· XLS file · Web view · 2018-02-05394 13.135999999999999 0 408.6...

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HEALTHMAN GENERAL SURGERY COSTING GUIDE 2018

COMPARATIVE TARIFFSHealthMan BankMed Bonitas

Code Terminology RCF RCF DPA DPA 110% 135% 150% 200% 215% 130% 150%

Units R R R R R R R R R R R R R R R Consultations:

See the Notes below for All Tariffs0109 Hospital follow-up visit 15 697.80 46.518 312.00 20.800 324.10 21.607 356.50 437.50 486.20 648.20 696.80 317.90 21.193 413.20 476.80 0129 Prolonged first/follow-up consultation : 15 min 15 697.80 46.518 312.00 20.800 324.10 21.607 356.50 437.50 486.20 648.20 696.80 317.90 21.193 413.20 476.80 0130 Telephone consultation (all hours) 12 558.20 46.518 249.50 20.792 259.20 21.600 285.10 349.90 388.80 518.40 557.30 254.40 21.200 330.70 381.60 0132 Repeat Script 5 232.60 46.518 104.10 20.820 108.10 21.620 118.90 145.90 162.20 216.20 232.40 106.20 21.240 138.00 159.30 0133 Writing of special motivations 9 418.70 46.518 187.20 20.800 194.50 21.611 214.00 262.60 291.80 389.00 418.20 190.70 21.189 247.90 286.00 0145 Consultation : Away from doctor's room 6 279.10 46.518 124.70 20.783 129.50 21.583 142.50 174.80 194.30 259.00 278.40 127.10 21.183 165.20 190.60 0146 Unscheduled consultation: Emergency (cons.room) 8 372.10 46.518 166.20 20.775 172.60 21.575 189.90 233.00 258.90 345.20 371.10 169.50 21.188 220.30 254.20 0147 Unscheduled consultation:Emergency(not cons.room) 14 651.30 46.518 291.10 20.793 302.40 21.600 332.60 408.20 453.60 604.80 650.20 296.70 21.193 385.70 445.00 0151 Pre-anaesthetic assessment: 10 and 20 minutes - - - - - - - - - - - - - - - 0173 Hospital Consultation 15 697.80 46.518 353.40 23.560 367.10 24.473 403.80 495.60 550.70 734.20 789.30 360.50 24.033 468.60 540.70 0174 Hospital Consultation 30 1,395.50 46.518 353.40 11.780 367.10 12.237 403.80 495.60 550.70 734.20 789.30 360.50 12.017 468.60 540.70 0175 Hospital Consultation 45 2,093.30 46.518 353.40 7.853 367.10 8.158 403.80 495.60 550.70 734.20 789.30 360.50 8.011 468.60 540.70

0177 30.8 - - - - - - - - - - - - - - - 0190 Consultation 15 697.80 46.518 353.40 23.560 367.10 24.473 403.80 495.60 550.70 734.20 789.30 360.50 24.033 468.60 540.70 0191 Consultation 30 1,395.50 46.518 353.40 11.780 367.10 12.237 403.80 495.60 550.70 734.20 789.30 360.50 12.017 468.60 540.70 0192 Consultation 45 2,093.30 46.518 353.40 7.853 367.10 8.158 403.80 495.60 550.70 734.20 789.30 360.50 8.011 468.60 540.70 0199 Chronic Medicine Forms 21.43 996.90 46.518 445.80 20.803 463.10 21.610 509.40 625.20 694.70 926.20 995.70 454.30 21.199 590.50 681.40

Procedures

0257 87 4,047.10 46.518 1147.617 13.191 1,147.62 13.191 1,262.40 1,549.30 1,721.40 2,295.20 2,467.40 1,142.10 13.128 1,484.70 1,713.10 0289 Large skin grafts, composite skin grafts, large full thickness free skin grafts 234 10,885.20 46.518 3,086.69 13.191 3,086.69 13.191 3,395.40 4,167.00 4,630.00 6,173.40 6,636.40 3,071.90 13.128 3,993.40 4,607.80 0302 Stitching of soft-tissue injuries: Deep laceration involving limited muscle damage 64 2,977.20 46.518 844.22 13.191 844.22 13.191 928.60 1,139.70 1,266.30 1,688.40 1,815.10 840.10 13.128 1,092.10 1,260.10

0303 Stitching of soft-tissue injuries: Deep laceration involving extensive muscle damage 128 5,954.30 46.518 1,688.45 13.191 1,688.45 13.191 1,857.30 2,279.40 2,532.70 3,376.90 3,630.20 1,680.30 13.128 2,184.30 2,520.40 0304 Major debridement of wound, sloughectomy or secondary suture 50 2,325.90 46.518 659.55 13.191 659.55 13.191 725.50 890.40 989.30 1,319.10 1,418.00 656.40 13.128 853.30 984.60

0307 27 1,256.00 46.518 356.16 13.191 356.16 13.191 391.80 480.80 534.20 712.30 765.70 354.40 13.128 460.70 531.60 0308 Each additional small procedure done at the same time 14 651.30 46.518 184.67 13.191 184.67 13.191 203.10 249.30 277.00 369.30 397.00 183.70 13.128 238.80 275.50 0311 Excision of large benign tumour (more than 5 cm) 55 2,558.50 46.518 725.51 13.191 725.51 13.191 798.10 979.40 1,088.30 1,451.00 1,559.80 722.00 13.128 938.60 1,083.00 0313 Extensive resection for malignant soft tissue tumour including muscle 283.9 13,206.50 46.518 3,744.92 13.191 3,744.92 13.191 4,119.40 5,055.60 5,617.40 7,489.80 8,051.60 3,727.00 13.128 4,845.10 5,590.50

0314 104 4,837.90 46.518 1,371.86 13.191 1,371.86 13.191 1,509.10 1,852.00 2,057.80 2,743.70 2,949.50 1,365.30 13.128 1,774.80 2,047.90

0315 55 2,558.50 46.518 725.51 13.191 725.51 13.191 798.10 979.40 1,088.30 1,451.00 1,559.80 722.00 13.128 938.60 1,083.00 0321 Biopsy or excision of cyst, benign tumour, aberrant breast tissue, duct papilloma 94.2 4,382.00 46.518 1,242.59 13.191 1,242.59 13.191 1,366.90 1,677.50 1,863.90 2,485.20 2,671.60 1,236.60 13.128 1,607.50 1,854.90 0323 Sub-areolar cone excision of ducts of wedge excision of breast 90 4,186.60 46.518 1,187.19 13.191 1,187.19 13.191 1,305.90 1,602.70 1,780.80 2,374.40 2,552.50 1,181.50 13.128 1,535.90 1,772.20 0324 Wedge excision of breast and axillary dissection 225 10,466.60 46.518 2,967.98 13.191 2,967.98 13.191 3,264.80 4,006.80 4,452.00 5,936.00 6,381.10 2,953.80 13.128 3,839.90 4,430.70 0325 Total mastectomy 155 7,210.30 46.518 2,044.61 13.191 2,044.61 13.191 2,249.10 2,760.20 3,066.90 4,089.20 4,395.90 2,034.80 13.128 2,645.20 3,052.20 0329 Total mastectomy with axillary gland dissection 275 12,792.50 46.518 3,627.53 13.191 3,627.53 13.191 3,990.30 4,897.20 5,441.30 7,255.10 7,799.20 3,610.20 13.128 4,693.20 5,415.30

0939 160 7,442.90 46.518 2,110.56 13.191 2,110.56 13.191 2,321.60 2,849.30 3,165.80 4,221.10 4,537.70 2,100.40 13.128 2,730.50 3,150.60 1204 Intensive care: Category 1: Cases requiring intensive monitoring : Per day 30 1,395.50 46.518 395.73 13.191 395.73 13.191 435.30 534.20 593.60 791.50 850.80 393.80 13.128 511.90 590.70 1205 Intensive care: Category 2: Cases requiring active system support: First day 100 4,651.80 46.518 1,319.10 13.191 1,319.10 13.191 1,451.00 1,780.80 1,978.70 2,638.20 2,836.10 1,312.80 13.128 1,706.60 1,969.20

1206 50 2,325.90 46.518 659.55 13.191 659.55 13.191 725.50 890.40 989.30 1,319.10 1,418.00 656.40 13.128 853.30 984.60

1207 30 1,395.50 46.518 395.73 13.191 395.73 13.191 435.30 534.20 593.60 791.50 850.80 393.80 13.128 511.90 590.70

1208 137 6,373.00 46.518 1,807.17 13.191 1,807.17 13.191 1,987.90 2,439.70 2,710.80 3,614.30 3,885.40 1,798.50 13.128 2,338.00 2,697.70

1209 58 2,698.00 46.518 765.08 13.191 765.08 13.191 841.60 1,032.90 1,147.60 1,530.20 1,644.90 761.40 13.128 989.80 1,142.10

1210 50 2,325.90 46.518 659.55 13.191 659.55 13.191 725.50 890.40 989.30 1,319.10 1,418.00 656.40 13.128 853.30 984.60 1213 Ventilation: Subsequent days, per day 50 2,325.90 46.518 659.55 13.191 659.55 13.191 725.50 890.40 989.30 1,319.10 1,418.00 656.40 13.128 853.30 984.60

Average Duration

ProfessionalPrivate

TariffNon-Network

Base RateNon-Network

RCF

Network

Base Rate

Network

RCF Entry Plan Network

Traditional & Comprehensive

Network (IH)


Network (OH)

PlusNetwork

(IH)

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(OH)BaseRate

Hospital Discharge Day Mangement > 30 Minutes (additional) - Governance Project only

Drainage of major hand/ foot infection: Drainage of major abscess with necrosis of tissue

Excision and repair by direct suture; excision nail fold or other minor procedures of similar magnitude

Requiring repair by large skin graft or large local flap or other procedures of similar magnitudeRequiring repair by small skin graft or small local flap or other procedures of similar magnitude

