16 Disember 2013 16 December 2013

P.U. (A) 358

WARTA KERAJAAN PERSEKUTUAN

FEDERAL GOVERNMENT GAZETTE

PERINTAH KEMUDAHAN DAN PERKHIDMATAN JAGAAN KESIHATAN SWASTA (HOSPITAL SWASTA

DAN KEMUDAHAN JAGAAN KESIHATAN SWASTA LAIN) (PINDAAN) 2013

PRIVATE HEALTHCARE FACILITIES AND SERVICES (PRIVATE HOSPITALS AND OTHER PRIVATE

HEALTHCARE FACILITIES) (AMENDMENT) ORDER 2013

DISIARKAN OLEH/ PUBLISHED BY

JABATAN PEGUAM NEGARA/ ATTORNEY GENERAL’S CHAMBERS

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AKTA KEMUDAHAN DAN PERKHIDMATAN JAGAAN KESIHATAN SWASTA 1998

PERINTAH KEMUDAHAN DAN PERKHIDMATAN JAGAAN KESIHATAN SWASTA (HOSPITAL SWASTA DAN KEMUDAHAN JAGAAN KESIHATAN SWASTA LAIN)

(PINDAAN) 2013

PADA menjalankan kuasa yang diberikan oleh subseksyen 106(2) Akta Kemudahan dan

Perkhidmatan Jagaan Kesihatan Swasta 1998 [Akta 586], Menteri membuat perintah

yang berikut:

Nama

1. Perintah ini bolehlah dinamakan Perintah Kemudahan dan Perkhidmatan

Jagaan Kesihatan Swasta (Hospital Swasta dan Kemudahan Jagaan Kesihatan

Swasta Lain) (Pindaan) 2013.

Pindaan Jadual Ketiga Belas

2. Peraturan-Peraturan Kemudahan dan Perkhidmatan Jagaan Kesihatan Swasta

(Hospital Swasta dan Kemudahan Jagaan Kesihatan Swasta Lain) 2006

[P.U. (A) 138/2006], dipinda dengan menggantikan Jadual Ketiga Belas dengan jadual

yang berikut:

“JADUAL KETIGA BELAS

[Peraturan 433]

JADUAL FI - FI PROFESIONAL

BAHAGIAN A - FI PERUBATAN

Catatan:

1. Dalam catatan ini:

"di luar jam" ertinya suatu tempoh antara 6 petang dalam satu hari dan 8 pagi hari

yang berikutnya pada hari-hari biasa, dan sepanjang hari pada hujung minggu dan

cuti awam;

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"kecemasan" ertinya suatu keadaan serius yang dikatakan wujud apabila kelewatan

dalam rawatan boleh menambah ancaman kepada nyawa atau bahagian badan;

"pakar bedah" merujuk kepada semua kategori pakar dan boleh termasuk pakar

anestesia;

"fi pakar anestesia" merujuk kepada fi yang dikenakan untuk induksi,

penyelenggaraan, pembalikan anestesia dan aktiviti pemantauan standard. Fi ini

hanya terpakai untuk anestesia am atau anestesia serantau.

2. Semua fi di dalam Jadual ini adalah fi maksimum yang boleh dikenakan dan ia terpakai

bagi apa-apa bentuk pembayaran.

3. Suatu fi tambahan yang tidak melebihi 50% daripada fi maksimum boleh dikenakan

oleh kedua-dua pakar bedah dan pakar anestesia bagi tatacara kecemasan yang

dilakukan di luar jam, yang hendaklah tidak termasuk tatacara elektif.

4. Bagi lawatan wad, termasuk lawatan selepas pembedahan dan penjagaan, fi

perundingan yang boleh dikenakan adalah bagi maksimum dua lawatan pada hari

yang sama, tanpa mengira jumlah sebenar lawatan yang dibuat, kecuali dalam hal

apabila lawatan tambahan adalah atas permintaan pesakit atau apabila keadaan

pesakit didapati memerlukan lawatan tambahan.

5. Fi bagi jagaan anestesia yang dipantau menjadi 80% daripada fi anestesia untuk

tatacara itu.

6. Apabila dua atau lebih tatacara yang dilakukan melalui insisi dan masa yang sama, fi

yang boleh dikenakan oleh kedua-dua pakar bedah dan pakar anestesia bagi selain

tatacara yang dimaksudkan, hendaklah tidak melebihi 50% daripada tatacara itu.

7. Apabila dua atau lebih tatacara dilakukan melalui insisi berasingan pada masa yang

P.U. (A) 358

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sama, fi bagi kedua-dua pakar bedah dan pakar anestesia hendaklah tidak melebihi

75% daripada fi profesional masing-masing yang ditetapkan bagi tatacara itu.

Peraturan ini tidak terpakai bagi insisi pelbagai yang dibuat untuk mewujudkan port

akses pelbagai dalam mana-mana tatacara endoskopi dan laparoskopi.

8. Dalam pembedahan yang melibatkan aras anatomi berbilang, fi yang boleh dikenakan

bagi tatacara itu adalah 100% bagi aras pertama dan tidak boleh melebihi 50%

daripada fi maksimum yang boleh dikenakan untuk aras berikutnya.

9. Apabila satu atau lebih tatacara yang dilakukan sama ada melalui insisi sama atau

berbeza, elektif atau kecemasan dan menghendaki khidmat beberapa pakar bedah

dengan kepakaran yang berbeza melakukan bersama-sama demi kepentingan

keselamatan pesakit, kecekapan operatif atau kualiti penjagaan, fi yang boleh

dikenakan oleh pakar bedah ini selain pakar bedah utama tidak boleh melebihi 75%

daripada fi maksimum yang dikenakan.

10. Apabila tatacara yang bersifat sangat kompleks menghendaki khidmat seorang pakar

bedah kedua dengan kepakaran yang sama, melakukan bersama-sama demi

kepentingan keselamatan pesakit, kecekapan operatif atau kualiti penjagaan, jumlah fi

yang boleh dikenakan oleh pakar bedah kedua hendaklah tidak melebihi 50%

daripada jumlah fi yang boleh dikenakan oleh pakar bedah pertama (utama) bagi

tatacara yang dilakukannya.

11. Dalam hal apabila fi tertentu bagi tatacara laparoskopi atau endoskopik tidak

dinyatakan dalam Jadual, fi tambahan tidak melebihi 15% daripada fi tatacara itu

boleh dikenakan oleh pakar bedah.

12. Dalam hal apabila tatacara terbuka dilakukan berikutan kegagalan tatacara

endoskopik, fi yang dikenakan adalah bagi satu tatacara sahaja.

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13. Apabila tatacara endoskopi atau laparoskopi terapeutik didahului oleh tatacara

endoskopi atau laparoskopi diagnostik, tiada fi tambahan akan dikenakan bagi

tatacara diagnostik.

14. Dalam hal apabila satu tatacara terdiri daripada gabungan beberapa tatacara yang

lazimnya dilakukan bersama-sama dan bagi tatacara gabungan yang dinyatakan

diperuntukkan atau tidak dalam Jadual, fi bagi tatacara gabungan yang dinyatakan

tidak boleh berpecah atau diasingkan dalam pengiraan fi.

I. FI PERUNDINGAN

Catatan:

1. Bagi tatacara yang dilakukan di bawah anestesia setempat (LA) atau sedasi atau

kedua-duanya, dan apabila anestesia setempat atau sedasi diberikan oleh pakar bedah

yang melakukan tatacara itu, fi tambahan tidak melebihi 20% daripada fi tatacara atau

RM 125, mana-mana yang lebih rendah boleh dikenakan. Fi tambahan ini tidak terpakai

kepada tatacara yang dilakukan di bawah anestesia setempat dan/atau sedasi yang

dianggap sebagai rutin, biasa dan lazim.

2. Dalam hal apabila tiada fi dinyatakan bagi pakar anestesia dan anestesia dianggap

perlu atau fi tidak melebihi 50% daripada fi tatacara pembedahan atau minimum

RM 265 atau mana-mana yang lebih tinggi boleh dikenakan oleh pakar anestesia.

1. Pengamal am (bukan pakar) (a) Lawatan pertama/Perundingan awal Butiran Fi (RM)

Perundingan sahaja

Perundingan dengan pemeriksaan 30-125 Perundingan dengan pemeriksaan dan pelan rawatan

Perundingan selepas waktu klinik yang dinyatakan

Sehingga 50% melebihi kadar biasa

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Panggilan atau lawatan ke rumah Sehingga 100% melebihi kadar biasa

(b) Klinik tanpa perkhidmatan farmaseutikal Butiran Fi (RM)

Perundingan sahaja

Perundingan dengan pemeriksaan 35 - 145 Perundingan dengan pemeriksaan dan pelan rawatan

Perundingan selepas waktu klinik yang dinyatakan

Sehingga 50% melebihi kadar biasa

Panggilan atau lawatan ke rumah Sehingga 100% melebihi kadar biasa

2. Fi pakar

Nota: Terpakai bagi semua kepakaran perubatan kecuali dinyatakan sebaliknya (a) Lawatan pertama/Perundingan awal Butiran Fi (RM)

Perundingan sahaja

Perundingan dengan pemeriksaan 80 - 235 Perundingan dengan pemeriksaan dan pelan rawatan

Perundingan selepas waktu klinik yang dinyatakan

Sehingga 50% melebihi kadar biasa

Panggilan atau lawatan ke rumah Sehingga 100% melebihi kadar biasa

(b) Lawatan susulan/ Perundingan susulan Butiran Fi (RM)

Perundingan sahaja

Perundingan dengan pemeriksaan 40 - 105 Perundingan dengan pemeriksaan dan pelan rawatan

Perundingan selepas waktu klinik yang dinyatakan

– Sehingga 50% melebihi kadar biasa

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Panggilan atau lawatan ke rumah – Sehingga 100% melebihi kadar biasa

(c) Perundingan khas untuk radioterapi dan onkologi

Nota: Termasuk perundingan sekali seminggu

Butiran Fi (RM)

Pelan Rawatan Asas termasuk simulasi bagi radioterapi pancaran luar (pelan semula akan dicaj berasingan)

860 -1715

Pelan rawatan untuk brakiterapi (Intrakavitari)

1145-2290

Pelan rawatan pakar 2290-4575 - Brakiterapi Interstitial - Radioterapi konformal - Radiosurgeri - Radioterapi modulasi intensiti II. FI TATACARA 1. Tatacara am

Butiran/Tatacara Fi (RM) Pakar Bedah

Pakar Anestesia

Pemantauan tekanan darah ambulatori 130 Pemakaian kas plaster (jika ini satu-satunya tatacara)

315

Pemakaian plaster jaket, spika pinggul, kas kaki panjang atau kas bres

410 265

Kanulasi arteri 130 Punktur arteri 65 Aspirasi hematoma subkutaneus 315 Pengikatan hemoroids 315 Biopsi kulit atau tisu subkutaneus 315 Resusitasi Kardiopulmonari (CPR) 315 Kanulasi talian tekanan vena sentral (CVP) 230 Pemasukan tiub dada 840 Kolposkopi (dengan/tanpa biopsi) 375 Pemantauan Holter berterusan 330 Pengkuretan/Krioterapi lesi kulit termasuk kauterisasi

315

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Aspirasi diagnostik sista, sendi dan kaviti 315 Ekokardiografi dengan laporan Pemetaan berwarna 380 Doppler ekokardiografi 380 Ekokardiogram-transtorasik 230 M-mod 380 Eko treadmill stres 380 Ekokardiografi stres 380 Ekokardiografi trans-esofagus 440 Dua dimensi (2-D) 380 Elektif kardioversi 290 Elektrokardiogram (EKG) dengan laporan 80 EKG (stres/ senaman) dengan laporan 270 Biopsi atau aspirasi endometrial 410 Sitologi aspirasi jarum halus 315 Insisi dan penyaliran (I & D) 315 Suntikan di sekeliling faset apofisial vertebra tanpa kawalan X-ray

315

Suntikan ke dalam sendi tanpa kawalan sinar-X

315

Suntikan ke dalam tisu subkutaneus/pusat pencetus kesakitan termasuk anestesia setempat (LA) dan steroid

315

Suntikan ke dalam vena varikos kaki 315 Suntikan bahan pengsklerosan ke dalam buasir

315

Suntikan bahan ke dalam kulit termasuk pelet hormon

315

Punktur lumbar 745 Paracentesis untuk asits 630 Blok paravertebral (tanpa kawalan sinar-X) 480 Biopsi perkutaneus (tidak dinyatakan di mana-mana)

315

Perikardiosentesis 505 Biopsi pleural 895 Penyaliran kaviti pleural 840 Pleurodesis 630 Sigmoidoskopi tegar dengan biopsi 315 EKG isyarat berpurata 45 Blok ganglion Stellate (LA) 480 Pemasangan kateter Swan Ganz 460 Perentak sementara 1145 Pencucian dan penjahitan (T & S) bagi setiap jahitan

20

Veneseksyen 35

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Venupunktur 65 2. Tatacara Spesifik (a) Anestesiologi

Perundingan awal, penilaian, tatacara dan sokongan hayat kardium lanjutan (ACLS) di dalam unit rawatan intensif (ICU)

630

Perundingan seterusnya dan penilaian di dalam ICU

Seperti perenggan 2(b) fi pakar

Perkhidmatan analgesia obstetrik - Epidural

445

Perawatan kesakitan akut, kronik dan barah

35

Venupunktur 65 (b) Abdomen (selain sistem urinari dan reproduktif)

Esofagus

Mobilisasi esofageal toraskopik melalui mediastinum

4750 1815

Esofagogastrektomi 4750 1815 Esofagogastrektomi total dan interposisi usus

5970 2500

Eksisi terbuka lesi esofagus 1890 1125 Pintasan esofagus 2480 1550 Tinjauan semula anastomosis esofageal 2705 1320 Penutupan pintasan esofagus 2145 1125 Pembaikan transtorasik esofagus 3600 1320 Pembaikan toraskopik esofagus 2895 1320 Esofagokardiomiotomi (pembedahan Heller)

2040 985

Miotomi esofagogastrik toraskopik 2145 985 Suntikan skleroterapi bagi varises esofageal

1000 685

Pembaikan transtorasik hernia hiatus 2305 940 Pembaikan transtorasik hernia diafragmatik

2305 940

Pembaikan transabdominal hernia hiatus 2145 760 Pembaikan transabdominal hernia diafragmatik

2895 820

Pembaikan laparoskopik hernia hiatus 2145 760 Pembedahan anti refluks transabdominal 2895 820 Tinjauan semula tatacara anti-refluks 3600 1320 Vagotomi/seromiotomi laparoskopik 2040 685 Gastro- jejunostomi laparoskopik 2145 685

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Gastrostomi/jejunostomi laparoskopik 1760 570 Perut

Vagotomi gastrik proksimal 2040 685 Vagotomi pilihan tinggi 2040 685 Vagotomi dan piloroplasti 2145 820 Gastrektomi total dan eksisi tisu sekitar 2895 1125 Gastrektomi separa 2305 760 Pembedahan plastik perut 1890 685 Gastro-jejunostomi 2145 685 Pengulangan gastro-jejunostomi 2305 685 Gastrostomi 1760 570 Penutupan gastrostomi 1565 570 Penutupan ulser berlubang di perut 1890 685 Penutupan laparoskopik ulser berlubang di perut

1890 685

Pembedahan perut terbuka lain 1890 685 Piloromiotomi 1890 685 Piloroplasti 1890 685 Gastrektomi separa (penyakit benigna) 2305 Gastrektomi separa (penyakit malignan) 2895

Duodenum

Eksisi terbuka lesi duodenum 2305 760 Pintasan duodenum 1890 760 Penutupan laparoskopik ulser berlubang duodenum

1890 685

Penutupan ulser berlubang duodenum 1890 685 Usus kecil

Eksisi jejunum 2145 685 Eksisi lesi jejunum 2480 685 Jejunostomi 1760 685 Reseksi laparoskopik usus kecil 1890 685 Pintasan jejunum 1890 685 Intubasi jejunum dekompresi usus 1890 685 Pintasan ileum 1890 685 Anastomosis ileoanal dan penciptaan kantung

4750 1550

Ileostomi 1890 685 Perhatian kepada ileostomi 1565 570 Penutupan ileotomi (dalam isolasi) 1565 570 Pembedahan terbuka ileum termasuk pengurangan intususepsi

1890 685

Usus besar

Apendisektomi 1565 570

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Apendisektomi laparoskopik 1565 570 Penyaliran abses apendiks 1565 625 Eksisi total kolon dan anastomosis ileorektal

3600 1320

Eksisi peluasan hemikolon kanan 2390 820 Eksisi lain hemikolon kanan 2390 760 Eksisi kolon transvers 2390 760 Eksisi hemikolon kiri 2390 820 Eksisi kolon sigmoid 2390 820 Eksisi lesi kolon (transabdominal) 1760 760 Pintasan kolon 2040 760 Eksteriorisasi sekum 1760 760 Penutupan kolostomi - peritoneal tambahan

1340 625

Penutupan kolostomi - intra peritoneal 1890 760 Kolostomi laparoskopik 2040 760 Kolostomi termasuk tinjauan semula 2040 760 Manipulasi intra - abdominal kolon termasuk pengurangan intususepsi

2040 685

Reseksi kolonik laparoskopik 2390 820 Pengurangan radiologi intususupan kolon menggunakan enema barium

580 570

Rektosigmoidektomi bagi penyakit Hirchsphrung

4750

Laparotomi enterokolitis nekrotik enterokolitis (NEC)

2705

Laparotomi atresia usus 2705 Rektum/Anus

Anastomosis ileoanal dan penciptaan kantung

4750 1550

Panproktokolektomi dan ileostomi 4750 1815 Penarikan abdominoperineal melalui reseksi dengan anastomosis kolo-anal dan kolostomi berkaitan

4750 1815

Reseksi abdominoperineal rektum dan anus

4750 1815

Reseksi anterior 4750 1815 Reseksi anterior rektum dan hujung kolostomi (dengan penutupan rektum)

2705 1550

Reseksi anterior laparoskopik rektum dan eksteriorisasi usus

4750 1550

Eksisi separa rektum dan kolon sigmoid bagi prolaps

2705 940

Pembalikan tatacara Hartman 3600 1550 Eksisi terbuka lesi rektum 2145 940 Fiksasi rektum bagi prolaps 1890 940

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Rektopeksi laparoskopik 1890 940 Reseksi transanal bagi kanser rektal 2040 625 Eksisi perineal lesi rektum 1340 625 Biopsi rektum ketebalan penuh atau separa

405 625

Pembaikan perineal prolaps rektum 1760 685 Pengembangan striktur rektum 370 265 Pembaikan fistula tinja 865 625 Eksisi lesi anus 370 265 Pemusnahan lesi anus 370 265 Pembaikan sfinkter anal 1565 625 Pembaikan trauma anal 1340 625 Hemoroidektomi 1000 505 Regangan anorektum termasuk pemeriksaan di bawah anestesia (EUA) dan sigmoidoskopi

370 265

Pembukaan lapisan fistula anal bawah 865 505 Pembukaan lapisan fistula anal atas 1565 625 Sfinkterektomi lateral anus 405 505 Eksisi fisur anal 405 405 Penyaliran melalui kawasan perineal termasuk abses iskiorektal

580 405

Eksisi sinus pilonidal dan graf sutur/kulit 1160 625 Pembukaan lapisan sinus pilonidal 580 265 Fistulektomi (tunggal) 865 Fistulektomi (berbilang) 1565 Anorektoplasti sagital posterior (PSARP) 3600 Laparotomi berkombinasi dengan PSARP 4750 Anoplasti 1340 Sagital posterior anorektovaginouretroplasti (PSARVUP)

4750

Laparotomi berkombinasi dengan PSARVUP

5970

Organ-organ lain, terutama pencernaan

Adrenalektomi 2145 940 Adrenalektomi - dwisisi 2305 1125 Pembedahan tisu adrenal aberan 2145 940 Eksisi separa hepar 3600 1550 Hemihepatektomi 5970 2110 Pembuangan tumor hepar 2895 985 Pembaikan hepar 2480 985 Penyaliran terbuka hepar 1160 685 Pembedahan laparoskopik terapeutik ke atas hepar

1340 570

Pemeriksaan laparoskopik diagnostik hepar termasuk apa-apa biopsi

1340 505

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Biopsi perkutaneus lesi hepar 480 315 Punktur terbuka hepar 1565 570 Kolesistektomi termasuk minikolesistektomi

1890 685

Kolesistektomi dengan peninjauperiksaan duktus hempedu umum

2040 760

Kolesistektomi laparoskopik 2480 1125 Kolesistektomi laparoskopik dengan kolangiogram peribedah

2705 1550

Anastomosis pundi hempedu (ke viskus lain)

2305 760

Eksisi separa duktus hempedu dan anastomosis duktus hempedu kepada duodenum/jejunum

2390 940

Eksisi lesi duktus hempedu 2145 940 Anastomosis duktus hepatik 2895 940 Anastomosis duktus hempedu umum 2145 940 Pengenalan terbuka prostesis ke dalam duktus hempedu

2145 760

Pembaikan duktus hempedu 2390 985 Insisi duktus hempedu termasuk peninjauperiksaan bagi pembuangan kalkulus

2145 940

Sfinkterektomi duktus hempedu dan duktus pankreatik menggunakan pendekatan duodenal

2145 820

Pemeriksaan perkutaneus duktus hempedu

1000 505

Pankreatektomi total dan eksisi tisu persekitaran

4750 1815

Pankreatektomi total 4750 1815 Pankreatoduodenektomi dan eksisi tisu sekitar (Tatacara Whipple)

4750 1815

Pankreatektomi distal 2705 985 Eksisi lesi pankreas 2040 985 Anastomosis pundi hempedu (ke viskus lain)

2705 940

Penyaliran terbuka lesi pankreas 2040 760 Penyaliran abses pankreatik 2040 760 Insisi pankreas 2040 760 Pemeriksaan terbuka pankreas 2040 760 Pembedahan perkutaneus terapeutik pankreas

1565 685

Splenektomi terbuka 1565 760 Splenektomi laparoskopik 1565 760

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Penciptaan penyimpangan peritoneovena (Levine/Denver)

1340 435

Penyaliran dalaman pseudosista pankreatik

2705

Hepato portoenterototomi (pembedahan Kasai)

4750

Eksisi sista koledokal 4750 Salur darah besar

Kanulasi terbuka arteri intra-abdominal bagi kemoterapi infusi

2145 685

Penciptaan penyimpangan portakaval 4750 1320 Plikasi vena kava 2305 940 Pembaikan luka arteri besar atau vena abdomen termasuk aorta dan vena kava

2145 1320

Dinding abdomen

Pembaikan hernia diafragmatik kongenital

2705 1550

Eksisi mudah sak hernia inguinal 1000 505 Eksisi mudah sak hernia inguinal - dwisisi 1760 760 Pembaikan primer hernia inguinal 1160 505 Pembaikan primer hernia inguinal - dwisisi

1890 820

Pembaikan primer hernia inguinal terjerut

1890 625

Pembaikan laparoskopik hernia groin 1160 505 Pembaikan hernia inguinal berulang 1890 685 Pembaikan hernia inguinal berulang - dwisisi

2895 985

Pembaikan primer hernia femoral 1000 505 Pembaikan primer hernia femoral terjerut

1890 625

Pembaikan hernia femoral berulang 1565 570 Pembaikan hernia umbilikal (tidak mengira umur)

1000 570

Pembaikan primer hernia insisi 1340 505 Pembaikan hernia insisi berulang 1890 685 Pembaikan hernia lain dinding abdomen 1340 505 Sutur semula insisi lalu dalam dinding abdomen (Abdomen pecah)

1340 570

Penutupan eksomfalos major/gastrokisis - penutupan primer

3600

Penutupan eksomfalos major/gastrokisis - penutupan silastik

2145

Penutupan eksomfalos major/gastrokisis - penutupan primer tertunda

2570

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Peritoneum Laparotomi bagi pendarahan selepas pembedahan

1760 820

Laparotomi dan pembaikan trauma visera berbilang

3600 1550

Penyaliran terbuka abses subfrenik 1760 685 Pembedahan omentum 1890 685 Tumor retroperitoneal 2705 940 Abses retroperitoneal 1160 685 Tumor presakral 1340 940 Pembebasan adhesi peritoneum 1565 685 Laparoskopi termasuk biopsi dan adhesiolisis

1160 435

Parasentesis abdominis bagi asites 315 265 Penyaliran suprapubik abses pelvik 865 505 Penyaliran transrektal/transvaginal abses pelvik

1160

Laparotomi - peninjauperiksaan 1890 (c) Otak, kranium dan organ intrakranial yang lain

Otak

Hemisferektomi 7030 2930 Eksisi abses otak 4750 2110 Eksisi lesi tisu otak 5970 2500 Ablasi stereotaktik tisu otak 4750 1815 Biopsi terbuka lesi tisu otak 3600 1550 Penanaman/pembuangan stimulator neuro daripada otak (apa-apa laluan)

2145 820

Ventrikulosisternostomi 3600 1550 Penciptaan anastomosis ventrikulovaskular

2040 820

Penciptaan penyimpangan ventrikuloperitoneal

2040 820

Penciptaan simpanan cecair serebrospinal (CSF) subkutaneus

2040 820

Penyenggaran penyimpangan serebroventrikular termasuk pengulangan

1565 685

Pembuangan penyimpangan serebroventrikular

1340 505

Irigasi penyimpangan serebroventrikular 580 685 Pembedahan endoskopik terapeutik ventrikel otak

2570 820

Pemeriksaan endoskopik diagnostik dan biopsi lesi ventrikel otak

1760 820

Punktur ventrikular 570 505

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Kranium Infeksi Intrakranial: lubang Burr 1890 760 Pembaikan plastik kranium 2705 1320 Kranioplasti rekonstruktif 2705 1320 Kraniostenosis (satu sutur) 2040 760 Kraniostenosis (lebih daripada satu sutur)

2705 1550

Kraniotomi terbuka eksploratori 2705 1320 Eksploratori lubang burr pada kranium 1565 685 Petrosektomi 3600 2110 Dekompresi Foramen Magnum 4750 1550 Eksisi lesi kranium 2145 820 Elevasi lekukan fraktur kranium 1565 760 Pembaikan fraktur kompaun kranium 2705 1320 Penyaliran tengkorak 1340 505

Meninges

Penyaliran ruang subaraknoid otak 1565 625 Eksisi lesi otak meninges 7030 2500 Pembedahan sista araknoid 2705 985 Pembaikan dura 3600 1320 Pengosongan hematoma ekstradural 3600 1320 Pengosongan hematoma atau abses subdural

3600 1320

Pendarahan subdural - toreh 315 435 Saraf

Transeksi intrakranial saraf kranial 5970 2930 Pemusnahan-pemusnahan lain saraf kranial

5970 2930

Eksisi lesi saraf kranial (lntrakranial) 7030 2930 Eksisi neuroma akustik 7030 2930 Pembaikan saraf kranial (Intrakranial) 2895 1815 Dekompresi saraf kranial (Kraniotomi) 5970 1815 Stimulasi neuro saraf kranial (Intrakranial)

2145 760

Pembuangan stimulasi neuro dari saraf kranial

1890 505

Eksisi tumor sudut serebelopontin 7030 2930 Pembuluh darah

Kraniotomi - pendarahan selepas pembedahan

2705 1320

Kraniotomi bagi tumor suprasellar 7030 Kraniotomi bagi tumor fossa posterior 7030 Ligasi/sepitan aneurisme arteri cerebral 5970 2110 Peneguhan aneurisme arteri cerebral 5970 2110

P.U. (A) 358

17

Pembedahan terbuka arteri cerebral 5970 2110 Eksisi malformasi arteriovenous (AV) 7030 2110 Pembentukan anastomosis ventrikulovaskular

2040 820

Pembentukan pintasan ventrikuloperitoneal

2040 820

Lain-lain

Hipofisektomi 5970 1815 Krioterapi kelenjar pituitari 2570 Eksisi lesi kelenjar pituitari 5970 1815 Eksisi kelenjar pineal 7030 1815

(d) Payudara

Mastektomi subkutaneus dengan implan serta merta

2040 760

Mastektomi radikal termasuk diseksi blok 2305 760

Mastektomi bergabung dengan rekonstruksi payudara menggunakan flap miokutaneous

2895 985

Mastektomi radikal diubah suai termasuk diseksi blok

2040 685

Mastektomi mudah termasuk biopsi nodus aksilari

1565 685

Eksisi lesi payudara 1000 405 Reseksi bersegmen atau quadrantektomi 1340 505 Eksisi setempat lebar lesi payudara 1340 505 Pengulangan eksisi setempat bagi menerangkan margin

1000 505

Biopsi eksisi lesi payudara selepas persetempatan

1000 505

Rekonstruksi payudara menggunakan latisimus dorsi

2895 940

Rekonstruksi payudara menggunakan flap setempat

2305 760

Rekonstruksi payudara menggunakan TRAMS

4750 1550

Pembuangan prostesis daripada payudara

865 405

Penanaman prostesis selepas mastektomi 1340 685 Biopsi perkutaneus lesi payudara 370 265 Eksisi stereotaktik/guidewire lesi payudara

1565 505

Penyaliran abses payudara 580 405 Mikrodokotomi 1000 405

P.U. (A) 358

18

Pembedahan puting (jika tidak termasuk dalam tatacara lain)

865 405

Diseksi blok nodus limfa aksilari (jika tidak termasuk dalam tatacara lain)

1760 625

Biopsi/pensampelan nodus limfa aksilari 405 315 Biopsi nodus limfa mama internal 725 505

(e) Dermatologi dan venereologi Ujian alergi

Ujian sensitiviti kulit (Intradermis) menggunakan sehingga 20 reagen (tidak termasuk kos reagen)

190

Ujian sensitiviti kulit (ujian tampalan) menggunakan sehingga 26 reagen, iaitu siri standard (tidak termasuk kos reagen)

250

Ujian sensitiviti kulit (ujian tampalan) menggunakan 26 reagen, iaitu siri standard dan tambahan (tidak termasuk kos reagen)

315

Ujian sensitiviti kulit (ujian tampalan) menggunakan siri tambahan iaitu kos bagi setiap siri (tidak termasuk kos reagen)

190

Dermatosurgeri umum

Eksisi - sista, parut, tumor benigna (mudah)

380

Eksisi - sista, parut, tumor benigna (rumit)

660

Eksisi - tumor kulit malignan yang memerlukan eksisi lebar

915

Suntikan steroid berbilang ke dalam lesi 190 Krioterapi - lesi kurang daripada 5 155 Krioterapi - lesi lebih daripada 5 250 Krioterapi - tumor malignan yang memerlukan rawatan bagi kawasan yang luas

505

Pengkuretan/krioterapi lesi kulit termasuk pengkauteran

315

Fototerapi

Fototerapi (pancaran ultra ungu) bagi setiap sesi - bahagian tertentu

65

Fototerapi (UVB)(pancaran ultra ungu) 100

P.U. (A) 358

19

bagi setiap sesi - keseluruhan badan Psoralen dan ultra ungu A (PUVA) bagi setiap sesi - bahagian tertentu

100

(PUVA) bagi setiap sesi - keseluruhan badan

125

Ujian tampalan foto 250 Ujian foto Dos eritema minimal (MED) 250 Ujian foto Dos fototoksik minimum (MPD)

250

Fototerapi ultra ungu Al (UVA 1) bagi setiap sesi - bahagian tertentu

100

Fototerapi ultra ungu Al (UVA 1) bagi setiap sesi - keseluruhan badan

125

Tatacara dermatologi lain

Eksisi mudah kuku 70 Eksisi baji kuku jari kaki 380 Eksisi baji atau avulsi kuku jari kaki termasuk ablasi kimia pada dasar kuku

480 315

Matriksektomi kuku 170 Pemeriksaan penyiasatan medan gelap (DGI) bagi spesimen

125

Biopsi kulit atau subkutaneus tisu 315 Biopsi perkutaneous (tidak dinyatakan di tempat lain)

315

Pemeriksaan mikroskopik (medan gelap)

65

Pemeriksaan mikroskopik untuk kikisan, calitan kulit dan sebagainya

65

Elektrokauteri - keratosis, ketuat, angioma, dan sebagainya (lesi kurang daripada 5)

190

Elektrokauteri - keratosis, ketuat, angioma, dan sebagainya (lesi daripada 5 hingga 20)

380

Elektrokauteri - keratosis, ketuat, angioma, dan sebagainya (lesi lebih daripada 20)

630

Kauteri kimia - keratosis, ketuat, angioma dan sebagainya (lesi tidak lebih daripada 5)

125

Kauteri kimia - keratosis, ketuat, angioma dan sebagainya (lesi lebih daripada 5)

250

Elektrolisis rambut bagi setiap sesi 250 Iontoforesis bagi setiap sesi 190 Iontoforesis transdermal 285

P.U. (A) 358

20

Tatacara laser kutaneus Ablasi laser kutaneus bagi tumor kulit (lesi kurang daripada 5)

290

Ablasi laser kutaneus bagi tumor kulit (lesi 5 hingga 20)

660

Ablasi laser kutaneus bagi tumor kulit (lesi lebih daripada 20)

860

Rawatan laser pigmen bagi pigmentasi kulit dan tatu - kawasan kecil (kurang daripada 9 sm2)

380

Rawatan laser pigmen bagi pigmentasi kulit dan tatu - kawasan bersaiz sederhana (9 sm2 hingga 50 sm2)

435

Rawatan laser pigmen bagi pigmentasi kulit dan tatu - kawasan besar (lebih daripada 50 sm2)

660

Rawatan laser pigmen bagi tatu bulu kening

380

Rawatan laser pigmen bagi tatu kelopak mata

435

Rawatan laser vaskular bagi lesi vaskular - kawasan kecil (kurang daripada 9 sm2)

380

Rawatan laser vaskular bagi lesi vaskular - kawasan bersaiz sederhana (9 sm2 hingga 50 sm2)

435

Rawatan laser vaskular bagi lesi vaskular - kawasan besar (lebih daripada 50 sm2)

660

Laser pelapisan semula bagi satu unit kosmetik (bukan ablatif)

860

Laser pelapisan semula bagi satu unit kosmetik (ablatif)

1145

Pembuangan bulu roma dengan bantuan laser/cahaya denyutan keamatan (IPL) - kawasan kecil (kurang daripada 9 sm2)

380

Pembuangan bulu roma dengan bantuan laser/IPL - kawasan bersaiz sederhana (9 sm2 hingga 50 sm2)

435

Pembuangan bulu roma dengan bantuan laser/IPL - kawasan besar (lebih daripada 50 sm2)

660

Pembuangan bulu roma dengan bantuan laser/IPL - keseluruhan muka

915

Pengelupasan kimia

Pengelupasan kimia bagi lesi kulit 290

P.U. (A) 358

21

- pengelupasan superfisial

Pengelupasan kimia bagi lesi kulit - kedalaman sederhana

380

Pengelupasan kimia bagi lesi kulit - pengelupasan dalam

660

Tatacara pelbagai

Ekstrak komedon bagi setiap sesi 190 Keratan hiperkeratosis, belulang dan sebagainya

190

Ekstraksi milia 190 Jagaan kejururawatan kulit harian bagi setiap sesi

190

Pembalutan keseluruhan badan (cth: ekzema atopi)

230

Mikrodermabrasi - muka 345 Mikrodermabrasi - badan 570 Suntikan toksin botulinum bagi satu unit kosmetik

685

Suntikan pengisian bagi satu unit kosmetik

570

(f) Telinga, hidung dan tekak Telinga eksternal

Eksisi total telinga eksternal 1565 820 Eksisi abnormaliti preaurikular 1000 405 Eksisi lesi telinga eksternal 725 405 Pembuangan eksostoses daripada kanal auditori eksternal

1760 505

Rekonstruksi telinga eksternal menggunakan graf

2895 685

Rekonstruksi telinga eksternal 2145 685 Meatoplasti telinga eksternal 1565 505 Pembaikan telinga eksternal 405 405 Pembuangan bahan asing daripada kanal auditori eksternal di bawah anestatik umum (GA) (dan dwisisi)

