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

Specialist

General Practitioner

Anaesthetic

U

R

U

R

U

R          T

3.1.1

Fractures

0383

Fracture (reduction under general anaesthetic): Scapula

112.30

3 312.85

112.30

3 312.85

3

413.58 +T+M

0384

Fracture: Scapula: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

284.2

8 383.90

227.36

6 707.12

3

413.58 +T+M

0386

Fracture: Clavicle: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

209.4

6 177.30

167.52

4 941.84

3

413.58 +T+M

0387

Fracture (reduction under general anaesthetic): Clavicle

93.80

2 767.10

93.80

2 767.10

3

413.58 +T+M

0388

Percutaneous pinning supracondylar fracture elbow - stand alone procedure

175.70

5 183.15

140.56

4 146.52

3

413.58 +T+M

0389

Fracture (reduction under general anaesthetic): Humerus

129.60

3 823.20

129.60

3 823.20

3

413.58 +T+M

0390

Fracture: Humerus: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

255.3

7 531.35

204.24

6 025.08

3

413.58 +T+M

0391

Fracture (reduction under general anaesthetic): Radius and/or Ulna

135.7

4 003.15

120

3 540.00

3

413.58 +T+M

0392

Open reduction of both radius and ulna (Modifier 0051 not applicable)

193.50

5 708.25

154.80

4 566.60

3

413.58 +T+M

0401

Fracture: Carpal bone: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

208.7

6 156.65

166.96

4 925.32

3

413.58 +T+M

0402

Fracture (reduction under general anaesthetic): Carpal bone

64

1 888.00

64

1 888.00

3

413.58 +T+M

0403

Bennett's fracture-dislocation

84.50

2 492.75

84.50

2 492.75

3

413.58 +T+M

0404

Fracture: Bennett fracture/dislocation: Open reduction and internal fixation (modifiers 0051, 0052, 0055 not applicable)

179.80

5 304.10

143.84

4 243.28

3

413.58 +T+M

0405

Fracture reduction under general anaesthetic: Open treatment of Metacarpal: Simple

75.40

2 224.30

75.40

2 224.30

3

413.58 +T+M

0406

Fracture: Metacarpal bone: Open reduction and internal fixation (modifier 0052 not applicable)

163.60

4 826.20

130.88

3 860.96

3

413.58 +T+M

0409

Fracture (reduction under general anaesthetic): Finger phalanx: Distal: Simple

77

2 271.50

77

2 271.50

3

413.58 +T+M

0410

Fracture: Finger phalanx, distal, simple: Open reduction and internal fixation (modifier 0052 not applicable)

141.10

4 162.45

120

3 540.00

3

413.58 +T+M

0413

Fracture (reduction under general anaesthetic): Finger phalanx: Proximal or middle

Replaces tariff code 0415

50.50

1 489.75

50.50

1 489.75

3

413.58 +T

0414

Fracture: Finger phalanx, proximal or middle: Open reduction and internal fixation (modifier 0052 not applicable)

Replaces tariff code 0411

169.90

5 012.05

135.92

4 009.64

3

413.58 +T

0417

Fracture (reduction under general anaesthetic): Pelvis fracture: Closed (modifier 0051 is applicable_

137.20

4 047.40

120

3 540.00

3

413.58 +T

0419

Fracture (reduction under general anaesthetic): Pelvis:Open reduction and internal fixation (modifier 0051 not applicable)

354.49

10 457.46

283.59

8 365.91

3

413.58 +T+M

0420

Fracture: Acetabulum: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

560

16 520.00

448

13 216.00

3

413.58 +T+M

0421

Fracture (reduction under general anaesthetic): Femur: Neck or Shaft

279.10

8 233.45

223.28

6 586.76

3

413.58 +T+M

0422

Fracture: Femur neck or shaft: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