Trans-abdominal anterior exposure of the spine for spinal fusion only if done by a second surgeon

Intensive care: Category 2: Cases requiring active system support : Subsequent days, per day

Intensive care: Category 2(ICU): Cases requiring active system support (where active specialised intervention is required in cases such as acute myocardial infarction, diabetic coma, head injury, severe asthma, acute pancreatitis, eclampsia, flail chest, etc. Ventilation may or may not be part of the active system support): After two weeks, per dayIntensive care: Category 3: Cases with multiple organ failure or Category 2 patients : First day Intensive care: Category 3: Cases with multiple organ failure or Category 2 patients: First day Intensive care: Category 3: Cases with multiple organ failure or Category 2 patients : Subsequent days

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Units R R R R R R R R R R R R R R R

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1218 Insertion of central venous line via subclavian or jugular veins 25 1,163.00 46.518 329.78 13.191 329.78 13.191 362.80 445.20 494.70 659.60 709.00 328.20 13.128 426.60 492.30

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1219 Hyperalimentation (daily tariff) 15 697.80 46.518 197.87 13.191 197.87 13.191 217.70 267.10 296.80 395.70 425.40 196.90 13.128 255.90 295.30 1372 Abdominal aorta and iliac artery: Unruptured 540 25,119.70 46.518 7,123.14 13.191 7,123.14 13.191 7,835.50 9,616.20 10,684.70 14,246.30 15,314.80 7,089.10 13.128 9,215.80 10,633.60

1376 594 27,631.70 46.518 7,835.45 13.191 7,835.45 13.191 8,619.00 10,577.90 11,753.20 15,670.90 16,846.20 7,798.00 13.128 10,137.40 11,697.00 1385 Prosthetic grafting 255 11,862.10 46.518 3,363.71 13.191 3,363.71 13.191 3,700.10 4,541.00 5,045.60 6,727.40 7,232.00 3,347.60 13.128 4,351.80 5,021.40 1387 Vein grafting proximal to knee joint 300 13,955.40 46.518 3,957.30 13.191 3,957.30 13.191 4,353.00 5,342.40 5,936.00 7,914.60 8,508.20 3,938.40 13.128 5,119.90 5,907.60 1388 Vein grafting distal to knee joint 444 20,654.00 46.518 5,856.80 13.191 5,856.80 13.191 6,442.50 7,906.70 8,785.20 11,713.60 12,592.10 5,828.80 13.128 7,577.40 8,743.20 1389 Endarterectomy when not part of another specified procedure 264 12,280.80 46.518 3,482.42 13.191 3,482.42 13.191 3,830.70 4,701.30 5,223.60 6,964.80 7,487.20 3,465.70 13.128 4,505.40 5,198.50 1390 Carotid endarterectomy 321 14,932.30 46.518 4,234.31 13.191 4,234.31 13.191 4,657.70 5,716.30 6,351.50 8,468.60 9,103.80 4,214.00 13.128 5,478.20 6,321.00 1393 Embolectomy: Peripheral embolectomy transfemoral 168 7,815.00 46.518 2,216.09 13.191 2,216.09 13.191 2,437.70 2,991.70 3,324.10 4,432.20 4,764.60 2,205.50 13.128 2,867.10 3,308.20 1396 Suture major blood vessel (artery or vein) - trauma 264 12,280.80 46.518 3,482.42 13.191 3,482.42 13.191 3,830.70 4,701.30 5,223.60 6,964.80 7,487.20 3,465.70 13.128 4,505.40 5,198.50 1408 Placement of Hickman catheter or similar 91 4,233.10 46.518 1,200.38 13.191 1,200.38 13.191 1,320.40 1,620.50 1,800.60 2,400.80 2,580.80 1,194.60 13.128 1,552.90 1,791.90

1413 141 6,559.00 46.518 1,859.93 13.191 1,859.93 13.191 2,045.90 2,510.90 2,789.90 3,719.90 3,998.90 1,851.00 13.128 2,406.30 2,776.50

1415 Combined procedure for varicose veins: Ligation of saphenous vein stripping: Bilateral 247 11,489.90 46.518 3,258.18 13.191 3,258.18 13.191 3,584.00 4,398.50 4,887.30 6,516.40 7,005.10 3,242.60 13.128 4,215.30 4,863.90 1435 Splenectomy (in all cases) 221.3 10,294.40 46.518 2,919.17 13.191 2,919.17 13.191 3,211.10 3,940.90 4,378.80 5,838.30 6,276.20 2,905.20 13.128 3,776.70 4,357.80 1439 Excision of lymph node for biopsy: Neck or axilla 65 3,023.70 46.518 857.42 13.191 857.42 13.191 943.20 1,157.50 1,286.10 1,714.80 1,843.40 853.30 13.128 1,109.20 1,279.90 1445 Radical excision of lymph nodes of neck: Total: Unilateral 315 14,653.20 46.518 4,155.17 13.191 4,155.17 13.191 4,570.70 5,609.50 6,232.70 8,310.30 8,933.60 4,135.30 13.128 5,375.80 6,202.90 1449 Radical excision of lymph nodes of axilla 160 7,442.90 46.518 2,110.56 13.191 2,110.56 13.191 2,321.60 2,849.30 3,165.80 4,221.10 4,537.70 2,100.40 13.128 2,730.50 3,150.60 1525 Partial parotidectomy 310 14,420.60 46.518 4,089.21 13.191 4,089.21 13.191 4,498.10 5,520.40 6,133.80 8,178.40 8,791.80 4,069.60 13.128 5,290.40 6,104.40 1563 Hiatus hernia and diaphragmatic hernia repair: With anti-reflux procedure 300 13,955.40 46.518 3,957.30 13.191 3,957.30 13.191 4,353.00 5,342.40 5,936.00 7,914.60 8,508.20 3,938.40 13.128 5,119.90 5,907.60

1565 350 16,281.30 46.518 4,616.85 13.191 4,616.85 13.191 5,078.50 6,232.70 6,925.30 9,233.70 9,926.20 4,594.80 13.128 5,973.20 6,892.20 1566 Private fee: Gastroplasty 325 15,118.40 46.518 4,287.08 13.191 4,287.08 13.191 4,715.80 5,787.60 6,430.60 8,574.20 9,217.20 4,266.60 13.128 5,546.50 6,399.90 1568 Hiatus hernia and diaphragmatic repair: Revision after previous repair 375 17,444.30 46.518 4,946.63 13.191 4,946.63 13.191 5,441.30 6,677.90 7,419.90 9,893.30 10,635.20 4,923.00 13.128 6,399.90 7,384.50 1578 Oesophageal motility (4 channel + pneumograph) 100 4,651.80 46.518 1,319.10 13.191 1,319.10 13.191 1,451.00 1,780.80 1,978.70 2,638.20 2,836.10 1,312.80 13.128 1,706.60 1,969.20 1580 Oesophageal motility (6 Channel + pneumograph + pH pull-through) 110 5,117.00 46.518 1,451.01 13.191 1,451.01 13.191 1,596.10 1,958.90 2,176.50 2,902.00 3,119.70 1,444.00 13.128 1,877.20 2,166.00 1584 24-hour oesophageal pH studies: Hire fee 55 2,558.50 46.518 725.51 13.191 725.51 13.191 798.10 979.40 1,088.30 1,451.00 1,559.80 722.00 13.128 938.60 1,083.00 1587 Upper gastro-intestinal endoscopy: Using hospital equipment 48.75 2,267.80 46.518 643.06 13.191 643.06 13.191 707.40 868.10 964.60 1,286.10 1,382.60 639.90 13.128 831.80 959.80 1597 Gastrostomy or Gastrotomy 147.5 6,861.40 46.518 1,945.67 13.191 1,945.67 13.191 2,140.20 2,626.70 2,918.50 3,891.30 4,183.20 1,936.30 13.128 2,517.10 2,904.40 1615 Suture of perforated gastric or duodenal ulcer, wound or injury 200 9,303.60 46.518 2,638.20 13.191 2,638.20 13.191 2,902.00 3,561.60 3,957.30 5,276.40 5,672.10 2,625.60 13.128 3,413.20 3,938.40 1617 Partial gastrectomy 328.3 15,271.90 46.518 4,330.61 13.191 4,330.61 13.191 4,763.70 5,846.30 6,495.90 8,661.20 9,310.80 4,309.90 13.128 5,602.80 6,464.80 1637 Operation for relief of intestinal obstruction 240 11,164.30 46.518 3,165.84 13.191 3,165.84 13.191 3,482.40 4,273.90 4,748.80 6,331.70 6,806.60 3,150.70 13.128 4,095.90 4,726.00 1639 Resection of small bowel with enterostomy or anastomosis 244.9 11,392.30 46.518 3,230.48 13.191 3,230.48 13.191 3,553.50 4,361.10 4,845.70 6,461.00 6,945.50 3,215.00 13.128 4,179.50 4,822.50 1641 Entero-enterostomy or entero-colostomy for bypass 213.1 9,913.00 46.518 2,811.00 13.191 2,811.00 13.191 3,092.10 3,794.90 4,216.50 5,622.00 6,043.70 2,797.50 13.128 3,636.70 4,196.20 1645 Suture of intestine (small or large): Perforated ulcer, wound or injury 185.2 8,615.10 46.518 2,442.97 13.191 2,442.97 13.191 2,687.30 3,298.00 3,664.50 4,885.90 5,252.40 2,431.30 13.128 3,160.60 3,646.90 1651 Excision of lesion of mesentery 171.6 7,982.50 46.518 2,263.58 13.191 2,263.58 13.191 2,489.90 3,055.80 3,395.40 4,527.20 4,866.70 2,252.70 13.128 2,928.50 3,379.00 1653 Total colonoscopy: With hospital equipment (including biopsy) 90 4,186.60 46.518 1,187.19 13.191 1,187.19 13.191 1,305.90 1,602.70 1,780.80 2,374.40 2,552.50 1,181.50 13.128 1,535.90 1,772.20 1654 Plus removal of polyps: ADD to colonoscopy (item 1653) 30 1,395.50 46.518 395.73 13.191 395.73 13.191 435.30 534.20 593.60 791.50 850.80 393.80 13.128 511.90 590.70 1656 Left-sided colonoscopy 60 2,791.10 46.518 791.46 13.191 791.46 13.191 870.60 1,068.50 1,187.20 1,582.90 1,701.60 787.60 13.128 1,023.80 1,181.40 1657 Right or left hemicolectomy or segmental colectomy 325.4 15,137.00 46.518 4,292.35 13.191 4,292.35 13.191 4,721.60 5,794.70 6,438.50 8,584.70 9,228.60 4,271.80 13.128 5,553.30 6,407.70 1658 Reconstruction of colon after Hartman’s procedure 359.4 16,718.60 46.518 4,740.85 13.191 4,740.85 13.191 5,214.90 6,400.10 7,111.30 9,481.70 10,192.80 4,718.20 13.128 6,133.60 7,077.30 1663 Total colectomy 390 18,142.00 46.518 5,144.49 13.191 5,144.49 13.191 5,658.90 6,945.10 7,716.70 10,289.00 11,060.70 5,119.90 13.128 6,655.80 7,679.80 1665 Colostomy or ileostomy isolated procedure 196 9,117.50 46.518 2,585.44 13.191 2,585.44 13.191 2,844.00 3,490.30 3,878.20 5,170.90 5,558.70 2,573.00 13.128 3,344.90 3,859.50 1667 Colostomy: Closure 179.1 8,331.40 46.518 2,362.51 13.191 2,362.51 13.191 2,598.80 3,189.40 3,543.80 4,725.00 5,079.40 2,351.20 13.128 3,056.50 3,526.80 1675 Appendicectomy 160 7,442.90 46.518 2,110.56 13.191 2,110.56 13.191 2,321.60 2,849.30 3,165.80 4,221.10 4,537.70 2,100.40 13.128 2,730.50 3,150.60 1676 Flexible sigmoidoscopy (including rectum and anus): Using hospital equipment 48.75 2,267.80 46.518 643.06 13.191 643.06 13.191 707.40 868.10 964.60 1,286.10 1,382.60 639.90 13.128 831.80 959.80

