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

3 020.87

112.30

3 020.87

3

377.07 + T+M

0384

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

284.2

7 644.98

227.36

6 115.98

3

377.07 +T+M

0386

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

209.4

5 632.86

167.52

4 506.29

3

377.07 +T+M

0387

Fracture (reduction under general anaesthetic): Clavicle

93.80

2 523.22

93.80

2 523.22

3

377.07 +T+M

0388

Percutaneous pinning supracondylar fracture elbow - stand alone procedure

175.70

4 726.33

140.56

3 781.06

3

377.07 +T+M

0389

Fracture (reduction under general anaesthetic): Humerus

129.60

3 486.24

129.60

3 486.24

3

377.07 +T+M

0390

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

255.3

6 867.57

204.24

5 494.06

3

377.07 +T+M

0391

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

135.7

3 650.33

120

3 228.00

3

377.07 +T+M

0392

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

193.50

5 205.15

154.80

4 164.12

3

377.07 +T+M

0401

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

208.7

5 614.03

166.96

4 491.22

3

377.07 +T+M

0402

Fracture (reduction under general anaesthetic): Carpal bone

64

1 721.60

64

1 721.60

3

377.07 +T+M

0403

Bennett's fracture-dislocation

84.50

2 273.05

84.50

2 273.05

3

377.07 +T+M

0405

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

75.40

2 028.26

75.40

2 028.26

3

377.07 +T+M

0409

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

77

2 071.30

77

2 071.30

3

377.07 +T+M

0411

Fracture (reduction under general anaesthetic): Finger phalanx: Distal: Compound (open) [Discontinued] Refer to item 0414

0413

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

50.50

1 358.45

50.50

1 358.45

3

377.07 +T

0414

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

169.90

4 570.31

135.92

3 656.25

3

377.07 +T

0415

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

[Discontinued] Refer to item 0413

102

2 743.80

102

2 743.80

3

377.07 +T+M

0417

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

137.20

3 690.68

120

3 228.00

3

377.07 +T

0419

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

354.49

9 535.78

283.59

7 628.57

3

377.07 +T+M

0420

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

560

15 064.00

448

12 051.20

3

377.07 +T+M

0421

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

279.10

7 507.79

223.28

6 006.23

3

377.07 +T+M

0422

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

392.3

10 552.87

313.84

8 442.30

3

377.07 +T+M

0425

Fracture (reduction under general anaesthetic) Patella

82.50

2 219.25

82.50

2 219.25

3

377.07 +T+M

0426

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

219.5

5 904.55

175.6

4 723.64

3

377.07 +T+M

0429

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

128

3 443.20

120

3 228.00

3

377.07 +T+M

0430

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

293.2

7 887.08

234.56

6 309.66

3

377.07 +T+M

0433

Fracture (reduction under general anaesthetic) Fibula shaft

112.40

3 023.56

112.40

3 023.56

3

377.07 +T+M

0434

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

207

5 568.30

165.6

4 454.64

3

377.07 +T+M

0435

Fracture (reduction under general anaesthetic): Malleolus of ankle

126.80

3 410.92

120

3 228.00

3

377.07 +T+M

0436

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

207.1

5 570.99

165.68

4 456.79

3

377.07 +T+M

0437

Fracture-dislocation of ankle

128

3 443.20

120

3 228.00

3

377.07 +T+M

0438

Open reduction Talus fracture (Modifier 0051 not applicable)

311.60

8 382.04

249.28

6 705.63

3

377.07 +T+M

0439

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

76.60

2 060.54

76.60

2 060.54

3

377.07 +T+M

0440

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

403.50

10 854.15

322.5

8 675.25

3

377.07 +T+M

0441

Fracture (reduction under general anaesthetic): Metatarsal

66.80

1 796.92

66.80

1 796.92

3

377.07 +T+M

0442

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

154.7

4 161.43

123.76

3 329.14

3

377.07 +T+M

0443

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

66.8

1 796.92

66.80

1 796.92

3

377.07 +T

0444

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

144.5

3 887.05

120

3 228.00

3

377.07 +T

0445

Fracture (reduction under general anaesthetic): Toe phalanx: Compound (Discontinued) Refer to item 0444

0446

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

178.2

4 793.58

142.56

3 834.86

3

377.07 +T+M

0447

Fracture (reduction under general anaesthetic): Other: Simple

26

699.40

26

699.40

3

377.07 +T

0448

Fracture: Calcaneus (reduction under general anaesthetic)

103.3

2 778.77

103.3

2 778.77

3

377.07 +T+M

0449

Fracture (reduction under general anaesthetic): Other: Compound [Discontinued] Refer to dedicated codes