370 265

Eksisi lesi kanal auditori eksternal 480 570 Rekonstruksi kanal auditori eksternal 2705 1125

Telinga tengah dan mastoid

Mastoidektomi radikal 2480 940 Mastoidektomi radikal diubah suai 2480 940 Mastoidektomi mudah 2305 625 Mastoidektomi tinjauan semula 2040 940 Peninjauperiksaan mastoid, saraf fasial 2305 940

P.U. (A) 358

22

Timpanoplasti 2145 940 Miringoplasti 2040 760 Miringotomi dan selitan tiub melalui membran timpanik (dan dwisisi)

865 355

Sedutan pembersihan telinga tengah 370 265 Miringotomi (dan dwisisi) 370 265 Osikuloplasti dengan/tanpa timpanoplasti

2705 940

Stapedektomi 2040 760 Eksisi tumor telinga tengah 2040 760 Polipektomi telinga tengah (dan dwisisi) 580 265 Timpanotomi dan biopsi lesi telinga tengah

1760 570

Petrosektomi 3600 2110 Telinga dalam

Elektrokokleografi transtimpanik 725 Pembedahan koklea 3600 1320 Pembedahan sak endolimfatik 2145 940 Labirintektomi bermembran 2390 940 Labirintektomi bertulang 2480 940 Eksisi sinus preaurikular - unilateral 1340 Eksisi sinus preaurikular - dwisisi 1760

Hidung dan kaviti hidung

Eksisi hidung total 1565 760 Septorinoplasti serta/tanpa graf/implan berikutan trauma atau eksisi tumor

2145 625

Rinoplasti berikutan trauma atau eksisi tumor

2040 625

Eksisi submukus septum hidung 1160 405 Eksisi lesi septum hidung 580 355 Biopsi lesi septum hidung 370 355 Penutupan tembusan septum hidung 1340 405 Insisi septum hidung 405 315 Septoplasti hidung 1340 435 Pengkauteran septum hidung (dan dwisisi)

315 265

Diatermi submukus turbinat hidung (dan dwisisi)

405 265

Eksisi turbinat hidung (dan dwisisi) 725 405 Eksisi lesi turbinat hidung (dan dwisisi) 405 405 Pembahagian perekatan turbinat hidung (dan dwisisi)

370 405

Biopsi lesi turbinat hidung (dan dwisisi) 370 405 Pengkauteran turbinat hidung (dan dwisisi)

370 265

P.U. (A) 358

23

Ligasi arteri hidung internal 1340 505 Embolisasi arteri hidung internal 1340 505 Pemadatan kaviti hidung (sebagai tatacara tunggal)

315 505

Polipektomi hidung internal (dan dwisisi)

480 355

Eksisi lesi hidung internal 405 355 Pembetulan atresia koana kongenital 1565 685 Pembuangan bahan asing daripada kaviti hidung

315 355

Eksisi lesi hidung eksternal 315 435

Sinus hidung Penyaliran antrum maksila termasuk Caldwell-Luc (dan dwisisi)

1000 435

Neurektomi transantral saraf vidian menggunakan pendekatan sublabial (dan dwisisi)

1760 685

Punktur antral dan pembasuhan (dan dwisisi)

480 265

Antrostomi intranasal termasuk endoskopik (dan dwisisi)

865 505

Penutupan fistula oro-antral 1340 435 Frontoetmoidektomi eksternal (dan dwisisi)

2145 760

Etmoidektomi intranasal (dan dwisisi) 1160 505 Etmoidektomi eksternal termasuk endoskopik (dan dwisisi)

1565 685

Pembukaan anterior dan posterior ke dalam pembedahan endoskopik fungsi sinus (FESS)

1760 685

Etmoidektomi transantral (dan dwisisi) 1565 685 Flap tulang sinus frontal (dan dwisisi) 2480 625 Membuat trefin sinus frontal 580 265 Frontoetmoidektomi radikal 2390 940 Pembedahan endoskopik fungsi sinus subtotal (FESS)

1565 685

Pembedahan ke atas sinus sfenoid 865 505 Pembedahan ke atas sinus hidung (tidak dinyatakan)

865 505

Rhinotomi lateral ke dalam sinus bagi malignansi

1760 625

Endoskopi diagnostik sinus (sebagai tatacara tunggal)

315 405

Tekak

Faringektomi total 5970 1815

P.U. (A) 358

24

Faringektomi separa 2305 1815 Adenoidektomi 405 265 Pembaikan farinks 2145 820 Eksisi terbuka lesi farinks 725 505 Pembedahan kantung faringeal 1890 685 Pembedahan endoskopik terapeutik farinks

580 405

Kantung faringeal - reseksi endoskopik 1890 625 Pemeriksaan endoskopik diagnostik farinks termasuk biopsi

580 405

Tonsilektomi - kanak-kanak (dan dwisisi)

1000 435

Tonsilektomi - dewasa (dan dwisisi) 1160 435 Eksisi tonsil lingual 865 435 Adenotonsilektomi (dan dwisisi) 1160 435 Penyaliran abses peritonsilar ("Quinsy") 315 315

Larinks dan trakea

Laringektomi total termasuk diseksi leher

3600 1815

Laringektomi separa 2145 985 Laringofisur dan kordektomi korda vokal

1760 625

Laringektomi (tidak termasuk diseksi leher)

2570 1320

Glottoplasty 1760 625 Rekonstruksi larinks dengan graf 3600 1815 Eksisi endoskopik lesi larinks termasuk mikrolaringoskopi

1160 570

Laringoskopi/endoskopi dengan biopsi 580 505

Suntikan ke dalam larinks 1160 505 Eksisi separa trakea dengan rekonstruksi

3600 2110

Trakeoplasti 1760 625 Penempatan terbuka prostesis di dalam trakea

1760 505

Trakeotomi 1000 570 Selitan mini-trakeostomi 580 405

Tatacara endoskopik gentian optik di bawah anestesia topikal

Pemeriksaan gentian optik trakea dan bronkus termasuk biopsi/pembuangan bahan asing

725 505

Lavaj bronkus (diagnosis atau terapeutik)

865

Pendilatan striktur trakea termasuk selitan sten

865

P.U. (A) 358

25

Pendilatan striktur bronkus oleh bronkoskop gentian optik

1000

Biopsi transbronkial 1000 (g) Tatacara endoskopik dan laparoskopik trek gastrointestinal (GIT)

Tatacara endoskopik GIT

Esofagoskopi tegar serta/tanpa biopsi/pembuangan/laser atau destruksi diatermi lesi

865 435

Esofagogastroduodenoskopi diagnostik termasuk biopsi

405 315

Esofagoduodenoskopi terapeutik termasuk pembuangan bahan asing/ polipektomi

580 435

Esofagogastroduodenoskopi terapeutik termasuk destruksi lesi, penyelitan prostesis, pendilatan, pengkanalan semula tumor

1000 435

Skleroterapi suntikan varises esofagus 1000 685 Intubasi bagi penyiasatan GIT serta/tanpa manometri, ukuran pH, fungsi pankreatik dan biopsi jejunal

480 315

Endoskopi dan pemeriksaan ilium melalui stoma termasuk pendilatan

580 315

Sigmoidoskopi fleksibel serta,/tanpa biopsi/pembuangan/pemusnahan lesi

580 435

Kolonoskopi gentian optik serta/tanpa eksisi biopsi/pemusnahan lesi

1000 435

Kolonoskopil gentian optik dan pengkanalan semula tumor

1565 435

Endoskopik kolangiopankreatografi retrograd (ERCP)

1160 505

ERCP dengan tatacara terapeutik 1760 505 Penyelitan sten pankreas 2040 760 Pembuangan batu pankreatik 2040 760 Penyaliran pseudosista pankreatik 2040 760 Ligasi gegelang getah varises 1000 405 PEG 1760 625 Reseksi mukosal endoskopik 2040 760 Polipektomi kolonik 1340 505 Pendilatan kolonik (belon) 1340 505 Penyelitan sten kolonik 1565 570 Tatacara terapeutik bagi pendarahan GIT (atas)

1000 405

P.U. (A) 358

26

Tatacara laparoskopik Pembaikan laparoskopik hernia hiatus 2145 760 Vagotomi/seromiotomi laparoskopik 2040 685 Gastrojejunostomi laparoskopik 2145 685 Gastrostomi/jejunostomi laparoskopik 1760 570 Penutupan laparoskopik ulser perut berliang

1890 685

Penutupan laparoskopik ulser duodenum berliang

1890 685

Reseksi laparoskopik usus kecil 1890 685 Apendisektomi laparoskopik 1565 570 Kolostomi laparoskopik 2040 760 Reseksi kolonik laparoskopik 2390 820 Reseksi anterior rektum dan eksteriorisasi usus laparoskopik

4750 1550

Rektopeksi laparoskopik 1890 940 Kolesistektomi laparoskopik 2480 1125 Kolesistektomi laparoskopik dengan kolangiogram peribedah

2705 1550

Splenektomi laparoskopik 1565 760 Pembaikan laparoskopik hernia groin 1160 505

(h) Mata dan kandungan orbit Tatacara am

Angiogram fluoresin fundus 345 Fotografi anterior/fundus 65 Perimetri automasi 250 Carta Hess 125 Keratometri 65 Topografi kornea Ultrasonografi 250 Imbasan - A 125 Imbasan - B 250 Pakimetri 125 Gonioskopi 65 Oftalmoskopi tidak langsung 65 Refraksi 65 Ujian Schirmers 30 Elektrofisiologi Elektroretinogram (ERG)/Elektrookulogram (EOG)/Tindak balas ditimbulkan visual (VER)

250

Pemancitan 125 Cucian 35 Irigasi 65 Eksisi/pengkuretan/krioterapi lesi kelopak mata

370 265

P.U. (A) 358

27

Pemecahan foto laser Yag ke atas kapsul posterior kanta termasuk kapsulotomi laser

580 505

Koagulasifoto laser/Krioterapi/Radioterapi lesi retina (dan dwisisi)

1000 405

Angiografi fluoresin mata 315 265 Pembedahan pembetulan juling (satu atau kedua-dua mata)

1890 625

Pembedahan trabekulektomi 2040 760 Trabekulektomi termasuk laser 1160 570 Biopsi lesi kelopak mata 480 315 Ekstraksi ekstrakapsular tanpa implan 2145 820 Ekstraksi ekstrakapsular dengan implan 2570 940

Glob atau orbit

Eksenterasi orbit 2040 760 Enukleasi bola mata 2040 685 Eksisi lesi orbit 1890 685 Rekonstruksi kaviti orbit 2305 760 Biopsi lesi orbit 1160 505 Penyaliran orbit 1340 355 Dekompresi orbit 2305 685 Pembuangan bahan asing daripada orbit 1890 685 Eksplorasi orbit 1890 685 Reduksi terbuka orbit patah 1340 685 Suntikan retrobulba 315 265 Eviserasi bola mata 2040 760 Implan orbital - Eviserasi/Enukleasi dengan implan

2390

Bulu kening dan kelopak

Eksisi lesi bulu kening 580 405 Jahitan bulu kening 315 405 Eksisi lesi kantus 1000 505 Pembetulan epikantus 1160 505 Pembetulan telekantus 1160 505 Graf kulit kantus 1000 505 Kantotomi/Pengkuretan 580 505 Eksisi/Pengkuretan/Krioterapi lesi kelopak mata

370 265

Graf kulit kelopak mata 1000 505 Pembetulan ektropion 1160 405 Pembetulan entropion 1160 405 Pembetulan trikiasis 405 405 Tarsorafi 865 405 Rekonstruksi total kelopak mata 1890 505

P.U. (A) 358

28

Jahitan kelopak mata (laserasi) 405 405 Rekonstruksi total kelopak mata - dwisisi 2895 820 Pembetulan ptosis kelopak mata 1760 625 Tarsomulerektomi 1760 505 Penyaliran lesi kelopak mata 370 355 Biopsi lesi kelopak mata 480 315 Pembuangan bulu mata melalui elektrolilis/laser/krioterapi

370 265

Sistem lakrimal

Kanalikulo dakriosistorinostomi 2390 940 Konjunktivo dakriosistorinostomi 2390 940 Dakriosistorinostomi (DCR) dengan/tanpa pemasukan tiub

2040 940

Eksisi kantung lakrimal 1000 505 Biopsi kantung lakrimal 580 505 Insisi kantung lakrimal 370 405 Pemancitan sistem nasolakrimal di bawah anestesia am (GA)

315 265

Penguaran kantung nasolakrimal di bawah GA

315 265

Pembaikan kanalikulus koyak 1000 265 Pendilatan punktum lakrimal di bawah GA

315 265

DCR endoskopik 2570 1320

Otot Pembedahan pembetulan juling (satu atau kedua-dua mata)

1890 625

Pembedahan tinjauan semula juling (satu atau kedua-dua mata)

2305 570

Tenotomi otot (satu atau kedua-dua mata)

1340 570

Transposisi otot (satu atau kedua-dua mata)

1760 570

Pembedahan pembetulan juling dengan jahitan boleh ubah (satu atau kedua-dua mata)

2480 685

Pembedahan tinjauan semula juling dengan sutur boleh ubah (satu atau kedua-dua mata)

2895 940

Pembetulan juling dengan toksin botulinum

1000

Konjunktiva

Eksisi lesi konjunktiva 480 505

P.U. (A) 358

29

Pengkauteran termasuk krioterapi ke atas lesi konjunktiva

315 505

Radioterapi lesi konjunktiva 580 505 Graf mukosa konjunktiva 1160 505 Jahitan konjunktiva 480 505 Pembuangan jahitan konjunktiva 315 435 Penyaliran sista konjunktiva 315 435 Pembahagian perekatan konjunktiva 315 435 Biopsi lesi konjunktiva 315 435 Suntikan subkonjunktival 315 435 Eksplorasi konjunktiva termasuk pembuangan bahan asing

370 435

Eksisi pterigium 1340 505 Graf limbal konjunktiva 725

Kornea

Eksisi lesi kornea 480 435 Krioterapi lesi kornea 315 435 Graf lameliar (Keratoplasti) kornea 2390 940 Graf penembusan (Keratoplasti) kornea 2390 940 Pembaikan luka kornea 580 505 Pembuangan jahitan kornea 315 405 Pembuangan bahan asing kornea superfisial

405 435

Jahitan ketegangan 1340 625 Pengelatan kornea 725 405 Pentatuan kornea 725 405 Kikisan kornea untuk kultur 405 405 Keratoplasti refraktif 1760 625 Keratektomi fotorefraktif (PRK)/Keratektomi fototerapeutik (PTK)

2145 820

Keratomileusis laser in situ (LASIK) 3600 2110 Graf lamellar (Keratoplasti) kornea 3600 Menjalankan graf (Keratoplasti) kornea 2895 Pemindahan sel stem limbal 2705 Graf membran amniotik 1160 Punktur stromal anterior 865 Keratotomi astigmatic 1565

Sklera

Eksisi lesi sklera 725 570 Pembaikan laserasi sklera 725 570 Graf sklera 1565 570

lris dan ruang anterior

Iridosikletomi 2390 940 Pembedahan iridektomi 1160 685

P.U. (A) 358

30

Pembedahan trabekulektomi 2040 760 Trabekuloplasti laser 1000 570 Trabekulotomi termasuk laser 1160 570 Goniotomi (rawatan pembedahan glaukoma)

1890 570

Iridotomi laser 1160 505 Pembaikan prolaps iris 1890 685 Eksisi lesi iris 1890 685 Pembuangan bahan asing daripada iris 1890 685 Siklosioterapi (pengkauteran badan siliari)

1160 505

Siklodialisis (pemisahan badan siliari) 1760 685 Pemulihan ruang anterior 1565 570 Parasentesis 1000 435 Suntikan ke dalam ruang anterior 480 435 lrigasi ruang anterior 480 435 Pembuangan bahan asing dari ruang anterior

1160 435

Implan injap di dalam glaukoma 2895 1815 Pembedahan trabekulektomi 2040 760 Siklofotokoagulasi 1565 570

Kanta

Ekstraksi ekstrakapsular tanpa implan - dwisisi

3600 1320

Ekstraksi ekstrakapsular tanpa implan - unilateral

2145 820

Phakoemulsifikasi lensa dengan/tanpa implan

2570 940

Ekstraksi ekstrakapsular dengan implan 2570 940 Ekstraksi ekstrakapsular dengan implan - dwisisi

4750 1550

Gangguan/pemecahan foto laser Yag ke atas kapsul posterior kanta termasuk kapsulotomi laser

580 505

Insersi sekunder kanta implan 1760 685 Tinjauan semula kanta implan 1760 685 Pembuangan kanta implan 1340 505 Pembedahan insisi kecil dengan/tanpa kanta intraokular (IOL)

2705 1550

Pembedahan katarak dalam kes-kes rumit (cth: kanta terdislokasi dengan/ tanpa implant)

3600

Fiksasi skleral kanta intraokular 2390 Vitreus

Vitrektomi oleh pendekatan anterior 1760 760

P.U. (A) 358

31

Vitrektomi pendekatan pars plana dengan insersi tamponad dalaman

2570 1320

Vitrektomi bergabung dengan membranektomi/insersi tamponad dalaman/laser atau krioterapi

3600 2110

Retina

Lengkok sklera termasuk implan/pemusingan eksplan/minyak silikon/pertukaran gas/laser atau krioterapi

2145 820

Pembuangan minyak silikon 865 355 Fotokoagulasi laser/krioterapi/radioterapi lesi retina (dan dwisisi)

1000 405

Eksisi lesi retina 2145 940 Biopsi lesi retina 2145 505 Vitrektomi pars plana dengan pembuangan IOL/kanta terdislokasi

5970 2930

Vitrektomi pars plana dengan pembuangan bahan asing intaokular

5970 2930

Lengkok sklera dengan vitrektomi trans pars plana

7030 3305

(i) Radiologi intervensional Biopsi

Biopsi berpandukan fluoroskopi 725 Biopsi berpandukan ultrasound 865 Biopsi berpandukan CT/MRI 1000 Biopsi hepar Transjugular/Transfemoral/Palam

1340

Penyaliran

Penyaliran cecair terkumpul berpandukan fluoroskopi

725

Penyaliran cecair terkumpul berpandukan ultrasound

1340

Penyaliran cecair terkumpul berpandukan CT/MRI

1565

Angioplasti

Angioplasti 1760 Angioplasti dengan insersi sten logam 1890 Angioplasti dengan insersi sten logam graf

2040

P.U. (A) 358

32

Insersi sten logam graf aorta 4750 1550 Angioplasti serebrum dengan/tanpa insersi sten logam

4750 1125

Angioplasti serebrum dengan insersi sten logam graf

4750 1125

Embolisasi

Embolisasi arteri atau vena 1890 Embolisasi jisim vaskular termasuk embolisasi uterin

2895

Embolisasi arteri bronkial 3600 Embolisasi aneurisme 5970 Embolisasi malformasi arteriovenus 7030

Trombolisis

Trombolisis atau sedutan trombus di bawah kawalan Pengimejan

1340

Pendilatan

Pendilatan penyempitan di bawah kawalan pengimejan

1160

Pendilatan perkutaneus striktur biliari di bawah kawalan Pengimejan

2305

Kepala dan leher

Ekstraksi batu endoluminal daripada duktus liur di bawah kawalan Pengimejan

725

Insersi sten nasolakrimal di bawah kawalan pengimejan

2040

Kepala dan leher spina

Kemonukleolisis 1160 Disektomi berpandukan fluoroskopi termasuk laser

2145

Disektomi berpandukan CT termasuk laser

2895

Vertebroplasti perkutaneus berpandukan fluoroskopi

2145

Vertebroplasti perkutaneus berpandukan CT

2895

Toraks

Insersi sten logam trakeal/bronkial 1760 Insersi sten logam esofageal di bawah kawalan pengimejan

1565

P.U. (A) 358

33

Gastro usus Gastrostomi Perkutaneus 1760 Gastrojejunostomi Perkutaneus 2145

Hepar

Kolesistektomi Perkutaneus 1890 Insersi perkutaneus endoprostesis biliari plastik

1890

Insersi perkutaneus endoprostesis biliari logam

2390

Transjugular pintasan intrahepatik portosistemik

2895 1815

Urinari

Nefrostomi Perkutaneus 1340 Pembuangan kalkulus Perkutaneus 2705 Pilolisis Perkutaneus 2705

Lain-lain

Insersi kateter vena sentral - tidak tembus (berpandukan sinar-X)

725

Insersi kateter vena sentral - tembus (berpandukan sinar-X)

1160

Ablasi sista di bawah kawalan pengimejan 1160 Pemasukan penyaring vena cava 1340 Pencarian bahan asing di bawah panduan sinar-X

1565

Penutupan fistula di bawah kawalan pengimejan

2145

Koagulasi laser perkutaneus jisim 3600

(j) Neurologi Laporan ujian neurofisiologi Elekroensefalogram (EEG) - rutin dan tidur atau mudah alih

315

Kajian potensial pembangkitan - potensial pembangkitan visual (VEP), potensial rangsangan pembangkitan auditori stem otak (BAEP) dan potensial pembangkitan somatosensori (SSEP)

580

Elektromiogram (EMG) dan kajian konduksi saraf

580

Kajian konduksi saraf 315

P.U. (A) 358

34

Neurosurgeri Dekompresi dan cantuman pertemuan kranio servikal

7030 3305

Kraniotomi tumor supraselar 7030 3305 Kraniotomi tumor fosa posterior 7030 3305 Rizotomi posterior selektif 5970 2930 Disektomi endoskopik 7030 Laminektomi servikal 3600

(k) Obstetrik dan ginekologi Kehamilan dan pantang

Kelahiran caesarean 1890 820 Histerektomi caesarean 2390 820 Pengkuretan uterus bersalin 480 405 Penempatan semula uterus songsang 725 685 Tranfusi pertukaran darah neonatal 1000

Organ reproduktif wanita Uterus/Adneksa

Histerektomi radikal dan limfadenektomi (Wertheim's)

4750 1550

Histerektomi total abdomen 2040 760 Histerektomi subtotal abdomen 2040 760 Histerektomi dan pembuangan adneksa uterus

2040 760

Histerektomi vagina termasuk bantuan laparoskopik

2040 760

Histerektomi dan pembuangan adneksa uterus bagi ketumbuhan malignan ovari

2895 820

Miomektomi termasuk laparoskopik 2040 760 Rekonstruksi plastik uterus 1565 685 Pembedahan endoskopik terapeutik uterus termasuk ablasi endometrial

1565 685

Histeroskopi dengan/tanpa D&C , biopsi termasuk polipektomi

865 435

Biopsi atau penyedutan endometrium 405 265 Ooforektomi dan salpigektomi dwisisi dalam isolasi

1890 685

Ooforektomi dan salpingektomi sisi tunggal dalam isolasi

1340 685

Pembuangan produk konsepsi daripada tiub falopian (kehamilan ektopik) termasuk laparoskopik

1760 760

Laparoskopi termasuk (cth: punktur sisia ovari serta/tanpa biopsi)

1160 570

P.U. (A) 358

35

Tatacara laparoskopi dan terapeutik termasuk laser, diatermi dan pemusnahan (cth: endometriosis, adesiolisis pembedahan tiub dan tumor pejal)

1890 760

Sistektomi ovari (tidak termasuk dalam tatacara lain) (dan dwisisi)

1890 685

Diseksi blok nodus limfa pelvik (tidak termasuk dalam tatacara lain)

2040 760

Eksenterasi penuh pelvis 5970 2930 Eksenterasi anterior pelvis 4750 1815 Eksenterasi posterior pelvis 4750 1815

Gantungan

Pembedahan bergabung abdomen dan vagina bagi menyokong saluran keluar pundi kencing wanita

1890 685

Pembedahan anduh suprapubik 1890 760 Gantungan retropubik leher pundi kencing

1890 685

Pembedahan vagina bagi menyokong saluran keluar pundi kencing wanita

1890 685

Ventro-gantungan uterus termasuk laparoskopi

1340 625

Serviks uteri

Kolposkopi (dengan/tanpa biopsi) 370 Amputasi uferi serviks 1160 505 Pemusnahan laser lesi serviks uterus 370 265 Pengkauteran lesi serviks uterus termasuk diatermi gelung

370 265

Biopsi kon serviks uterus termasuk laser 865 505 Biopsi tebuk serviks uterus 315 265 Pendilatan serviks uterus dan pengkuretan uterus termasuk polipektomi dan diatermi serviks (bagi wanita melebihi umur 40 tahun)

480 315

Vagina/Perineum

Sistouretroplasti 1760 685 Eksisi/Diatermi karunkel uretra 370 265 Pembedahan Perineum wanita 480 265 Insisi introitus vagina 480 505 Obliterasi lain vagina 1890 760 Eksisi septum vagina 725 505 Eksisi lesi vagina (cth: ketuat dan sista) 865 505 Rekontruksi vagina 2705 820

P.U. (A) 358

36

Kolporafi anterior serta/tanpa posterior dan amputasi uterus serviks termasuk pembaikan primer enterosele

2040 685

Kolporafi posterior 1340 625 Kolporafi anterior serta/tanpa posterior termasuk pembaikan primer enterosele

1890 685

Pembaikan enterosele (dalam isolasi) serta/tanpa kolporafi posterior

1760 685

Kolporafi anterior serta/tanpa posterior dengan histerektomi vagina termasuk pembaikan primer enterosele

2480 820

Pembaikan fistula vesikovaginal 2145 820 Pembaikan fistula uretrovaginal 1890 820 Pembaikan fistula rektovaginal 2480 820 Pembaikan fistula ureterovaginal 2480 820

Vulva/Labia Eksisi kelenjar Bartholin 865 355

Marsupialisasi kelenjar Bartholin 865 355 Vulvektomi mudah 2145 760 Eksisi tisu labial berlebihan 725 435 Vulvektomi radikal termasuk diseksi blok kelenjar inguinal

2895 985

Eksisi lesi vulva 580 355

(l) Pembedahan pediatrik Penyaliran abses paru-paru 2480 1125 Laparotomi NEC 4750 2500 Penutupan peringkat tunggal epispadias 3600 2110 Eksisi barah kemuncak neural (torasik) 3600 2110 Eksisi transternal teratoma 3600 2110 Eksisi transternal limfangioma 4750 2500 Endoskopi dan kanulasi fistula trakea 1565 570 Eksisi sista bronkial 3600 2110 Pembaikan paru-paru 2895 1815 Eksisi duplikasi esofageal 3600 2110 Pembaikan jenis H bagi Tetralogi Fallot (TOF)

3600 2110

Pembaikan belah trakeo-esofageal 5970 2930 Torakotomi dan pembaikan primer atresia esofageal

4750 2500

Pembaikan TOF berulang 5970 2930 Torakotomi dan pembahagian fistula 2895 1815 Esofagostomi 1760 625 Transeksyen esofageal 2705 1550

P.U. (A) 358

37

Rectosigmoidektomi dengan rekonstruksi koloanal bagi penyakit Hirshsprung

4750 2500

Modifikasi Lester-Martin Duhamel 5970 2930 Pembedahan Kimura bagi aganglionosis kolonik total

7030 3305

Tampalan ileosekal/jejunal bagi aganglionosis kolonik total

7030 3305

Suntikan prasakral larutan garam hipertonik

480 265

Insersi jahitan mengelilingi sfinkter perianal

480 265

Anorektoplasti sagital posterior 3600 2110 Anorektoplasti sagital posterior dengan laparotomi bagi anomali anorektal jenis tinggi

4750 2500

Anorektoplasti sagital anterior 2895 1815 Pull-through sakroperineal 2895 1815 Anorektorvaginouretoplasti sagital posterior bagi kloakal jenis pertengahan

5970 2930

Anorektovaginouretoplasti sagital posterior dengan laparotomi bagi jenis tinggi

7030 3305

Pembuatan semula anaorektoplasti sagital posterior bagi anomoli anorektal

5970 2930

Anoplasti 1760 625 Penyaliran sista koledokal 2390 985 Pembedahan Kasai bagi biliari atresia 7030 3305 Splenektomi subtotal 3600 2110 Pembaikan limpa 2705 1550 Aortopeksi (bagi trakriomalasia) 3600 2110 Insersi perkutaneus tiub nefrostomi 1160 435 Ureterostomi kutaneus 1565 570 Eksisi ureterosil 2480 1125 Eksisi ureterosil ektopik 2570 1320 Penutupan eksostrofi pundi kencing 5970 2930 Penukaran ekstrofi klokal kepada ekstrofi pundi kencing dengan kolostomi akhir

4750 2500

Penukaran ekstrofi klokal, ileostomi, pemisahan sekum daripada kedua-dua pundi kencing hemibladders

7030 3305

Vesikostomi 1760 625 Apendikovasikostomi Mitrofanoff 3600 2110 Pembaikan hipospadias kelenjar (cth: MAGPI)

1565 570

Pembaikan hipospadias penis distal (cth: pembaikan Flip-flap)

2390 985

Penutupan fistula uretra 1000 405

P.U. (A) 358

38

Pembaikan peringkat pertama hipospadias penis

1565 570

Pembaikan flap pulau peringkat tunggal proksimal atau hipospadias penoskrotal

3600 2110

Pembaikan peringkat tunggal bagi hipospadias dengan transposisi penoskrotal

4750 2500

Rekonstruksi lelaki peringkat tunggal dengan vaginektomi bagi genitalia meragukan

7030 3305

Pembetulan transposisi penoskrotal 1890 685 Pembetulan kordae tanpa hipospadias (tiada keperluan bagi dretroplasti)

1565 570

Pembaikan peringkat kedua hipospadias 1565 570 Pembetulan kordae penis tanpa hipospadias yang memerlukan uretroplasti

2895 1815

Pembaikan hipospadias dengan graf bebas pundi kencing atau mukosa mulut

4750 2500

Eksplorasi skrotum 1000 405 Pemindahan mikrovaskular testis ke skrotum

2705 1550

Laparoskopi dan orkidopeksi bagi testis intraabdomen

2145 820

Laparotomi dan pengikatan arteri testikular

865 355

Pembahagian laparoskopik arteri testikular

1565 570

Pembelahan dorsal prepus 405 265 Reduksi klitoroplasti bagi hiperplasia adrenal congenital

2705 1550

Reduksi klitoroplasti dengan vaginoplasti bagi hiperplasia adrenal kongenital

4750 2500

Reduksi klitoroplasti, laparotomi dan vaginoplasti-kolon sigmoid

7030 3305

Reduksi semula klitoroplasti dengan vaginoplasti - semula dengan laporotomi dan sigmoid

7030 3305

Eksisi sistik higroma servikal - kecil 1160 435 Eksisi sistik higroma servikal - besar 2480 1125 Eksisi sistik higroma servikal - menyeluruh/ekstensif

3600 2110

Pembetulan hidrosil - unilateral 1000 Pembetulan hidrosil - dwisisi 1760 Penutupan eksomfalos major/gastroskisis - penutupan primer

3600

P.U. (A) 358

39

Penutupan eksomfalos major/gastroskisis - penutupan silastik

2145

Penutupan eksomfalos major/gastroskisis - penutupan primer tertunda

2570

(m) Pembedahan ortopedik pediatrik Dislokasi kongenital pinggul (CDH)

Reduksi tertutup dengan/tanpa bius dan spika pinggul

865 355

Reduksi tertutup dengan pemakaian alat sokongan

315 265

Reduksi terbuka dengan dengan spika pinggul

1890 685

Reduksi terbuka dengan osteotomi pelvik 2305 940 Reduksi terbuka dengan osteotomi femoral

2305 940

Reduksi terbuka dengan osteotomi pelvik dan femoral

2705 1550

Lutut Pembetulan kecacatan melalui penuangan bersiri

315 265

Pembetulan kecacatan dengan pelepasan tisu lembut

1340 505

Pembetulan kecacatan melalui osteotomi 2305 940 Penstabilan patela melalui penuangan 1160 435 Pseudoartrodesis Eksisi dan graf hidup 2895 1815 Eksisi dan pemindahan tulang 2705 1550 Pemanjangan tulang dan pembetulan kecacatan

Menggunakan rangka bulat 2705 1550 Menggunakan rangka uniaksial 2480 1125 Menggunakan rangka bulat dan uniaksial (digabungkan)

2705 1550

Kaki Pembetulan kaki belantan melalui penuangan

315 265

Pembetulan kaki belantan melalui pemanjangan tendon Achilles

725 315

Pembetulan kaki belantan melalui pelepasan tisu lembut sepenuhnya

1760 625

Pembetulan kaki belantan melalui rangka bulat

1760 625

P.U. (A) 358

40

Pembetulan kecacatan melalui pemindahan tendon dan pelepasan tisu lembut

2145 820

Pembetulan kecacatan melalui osteotomi dan cantuman tulang

2145 820

Artrodesis 2145 820 Polio dan Palsi serebrum

Pelepasan tisu lembut dan neurektomi pinggul - dwisisi

1340 505

Pelepasan tisu lembut lutut - dwisisi 1340 505 Pelepasan tisu lembut pergelangan kaki - dwisisi

1340 505

Pemindahan tendon 1565 570 Atrodesis

2145 820

Reseksi tumor dan penyelamatan anggota Tumor tisu lembut - mudah 2145 820 Tumor tisu lembut - kompleks termasuk rekonstruksi neurovaskular

7030 3305

Tumor tulang dengan endoprostesis 7030 3305 (n) Patologi (Patologi anatomi) Eksisi spesimen tidak kompleks – (cth: apendiks, tiub fallopian, vas, tonsil,

adenoid, sista sebaseus, polip hidung, injap jantung)

55 - 70

Eksisi spesimen lebih kompleks

Biopli diagnostik (baji/tebuk/trucut) (satu blok parafin)

115 - 135

Spesimen saiz pertengahan – (cth: mata, kelenjar air liur,tiroid,ketulan payudara, pundi hempedu,cebisan prostat, splenektomi, histerekromi, mudah, sista ovari,keratan ulser diabetik, keratan tumor tidak lebih daripada 10 sm, biopsi diagnostik dihantar sebagai 2 hingga 3 spesimen berasingan)

170 - 225

Spesimen besar- (cth: laringektomi, pneurnonektomi, mastektomi biasa, wayar penyangkut payudara dengan jidar, gastrektomi, reseksi usus, nefreketomi, histerktomi total dan salfingoooferektomi dwisisi (TAHBSO), biopsi kon, potongan anggota

345 - 420

P.U. (A) 358

41

(kecuali diabetes), keratan tumor lebih daripada 10 sm, biopsi diagnostik dihantar sebagai 4 hingga 10 spesimen berasingan)

Spesimen radikal – (cth: keratan radikal leher, mastektomi dengan pembersihan aksilari, Whipple's Wertheim's, vulvektomi dengan adenektomi limfa, dan sebarang pemotongan radikal yang lain yang memerlukan margin dan status kelenjar limfa)

440 - 490

Histopatologi pengkhususan

Hepar bagi keadaan bukan neoplastik termasuk pewarna khusus

205 - 240

Otot termasuk pewarna khusus 280 - 345 Biopsi buah pinggang termasuk pewarna khusus dan imunofluoresen

410 - 485

Kecelaruan limfoproliferatif termasuk imunohistofenotaiping limfoma

280 - 345

Seksyen beku (dengan seksyen laporan paraffin susulan)

410 - 555

Autopsi Lawatan ke tempat jenayah 410 - 685 Tatacara dan laporan 685 - 1375

Sitopatologi Laporan calitan ginekologi 45 - 50 Laporan calitan bukan ginekologi 85 - 95 Tatacara sedutan sitologi 315 Laporan sedutan sitologi 165 - 205

Hematologi dan transfusi Laporan berdasarkan filem darah 45 - 70 Tatacara sedutan sum-sum tulang 480 Laporan sedutan sum-sum tulang 135 - 275 Tatacara trefin sum-sum tulang 580 405 Laporan trefin sum-sum tulang 135 - 275 Laporan ujian koagulasi 70 - 135

Laporan kajian ke atas hematologi khusus - (cth: status folat-B12, ujian Coomb's,

analisis hemoglobin, sitokemistri, dsb.)