1687 381.3 17,737.30 46.518 5,029.73 13.191 5,029.73 13.191 5,532.70 6,790.10 7,544.60 10,059.50 10,813.90 5,005.70 13.128 6,507.40 7,508.50

1688 445 20,700.50 46.518 5,870.00 13.191 5,870.00 13.191 6,457.00 7,924.50 8,805.00 11,740.00 12,620.50 5,841.90 13.128 7,594.40 8,762.80 1691 Abdomino-perineal resection of rectum: Abdominal surgeon 409.3 19,039.80 46.518 5,399.08 13.191 5,399.08 13.191 5,939.00 7,288.80 8,098.60 10,798.20 11,608.00 5,373.20 13.128 6,985.10 8,059.80 1697 Repair of prolapsed rectum: Abdominal: Roscoe Graham Moskovitz 300 13,955.40 46.518 3,957.30 13.191 3,957.30 13.191 4,353.00 5,342.40 5,936.00 7,914.60 8,508.20 3,938.40 13.128 5,119.90 5,907.60 1701 Repair of prolapsed rectum: Abdominal: Perineal 150 6,977.70 46.518 1,978.65 13.191 1,978.65 13.191 2,176.50 2,671.20 2,968.00 3,957.30 4,254.10 1,969.20 13.128 2,559.90 2,953.80 1709 Drainage of ischio-rectal abscess 87 4,047.10 46.518 1,147.62 13.191 1,147.62 13.191 1,262.40 1,549.30 1,721.40 2,295.20 2,467.40 1,142.10 13.128 1,484.70 1,713.10 1711 Excision of pelvi-rectal fistula 200 9,303.60 46.518 2,638.20 13.191 2,638.20 13.191 2,902.00 3,561.60 3,957.30 5,276.40 5,672.10 2,625.60 13.128 3,413.20 3,938.40 1713 Excision of fistula-in-ano 105 4,884.40 46.518 1,385.06 13.191 1,385.06 13.191 1,523.60 1,869.80 2,077.60 2,770.10 2,977.90 1,378.40 13.128 1,791.90 2,067.60 1715 Operation for fissure-in-ano 66.8 3,107.40 46.518 881.16 13.191 881.16 13.191 969.30 1,189.60 1,321.70 1,762.30 1,894.50 876.90 13.128 1,139.90 1,315.30 1723 Haemorrhoidectomy 120 5,582.20 46.518 1,582.92 13.191 1,582.92 13.191 1,741.20 2,136.90 2,374.40 3,165.80 3,403.30 1,575.30 13.128 2,047.80 2,362.90 1727 Multiple procedures (haemorrhoids, fissure, etc.) 90 4,186.60 46.518 1,187.19 13.191 1,187.19 13.191 1,305.90 1,602.70 1,780.80 2,374.40 2,552.50 1,181.50 13.128 1,535.90 1,772.20 1749 Hemi-hepatectomy: Right 564 26,236.20 46.518 7,439.72 13.191 7,439.72 13.191 8,183.70 10,043.60 11,159.60 14,879.40 15,995.40 7,404.10 13.128 9,625.30 11,106.10 1753 Partial or segmental hepatectomy 378 17,583.80 46.518 4,986.20 13.191 4,986.20 13.191 5,484.80 6,731.40 7,479.30 9,972.40 10,720.30 4,962.30 13.128 6,450.90 7,443.40

Aorta bi-femoral graft, including proximal and distal endarterectomy and preparation for anastomosis

Combined procedure for varicose veins: , multiple ligation including perforating veins : Unilateral

Hiatus hernia and diaphragmatic hernia repair: With Collis Nissen oesophageal lengthening procedure

Anterior resection of rectum performed for carcinoma of rectum incl excision of any part of proximal colonTotal mesorectal excision with colo-anal anastomosis and defunctioning enterostomy or colostomy

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PlusNetwork

(OH)BaseRate

1755 Liver transplant 1400.8 65,162.40 46.518 18,477.95 13.191 18,477.95 13.191 20,325.70 24,945.20 27,716.90 36,955.90 39,727.60 18,389.70 13.128 23,906.60 27,584.50 1761 Cholecystectomy 225 10,466.60 46.518 2,967.98 13.191 2,967.98 13.191 3,264.80 4,006.80 4,452.00 5,936.00 6,381.10 2,953.80 13.128 3,839.90 4,430.70

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Network (OH)

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(IH)

PlusNetwork

(OH)BaseRate

1762 Cholecystectomy and operative cholangiogram 255 11,862.10 46.518 3,363.71 13.191 3,363.71 13.191 3,700.10 4,541.00 5,045.60 6,727.40 7,232.00 3,347.60 13.128 4,351.80 5,021.40

1778 105.9 4,926.30 46.518 1,396.93 13.191 1,396.93 13.191 1,536.60 1,885.90 2,095.40 2,793.90 3,003.40 1,390.20 13.128 1,807.20 2,085.30 1789 Pancreatico-duodenectomy 704.8 32,785.90 46.518 9,297.02 13.191 9,297.02 13.191 10,226.70 12,551.00 13,945.50 18,594.00 19,988.60 9,252.60 13.128 12,028.30 13,878.90

1807 ADD to open procedure where procedure was performed through a laparoscope 45 2,093.30 46.518 593.60 13.191 593.60 13.191 653.00 801.40 890.40 1,187.20 1,276.20 590.70 13.128 767.90 886.00 1809 Laparotomy 196 9,117.50 46.518 2,585.44 13.191 2,585.44 13.191 2,844.00 3,490.30 3,878.20 5,170.90 5,558.70 2,573.00 13.128 3,344.90 3,859.50

1810 350 16,281.30 46.518 4,616.85 13.191 4,616.85 13.191 5,078.50 6,232.70 6,925.30 9,233.70 9,926.20 4,594.80 13.128 5,973.20 6,892.20