392.3

11 572.85

313.84

9 258.28

3

413.58 +T+M

0425

Fracture (reduction under general anaesthetic) Patella

82.50

2 433.75

82.50

2 433.75

3

413.58 +T+M

0426

Fracture: Patella: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

219.5

6 475.25

175.6

5 180.20

3

413.58 +T+M

0429

Fracture (reduction under general anaesthetic) Tibia with or without Fibula

128

3 776.00

120

3 540.00

3

413.58 +T+M

0430

Fracture: Tibia, with or without fibula: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

293.2

8 649.40

234.56

6 919.52

3

413.58 +T+M

0433

Fracture (reduction under general anaesthetic) Fibula shaft

112.40

3 315.80

112.40

3 315.80

3

413.58 +T+M

0434

Fracture: Fibula shaft: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

207

6 106.50

165.6

4 885.20

3

413.58 +T+M

0435

Fracture (reduction under general anaesthetic): Malleolus of ankle

126.80

3 740.60

120

3 540.00

3

413.58 +T+M

0436

Fracture: Ankle malleolus: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

207.1

6 109.45

165.68

4 887.56

3

413.58 +T+M

0437

Fracture-dislocation of ankle

128

3 776.00

120

3 540.00

3

413.58 +T+M

0438

Open reduction Talus fracture (Modifier 0051 not applicable)

311.60

9 192.20

249.28

7 353.76

3

413.58 +T+M

0439

Fracture (reduction under general anaesthetic): Tarsal bones (excluding talus and calcaneus)

76.60

2 259.70

76.60

2 259.70

3

413.58 +T+M

0440

Open reduction: Calcaneus fracture (Modifiers  0051, 0052 not applicable)

403.50

11 903.25

322.5

9 513.75

3

0441

Fracture (reduction under general anaesthetic): Metatarsal

66.80

1 970.60

66.80

1 970.60

3

413.58 +T+M

0442

Fracture: Metatarsal bones: Open reduction with internal fixation (modifiers 0051, 0052 not applicable)

154.7

4 563.65

123.76

3 650.92

3

413.58 +T+M

0443

Fracture (reduction under general anaesthetic): Toe phalanx: Distal: Simple

66.8

1 970.60

66.80

1 970.60

3

413.58 +T

0444

Fracture: Toe phalanx, distal: Open reduction with internal fixation (modifier 0052 not applicable)

Replaces tariff code 0445

144.5

4 262.75

120

3 540.00

3

413.58 +T

0446

Fracture: Tarsal bones (excluding talus and calcaneus): Open reduction with internal fixation (modifiers 0051, 0052 not applicable)

178.2

5 256.90

142.56

4 205.52

3

413.58 +T+M

0447

Fracture (reduction under general anaesthetic): Other: Simple

26

767.00

26

767.00

3

413.58 +T

0448

Fracture: Calcaneus (reduction under general anaesthetic)

103.3

3 047.35

103.3

3 047.35

3

413.58 +T+M

0452

Fracture (reduction under general anaesthetic): Sternum and/or ribs: Open reduction and fixation of multiple fractured ribs for flail chest

Replaces tariff code 0451

230

6 785.00

184

5 428.00

3

413.58 +T+M

3.1.1.1

Operations for fractures

0465

Fractures involving large joints (includes the item for the relative bone). This item may not be used as a modifier

288

8 496.00

230.4

6 796.80

3

413.58 +T+M

0466

Fratures involving digital joints: Includes the metaphysis of the relative bone. Open reduction and internal fixation (modifier 0052 not applicable)

210.90

6 221.55

168.72

4 977.24

3

413.58 +T+M

0473

Percutaneous insertion plus subsequent removal of Kirschner wires or Steinmann pin (Not subject to rite G) (Modifier 0005 not applicable)

43

1 268.50

43

1 268.50

3

413.58 +T

0475

Bonegrafting or internal fixation for malunion or non-union: Femur, Tibia, Humerus, Radius and Ulna

328.20

9 681.90

262.56

7 745,52

3

413.58 +T+M

0479

Bonegrafting or internal fixation for malunion or non-union: Other bones (not applicable to fingers and toes)

