1 630.08 |
|
As per bone |
0545 |
Biopsy: Open (modifier 0005 is not applicable): Less accessible site |
96 |
2 445.12 |
96 |
2 445.12 |
|
As per bone |