1815 248.4 11,555.10 46.518 3,276.64 13.191 3,276.64 13.191 3,604.30 4,423.50 4,915.00 6,553.30 7,044.80 3,260.90 13.128 4,239.10 4,891.30 1819 Inguinal or femoral hernia: Adult 125 5,814.80 46.518 1,648.88 13.191 1,648.88 13.191 1,813.80 2,226.00 2,473.30 3,297.80 3,545.10 1,641.00 13.128 2,133.30 2,461.50 1821 Inguinal or femoral hernia: Child under 14 years old 90 4,186.60 46.518 1,187.19 13.191 1,187.19 13.191 1,305.90 1,602.70 1,780.80 2,374.40 2,552.50 1,181.50 13.128 1,535.90 1,772.20 1823 Inguinal hernia: Infant under 1 year 100 4,651.80 46.518 1,319.10 13.191 1,319.10 13.191 1,451.00 1,780.80 1,978.70 2,638.20 2,836.10 1,312.80 13.128 1,706.60 1,969.20 1825 Recurrent inguinal or femoral hernia 155 7,210.30 46.518 2,044.61 13.191 2,044.61 13.191 2,249.10 2,760.20 3,066.90 4,089.20 4,395.90 2,034.80 13.128 2,645.20 3,052.20 1827 Strangulated hernia or femoral hernia 238 11,071.30 46.518 3,139.46 13.191 3,139.46 13.191 3,453.40 4,238.30 4,709.20 6,278.90 6,749.80 3,124.40 13.128 4,061.70 4,686.60 1829 Epigastric hernia 93.3 4,340.10 46.518 1,230.72 13.191 1,230.72 13.191 1,353.80 1,661.50 1,846.10 2,461.40 2,646.00 1,224.80 13.128 1,592.20 1,837.20 1831 Umbilical hernia: Adult 140 6,512.50 46.518 1,846.74 13.191 1,846.74 13.191 2,031.40 2,493.10 2,770.10 3,693.50 3,970.50 1,837.90 13.128 2,389.20 2,756.80 1835 Incisional hernia 166.8 7,759.20 46.518 2,200.26 13.191 2,200.26 13.191 2,420.30 2,970.30 3,300.40 4,400.50 4,730.60 2,189.70 13.128 2,846.60 3,284.50 1836 Implantation of mesh or other prosthesis for incisional or ventral hernia repair 77 3,581.90 46.518 1,015.71 13.191 1,015.71 13.191 1,117.30 1,371.20 1,523.60 2,031.40 2,183.80 1,010.80 13.128 1,314.00 1,516.20 1895 Allo-transplantation of kidney 420 19,537.60 46.518 5,540.22 13.191 5,540.22 13.191 6,094.20 7,479.30 8,310.30 11,080.40 11,911.50 5,513.70 13.128 7,167.80 8,270.50 2137 Circumcision: Surgical excision other than by clamp or dorsal slit, any age 60 2,791.10 46.518 791.46 13.191 791.46 13.191 870.60 1,068.50 1,187.20 1,582.90 1,701.60 787.60 13.128 1,023.80 1,181.40 2493 Diagnostic laparoscopy (excluding after-care) 94.4 4,391.30 46.518 1,245.23 13.191 1,245.23 13.191 1,369.80 1,681.10 1,867.80 2,490.50 2,677.20 1,239.20 13.128 1,610.90 1,858.80 2527 Removal of ovarian tumour or cyst 187 8,698.90 46.518 2,466.72 13.191 2,466.72 13.191 2,713.40 3,330.10 3,700.10 4,933.40 5,303.40 2,454.90 13.128 3,191.30 3,682.30 2848 Cervical sympathectomy: Bilateral 268 12,466.80 46.518 3,535.19 13.191 3,535.19 13.191 3,888.70 4,772.50 5,302.80 7,070.40 7,600.70 3,518.30 13.128 4,573.70 5,277.40 2985 Lobectomy: Total 200 9,303.60 46.518 2,638.20 13.191 2,638.20 13.191 2,902.00 3,561.60 3,957.30 5,276.40 5,672.10 2,625.60 13.128 3,413.20 3,938.40 2987 Thyroidectomy: Subtotal 266 12,373.80 46.518 3,508.81 13.191 3,508.81 13.191 3,859.70 4,736.90 5,263.20 7,017.60 7,543.90 3,492.00 13.128 4,539.60 5,238.00 2989 Thyroidectomy: Total 279 12,978.50 46.518 3,680.29 13.191 3,680.29 13.191 4,048.30 4,968.40 5,520.40 7,360.60 7,912.60 3,662.70 13.128 4,761.50 5,494.00 2993 Exploration of parathyroid glands for hyperparathyroidism including removal 275 12,792.50 46.518 3,627.53 13.191 3,627.53 13.191 3,990.30 4,897.20 5,441.30 7,255.10 7,799.20 3,610.20 13.128 4,693.20 5,415.30

3559 Selective first order catheterisation, arterial or venous, with angiogram/venogram 95 4,419.20 46.518 1,776.22 18.697 1,776.22 18.697 1,953.80 2,397.90 2,664.30 3,552.40 3,818.90 1,763.80 18.567 2,292.90 2,645.70

3562 Selective third order catheterisation, arterial or venous, with angiogram/venogram 122 5,675.20 46.518 2,281.03 18.697 2,281.03 18.697 2,509.10 3,079.40 3,421.60 4,562.10 4,904.20 2,265.10 18.567 2,944.60 3,397.60 3627* Ultrasound examination includes whole abdomen and pelvic organs 60 - 12.778 754.44 12.574 754.44 12.574 829.90 1,018.50 1,131.70 1,508.90 1,622.00 750.90 12.516 976.10 1,126.30 4821 Routine HBO table (2-2,5 ATA x 90-120 min): Technical component 131.26 6,106.00 46.518 1,650.46 12.574 1,650.46 12.574 1,815.50 2,228.10 2,475.70 3,300.90 3,548.50 1,642.80 12.516 2,135.60 2,464.20 5008 Percutaneous transluminal angioplasty: Sub-popliteal sub-brachial 232 10,792.20 46.518 4,337.70 18.697 4,337.70 18.697 4,771.50 5,855.90 6,506.60 8,675.40 9,326.10 4,307.50 18.567 5,599.70 6,461.20

5060 232 10,792.20 46.518 4,337.70 18.697 4,337.70 18.697 4,771.50 5,855.90 6,506.60 8,675.40 9,326.10 4,307.50 18.567 5,599.70 6,461.20

5110 128 5,954.30 46.518 1,609.47 12.574 1,609.47 12.574 1,770.40 2,172.80 2,414.20 3,218.90 3,460.40 1,602.00 12.516 2,082.60 2,403.00

5111 206 8,370.20 40.632 2,590.24 12.574 2,590.24 12.574 2,849.30 3,496.80 3,885.40 5,180.50 5,569.00 2,578.20 12.516 3,351.60 3,867.30

5112 117 4,753.90 40.632 1,471.16 12.574 1,471.16 12.574 1,618.30 1,986.10 2,206.70 2,942.30 3,163.00 1,464.30 12.516 1,903.50 2,196.40

5113 117 4,753.90 40.632 1,471.16 12.574 1,471.16 12.574 1,618.30 1,986.10 2,206.70 2,942.30 3,163.00 1,464.30 12.516 1,903.50 2,196.40

5114 178 7,232.50 40.632 2,238.17 12.574 2,238.17 12.574 2,462.00 3,021.50 3,357.30 4,476.30 4,812.10 2,227.80 12.516 2,896.10 3,341.70

Endoscopic Retrograde Cholangiopancreatography (ERCP): Endoscopy + catheterisation of pancreas duct

Radical removal of retro-peritoneal malignant tumours (including sacro-coccygeal and pre-sacral)Drainage of other intraperitoneal abscess (excluding appendix abscess): Transabdominal

Stent insertion: Iliac/subclavian/AV fistula – including percutaneous transluminal angioplasty (PTA)Carotid ultrasound vascular study:B mode, pulsed & colour Doppler; bilateral, internal, external & common carotid flow & anatomyFull ultrasonic and colour Doppler evaluation of entire extracranial vascular tree: Carotids, vertebral and subclavian vessels Peripheral arterial ultrasound vascular study: B mode, pulsed and colour Doppler; per limbPeripheral venous ultrasound vascular study; B mode, pulsed and colour Doppler; to evaluate deep vein thrombosisPeripheral venous ultrasound vascular study; B mode, pulsed and colour Doppler; in erect and supine position, bilaterally

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RCF

Network

Base Rate

Network



Network (IH)


Network (OH)

PlusNetwork

(IH)

PlusNetwork

(OH)BaseRate

New & Updated Procedures (Coding Changes)

0258 Incision/removal of foreign body: Subcutaneous tissue, simple 31.00 1,442.10 46.518 408.92 13.191 408.92 13.191 449.80 552.00 613.40 817.80 879.20 406.90 13.128 528.90 610.30 0260 Incision/removal of foreign body: Subcutaneous tissue, complicated 55.50 2,581.70 46.518 732.10 13.191 732.10 13.191 805.30 988.30 1,098.20 1,464.20 1,574.00 728.60 13.128 947.10 1,092.90 0644 Removal of foreign body: Shoulder, subcutaneous 49.70 2,311.90 46.518 655.59 13.191 655.59 13.191 721.20 885.10 983.40 1,311.20 1,409.50 652.40 13.128 848.10 978.60 0647 Removal of foreign body: Upper arm or elbow area, subcutaneous 41.70 1,939.80 46.518 550.06 13.191 550.06 13.191 605.10 742.60 825.10 1,100.10 1,182.60 547.40 13.128 711.60 821.10 0648 Removal of foreign body: Upper arm or elbow area, subfascial or intramuscular 109.00 5,070.50 46.518 1,437.82 13.191 1,437.82 13.191 1,581.60 1,941.10 2,156.70 2,875.60 3,091.30 1,430.90 13.128 1,860.10 2,146.30 0651 Exploration with removal of deep foreign body: Forearm or wrist 122.80 5,712.40 46.518 1,619.85 13.191 1,619.85 13.191 1,781.80 2,186.80 2,429.80 3,239.70 3,482.70 1,612.10 13.128 2,095.70 2,418.10 0652 Removal of foreign body: Pelvis or hip, subcutaneous tissue 45.30 2,107.30 46.518 597.55 13.191 597.55 13.191 657.30 806.70 896.30 1,195.10 1,284.70 594.60 13.128 772.90 891.90 0653 Removal of foreign body: Pelvis or hip, subfascial or intramuscular 186.90 8,694.20 46.518 2,465.40 13.191 2,465.40 13.191 2,711.90 3,328.30 3,698.10 4,930.80 5,300.60 2,453.60 13.128 3,189.60 3,680.40 0654 Excision of soft tissue tumour: Thigh or knee area, subcutaneous <3 cm 120.60 5,610.10 46.518 1,590.83 13.191 1,590.83 13.191 1,749.90 2,147.60 2,386.30 3,181.70 3,420.30 1,583.20 13.128 2,058.10 2,374.80 0655 Removal of foreign body: Foot, subcutaneous 40.00 1,860.70 46.518 527.64 13.191 527.64 13.191 580.40 712.30 791.50 1,055.30 1,134.40 525.10 13.128 682.60 787.60 0656 Removal of foreign body: Foot, deep 94.20 4,382.00 46.518 1,242.59 13.191 1,242.59 13.191 1,366.90 1,677.50 1,863.90 2,485.20 2,671.60 1,236.60 13.128 1,607.50 1,854.90 0657 Removal of foreign body: Foot, complicated 110.50 5,140.20 46.518 1,457.61 13.191 1,457.61 13.191 1,603.40 1,967.80 2,186.40 2,915.20 3,133.90 1,450.60 13.128 1,885.70 2,175.90 1096 Removal of foreign body: Pharynx 40.50 1,884.00 46.518 534.24 13.191 534.24 13.191 587.70 721.20 801.40 1,068.50 1,148.60 531.60 13.128 691.00 797.40 1462 Removal of embedded foreign body: Vestibule of mouth, simple 41.10 1,911.90 46.518 542.15 13.191 542.15 13.191 596.40 731.90 813.20 1,084.30 1,165.60 539.50 13.128 701.30 809.20 1464 Removal of embedded foreign body: Vestibule of mouth; complicated 73.10 3,400.50 46.518 964.26 13.191 964.26 13.191 1,060.70 1,301.80 1,446.40 1,928.50 2,073.20 959.60 13.128 1,247.40 1,439.40 1466 Removal of embedded foreign body: Dentoalveolar structures, soft tissues 52.80 2,456.20 46.518 696.48 13.191 696.48 13.191 766.10 940.30 1,044.70 1,393.00 1,497.40 693.10 13.128 901.00 1,039.60 2172 Removal foreign body: Deep penile tissue (eg., plastic implant) 123.10 5,726.40 46.518 1,623.81 13.191 1,623.81 13.191 1,786.20 2,192.10 2,435.70 3,247.60 3,491.20 1,616.00 13.128 2,100.80 2,424.00 2228 Removal of foreign body: Scrotum 104.90 4,879.70 46.518 1,383.74 13.191 1,383.74 13.191 1,522.10 1,868.00 2,075.60 2,767.50 2,975.00 1,377.10 13.128 1,790.20 2,065.60