0451

Fracture (reduction under general anaesthetic): Sternum and/or ribs: Closed [Discontinued 2020] Refer to item 0452

0452

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

230

6 187.00

184

4 949.60

3

377.07  +T+M

0455

Fracture (reduction under general anaesthetic): Spine: With or without paralysis: Cervical [Discontinued 2020]

0456

Fracture (reduction under general anaesthetic): Spine: With or without paralysis: Rest [Discontinued 2020]

0461

Fracture (reduction under general anaesthetic): Compression fracture: Cervical [Discontinued 2020]

0462

Fracture (reduction under general anaesthetic): Compression fracture: Rest[Discontinued 2020]

0463

Fracture (reduction under general anaesthetic): Spinous or transversa processes: Cervical [Discontinued 2020]

0464

Fracture (reduction under general anaesthetic): Spinous or transverse processes: Rest [Discontinued 2020]

3.1.1.1

Operations for fractures

0465

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

288

7 747.20

230.4

6 197.76

3

377.07 +T+M

0473

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

43

1 156.70

43

1 156.70

3

377.07 +T    

0475

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

328.20

8 828.58

262.56

7 062.86

3

377.07 +T+M

0479

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

154

4 142.60

123.2

3 314.08

3

377.07 +T+M

3.1.2

Bony operations

3.1.2.1

Bone grafting

0497

Resection of bone with or without grafting (benign)

282

7 585.80

225.6

6 068.64

3

377.07 +T+M

0498

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

340

9 146.00

272

7 316.80

3

377.07 +T+M

0499

Grafts to cysts: Large bones

192

5 164.80

153.6

4 131.84

3

377.07 +T+M

0501

Grafts to cysts: Small bones

128

3 443.20

120

3 228.00

3

377.07 +T+M

0503

Grafts to cysts: Cartilage graft

206

5 541.40

164.8

4 433.12

3

377.07 +T+M

0505

Grafts to cysts: Inter-metacarpal bone graft

147

3 954.30

120

3 228.00

3

377.07 +T+M

0506

Harvesting of graft: Cartilage graft, costochondral

91.1

2 450.59

91.1

2 450.59

6

754.14 +T    

0507

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

50

1 345.00

50

1 345.00

3

377.07 +T+M

3.1.2.2

Acute/chronic osteomyelitis

0509

Conservative treatment [Discontinued 2020]

0511

Operation: Tariff which would be applicable for compound (open) fracture of the bone involved, including six weeks post-operative care [Discontinued 2020]

0512

Sternum sequestrectomy and drainage: Including FOUR weeks after care

128

3 443.20

120

3 228.00

3

377.07 +T+M

3.1.2.3

Osteotomy

0514

Osteotomy: Sternum: Repair of pectus-excavatum

330

8 877.00

264

7 101.60

3

377.07 +T+M

0515

Osteotomy: sternum: Repair of pectus carinatum

330

8 877.00

264

7 101.60

3

377.07 +T+M

0516

Osteotomy: Pelvic

320

8 608.00

256

6 886.40

3

377.07 +T+M

0521

Osteotomy: Femoral: Proximal (Modifier 0051 is applicable)

320

8 608.00

256

6 886.40

3

377.07 +T+M

0527

Osteotomy: Knee region (Modifier 0051 is applicable)

320

8 608.00

256

6 886.40

3

377.07 +T+M

0528

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

115

3 093.50

115

3 093.50

3

377.07 +T+M

0530

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

120

3 228.00

120

3 228.00

3

377.07 +T+M

0531

Rotational osteotomy tibia and fibula - stand alone procedure

278.90

7 502.41

223.12

6 001.93

3

377.07 +T+M

0532

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

160

4 304.00

128

3 443.20

3

377.07 +T+M

0533

Osteotomy single metatarsal (modifier 0051 Is applicable)

60

1 614.00

60

1 614.00

3

377.07 +T+M

0534

Multiple metatarsal osteotomies (modifier 0051 is applicable

150

4 035.00

120

3 228.00

3

377.07 +T+M

3.1.2.4

Exostosis

0535

Exostosis: Excision: Readily accessible sites

60

1 614.00

60

1 614.00

3

377.07 +T+M

0537

Exostosis: Excision: Less accessible sites

96

2 582.40

96

2 582.40

3

377.07 +T+M

3.1.2.5

Biopsy

0539

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

50

1 345.00

50

1 345.00

4

502.76 +T

0541

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

32

860.80

32

860.80

4

502.76 +T

0543

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

64

1 721.60

64

1 721.60

As per bone

0545

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

96

2 582.40

96

2 582.40

As per bone