70 - 135

Laporan transfusi asas - (cth: perbezaan kumpulan dan

ketidakserasian darah/produk darah)

45 - 70

Laporan masalah transfusi 135 - 275 Feresis 1000

P.U. (A) 358

42

Tuaian sum-sum tulang 1340 Graf sum-sum tulang 1340

Genetik

Kajian kromosom imunofluoresen 135 - 410 Imunofenotaiping 135 - 410 Kandungan asid deoksiribonukleik (DNA)(Ploidi)

135 - 410

Kajian penyusunan semula baka 135 - 410 Subset limfosit 135 - 410 Laporan kajian genetik molekular lain 135 - 410 Ujian paterniti 135 - 410 Penjenisan antigen leukosit manusia (HLA)

135 - 410

Imunologi

Laporan penyelidikan imunologi umum (cth: saringan penyakit autoimun, saringan autoantibodi)

40 - 70

Laporan ujian imunologi khusus (cth: elektroforesis protin serum, elektroforesis cecair serebrospinal (CSF), imunotaiping protin monoklonal, imunofenotaiping kecelaruan imun, ujian protinurit, kajian fungsi sel)

70 - 275

Mikrobiologi perubatan

Laporan kultur dan sensitiviti rutin 15 - 20 Laporan kultur khusus 70 - 135 Laporan pemeriksaan calitan terus (gram/basili fast asid (AFB))

45 - 55

Laporan ujian serologi 45 - 55 Laporan ujian serologi khusus 70 - 135 Laporan bagi ujian kerentanan antimikrobial (per ujian)

105 - 205

Perundingan atas perawatan pesakit (siasatan dan terapi empirikal)

105 - 135

Pemeriksaan calitan kultur darah positif dan laporan awal dengan perundingan bagi perawatan pesakit

135 - 205

Perundingan kawalan jangkitan 135 - 205 Laporan penemuan antijen (Imunofluoresen, Esei imunosoiben dihubungkan enzim IgG (ELISA), lateks/koaglutinasi)

70 - 105

P.U. (A) 358

43

Patologi kimia Laporan profil kimia umum (cth: hepar,tulang, jantung)

45 - 70

Laporan saringan kimia umum termasuk saringan eksekutif

70 - 205

Laporan siasatan kimia khusus (cth: kajian metabolik (lipid, tulang) kecelaruan endokrin, kajian toksikologi, pemantauan ubatan terapeutik penilaian kesihatan ibu dan janin)

70 - 410

Laporan kajian dinamik (cth: kajian fungsi (GIT, endokrin, renal))

115 - 410

Perundingan bagi -

Strategi siasatan 105 - 135 Variasi bukan analitikal 105 - 135 Gangguan ubatan 105 - 135 Korelasi di antara data klinikal dan maklumat klinikal yang disediakan

105 - 135

Pelbagai

Mikroskopi elektron 340 - 410 Pandangan kedua - Mentafsir data dan slaid sumsum tulang 135 - 275 Histopatologi dan sitopatologi 275 - 685 Penemuan autopsi 275 - 1375

(o) Psikiatrik-Psikoterapi Psikoterapi perseorangan - tidak kurang daripada 45 minit bagi setiap sesi termasuk terapi tingkah laku dan hipnoterapi

250

Psikoterapi berkumpulan bagi setiap seorang - satu jam bagi setiap kumpulan yang tidak kurang daripada tiga orang pesakit dan tidak lebih daripada lapan orang pesakit

65

Terapi perkahwinan bagi setiap pasangan - tidak kurang daripada 45 minit bagi setiap sesi bagi suatu pasangan serentak

250

Terapi keluarga bagi setiap keluarga - tidak kurang daripada 45 minit bagi setiap sesi dan tidak kurang daripada tiga anggota

250

Psikoterapi kanak-kanak - tidak kurang daripada 30 minit bagi setiap sesi

250

P.U. (A) 358

44

termasuk temuduga keluarga berkaitan Setiap terapi elektrokonvulsif (ECT) 315

(p) Radiologi dan imejan diagnostik

Nota: Jika berkenaan, fi pakar radiologi menjadi 30% daripada jumlah fi yang boleh dicajkan bagi radiologi dan imejan diagnostik.

Dada Dada (satu pandangan) 45 Dada (dua pandangan) 70 Dada (tiga pandangan) 90 Dada (empat pandangan) 115

Abdomen Abdomen (satu pandangan) 45 Abdomen (dua pandangan) 70 Abdomen (tiga pandangan) 90 Ginjal, ureter dan pundi kencing (KUB) (satu pandangan)

115

Pelvimetri lateral 55 Pelvimetri antero-posterior (AP) dan lateral

90

Spina

Spina servikal (satu pandangan) 45 Spina servikal (dua pandangan) 70 Spina servikal (tiga pandangan) 92 Spina servikal (empat pandangan) 115 Spina servikal (lima pandangan) 135 Spina torasik (satu pandangan) 45 Spina torasik (dua pandangan) 70 Spina torasik (tiga pandangan) 90 Spina lumbo-sakral (satu pandangan) 45 Spina lumbo-sakral (dua pandangan) 70 Spina lumbo-sakral (tiga pandangan) 90 Spina lumbo-sakral (empat pandangan) 115 Kaji selidik skeletal 250

Tengkorak

Tengkorak (satu pandangan) 45 Tengkorak (dua pandangan) 70 Tengkorak (tiga pandangan) 90 Tengkorak (empat pandangan) 115 Tulang muka

P.U. (A) 358

45

Tulang muka (satu pandangan) 45 Tulang muka (dua pandangan) 70 Tulang muka (tiga pandangan) 90 Tulang hidung (satu pandangan) 45

Mandibel

Mandibel (satu pandangan) 45 Mandibel (dua pandangan) 70 Mandibel (tiga pandangan) 90

Sendi temporo-mandibular

Sendi temporo-mandibular (satu pandangan)

45

Sendi temporo-mandibular (dua pandangan)

70

Sendi temporo-mandibular (tiga pandangan)

90

Sendi temporo-mandibular (empat pandangan)

115

Mastoid

Mastoid (satu pandangan) 45 Mastoid (dua pandangan) 75 Mastoid (tiga pandangan) 110 Mastoid (empat pandangan) 130

Sinus paranasal

Sinus paranasal (satu pandangan) 45 Sinus paranasal (dua pandangan) 70 Sinus paranasal (tiga pandangan) 90

Pandangan foramina optik

Sesisi 70 Dwisisi 105

Orbit

Orbit (dua pandangan) 45 Orbit (tiga pandangan) 70 Orbit (empat pandangan) 90

Kanal auditori internal

Kanal auditori internal (satu pandangan) 45 Kanal auditori internal (dua pandangan) 70 Kanal auditori internal (tiga pandangan) 90

Bahu

Bahu (satu pandangan) 45

P.U. (A) 358

46

Bahu (dua pandangan) 70 Bahu (tiga pandangan) 90 Bahu (empat pandangan) 115 Sendi akromioklavikular - kedua-dua belah menanggung berat

55

Lengan atas (Humerus)

Lengan atas (satu pandangan) 45 Lengan atas (dua pandangan) 70

Sendi siku

Sendi siku (satu pandangan) 45 Sendi siku (dua pandangan) 70 Sendi siku (tiga pandangan) 90 Sendi siku (empat pandangan) 115

Lengan bawah (Radius/Ulna)

Lengan bawah (satu pandangan) 45 Lengan bawah (dua pandangan) 70

Sendi pergelangan tangan

Sendi pergelangan tangan (satu pandangan)

45

Sendi pergelangan tangan (dua pandangan)

70

Sendi pergelangan tangan (tiga pandangan)

90

Sendi pergelangan tangan (empat pandangan)

115

Tangan

Tangan (sebelah - satu pandangan) 45 Tangan (sebelah - dua pandangan) 70 Tangan (sebelah - tiga pandangan) 90 Tangan (kedua-dua belah - satu pandangan)

55

Tangan (kedua-dua belah - dua pandangan)

80

Tangan (kedua-dua belah - tiga pandangan)

105

Tangan kiri bagi usia tulang 45 Ibu jari atau setiap jari lain

Ibu jari atau setiap jari lain (satu pandangan)

30

Ibu jari atau setiap jari lain (dua pandangan)

40

P.U. (A) 358

47

Klavikel Klavikel (satu pandangan) 45 Klavikel (dua pandangan) 70

Sendi sterno-klavikel

Sendi sterno-klavikel (satu pandangan) 45 Sendi sterno-klavikel (dua pandangan) 70 Sendi sterno-klavikel (tiga pandangan) 90 Sternum (satu pandangan) 45

Skapula

Skapula (satu pandangan) 45 Skapula (dua pandangan) 70

Pandangan kanal karpal 70 Pandangan skafoid 90

Pelvis

Pelvis (satu pandangan) 50 Pelvis (dua pandangan) 75 Pelvis (tiga pandangan) 95

Sendi pinggul

Sendi pinggul (satu pandangan) 50 Sendi pinggul (dua pandangan) 75 Sendi pinggul (tiga pandangan) 95 Sendi pinggul (empat pandangan) 120 Sendi pinggul (lima pandangan) 145

Femur (paha) Femur (satu pandangan) 50 Femur (dua pandangan) 70

Lutut Lutut (satu pandangan) 45 Lutut (dua pandangan) 70 Lutut (tiga pandangan) 90 Lutut (empat pandangan) 115 Lutut (lima pandangan) 135 Tulang keting (Tibia/Fibula) Tulang keting (satu pandangan) 45 Tulang keting (dua pandangan) 70

Pergelangan kaki Pergelangan kaki (satu pandangan) 45 Pergelangan kaki (dua pandangan) 70

P.U. (A) 358

48

Pergelangan kaki (tiga pandangan) 90 Pergelangan kaki (empat pandangan) 115 Pergelangan kaki (lima pandangan) 135

Kaki Kaki (satu pandangan) 45 Kaki (dua pandangan) 70 Kaki (tiga pandangan) 90 Kedua-dua belah kaki (dua pandangan) 80 Kedua-dua belah kaki (tiga pandangan) 105

Sendi subtalar Sendi subtalar (satu pandangan) 45 Sendi subtalar (dua pandangan) 70 Sendi subtalar (tiga pandangan) 90 Sendi subtalar (empat pandangan) 115

Kalkaneum Kalkaneum (satu pandangan) 45 Kalkaneum (dua pandangan)

70

Densitometri tulang Dexa 170 Ultrasound 150

Pemeriksaan radiografik berkontras (fi pakar radiologi dalam parentesis)

Barium telan (40%) 115 Barium makan (kontras berganda) (40%) 170 Barium makan dan ikut lalu (40%) 205 Enema usus kecil (40%) 205 Gastrografin atau kontras bukan berion kajian gastrointestinal atas (40%)

205

Enema Barium (satu kontras atau berganda dua) (40%)

205

Gastrografin atau enema kontras bukan berion (40%)

205

Loopogram (40%) 205 Intubasi duodenum (40%) 230 Kolesistogram oral (Satu dos) (30%) 135 Kolesistograrn oral (dos berganda dua) (30%)

170

Sistogram (30%) 205 Ureterogram menaik ((40%) 230 Sistouretgram kencing (40%) 285 Pailogram retrogred - sebelah (30%) 135 Pailogram retrogred - dua belah (30%) 205

P.U. (A) 358

49

Kajian konduit ilium (40%) 205 Pailogram nefrostomi - sebelah (30%) 170 Pailogram nefrostomi - dua belah (30%) 235 IVU dos kontras standard (30%) 230 IVU dos kontras standard dan tomogram (30%)

265

IVU dos kontras berganda dua (30%) 310 IVU dos kontras berganda dua dan tomogram (30%)

345

IVU dos standard dan radiograf tertunda (30%)

285

IVU dos kontras berganda dua dan radiograf tertunda (30%)

365

IVU dos standard dan tomogram dan radiograf tertunda (30%)

320

IVU dos kontras berganda dua dan tomogram dan radiograf tertunda (30%)

400

Kolangiogram tiub-T (30%) 135 Kolangiogram pembedahan (30%) - laporan segera sahaja

285

Histerosalfingogram (kontras berion) (30%) - saringan dan laporan sahaja

135

Histerosalfingogram (kontras bukan ion) (30%) - saringan dan laporan sahaja

135

Histerosalfingogram serta kontras berion (keseluruhan tatacara) (40%)

205

Histerosalfingogram serta kontras bukan berion (keseluruhan latacara) (40%)

230

Sinogram (40%) 170 Sialogram kelenjar parotid - sebelah (50%)

230

Sialogram kelenjar parotid - dua belah (50%)

460

Sialogram kelenjar submandibular - sebelah (50%)

230

Sialogram kelenjar submandibular - dua belah (50%)

460

Artrogram - sebelah (50%) 230 Artrogram - dua belah (50%) 400 Mailogram lumbar (kontras bukan berion larut air) (50%)

515

Mailogram servik/torasik (50%) 605 Bronkogram - sebelah (40%) saringan, laporan serta radiograf sahaja

230

Bronkogram - kedua belah (40%) saringan, laporan serta radiograf sahaja

345

P.U. (A) 358

50

Tomografi Tomogram - satu satah (30%) 195 Tomogram - dua satah (30%) 250 Tomogram - fosa pituitari AP/Lateral (30%)

195

Mamogram

Mamografi sehingga empat pandangan (35%)

230

Mamografi dan satu pandangan tambahan (35%)

265

Mamografi dan dua pandangan tambahan (35%)

295

Mamografi dan tambahan ultrasound terhad (35%)

285

Imbasan tomografi komputer (imbasan CT) Nota: Caj di atas adalah berdasarkan kepada 100 ml kontras intravena bukan berion kecuali bagi CT otak/orbit - 50 ml

Otak (tanpa kontras) (30%) 400 Otak (dengan kontras bukan ionik) (35%) 490 CT otak kompleks (50%) 630 Abdomen (tanpa kontras) (30%) 400 Abdomen (dengan kontras bukan ionik) (35%)

515

Abdomen dua fasa (40%) 630 Abdomen tiga fasa (40%) 745 Abdomen empat fasa (40%) 915 Abdomen kompleks (40%) 860 Pelvis (tanpa kontras) (30%) 345 Pelvis (dengan kontras bukan ionik) (35%)

460

Pelvis kompleks (50%) 570 Spina - servikal atau lumbar (tanpa kontras) (30%)

400

Spina - servikal atau lumbar (dengan kontras bukan ionik intraspinal (50%))

745

Spina kompleks (50%) 860 Spina - torasik (tanpa kontras) 30% 460 Spina - torasik (dengan kontras bukan ionik intraspinal ) 50%

745

Spina kompleks (50%) 860 Dada (tanpa kontras) (30%) 345 Dada (dengan kontras bukan ionik) (35%)

460

P.U. (A) 358

51

Dada kompleks (50%) 570 Saringan CT dos rendah ke atas dada (30%)

285

Resolusi tinggi tomografi berkomputer (HRCT) - inspiratori atau ekspiratori (30%)

345

HRCT - inspiratori serta ekspiratori (40%)

515

Leher/Tiroid (tanpa kontras) (30%) 345 Leher/Tiroid (dengan kontras bukan berion) (30%)

460

Ruang posnasal dan leher (tanpa kontras) (30%)

515

Ruang posnasal dan leher (dengan kontras bukan ionik) (30%)

630

Ruang posnasal kompleks (50%) 745 Orbit (tanpa kontras) (20%) 345 Orbit (dengan kontras bukan ionik) (25%)

460

Orbit kompleks (50%) Fosa Pituitari (tanpa kontras) (20%) 345 Fosa Pituitari (dengan kontras bukan ionik) (25%)

460

I.A.M. (tanpa kontras) (20%) 345 I.A.M. (dengan kontras bukan berion) (25%)

460

Imbasan badan total (otak, leher, dada, abdomen dan pelvis) (tanpa kontras) (20%)

1030

Imbasan badan total (dengan kontras bukan berion) (25%)

1145

Imbasan badan total yang kompleks (50%)

1260

Dada, abdomen dan pelvis (tanpa kontras) (20%)

915

Dada, abdomen dan pelvis (dengan kontras bukan berion) (25%)

1030

Dada, abdomen dan pelvis kompleks (50%)

1145

Spiral CT abdomen dan pelvis bagi batu karang (tanpa kontras intravena (IV)) (30%)

345

CT sinus paranasal bersatah tunggal beresolusi tinggi bagi sinusitis (tanpa kontras) (20%)

230

CT sinus paranasal bersatah tunggal (tanpa kontras) (20%)

345

P.U. (A) 358

52

CT sinus paranasal bersatah tunggal (dengan kontras bukan berion) (25%)

460

Abdomen dan pelvis (tanpa kontras) (30%)

685

Abdomen dan pelvis (dengan kontras) (35%)

800

Abdomen dan pelvis kompleks(50%) 915 Dada dan abdomen atas (tanpa kontras) (30%)

685

Dada dan abdomen atas (dengan kontras) (35%)

800

Dada dan abdomen atas kompleks (50%) 915 CT dua sistem (tidak tersenarai di atas) - (tanpa kontras) (30%)

685

CT dua sistem (tidak tersenarai di atas) - (tanpa kontras) (35%)

800

CT dua sistem (tidak tersenarai di atas) (kompleks) (50%)

915

CT ekstremiti (tanpa kontras) (satu kawasan) (30%)

400

CT ekstremiti (dengan kontras satu kawasan) (35%)

515

CT ekstremiti kompleks (50%) 630 Ultrasound

Abdomen atas (40%) 170 Pelvis (40%) 135 Abdomen dan pelvis (50%) 230 Ginjal dan pundi kencing (40%) 115 Ginjal dan pundi kencing serta anggaran isi padu urin baki (50%)

135

Otak (neonatal) (40%) 135 Ultrasound terperinci imbasan janin 285 Tiroid (40%) 115 Payudara (40%) 160 Ultrasound Doppler karotid ekstrakranium (50%) -

400

Ultrasound Doppler arteri bagi satu kawasan (50%)

285

Ultrasound Doppler vena bagi satu anggota (50%)

285

Ultrasound Doppler vena bagi dua anggota (50%) -

460

Ultrasound Doppler arteri bagi satu anggota (50%)

345

Ultrasound Doppler arteri bagi dua anggota (50%)

515

P.U. (A) 358

53

Ultrasound otot skeletal bagi setiap kawasan (40%)

170

Ultrasound skrotum (40%) 115 Ultrasound Doppler bagi skrotum (50%) 230 Ultrasound Doppler bagi organ lain (setiap organ) yang tidak tersenarai di atas (50%)

345

Ultrasound endokavitari (50%) 170 Ultrasound jantung bagi penyakit perikardial

90

Caj tambahan bagi setiap pemeriksaan ultrasound bergerak (boleh dibayar kepada pakar radiologi semasa waktu bekerja biasa)

55

Caj tambahan bagi setiap pemeriksaan ultrasound bergerak (boleh dibayar kepada pakar radiologi selepas waktu bekerja biasa)

170

Saringan

Pankreatografi kolangio endoskopik retrogred (ERCP) (30%) (saringan dan laporan sahaja) -biasa

230

ERCP biasa (30%) (saringan dan laporan sahaja -kompleks

345

Pengimejan Resonan Magnetik (MRI)

Otak

Otak (tanpa kontras) 800 Otak (dengan kontras) 1030 Otak dengan angiografi resonans magnetik (MRA) (inkranium)

1375

Otak dengan MRA serta kontras 1600 Otak dengan MRA serta karotid dwisisi serta kontras

2060

MRA karotid intrakranium atau ekstrakranium

800

MRV otak - biasa 800 MRV otak - kompleks 1030 Pituitari (tanpa kontras) 800 Pituitari (dengan kontras) 1030 Pituitari (dengan kontras dinamik) 1375 I.A.M (tanpa kontras) 800 I.A.M (dengan kontras) 1030 I.A.M serta otak (tanpa kontras) 1375 I.A.M serta otak (dengan kontras) 1600

P.U. (A) 358

54

Orbit Orbit (tanpa kontras) 800 Orbit (dengan kontras) 1030 Orbit dan otak (tanpa kontras) 1375 Orbit dan otak (dengan kontras) 1600

Leher Leher (tanpa kontras) 800 Leher (dengan kontras) 1030 Leher dan otak (tanpa kontras) 1485 Leher dan otak (dengan kontras) 1715 Pleksus Brakial (tanpa kontras) 915 Pleksus Brakial (dengan kontras) 1145

Toraks

Mediastinum (tanpa kontras) 800 Mediastinum (dengan kontras) 1030

Kardiak

MRI Kardiak - biasa 1145 MRI Kardiak - pertengahan 1715 MRI Kardiak - kompleks 2290 MRA Torasik - biasa 1030 MRA Torasik - pertengahan 1260 MRA Torasik - kompleks 1485 MRA Pulmonari - biasa 1030 MRA Pulmonari - pertengahan 1260 MRA Pulmonari - kompleks 1485 (Surcaj bagi setiap l0ml agen kontras MRI intravena (IV))

285

Abdomen atas

Abdomen atas - biasa 1030 Abdomen atas - pertengahan 1260 Abdomen atas - kompleks 1485 Magnetik resonans kolangiopankreatikografi (MRCP)

800

Magnetik resonans urografi 800 MRA abdomen atas - biasa 1030 MRA abdomen atas - pertengahan 1260 MRA abdomen atas - kompleks/rumit 1485 (Caj tambahan bagi setiap 10ml agen kontras MRI intravena (IV))

285

Pelvis

Pelvis - biasa 1030 Pelvis - pertengahan 1260

P.U. (A) 358

55

Pelvis - kompleks 1485 MRI Pelvimetri 570 (caj tambahan bagi setiap 10ml agen kontras MRI intravena (IV))

285

Spina

MRI kesemua spina (tanpa kontras) (bagi tekanan korda)

1600

MRI kesemua spina (dengan kontras) (bagi tekanan korda)

1830

MRI spina servikal (tanpa kontras) 1030 MRI spina servikal (dengan kontras) 1375 MRI spina torasik (tanpa kontras) 1030 MRI torasik spina (dengan kontras) 1375 MRI spina lumbar (tanpa kontras) 1030 MRI spina lumbar (dengan kontras) 1375

Sendi (bahu, sternoklavikular, siku,pergelangan tangan, pinggul, sacro-iliac, lutut,pergelangan kaki, sub-tarsal)

MRI satu sendi (tanpa kontras) 1030

MRI satu sendi (dengan kontras) 1375

Kawasan (lengan atas, lengan bawah, tangan,peha, kaki bawah-betis, kaki)

MRI satu kawasan (tanpa kontras) 1145 MRI satu kawasan (dengan kontras) 1490 MRI Artrografi (fi pakar radiologi) 345

(q) Radioterapi dan onkologi

Rawatan iradiasi luaran (akselerator linear)- Lazimnya termasuk rawatan 5 kali seminggu pada dos 200cGy setiap rawatan

170

Rawatan iradiasi luaran menggunakan apa-apa pecahan lain haruslah dicaj berdasarkan dos penyamarataan biologi - rawatan menggunakan unit teleterapi Co 60 sepatutnya dicaj kurang 30% daripada fi rawatan harian

115 - 345

Fi rawatan termasuk fi kepakaran

Rawatan intrakavitari pada kadar dos rendah setiap sesi termasuk sumber radioaktif, aplikator

2860 - 5720

P.U. (A) 358

56

(tidak termasuk fi bagi wad, dewan bedah dan anestatik)

Rawatan ruang-antara (cth: implan termasuk sumber dan aplikator lain)

3430 - 5720

Radioterapi intrakaviti/intraluminal kadar dos tinggi bagi rawatan lengkap (tidak termasuk aplikator)

2290 - 5720

Terapi sitotoksik (tidak termasuk perundingan)

Infusi 570 - 860 Infusi berpanjangan 685 - 1030 Kemoterapi progresif sehari (berbilang hari)

170 - 285

(r) Kulit dan tisu subkutaneus Lesi kulit

Eksisi ulser tekanan koksik 865 685 Eksisi terkawal mikroskopikal lesi kulit atau tisu subkutaneus (kemosurgeri Moh)

2480 820

Eksisi melanoma malignan termasuk graf 2145 685 Eksisi lesi kulit atau tisu subkutaneus - sehingga tiga

405 405

Eksisi lesi kulit atau tisu subkutaneus - empat atau lebih

1000 505

Lesi yang memerlukan eksisi lebar termasuk eksisi ulser roden

1000 405

Pengkuretan/krioterapi lesi kulit termasuk pengkauteran - empat atau lebih

1000 315

Pemusnahan laser lesi kulit 580 265 Biopsi cukur lesi kulit 315 265 Pengeluaran benda asing tisu dalam 725 355 Penyaliran lesi kulit termasuk abses 370 265 Penyaliran abses subkutaneus besar/hematoma

580 405

Dermabrasi kawasan terhad kulit 580 315 Dermabrasi meluas kulit 1000 435 Eksisi dasar kuku (Zadeks) 725 435

Pembaikan

Sutur primer luka yang melibatkan tisu dalam

1340 625

Sutur sekunder kulit 370 315 Penyelitan/pengeluaran pengembang kulit ke dalam tisu

1340 505

P.U. (A) 358

57

Pembersihan luka (dan pembersihan pembedahan)

480 315

Luka terbakar

Eskaiektomi kulit luka terbakar atau tisu subkuraneus (tidak lebih daripada l0%)

1340 435

Eskarektomi kulit luka terbakar atau tisu subkutaneus (lebih daripada 10%)

1760 760

Balutan menyeluruh kulit luka terbakar atau tisu subkutaneus

480 625

Transplan

Flap jauh kulit dan otot 1890 940 Flap pulau neurovaskular 2390 940 Flap setempat besar termasuk miokutaneus dan fasia

1760 505

Flap setempat kecil 1760 505 Graf

Autograf belah kulit - tapak kecil 1000 505 Autograf belah kulit - tapak besar 2040 685 Graf ketebalan penuh 1160 685 Pemindahan tisu bebas mikrovaskular 3600 1550

(s) Spina, spina korda dan saraf periferi Kawasan servikal

Dekompresi posterior primer termasuk cantuman

3600 1320

Dekompresi posterior primer dengan cantuman dan pengalatan

3600 1320

Laminoplasti pintu terbuka bagi kawasan servikal (Hirobiashi)

3600 1320

Dekompresi posterior tinjauan semula termasuk cantuman

4750 1320

Dekompresi posterior tinjauan semula dengan cantuman dan pengalatan

4750 1320

Dekompresi anterior tinjauan semula termasuk cantuman

4750 1320

Dekompresi anterior tinjauan semula dengan cantuman dan pengalatan

4750 1320

Gabungan cantuman anterior dan posterior spina servikal termasuk pengalatan

5970 1815

Pembedahan trans oral termasuk fiksasi posterior

5970 1550

Disektomi endoskopik 7030

P.U. (A) 358

58

Laminektomi servikal 3600 Dekompresi dan cantuman pertemuan kranio servikal

7030

Eksisi posterior primer cakera servikal 2895 1320 Eksisi posterior tinjauan semula cakera intervertebra termasuk cantuman

4750 1320

Eksisi posterior tinjauan semula cakera intervertebra dengan cantuman dan pengalatan

4750 1320

Ekrisi anterior primer cakera termasuk cantuman

3600 1320

Eksisi anterior primer cakera dengan cantuman dan pengalatan

3600 1320

Eksisi anterior tinjauan semula cakera termasuk cantuman

4750 1550

Eksisi anferior tinjauan semula cakera dengan cantuman dan pengalatan

4750 1550

Kawasan torasik

Eksisi transtorasik primer/posterior/anterolateral cakera intervertebra termasuk cantuman

2895 1320

Eksisi transtorasik primer/posterior/anterolateral cakera intervertebra dengan cantuman dan pengalatan

2705 1320

Dekompresi posterior primer termasuk cantuman

3600 1320

Dekompresi posterior primer dengan cantuman dan pengalatan

3600 1320

Dekompresi posterior tinjauan semula termasuk cantuman

4750 1320

Dekompresi posterior tinjauan semula dengan cantuman dan pengalatan

4750 1320

Dekompresi anterior primer/transtorasik termasuk cantuman

4750 1320

Dekompresi anterior primer/transtorasik dengan cantuman dan pengalatan

4750 1320

Dekompresi anterior/transtorasik tinjauan semula termasuk cantuman

4750 1320

Kawasan lumbar

Eksisi posterior primer cakera intervertebra termasuk cantuman

2390 940

Eksisi posterior primer cakera intervertebra dengan cantuman dan pengalatan termasuk kestabilan graf

3600 1550

P.U. (A) 358

59

Eksisi posterior tinjauan semula cakera intervertebra termasuk cantuman

2895 1125

Eksisi posterior tinjauan semula cakera intervertebra dengan cantuman dan pengalatan

4750 1550

Eksisi transabdominal/retroperitoneum primer cakera intervertebra termasuk cantuman dan pengalatan

3600 1320

Eksisi anterior tinjauan semula cakera intervertebra termasuk cantuman

4750 1550

Eksisi anterior tinjauan semula cakera intervertebra dengan cantuman dan pengalatan

4750 1550

Dekompresi posterior primer spina, termasuk cantuman

2895 985

Dekompresi posterior primer dengan cantuman dan pengalatan

2895 985

Dekompresi posterior tinjauan semula dengan cantuman dan pengalatan

2895 1125

Dekompresi anterior primer termasuk cantuman

3600 1550

Dekompresi anterior primer dengan cantuman dan pengalatan

3600 1550

Dekompresi anterior tinjauan semula dengan cantuman dan pengalatan

4750 1815

Dekompresi gabungan anterior dan posterior termasuk cantuman dan pengalatan

5970 1815

Cantuman spina posterior dengan pengalatan bagi scoliosis, kifosis, fraktur, tumor atau jangkitan

5970 2110

Cantuman spina anterior dengan pengalatan bagi scoliosis, kifosis, fraktur, tumor atau jangkitan

7030 2500

Disektomi perkutaneus (atau laser) 2145 940 Mikrodisektomi 2390 940 Mikrodisektomi ulangan semula 2895 1125 Pengeluaran pembetulan pengalatan daripada spina

1565 625

Peninjau periksaan spina termasuk biopsi 1890 685 Manipulasi spina 580 405 Kemonukleolisis 1160 435

Korda spina Eksisi separa korda spina 4750 1550 Pembedahan terbuka korda spina 4750 1550 Pembaikan mielomeningosele spina 3600 1320

P.U. (A) 358

60

Eksisi lesi intradural 4750 1550 Penyaliran kanal spina termasuk penyelitan pintasan

2705 820

Punktur lumbar termasuk manometri spina

370 265

Eksisi tumor intramedula 4750 1550

Akar saraf Rizolisis (terbuka) 2705 820 Simpatektomi terbuka 7030 Simpatektomi endoskopik 7030

Saraf simpatetik Simpatektomi servikal toraskopik 2705 820 Simpatektomi lumbar laparoskopik 1890 760

Simpatektomi prasakral 1565 685

Rizotomi posterior selektif 7030

Saraf periferal Eksisi saraf periferal 865 435 Transeksi saraf periferal 865 435 Neurektomi (saraf major) 1340 505 Eksisi lesi saraf periferal 1000 435 Eksisi lesi (saraf major) 1340 505 Pembaikan primer saraf periferal termasuk mikrosurgeri

2040 820

Pembaikan sekunder saraf periferal termasuk mikrosurgeri

2145 760

Graf primer saraf periferal 2390 760 Graf sekunder saraf periferal 2390 685 Pembaikan primer saraf periferal 865 505 Pembaikan sekunder saraf periferal 1160 435 Pembaikan primer trunkus saraf 1000 505 Pembaikan sekunder trunkus saraf 1565 505 Pelepasan karpal atau terowong kubital termasuk endoskopik

865 435

Pelepasan karpal atau terowong kubital termisuk endoskopik - dwisisi

1565 760

Pelepasan saraf periferal terjerat jauh ke dalam

865 435

Pelepasan saraf periferal terjerat 865 435 Neuiolisis dan transposisi saraf periferal 1000 505 Pelepasan saraf periferal tinjauan semula 1565 505 Penanaman neurostimulator ke dalam saraf periferal

2040 315

Biopsi saraf periferal 865 355

P.U. (A) 358

61

Peninjauperiksaan dan graf pleksus brakial

1000 570

Kelegaan kesakitan

Blok paravertebra sehingga dua aras (di bawah kawalan sinar-X)

580

Blok akar sakral (di bawah kawalan sinar-X)

580

Blok simpatetik kawasan intravena (blok guanethadine) - satu suntikan

480

Blok simpatetik kawasan intravena (blok guanethadine) - tiga sesi

1000

Blok ganglion stelat (anestetik setempat (LA))

480

Blok ganglion stelat (neurolitik) 580 Blok pleksus seliak (LA atau neurolitik) 1160 Blok saraf splanknik - dwisisi (Anestetik setempat atau neurolitik)

1160

Blok ganglion akar dorsal (LA atau neurolitik)

1000

Blok ganglion akar dorsal (frekuensi setempat)

1565 315

Neurolisis intratekal 1160 Suntikan ganglion trigeminal (LA di bawah kawalan sinar-X)

1160

Lesi frekuensi radio ganglion trigeminal (di bawah kawalan sinar-X)

2145

Kordotomi perkutaneus korda spina 2705 940 Suntikan epidural (servikal) 725 265 Suntikan epidural (lumbar) 580 265 Suntikan epidural(torasik) 725 265 Suntikan bahan terapeutik ke dalam CSF 370 820 Termokoagulasi frekuensi radio (RF) permukaan atau sendi sakroiliak termasuk rizolisis (di bawah kawalan sinar-X dengan sedatif/(GA) - 3 sendi

1160 405

Termokoagulasi frekuensi radio (RF) permukaan atau sendi sakroiliak termasuk rizolisis (di bawah kawalan sinar-X dengan sedatif/GA) - 6 sendi

2040 685

Suntikan sendi permukaan (di bawah kawalan sinar-X dengan sedatif/GA) - 2 sendi

725 265

Suntikan sendi permukaan (di bawah kawalan sinar-X dengan sedatif/GA) - 4 sendi

865 315

Suntikan sendi permukaan (di bawah 1000 355

P.U. (A) 358

62

kawalan sinar-X dengan sedatif/GA) - 6 sendi Penanaman neurostimulator ke dalam saraf periferal

2040 315

Lesi saraf periferal (frekuensi radio, krioprob atau fenol)

725

Sekatan LA trunkus saraf major 370

Simpatektomi lumbar - diagnosis (LA di bawah kawalan sinar-X)

1000

Simpatektomi torasik - diagnosis (LA di bawah kawalan sinar-X)

1000

Simpatetik lumbar - terapeutik (neurolitik di bawah kawalan sinar-X)

1340 405

Simpatektomi torasik - terapeutik (neurolitik di bawah kawalan sinar-X)

1565 435

Krioterapi pada kelenjar pituitari 2570 940 Suntikan ke dalam sendi besar di bawah kawalan sinar-X

480

Tatacara neurofisiologikal

Terapi elektro-konvulsif (ECT) 315 265 Elektroeksefalografi (EEG) 315 Perekodan dan pelaporan ke atas kajian berpotensi rangsangan

580

Perekodan dan pelaporan ke atas elektromiografi (EMG) dan kajian konduksi saraf

580

Elektrokokleografi trans timpanik 725 (t) Torak dan organ intra-torasik Esofagus

Mobilisasi esofageal torakoskopik melalui mediastinum

4750 1815

Esofagogastrektomi 5970 2500 Esofagektomi menyeluruh dan interposisi usus

7030 3305

Eksisi terbuka lesi esofagus 1890 1125 Pintasan esofagus 2480 1550 Anastomosis esofageal tinjauan semula 2705 1320 Penutupan pintasan esofagus 2145 1125 Pembaikan tratrstorasik esofagus 3600 1320 Pembaikan toraskopik esofagus 2895 1320 Esofagokardiomiotomi (pembedahan Heller)