Note:1. Codes, Descriptors and Unit Values have been extracted from the SAMA Electronic Medical Doctors Coding Manual (eMDCM) previously known as the SAMA Doctors Billing Manual (DBM).

2. Tariffs may differ due to rounding3. Above codes are the most frequently used codes and is not all inclusive of all the codes4. The HealthMan Rate increased by 6.5%5.1 The BankMed Non-Network base rate increased by 5% and the Network base rate increased by 6% for 20185.2 The Discovery Network base rate for consultations is increased by 6% for 20185.3 The Discovery Network base rate for prcedures and all Non-Network base rates increased by 5% for 2018 5.4 The Discovery Classic DPA OH consult base rate, above which you can balance bill the patient.5.5 Please note that Discovery ICU coding has separate RCFs since 2017.5.6 POLMED and Medihelp increased their base rate by 5.7% for 2018 (please note the additional 10% increase on the POLMED DPA)6. Payment Arrangement Rates have NOT been split between In-Hospital & Out-Hospital. Use as appropriate. 7. The Healthman tariff for codes that relate to equipment have been retained at Profmed rate*8. All Tariffs are inlcusive of VAT9. All Fees marked in "Green" have not been published by the particular Scheme, the tariffs were calculated based on the relvant RCF, e.g. Consulting RCF (please refer to the Disclaimer)10. The new and updated procedure codes were approved by Surgicom, SAGES, SAPPF and SAMA in 2015. We encourage practitioners to use it. 11. Applicable to Governance Project Participants (only)

Disclaimer:The above schedule is based on information avaiable to HealthMan and HealthMan will NOT be held responsible for any losses incurred by practitioners resulting from the use of this schedule.

Legend:DPA = Direct Payment ArrangementPrem = PremierR = RandRCF = Rand Conversion Factor (Rand Value per Unit)VAT = Value Added Tax

Please note that many of the descriptors are shortened versions. For the full descriptors please refer to the 2018 SAMA eMDCM.

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COMPARATIVE TARIFFSHealthMan

Code Terminology RCF

Units R R Consultations:

See the Notes below for All Tariffs0109 Hospital follow-up visit 15 697.80 46.518 0129 Prolonged first/follow-up consultation : 15 min 15 697.80 46.518 0130 Telephone consultation (all hours) 12 558.20 46.518 0132 Repeat Script 5 232.60 46.518 0133 Writing of special motivations 9 418.70 46.518 0145 Consultation : Away from doctor's room 6 279.10 46.518 0146 Unscheduled consultation: Emergency (cons.room) 8 372.10 46.518 0147 Unscheduled consultation:Emergency(not cons.room) 14 651.30 46.518 0151 Pre-anaesthetic assessment: 10 and 20 minutes - - 0173 Hospital Consultation 15 697.80 46.518 0174 Hospital Consultation 30 1,395.50 46.518 0175 Hospital Consultation 45 2,093.30 46.518

0177 30.8 - - 0190 Consultation 15 697.80 46.518 0191 Consultation 30 1,395.50 46.518 0192 Consultation 45 2,093.30 46.518 0199 Chronic Medicine Forms 21.43 996.90 46.518

Procedures

0257 87 4,047.10 46.518 0289 Large skin grafts, composite skin grafts, large full thickness free skin grafts 234 10,885.20 46.518 0302 Stitching of soft-tissue injuries: Deep laceration involving limited muscle damage 64 2,977.20 46.518

0303 Stitching of soft-tissue injuries: Deep laceration involving extensive muscle damage 128 5,954.30 46.518 0304 Major debridement of wound, sloughectomy or secondary suture 50 2,325.90 46.518

0307 27 1,256.00 46.518 0308 Each additional small procedure done at the same time 14 651.30 46.518 0311 Excision of large benign tumour (more than 5 cm) 55 2,558.50 46.518 0313 Extensive resection for malignant soft tissue tumour including muscle 283.9 13,206.50 46.518

0314 104 4,837.90 46.518

0315 55 2,558.50 46.518 0321 Biopsy or excision of cyst, benign tumour, aberrant breast tissue, duct papilloma 94.2 4,382.00 46.518 0323 Sub-areolar cone excision of ducts of wedge excision of breast 90 4,186.60 46.518 0324 Wedge excision of breast and axillary dissection 225 10,466.60 46.518 0325 Total mastectomy 155 7,210.30 46.518 0329 Total mastectomy with axillary gland dissection 275 12,792.50 46.518

0939 160 7,442.90 46.518 1204 Intensive care: Category 1: Cases requiring intensive monitoring : Per day 30 1,395.50 46.518 1205 Intensive care: Category 2: Cases requiring active system support: First day 100 4,651.80 46.518

1206 50 2,325.90 46.518

1207 30 1,395.50 46.518

1208 137 6,373.00 46.518

1209 58 2,698.00 46.518

1210 50 2,325.90 46.518 1213 Ventilation: Subsequent days, per day 50 2,325.90 46.518

Average Duration

ProfessionalPrivate

Tariff








Discovery

KeyCare Prem B Classic Rate Exec Rate110% 137% 162% 147% 217% 300%

R R R R R R R R R R

210.80 14.053 224.50 14.967 246.90 307.50 363.60 330.00 487.10 673.50 294.00 19.600 313.10 20.873 344.40 428.90 507.20 460.20 679.40 939.30 235.40 19.617 250.70 20.892 275.70 343.40 406.10 368.50 544.00 752.10 97.90 19.580 104.20 20.840 114.60 142.70 168.80 153.10 226.10 312.60 176.20 19.578 187.60 20.844 206.30 257.00 303.90 275.70 407.00 562.80 117.70 19.617 125.40 20.900 137.90 171.70 203.10 184.30 272.10 376.20 156.90 19.613 167.10 20.888 183.80 228.90 270.70 245.60 362.60 501.30 274.70 19.621 292.60 20.900 321.80 400.80 474.00 430.10 634.90 877.80 - - - - - - - - - - 333.70 22.247 355.40 23.693 390.90 486.80 575.70 522.40 771.20 1,066.20 333.70 11.123 355.40 11.847 390.90 486.80 575.70 522.40 771.20 1,066.20 333.70 7.416 355.40 7.898 390.90 486.80 575.70 522.40 771.20 1,066.20

- - 424.00 13.766 424.00 424.00 424.00 424.00 424.00 424.00 375.50 25.033 399.90 26.660 439.80 547.80 647.80 587.80 867.70 1,199.70 375.50 12.517 399.90 13.330 439.80 547.80 647.80 587.80 867.70 1,199.70 375.50 8.344 399.90 8.887 439.80 547.80 647.80 587.80 867.70 1,199.70 420.30 19.613 447.60 20.887 447.60 447.60 447.60 447.60 447.60 447.60

1,114.30 12.809 1,114.30 12.809 1,225.70 1,526.50 1,805.10 1,638.00 2,418.00 3,342.90 2,997.30 12.809 2,997.30 12.809 3,297.00 4,106.30 4,855.60 4,406.00 6,504.10 8,991.90 819.70 12.809 819.70 12.809 901.60 1,122.90 1,327.90 1,204.90 1,778.70 2,459.10

1,639.50 12.809 1,639.50 12.809 1,803.40 2,246.10 2,655.90 2,410.00 3,557.70 4,918.50 640.40 12.809 640.40 12.809 704.40 877.30 1,037.40 941.30 1,389.60 1,921.20

345.80 12.809 345.80 12.809 380.30 473.70 560.10 508.30 750.30 1,037.40 179.30 12.809 179.30 12.809 197.20 245.60 290.40 263.50 389.00 537.90 704.40 12.809 704.40 12.809 774.80 965.00 1,141.10 1,035.40 1,528.50 2,113.20 3,636.40 12.809 3,636.40 12.809 4,000.00 4,981.80 5,890.90 5,345.50 7,890.90 10,909.20

1,332.10 12.809 1,332.10 12.809 1,465.30 1,824.90 2,158.00 1,958.10 2,890.60 3,996.30