154

4 543.00

123.2

3 634.40

3

413.58 +T+M

3.1.2

Bony operations

3.1.2.1

Bone grafting

0497

Resection of bone with or without grafting

282

8 319.00

225.6

6 655.20

3

413.58 +T+M

0498

Resection of bone or tumour (malignant) with or without grafting (does not include digits)

340

10 030.00

272

8 024.00

3

413.58 +T+M

0499

Grafts to cysts: Large bones

192

5 664.00

153.6

4 531.20

3

413.58 +T+M

0501

Grafts to cysts: Small bones

128

3 776.00

120

3 540.00

3

413.58 +T+M

0503

Grafts to cysts: Cartilage graft

206

6 077.00

164.8

4 861.60

3

413.58 +T+M

0505

Grafts to cysts: Inter-metacarpal bone graft

147

4 336.50

120

3 640.00

3

413.58 +T+M

0506

Harvesting of graft: Cartilage graft, costochondral

91.1

2 687.45

91.1

2 687.45

6

827.16 +T

0507

Removal of autogenous bone for grafting (not subject to modifier 0005)

50

1 475.00

50

1 475.00

3

413.58 +T+M

3.1.2.2

Acute/chronic osteomyelitis

0512

Sternum sequestrectomy and drainage: Including FOUR weeks after care

128

3 776.00

120

3 540.00

3

413.58 +T+M

3.1.2.3

Osteotomy

0514

Osteotomy: Sternum: Repair of pectus-excavatum

330

9 735.00

264

7 788.00

3

413.58 +T+M

0515

Osteotomy: Sternum: Repair of pectus carinatum

330

9 735.00

264

7 788.00

3

413.58 +T+M

0516

Osteotomy: Pelvic

320

9 440.00

256

7 552.00

3

413.58 +T+M

0521

Osteotomy: Femoral: Proximal (Modifier 0051 is applicable)

320

9 440.00

256

7 552.00

3

413.58 +T+M

0527

Osteotomy: Knee region (Modifier 0051 is applicable)

320

9 440.00

256

7 552.00

3

413.58 +T+M

0528

Osteotomy: Os Calcis (Dwyer operation) (Modifier 0051 is applicable)

115

3 392.50

115

3 392.50

3

413.58 +T+M

0530

Osteotomy: Metacarpal and phalanx: Corrective for mal-union or rotation (Modifier 0051 is applicable)

120

3 540.00

120

3 540.00

3

413.58 +T+M

0531

Rotational osteotomy tibia and fibula - stand alone procedure

278.90

8 227.55

223.12

6 582.04

3

413.58 +T+M

0532

Rotation osteotomy of the Radius. Ulna or Humerus (modifier 0051 is applicable)

160

4 720.00

128

3 776.00

3

413.58 +T+M

0533

Osteotomy single metatarsal (modifier 0051 Is applicable)

60

1 770.00

60

1 770.00

3

413.58 +T+M

0534

Multiple metatarsal osteotomies (modifier 0051 is applicable

150

4 425.00

120

3 540.00

3

413.58 +T+M

3.1.2.4

Exostosis

0535

Exostosis: Excision: Readily accessible sites

60

1 770.00

60

1 770.00

3

551.44 +T

0537

Exostosis: Excision: Less accessible sites

96

2 832.00

96

2 832.00

3

551.44 +T

3.1.2.5

Biopsy

0539

Needle Biopsy: Spine (no after-care), Modifier 0005 not applicable

50

1 475.00

50

1 475.00

4

As per bone

0541

Needle Biopsy: Other sites (no after-care), Modifier 0005 not applicable

32

944.00

32

944.00

4

As per bone

0543

Biopsy: Open (modifier 0005 is not applicable): Readily accessible site

64

1 888.00

64

1 888.00

0545

Biopsy: Open (modifier 0005 is not applicable): Less accessible site

96

2 832.00

96

2 832.00