2040 985

Miotomi esofagogastrik toraskopik 2145 985 Suntikan skleroterapi bagi varisis esofageal

1000 685

P.U. (A) 358

63

Pembaikan transtorasik hernia hiatus 2305 940 Pembaikan transtorasik hernia diafragmatik

2305 940

Pembaikan transabdominal hemia hiatus 2145 760 Pembaikan transabdominal hernia diafragmatik

2895 820

Pembaikaan laparoskopik hernia hiatus 2145 760 Pembedahan anti-refluks transabdominal 2895 820 Pembedahan anti-refluks tinjauan semula 3600 1320

Dinding dada

Torakoplasti 2705 985 Eksisi tumor dinding dada 2390 940 Pembetulan kecacatan pektus dinding dada

2895 940

Fiksasi fraktur berbilang 2305 940 Eksploratori sternotomi median 1160 760 Eksploratori torakotomi 1565 760 Reseksi tulang rusuk dan penyaliran terbuka kaviti pleural

1565 760

Pembaikan pecahan pada diafragma 2895 1125 Plikasi diafragma yang lumpuh 2390 985 Pembaikan hernia diafragma kongenital 2705 1550

Trakea

Eksisi separa trakea termasuk rekonstruksi

3600 2110

Trakeoplasti 1760 625 Penempatan terbuka prostesis dalam trakea

1760 505

Trakeostomi 1000 570 Penyelitan mini-trakeostomi 580 405 Torakotomi, ligasi bagi Tetralogi Fallot (TOF) anastomosis esofageal

4750

Torakotomi, ligasi bagi TOF servikal esofagostomi

4750

Servikal esofagostomi dan gastrektomi 2305 Tatacara endoskopik fiberoptik di bawah anestesia setempat

Pemeriksaan fiberoptik trakea dan bronkus termasuk biopsi/pengeluaran bahan asing

725 505

Lavaj bronkus (diagnostik atau terapeutik)

865

Pendilatan striktur trakea termasuk penyelitan sten

865

P.U. (A) 358

64

Pendilatan striktur bronkus melalui bronkoskop fiberoptik

1000

Biopsi transbronkial 1000 Bronkus, paru-paru dan pleura

Pemeriksaan diagnostik bronkus menggunakan bronkoskop keras termasuk biopsi/pengeluaran bahan asing/pendilatan striktur

1000 505

Pneumonektomi total 3600 1550 Lobektomi terbuka paru-paru termasuk eksisi segmen

3600 1550

Reseksi paru-paru dengan reseksi dinding dada

5970 1815

Reseksi paru-paru toraskopik termasuk bantuan video

1890 685

Eksisi terbuka lesi paru-paru 2895 1320 Biopsi jarum paru-paru 480 315 Pendekorteksan pleura atau paru-paru 2895 1125 Pleurektomi bagi pneumotoraks 2480 985 Eksisi terbuka/biopsi lesi pleura 2705 940 Eksisi endoskopik lesi paru-paru/pleura 1000 505 Torakoskopi (serta/tanpa biopsi) pleura/paru-paru

580 505

Penyaliran kaviti pleura 580 315 Penyelitan saliran tiub ke dalam kaviti pleura

580 315

Pemasukan bahan ke dalam kaviti pleura dengan saliran dada

315 265

Biopsi pleura 580 315 Transplan paru-paru 7030 3305 Pembedahan pengurangan isi padu paru-paru

4750 2500

Mediastinum

Timektomi 2145 1550 Eksplorasi mediastinum 1160 760 Eksisi endoskopik lesi mediastinum 1340 505 Pemeriksaan endoskopik diagnosis mediastinum

1340 505

Pembedahan kardium jantung

Pembetulan Tetralogi Fallot (TOF) 7030 3305 Songsangan atrium bagi transposisi pembuluh besar

7030 3305

Pembetulan lain transposisi pembuluh besar

7030 3305

P.U. (A) 358

65

Pembetulan sambungan vena pulmonari anomalus total

7030 3305

Penutupan kecacatan septum atrioventrikel menggunakan tampalan prostetik dual

7030 3305

Penutupan kecacatan septum interatrium 7030 2930 Penutupan kecacatan septum interventrikel

7030 2930

Pembedahan terapeutik transluminal ke atas septum jantung

2895 2500

Pembentukan konduit injap kardium 7030 3305 Eksisi tumor kardium 7030 3305 Penggantian injap mitral termasuk valvuloplasti

7030 2930

Pembaikan plastik injap mitral 7030 2930 Penggantian injap aorta termasuk valvuloplasti

7030 2930

Penggantian injap trikuspid 7030 2930 Penggantian injap pulmonari termasuk valvuloplasti/valvotomi

7030 2930

Penggantian injap jantung tidak khusus 7030 2930 Valvotomi terbuka 7030 2930 Valvotomi tertutup (mitral/pulmonari) 4750 2500 Pembedahan terapeutik transluminal ke atas injap jantung

2705 2110

Pengeluaran penyumbatan daripada struktur bersebelahan injap jantung

7030 2930

Pintasan autograf bagi arteri koronari termasuk pengeluaran graf dan endarterektomi

7030 2930

Pembuatan semula pintasan arteri koronari termasuk pembuangan graf

7030 3305

Pembetulan arteri koronari anomali 7030 3305 Pembedahan terbuka ke atas sistem konduksi jantung

7030 2930

Pembaikan aneurisme ventrikel 5970 2930 Eksisi perikardium 3600 1125 Dekompresi tamponad kardium 2305 985 Insisi perikardium 1340 985 Graf pintasan arteri koronari midcab tanpa pam pintasan cardio-pulmonari

7030 3305

Pembedahan jantung terbuka dengan penerokaan minima dengan pam pintasan kardio-pulmonari

7030 3305

Alat bantuan ventrikular 7030 3305 Transplan jantung 7030 3305

P.U. (A) 358

66

Kardiologi jantung Angioplasti transluminal perkutaneus arteri koronari termasuk laser

2895 1550

Angioplasti transluminal perkutaneus dengan penyelitan sten

3600 1550

Pembedahan berpandukan peta bagi aritmia ventrikel termasuk pemetaan

2705 3305

Ablasi transluminal perkutaneus nodus ventrikel

2390 985

Ablasi transluminal perkutaneus laluan aksesori termasuk pemetaan

4750 1550

Pemetaan sistem konduksi (dalam pengasingan)

1565 820

Sistem perentak kardium dimasukkan melalui vena (bilik tunggal)

1565 820

Sistem perentak kardium dimasukkan melalui vena (dua bilik)

2145 820

Peletakan semula sistem perentak kardium intravena

1340 685

Penggantian penjana bagi sistem perentak kardium intravena

1760 760

Pengeluaran sistem perentak dengan pintasan

4750 2500

Pengeluaran sistem perentak tanpa pintasan

580 940

Penanaman kardiokonverter/detibrilator automatik

3600 940

Pengkateteran kardium dewasa termasuk arteriografi koronari/pengkateteran bahagian kanan/kiri jantung/radiologi kontras

1340 760

Pengkateteran kardium pediatrik 1565 820 Perikardiosentesis 1340 685 Angioplasti periferal transluminal perkutaneus (femoral, iliak, renal, popliteal, subklavian dan pembuluh distal lain)

2705 1550

Angioplasti periferal transluminal perkutaneus dengan peletakan sten

2895 1550

Angioplasti karotid transluminal perkutaneus dengan peletakan sten

4750 1550

Ablasi transluminal perkutaneus takikardia ventrikel

3600 1550

Pengubahsuaian transluminal perkutaneus nodus atrioventrikel

2480 985

Oklusi transluminal perkutaneus fistula koronari/malformasi arteriovenus (AV)

3600 1550

P.U. (A) 358

67

Pembuluh besar Pembetulan trunkus arteriosus 4750 3305 Ligasi tertutup duktus arteriosus paten 3600 2110 Oklusi prostesis transluminal perkutaneus duktus arteriosus paten

2895 1125

Penciptaan pintas ke arteri pulmonari daripada aorta menggunakan prostesis tiub

5970 2110

Sambungan ke arteri pulmonari daripada aorta

5970 2110

Penciptaan pintas ke arteri pulmonari daripada arteri subklavian menggunakan tiub prostesis antara kedudukan

4750 2110

Sambungan ke arteri pulmonari daripada arteri subklavian

5970 2110

Pembaikan arteri pulmonari 7030 2110 Pembedahan terbuka arteri pulmonari 3600 2110 Embolektomi pulmonari 5970 3305 Pembedahan transluminal ke atas arteri pulmonari

2705 1550

Penggantian kecemasan segmen aneurismal pada aorta menaik

7030 3305

Penggantian kecemasan segmen aneurismal pada aorta arkus

7030 3305

Penggantian kecemasan segmen aneurismal pada aorta torasik

7030 3305

Penggantian terancang segmen aneurismal pada aorta menaik

4750 2930

Penggantian terancang segmen aneurismal pada aorta arkus

7030 3305

Penggantian terancang segmen aneurismal aorta torasik

7030 3305

Penggantian aneurisme torakoabdominal 7030 3305 Prostesis aorta abdominal tinjauan semula

4750 2110

Eksisi graf aorta terinfeksi dengan pintasan

7030 3305

Pembaikan plastik aorta 4750 1815 Pembedahan belon transluminal perkutaneus pada aorta

1760 625

Lain-lain

Vagotomi gaster proksimal 2040 685 Vagotomi pilihan tinggi 2040 685 Vagotomi dengan piloroplasti 2145 820 Kardioversi eksternal 315 315 Ekokardiografi transoesofageal 1000 435

P.U. (A) 358

68

Pasukan tunggu sedia angioplasti koronari

315 355

(u) Sistem urinari dan organ reproduktif lelaki

Ginjal/pelvik renal

Pemindahan ginjal 4750 2500 Nefrektomi dan eksisi tisu sekeliling ginjal

2390 1125

Nefro-ureterektomi 2390 820 Eksisi ginjal dipindah tertolak 2040 760 Nefrektomi (dan dwisisi) 2040 820 Nefrektomi laparoskopik 2040 820 Eksisi separa ginjal 2145 820 Pieloplasti terbuka 2040 685 Pembaikan luka ginjal 2305 760 Pembuangan terbuka kalkulus dari ginjal 2390 685 Penyaliran ginjal 1760 760 Penyaliran pionefrosis 1760 760 Pembedahan terbuka lain ginjal 1890 685 Penyaliran abses perinefrik 1760 685 Fragmentasi endoskopik kalkulus ginjal 1890 685 Nefrolitotomi perkutaneus termasuk sistoskopi dan pengkateteran retrograd

3600 985

Pemeriksaan endoskopik diagnostik ginjal termasuk biopsi dan tatacara terapeutik lain

2040 685

Biopsi jarum halus perkutaneus lesi ginjal 480 355 Insersi perkutaneus tiub nefrostomi 1340 405 Biopsi jarum tru-kut perkutaneus lesi ginjal

865

Fragmentasi ekstrakorporeaum kalkulus ginjal (Litotripsi) - satu rawatan

1160 505

Fragmentasi ekstrakorporeum kalkulus ginjal tiada batu/satu kitaran rawatan

1565 625

Pengeluaran laparoskopi sista renal 2040 760 Pembedahan batu terbuka bagi ginjal ladam

3600

Piloplasti bagi ginjal ladam 3600 Ureter

Eksisi segmen ureter 1760 625 Pembentukan konduit ilium termasuk penanaman ureterik

2390 985

Penanaman semula dwisisi ureter ke dalam usus

2705 940

P.U. (A) 358

69

Penanaman semula satu sisi ureter ke dalam usus

2145 820

Penanaman semula dwisisi ureter ke dalam pundi kencing

2480 940

Penanaman semula satu sisi ureter ke dalam pundi kencing

1890 820

Penyambung lain bagi ureter 2145 820 Penggantian ilium atau kolonic bagi ureter

2895 940

Ureterostomi - penutupan 2145 685 Pembetulan terbuka refluks vesiko-ureterik - unilateral

2145 685

Pembetulan terbuka refluks vesiko-ureterik - dwisisi

3600 985

Ureterolitotomi terbuka 1890 685 Uretorolisis - unilateral 2145 685 Uretorolisig - dwisisi 2570 1320 Pembedahan nefroskopik terapeutik ke atas ureter

1760 820

Pengekstrakan ureterskopik kalkulus ureter

1340 435

Insersi endoskopik prostesis ke dalam ureter

1000 435

Pengeluaran prostesis dari ureter 480 435 Meatotomi ureterik 480 265 Pemeriksaan endoskopik ureter 865 435 Pielografi retrogred endoskopik 865 435 Gelombang kejutan ekstrakorporeum litotripsi kalkulus ureter

1160 685

Pembedahan pada orifis ureterik 725 505 Meatotomi endoskopik orifis ureterik 725 505 Biopsi ureterskop lesi 1565 570 Peralihan kontinen urinari 4750 Penggantian sistoskopi 4750 Transureteroureterostomi 2705 Insersi endoskopik prostesis tetap ke dalam ureter

2145

Pundi kencing

Tatacara anti - refluks endoskopik (dan dwisisi)

1340 505

Sistektomi menyeluruh (dengan pembinaan konduit usus atau pundi kencing)

4750 1550

Sistektomi separa 2040 685 Divertikulektomi pundi kencing 1760 685 Pembesaran pundi kencing 2895 820

P.U. (A) 358

70

Pembaikan pundi kencing 2145 685 Pembaikan fistula vesikokolik 2305 820 Pembaikan fistula vesikal kutaneus 1160 820 Sistostomi dan insersi tiub suprapubik ke dalam pundi kencing

725 625

Sistotomi tikaman 315 265 Pengeluaran terbuka kalkulus dari pundi kencing

1340 505

Eksisi terbuka lesi dari pundi kencing 1890 685 Reseksi endoskopik lesi pundi kencing 1890 685 Penghancuran endoskopik lesi pundi kencing

865 435

Transaksi endoskopik pundi kencing 1890 685 Pengembungan hidrostatik endoskopik pundi kencing

405 265

Sfinkterotomi 1160 435 Litolapaksi 1760 685 Ekstraksi endoskopik kalkulus pundi kencing

1000 435

Pengeluaran endoskopik bahan asing daripada pundi kencing

1000 435

Reseksi leher pundi kencing 1340 435 Pemeriksaan diagnostik endoskopik pundi kencing termasuk sebarang biopsi

580 315

Kajian urodinamik/penaksiran urodinamik

580

Penutupan sistostomi 865 435 Pembedahan gabungan abdominal dan vagina bagi menyokong saluran keluar pundi kencing wanita

1890 685

Pembedahan anduh suprapubik 1890 760 Gantungan retropubik leher pundi kencing

1890 685

Pembedahan vagina bagi menyokong saluran keluar pundi kencing wanita

1890 685

Penanaman sfinkter tiruan urinari ke pundi kencing dan/atau pengeluaran

2145 685

Pendilatan saluran keluar pundi kencing wanita (dengan sistoskopi)

580 355

Insisi endoskopik saluran keluar pundi kencing lelaki (dengan sistoskopi)

1340 435

Pembaikan fistula vesiko-vagina 2145 820 Vesiko-litotripsi endoskopik batu pundi kencing

1760 625

Sistoskopi dengan biopsi 1000 405 Reseksi endoskopik tumor jangkau dalaman pundi kencing

2145

P.U. (A) 358

71

Kontinen kantung/neo pundi kencing 4750 2500 Penutupan kombinasi abdomino-perineal fistula vesiko-vaginal

4750

Uretra

Uretrosele 1160 505 Eksisi karunkel uretra 370 265 Pembedahan endoskopik terapeutik pada saluran keluar pundi kencing wanita

725 405

Uretrektomi 1760 685 Reseksi injab uretra 1565 505 Pembaikan hipospadias 2040 685 Pembaikan epispadias 2480 685 Penutupan fistula uretra 865 505 Pembaikan fistula ureterorektal 1760 685 Ureteroplasti (mudah) 1760 625 Ureteroplasti (kompleks) 2040 685 Pembaikan pecahan pada uretra 2040 685 Eksisi pada divetilula uretra 1160 505 Eksisi pada prolaps uretra 480 405 Pembedahan endoskopik terapeutik pada uretra

865 435

Pengeluaran bahan asing daripada uretra 405 435 Pemeriksaan endoskopik diagnostik uretra dalam isolasi

405 265

Pendilatasian uretra 315 355 Uretrotomi dalaman termasuk sistoskopi 865 435 Penutupan eksostrofi pundi kencing 5970 Penutupan eksostrofi kloakal 7030 Pembaikan hipospadias - sedikit 2305 Pembaikan hipospadias - sederhana 2895 Pembaikan hipospadias - tersangat 3600

Prostat Eksisi terbuka prostat 2040 685 Prostektomi radikal, rekonstruksi leher pundi kencing termasuk limfadinektomi pelvik dwisisi

4750 1550

Biopsi terbuka lesi prostat 865 685 Reseksi endoskopik prostat (TURP) 2040 760 Biopsi endoskopik prostat 865 435 Terapi gelombangmikro transuretral 1565 570 Penyaliran abses prostat 1340 505 Hiperthermia prostatik (sehingga enam siri)

1565 570

Prostat, biopsi jarum 405 265 Ultrasound dan biopsi transrektal 580

P.U. (A) 358

72

Memasukkan sten uretra bagi kelegaan halangan prostat

1890 685

Genitalia

Meatoplasti 725 355 Meatotomi luaran orifis uretra 580 265 Eksisi dwisisi testis 1760 625 Orkidektomi laparoskopik 1340 435 Orkidektomi dan eksisi korda spermatik 1340 435 Eksisi lesi testis 725 505 Orkidopeksi - dwisisi 1760 820 Pemindahan mikrovaskular testis ke skrotum

2305 820

Orkidopeksi 1000 505 Testis abdomen yang tidak turun 1565 625 Testis prostesis (kemasukan atau pembuangan)

725 405

Pembetulan hidrosele 725 435 Fiksasi testis 865 435 Biopsi testis 580 315 Eksplorasi testis termasuk biopsi 865 435 Fiksasi testis dwisisi 865 505 Epididimektomi dwisisi 1340 570 Epididimektomi satu sisi 865 505 Eksisi sista epididimal 865 505 Pembedahan varikocele 865 505 Vasografi 370 315 Pembedahan vesikel seminal 1565 505 Amputasi total penis 2145 685 Amputasi separa penis 1565 685 Pembedahan bagi penyakit Peyronie 1160 435 Rekonstruksi penis 1760 685 Pembaikan avulsi penis 2145 685 Pembaikan kecederaan pada penis 1340 505 Pembahagian perekatan preputial 405 265 Berkhatan 725 405 Biopsi lesi penis 405 265 Prostesis penis (mudah - rod sahaja) 1890 685 Prostesis penis (kompleks - tiga keping) 2895 1815 Pembalikan vasektomi - dwisisi (mikroskopik)

1760 625

Pembalikan vasektomi - dwisisi (makroskopik)

1890 685

Epididimo-vasostomi (makroskopik) 1890 685 Epididimo-vasostomi (mikroskopik) 2040 760 Tenkoff 1340 Tenkoff dan adesiolisis 1890

P.U. (A) 358

73

Ultrasound transrektal (diagnostik) 580 Ultrasound transrektal dan biopsi prostat sistematik

1000

Eksisi dan graf bagi penyakit Peyronie 2705

Lain-lain Diseksi blok nodus limfa para-aortik 2570 760

(v) Sistem vaskular (selain daripada intratorasik) Kepala dan leher Pintasan arteri karotid daripada arkus 4750 1550 Endarterektomi karotid 4750 1550 Rekonstruksi arteri karotid (tampalan vena dan pintasan)

3600 1550

Pintasan arteri subklavian daripada arkus 4750 1550 Pintasan arteri subklavian - ekstratoraks 2895 1320 Endarterektomi dan pembaikan tampalan arteri subklavian

4750 1550

Renal

Endarterektomi arteri renal 4750 1550 Rekonstruksi arteri renal 4750 1550 Pembedahan transluminal arteri renal 1565 685

Salur darah abdominal Pintasan aksilo-femoral 2895 1550 Pintasan aksilo-bifemoral 2895 1550 Graf tiub aneurisme aorta abdominal infrarenal

4750 1815

Graf dwicabangan aneurisme aorta abdominal infrarenal

5970 1815

Prostesis aorta abdominal tinjauan semula

4750 2110

Pembedahan belon transluminal perkutaneus pada aorta

1760 625

Endarterektomi karotid (dengan tampalan)

5970

Endarterektomi dan pembaikan tampalan cabang viseral pada aorta abdominal

5970 2110

Pembedahan terbuka yang lain pada cabang viseral aofla abdominal lain

5970 2110

Pembuluh ileo-femoral

Pintasan aorto-iliak, aorto-femoral, ileo-femoral

4750 1550

Pintasan aorto-bifemoral 4750 1550

P.U. (A) 358

74

Endarterektomi dan pembaikan tampalan arteri iliak

3600 1550

Pembedahan terbuka arteri iliak 3600 1550 Pembedahan transluminal arteri iliak 1340 505 Pintasan femoro-femoral 2895 1320 Pintasan femoro-popliteal menggunakan prostesis dan/atau vena dan/atau kuf/tampalan vena

3600 1550

Pintasan betis femoro-distal menggunakan prostesis dan/atau vena dan/atau kuf/tampalan vena

3600 1550

Endarterektomi arteri femoral 2895 1125 Rekonstruksi/pintasan bagi aneurisme popliteal

3600 2110

Tatacara transluminal arteri femoral 1565 505 Graf pintasan femoral tinjauan semula 2705 1320

Tidak spesifik Rekonstruksi arteri tinjauan semula 3600 940 Biopsi arteri termasuk temporal 580 265 Pembaikan arteri 2305 685 Graf mikro-arteri atau mikro-vena 4750 1550 Pembaikan arteri menggunakan graf vena 2705 940 Pembaikan pembedahan mikro arteri 2705 985 Embolektomi terbuka arteri 2570 940 Angioplasti transluminal perkutaneus arteri

1340 625

Ciptaan fistula arteriovenous (AV) termasuk penutupan seterusnya

1340 820

Eksisi malformasi AV 7030 2110 Pembaikan fistula AV perolehan 2895 985 Pembaikan fistula AV 2895 1125 Ciptaan penyimpangan peritenio-vena (Levine/Denver)

1340 435

Pengeluaran terbuka trombus daripada vena

2145 685

Insersi garisan Hickman, saluran tengah terowong, dsb.

725 505

Kemasukan unit portocath/vasiport 1000 405 Perfusi anggota terpencil 2705 1320

Vena varikos

Ligasi/pelucutan vena safenus panjang atau pendek termasuk eksisi selempat/flebektomi berbilang

1340 505

P.U. (A) 358

75

Ligasi/pelucutan vena safenus panjang atau pendek termasuk eksisi setempat/flebektomi berbilang - dwisisi

2145 820

Pembedahan bagi vena varikos berulang 2145 760 Pembedahan bagi vena varikos berulang - dwisisi

3600 1125

Ligasi/pelucutan vena safenus panjang dan pendek termasuk eksisi setempat/flebektomi berbilang

2145 760

Eksisi setempat (flebektomi berbilang) vena varikos kaki

725 505

Ligasi/pelucutan vena safenus panjang dan pendek termasuk eksisi setempat/flebektomi berbilang - dwisisi

3600 1125

Venografi -dwisisi 405 Pintasan femoro-popliteal menggunakan prostesis

4750

Pintasan femoro-popliteal menggunakan prostesis vena/atau kuf/tampalan

5970

Ciptaan fistula arteriovenous menggunakan graf/prostesis

3600

Limfatik

Diseksi blok nodus limfa servikal (tidak termasuk dalam tatacara lain)

2895 940

Diseksi blok nodus limfa aksilari 1760 625 Diseksi blok nodus limfa para-aorta 2570 760 Diseksi blok nodus limfa inguinal 1760 685 Diseksi blok nodus limfa pelvik (tidak termasuk dalam tatacara lain)

2040 760

Biopsi/persampelan nodus limfa servikal 405 505 Biopsi/persampelan nodus limfa aksilari 405 315 Biopsi/persampelan nodus limfa inguinal 405 405 Biopsi eksisi nodus limfa 725 435 Biopsi eksisi nodus limfa skalen 725 435 Penyaliran lesi nodus limfa 480 265 Pembedahan duktus limfatik 2305 820 Eksisi sistik higroma 1565 760

(w) Tulang, sendi, dsb. (tidak disenaraikan di mana-mana)

Tisu penghubung/otot tendon Fasiektomi plantar 725 505 Eksisi lesi fasia 480 505 Pembedahan fasia lain 580 315 Eksisi ganglion, termasuk eksisi ulangan 1000 315 Eksisi bursa 725 405

P.U. (A) 358

76

Pemindahan tendon 1000 435 Pemindahan tendon berbilang 1565 685 Eksisi lesi tendon 725 435 Graf tendon, sebagai tatacara tunggal 1340 435 Pembaikan tendon sekunder termasuk graf, pemindahan dan/atau prostesis

1890 505

Tenolisis, selain daripada fleksor 1000 435 Tenotomi perkutaneus 405 265 Pemanjangan tendon, termasuk tenotomi 1160 435 Tenosinovektomi, termasuk artroskopik 865 435 Pelepasan pencerutan sarung tendon 1000 435 Pembaikan terhad otot iaitu koyakan tidak lebih daripada 2 sm (cth: kuf rotator), termasuk artroskopik

725 625

Pembaikan menyeluruh otot iaitu koyakan lebih daripada 2 sm (cth: kuf rotator) termasuk artroskopik

2145 625

Pelepasan pencerutan otot 1160 570 Biopsi otot terbuka 580 315 Biopsi jarum/tru-kut otot 315 Eksisi lesi otot tanpa graf kulit 1565 625 Eksisi lesi otot dengan graf kulit 1890 685

Tulang (tidak spesifik) Biopsi tulang terbuka 725 405 Introduksi bahan terapeutik ke dalam tulang (cth: seperti aplikasi antibiotik bagi penggantian pinggul yang dijangkiti sebagai tatacara tunggal)

580 265

Pembuangan wayar dari tulang, termasuk wayar-K

405

Eksisi tulang ektopik 580 405 Eksisi total tulang sesamoid 725 435 Eksisi separa tulang termasuk eksostosis 1000 405 Eksisi total tulang dengan/tanpa penggantian/rekonstruksi prostetik (cth: trapezium)

2480 820

Reseksi radikal tumor tulang 2705 820 Osteotomi tulang besar, dengan/tanpa fiksasi, termasuk graf

2040 685

Penyaliran/pembersihan tulang, termasuk sekuestrektomi bagi osteomilitis

1340 405

Fiksasi epifisis 1160 685

Fraktur Reduksi terbuka primer fraktur femur 2305 760

P.U. (A) 358

77

dan fiksasi terbuka menggunakan pin dan plat Reduksi tertutup primer fraktur atau dislokasi sendi, dengan/tanpa fiksasi termasuk plaster Paris (POP)(cth: Colles')

725 405

Reduksi tertutup fraktur tulang panjang dan fiksasi luaran termasuk POP dan wayar-K perkutaneus (cth: lengan bawah)

1760 685

Reduksi tertutup fraktur tulang kecil dan fiksasi luaran termasuk POP dan wayar-K perkutaneus

865 505

Reduksi terbuka primer tulang panjang dengan fiksasi

2040 760

Reduksi terbuka primer fraktur dengan/tanpa dislokasi sendi

1890 685

Reduksi terbuka primer tulang kecil dengan fiksasi termasuk intra-artikular

1340 570

Reduksi terbuka primer fraktur intra-artikular tulang panjang (cth: humerus proksimal)

1890 760

Reduksi terbuka fraktur pelvis dan fiksasi dalaman

2895 760

Reduksi terbuka dan fiksasi dalaman fraktur pelvis asetabular kompleks

4750 1550

Reduksi terbuka sekunder dislokasi sendi 865 405 Reduksi terbuka sekunder fraktur tulang kecil termasuk intra-artikular

1340 505

Reduksi terbuka sekunder fraktur tulang panjang dan fiksasi intermedulari atau fiksasi dalaman bagi tulang tidak bersambung/sambungan tidak sempurna

1890 685

Pakuan intramedulari berkunci 2705 820 Reduksi terbuka sekunder fraktur intra-artikular tulang

1890 685

Aplikasi rangka Ilizarov bagi tulang tidak bersambung/sambungan tidak sempurna sekunder

4750 1550

Penyesuaian lingkaran rangka Ilizarov bagi tulang tidak bersambung/ sambungan tidak sempurna sekunder

1760 505

Penyesuaian tapak pin sekunder bagi tulang tidak bersambung/sambungan tidak sempurna

580

Graf tulang (kecuali di mana bahagian tatacara lain)

1565 570

Pengeluaran fiksasi dalaman/prostesis dari tulang/sendi tidak termasuk wayar-K

1340 435

P.U. (A) 358

78

Pengeluaran wayar dari tulang, termasuk wayar-K

405 315

Pencucian pembedahan ke atas luka di bawah anestetik umum

480 265

Saraf Pelepasan pemerangkapan saraf periferi di tempat paling dalam termasuk Interos Anterior dan saraf Interos Posterior

865 435

Transposisi anterior saraf ulna 1000 505 Trarisposisi submuskular saraf ulna 1890 505 Tinjauan semula pelepasan saraf periferi 1565 505 Eksplorasi/neurolisis/biopsi saraf periferi

865 355

Sendi (tidak disenaraikan di mana-mana)

Eksisi membran sinovial sendi 1565 625 Penggantian/rekonstruksi/pembaikan ligamen prostetik primer termasuk prostesis

1565 505

Pembedahan yang menstabilkan ke atas sendi

1565 625

Pelepasan kontraktur sendi 1160 405 Artrotomi sendi besar termasuk pembuangan bahagian longgar dari sendi

1160 405

Artrotomi sendi kecil termasuk pembuangan bahagian longgar dari sendi

315 265

Pembedahan artroskopik terapeutik ke atas rawan intra-artikular (selain daripada W8200)

1160 505

Pembedahan artroskopik terapeutik ke atas rawan intra-artikular (selain daripada W8200) - dwisisi

1890 820

Pembedahan artroskopik terapeutik ke atas kaviti sendi

1890 505

Pembedahan artroskopik terapeutik ke atas kaviti sendi - dwisisi

2895 820

Pemeriksaan artroskopik diagnostik sendi, dengan/tanpa biopsi

865 435

Suntikan ke dalam sendi di bawah kawalan sinar-X

480 265

Manipulasi sendi 405 405

Sendi (tidak disenaraikan di mana-mana) Penggantian prostetik artikulasi tulang 2145 685 Interposisi artroplasti sendi prostetik (cth: pinggul, lutut, bahu)

2305 820

Rekonstruksi eksisi sendi 1760 625

P.U. (A) 358

79

Fiksasi/Artrodesis

Osteirtomi pinggul dengan fiksasi 2305 940 Osteotomi pelvis dengan fiksasi 3600 940 Artrodesis primer sendi besar dan graf tulang

1760 820

Artrodesis primer dan fiksasi dalaman (cth: tangan/kaki) termasuk graf tulang

1160 685

Tangan

Fasiotomi subkutaneus Dupuytren 580 315 Fasiektomi Dupuytren - digit tunggal 1160 435 Fasiektomi Dupuytren bagi tapak tangan dan digit berbilang

1760 625

Dermofasiektomi dan graf Dupuytren, atau bagi penyakit berulang

2145 820

Pembaikan extensor tangan 865 435 Pembaikan fleksor tangan termasuk implan prostetik

1760 435

Pembaikan sekunder atau peringkat kedua fleksor tangan termasuk implan prostetik

1890 570

Pembaikan sekunder tendon tangan/lengan bawah (tidak termasuk fleksor), tanpa pemindahan atau graf

1000 435

Pembaikan sekunder tendon tangan/lengan bawah (tidak termasuk fleksor), dengan pemindahan/graf

1760 435

Graf tendon sebagai tatacara tunggal 1340 435 Tenolisis - selain daripada fleksor 1160 435 Tenolisis fleksor 1565 435 Polisisasi jari bagi rekonstruksi ibu jari tangan

3600 435

Pembaikan kecederaan hujung jari akibat avulsi dengan flap

1565 505

Tatacara berbilang sendi pada tangan termasuk sinovektomi

2390 820

Cantuman sendi metakarpo-falang/interkarpus

1000 570

Artroplasti prostetik sendi digit 1760 435 Graf tulang pada skafoid dengan fiksasi dalaman, termasuk skru Herbert

1890 625

Amputasi tangan 1565 625 Amputasi digit 1000 505 Amputasi melalui mid-karpus/ transmetakarpus

1000 435

Cantuman pergelangan tangan 2040 820

P.U. (A) 358

80

Bahu Pembaikan terhad otot iaitu koyakan kurang daripada 2 sm (cth: kuf rotator) termasuk artroskopik

725 625

Pembaikan menyeluruh otot iaitu koyakan lebih daripada 2 sm (cth: kuf rotator) termasuk artroskopik

2145 625

Pembaikan kuf rotator tinjauan semula 2145 625 Akromiopiasti 1565 625 Eksisi klavikel distal, secara isolasi 1565 625 Interposisi artroplasti sendi prostetik (cth: pinggul, lutut, bahu)

2305 820

Pembaikan primer sendi akromioklavikular yang pecah termasuk fiksasi dalaman

2705 685

Pembaikan sekunder sendi akromioklavikular yang pecah termasuk fiksasi dalaman

2705 685

Rekonstruksi sendi akromioklavikular 2705 685 Hemiartroplasti bahu 2305 685 Hemiartroplasti bahu tinjauan semula 2570 685 Penggantian total bahu primer 2705 940 Penggantian total bahu tinjauan semula 3600 1550 Penstabilan sendi bahu termasuk anterior, postefior atau pelbagai arah (termasuk artroskopik)

1890 685

Penstabilan sendi bahu tinjauan semula 2390 760 Pelepasan kontraktur bahu 2145 685 Penyaduran dan/atau graf tulang bagi klavikel yang tidak bersambung

2040 685

Eksplorasi dan cantuman pleksus brakial 3600 2110 Dekompresi sub-akromial termasuk artroskopik

1890 685

Eksisi total servikal atau rusuk pertama 2145 820 Siku

Penggantian prostetik total siku 2705 940 Penggantian prostetik total siku tinjauan semula

3600 1550

Pelepasan kontriksi pada salutan tendon 1000 435 Pinggul, kaki dan pelvis

Eksisi lesi tulang pelvis/pinggul 1565 685 Osteotomi pinggul dengan fiksasi 2305 940 Osteotomi pelvis dengan fiksasi 3600 940 Penggantian prostetik total sendi pinggul 2705 985

P.U. (A) 358

81

Penggantian prostetik total sendi pinggul tinjauan semula

3600 1550

Penggantian prostetik total sendi pinggul- dwisisi

4750 1550

Penggantian prostetik kepala femur 2145 820 Pelepasan fasiotomi kompartment anterior/ posterior tulang keting

1760 625

Amputasi tulang keting/kaki 2040 685 Manipulasi dan plaster Paris (POP) pinggul

580 405

Lutut Pembedahan artroskopik terapeutik rongga sendi

1890 505

Pembedahan artroskopik terapeutik rongga sendi- dwisisi

2895 820

Pemeriksaan artroskopik diagnostik sendi,dengan/tanpa biopsi

865 435

Penggantian prostetik total sendi lutut 2705 985 Penggantian lutut unikompartment 2705 820 Penggantian total sendi lutut tinjauan semula

3600 1550

Penggantian prostetik total sendi lutut - dwisisi

4750 1550

Penggantian prostetik primer ligamen krusiat

2480 820

Rekonstruksi autograf ligamen krusiat termasuk artroskopik

2570 940

Penstabilan patella 2480 940 Pembedahan artroskopik terapeutik rawan semi lunar

1890 685

Pembedahan artroskopik terapeutik rawan semi lunar - dwisisi

2895 985

Pembaikan mudah ligamen lutut 1890 570 Pembedahan artroskopik terapeutik pada rongga lutut

1890 685

Pembedahan artroskopik terapeutik pada rongga lutut - dwisisi

2895 985

Kaki

Pembaikan primer tendon kaki 480 435 Pembaikan primer tendon Achilles 1160 435 Pembaikan sekunder tendon Achilles 1890 435 Pembaikan sekunder tendon kaki 725 435 Tatabara sendi berbilang kaki hadapan 2390 760 Tatacara sendi berbilang kaki hadapan - dwisisi

3600 1125

P.U. (A) 358

82

Osteotomi metatarsal (cth: akin, mcNab, dsb.)