704.40 12.809 704.40 12.809 774.80 965.00 1,141.10 1,035.40 1,528.50 2,113.20 1,206.60 12.809 1,206.60 12.809 1,327.20 1,653.00 1,954.60 1,773.70 2,618.30 3,619.80 1,152.80 12.809 1,152.80 12.809 1,268.00 1,579.30 1,867.50 1,694.60 2,501.50 3,458.40 2,882.00 12.809 2,882.00 12.809 3,170.20 3,948.30 4,668.80 4,236.50 6,253.90 8,646.00 1,985.30 12.809 1,985.30 12.809 2,183.80 2,719.80 3,216.10 2,918.30 4,308.10 5,955.90 3,522.40 12.809 3,522.40 12.809 3,874.60 4,825.60 5,706.20 5,177.90 7,643.60 10,567.20

2,049.40 12.809 2,049.40 12.809 2,254.30 2,807.60 3,320.00 3,012.60 4,447.10 6,148.20 364.20 12.140 387.90 12.930 426.60 531.40 628.30 570.20 841.70 1,163.70 1,214.00 12.140 1,293.00 12.930 1,422.30 1,771.40 2,094.60 1,900.70 2,805.80 3,879.00

607.00 12.140 646.50 12.930 711.10 885.70 1,047.30 950.30 1,402.90 1,939.50

364.20 12.140 387.90 12.930 426.60 531.40 628.30 570.20 841.70 1,163.70

1,663.10 12.140 1,771.40 12.930 1,948.50 2,426.80 2,869.60 2,603.90 3,843.90 5,314.20

704.10 12.140 749.90 12.930 824.80 1,027.30 1,214.80 1,102.30 1,627.20 2,249.70

607.00 12.140 646.50 12.930 711.10 885.70 1,047.30 950.30 1,402.90 1,939.50 640.40 12.809 640.40 12.809 704.40 877.30 1,037.40 941.30 1,389.60 1,921.20

Non-NetworkBase Rate

Non-

NetworkRCF

Network

Base Rate

Network

RCFPrem A

(IH)Prem A

(OH)

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Units R R

Average Duration

ProfessionalPrivate

Tariff

1218 Insertion of central venous line via subclavian or jugular veins 25 1,163.00 46.518

Discovery


R R R R R R R R R R


Non-

NetworkRCF

Network

Base Rate

Network

RCFPrem A

(IH)Prem A

(OH)

320.20 12.809 320.20 12.809 352.20 438.60 518.70 470.60 694.80 960.60

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Units R R

Average Duration

ProfessionalPrivate

Tariff

1219 Hyperalimentation (daily tariff) 15 697.80 46.518 1372 Abdominal aorta and iliac artery: Unruptured 540 25,119.70 46.518

1376 594 27,631.70 46.518 1385 Prosthetic grafting 255 11,862.10 46.518 1387 Vein grafting proximal to knee joint 300 13,955.40 46.518 1388 Vein grafting distal to knee joint 444 20,654.00 46.518 1389 Endarterectomy when not part of another specified procedure 264 12,280.80 46.518 1390 Carotid endarterectomy 321 14,932.30 46.518 1393 Embolectomy: Peripheral embolectomy transfemoral 168 7,815.00 46.518 1396 Suture major blood vessel (artery or vein) - trauma 264 12,280.80 46.518 1408 Placement of Hickman catheter or similar 91 4,233.10 46.518

1413 141 6,559.00 46.518

1415 Combined procedure for varicose veins: Ligation of saphenous vein stripping: Bilateral 247 11,489.90 46.518 1435 Splenectomy (in all cases) 221.3 10,294.40 46.518 1439 Excision of lymph node for biopsy: Neck or axilla 65 3,023.70 46.518 1445 Radical excision of lymph nodes of neck: Total: Unilateral 315 14,653.20 46.518 1449 Radical excision of lymph nodes of axilla 160 7,442.90 46.518 1525 Partial parotidectomy 310 14,420.60 46.518 1563 Hiatus hernia and diaphragmatic hernia repair: With anti-reflux procedure 300 13,955.40 46.518

1565 350 16,281.30 46.518 1566 Private fee: Gastroplasty 325 15,118.40 46.518 1568 Hiatus hernia and diaphragmatic repair: Revision after previous repair 375 17,444.30 46.518 1578 Oesophageal motility (4 channel + pneumograph) 100 4,651.80 46.518 1580 Oesophageal motility (6 Channel + pneumograph + pH pull-through) 110 5,117.00 46.518 1584 24-hour oesophageal pH studies: Hire fee 55 2,558.50 46.518 1587 Upper gastro-intestinal endoscopy: Using hospital equipment 48.75 2,267.80 46.518 1597 Gastrostomy or Gastrotomy 147.5 6,861.40 46.518 1615 Suture of perforated gastric or duodenal ulcer, wound or injury 200 9,303.60 46.518 1617 Partial gastrectomy 328.3 15,271.90 46.518 1637 Operation for relief of intestinal obstruction 240 11,164.30 46.518 1639 Resection of small bowel with enterostomy or anastomosis 244.9 11,392.30 46.518 1641 Entero-enterostomy or entero-colostomy for bypass 213.1 9,913.00 46.518 1645 Suture of intestine (small or large): Perforated ulcer, wound or injury 185.2 8,615.10 46.518 1651 Excision of lesion of mesentery 171.6 7,982.50 46.518 1653 Total colonoscopy: With hospital equipment (including biopsy) 90 4,186.60 46.518 1654 Plus removal of polyps: ADD to colonoscopy (item 1653) 30 1,395.50 46.518 1656 Left-sided colonoscopy 60 2,791.10 46.518 1657 Right or left hemicolectomy or segmental colectomy 325.4 15,137.00 46.518 1658 Reconstruction of colon after Hartman’s procedure 359.4 16,718.60 46.518 1663 Total colectomy 390 18,142.00 46.518 1665 Colostomy or ileostomy isolated procedure 196 9,117.50 46.518 1667 Colostomy: Closure 179.1 8,331.40 46.518 1675 Appendicectomy 160 7,442.90 46.518 1676 Flexible sigmoidoscopy (including rectum and anus): Using hospital equipment 48.75 2,267.80 46.518

1687 381.3 17,737.30 46.518

1688 445 20,700.50 46.518 1691 Abdomino-perineal resection of rectum: Abdominal surgeon 409.3 19,039.80 46.518 1697 Repair of prolapsed rectum: Abdominal: Roscoe Graham Moskovitz 300 13,955.40 46.518 1701 Repair of prolapsed rectum: Abdominal: Perineal 150 6,977.70 46.518 1709 Drainage of ischio-rectal abscess 87 4,047.10 46.518 1711 Excision of pelvi-rectal fistula 200 9,303.60 46.518 1713 Excision of fistula-in-ano 105 4,884.40 46.518 1715 Operation for fissure-in-ano 66.8 3,107.40 46.518 1723 Haemorrhoidectomy 120 5,582.20 46.518 1727 Multiple procedures (haemorrhoids, fissure, etc.) 90 4,186.60 46.518 1749 Hemi-hepatectomy: Right 564 26,236.20 46.518 1753 Partial or segmental hepatectomy 378 17,583.80 46.518





Discovery


R R R R R R R R R R


Non-

NetworkRCF

Network

Base Rate

Network

RCFPrem A

(IH)Prem A

(OH)

192.10 12.809 192.10 12.809 211.30 263.10 311.20 282.30 416.80 576.30 6,916.80 12.809 6,916.80 12.809 7,608.40 9,476.00 11,205.20 10,167.60 15,009.40 20,750.40

7,608.50 12.809 7,608.50 12.809 8,369.30 10,423.60 12,325.70 11,184.40 16,510.40 22,825.50 3,266.20 12.809 3,266.20 12.809 3,592.80 4,474.60 5,291.20 4,801.30 7,087.60 9,798.60 3,842.70 12.809 3,842.70 12.809 4,226.90 5,264.40 6,225.10 5,648.70 8,338.60 11,528.10 5,687.10 12.809 5,687.10 12.809 6,255.80 7,791.30 9,213.10 8,360.00 12,341.00 17,061.30 3,381.50 12.809 3,381.50 12.809 3,719.60 4,632.60 5,478.00 4,970.80 7,337.80 10,144.50 4,111.60 12.809 4,111.60 12.809 4,522.70 5,632.80 6,660.70 6,044.00 8,922.10 12,334.80 2,151.90 12.809 2,151.90 12.809 2,367.00 2,948.10 3,486.00 3,163.20 4,669.60 6,455.70 3,381.50 12.809 3,381.50 12.809 3,719.60 4,632.60 5,478.00 4,970.80 7,337.80 10,144.50 1,165.60 12.809 1,165.60 12.809 1,282.10 1,596.80 1,888.20 1,713.40 2,529.30 3,496.80

1,806.00 12.809 1,806.00 12.809 1,986.60 2,474.20 2,925.70 2,654.80 3,919.00 5,418.00

3,163.80 12.809 3,163.80 12.809 3,480.10 4,334.40 5,125.30 4,650.70 6,865.40 9,491.40 2,834.60 12.809 2,834.60 12.809 3,118.00 3,883.40 4,592.00 4,166.80 6,151.00 8,503.80 832.50 12.809 832.50 12.809 915.70 1,140.50 1,348.60 1,223.70 1,806.50 2,497.50 4,034.80 12.809 4,034.80 12.809 4,438.20 5,527.60 6,536.30 5,931.10 8,755.50 12,104.40 2,049.40 12.809 2,049.40 12.809 2,254.30 2,807.60 3,320.00 3,012.60 4,447.10 6,148.20 3,970.70 12.809 3,970.70 12.809 4,367.70 5,439.80 6,432.50 5,836.90 8,616.40 11,912.10 3,842.70 12.809 3,842.70 12.809 4,226.90 5,264.40 6,225.10 5,648.70 8,338.60 11,528.10

4,483.10 12.809 4,483.10 12.809 4,931.40 6,141.80 7,262.60 6,590.10 9,728.30 13,449.30 4,162.90 12.809 4,162.90 12.809 4,579.10 5,703.10 6,743.80 6,119.40 9,033.40 12,488.70 4,803.30 12.809 4,803.30 12.809 5,283.60 6,580.50 7,781.30 7,060.80 10,423.10 14,409.90 1,280.90 12.809 1,280.90 12.809 1,408.90 1,754.80 2,075.00 1,882.90 2,779.50 3,842.70 1,408.90 12.809 1,408.90 12.809 1,549.70 1,930.10 2,282.40 2,071.00 3,057.30 4,226.70 704.40 12.809 704.40 12.809 774.80 965.00 1,141.10 1,035.40 1,528.50 2,113.20 624.40 12.809 624.40 12.809 686.80 855.40 1,011.50 917.80 1,354.90 1,873.20 1,889.30 12.809 1,889.30 12.809 2,078.20 2,588.30 3,060.60 2,777.20 4,099.70 5,667.90 2,561.80 12.809 2,561.80 12.809 2,817.90 3,509.60 4,150.10 3,765.80 5,559.10 7,685.40 4,205.10 12.809 4,205.10 12.809 4,625.60 5,760.90 6,812.20 6,181.40 9,125.00 12,615.30 3,074.10 12.809 3,074.10 12.809 3,381.50 4,211.50 4,980.00 4,518.90 6,670.70 9,222.30 3,136.90 12.809 3,136.90 12.809 3,450.50 4,297.50 5,081.70 4,611.20 6,807.00 9,410.70 2,729.50 12.809 2,729.50 12.809 3,002.40 3,739.40 4,421.70 4,012.30 5,923.00 8,188.50 2,372.20 12.809 2,372.20 12.809 2,609.40 3,249.90 3,842.90 3,487.10 5,147.60 7,116.60 2,198.00 12.809 2,198.00 12.809 2,417.80 3,011.20 3,560.70 3,231.00 4,769.60 6,594.00 1,152.80 12.809 1,152.80 12.809 1,268.00 1,579.30 1,867.50 1,694.60 2,501.50 3,458.40 384.20 12.809 384.20 12.809 422.60 526.30 622.40 564.70 833.70 1,152.60 768.50 12.809 768.50 12.809 845.30 1,052.80 1,244.90 1,129.60 1,667.60 2,305.50 4,168.00 12.809 4,168.00 12.809 4,584.80 5,710.10 6,752.10 6,126.90 9,044.50 12,504.00 4,603.50 12.809 4,603.50 12.809 5,063.80 6,306.70 7,457.60 6,767.10 9,989.50 13,810.50 4,995.50 12.809 4,995.50 12.809 5,495.00 6,843.80 8,092.70 7,343.30 10,840.20 14,986.50 2,510.50 12.809 2,510.50 12.809 2,761.50 3,439.30 4,067.00 3,690.40 5,447.70 7,531.50 2,294.00 12.809 2,294.00 12.809 2,523.40 3,142.70 3,716.20 3,372.10 4,977.90 6,882.00 2,049.40 12.809 2,049.40 12.809 2,254.30 2,807.60 3,320.00 3,012.60 4,447.10 6,148.20 624.40 12.809 624.40 12.809 686.80 855.40 1,011.50 917.80 1,354.90 1,873.20

4,884.00 12.809 4,884.00 12.809 5,372.40 6,691.00 7,912.00 7,179.40 10,598.20 14,652.00

5,700.00 12.809 5,700.00 12.809 6,270.00 7,809.00 9,234.00 8,379.00 12,369.00 17,100.00 5,242.70 12.809 5,242.70 12.809 5,766.90 7,182.40 8,493.10 7,706.70 11,376.60 15,728.10 3,842.70 12.809 3,842.70 12.809 4,226.90 5,264.40 6,225.10 5,648.70 8,338.60 11,528.10 1,921.30 12.809 1,921.30 12.809 2,113.40 2,632.10 3,112.50 2,824.30 4,169.20 5,763.90 1,114.30 12.809 1,114.30 12.809 1,225.70 1,526.50 1,805.10 1,638.00 2,418.00 3,342.90 2,561.80 12.809 2,561.80 12.809 2,817.90 3,509.60 4,150.10 3,765.80 5,559.10 7,685.40 1,344.90 12.809 1,344.90 12.809 1,479.30 1,842.50 2,178.70 1,977.00 2,918.40 4,034.70 855.60 12.809 855.60 12.809 941.10 1,172.10 1,386.00 1,257.70 1,856.60 2,566.80 1,537.00 12.809 1,537.00 12.809 1,690.70 2,105.60 2,489.90 2,259.30 3,335.20 4,611.00 1,152.80 12.809 1,152.80 12.809 1,268.00 1,579.30 1,867.50 1,694.60 2,501.50 3,458.40 7,224.20 12.809 7,224.20 12.809 7,946.60 9,897.10 11,703.20 10,619.50 15,676.50 21,672.60 4,841.80 12.809 4,841.80 12.809 5,325.90 6,633.20 7,843.70 7,117.40 10,506.70 14,525.40

of 30




Units R R

Average Duration

ProfessionalPrivate

Tariff

1755 Liver transplant 1400.8 65,162.40 46.518 1761 Cholecystectomy 225 10,466.60 46.518

Discovery


R R R R R R R R R R


Non-

NetworkRCF

Network

Base Rate

Network

RCFPrem A

(IH)Prem A

(OH)

17,942.80 12.809 17,942.80 12.809 19,737.00 24,581.60 29,067.30 26,375.90 38,935.80 53,828.40 2,882.00 12.809 2,882.00 12.809 3,170.20 3,948.30 4,668.80 4,236.50 6,253.90 8,646.00

of 30




Units R R

Average Duration

ProfessionalPrivate

Tariff

1762 Cholecystectomy and operative cholangiogram 255 11,862.10 46.518

1778 105.9 4,926.30 46.518 1789 Pancreatico-duodenectomy 704.8 32,785.90 46.518

1807 ADD to open procedure where procedure was performed through a laparoscope 45 2,093.30 46.518 1809 Laparotomy 196 9,117.50 46.518

1810 350 16,281.30 46.518

1815 248.4 11,555.10 46.518 1819 Inguinal or femoral hernia: Adult 125 5,814.80 46.518 1821 Inguinal or femoral hernia: Child under 14 years old 90 4,186.60 46.518 1823 Inguinal hernia: Infant under 1 year 100 4,651.80 46.518 1825 Recurrent inguinal or femoral hernia 155 7,210.30 46.518 1827 Strangulated hernia or femoral hernia 238 11,071.30 46.518 1829 Epigastric hernia 93.3 4,340.10 46.518 1831 Umbilical hernia: Adult 140 6,512.50 46.518 1835 Incisional hernia 166.8 7,759.20 46.518 1836 Implantation of mesh or other prosthesis for incisional or ventral hernia repair 77 3,581.90 46.518 1895 Allo-transplantation of kidney 420 19,537.60 46.518 2137 Circumcision: Surgical excision other than by clamp or dorsal slit, any age 60 2,791.10 46.518 2493 Diagnostic laparoscopy (excluding after-care) 94.4 4,391.30 46.518 2527 Removal of ovarian tumour or cyst 187 8,698.90 46.518 2848 Cervical sympathectomy: Bilateral 268 12,466.80 46.518 2985 Lobectomy: Total 200 9,303.60 46.518 2987 Thyroidectomy: Subtotal 266 12,373.80 46.518 2989 Thyroidectomy: Total 279 12,978.50 46.518 2993 Exploration of parathyroid glands for hyperparathyroidism including removal 275 12,792.50 46.518

3559 Selective first order catheterisation, arterial or venous, with angiogram/venogram 95 4,419.20 46.518

3562 Selective third order catheterisation, arterial or venous, with angiogram/venogram 122 5,675.20 46.518 3627* Ultrasound examination includes whole abdomen and pelvic organs 60 - 12.778 4821 Routine HBO table (2-2,5 ATA x 90-120 min): Technical component 131.26 6,106.00 46.518 5008 Percutaneous transluminal angioplasty: Sub-popliteal sub-brachial 232 10,792.20 46.518

5060 232 10,792.20 46.518

5110 128 5,954.30 46.518

5111 206 8,370.20 40.632

5112 117 4,753.90 40.632

5113 117 4,753.90 40.632

5114 178 7,232.50 40.632




Discovery


R R R R R R R R R R


Non-

NetworkRCF

Network

Base Rate

Network

RCFPrem A

(IH)Prem A

(OH)

3,266.20 12.809 3,266.20 12.809 3,592.80 4,474.60 5,291.20 4,801.30 7,087.60 9,798.60

1,356.40 12.809 1,356.40 12.809 1,492.00 1,858.20 2,197.30 1,993.90 2,943.30 4,069.20 9,027.70 12.809 9,027.70 12.809 9,930.40 12,367.90 14,624.80 13,270.70 19,590.10 27,083.10

576.40 12.809 576.40 12.809 634.00 789.60 933.70 847.30 1,250.70 1,729.20 2,510.50 12.809 2,510.50 12.809 2,761.50 3,439.30 4,067.00 3,690.40 5,447.70 7,531.50

4,483.10 12.809 4,483.10 12.809 4,931.40 6,141.80 7,262.60 6,590.10 9,728.30 13,449.30