865 435

Cantuman sendi metatarso-falang pertama

1000 505

Cantuman sendi metatarso-falang pertama - dwisisi

1760 820

Seilektomi metatarso-falang 1565 505 Cantuman tiga sendi-sendi kaki belakang 1890 685 Osteotomi pes klavus 1890 685 Pembetulan kecacatan kongenital kaki minor

1565 505

Pembetulan kecacatan kongenital kaki minor - dwisisi

2480 820

Penggantian prostetik total sendi pergelangan kaki

2705 940

Penggantian prostetik total sendi pergelangan kaki tinjauan semula

3600 1550

Penutupan osteotomi baji/translasi taji kalkaneum termasuk fiksasi dalaman

1760 505

Artroplasti eksisi sendi metatarso-falang pertama dengan implan prostetik

1760 625

Artroplasti eksisi sendi metatarso-falang pertama termasuk Keller

1160 505

Artroplasti eksisi sendi metatarso-falang pertama termasuk Keller - dwisisi

1890 820

Cantuman sendi interfalang ibu jari kaki 1000 435 Pembetulan sendi metatarso-falang yang tertarik/dislokasi termasuk pemindahan tendon, pembahagian/penyusunan semula tulang dan fiksasi dalaman

1890 820

Cantuman sendi interfalang ibu jari kaki - dwisisi

1760 760

Artrodesis primer dan fiksasi dalaman (tangan/kaki) termasuk graf tulang

1160 685

Buniektomi mudah 725 355 Buniektomi mudah - dwisisi 1160 625 Osteotomi metatarsal valgus Hallux 1340 685 Osteotorni metatarsal valgus Hallux - dwisisi

2145 985

Osteotomi metatarsal valgus Hallux, dengan fiksasi dalaman dan pembetulan tisu lembut

1890 760

Osteotomi metatarsal valgus Hallux, dengan fiksasi dalaman dan pembetulan tisu lembut - dwisisi

2895 1125

Amputasi jari kaki

1000 435

P.U. (A) 358

83

Eksisi radikal tumor tulang dengan implan prostesis bagi anggota

4750 1550

Fiksasi luaran/tarikan

Aplikasi tarikan rangka kepada tulang 580 505 Pengeluaran tarikan rangka daripada tulang

405 315

Aplikasi fiksasi luaran kepada tulang 1760 505 Pengeluaran fiksasi luaran daripada tulang

580 315

(x) Muka, mulut dan leher (tidak disenaraikan di mana-mana)

Muka dan rahang

Reduksi terbuka fraktur maksila 1340 685 Reduksi tertutup fraktur maksila 725 570 Reduksi fraktur tulang muka yang lain 580 435 Reduksi fraktur tulang komplek zigomatik 1000 505 Reduksi terbuka fraktur tulang kompleks zigomatik

1565 570

Eksisi maksila 2040 940 Hemi-maksilektomi formal bagi malignan 2570 940 Fiksasi dalaman maksila 725 685 Fiksasi ekstra-oral maksila 725 685 Pengeluaran fiksator daripada maksila 580 570 Biopsi lesi tulang muka 405 355 Eksisi mandibel 2040 940 Eksisi mandibel yang luas 2390 985 Eksisi lesi rahang 1160 435 Reduksi terbuka fraktur mandibel 1000 685 Reduksi tertutup fraktur mandibel 580 570 Fiksasi intermaksilari mandibel 725 685 Fiksasi ekstra-oral mandibel 1000 685 Pengeluaran fiksator dari mandibel 580 505 Rekonstruksi rahang 2705 940 Graf tulang alveolar 1340 570 Manipulasi mandibel 405 355 Penggantian prostetik sendi temporomandibular

2305 625

Arthroplasti sendi temporomandibular 1890 625 Menisektomi sendi temporomandibular 1160 505 Reduksi dislokasi sendi temporamandibular

725 355

Bibir

Eksisi sempadan vermilion bibir dan pendahuluan mukosa bibir

1000 435

P.U. (A) 358

84

Eksisi lesi bibir 865 405 Penutupan bibir rekah (dan dwisisi) 1760 820 Penutupan primer bibir rekah tinjauan semula

2145 820

Rekonstruksi bibir menggunakan flap lidah

2145 685

Rekonstruksi bibir menggunakan flap kulit

2040 760

Sutur bibir 480 435 Biopsi lesi bibir 480 355

Lidah Glosektomi total termasuk diseksi blok 2480 760 Glosektomi separa termasuk diseksi blok 2145 820 Eksisi/pemusnahan lesi lidah 865 505 Biopsi lesi lidah 315 405 Frenotomi/frenektomi lidah 480 435 Pembebasan pelekatan lidah 315 405 Flap lidah - peringkat pertama 1760 820 Flap lidah - peringkat kedua 1000 625

Lelangit Eksisi/pemusnahan lesi lelangit 865 505 Pembaikan primer lelangit rekah 2305 820 Pembaikan lelangit rekah tinjauan semula 1565 685 Pembaikan plastik lelangit menggunakan flap lelangit

1340 685

Pembaikan plastik lelangit menggunakan flap kulit

1890 685

Jahitan lelangit 580 435 Biopsi lesi lelangit 480 405 Insisi lelangit 370 405 Pembedahan ke atas uvula 725 435

Rongga mulut Vestibuloplasti berikutan trauma 1160 435 Eksisi/pemusnahan lesi mulut 580 405 Rekonstruksi mulut menggunakan flap 2145 760 Rekonstruksi mulut menggunakan graf 1000 760 Graf kulit ke mulut 1000 625 Graf mukosa ke mulut 865 570 Jahitan mulut 580 505 Biopsi lesi mulut 370 355 Pengeluaran mukosa berlebihan dari mulut

865 435

P.U. (A) 358

85

Kelenjar liur Eksisi kelenjar parotid (selain daripada F4410/F4430)

1890 685

Eksisi total kelenjar parotid dan pemeliharaan saraf muka

3600 985

Eksisi separa kelenjar parotid dan pemeliharaan saraf muka

2895 985

Eksisi kelenjar submandibular 1340 505 Eksisi kelenjar sublingual 1000 505 Eksisi lesi kelenjar parotid 1160 505 Eksisi lesi kelenjar submandibular 1160 505 Eksisi lesi kelenjar sublingual 405 505 Insisi kelenjar parotid 405 405 Insisi kelenjar submandibular 405 405 Insisi kelenjar sublingual 405 405 Biopsi lesi kelenjar liur 580 435 Penutupan fistula kelenjar liur 865 435 Transposisi salur parotid 1160 435 Transposisi salur submandibular 1160 435 Pengekstrakan terbuka kalkulus daripada salur parotid

865 355

Pengekstrakan terbuka kalkulus daripada salur submandibular

725 435

Pengikatan salur parotid 480 435 Pengikatan salur submandibular 480 435 Pembedahan salur submandibular 480 435 Pengembangan salur parotid 405 265 Manipulasi pengeluaran kalkulus dari salur parotid

725 315

Gigi

Penanaman semula gigi berikutan trauma 865 355 Pembedahan pengeluaran gigi terimpak/tertanam

1000 435

Pembedahan pengeluaran akar tertanam yang rumit

725 435

Enukleasi sista rahang 865 435

Leher Diseksi blok nodus limfa servikal (tidak termasuk dalam tatacara lain)

2895 940

Biopsi/pensampelan nodus limfa servikal 405 505 Pembedahan ke atas sista rekahan brankial

1340 820

Pembedahan ke atas fistula rekahan brankial

2040 820

P.U. (A) 358

86

Kelenjar Tiroid dan paratiroid Tiroidektomi total 2040 820 Subtotal tiroidektomi dwisisi 2040 760 Hemitiroidektomi 2040 685 Tiroidektomi separa 2040 685 Tiroplasti (Isshiki jenis I) 1760 625 Pembedahan ke atas tisu tiroid aberan termasuk retrosternal

2480 940

Eksisi sista tiroglosal 1000 625 Eksisi laluan tiroglosal 1340 625 Eksisi lesi kelenjar tiroid 1340 435 Aspirasi jarum halus kelenjar tiroid 315 315 Biopsi jarum kelenjar tiroid 580 315 Paratiroidektomi 2705 940 Paratiroid: pembedahan kedua 2705 985 Penyaliran abses kelenjar liur 405

III. PELBAGAI 1. Fi pemeriksaan perubatan (a) Bukan pakar Butiran Fi (RM) Pemeriksaan perubatan – pra-pekerjaan, rutin dan pemeriksaan perubatan tahunan, pemeriksaan perubatan kesihatan, pemeriksaan perubatan menyeluruh, pemeriksaan perubatan penerbangan (tidak termasuk siasatan makmal, sinar-X, ECG, dsb.)

45 – 230

Pemeriksaan bagi kes medico-legal 570 – 1145 Pemeriksaan bagi penilaian kehilangan upaya

570 – 1145

Penyertaan dalam Peperiksaan Lembaga Perubatan

230 – 1145

Pemeriksaan perubatan bagi insurans hayat 90 – 230 Pemeriksaan kesihatan lesen vokasional 35 – 115 (b) Pakar Butiran Fi (RM) Pemeriksaan perubatan - pra-pekerjaan, pemeriksaan rutin dan pemeriksaan perubatan tahunan, pemeriksaan perubatan kesihatan, pemeriksaan perubatan menyeluruh, pemeriksaan perubatan

115 – 570

P.U. (A) 358

87

penerbangan (tidak termasuk siasatan makmal, sinar-X, ECG, dsb.) Pemeriksaan bagi kes medico legal 570 – 2290 Pemeriksaan bagi penilaian kehilangan upaya

570 – 2290

Penyertaan dalam Peperiksaan Lembaga Perubatan

570 – 2290

Pemeriksaan perubatan bagi insurans hayat 170 – 460 Pemeriksaan kesihatan lesen vokasional 35 – 115 2. Fi laporan perubatan Butiran Fi (RM) Bukan pakar 55 – 230 Pakar 115 – 570 3. Fi panggilan ke rumah dan bantuan perubatan (Pengamal am)

Butiran Fi (RM) Tugas perubatan bagi acara dan majlis bagi setiap jam

55

Liputan perubatan bagi pemindahan/penghantaran pulang pesakit (tidak termasuk perbelanjaan sebenar yang ditanggung untuk kos perjalanan, makan dan penginapan) bagi satu hari

570

4. Fi kehadiran di mahkamah Butiran Fi (RM) Kelayakan perbelanjaan bagi satu hari-ini adalah untuk menampung kos pengamal perubatan yang apabila dipanggil sebagai saksi, dikehendaki untuk mengkaji dan menyelidik kes yang dahulunya bukan merupakan pesakit pengamal perubatan yang sama (tidak termasuk belanja perjalanan, makan dan penginapan dan laporan perubatan)

285 – 570

Wang pengendalian Perbelanjaan sebenar yang ditanggung dalam kos perjalanan dan penginapan

Saksi bukan pakar (testimoni yang melibatkan pernyataan fakta sahaja)

570 – 1145

Saksi pakar (testimoni yang melibatkan pendapat pakar)

1145 – 2290

P.U. (A) 358

88

Laporan perubatan yang menyeluruh (diminta oleh syarikat insurans, peguam dan lain-lain)

90 – 285

Pernyataan pakar perubatan yang merawat bagi syarikat insurans

55

BAHAGIAN B - FI PERGIGIAN I. FI PERUNDINGAN Butiran Fi (RM) Perundingan sahaja Perundingan dengan pemeriksaan 30 - 285 Perundingan dengan pemeriksaan dan pelan rawatan

II. FI TATACARA PERGIGIAN ASAS Butiran Fi (RM) Pendarahan selepas cabutan 55 – 345 Rawatan untuk rongga kering 55 – 345 Tampalan sementara 35 – 170 Insisi dan penyaliran 55 – 230 Tampalan amalgam 45 – 345 Tampalan sewarna gigi/bahan lekat 55 – 685 Pembuangan kalkulus 55 – 345 Pembuangan plak dan/atau kesan ektrinsik 70 – 285 Dentur akrilik (separa) bagi setiap rahang 115 – 1145 Dentur akrilik (penuh) bagi setiap rahang 285 – 2290 Cabutan gigi dan/atau akar yang mudah tanpa pembedahan

Kekal 45 – 285 Desidus 30 – 115 Radiograf periapeks/bite wings/oklusal - bagi setiap pendedahan

25 – 115

III. PELBAGAI Butiran Fi (RM) Laporan pergigian 55 – 345 Panggilan ke rumah 170 – 570

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Fi kehadiran di mahkamah - kelayakan perbelanjaan bagi satu hari. Ini adalah untuk menampung kos pengamal pergigian yang apabila dipanggil sebagai saksi, dikehendaki untuk mengkaji dan menyelidik kes yang dahulunya bukan merupakan pesakit pengamal pergigian yang sama (tidak termasuk belanja perjalanan, makan dan penginapan dan laporan pergigian)

285 – 570

Wang pengendalian Perbelanjaan sebenar yang ditanggung dalam kos perjalanan dan penginapan

Saksi bukan pakar (testimoni yang melibatkan pernyataan fakta sahaja)

570 – 1145

Saksi pakar (testimoni yang melibatkan pendapat pakar)

1145 – 2290

Laporan pergigian yang komprehensif (diminta oleh syarikat insurans, peguam dan lain-lain)

55 – 345

Pernyataan pakar pergigian yang merawat bagi syarikat insurans

55”.

Dibuat 10 Oktober 2013 [KK(R)/654(336) (17); PN(PU2)610/IV] DATUK SERI DR. S. SUBRAMANIAM Menteri Kesihatan

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PRIVATE HEALTHCARE FACILITIES AND SERVICES ACT 1998

PRIVATE HEALTHCARE FACILITIES AND SERVICES (PRIVATE HOSPITALS AND OTHER PRIVATE HEALTHCARE FACILITIES) (AMENDMENT) ORDER 2013

IN exercise of the powers conferred by subsection 106(2) of the Private Healthcare

Facilities and Services Act 1998 [Act 586], the Minister makes the following order:

Citation

1. This order may be cited as the Private Healthcare Facilities and Services

(Private Hospitals and Other Private Healthcare Facilities) (Amendment) Order

2013.

Amendment of Thirteenth Schedule

2. The Private Healthcare Facilities and Services (Private Hospitals and Other

Private Healthcare Facilities) Regulations 2006 [P.U. (A) 138/2006], are amended by

substituting for the Thirteenth Schedule the following schedule:

“THIRTEENTH SCHEDULE

[Regulation 433] FEE SCHEDULE – PROFESSIONAL FEE

PART A - MEDICAL FEE

Note:

1. In this note:

“out-of-hours” means a period between 6 p.m. on one day and 8 a.m the following

day on weekdays, and all day on weekends and public holidays;

“emergency” means a serious situation which is said to exist when delay in

treatment may lead to increased threat to life or body part;

“surgeons’” refers to all categories of specialists and may include anaesthetists;

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“anaesthetist fee” refers to fee chargeable for induction, maintenance, reversal of

anaesthesia and standard monitoring activities. This fee is only applicable to

either general or regional anaesthesia.

2. All fees in this Schedule shall be the maximum chargeable fees and it is applicable

to any form of payment.

3. An additional fee not exceeding 50% of the maximum chargeable fee may be

charged by both surgeons and anaesthetists for emergency procedures performed

out-of-hours which shall not include elective procedures.

4. For ward visit, including post-operative rounds and care, the fees for consultation

that can be charged shall be for a maximum of two visits on the same day,

regardless of the actual number of visits made, except in cases where additional

visits are at the patient’s request or when the patient’s condition deems the

additional visit(s) necessary.

5. Fee for monitored anaesthesia care make up 80% of the anaesthetic fee for such

procedure.

6. When two or more procedures are performed through the same incision and

occasion, the fees chargeable by both surgeons and anaesthetists for other than

the intended procedure(s), shall not exceed 50% of that procedure(s).

7. When two or more procedures are performed through separate incisions on same

occasion, the fees for both surgeons and anaesthetists shall not exceed 75% of the

respective professional fee stipulated for that procedure. This rule is not

applicable for multiple incisions made to create multiple access ports in any

endoscopic and laparoscopic procedure.

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8. In a surgery that involves multiple anatomical levels, the fees chargeable for that

procedure is 100% for the first level and should not exceed 50% of the maximum

chargeable fee for the subsequent levels.

9. When one or more procedures performed either through the same or different

incision, elective or emergencies and require the services of multiple surgeons of

different specialties performing together in the interest of patient safety,

operative efficiency or quality of care, the fees chargeable by these surgeons other

than the primary surgeon should not exceed 75% of the maximum chargeable fee.

10. When procedures of highly complex nature require the service of a second

surgeon of the same specialty, perform together in the interest of patient safety,

operative efficiency or quality of care, the total fees chargeable by the second

surgeon shall not exceed 50% of the total fees chargeable by the first (primary)

surgeon for the procedure(s) performed by him.

11. In cases where a specific fee for a laparoscopic or endoscopic procedure is not

stipulated in the Schedule, an additional fee not exceeding 15% of the procedure

fee may be charged by the surgeon.

12. In cases where an open procedure is performed following a failed endoscopic

procedure, the fee that is charged shall only be for one procedure.

13. When a therapeutic endoscopy or laparoscopic procedures is preceded by a

diagnostic endoscopy or laparoscopy, no additional fee can be charged for the

diagnostic procedure.

14. In cases where a procedure comprises of a combination of procedures which are

customarily performed together and for which a specified combined procedure is

provided or not in the Schedule, the fee for the specified combined procedure

shall not be fragmented or unbundled in the computation of fees.

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Note:

1. For procedures performed under local anaesthetic (LA) or sedation or both, and

when the LA or sedation is administered by the surgeon who performs the

procedure, an additional fee not exceeding 20% of the procedure fee or RM 125,

whichever is lower may be charged. This additional fee shall not apply to

procedures that are performed under LA and/or sedation where it is considered

as a routine, usual and customary.

2. In cases where no fee is stipulated for the anaesthetist and anaesthesia is deemed

necessary, a fee not exceeding 50% of the surgical procedure fee or a minimum of

RM 265 or whichever is higher may be charged by the anaesthetist.

1. General practitioner (non-specialist) (a) First visit/Initial consultation Item Fee (RM) Consultation only

Consultation with examination 30-125 Consultation with examination and treatment plan

Consultation after stipulated clinic hours Up to 50% above the usual rate

House call or home visit Up to 100% above the usual rate

(b) Clinic without pharmaceutical services Item Fee (RM)

Consultation only

Consultation with examination 35 - 145 Consultation with examination and treatment plan

I. CONSULTATION FEE

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Consultation after stipulated clinic hours Up to 50% above the usual rate

House call or home visit Up to 100% above the usual rate

2. Specialist fee

Note: applicable to all medical specialties unless specified otherwise (a) First visit/Initial consultation Item Fee (RM)

Consultation only

Consultation with examination 80 - 235 Consultation with examination and treatment plan

Consultation after stipulated clinic hours – Up to 50% above the usual rate

House call or home visit – Up to 100% above the usual rate

(b) Follow-up visit/Follow-up consultation Item Fee (RM) Consultation only Consultation with examination 40 - 105 Consultation with examination and treatment plan

Consultation after stipulated clinic hours – Up to 50% above the usual rate

House call or home visit – Up to 100% above the usual rate

(c) Special consultation for radiotherapy and

oncology

Note: Includes once a week consultation Item Fee (RM)

Basic Treatment planning including simulation for external beam radiotherapy (replanning will be charged separately)

860 -1715

Treatment planning for brachytherapy (Intracavitary)

1145-2290

Specialised treatment planning 2290-4575 - Interstitial brachytherapy

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- Conformal radiotherapy - Radiosurgery - Intensity modulated radiotherapy II. PROCEDURE FEE 1. General Procedures

Item/Procedure Fee (RM) Surgeon Anaesthetist

Ambulatory blood pressure monitoring 130 Application of plaster cast (where this is the sole procedure)

315

Application of plaster jacket, hip spica, long leg cast or cast brace

410 265

Arterial cannulation 130 Arterial puncture 65 Aspiration of subcutaneous haemotoma 315 Banding of haemorrhoids 315 Biopsy of skin or subcutaneous tissue 315 Cardiopulmonary resuscitation (CPR) 315 Central venous pressure (CVP) line cannulation

230

Chest tube insertion 840 Colposcopy (plus/minus biopsy) 375 Continuous Holter monitoring 330 Curettage/Cryotherapy of lesion of skin including cauterisation

315

Diagnostic aspiration of cysts, joints and cavities

315

Echocardiography with report

Colour form mapping 380 Doppler echocardiography 380 Echocardiogram-transthoracic 230 M-mode 380 Stress echo treadmill 380 Stress echocardiography 380 Trans-oesophageal echocardiography 440 Two dimensional (2-D) 380 Elective cardioversion 290 Electrocardiogram (ECG) with report 80 ECG (stress/exercise) with report 270 Endometrial biopsy or aspiration 410 Fine needle aspiration cytology 315 Incision and drainage (I & D) 315

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Injection around apophyseal facet of vertebra without X-ray control

315

Injection into joint without X-ray control 315 Injection into subcutaneous tissue/painful trigger point including local anesthesia (LA) and steroid

315

Injection into varicose veins of leg 315 Injection of sclerosing substance into haemorrhoids

315

Introduction of substance into skin including hormone pellet

315

Lumbar puncture 745 Paracentesis for ascites 630 Paravertebral block (without X-ray control) 480 Percutaneous biopsy (not elsewhere specified)

315

Pericardiocentesis 505 Pleural biopsy 895 Pleural cavity drainage 840 Pleurodesis 630 Rigid sigmoidoscopy with biopsy 315 Signal averaging ECG 45 Stellate ganglion block (LA) 480 Swan Ganz cathether placement 460 Temporary pacing 1145 Toilet and suturing (T & S) per stitch 20 Venesection 35 Venupuncture 65

2. Specific Procedures (a) Anaesthesiology

First consultation, assessment, procedure and advanced cardiac life support (ACLS) in the intensive care unit (ICU)

630

Subsequent consultation and assessment in the ICU

As per paragraph 2(b) of the

specialist fees

Obstetric analgesia service – Epidural 445 Management of acute, chronic and cancer pains

35

Venepuncture 65 (b) Abdomen (other than urinary and reproductive system)

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Oesophagus Thorascopic oesophageal mobilisation via mediastinum

4750 1815

Oesophagogastrectomy 4750 1815 Total oesophagogastrectomy and interposition of intestine

5970 2500

Open excision of lesion of oesophagus 1890 1125 Bypass of oesophagus 2480 1550 Revision of oesophageal anastomosis 2705 1320 Closure of bypass of oesophagus 2145 1125 Transthoracic repair of oesophagus 3600 1320 Thorascopic repair of oesophagus 2895 1320 Oesophagocardiomyotomy (Heller's operation)

2040 985

Thorascopic oesophagogastric myotomy 2145 985 Injection sclerotherapy for oesophageal varices

1000 685

Transthoracic repair of hiatus hernia 2305 940 Transthoracic repair of diaphragmatic hernia

2305 940

Transabdominal repair of hiatus hernia 2145 760 Transabdominal repair of diaphragmatic hernia

2895 820

Laparoscopic repair of hiatus hernia 2145 760 Transabdominal anti-reflux operation 2895 820 Revision of anti-reflux procedure 3600 1320 Laparoscopic vagotomy/seromyotomy 2040 685 Laparoscopic gastro-jejunostomy 2145 685 Laparoscopic gastrostomy/jejunostomy 1760 570

Stomach

Proximal gastric vagotomy 2040 685 Highly selective vagotomy 2040 685 Vagotomy and pyloroplasty 2145 820 Total gastrectomy and excision of surrounding tissue

2895 1125

Partial gastrectomy 2305 760 Plastic operation on stomach 1890 685 Gastro-jejunostomy 2145 685 Revision of gastro-jejunostomy 2305 685 Gastrostomy 1760 570 Closure of gastrostomy 1565 570 Closure of perforated ulcer of stomach 1890 685 Laparoscopic closure of perforated ulcer of stomach

1890 685

Other open operation on stomach 1890 685 Pyloromyotomy 1890 685

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Pyloroplasty 1890 685 Partial gastrectomy (benign disease) 2305 Partial gastrectomy (malignant disease) 2895

Duodenum Open excision of lesion of duodenum 2305 760 Bypass of duodenum 1890 760 Laparoscopic closure of perforated ulcer of duodenum

1890 685

Closure of perforated ulcer of duodenum 1890 685 Small intestine

Excision of jejunum 2145 685 Excision of lesion of jejunum 2480 685 Jejunostomy 1760 685 Laparoscopic resection of small intestine 1890 685 Bypass of jejunum 1890 685 Intubation of jejunum of decompression of intestine

1890 685

Bypass of ileum 1890 685 Ileoanal anastomosis and creation of pouch 4750 1550 Ileostomy 1890 685 Attention to ileostomy 1565 570 Closure of ileostomy (in isolation) 1565 570 Open operation on ileum including reduction of intussusception

1890 685

Large intestine

Appendicectomy 1565 570 Laparoscopic appendicectomy 1565 570 Drainage of abscess of appendix 1565 625 Total excision of colon and ileorectal anastomosis

3600 1320

Extended excision of right hemicolon 2390 820 Other excision of right hemicolon 2390 760 Excision of transverse colon 2390 760 Excision of left hemicolon 2390 820 Excision of sigmoid colon 2390 820 Excision of lesion of colon (transabdominal)

1760 760

Bypass of colon 2040 760 Exteriorisation of caecum 1760 760 Closure of colostomy – extra peritoneal 1340 625 Closure of colostomy – intra peritoneal 1890 760 Laparoscopic colostomy 2040 760 Colostomy including revision 2040 760

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Intra-abdominal manipulation of colon including reduction of intussusception

2040 685

Laparoscopic colonic resection 2390 820 Radiological reduction of intussusception of colon using barium enema

580 570

Rectosigmoidectomy for Hirchsprung's disease

4750

Laparotomy of necrotising enterocolitis (NEC)

2705

Laporotomy for intestinal atresia 2705 Rectum/Anus

Ileoanal anastomosis and creation of pouch 4750 1550 Panproctocolectomy and ileostomy 4750 1815 Abdominoperineal pull through resection with colo-anal anastomosis and associated colostomy

4750 1815

Abdominoperineal resection of rectum and anus

4750 1815

Anterior resection 4750 1815 Anterior resection of rectum and end colostomy (with closure of rectum)

2705 1550

Laparoscopic anterior resection of rectum and exteriorisation of bowel

4750 1550

Partial excision of rectum and sigmoid colon for prolapse

2705 940

Reversal of Hartman's procedure 3600 1550 Open excision of lesion of rectum 2145 940 Fixation of rectum for prolapse 1890 940 Laparoscopic rectopexy 1890 940 Transanal resection for rectal cancer 2040 625 Perineal excision of lesion of rectum 1340 625 Full or partial thickness rectal biopsy 405 625 Perineal repair of prolapse of rectum 1760 685 Dilation of stricture of rectum 370 265 Repair of faecal fistula 865 625 Excision of lesion of anus 370 265 Destruction of lesion of anus 370 265 Repair of anal sphincter 1565 625 Repair of anal trauma 1340 625 Haemorrhoidectomy 1000 505 Anorectal stretch including examination under anaesthesia (EUA) and sigmoidoscopy

370 265

Laying open of low anal fistula 865 505

Laying open of high anal fistula 1565 625 Lateral sphincterotomy of anus 405 505

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100

Excision of anal fissure 405 405 Drainage through perineal region including ischiorectal abscess

580 405

Excision of pilonidal sinus and suture/skin graft

1160 625

Laying open of pilonidal sinus 580 265 Fistulectomy (single) 865 Fistulectomy (multiple) 1565 Posterior saggital anorectoplasty (PSARP) 3600 Combined laparotomy plus PSARP 4750 Anoplasty 1340 Posterior saggital anorectovaginourethroplasty (PSARVUP)

4750

Combined laparotomy plus PSARVUP 5970 Other organs, mainly digestive

Adrenalectomy 2145 940 Adrenalectomy – bilateral 2305 1125 Operation on aberrant adrenal tissue 2145 940 Partial excision of liver 3600 1550 Hemihepatectomy 5970 2110 Removal of liver tumour 2895 985 Repair of liver 2480 985 Open drainage of liver 1160 685 Therapeutic laparoscopic operation on liver

1340 570

Diagnostic laparoscopic examination of liver including any biopsy

1340 505

Percutaneous biopsy of lesion of liver 480 315 Open puncture of liver 1565 570 Cholecystectomy including mini-cholecystectomy

1890 685

Cholecystectomy with exploration of common bile duct

2040 760

Laparoscopic cholecystectomy 2480 1125 Laparoscopic cholecystectomy with perioperative cholangiogram

2705 1550

Anastomosis of gall bladder (to another viscus)

2305 760

Partial excision of bile duct and anastomosis of bile duct to duodenum/jejunum

2390 940

Excision of lesion of bile duct 2145 940 Anastomosis of hepatic duct 2895 940 Anastomosis of common bile duct 2145 940 Open introduction of prosthesis into bile duct

2145 760

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101

Repair of bile duct 2390 985 Incision of bile duct including exploration for calculus removal

2145 940

Sphincterotomy of bile duct and pancreatic duct using duodenal approach

2145 820

Percutaneous examination of bile duct 1000 505 Total pancreatectomy and excision of surrounding tissue

4750 1815

Total pancreatectomy 4750 1815 Pancreatoduodenectomy and excision of surrounding tissue (Whipple's procedure)

4750 1815

Distal pancreatectomy 2705 985 Excision of lesion of pancreas 2040 985 Anastomosis of pancreatic duct (to another viscus)

2705 940

Open drainage of lesion of pancreas 2040 760 Drainage of pancreatic abscess 2040 760 Incision of pancreas 2040 760 Open examination of pancreas 2040 760 Therapeutic percutaneous operation on pancreas

1565 685

Open splenectomy 1565 760 Laparoscopic splenectomy 1565 760 Creation of peritoneo-venous shunt (Levine/Denver)

1340 435

Internal drainage of pancreatic pseudocyst 2705 Hepato portoenterototomy (Kasai operation)

4750

Excision of choledochal cyst 4750 Major vessels

Open cannulation of intra-abdominal artery for infusion chemotherapy

2145 685

Creation of portacaval shunt 4750 1320 Plication of vena cava 2305 940 Repair of wound of major artery or vein of abdomen including aorta and vena cava

2145 1320

Abdominal wall

Repair of congenital diaphragmatic hernia 2705 1550 Simple excision of inguinal hernial sac 1000 505 Simple excision of inguinal hernial sac – bilateral

1760 760

Primary repair of inguinal hernia 1160 505 Primary repair of inguinal hernia – bilateral 1890 820 Primary repair of strangulated inguinal hernia

1890 625

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102

Laparoscopic repair of groin hernia 1160 505 Repair of recurrent inguinal hernia 1890 685 Repair of recurrent inguinal hernia – bilateral

2895 985

Primary repair of femoral hernia 1000 505 Primary repair of strangulated femoral hernia

1890 625

Repair of recurrent femoral hernia 1565 570 Repair of umbilical hernia (irrespective of age)

1000 570

Primary repair of incisional hernia 1340 505 Repair of recurrent incisional hernia 1890 685 Repair of other hernia of abdominal wall 1340 505 Resuture of previous incision in abdominal wall (burst abdomen)

1340 570

Closure of exomphalos major/gastroschisis – primary closure

3600

Closure of exomphalos major/gastroschisis – silastic closure

2145

Closure of exomphalos major/gastroschisis – delayed primary closure

2570

Peritoneum

Laparotomy for post-operative haemorrhage

1760 820

Laparotomy and repair of multiple visceral trauma

3600 1550

Open drainage of subphrenic abscess 1760 685 Operation on omentum 1890 685 Retroperitoneal tumour 2705 940 Retroperitoneal abscess 1160 685 Presacral tumour 1340 940 Freeing of adhesions of peritoneum 1565 685 Laparoscopy including biopsy and adhesiolysis

1160 435

Paracentesis abdominis for ascites 315 265 Suprapubic drainage of pelvic abscess 865 505 Transrectal/transvaginal drainage of pelvic abscess

1160

Laparotomy – exploratory 1890 (c) Brain, cranium and other intracranial organs

Brain

Hemispherectomy 7030 2930 Excision of abscess of brain 4750 2110 Excision of lesion of tissue of brain 5970 2500

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103

Stereotactic ablation of tissue of brain 4750 1815 Open biopsy of lesion of tissue of brain 3600 1550 Implantation/removal of neurostimulator from brain (any route)

2145 820

Ventriculocisternostomy 3600 1550 Creation of ventriculovascular anastomosis 2040 820 Creation of ventriculoperitoneal shunt 2040 820 Creation of subcutaneous cerebrospinal fluid (CSF) reservoir

2040 820

Maintenance of cerebroventricular shunt including revision

1565 685

Removal of cerebroventricular shunt 1340 505 Irrigation of cerebroventricular shunt 580 685 Therapeutic endoscopic operations on ventricle of brain

2570 820

Diagnostic endoscopic examination and biopsy of lesion of ventricle of brain

1760 820

Ventricular puncture 570 505 Cranium

Intracranial infection: Burr-hole 1890 760 Plastic repair of cranium 2705 1320 Reconstructive cranioplasty 2705 1320 Craniostenosis (single suture) 2040 760 Craniostenosis (more than one suture) 2705 1550 Exploratory open craniotomy 2705 1320 Exploratory Burr-hole of cranium 1565 685 Petrosectomy 3600 2110 Foramen Magnum decompression 4750 1550 Excision of lesion of cranium 2145 820 Elevation of depressed fracture of cranium 1565 760 Repair of compound fracture of cranium 2705 1320 Drainage of skull 1340 505

Meninges

Drainage of subarachnoid space of brain 1565 625 Excision of lesion of meninges of brain 7030 2500 Operation of arachnoid cyst 2705 985 Repair of dura 3600 1320 Evacuation of extradural haematoma 3600 1320 Evacuation of subdural haematoma or abscess

3600 1320

Subdural haemorrhage – tap 315 435 Nerves

Intracranial transection of cranial nerve 5970 2930

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Other intracranial destruction of cranial nerve

5970 2930

Excision of lesion of cranial nerve (Intracranial)

7030 2930

Excision of acoustic neuroma 7030 2930 Repair of cranial nerve (Intracranial) 2895 1815 Decompression of cranial nerve (Craniotomy)

5970 1815

Neurostimulation of cranial nerve (Intracranial)

2145 760

Removal of neurostimulator from cranial nerve

1890 505

Excision of cerebellopontine angle tumour 7030 2930 Vessels

Craniotomy – post-operative haemorrhage 2705 1320 Craniotomy for suprasellar tumour 7030 Craniotomy for posterior fossa tumour 7030 Ligation/clipping of aneurysm of cerebral artery

5970 2110

Reinforcement of aneurysm of cerebral artery

5970 2110

Open operations on cerebral artery 5970 2110 Excision of arteriovenous (AV) malformation

7030 2110

Creation of ventriculovascular anastomosis 2040 820 Creation of ventriculoperitoneal shunt 2040 820

Others

Hypophysectomy 5970 1815 Cryotherapy to pituitary gland 2570 Excision of lesion of pituitary gland 5970 1815 Excision of pineal gland 7030 1815

(d) Breasts

Subcutaneous mastectomy with immediate implant

2040 760

Radical mastectomy including block dissection

2305 760

Mastectomy combined with reconstruction of breast using myocutaneous flap

2895 985

Modified radical mastectomy including block dissection

2040 685

Simple mastectomy including axillary node biopsy

1565 685

Excision of lesion of breast 1000 405

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105

Segmental resection or quadrantectomy 1340 505 Wide local excision of lesion of breast 1340 505 Repeat local excision to clear margins 1000 505 Excision biopsy of breast lesion after localisation

1000 505

Reconstruction of breast using latissimus dorsi

2895 940

Reconstruction of breast using local flap 2305 760 Reconstruction of breast using TRAMS 4750 1550 Removal of prosthesis from breast 865 405 Implantation of prosthesis following mastectomy

1340 685

Percutaneous biopsy of lesion of breast 370 265 Stereotactic/guidewire excision of lesion of breast

1565 505

Drainage of breast abscess 580 405 Microdochotomy 1000 405 Operation(s) on nipple (where not included in other procedures)

865 405

Block dissection of axillary lymph nodes (where not included in other procedures)

1760 625

Biopsy/sampling of axillary lymph nodes 405 315 Biopsy of internal mammary lymph nodes 725 505

(e) Dermatology and venereology Allergy test

Skin sensitivity tests (Intradermal) using up to 20 reagents (excluding cost of reagents)

190

Skin sensitivity tests (patch test) using up to 26 reagents, i.e. standard series (excluding cost of reagents)

250

Skin sensitivity tests (patch test) using more than 26 reagents, i.e. standard and extra series (excluding cost of reagents)

315

Skin sensitivity tests (patch test) using supplementary series i.e. cost per series (excluding cost of reagents)

190

General dermatosurgery

Excision – cysts, scars, benign tumours (simple)

380

Excision – cysts, scars, benign tumours (complex)

660

Excision – malignant skin tumours requiring wide excision

915

P.U. (A) 358

106

Multiple intralesional steroid injections 190 Cryotherapy – not more than 5 lesions 155 Cryotherapy – more than 5 lesions 250 Cryotherapy – malignant tumours requiring wide areas of treatment

505

Curettage/Cryotherapy lesion of skin including cauterisation

315

Phototherapy

Phototherapy (ultra violet beam (UVB)) per session – regional

65

Phototherapy (UVB) per session – whole body

100

Psoralen and ultra violet A (PUVA) per session – regional

100

PUVA per session – whole body 125 Photopatch testing 250 Minimum erythema doses (MED) phototesting

250

Minimum photoxic doses (MPD) phototesting

250

Phototherapy ultraviolet A1 (UVA 1) per session – regional

100

Phototherapy ultraviolet A1 (UVA 1) per session – whole body

125

Other dermatology procedures

Simple excision of nail 70 Wedge excision of toe nail 380 Wedge excision or avulsion of toe nail including chemical ablation of nail bed

480 315

Matrixectomy of nail 170 Dark ground investigation (DGI) examination of specimen

125

Biopsy of skin or subcutaneous tissue 315 Percutaneous biopsy (not elsewhere specified)

315

Microscopic examination (dark ground) 65 Microscopic examination for skin scrapings, smears, and etc.

65

Electrocautery – keratosis, warts, angiomas, etc. (less than 5 lesions)

190

Electrocautery – keratosis, warts, angiomas, etc. (from 5 to 20 lesions)

380

Electrocautery – keratosis, warts, angiomas, etc. (more than 20 lesions)

630

P.U. (A) 358

107

Chemical cautery – keratosis, warts, angiomas, etc. (not more than 5 lesions)

125

Chemical cautery – keratosis, warts, angiomas, etc. (more than 5 lesions)

250

Electrolysis of hair per session 250 Iontophoresis per session 190 Transdermal iontophoresis 285

Cutaneous laser procedures

Cutaneous laser ablation of skin tumours (less than 5 lesions)

290

Cutaneous laser ablation of skin tumours (5 to 20 lesions)

660

Cutaneous laser ablation of skin tumours (more than 20 lesions)

860

Pigment laser treatment of skin pigmentation and tattoos – small area (less than 9 cm2)

380

Pigment laser treatment of skin pigmentation and tattoos – medium sized area (9 cm2 to 50 cm2)

435

Pigment laser treatment of skin pigmentation – large area (more than 50 cm2)

660

Pigment laser treatment of tattoo of eyebrows

380

Pigment laser treatment of tattoo of eyelids 435 Vascular laser treatment of vascular lesion – small area (less than 9 cm2)

380

Vascular laser treatment of vascular lesion – medium sized area (9 cm2 to 50 cm2)

435

Vascular laser treatment of vascular lesion – large area (more than 50 cm2)

660

Laser resurfacing of one cosmetic unit – non-ablative

860

Laser resurfacing of one cosmetic unit – ablative

1145

Laser-assisted/intense pulsed light (IPL) hair removal – small area (less than 9cm2)

380

Laser-assisted/IPL hair removal – medium sized area (9 cm2 to 50 cm2)

435

Laser-assisted/IPL hair removal – large area (more than 50 cm2)

660

Laser-assisted/IPL hair removal – whole face

915

P.U. (A) 358

108

Chemical peeling Chemical peeling of lesion of skin – superficial peel

290

Chemical peeling of lesion of skin – medium depth

380

Chemical peeling of lesion of skin – deep peel

660

Miscellaneous procedures

Comedone extract per session 190 Paring of hyperkeratosis, corns, etc. 190 Milia extraction 190 Day care skin nursing per session 190 Whole body wrap dressing (e.g: atopic eczema)

230

Microdermabrasion – face 345 Microdermabrasion – body 570 Botulinum toxin injection of one cosmetic unit

685

Fillers injection of one cosmetic unit 570

(f) Ear, nose and throat

External ear Total excision of external ear 1565 820 Excision of preauricular abnormality 1000 405 Excision of lesion of external ear 725 405 Removal of exostoses from external auditory canal

1760 505

Reconstruction of external ear using graft 2895 685 Reconstruction of external ear 2145 685 Meatoplasty of external ear 1565 505 Repair of external ear 405 405 Removal of foreign body from external auditory canal under general anaesthetic (GA) (and bilateral)

370 265

Excision of lesion of external auditory canal 480 570 Reconstruction of external auditory canal 2705 1125

Middle ear and mastoid

Radical mastoidectomy 2480 940 Modified radical mastoidectomy 2480 940 Simple mastoidectomy 2305 625 Revision of mastoidectomy 2040 940 Exploration of mastoid, facial nerve 2305 940 Tympanoplasty 2145 940 Myringoplasty 2040 760

P.U. (A) 358

109

Myringotomy and insertion of tube through tympanic membrane (and bilateral)

865 355

Suction clearance of middle ear 370 265 Myringotomy (and bilateral) 370 265 Ossiculoplasty with/without tympanoplasty

2705 940

Stapedectomy 2040 760 Middle ear tumour excision 2040 760 Middle ear polypectomy (and bilateral) 580 265 Tympanotomy and biopsy of lesion of middle ear

1760 570

Petrosectomy 3600 2110 Inner ear

Transtympanic electrocochleography 725 Operation on cochlea 3600 1320 Operation on endolymphatic sac 2145 940 Membranous labyrinthectomy 2390 940 Osseous labyrinthectomy 2480 940 Excision of preauricular sinus – unilateral 1340 Excision of preauricular sinus – bilateral 1760

Nose and nasal cavity

Total excision of nose 1565 760 Septorhinoplasty plus/minus graft/implant following trauma or excision of tumour

2145 625

Rhinoplasty following trauma or excision of tumour

2040 625

Submucous excision of septum of nose 1160 405 Excision of lesion of septum of nose 580 355 Biopsy of lesion of septum of nose 370 355 Closure of perforation of septum of nose 1340 405 Incision of septum of nose 405 315 Septoplasty of nose 1340 435 Nasal septum cauterisation (and bilateral) 315 265 Submucous diathermy to turbinate of nose (and bilateral)

405 265

Excision of turbinate of nose (and bilateral) 725 405 Excision of lesion of turbinate of nose (and bilateral)

405 405

Division of adhesions of turbinate of nose (and bilateral)

370 405

Biopsy of lesion of turbinate of nose (and bilateral)

370 405

Cauterisation of turbinate of nose (and bilateral)

370 265

Ligation of artery of internal nose 1340 505

P.U. (A) 358

110

Embolisation of artery of internal nose 1340 505 Packing of cavity of nose (as sole procedure)

315 505

Polypectomy of internal nose (and bilateral)

480 355

Excision of lesion of internal nose 405 355 Correction of congenital atresia of choana 1565 685 Removal of foreign body from cavity of nose

315 355

Excision of lesion of external nose 315 435 Nasal sinuses

Drainage of maxillary antrum including Caldwell-Luc (and bilateral)

1000 435

Transantral neurectomy of vidian nerve using sublabial approach (and bilateral)

1760 685

Antral puncture and wash-out (and bilateral)

480 265

Intranasal antrostomy including endoscopic (and bilateral)

865 505

Closure of oro-antral fistula 1340 435 External frontoethmoidectomy (and bilateral)

2145 760

Intranasal ethmoidectomy (and bilateral) 1160 505 External ethmoidectomy including endoscopic (and bilateral)

1565 685

Anterior and posterior opening into functional endoscopic sinus surgery (FESS)

1760 685

Transantral ethmoidectomy (and bilateral) 1565 685 Bone flap to frontal sinus (and bilateral) 2480 625 Trephining of frontal sinus 580 265 Radical frontoethmoidectomy 2390 940 Subtotal FESS 1565 685 Operation on sphenoid sinus 865 505 Operation on nasal sinus (unspecified) 865 505 Lateral Rhinotomy into sinus for malignancy

1760 625

Diagnostic endoscopy of sinus (as sole procedure)

315 405

Throat

Total pharyngectomy 5970 1815 Partial pharyngectomy 2305 1815 Adenoidectomy 405 265 Repair of pharynx 2145 820 Open excision of lesion of pharynx 725 505 Operation on pharyngeal pouch 1890 685

P.U. (A) 358

111

Therapeutic endoscopic operation on pharynx

580 405

Pharyngeal pouch – Endoscopic resection 1890 625 Diagnostic endoscopic examination of pharynx including biopsy

580 405

Tonsillectomy – child (and bilateral) 1000 435 Tonsillectomy – adult (and bilateral) 1160 435 Excision of lingual tonsil 865 435 Adenotonsillectomy (and bilateral) 1160 435 Drainage of peritonsillar abscess ("Quinsy") 315 315

Larynx and trachea

Total laryngectomy including neck dissection

3600 1815

Partial laryngectomy 2145 985 Laryngofissure and chordectomy of vocal chord

1760 625

Laryngectomy (excluding neck dissection) 2570 1320 Glottoplasty 1760 625 Reconstruction of larynx with graft 3600 1815 Endoscopic excision of lesion of larynx including microlaryngoscopy

1160 570

Laryngoscopy/endoscopy with/without biopsy

580 505

Injection into larynx 1160 505 Partial excision of trachea with reconstruction

3600 2110

Tracheoplasty 1760 625 Open placement of prosthesis in trachea 1760 505 Tracheotomy 1000 570 Insertion of mini-tracheostomy 580 405

Fibreoptic endoscopic procedures under topical anaesthesia

Fibreoptic examination of trachea and bronchus including biopsy/removal of foreign body

725 505

Bronchial lavage (diagnostic or therapeutic)

865

Dilatation of tracheal stricture including insertion of stent

865

Dilatation of bronchial stricture by fibreoptic bronchoscope

1000

Transbronchial biopsy 1000

(g) Endoscopic and laparoscopic gastro-intestinal tract (GIT) procedures

Endoscopic GIT procedure

P.U. (A) 358

112

Rigid oesophagoscopy plus/minus biopsy/removal/laser or diathermy destruction of lesions

865 435

Diagnostic esophagogastroduodenoscopy including Biopsy

405 315

Therapeutic esophagoduodenoscopy including removal of foreign body/polypectomy

580 435

Therapeutic esophagogastroduodenoscopy including destruction of lesion, insertion of prosthesis, dilatation, recanalisation of tumour

1000 435

Injection sclerotherapy for oesophageal varices

1000 685

Intubation for investigation of GIT plus/minus manometry, pH measurement, pancreatic function and jejunal biopsy

480 315

Endoscopy and examination of ilium through stoma including dilatation

580 315

Flexible sigmoidoscopy plus/minus biopsy/removal/destruction of lesion

580 435

Fibreoptic colonoscopy plus/minus excision biopsy/destruction of lesion

1000 435

Fibreoptic colonoscopy and recanalisation of tumour

1565 435

Endoscopic retrogradecholangiopancreatography (ERCP)

1160 505

ERCP with therapeutic procedure 1760 505 Pancreatic stent insertion 2040 760 Pancreatic stone removal 2040 760 Pancreatic pseudocyst drainage 2040 760 Rubber band ligation of varices 1000 405 PEG 1760 625 Endoscopic mucosal resection 2040 760 Colonic polypectomy 1340 505 Colonic dilatation (balloon) 1340 505 Colonic stent insertion 1565 570 Therapeutic GIT bleeding procedures (upper)

1000 405

Laparoscopic procedure

Laparoscopic repair of hiatus hernia 2145 760 Laparoscopic vagotomy/seromyotomy 2040 685 Laparoscopic gastrojejunostomy 2145 685 Laparoscopic gastrostomy/jejunostomy 1760 570

P.U. (A) 358

113

Laparoscopic closure of perforated ulcer of stomach

1890 685

Laparoscopic closure of perforated ulcer of duodenum

1890 685

Laparoscopic resection of small intestine 1890 685 Laparoscopic appendicectomy 1565 570 Laparoscopic colostomy 2040 760 Laparoscopic colonic resection 2390 820 Laparoscopic anterior resection of rectum and exteriorisation of bowel

4750 1550

Laparoscopic rectopexy 1890 940 Laparoscopic cholecystectomy 2480 1125 Laparoscopic cholecystectomy with perioperative cholangiogram

2705 1550

Laparoscopic splenectomy 1565 760 Laparoscopic repair of groin hernia 1160 505

(h) Eye and orbital content General procedures

Fundus fluorescein angiogram 345 Anterior/Fundus photography 65 Automated perimetry 250 Hess chart 125 Keratometry 65 Corneal topography Ultrasonography 250 A - Scan 125 B - Scan 250 Pachymetry 125 Gonioscopy 65 Indirect ophthalmoscopy 65 Refraction 65 Schirmer’s test 30 Electrophysiology Electroretinogram (ERG)/ Electrooculogram (EOG)/Visual evoked response (VER)

250

Syringing 125 Dressing 35 Irrigation 65 Excision/curettage/cryotherapy of lesion of eyelid(s)

370 265

Yag laser photo disruption of posterior capsule of lens including laser capsulotomy

580 505

Laser photocoagulation/Cryotherapy/ Radiotherapy of lesion of retina (and bilateral)

1000 405

P.U. (A) 358

114

Flourescein angiography of eye 315 265 Surgical correction of squint (one or both eyes)

1890 625

Surgical trabeculectomy 2040 760 Trabeculectomy including laser 1160 570 Biopsy of lesion of eyelid 480 315 Extracapsular extraction without implant 2145 820 Extracapsular extraction with implant 2570 940

Globe or orbit Exenteration of orbit 2040 760 Enucleation of eyeball 2040 685 Excision of lesion of orbit 1890 685 Reconstruction of cavity of orbit 2305 760 Biopsy of lesion of orbit 1160 505 Drainage of orbit 1340 355 Decompression of orbit 2305 685 Removal of foreign body from orbit 1890 685 Exploration of orbit 1890 685 Open reduction of fracture of orbit 1340 685 Retrobulbar injection 315 265 Evisceration of eyeball 2040 760 Orbital implants – Evisceration/ Enucleation with implant

2390

Eyebrow and lid

Excision of lesion of eyebrow 580 405 Suture of eyebrow 315 405 Excision of lesion of canthus 1000 505 Correction of epicanthus 1160 505 Correction of telecanthus 1160 505 Graft of skin to canthus 1000 505 Canthotomy/Curettage 580 505 Excision/Curettage/Cryotherapy of lesion of eyelid(s)

370 265

Graft of skin to eyelid 1000 505 Correction of ectropion 1160 405 Correction of entropion 1160 405 Correction of trichiasis 405 405 Tarsorrhaphy 865 405 Total reconstruction of eyelid 1890 505 Suture of eyelid (laceration) 405 405 Total reconstruction of eyelid – bilateral 2895 820 Correction of ptosis of eyelid 1760 625 Tarsomullerectomy 1760 505 Drainage of lesion of eyelid 370 355 Biopsy of lesion of eyelid 480 315

P.U. (A) 358

115

Removal of eyelashes by electrolysis/laser/cryotherapy

370 265

Lacrimal system

Canaliculo dacryocystorhinostomy 2390 940 Conjunctivo dacryocystorhinostomy 2390 940 Dacryocysto rhinostomy (DCR) with/without insertion of tube

2040 940

Excision of lacrimal sac 1000 505 Biopsy of lacrimal sac 580 505 Incision of lacrimal sac 370 405 Syringing of nasolacrimal system under general anaesthesia (GA)

315 265

Probing of nasolacrimal sac under GA 315 265 Repair of torn canaliculus 1000 265 Dilation of lacrimal punctum under GA 315 265 Endoscopic DCR 2570 1320

Muscles

Surgical correction of squint (one or both eyes)

1890 625

Revision of squint surgery (one or both eyes)

2305 570

Tenotomy of muscle (one or both eyes) 1340 570 Transposition of muscle (one or both eyes) 1760 570 Surgical correction of squint with adjustable sutures (one or both eyes)

2480 685

Revision of squint surgery with adjustable sutures (one or both eyes)

2895 940

Correction of squint with botulinum toxin 1000 Conjunctiva

Excision of conjunctival lesion 480 505 Cauterisation including cryotherapy to conjunctival lesion

315 505

Radiotherapy to conjunctival lesion 580 505 Mucosal graft to conjunctiva 1160 505 Suture of conjunctiva 480 505 Removal of suture of conjunctiva 315 435 Drainage of conjunctival cyst 315 435 Division of adhesions of conjunctiva 315 435 Biopsy of lesion of conjunctiva 315 435 Subconjunctival injection 315 435 Exploration of conjunctiva including removal of foreign body

370 435

Pterygium excision 1340 505 Conjunctival limbal graft 725

P.U. (A) 358

116

Cornea Excision of lesion of cornea 480 435 Cryotherapy of lesion of cornea 315 435 Lameliar graft (Keratoplasty) to cornea 2390 940 Perforating graft (Keratoplasty) to cornea 2390 940 Repair of corneal wound 580 505 Removal of corneal suture 315 405 Removal of superficial corneal foreign body 405 435 Tension sutures 1340 625 Chelation of cornea 725 405 Tattooing of cornea 725 405 Corneal scraping for culture 405 405 Refractive keratoplasty 1760 625 Photorefrative keratectomy (PRK)/ Phototherapeutic keratectomy (PTK)

2145 820

Keratomileusis laser in situ (LASIK) 3600 2110 Lamellar graft (Keratoplasty) to cornea 3600 Performing graft (Keratoplasty) to cornea 2895 Limbal stem cells transplantation 2705 Amniotic membrane graft 1160 Anterior stromal puncture 865 Astigmatic keratotomy 1565

Sclera Excision of lesion sclera 725 570 Repair of scleral laceration 725 570 Scleral graft 1565 570

Iris and anterior chamber Iridocycletomy 2390 940 Surgical iridectomy 1160 685 Surgical trabeculectomy 2040 760 Laser trabeculoplasty 1000 570 Trabeculotomy including laser 1160 570 Goniotomy (surgical treatment of glaucoma)

1890 570

Laser iridotomy 1160 505 Repair of prolapsed iris 1890 685 Excision of lesion of iris 1890 685 Removal of foreign body from iris 1890 685 Cyclocyotherapy (cauterisation of ciliary body)

1160 505

Cyclodialysis (separation of ciliary body) 1760 685 Reformation of anterior chamber 1565 570 Paracentesis 1000 435 Injection into anterior chamber 480 435 Irrigation of anterior chamber 480 435

P.U. (A) 358

117

Removal of foreign body from anterior chamber

1160 435

Valve implant in glaucoma 2895 1815 Surgical trabeculectomy 2040 760 Cyclophotocoagulation 1565 570

Lens Extracapsular extraction without implant – bilateral

3600 1320

Extracapsular extraction without implant - unilateral

2145 820

Phakoemulsification of lens with/without implant

2570 940

Extracapsular extraction with implant 2570 940 Extracapsular extraction with implant – bilateral

4750 1550

Yag laser photodistruption of posterior capsule of lens including laser capsulotomy

580 505

Secondary insertion of lens implant 1760 685 Revision of lens implant 1760 685 Removal of lens implant 1340 505 Small incision surgery with/without intra ocular lens (IOL)

2705 1550

Cataract surgery in complicated cases (e.g: dislocated lens) with/without implant

3600

Scleral fixation of intraocular lens 2390 Vitreous

Vitrectomy by anterior approach 1760 760 Vitrectomy pars plana approach with insertion of internal tamponade

2570 1320

Vitrectomy combined with membranectomy/insertion of internal tamponade/laser or cryotherapy

3600 2110

Retina

Buckling of sclera including implant/encircling explant/silicone oil/gas exchange/laser or cryotherapy

2145 820

Removal of silicone oil 865 355 Laser photocoagulation/Cryotherapy/ Radiotherapy of lesion of retina (and bilateral)

1000 405

Excision of lesion of retina 2145 940 Biopsy of lesion of retina 2145 505 Pars plana vitrectomy with removal of IOL/dislocated lens

5970 2930

P.U. (A) 358

118

Pars plana vitrectomy with removal of intra ocular foreign body

5970 2930

Buckling of sclera with trans pars plana vitrectomy

7030 3305

(i) Interventional radiology Biopsy

Fluoroscopically guided biopsy 725 Ultrasound guided biopsy 865 CT/MRI guided biopsy 1000 Transjugular/Transfemoral/plugged liver biopsy

1340

Drainage

Fluoroscopically guided drainage of fluid collection

725

Ultrasound guided drainage of fluid collection

1340

CT/MRI guided drainage of fluid collection 1565

Angioplasty Angioplasty 1760 Angioplasty with insertion of metallic stent 1890 Angioplasty with insertion of metallic stent-graft

2040

Insertion of aortic metallic stent-graft 4750 1550 Cerebral angioplasty with/without insertion of metallic stent

4750 1125

Cerebral angioplasty with insertion of metallic stent-graft

4750 1125

Embolization

Embolization of artery or vein 1890 Embolization of vascular mass including uterine embolization

2895

Embolization of bronchial artery 3600 Embolization of aneurysm 5970 Embolization of arteriovenous malformation

7030

Thrombolysis

Thrombolysis or aspiration of thrombus under imaging control

1340

Dilatation

P.U. (A) 358

119

Dilatation of stricture under imaging control

1160

Percutaneous dilatation of biliary stricture under imaging control

2305

Head and neck

Endoluminal stone extraction from salivary duct imaging control

725

Insertion of nasolacrimal stent under imaging control

2040

Head and neck spine

Chemonucleolysis 1160 Fluoroscopically guided discectomy including laser

2145

CT guided discectomy including laser 2895 Fluoroscopically guided percutaneous vertebroplasty

2145

CT Guided percutaneous vertebroplasty 2895

Thorax Insertion of tracheal/bronchial metallic stent

1760

Insertion of oesophageal metallic stent under imaging control

1565

Gastro-intestinal

Percutaneous gastrostomy 1760 Percutaneous gastrojejunostomy 2145

Liver Percutaneous cholecystotomy 1890 Percutaneous insertion of plastic biliary endoprosthesis

1890

Percutaneous insertion of metallic biliary endoprosthesis

2390

Transjugular intrahepatic portosystemic shunt

2895 1815

Urinary

Percutaneous nephrostomy 1340 Percutaneous removal of calculus 2705 Percutaneous pyelolysis 2705

Others Insertion of central venous catheter – non-tunnelled (X-ray guided)

725

P.U. (A) 358

120

Insertion of central venous catheter – tunnelled (X-ray guided)

1160

Cystablation under imaging control 1160 Insertion of vena cava filter 1340 Retrieval of foreign body under X-ray guidance

1565

Occlusion of fistula under imaging control 2145 Percutaneous laser coagulation of mass 3600

(j) Neurology Reporting of neurophysiology tests

Electroencephalogram (EEG) – routine and sleep or portable

315

Evoked potential study – visual evoked potential (VEP), brainstem auditory evoked response (BAEP) and somatosensory evoked response (SSEP)

580

Electromyography (EMG) and nerve conduction study

580

Nerve conduction study 315 Neurosurgery

Decompression and fusion of cranio cervical junction

7030 3305

Craniotomy for suprasellar tumour 7030 3305 Craniotomy for posterior fossa tumour 7030 3305 Selective posterior rhizotomy 5970 2930 Endoscopic discectomy 7030 Cervical laminectomy 3600

(k) Obstetrics and gynaecology Pregnancy and confinement

Caesarean delivery 1890 820 Caesarean hysterectomy 2390 820 Curettage of delivered uterus 480 405 Repositioning of inverted uterus 725 685 Neonatal exchange blood transfusion 1000

Female reproductive organs Uterus/Adnexa

Radical hysterectomy and lymphadenectomy (Wertheim's)

4750 1550

Total abdominal hysterectomy 2040 760 Subtotal abdominal hysterectomy 2040 760

P.U. (A) 358

121

Hysterectomy and removal of uterine adnexa

2040 760

Vaginal hysterectomy including laparoscopically assisted

2040 760

Hysterectomy and removal of uterine adnexa for ovarian malignancy

2895 820

Myomectomy including laparoscopically 2040 760 Plastic reconstruction of uterus 1565 685 Therapeutic endoscopic operation on uterus including endometrial ablation

1565 685

Hysteroscopy with/without D&C, biopsy including polypectomy

865 435

Endometrial biopsy or aspiration 405 265 Bilateral oophorectomy and salpingectomy in isolation

1890 685

Unilateral oophorectomy and salpingectomy in isolation

1340 685

Removal of products of conception from fallopian tube (ectopic pregnancy) including laparoscopically

1760 760

Laparoscopy including (e.g: puncture of ovarian cysts) plus/minus biopsy

1160 570

Laparoscopy and therapeutic procedures including laser, diathermy and destruction (e.g: endometriosis, adhesiolysis, tubal surgery and solid tumours)

1890 760

Ovarian cystectomy (not included in other procedures) (and bilateral)

1890 685

Block dissection of pelvic lymph nodes (not included in other procedures)

2040 760

Total exenteration of pelvis 5970 2930 Anterior exenteration of pelvis 4750 1815 Posterior exenteration of pelvis 4750 1815

Suspension Combined abdominal and vaginal operations to support outlet of female bladder

1890 685

Suprapubic sling operation 1890 760 Retropubic suspension of neck of bladder 1890 685 Vaginal operation to support outlet of female bladder

1890 685

Ventro-suspension of uterus including laparoscopic

1340 625

Cervix uteri

Colposcopy (with/without biopsy) 370

P.U. (A) 358

122

Amputation of cervix uteri 1160 505 Laser destruction of lesion of cervix uteri 370 265 Cauterisation of lesion of cervix uteri including loop diathermy

370 265

Cone biopsy of cervix uteri including laser 865 505 Punch biopsy of cervix uteri 315 265 Dilatation of cervix uteri and curettage of uterus including polypectomy and diathermy of cervix (for women over 40 years of age)

480 315

Vagina/Perineum

Cystourethroplasty 1760 685 Excision/Diathermy of urethral carbuncle 370 265 Operation on female perineum 480 265 Incision of introitus of vagina 480 505 Other obliteration of vagina 1890 760 Excision of septum of vagina 725 505 Excision of lesion of vagina (e.g: warts and cysts)

865 505

Reconstruction of vagina 2705 820 Anterior plus/minus posterior colporrhaphy and amputation of cervix uteri including primary repair of enterocele

2040 685

Posterior colporrhaphy 1340 625 Anterior plus/minus posterior colporrhaphy including primary repair of enterocoele

1890 685

Repair of enterocele (in isolation) plus/minus posterior colporrhaphy

1760 685

Anterior (plus/minus posterior) colporrhaphy with vaginal hysterectomy including primary repair of enterocoele

2480 820

Repair of vesicovaginal fistula 2145 820 Repair of urethrovaginal fistula 1890 820 Repair of rectovaginal fistula 2480 820 Repair of ureterovaginal fistula 2480 820

Vulva/Labia Excision of Bartholin’s gland 865 355 Marsupialisation of Bartholin’s gland 865 355 Simple vulvectomy 2145 760 Excision of excess labial tissue 725 435 Radical vulvectomy including block dissection of inguinal gland

2895 985

Excision of lesion of vulva 580 355

P.U. (A) 358

123

(l) Paediatric surgery Drainage of abscess of lung 2480 1125 Laparotomy for NEC 4750 2500 Single stage closure of epispadias 3600 2110 Excision of neural crest tumours (thoracic) 3600 2110 Transternal excision teratoma 3600 2110 Transternal excision lymphangioma 4750 2500 Endoscopy and cannulation of tracheal fistula

1565 570

Excision of bronchial cyst 3600 2110 Repair of lung 2895 1815 Excision of oesophageal duplication 3600 2110 Repair of H type of Tetralogy of Fallot (TOF)

3600 2110

Repair of tracheo-oesophageal cleft 5970 2930 Thoracotomy and primary repair of oesophageal atresia

4750 2500

Repair of recurrent TOF 5970 2930 Thoracotomy and division of fistula 2895 1815 Esophagostomy 1760 625 Oesophageal transection 2705 1550 Rectosigmoidectomy with coloanal reconstruction for Hirschsprung's disease

4750 2500

Lester-Martin modification of Duhamel 5970 2930 Kimura operation for total colonic aganglionosis

7030 3305

Ileocecal/jejunal patch for total colonic aganglionosis

7030 3305

Presacral injection of hypertonic saline 480 265 Insertion of encircling suture perianal sphincter

480 265

Posterior sagittal anorectoplasty 3600 2110 Posterior sagittal anorectoplasty with laparotomy for high type anorectal anomaly

4750 2500

Anterior sagittal anorectoplasty 2895 1815 Sacroperineal pull-through 2895 1815 Posterior sagittal anorectovaginourethroplasty for intermediate type cloacal

5970 2930

Posterior sagittal anorectovaginourethroplasty with laparotomy for high type

7030 3305

Redo posterior sagittal anorectoplasty for anorectal anomaly

5970 2930

Anoplasty 1760 625

P.U. (A) 358

124

Drainage of choledochal cyst 2390 985 Kasai operation for biliary atresia 7030 3305 Subtotal splenectomy 3600 2110 Repair of spleen 2705 1550 Aortopexy (for tracheomalacia) 3600 2110 Percutaneous insertion of nephrostomy tube

1160 435

Cutaneous ureterostomy 1565 570 Excision of ureterocoele 2480 1125 Excision of ectopic ureterocoele 2570 1320 Closure of bladder exostrophy 5970 2930 Conversion of cloacal exstrophy to bladder exstrophy with end colostomy

4750 2500

Conversion of cloacal exstrophy, ileostomy, separation of caecum from both hemibladders

7030 3305

Vesicostomy 1760 625 Mitrofanoff Appendicovasicostomy 3600 2110 Glandular hypospadias repair (e.g: MAGPI) 1565 570 Distal penile hypospadias repair (e.g: Flip-flap repair)

2390 985

Closure of urethra fistula 1000 405 First state repair of penile hypospadias 1565 570 Single stage island flap repair of proximal or penoscrotal hypospadias

3600 2110

Single stage repair for severe hypospadias with penoscrotal transposition

4750 2500

Single stage male reconstruction with vaginectomy for ambiguous genitalia

7030 3305

Correction of penoscrotal transposition 1890 685 Correction of chordae without hypospadias (no need for urethroplasty)

1565 570

Second stage repair of hypospadias 1565 570 Correction of penile chordae without hypospadius requiring urethroplasty

2895 1815

Hypospadias repair with free bladder or buccal mucusa graft

4750 2500

Exploration of scrotum 1000 405 Microvascular transfer of testis to scrotum 2705 1550 Laparoscopy and orchidopexy for intra-abdominal testis

2145 820

Laparotomy and ligation of testicular artery 865 355 Laparoscopic division of testicular artery 1565 570 Dorsal slit prepuce 405 265 Reduction clitoroplasty for congenital adrenal hyperplasia

2705 1550

P.U. (A) 358

125

Reduction clitoroplasty with vaginoplasty for congenital adrenal hyperplasia

4750 2500

Reduction clitoroplasty, laparotomy and sigmoid colon vaginoplasty

7030 3305

Redo reduction clitoroplasty with redo vaginoplasty with laparotomy and sigmoid

7030 3305

Excision of cervical cystic hygroma – small 1160 435 Excision of cervical cystic hygroma – large 2480 1125 Excision of cervical cystic hygroma – extensive

3600 2110

Correction of hydrocele – unilateral 1000 Correction of hydrocele – bilateral 1760 Closure of exomphalos major/gastroschisis – primary closure

3600

Closure of exomphalos major/gastroschisis – silastic closure

2145

Closure of exomphalos major/gastroschists – delayed primary closure

2570

(m) Paediatric orthopaedic surgery

Congenital dislocation of hip (CDH)

Close reduction with/without anaesthesia and hip spica

865 355

Close reduction with application of brace 315 265 Open reduction with hip spica 1890 685 Open reduction with pelvic osteotomy 2305 940 Open reduction with femoral osteotomy 2305 940 Open reduction with pelvic and femoral osteotomy

2705 1550

Knee Correction of deformity by serial casting 315 265 Correction of deformity by soft tissue release

1340 505

Correction of deformity by osteotomy 2305 940 Patellar stabilisation by casting 1160 435 Pseudoarthrodesis Excision and live graft 2895 1815 Excision and bone transport 2705 1550 Bone lengthening and correction of deformity

Using circular frame 2705 1550 Using uniaxial frame 2480 1125 Using circular and uniaxial frames (combined)

2705 1550

P.U. (A) 358

126

Foot Clubfoot correction by serial casting 315 265 Clubfoot correction by elongation of tendon Achilles

725 315

Clubfoot correction by complete soft tissue release

1760 625

Clubfoot correction by circular frame 1760 625 Deformity correction by tendon transfer and soft tissue release

2145 820

Deformity correction by osteotomy and fusion

2145 820

Arthrodesis

2145 820

Polio and cerebral palsy Soft tissue release and neurectomy of hip –bilateral

1340 505

Soft tissue release of knee – bilateral 1340 505 Soft tissue release of ankle – bilateral 1340 505 Tendon transfer 1565 570 Arthrodesis 2145 820

Tumour resection and limb salvage Soft tissue tumours - simple 2145 820 Soft tissue tumours - complex including neurovascular reconstruction

7030 3305

Bone tumours with endoprosthesis 7030 3305

(n) Pathology (Anatomical pathology)

Uncomplicated excision specimens - (e.g: appendix, fallopian tubes, vas,

tonsils, adenoids, sebaceous cyst, nasal polyp, heart valve)

55 - 70

More complicated excision specimens

Diagnostic biopsy (wedge/punch/trucut) (one paraffin block)

115 - 135

Medium sized specimens - (e.g: eye, salivary gland, thyroid, breast

lump, gall bladder, prostatic chips, splenectomy, simple hysterectomy, ovarian cyst, excised diabetic ulcer, excised tumour not more than 10cm, diagnostic biopsy sent as 2 to 3 separate specimens)

170 - 225

P.U. (A) 358

127

Large specimens - (e.g: laryngectomy, pneumonectomy,

simple mastectomy, breast hook wire with margins, gastrectomy, gut resection, nephrectomy, total abdominal hysterectomy and bilateral salphingoopherectomy (TAHBSO), cone biopsy, amputated limb (except for diabetes), excised tumour more than 10cm, diagnostic biopsy sent as 4 to10 separate specimens)

345 - 420

Radical specimens - (e.g: radical neck dissection,

mastectomy with axillary clearance, Whipple's Wertheim's, vulvectomy with lymphadenectomy, any other radical dissections requiring margins and lymph node status)

440 - 490

Specialised histopathology

Liver for non-neoplastic conditions including special stains

205 - 240

Muscle including special stains 280 - 345 Renal biopsy including special stains and immunofluorescence

410 - 485

Lymphoproliferative disorders including immunohistophenotyping of lymphomas

280 - 345

Frozen section (with follow-up paraffin section report)

410 - 555

Autopsy Visit to scene of crime 410 - 685 Procedure and report

685 - 1375

Cytopathology Report on gynaecological smear 45 - 50 Report on non-gynaecological smear 85 - 95 Procedure on aspiration cytology 315 Report on aspiration cytology

165 - 205

Haematology and transfusion Report based on blood film 45 - 70 Procedure on bone marrow aspiration 480 Report on bone marrow aspiration 135 - 275 Procedure on bone marrow trephine 580 405 Report on bone marrow trephine 135 - 275

P.U. (A) 358

128

Report on coagulation tests 70 - 135 Report on special haematological investigations - (e.g: folate-B12 status, Coomb's test,

Haemoglobin analysis, cytochemistry etc.)

70 - 135

Basic transfusion report - (e.g: discrepancies of grouping and

incompatibility of blood/blood products)

45 - 70

Report on transfusion problems 135 - 275 Pheresis 1000 Harvesting of bone marrow 1340 Grafting of bone marrow

1340

Genetics Chromosomes study immunofluorescence 135 - 410 Immunophenotyping 135 - 410 Deoxyribonucleic acid (DNA) content (Ploidy)

135 - 410

Gene rearrangement studies 135 - 410 Lymphocyte subsets 135 - 410 Report on other molecular genetic studies 135 - 410 Paternity testing 135 - 410 Human leucocyte antigen (HLA) typing

135 - 410

Immunology Report on general immunology test - (e.g: autoimmune disease screen,

autoantibodies screen)

40 - 70

Report on special immunological investigations - (e.g: Serum protein electrophoresis,

Cerebrospinal fluid (CSF) electrophoresis, immunotyping of monoclonal proteins, immunophenotyping of immune disorders, investigations of proteinuria, cellular function studies)

70 - 275

Medical microbiology Report on routine culture and sensitivity 15 - 20 Report on special cultures 70 - 135

P.U. (A) 358

129

Report on direct smears examination (gram/acid fast bacilli (AFB))

45 - 55

Report on serological tests 45 - 55 Report on special serological tests 70 - 135 Report on antimicrobial susceptibility testing (per test)

105 - 205

Consultation on patient management (Investigation and empirical therapy)

105 - 135

Positive blood culture smear examination and preliminary report with consultation on patient management

135 - 205

Consultation on infection control 135 - 205 Report on antigen detection (Immunofluorescence, IgG enzyme linked immuno-sorbent assay (ELISA), latex/coagglutination)

70 - 105

Chemical pathology Report on general chemistry profiles - (e.g: liver, bone, cardiac)

45 - 70

Report on general chemistry screen including executive screen

70 - 205

Report on special chemistry investigations - (e.g: metabolic studies (lipid, bone)

endocrine disorders, toxicology studies, therapeutic drug monitoring, maternal and foetal health assessment)

70 - 410

Report on dynamic studies - (e.g: function studies (GIT, endocrine,

renal))

115 - 410

Consultation for – Investigation strategy 105 - 135 Non-analytical variation 105 - 135 Drug interferences 105 - 135 Correlation between clinical data and clinical information provided

105 - 135

Miscellaneous Electron microscopy 340 - 410 Second opinion for – Data interpretation and bone marrow slides

135 - 275

Histopathology and cytopathology 275 - 685 Autopsy findings 275 - 1375

P.U. (A) 358

130

(o) Psychiatry – Psychotherapy

Individual psychotherapy – not less than 45 minutes per session including behaviour therapy and hypnotherapy

250

Group psychotherapy per person – one hour per group of not less than three patients and not more than eight patients

65

Marital therapy per couple – not less than 45 minutes per session for a couple together

250

Family therapy per family – not less than 45 minutes per session and not less than three members

250

Child psychotherapy – not less than 30 minutes per session including relevant family interviews

250

Each electroconvulsive therapy (ECT) 315 (p) Radiology and diagnostic imaging

Note: Where applicable, radiologist fee make up 30% of the total fee chargeable for radiology and diagnostic imaging.

Chest Chest (single view) 45 Chest (two views) 70 Chest (three views) 90 Chest (four views) 115

Abdomen Abdomen (single view) 45 Abdomen (two views) 70 Abdomen (three views) 90 Kidney, ureter and bladder (KUB) (single view)

115

Lateral pelvimetry 55 Anteroposterior (AP) and lateral pelvimetry

90

Spine

Cervical spine (single view) 45 Cervical spine (two views) 70 Cervical spine (three views) 90 Cervical spine (four views) 115 Cervical spine (five views) 135 Thoracic spine (single view) 45 Thoracic spine (two views) 70

P.U. (A) 358

131

Thoracic spine (three views) 90 Lumbo-sacral spine (single view) 45 Lumbo-sacral spine (two views) 70 Lumbo-sacral spine (three views) 90 Lumbo-sacral spine (four views) 115 Skeletal survey 250

Skull

Skull (single view) 45 Skull (two views) 70 Skull (three views) 90 Skull (four views) 115 Facial bones Facial bones (single view) 45 Facial bones (two views) 70 Facial bones (three views) 90 Nasal bones (single view) 45

Mandible

Mandible (single view) 45 Mandible (two views) 70 Mandible (three views) 90

Temporo-mandibular joints

Temporo-mandibular joints (single view) 45 Temporo-mandibular joints (two views) 70 Temporo-mandibular joints (three views) 90 Temporo-mandibular joints (four views) 115

Mastoids

Mastoids (single view) 45 Mastoids (two views) 75 Mastoids (three views) 110 Mastoids (four views) 130

Paranasal sinuses

Paranasal sinuses (single view) 45 Paranasal sinuses (two views) 70 Paranasal sinuses (three views) 90

Optic foramina view Unilateral 70 Bilateral 105

Orbits

Orbits (two views) 45 Orbits (three views) 70 Orbits (four views) 90

P.U. (A) 358

132

Internal auditory canal Internal auditory canal (single view) 45 Internal auditory canal (two views) 70 Internal auditory canal (three views) 90

Shoulder Shoulder (single view) 45 Shoulder (two views) 70 Shoulder (three views) 90 Shoulder (four views) 115 Acriomo-clavicular joints – both weight bearing

55

Arm (Humerus)

Arm (single view) 45 Arm (two views) 70

Elbow joint

Elbow joint (single view) 45 Elbow joint (two views) 70 Elbow joint (three views) 90 Elbow joint (four views) 115

Forearm (Radius/Ulna)

Forearm (single view) 45 Forearm (two views) 70

Wrist joint

Wrist Joint (single view) 45 Wrist Joint (two views) 70 Wrist Joint (three views) 90 Wrist Joint (four views) 115

Hand

Hand (single – one view) 45 Hand (single – two views) 70 Hand (single – three views) 90 Hand (both – one view) 55 Hand (both – two views) 80 Hand (both – three views) 105 Left Hand for bone age 45

Thumb or single digit

Thumb or single digit (single view) 30 Thumb or single digit (two views) 40

P.U. (A) 358

133

Clavicle Clavicle (single view) 45 Clavicle (two views) 70

Sterno-clavicular joint Sterno-clavicular joint (single view) 45 Sterno-clavicular joint (two views) 70 Sterno-clavicular joint (three views) 90 Sternum (single view) 45

Scapula Scapula (single view) 45 Scapula (two views) 70 Carpal tunnel view 70 Scaphoid views 90

Pelvis Pelvis (single view) 50 Pelvis (two views) 75 Pelvis (three views) 95

Hip joint Hip joint (single view) 50 Hip joint (two views) 75 Hip joint (three views) 95 Hip joint (four views) 120 Hip joint (five views) 145

Femur (thigh) Femur (single view) 50 Femur (two views) 70

Knee Knee (single view) 45 Knee (two views) 70 Knee (three views) 90 Knee (four views) 115 Knee (five views) 135

Lower Leg (Tibia/Fibula) Lower leg (single view) 45 Lower leg (two views) 70

Ankle Ankle (single view) 45 Ankle (two views) 70 Ankle (three views) 90

P.U. (A) 358

134

Ankle (four views) 115 Ankle (five views) 135

Foot Foot (single view) 45 Foot (two views) 70 Foot (three views) 90 Both feet (two views) 80 Both feet (three views) 105

Subtalar joints Subtalar joints (single view) 45 Subtalar joints (two views) 70 Subtalar joints (three views) 90 Subtalar joints (four views) 115

Calcaneum Calcaneum (single view) 45 Calcaneum (two views)

70

Bone densitometry Dexa 170 Ultrasound 150

Radiographic contrast examination (radiologist fee in parenthesis)

Barium swallow (40%) 115 Barium meal (double contrast) (40%) 170 Barium meal and follow through (40%) 205 Small bowel enema (40%) 205 Gastrograffin or non-ionic contrast upper gastrointestinal study (40%)

205

Barium enema (single or double contrast) (40%)

205

Gastrograffin or non-ionic contrast enema (40%)

205

Loopogram (40%) 205 Duodenal intubation (40%) 230 Oral cholecystogram (single dose) (30%) 135 Oral cholecystogram (double dose) (30%) 170 Cystogram (30%) 205 Ascending urethrogram (40%) 230 Micturating cystourethrogram (40%) 285 Retrograde pyelogram – one side (30%) 135 Retrograde pyelogram – both sides (30%) 205 Ileal conduit study (40%) 205 Nephrostomy pyelogram – one side (30%) 170

P.U. (A) 358

135

Nephrostomy pyelogram – both sides (30%)

235

IVU standard dose contrast (30%) 230 IVU standard and tomograms (30%) 265 IVU double dose contrast (30%) 310 IVU double dose of contrast and tomogram (30%)

345

IVU standard dose and delayed radiographs (30%)

285

IVU double dose of contrast and delayed radiographs (30%)

365

IVU standard dose and tomograms and delayed radiographs (30%)

320

IVU double dose and tomograms and delayed radiographs (30%)

400

T-tube cholangiogram (30%) 135 Operative cholangiogram (30%) – urgent reporting only

285

Hysterosalpingogram (ionic contrast) (30%) – Screening and reporting only

135

Hysterosalpingogram (non-ionic contrast) (30%) – Screening and reporting only

135

Hysterosalpingogram plus ionic contrast (whole procedure) (40%)

205

Hysterosalpingogram plus non-ionic contrast (whole procedure) (40%)

230

Sinogram (40%) 170 Parotid sialogram – one side (50%) 230 Parotid sialogram – both sides (50%) 460 Submandible sialogram – one side (50%) 230 Submandible sialogram – both sides (50%) 460 Arthrogram – one side (50%) 230 Arthrogram – both sides (50%) 400 Lumbar myelogram (water soluble non-ionic contrast) (50%)

515

Cervical/thoracic myelogram (50%) 605 Bronchogram – one side (40%) (screening, reporting plus radiographs only)

230

Bronchogram – both sides (40%) (screening, reporting plus radiographs only)

345

Tomography

Tomogram – one plane (30%) 195 Tomogram – two planes (30%) 250

P.U. (A) 358

136

Tomogram – pituitary fossa AP/lateral (30%)

195

Mammogram

Mammography up to four views (35%) 230 Mammography and one additional view (35%)

265

Mammography and two additional views (35%)

295

Mammography and limited ultrasound additional (35%)

285

Computer tomography scans (CT scans)

Note: Charges are based on 100ml of intravenous non-ionic contrast except CT brain/orbit – 50 ml

Brain (without contrast) (30%) 400 Brain (with non-ionic contrast) (35%) 490 Brain complex CT (50%) 630 Abdomen (without contrast) (30%) 400 Abdomen (with non-ionic contrast) (35%) 515 Abdomen two phases (40%) 630 Abdomen three phases (40%) 745 Abdomen four phases (40%) 915 Abdomen complex (40%) 860 Pelvis (without contrast) (30%) 345 Pelvis (with non-ionic contrast) (35%) 460 Pelvis complex (50%) 570 Spines – cervical or lumbar (without contrast) (30%)

400

Spines – cervical or lumbar (with intraspinal non-ionic contrast (50%)

745

Spine complex (50%) 860 Spines – thoracic (without contrast) 30% 460 Spines – thoracic (with intraspinal non-ionic contrast) (50%)

745

Spine complex (50%) 860 Chest (without contrast) (30%) 345 Chest (with non-ionic contrast) (35%) 460 Chest complex (50%) 570 Low dose screening CT of the chest (30%) 285 High resolution computerised tomography (HRCT) – inspiratory or expiratory (30%)

345

HRCT – inspiratory plus expiratory (40%) 515 Neck/Thyroid (without contrast) (30%) 345

P.U. (A) 358

137

Neck/Thyroid (with non-ionic contrast) (30%)

460

Postnasal space and neck (without contrast) (30%)

515

Postnasal space and neck (with non-ionic contrast) (30%)

630

Postnasal space complex (50%) 745 Orbits (Without contrast) (20%) 345 Orbits (With non-ionic contrast) (25%) 460 Orbits complex (50%) Pituitary fossa (Without contrast) (20%) 345 Pituitary fossa (With ionic contrast) (25%) 460 I.A.M. (Without contrast) (20%) 345 I.A.M. (Without non-ionic contrast) (25%) 460 Total body scan (brain, neck, chest, abdomen and pelvis) (without contrast) (20%)

1030

Total body scan (with non-ionic contrast) (25%)

1145

Total body scan complex (50%) 1260 Chest, abdomen and pelvis (without contrast) (20%)

915

Chest, abdomen and pelvis (with non-ionic contrast) (25%)

1030

Chest, abdomen and pelvis complex (50%) 1145 Spiral CT of abdomen and pelvis for renal calculi (without intravenous (IV) contrast) (30%)

345

Single plane high resolution CT of the parasanal sinuses for sinusitis (without contrast) (20%)

230

Single plane CT of the paranasal sinuses (without contrast) (20%)

345

Single plane CT of the parasanal sinuses (with non-ionic contrast) (25%)

460

Abdomen and pelvis (without contrast) (30%)

685

Abdomen and pelvis (with contrast) (35%) 800 Abdomen and pelvis complex (50%) 915 Chest and upper abdomen (without contrast) (30%)

685

Chest and upper abdomen (with contrast) (35%)

800

Chest and upper abdomen complex (50%) 915 CT two system (not listed above) (without contrast) (30%)

685

P.U. (A) 358

138

CT two system (not listed above) (with contrast) (35%)

800

CT two system (not listed above) (complex) (50%)

915

CT extremities (without contrast) (one region) (30%)

400

CT extremities (with contrast one region) (35%)

515

CT extremities complex (50%) 630

Ultrasound Upper abdomen (40%) 170 Pelvis (40%) 135 Abdomen and pelvis (50%) 230 Kidneys and bladder (40%) 115 Kidneys and bladder plus residual urine volume estimation (50%)

135

Brain (neonatal) (40%) 135 Detailed ultrasound scan of foetus 285 Thyroid (40%) 115 Breast (40%) 160 Doppler ultrasound of extra-cranial carotids (50%)

400

Doppler ultrasound of arteries per region (50%)

285

Doppler ultrasound of veins single limb (50%)

285

Doppler ultrasound of veins two limbs (50%)

460

Doppler ultrasound of arteries for single limb (50%)

345

Doppler ultrasound of arteries for two limbs (50%)

515

Musculoskeletal ultrasound per region (40%)

170

Ultrasound scrotum (40%) 115 Doppler ultrasound for scrotum (50%) 230 Doppler ultrasound for other organs (per organ) not listed above (50%)

345

Endocavitary ultrasound (50%) 170 Heart ultrasound for pericardial disease 90 Surcharge for each portable ultrasound (payable to radiologist during normal working hours)

55

Surcharge for each portable ultrasound (payable to radiologist after normal working hours)

170

P.U. (A) 358

139

Screening Endoscopic retrograde cholangio pancreatography (ERCP) (30%) (screening and reporting only) – simple

230

ERCP (30%) (screening and reporting only) – complex

345

Magnetic Resonance Imaging (MRI) Brain

Brain (without contrast) 800 Brain (with contrast) 1030 Brain with magnetic resonance angiography (MRA) (Intracranial)

1375

Brain with MRA plus contrast 1600 Brain with MRA plus bilateral carotids plus contrast

2060

MRA intracranial or extracranial carotids 800 Brain MRV – simple 800 Brain MRV – complex 1030 Pituitary (without contrast) 800 Pituitary (with contrast) 1030 Pituitary (with contrast dynamic) 1375 I.A.M (without contrast) 800 I.A.M (with contrast) 1030 I.A.M plus brain (without contrast) 1375 I.A.M plus brain (with contrast) 1600

Orbit Orbits (without contrast) 800 Orbits (with contrast) 1030 Orbits and brain (without contrast) 1375 Orbits and brain (with contrast) 1600

Neck

Neck (without contrast) 800 Neck (with contrast) 1030 Neck and brain (without contrast) 1485 Neck and brain (with contrast) 1715 Brachial plexus (without contrast) 915 Brachial plexus (with contrast) 1145

Thorax

Mediastinum (without contrast) 800 Mediastinum (with contrast) 1030

P.U. (A) 358

140

Cardiac Cardiac MRI – simple 1145 Cardiac MRI – intermediate 1715 Cardiac MRI – complex 2290 Thoracic MRA – simple 1030 Thoracic MRA – intermediate 1260 Thoracic MRA – complex 1485 Pulmonary MRA – simple 1030 Pulmonary MRA – intermediate 1260 Pulmonary MRA – complex 1485 (surcharge for each 10 ml of intravenous (IV) MRI contrast agent)

285

Upper Abdomen

Upper abdomen – simple 1030 Upper abdomen – intermediate 1260 Upper abdomen – complex 1485 Magnetic resonance cholangio pancreaticography (MRCP)

800

Magnetic resonance urography 800 Upper abdomen MRA – simple 1030 Upper abdomen MRA – intermediate 1260 Upper abdomen MRA – complex 1485 (surcharge for each 10 ml of intravenous (IV) MRI contrast agent)

285

Pelvis

Pelvis – simple 1030

Pelvis – intermediate 1260 Pelvis – complex 1485 MRI pelvimetry 570 (Surcharge for each 10 ml of intravenous (IV) MRI contrast agent)

285

Spine

MRI whole spine (without contrast) (for cord compression)

1600

MRI whole spine (with contrast) (for cord compression)

1830

MRI cervical spine (without contrast) 1030 MRI cervical spine (with contrast) 1375 MRI thoracic spine (without contrast) 1030 MRI thoracic spine (with contrast) 1375 MRI lumbar spine (without contrast) 1030 MRI lumbar spine (with contrast) 1375

P.U. (A) 358

141

Joints (shoulder, sternoclavicular, elbow, wrist, hip, sacro-iliac, knee, ankle, sub-tarsal)

MRI single joint (without contrast) 1030 MRI single joint (with contrast) 1375

Region (arm, forearm, hand, thigh, lower leg-calf/foot)

MRI single region (without contrast) 1145 MRI single region (with contrast) 1490 MRI Arthrography (radiologist fee) 345

(q) Radiotherapy and oncology External irradiation treatment (linear accelerator)

Usually entails daily treatment 5 times weekly at 200cGy per treatment

170

External irradiation treatment using any other fraction to be charged according to biological equivalent dose - treatment of a Co 60 teletherapy unit to be charged 30% less on daily treatment fee

115 - 345

Treatment fee inclusive of specialist fee

Low dose rate intracavitary treatment each session to include radioactive source, applicators (not inclusive of ward, theatre and anaesthetic fees)

2860 - 5720

Interstitial treatment - (e.g: implants inclusive of source and

other applicators)

3430 - 5720

High dose rate intracavitary/intraluminal radiotherapy for complete treatment (not inclusive of applicators)

2290 - 5720

Cytotoxic therapy (excluding consultation)

Infusion 570 - 860 Prolonged Infusion 685 - 1030 Progressive chemotheraphy per day (Multiple days)

170 - 285

(r) Skin and subcutaneous tissue Lesions of skin

Coccygeal pressure ulcer excision 865 685 Microscopically controlled excision of

2480 820

P.U. (A) 358

142

lesion of skin or subcutaneous tissue (Moh's chemosurgery)

Malignant melanoma excision including grafting

2145 685

Excision of lesion of skin or subcutaneous tissue – up to three excision

405 405

Excision of lesion of skin or subcutaneous tissue – four or more excision

1000 505

Lesion requiring wide excision including rodent ulcer excision

1000 405

Curettage/cryotherapy of lesions of skin including cauterisation – four or more

1000 315

Laser destruction of lesion of skin 580 265 Shave biopsy of lesion of skin 315 265 Removal of foreign body in deeper tissue 725 355 Drainage of lesion of skin including abscess 370 265 Drainage of large subcutaneous abscess/haematoma

580 405

Limited area dermabrasion of skin 580 315 Extensive dermabrasion of skin 1000 435 Excision of nail bed (Zadeks) 725 435

Repair Primary suture of wound with involvement of deeper tissue

1340 625

Secondary suture of skin 370 315 Insertion/removal of skin expander into tissue

1340 505

Debridement of wound (and surgical toilet) 480 315

Burns Escharectomy of burnt skin or subcutaneous tissue (not more than 10%)

1340 435

Escharectomy of burnt skin or subcutaneous tissue (greater than 10%)

1760 760

Extensive dressing of burn of skin or subcutaneous tissue

480 625

Transplant

Distant flap of skin and muscle 1890 940 Neurovascular island flap 2390 940 Large local flap including myocutaneous and fascia

1760 505

Small local flap 1760 505

Grafts Split autograft of skin – small site 1000 505

P.U. (A) 358

143

Split autograft of skin – large site 2040 685 Full thickness graft 1160 685 Microvascular free tissue transfer 3600 1550

(s) Spine, spinal cord and peripheral nerves

Cervical region Primary posterior decompression including fusion

3600 1320

Primary posterior decompression with fusion and instrumentation

3600 1320

Open door laminoplasty of the cervical region (Hirobyashi)

3600 1320

Revision posterior decompression including fusion

4750 1320

Revision posterior decompression with fusion and instrumentation

4750 1320

Revision anterior decompression including fusion

4750 1320

Revision anterior decompression with fusion and instrumentation

4750 1320

Combined anterior and posterior fusion of cervical spine including instrumentation

5970 1815

Trans oral surgery including posterior fixation

5970 1550

Endoscopic discectomy 7030 Cervical laminectomy 3600 Decompression and fusion of craniocervical junction

7030

Primary posterior excision of cervical disc 2895 1320 Revision posterior excision of intervertebral disc(s) including fusion

4750 1320

Revision posterior excision of intervertebral disc(s) with fusion and instrumentation

4750 1320

Primary anterior excision of disc(s) including fusion

3600 1320

Primary anterior excision of disc(s) with fusion and Instrumentation

3600 1320

Revision anterior excision of disc(s) including fusion

4750 1550

Revision anterior excision of disc(s) with fusion and instrumentation

4750 1550

P.U. (A) 358

144

Thoracic region Primary transthoracic/posterior/antero-lateral excision of intervertebral disc(s) including fusion

2895 1320

Primary transthoracic/posterior/antero-lateral excision of intervertebral disc(s) with fusion and instrumentation

2705 1320

Primary posterior decompression including fusion

3600 1320

Primary posterior decompression with fusion and instrumentation

3600 1320

Revision posterior decompression including fusion

4750 1320

Revision posterior decompression with fusion and instrumentation

4750 1320

Primary anterior/transthoracic decompression including fusion

4750 1320

Primary anterior/transthoracic decompression with fusion and instrumentation

4750 1320

Revision anterior/transthoracic decompression including fusion

4750 1320

Lumbar region

Primary posterior excision of intervertebral disc(s) including fusion

2390 940

Primary posterior excision of intervertebral disc(s) with fusion and instrumentation including graft stabilisation

3600 1550

Revision posterior excision of intervertebral disc(s) including fusion

2895 1125

Revision posterior excision of intervertebral disc(s) with fusion and instrumentation

4750 1550

Primary transabdominal/retroperitoneal excision of intervertebral disc(s) including fusion and instrumentation

3600 1320

Revision anterior excision of intervertebral disc(s) including fusion

4750 1550

Revision anterior excision of intervertebral disc(s) with fusion and instrumentation

4750 1550

Primary posterior decompression on spine, including fusion

2895 985

Primary posterior decompression with fusion and instrumentation

2895 985

P.U. (A) 358

145

Revision posterior decompression with fusion and instrumentation

2895 1125

Primary anterior decompression including fusion

3600 1550

Primary anterior decompression with fusion and instrumentation

3600 1550

Revision anterior decompression with fusion and instrumentation

4750 1815

Combined anterior and posterior decompression including fusion and instrumentation

5970 1815

Posterior spinal fusion with instrumentation for scoliosis, kyphosis, fractures, tumours or infection

5970 2110

Anterior spinal fusion with instrumentation for scoliosis, kyphosis, fractures, tumours or infection

7030 2500

Percutaneous (or laser) discectomy 2145 940 Microdiscectomy 2390 940 Revision microdiscectomy 2895 1125 Removal of correctional instrumentation from spine

1565 625

Exploration of spine including biopsy 1890 685 Manipulation of spine 580 405 Chemonucleoysis 1160 435

Spinal cord

Partial excision of spinal cord 4750 1550 Open operation on spinal cord 4750 1550 Repair of spinal myelomeningocele 3600 1320 Excision of intradural lesion 4750 1550 Drainage of spinal canal including insertion of shunt

2705 820

Lumbar puncture including spinal manometry

370 265

Excision of intramedullary tumour 4750 1550 Nerve roots

Rhizolysis (open) 2706 820 Open sympathectomy 7030 Endoscopic sympathectomy 7030

Symphathetic nerves

Thorascopic cervical sympathectomy 2705 820 Laparoscopic lumbar sympathectomy 1890 760 Presacral sympathectomy 1565 685 Selective posterior rhizotomy 7030

P.U. (A) 358

146

Peripheral nerves Excision of peripheral nerve 865 435 Transection of peripheral nerve 865 435 Neurectomy (major nerve) 1340 505 Excision of lesion of peripheral nerve 1000 435 Excision of lesion (major nerve) 1340 505 Primary repair of peripheral nerve including microsurgery

2040 820

Secondary repair of peripheral nerve including microsurgery

2145 760

Primary graft to peripheral nerve 2390 760 Secondary graft to peripheral nerve 2390 685 Primary repair of peripheral nerve 865 505 Secondary repair of peripheral nerve 1160 435 Primary repair of nerve trunk 1000 505 Secondary repair of nerve trunk 1565 505 Carpal or cubital tunnel release including endoscopic

865 435

Carpal or cubital tunnel release including endoscopic – bilateral

1565 760

Release of entrapment of deeply placed peripheral nerve

865 435

Release of entrapment of peripheral nerve 865 435 Neurolysis and transposition of peripheral nerve

1000 505

Revision of release of peripheral nerve 1565 505 Implantation of neurostimulator into peripheral nerve

2040 315

Biopsy of peripheral nerve 865 355 Exploration and grafting of brachial plexus 1000 570

Pain relief

Paravertebral block up to two levels (under X-ray control)

580

Sacral root block (under X-ray control) 580 Intravenous regional sympathetic block (guanethidine block) – one injection

480

Intravenous regional sympathetic block (guanethidine block) - course of three

1000

Stellate ganglion block (local anaesthethic (LA))

480

Stellate ganglion block (neurolytic) 580 Coeliac plexus block (LA or neurolytic) 1160 Splanchnic nerve block – bilateral (local anaesthethic or neurolytic)

1160

Dorsal root ganglion block (LA or neurolytic)

1000

P.U. (A) 358

147

Dorsal root ganglion block (local frequency)

1565 315

Intrathecal neurolysis 1160 Trigeminal ganglion injection (LA under X-ray control)

1160

Trigeminal ganglion radio frequency lesion (under X-ray control)

2145

Percutaneous cordotomy of spinal cord 2705 940 Epidural injection (cervical) 725 265 Epidural injection (lumbar) 580 265 Epidural injection (thoracic) 725 265 Injection of therapeutic substance into CSF 370 820 Facet or sacroiliac joint radio frequency (RF) thermocoagulation including rhizolysis (under X-ray control with sedation/GA) – 3 joints

1160 405

Facet or sacroiliac joint radio frequency (RF) thermocoagulation including rhizolysis (under X-ray control with sedation/GA – 6 joints

2040 685

Facet joint injection (under X-ray control with sedation/GA) – 2 joints

725 265

Facet joint injection (under X-ray control with sedation/GA) – 4 joints

865 315

Facet joint injection (under X-ray control with sedation/GA) – 6 joints

1000 355

Implantation of neurostimulator into peripheral nerve

2040 315

Peripheral nerve lesion (radio frequency, cryoprobe or phenol)

725

LA blockade of major nerve trunk 370 Lumbar sympathectomy - diagnostic (LA under X-ray control)

1000

Thoracic sympathectomy - diagnostic (LA under X-ray control)

1000

Lumbar sympathectomy - therapeutic (neurolytic under X-ray control)

1340 405

Thoracic sympathectomy - therapeutic (neurolytic under X-ray control)

1565 435

Cryotherapy to pituitary gland 2570 940 Injection(s) into large joint(s) under X-ray control

480

Neurophysiological procedures

Electro-convulsive therapy (ECT) 315 265 Electroencephalography (EEG) 315

P.U. (A) 358

148

Recording and reporting on evoked potential study

580

Recording and reporting on electromyography and nerve conduction studies (EMG)

580

Trans tympanic electrocochleography 725 (t) Thorax and intra-thoracic organs Oesophagus

Thorascopic oesophageal mobilisation via mediastimum

4750 1815

Oesophagogastrectomy 5970 2500 Total oesophagectomy and interposition of intestine

7030 3305

Open excision of lesion of oesophagus 1890 1125 Bypass of oesophagus 2480 1550 Revision of oesophageal anastomosis 2705 1320 Closure of bypass of oesophagus 2145 1125 Transthoracic repair of oesophagus 3600 1320 Thorascopic repair of oesophagus 2895 1320 Oesophagocardiomyotomy (Heller's operation)

2040 985

Thorascopic oesophagogastric myotomy 2145 985 Injection sclerotherapy for oesophageal varices

1000 685

Transthoracic repair of hiatus hernia 2305 940 Transthoracic repair of diaphragmatic hernia

2305 940

Transabdominal repair of hiatus hernia 2145 760 Transabdominal repair of diaphragmatic hernia

2895 820

Laparoscopic repair of hiatus hernia 2145 760 Transabdominal anti-reflux operations 2895 820 Revision of anti-reflux operations 3600 1320

Chest wall Thoracoplasty 2705 985 Excision of chest wall tumour 2390 940 Correction of pectus deformity of chest wall 2895 940 Multiple fracture fixation 2305 940 Exploratory median sternotomy 1160 760 Exploratory thoracotomy 1565 760 Resection of rib and open drainage of pleural cavity

1565 760

Repair of rupture of diaphragm 2895 1125 Plication of paralysed diaphragm 2390 985

P.U. (A) 358

149

Repair of congenital diaphragmatic hernia 2705 1550

Trachea Partial excision of trachea including reconstruction

3600 2110

Tracheoplasty 1760 625 Open placement of prosthesis in trachea 1760 505 Tracheostomy 1000 570 Insertion of mini-tracheostomy 580 405 Thoracotomy, ligation of Tetralogy of Fallot (TOF) oesophageal anastomosis

4750

Thoracotomy, ligation of TOF, cervical oesophagostomy

4750

Cervical oesophagostomy and gastrectomy 2305

Fibreoptic endoscopic procedures under topical anaesthesia

Fibreoptic examination of trachea and bronchus including biopsy/removal of foreign body

725 505

Bronchial lavage (diagnostic or therapeutic)

865

Dilatation of tracheal stricture including insertion of stent

865

Dilatation of bronchial stricture by fibreoptic bronchoscope

1000

Transbronchial biopsy 1000

Bronchus, lungs and pleura Diagnostic examination of bronchus using rigid bronchoscope including biopsy/removal of foreign body/dilatation of stricture

1000 505

Total pneumonectomy 3600 1550 Open lobectomy of lung including excision of segment

3600 1550

Lung resection with resection of chest wall 5970 1815 Thorascopic lung resection including video assisted

1890 685

Open excision of lesion of lung 2895 1320 Needle biopsy of lung 480 315 Decortication of pleura or lung 2895 1125 Pleurectomy for pneumothorax 2480 985 Open excision/biopsy of lesion of pleura 2705 940 Endoscopic excision of lesion(s) of lung/pleura

1000 505

P.U. (A) 358

150

Thoracoscopy (plus/minus biopsy) pleura/lung

580 505

Drainage of pleural cavity 580 315 Insertion of tube drain into pleural cavity 580 315 Introduction of substance into pleural cavity with chest drain

315 265

Biopsy of pleura 580 315 Lung transplant 7030 3305 Lung volume reduction surgery 4750 2500

Mediastinum

Thymectomy 2145 1550 Exploration of mediastinum 1160 760 Endoscopic excision of lesion of mediastinum

1340 505

Diagnostic endoscopic examination of mediastinum

1340 505

Heart-cardiac surgery

Correction of Tetralogy of Fallot (TOF) 7030 3305 Atrial inversion for transposition of great vessels

7030 3305

Other correction of transposition of great vessels

7030 3305

Correction of total anomalous pulmonary venous connection

7030 3305

Closure of defect of atrioventricular septum using dual prosthetic patches

7030 3305

Closure of defect of interatrial septum 7030 2930 Closure of defect of interventricular septum 7030 2930 Therapeutic transluminal operation on septum of heart

2895 2500

Creation of valved cardiac conduit 7030 3305 Excision of cardiac tumour 7030 3305 Replacement of mitral valve including valvuloplasty

7030 2930

Plastic repair of mitral valve 7030 2930 Replacement of aortic valve including valvuloplasty

7030 2930

Replacement of tricuspid valve 7030 2930 Replacement of pulmonary valve including valvuloplasty/valvotomy

7030 2930

Replacement of unspecified valve of heart 7030 2930 Open valvotomy 7030 2930 Closed valvotomy (mitral/pulmonary) 4750 2500 Therapeutic transluminal operation on valve of heart

2705 2110

P.U. (A) 358

151

Removal of obstruction from structure adjacent to valve of heart

7030 2930

Autograft bypass for coronary arteries including harvesting of grafts and endarterectomy

7030 2930

Redo of bypass for coronary arteries including harvesting of grafts

7030 3305

Correction of anomalous coronary arteries 7030 3305 Open operation on conducting system of heart

7030 2930

Repair of ventricular aneurysm 5970 2930 Excision of pericardium 3600 1125 Decompression of cardiac tamponade 2305 985 Incision of pericardium 1340 985 Midcab coronary artery bypass grafts without cardio-pulmonary bypass pump

7030 3305

Minimally invasive open heart surgery with cardio-pulmonary bypass pump

7030 3305

Ventricular assist device 7030 3305 Heart transplant 7030 3305

Heart-cardiology Percutaneous transluminal angioplasty of coronary arteries including laser

2895 1550

Percutaneous transluminal angioplasty with stent insertion

3600 1550

Map guided surgery for ventricular arrhythmias including mapping

2705 3305

Percutaneous transluminal ablation of atrio-ventricular node

2390 985

Percutaneous transluminal ablation of accessory pathway including mapping

4750 1550

Mapping of conducting system (in isolation)

1565 820

Cardiac pacemaker system introduced through vein (single chamber)

1565 820

Cardiac pacemaker system introduced through vein (dual chamber)

2145 820

Resiting of intravenous cardiac pacemaker system

1340 685

Replacement of generator for intravenous cardiac pacemaker system

1760 760

Removal of pacing system with bypass 4750 2500 Removal of pacing system without bypass 580 940 Implantation of automatic cardioverter/ defibrillator

3600 940

P.U. (A) 358

152

Adult cardiac catheterisation including coronary arteriography/catheterisation of right/left side of heart/contrast radiology

1340 760

Paediatric cardiac catheterisation 1565 820 Pericardiocentesis 1340 685 Percutaneous transluminal peripheral angioplasty (femoral, iliac, renal, popliteal, subclavian, other distal vessels)

2705 1550

Percutaneous transluminal peripheral angioplasty with stent placement

2895 1550

Percutaneous transluminal carotid angioplasty with stent placement

4750 1550

Percutaneous transluminal ablation of ventricular tachycardia

3600 1550

Percutaneous transluminal modification of atrioventricular node

2480 985

Percutaneous transluminal occlusion of coronary fistula/arteriovenous (AV) malformation

3600 1550

Great vessels

Correction of truncus arteriosus 4750 3305 Closed ligation of patent ductus arteriosus 3600 2110 Percutaneous transluminal prosthetic occlusion of patent ductus arteriosus

2895 1125

Creation of shunt to pulmonary artery from aorta using tube prosthesis

5970 2110

Connection to pulmonary artery from aorta 5970 2110 Creation of shunt to pulmonary artery from subclavian artery using interposition tube prosthesis

4750 2110

Connection to pulmonary artery from subclavian artery

5970 2110

Repair of pulmonary artery 7030 2110 Open operation on pulmonary artery 3600 2110 Pulmonary embolectomy 5970 3305 Transluminal operation on pulmonary artery

2705 1550

Emergency replacement of aneurysmal segment of ascending aorta

7030 3305

Emergency replacement of aneurysmal segment of arch of aorta

7030 3305

Emergency replacement of aneurysmal segment of thoracic aorta

7030 3305

Planned replacement of aneurysmal segment of ascending aorta

4750 2930

P.U. (A) 358

153

Planned replacement of aneurysmal segment of arch of aorta

7030 3305

Planned replacement of aneurysmal segment of thoracic aorta

7030 3305

Replacement of thoracoabdominal aneurysms

7030 3305

Revision of prosthesis of abdominal aorta 4750 2110 Excision of infected aortic graft with bypass 7030 3305 Plastic repair of aorta 4750 1815 Percutaneous transluminal balloon operation on aorta

1760 625

Others

Proximal gastric vagotomy 2040 685 Highly selective vagotomy 2040 685 Vagotomy with pyloroplasty 2145 820 External cardioversion 315 315 Transoesophageal echocardiography 1000 435 Coronary angioplasty standby team 315 355

(u) Urinary system and male reproductive organs

Kidney/renal pelvic

Transplantation of kidney 4750 2500 Nephrectomy and excision of perirenal tissue

2390 1125

Nephro-ureterectomy 2390 820 Excision of rejected transplanted kidney 2040 760 Nephrectomy (and bilateral) 2040 820 Laparoscopic nephrectomy 2040 820 Partial excision of kidney 2145 820 Open pyeloplasty 2040 685 Repair of kidney wound 2305 760 Open removal of calculus from kidney 2390 685 Drainage of kidney 1760 760 Drainage of pyonephrosis 1760 760 Other open operation on kidney 1890 685 Drainage of perinephric abscess 1760 685 Endoscopic fragmentation of calculus of kidney

1890 685

Percutaneous nephrolithotomy including cystoscopy and retrograde catheterisation

3600 985

Diagnostic endoscopic examination of kidney including biopsy and other therapeutic procedures

2040 685

P.U. (A) 358

154

Percutaneous fine needle biopsy of lesion of kidney

480 355

Percutaneous insertion of nephrostomy tube

1340 405

Percutaneous tru-cut needle biopsy of lesion of kidney

865

Extracorporeal fragmentation of calculus of kidney (Lithotripsy) – single treatment

1160 505

Extracorporeal fragment of calculus of kidney-stone free/course of treatment

1565 625

Laparoscopy removal of renal cyst 2040 760 Open stone surgery for horseshoe kidney 3600 Pyeloplasty for horseshoe kidney 3600

Ureter Excision of segment of ureter 1760 625 Construction of ileal conduit including ureteric implantation

2390 985

Bilateral replantation of ureter into bowel 2705 940 Unilateral replantation of ureter into bowel 2145 820 Bilateral replantation of ureter into bladder 2480 940 Unilateral replantation of ureter into bladder

1890 820

Other connection of ureter 2145 820 Ileal or colonic replacement of ureter 2895 940 Ureterostomy – closure 2145 685 Open correction vesico-ureteric reflux – unilateral

2145 685

Open correction vesico-ureteric reflux – bilateral

3600 985

Open ureterolithotomy 1890 685 Ureterolysis – unilateral 2145 685 Ureterolysis – bilateral 2570 1320 Therapeutic nephroscopic operations on ureter

1760 820

Ureteroscopic extraction of calculus of ureter

1340 435

Endoscopic insertion of prosthesis into ureter

1000 435

Removal of prosthesis from ureter 480 435 Ureteric meatotomy 480 265 Endoscopic examination of ureter 865 435 Endoscopic retrograde pyelography 865 435 Extracorporeal shockwave lithotripsy of calculus of ureter

1160 685

Operation on ureteric orifice 725 505 Endoscopic meatotomy of ureteric orifice 725 505

P.U. (A) 358

155

Ureterscopic biopsy of lesion 1565 570 Continent urinary diversion 4750 Substitution cystoplasty 4750 Transureteroureterostomy 2705 Endoscopic insertion of permanent prosthesis into ureter

2145

Bladder

Endoscopic anti-reflux procedure (and bilateral)

1340 505

Total cystectomy (with construction of intestinal conduit or bladder)

4750 1550

Partial cystectomy 2040 685 Diverticulectomy of bladder 1760 685 Enlargement of bladder 2895 820 Repair of bladder 2145 685 Repair of vesicocolic fistula 2305 820 Repair of cutaneous vesical fistula 1160 820 Cystostomy and insertion of suprapubic tube into bladder

725 625

Stab cystotomy 315 265 Open removal of calculus from bladder 1340 505 Open excision of lesion from bladder 1890 685 Endoscopic resection of lesion of bladder 1890 685 Endoscopic destruction of lesion of bladder 865 435 Endoscopic transection of bladder 1890 685 Endoscopic hydrostatic distention of bladder

405 265

Sphincterotomy 1160 435 Litholapaxy 1760 685 Endoscopic extraction of calculus of bladder

1000 435

Endoscopic removal of foreign body from bladder

1000 435

Resection of bladder neck 1340 435 Diagnostic endoscopic examination of bladder including any biopsy

580 315

Urodynamic studies/urodynamic assessment

580

Closure of cystostomy 865 435 Combined abdominal and vaginal operations to support outlet of female bladder

1890 685

Suprapubic sling operation 1890 760 Retropubic suspension of neck of bladder 1890 685 Vaginal operation to support outlet of female bladder

1890 685

P.U. (A) 358

156

Implantation of artificial urinary sphincter into bladder and/or removal

2145 685

Dilatation of outlet of female bladder (with cystoscopy)

580 355

Endoscopic incision of outlet of male bladder (with cystoscopy)

1340 435

Repair of vesico-vaginal fistula 2145 820 Endoscopic vesico-lithotripsy of bladder stone

1760 625

Cystoscopy with biopsy 1000 405 Endoscopic resection of deep invasive tumour of bladder

2145

Continent pouch/neo bladder 4750 2500 Combined abdomino-perineal closure of vesico-vaginal fistula

4750

Urethra

Urethrocele 1160 505 Excision of urethral caruncle 370 265 Therapeutic endoscopic operations on outlet of female bladder

725 405

Urethrectomy 1760 685 Urethral valve resection 1565 505 Repair of hypospadias 2040 685 Repair of epispadias 2480 685 Closure of fistula of urethra 865 505 Repair of urethrorectal fistula 1760 685 Urethroplasty (simple) 1760 625 Urethroplasty (complex) 2040 685 Repair of rupture of urethra 2040 685 Excision of diverticulum of urethra 1160 505 Excision of prolapse of urethra 480 405 Therapeutic endoscopic operation on urethra

865 435

Removal of foreign body from urethra 405 435 Diagnostic endoscopic examination of urethra in isolation

405 265

Dilatation of urethra 315 355 Internal urethrotomy including cystoscopy 865 435 Closure of bladder exostrophy 5970 Closure of cloacal exostrophy 7030 Repair of hypospadias – mild 2305 Repair of hypospadias – moderate 2895 Repair of hypospadias – severe 3600

Prostate

Open excision of prostate 2040 685

P.U. (A) 358

157

Radical prostatectomy, reconstruction of bladder neck including bilateral pelvic lymphadenectomy

4750 1550

Open biopsy of lesion of prostate 865 685 Endoscopic resection of prostate (TURP) 2040 760 Endoscopic biopsy of prostate 865 435 Transurethral microwave therapy 1565 570 Drainage of prostatic abscess 1340 505 Prostatic hyperthermia (up to six courses) 1565 570 Prostate, needle biopsy 405 265 Transrectal ultrasound and biopsy 580 Insertion of urethral stent for relief of prostatic obstruction

1890 685

Genitalia

Meatoplasty 725 355 External meatotomy of urethral orifice 580 265 Bilateral excision of testes 1760 625 Laparoscopic orchidectomy 1340 435 Orchidectomy and excision of spermatic cord

1340 435

Excision of lesion of testis 725 505 Orchidopexy – bilateral 1760 820 Microvascular transfer of testis to scrotum 2305 820 Orchidopexy 1000 505 Abdominal undescended testis 1565 625 Prosthesis of testis (insertion or removal) 725 405 Correction of hydrocele 725 435 Fixation of testis 865 435 Biopsy of testis 580 315 Exploration of testis including biopsy 865 435 Bilateral fixation of testis 865 505 Bilateral epididymectomy 1340 570 Unilateral epididymectomy 865 505 Excision of epididymal cyst 865 505 Operation on varicocele 865 505 Vasography 370 315 Operation on seminal vesicle 1565 505 Total amputation of penis 2145 685 Partial amputation of penis 1565 685 Operation for Peyronie's disease 1160 435 Reconstruction of penis 1760 685 Repair of avulsion on penis 2145 685 Repair of injury on penis 1340 505 Division of preputial adhesions 405 265 Circumcision 725 405 Biopsy of lesion of penis 405 265

P.U. (A) 358

158

Penile prosthesis (simple – rod only) 1890 685 Penile prosthesis (complex – three pieces) 2895 1815 Vasectomy reversal – bilateral (microscopic)

1760 625

Vasectomy reversal – bilateral (macroscopic)

1890 685

Epididymo-vasostomy (macroscopic) 1890 685 Epididymo-vasostomy (microscopic) 2040 760 Tenchkoff 1340 Tenchkoff and adhesiolysis 1890 Transrectal ultrasound (diagnostic) 580 Transrectal ultrasound and systematic prostate biopsy

1000

Excision and grafting for Peyronie’s disease 2705

Other Block dissection of para-aortic lymph nodes

2570 760

(v) Vascular system (other than intrathoracic)

Head and neck

Bypass of carotid artery from the arch 4750 1550 Carotid endarterectomy 4750 1550 Reconstruction of carotid artery (vein patch and bypass)

3600 1550

Bypass of subclavian artery from the arch 4750 1550 Bypass of subclavian artery – extra-thoracic

2895 1320

Endarterectomy and patch repair of subclavian artery

4750 1550

Renal

Endarterectomy of renal artery 4750 1550 Reconstruction of renal artery 4750 1550 Transluminal operation on renal artery 1565 685

Abdominal vessels

Axillo-femoral bypass 2895 1550 Axillo-bifemoral bypass 2895 1550 Infrarenal abdominal aortic aneurysm tube graft

4750 1815

Infrarenal abdominal aortic aneurysm bifurcation graft

5970 1815

Revision of prosthesis of abdominal aorta 4750 2110 Pecutaneous transluminal balloon operation on aorta

1760 625

P.U. (A) 358

159

Carotid endarterectomy (with patch) 5970 Endarterectomy and patch repair of visceral branch of abdominal aorta

5970 2110

Other open operations on other visceral branch of abdominal aorta

5970 2110

Ileo-femoral vessels

Aorto-iliac, aorto-femoral, ileo-femoral bypass

4750 1550

Aorto-bifemoral bypass 4750 1550 Endarterectomy and patch repair of iliac artery

3600 1550

Open operation on iliac artery 3600 1550 Transluminal operation on iliac artery 1340 505 Femoro-femoral bypass 2895 1320 Femoro-popliteal bypass using prosthesis and/or vein and/or vein cuff/patch

3600 1550

Femoro-distal calf bypass using prosthesis and/or vein and/or vein cuff/patch

3600 1550

Endarterectomy of femoral artery 2895 1125 Reconstruction/bypass for popliteal aneurysm

3600 2110

Transluminal procedures on femoral artery 1565 505 Revision of femoral bypass graft 2705 1320

Non-specific

Revision of reconstruction of artery 3600 940 Biopsy of artery including temporal 580 265 Repair of artery 2305 685 Micro-arterial or micro-venous graft 4750 1550 Repair of artery using vein graft 2705 940 Microsurgical repair of artery 2705 985 Open embolectomy of artery 2570 940 Percutaneous transluminal angioplasty of artery

1340 625

Creation of arteriovenous (AV) fistula including subsequent closure

1340 820

Excision of AV malformation 7030 2110 Repair of acquired AV fistula 2895 985 Repair of AV fistula 2895 1125 Creation of peritoneo-venous shunt (Levine/Denver)

1340 435

Open removal of thrombus from vein 2145 685 Insertion of Hickman line, tunnelled central line, etc.

725 505

Insertion of portocath/vasoport unit 1000 405 Isolated limb perfusion 2705 1320

P.U. (A) 358

160

Varicose veins Ligation/stripping of long or short saphenous vein including local excision/multiple phlebectomy

1340 505

Ligation/stripping of long or short saphenous vein including local excision/multiple phlebectomy – bilateral

2145 820

Operation for recurrent varicose veins 2145 760 Operation for recurrent varicose veins – Bilateral

3600 1125

Ligation/stripping of long and short saphenous veins including local excision/multiple phlebectomy

2145 760

Local excision (multiple phlebectomy) of varicose vein(s) of leg

725 505

Ligation/stripping of long and short saphenous veins including local excision/multiple phlebectomy – bilateral

3600 1125

Venography – bilateral 405 Femoro-popliteal bypass using prosthesis 4750 Femoro-popliteal bypass using prosthesis vein/or cuff/patch

5970

Creation of arteriovenous fistula using prosthesis/graft

3600

Lymphatic

Block dissection of cervical lymph nodes (not included in other procedures)

2895 940

Block dissection of axillary lymph nodes 1760 625 Block dissection of para-aortic lymph nodes

2570 760

Block dissection of inguinal lymph nodes 1760 685 Block dissection of pelvic lymph nodes (not included in other procedures)

2040 760

Biopsy/sampling of cervical lymph nodes 405 505 Biopsy/sampling of axillary lymph nodes 405 315 Biopsy/sampling of inguinal lymph nodes 405 405 Excision biopsy of lymph node 725 435 Excision biopsy of scalene lymph node 725 435 Drainage of lesion of lymph node 480 265 Operation on lymphatic duct 2305 820 Excision of cystic hygroma 1565 760

(w) Bones, joints, etc. (not listed elsewhere) Connective tissue/tendon muscles

Plantar fasciectomy 725 505

P.U. (A) 358

161

Excision of lesion of fascia 480 505 Other operations of fascia 580 315 Excision of ganglion, including repeat excision

1000 315

Excision of bursa 725 405 Transfer of tendon 1000 435 Transfer of multiple tendons 1565 685 Excision of lesion of tendon 725 435 Tendon graft, as sole procedure 1340 435 Secondary repair of tendon including graft, transfer and/or prosthesis

1890 505

Tenolysis, other than flexor 1000 435 Percutaneous tenotomy 405 265 Lengthening of tendon(s), including tenotomy

1160 435

Tenosynovectomy, including arthroscopic 865 435 Release of constriction of sheath of tendon 1000 435 Limited repair of muscle that is not more than 2cm tear (e.g: rotator cuff) including arthroscopic

725 625

Extensive repair of muscle that is greater than 2cm tear (e.g: rotator cuff) including arthroscopic

2145 625

Release of contracture of muscle 1160 570 Open biopsy of muscle 580 315 Needle/tru-cut biopsy of muscle 315 Excision of lesion of muscle without skin graft

1565 625

Excision of lesion of muscle with skin graft 1890 685

Bone (non-specific) Open bone biopsy 725 405 Introduction of therapeutic substance into bone (e.g: application of antibiotic for infected hip replacement as a sole procedure)

580 265

Removal of wire from bone including K-wires

405

Excision of ectopic bone 580 405 Total excision of sesamoid bone 725 435 Partial excision of bone including exostoses 1000 405 Total excision of bone with/without prosthetic replacement/reconstruction (e.g: trapezium)

2480 820

Radical resection of bone tumour 2705 820 Osteotomy of large bone, with/without fixation, including graft

2040 685

P.U. (A) 358

162

Drainage/debridement of bone(s), including sequestectomy for osteomylelitis

1340 405

Fixation of epiphysis 1160 685 Fractures

Primary open reduction of fracture of femur and open fixation using pin and plate

2305 760

Primary closed reduction of fracture or dislocation of joint, with/without fixation including plaster of Paris (POP) (e.g: Colles)

725 405

Closed reduction of fracture of long bone and external fixation including POP and percutaneous K-wires (e.g: forearm)

1760 685

Closed reduction of fracture of small bone and external fixation, including POP and percutaneous K-wires

865 505

Primary open reduction of long bone with fixation

2040 760

Primary open reduction of fracture with/without dislocation of joint

1890 685

Primary open reduction of small bone with fixation including intra-articular

1340 570

Primary open reduction of intra-articular fracture of long bone (e.g: proximal humerus)

1890 760

Open reduction of fracture of pelvis and internal fixation

2895 760

Open reduction and internal fixation of complex acetabular pelvic fracture

4750 1550

Secondary open reduction of dislocation of joint

865 405

Secondary open reduction of fracture of small bone including intra-articular

1340 505

Secondary open reduction of fracture of long bone and intermedullary fixation or internal fixation for non-union/mal-union

1890 685

Locked intramedullary nailing 2705 820 Secondary open reduction of intra-articular fracture of bone

1890 685

Application of IIizarov frame for secondary non-union/mal-union

4750 1550

Adjustments to IIizarov frame rings for secondary non-union/mal-union

1760 505

Adjustments to pin sites secondary for non-union/mal-union

580

Bone graft (except where part of another procedure)

1565 570

P.U. (A) 358

163

Removal of internal fixation/prosthesis from bone/joint excluding K-wires

1340 435

Removal of wire from bone including K-wires

405 315

Surgical toilet to wound under general anaesthetic

480 265

Nerves

Release of entrapment of deeply placed peripheral nerve including Anterior Interosseous nerve and Posterior Interosseous nerve

865 435

Anterior transposition of ulna nerve 1000 505 Submuscular transposition of ulna nerve 1890 505 Revision of release of peripheral nerve 1565 505 Exploration/neurolysis/biopsy of peripheral nerve

865 355

Joints (not listed elsewhere)

Excision of synovial membrane of joint 1565 625 Primary prosthetic replacement/ reconstruction/ repair of ligament including prosthesis

1565 505

Stabilising operation on joint 1565 625 Release of contracture of joint 1160 405 Arthrotomy of large joint, including removal of loose body from joint

1160 405

Arthrotomy of small joint, including removal of loose body from joint

315 265

Therapeutic arthroscopic operation on intra-articular cartilage (other than W8200)

1160 505

Therapeutic arthroscopic operation on intra-articular cartilage (other than W8200) – bilateral

1890 820

Therapeutic arthroscopic operation on cavity of joint

1890 505

Therapeutic arthroscopic operation on cavity of joint – bilateral

2895 820

Diagnostic arthroscopic examination of joint, with/without biopsy

865 435

Injection(s) into joint(s) under X-ray control

480 265

Manipulation of joint 405 405 Joints (not listed elsewhere)

Prosthetic replacement of articulation of 2145 685

P.U. (A) 358

164

bone Prosthetic interposition arthroplasty of joint (e.g: hip, knee, shoulder)

2305 820

Excision reconstruction of joint 1760 625 Fixation/Arthrodesis

Osteotomy of hip with fixation 2305 940 Pelvic osteotomy with fixation 3600 940 Primary arthrodesis of large joint and bone graft

1760 820

Primary arthrodesis and internal fixation (e.g: hand/foot) including bone graft

1160 685

Hand

Dupuytren's subcutaneous fasciotomy 580 315 Dupuytren's fasciectomy – single digit 1160 435 Dupuytren's fasciectomy for palm and multiple digits

1760 625

Dupuytren's dermofasciectomy and graft, or for recurrent disease

2145 820

Repair of extensor of hand 865 435 Repair of flexor of hand including prosthetic implant

1760 435

Secondary or second stage repair of flexor of hand including prosthetic implant

1890 570

Secondary repair of tendon of hand/forearm (excluding flexor) without transfer or graft

1000 435

Secondary repair of tendon of hand/forearm (excluding flexor) with graft/transfer

1760 435

Tendon graft as sole procedure 1340 435 Tenolysis – other than flexor 1160 435 Tenolysis of flexor 1565 435 Pollicisation of finger for thumb reconstruction

3600 435

Repair of fingertip injury following avulsion with flap

1565 505

Multiple joint procedures on hand including synovectomy

2390 820

Fusion of metacarpo-phalangeal/intercarpal joint

1000 570

Prosthetic arthroplasty of digital joint(s) 1760 435 Bone graft to scaphoid with internal fixation, including Herbert screw

1890 625

Amputation of hand 1565 625 Amputation of digit 1000 505

P.U. (A) 358

165

Amputation through mid-carpal/transmetacarpal

1000 435

Fusion of wrist 2040 820

Shoulder Limited repair of muscle that is not more than 2cm tear (e.g: rotator cuff) including arthroscopic

725 625

Extensive repair of muscle that is greater than 2cm tear (e.g: rotator cuff) including arthroscopic

2145 625

Revision rotator cuff repair 2145 625 Acromioplasty 1565 625 Excision distal clavicle, in isolation 1565 625 Prosthetic interposition arthroplasty of joint (e.g: hip, knee, shoulder)

2305 820

Primary repair of rupture of acromioclavicular joint including internal fixation

2705 685

Secondary repair of rupture of acromioclavicular joint including internal fixation

2705 685

Reconstruction of acromioclavicular joint 2705 685 Shoulder hemiarthroplasty 2305 685 Revision shoulder hemiarthroplasty 2570 685 Primary total shoulder replacement 2705 940 Revision total shoulder replacement 3600 1550 Stabilisation of shoulder joint including anterior, posterior or multi-directional (including arthroscopic)

1890 685

Revision stabilisation of shoulder joint 2390 760 Release of shoulder contracture 2145 685 Plating and/or bone grafting for non-union of clavicle

2040 685

Exploration and grafting of brachial plexus 3600 2110 Sub-acromial decompression including arthroscopic

1890 685

Total excision of cervical or first rib 2145 820

Elbow Total prosthetic replacement of elbow 2705 940 Revisional prosthetic replacement of elbow 3600 1550 Release of constriction of sheath of tendon 1000 435

Hip, leg and pelvis

Excision of lesion of bone pelvis/hip 1565 685 Osteotomy of hip with fixation 2305 940

P.U. (A) 358

166

Pelvic osteotomy with fixation 3600 940 Total prosthetic replacement of hip joint 2705 985 Revision of total prosthetic replacement of hip joint

3600 1550

Total prosthetic replacement of hip joint – bilateral

4750 1550

Prosthetic replacement of head of femur 2145 820 Release fasciotomy of anterior/posterior compartment of leg

1760 625

Amputation of leg/foot 2040 685 Manipulation and plaster of Paris (POP) for hip

580 405

Knee

Therapeutic arthroscopic operations of cavity of joint

1890 505

Therapeutic arthroscopic operations of cavity of joint – bilateral

2895 820

Diagnostic arthroscopic examination of joint, with/without biopsy

865 435

Total prosthetic replacement of knee joint 2705 985 Unicompartmental knee replacement 2705 820 Revision of total replacement of knee joint 3600 1550 Total prosthetic replacement of knee joint – bilateral

4750 1550

Primary prosthetic replacement of cruciate ligament

2480 820

Autograft reconstruction of cruciate ligament including arthroscopic

2570 940

Stablisation of patella 2480 940 Therapeutic arthroscopic operations of semi lunar cartilage

1890 685

Therapeutic arthroscopic operations of semi lunar cartilage – bilateral

2895 985

Simple repair of knee ligaments 1890 570 Therapeutic arthroscopic operations on cavity of knee

1890 685

Therapeutic arthroscopic operations on cavity of knee – bilateral

2895 985

Foot

Primary repair of tendon of foot 480 435 Primary repair of Achilles tendon 1160 435 Secondary repair of Achilles tendon 1890 435 Secondary repair of tendon of foot 725 435 Multiple joint procedures on forefoot 2390 760

P.U. (A) 358

167

Multiple joint procedures on forefoot – bilateral

3600 1125

Osteotomy of metatarsal (e.g: akin, mcNab, etc.)

865 435

Fusion of first metatarso – phalangeal joint 1000 505 Fusion of first metatarso – phalangeal joint – bilateral

1760 820

Metartarso-phalangeal cheilectomy 1565 505 Triple fusion of joints of hind foot 1890 685 Osteotomy for pes clavus 1890 685 Correction of minor congenital deformity of foot

1565 505

Correction of minor congenital deformity of foot – bilateral

2480 820

Total prosthetic replacement of ankle joint 2705 940 Revision of total prosthetic replacement of ankle joint

3600 1550

Closing wedge osteotomy/translation of calcaneal spur including internal fixation

1760 505

Excision arthroplasty of first metatarso-phalangeal joint with prosthetic implantation

1760 625

Excision arthroplasty of first metatarso-phalangeal joint including Keller's

1160 505

Excision arthroplasty of first metatarso-phalangeal joint including Keller's – bilateral

1890 820

Fusion of interphalangeal joint(s) of toe 1000 435 Correction of retracted/dislocated metatarso-phangeal joint(s) including tendon transfer, division/realignment of bone and internal fixation

1890 820

Fusion of interphalangeal joint(s) of toe – bilateral

1760 760

Primary arthrodesis and internal fixation (hand/foot) including bone graft

1160 685

Simple bunionectomy 725 355 Simple bunionectomy – bilateral 1160 625 Metatarsal osteotomy for Hallux valgus 1340 685

Metatarsal osteotomy for Hallux valgus – bilateral

2145 985

Metatarsal osteotomy for Hallux valgus, with internal fixation and soft tissue correction

1890

760 Metatarsal osteotomy for Hallux valgus,

2895 1125

P.U. (A) 358

168

with internal fixation and soft tissue correction – bilateral Amputation of toe 1000 435 Radical excision of bone tumour with implantation of prosthesis for limb

4750 1550

External fixation/traction

Application of skeletal traction to bone 580 505 Removal of skeletal traction from bone 405 315 Application of external fixation to bone 1760 505 Removal of external fixation from bone 580 315

(x) Face, mouth and neck (not elsewhere listed) Face and jaws

Open reduction of fracture of maxilla 1340 685 Closed reduction of fracture of maxilla 725 570 Reduction of other fractures of bones of face

580 435

Reduction of fracture of zygomatic complex of bones

1000 505

Open reduction of fracture of zygomatic complex of bones

1565 570

Excision of maxilla 2040 940 Formal hemi-maxillectomy for malignancy 2570 940 Internal fixation of maxilla 725 685 Extra-oral fixation of maxilla 725 685 Removal of fixator from maxilla 580 570 Biopsy of lesion of facial bone 405 355 Excision of mandible 2040 940 Extensive excision of mandible 2390 985 Excision of lesion of jaw 1160 435 Open reduction of fracture of mandible 1000 685 Closed reduction of fracture of mandible 580 570 Intermaxillary fixation of mandible 725 685 Extra-oral fixation of mandible 1000 685 Removal of fixator from mandible 580 505 Reconstruction of jaw 2705 940 Alveolar bone graft 1340 570 Manipulation of mandible 405 355

Prosthetic replacement of temporomandibular joint

2305 625

Arthroplasty of temporomandibular joint 1890 625 Menisectomy of temporomandibular joint 1160 505 Reduction of dislocation of temporamandibular joint

725 355

P.U. (A) 358

169

Lips Excision of vermilion border of lip and advance of mucosa of lip

1000 435

Excision of lesion of lip 865 405 Primary closure of cleft lip (and bilateral) 1760 820 Revision of primary closure of cleft lip 2145 820 Reconstruction of lip using tongue flap 2145 685 Reconstruction of lip using skin flap 2040 760 Suture of lip 480 435 Biopsy of lesion of lip 480 355

Tongue Total glossectomy including block dissection

2480 760

Partial glossectomy including block dissection

2145 820

Excision/destruction of lesion of tongue 865 505 Biopsy of lesion of tongue 315 405 Frenotomy/frenectomy of tongue 480 435 Freeing of adhesions of tongue 315 405 Tongue flap – first stage 1760 820 Tongue flap – second stage 1000 625

Palate Excision/destruction of lesion of palate 865 505 Primary repair of cleft palate 2305 820 Revision of repair of cleft palate 1565 685 Plastic repair of palate using flap of palate 1340 685 Plastic repair of palate using flap of skin 1890 685 Suture of palate 580 435 Biopsy of lesion of palate 480 405 Incision of palate 370 405 Operation on uvula 725 435

Mouth cavity Vestibuloplasty following trauma 1160 435 Excision/destruction of lesion of mouth 580 405 Reconstruction of mouth using flap 2145 760 Reconstruction of mouth using graft 1000 760 Graft of skin to mouth 1000 625 Graft of mucosa to mouth 865 570 Suture of mouth 580 505 Biopsy of lesion of mouth 370 355 Removal of excess mucosa from mouth 865 435

P.U. (A) 358

170

Salivary glands Excision of parotid gland (other than F4410/F4430)

1890 685

Total excision of parotid gland and preservation of facial nerve

3600 985

Partial excision of parotid gland and preservation of facial nerve

2895 985

Excision of submandibular gland 1340 505 Excision of sublingual gland 1000 505 Excision of lesion of parotid gland 1160 505 Excision of lesion of submandibular gland 1160 505 Excision of lesion of sublingual gland 405 505 Incision of parotid gland 405 405 Incision of submandibular gland 405 405 Incision of sublingual gland 405 405 Biopsy of lesion of salivary gland 580 435 Closure of fistula of salivary gland 865 435 Transposition of parotid duct 1160 435 Transposition of submandibular duct 1160 435 Open extraction of calculus from parotid duct

865 355

Open extraction of calculus from submandibular duct

725 435

Ligation of parotid duct 480 435 Ligation of submandibular duct 480 435 Operation on submandibular duct 480 435 Dilation of parotid duct 405 265 Manipulative removal of calculus from parotid duct

725 315

Teeth

Replantation of tooth/teeth following trauma

865 355

Surgical removal of impacted/buried tooth/teeth

1000 435

Surgical removal of complicated buried roots

725 435

Enucleation of cyst of jaw 865 435 Neck

Block dissection of cervical lymph nodes (not included in other procedures)

2895 940

Biopsy/sampling of cervical lymph nodes 405 505 Operation on branchial cleft cyst 1340 820 Operation on branchial cleft fistula 2040 820

P.U. (A) 358

171

Thyroid and parathyroid glands Total thyroidectomy 2040 820 Bilateral subtotal thyroidectomy 2040 760 Hemithyroidectomy 2040 685 Partial thyroidectomy 2040 685 Thyroplasty (Isshiki type I) 1760 625 Operation on aberrant thyroid issue including retrosternal

2480 940

Excision of thyroglossal cyst 1000 625 Excision of thyroglossal tract 1340 625 Excision of lesion of thyroid gland 1340 435 Fine needle aspiration of thyroid gland 315 315 Needle biopsy of thyroid gland 580 315 Parathyroidectomy 2705 940 Parathyroid: second operation 2705 985 Drainage of salivary gland abscesses 405

III. MISCELLANEOUS 1. Medical examination fee (a) Non-specialist Item Fee (RM) Medical examination – pre-employment, routine and annual medical examination, fitness medical examination, comprehensive medical examination, aviation medical examination (excluding laboratory investigations, X-ray, ECG, etc.)

45 - 230

Examination for medico-legal cases 570 - 1145 Examination for evaluation of disability 570 - 1145 Participation in Medical Board Examination 230 - 1145 Medical examination for life insurance 90 - 230 Vocational licence health examination 35 - 115 (b) Specialist Item Fee (RM) Medical examination – pre-employment, routine and annual medical examination, fitness medical examination, comprehensive

115 - 570

medical examination, aviation medical examination (excluding laboratory investigations, X-ray, ECG, etc.)

Examination for medico-legal cases 570 - 2290

P.U. (A) 358

172

Examination for evaluation of disability 570 - 2290 Participation in Medical Board Examination 570 - 2290 Medical examination for life insurance 170 - 460 Vocational licence health examination 35 - 115 2. Medical report fee Item Fee (RM) Non-specialist 55 - 230 Specialist 115 - 570

3. House call and medical assistance fee (General Practitioners) Item Fee (RM) Medical duty for events and functions per hour 55

Medical coverage for transfer/repatriation of patient (excluding actual expenses incurred in the cost of travel, board and lodging) per day

570

4. Court attendance fee Item Fee (RM) Qualifying expenses per day - this is to cover the cost of the medical practitioner who on being called as a witness, is required to study and research a case not previously a patient of the same practitioner (excluding travel, board and lodging expenses and medical report)

285 - 570

Conduct money Actual expenses incurred in the cost of travelling and lodging

Non-expert witness (testimony involving statement of facts only)

570 - 1145

Expert witness (testimony involving expert opinion)

1145 - 2290

Comprehensive medical report (requested by insurance company, lawyers, others)

90 - 285

Attending physician statement for insurance company

55

P.U. (A) 358

173

PART B – DENTAL FEE

I. CONSULTATION FEE Item Fee (RM) Consultation only Consultation with examination 30 - 285 Consultation with examination and treatment plan

II. BASIC DENTAL PROCEDURE FEE

Item Fee (RM) Post-extraction bleeding 55 - 345 Treatment for dry socket 55 - 345 Temporary dressings 35 - 170 Incision and drainage 55 - 230 Amalgam restorations 45 - 345 Tooth coloured/adhesive restoration 55 - 685 Removal of calculus 55 - 345 Removal of plaque and/or extrinsic stains 70 - 285 Dentures acrylic (partial) per jaw 115 - 1145 Dentures acrylic (full) per jaw 285 - 2290 Non-surgical/simple extraction of teeth and/or root(s)

Permanent 45 - 285 Deciduous 30 - 115 Intra-oral periapical/bite wings/occlusal radiograph – per exposure

25 - 115

III. MISCELLANEOUS Item Fee (RM) Dental report 55 - 345 House call 170 - 570 Court attendance fee - qualifying expenses per day. This is to cover the cost of the dental practitioner who on being called as a witness, is required to study and research a case not previously a patient of the same practitioner (excluding travel, board and lodging expenses and dental report)

285 - 570

Conduct money Actual expenses incurred in the cost of travelling and lodging

P.U. (A) 358

174

Non-expert witness (testimony involving statement of facts only)

570 - 1145

Expert witness (testimony involving expert opinion)

1145 - 2290

Comprehensive dental report (requested by insurance companies, lawyers and others)

55 - 345

Attending dentist statement for insurance company

55”.

Made 10 October 2013 [KK(R)/654(336) (17); PN(PU2)610/IV] DATUK SERI DR. S. SUBRAMANIAM Minister of Health