3,181.70 12.809 3,181.70 12.809 3,499.80 4,358.90 5,154.30 4,677.00 6,904.20 9,545.10 1,601.10 12.809 1,601.10 12.809 1,761.20 2,193.50 2,593.70 2,353.60 3,474.30 4,803.30 1,152.80 12.809 1,152.80 12.809 1,268.00 1,579.30 1,867.50 1,694.60 2,501.50 3,458.40 1,280.90 12.809 1,280.90 12.809 1,408.90 1,754.80 2,075.00 1,882.90 2,779.50 3,842.70 1,985.30 12.809 1,985.30 12.809 2,183.80 2,719.80 3,216.10 2,918.30 4,308.10 5,955.90 3,048.50 12.809 3,048.50 12.809 3,353.30 4,176.40 4,938.50 4,481.20 6,615.20 9,145.50 1,195.00 12.809 1,195.00 12.809 1,314.50 1,637.10 1,935.90 1,756.60 2,593.10 3,585.00 1,793.20 12.809 1,793.20 12.809 1,972.50 2,456.60 2,904.90 2,636.00 3,891.20 5,379.60 2,136.50 12.809 2,136.50 12.809 2,350.10 2,927.00 3,461.10 3,140.60 4,636.20 6,409.50 986.20 12.809 986.20 12.809 1,084.80 1,351.00 1,597.60 1,449.70 2,140.00 2,958.60 5,379.70 12.809 5,379.70 12.809 5,917.60 7,370.10 8,715.10 7,908.10 11,673.90 16,139.10 768.50 12.809 768.50 12.809 845.30 1,052.80 1,244.90 1,129.60 1,667.60 2,305.50 1,209.10 12.809 1,209.10 12.809 1,330.00 1,656.40 1,958.70 1,777.30 2,623.70 3,627.30 2,395.20 12.809 2,395.20 12.809 2,634.70 3,281.40 3,880.20 3,520.90 5,197.50 7,185.60 3,432.80 12.809 3,432.80 12.809 3,776.00 4,702.90 5,561.10 5,046.20 7,449.10 10,298.40 2,561.80 12.809 2,561.80 12.809 2,817.90 3,509.60 4,150.10 3,765.80 5,559.10 7,685.40 3,407.10 12.809 3,407.10 12.809 3,747.80 4,667.70 5,519.50 5,008.40 7,393.40 10,221.30 3,573.70 12.809 3,573.70 12.809 3,931.00 4,895.90 5,789.30 5,253.30 7,754.90 10,721.10 3,522.40 12.809 3,522.40 12.809 3,874.60 4,825.60 5,706.20 5,177.90 7,643.60 10,567.20

1,723.70 18.145 1,723.80 18.145 1,896.10 2,361.60 2,792.50 2,533.90 3,740.60 5,171.40

2,213.60 18.145 2,213.70 18.145 2,435.00 3,032.70 3,586.10 3,254.10 4,803.70 6,641.10 732.60 12.210 732.60 12.210 805.80 1,003.60 1,186.80 1,076.90 1,589.70 2,197.80 1,602.60 12.210 1,602.70 12.210 1,762.90 2,195.60 2,596.30 2,355.90 3,477.80 4,808.10 4,209.60 18.145 4,209.60 18.145 4,630.50 5,767.10 6,819.50 6,188.10 9,134.80 12,628.80

4,209.60 18.145 4,209.60 18.145 4,630.50 5,767.10 6,819.50 6,188.10 9,134.80 12,628.80

1,562.80 12.210 1,562.90 12.210 1,719.10 2,141.10 2,531.80 2,297.40 3,391.40 4,688.70

2,515.20 12.210 2,515.30 12.210 2,766.80 3,445.90 4,074.70 3,697.40 5,458.20 7,545.90

1,428.50 12.210 1,428.60 12.210 1,571.40 1,957.10 2,314.30 2,100.00 3,100.00 4,285.80

1,428.50 12.210 1,428.60 12.210 1,571.40 1,957.10 2,314.30 2,100.00 3,100.00 4,285.80

2,173.30 12.210 2,173.40 12.210 2,390.70 2,977.50 3,520.90 3,194.80 4,716.20 6,520.20

of 30




Units R R

Average Duration

ProfessionalPrivate

Tariff


0258 Incision/removal of foreign body: Subcutaneous tissue, simple 31.00 1,442.10 46.518 0260 Incision/removal of foreign body: Subcutaneous tissue, complicated 55.50 2,581.70 46.518 0644 Removal of foreign body: Shoulder, subcutaneous 49.70 2,311.90 46.518 0647 Removal of foreign body: Upper arm or elbow area, subcutaneous 41.70 1,939.80 46.518 0648 Removal of foreign body: Upper arm or elbow area, subfascial or intramuscular 109.00 5,070.50 46.518 0651 Exploration with removal of deep foreign body: Forearm or wrist 122.80 5,712.40 46.518 0652 Removal of foreign body: Pelvis or hip, subcutaneous tissue 45.30 2,107.30 46.518 0653 Removal of foreign body: Pelvis or hip, subfascial or intramuscular 186.90 8,694.20 46.518 0654 Excision of soft tissue tumour: Thigh or knee area, subcutaneous <3 cm 120.60 5,610.10 46.518 0655 Removal of foreign body: Foot, subcutaneous 40.00 1,860.70 46.518 0656 Removal of foreign body: Foot, deep 94.20 4,382.00 46.518 0657 Removal of foreign body: Foot, complicated 110.50 5,140.20 46.518 1096 Removal of foreign body: Pharynx 40.50 1,884.00 46.518 1462 Removal of embedded foreign body: Vestibule of mouth, simple 41.10 1,911.90 46.518 1464 Removal of embedded foreign body: Vestibule of mouth; complicated 73.10 3,400.50 46.518 1466 Removal of embedded foreign body: Dentoalveolar structures, soft tissues 52.80 2,456.20 46.518 2172 Removal foreign body: Deep penile tissue (eg., plastic implant) 123.10 5,726.40 46.518 2228 Removal of foreign body: Scrotum 104.90 4,879.70 46.518






Discovery


R R R R R R R R R R


Non-

NetworkRCF

Network

Base Rate

Network

RCFPrem A

(IH)Prem A

(OH)

397.00 12.809 397.00 12.809 436.70 543.80 643.10 583.50 861.40 1,191.00 710.80 12.809 710.80 12.809 781.80 973.70 1,151.40 1,044.80 1,542.40 2,132.40 636.60 12.809 636.60 12.809 700.20 872.10 1,031.20 935.80 1,381.40 1,909.80 534.10 12.809 534.10 12.809 587.50 731.70 865.20 785.10 1,158.90 1,602.30 1,396.10 12.809 1,396.10 12.809 1,535.70 1,912.60 2,261.60 2,052.20 3,029.50 4,188.30 1,572.90 12.809 1,572.90 12.809 1,730.10 2,154.80 2,548.00 2,312.10 3,413.10 4,718.70 580.20 12.809 580.20 12.809 638.20 794.80 939.90 852.80 1,259.00 1,740.60 2,394.00 12.809 2,394.00 12.809 2,633.40 3,279.70 3,878.20 3,519.10 5,194.90 7,182.00 1,544.70 12.809 1,544.70 12.809 1,699.10 2,116.20 2,502.40 2,270.70 3,351.90 4,634.10 512.30 12.809 512.30 12.809 563.50 701.80 829.90 753.00 1,111.60 1,536.90 1,206.60 12.809 1,206.60 12.809 1,327.20 1,653.00 1,954.60 1,773.70 2,618.30 3,619.80 1,415.30 12.809 1,415.30 12.809 1,556.80 1,938.90 2,292.70 2,080.40 3,071.20 4,245.90 518.70 12.809 518.70 12.809 570.50 710.60 840.20 762.40 1,125.50 1,556.10 526.40 12.809 526.40 12.809 579.00 721.10 852.70 773.80 1,142.20 1,579.20 936.30 12.809 936.30 12.809 1,029.90 1,282.70 1,516.80 1,376.30 2,031.70 2,808.90 676.30 12.809 676.30 12.809 743.90 926.50 1,095.60 994.10 1,467.50 2,028.90 1,576.70 12.809 1,576.70 12.809 1,734.30 2,160.00 2,554.20 2,317.70 3,421.40 4,730.10 1,343.60 12.809 1,343.60 12.809 1,477.90 1,840.70 2,176.60 1,975.00 2,915.60 4,030.80

of 30







Procedures




0314 104 4,837.90 46.518



1206 50 2,325.90 46.518

1207 30 1,395.50 46.518

1208 137 6,373.00 46.518

1209 58 2,698.00 46.518


Average Duration

ProfessionalPrivate

Tariff








FedHealth GEMS

RCF DPA DPA DPA RCF 165% 210% 300%

R R R R R R R R R

317.30 21.153 523.50 666.30 951.90 318.10 21.207 - 317.30 21.153 523.50 666.30 951.90 - - - 254.00 21.167 419.10 533.40 762.00 248.10 20.675 - 106.00 21.200 174.90 222.60 318.00 106.00 21.200 - 190.30 21.144 314.00 399.60 570.90 190.80 21.200 - 126.90 21.150 209.40 266.50 380.70 127.30 21.217 - 169.20 21.150 279.20 355.30 507.60 169.80 21.225 - 296.10 21.150 488.60 621.80 888.30 291.10 20.793 - - - - - - - - - - 359.80 23.987 593.70 755.60 1,079.40 351.50 23.433 - 359.80 11.993 593.70 755.60 1,079.40 351.50 11.717 - 359.80 7.996 593.70 755.60 1,079.40 351.50 7.811 -

- - - - - - - - - 359.80 23.987 593.70 755.60 1,079.40 351.50 23.433 - 359.80 11.993 593.70 755.60 1,079.40 351.50 11.717 - 359.80 7.996 593.70 755.60 1,079.40 351.50 7.811 - 453.50 21.162 748.30 952.40 1,360.50 400.10 18.670 -

1,140.90 13.114 1,882.50 2,395.90 3,422.70 1,142.80 13.136 - 3,068.60 13.114 5,063.20 6,444.10 9,205.80 3,073.80 13.136 - 839.20 13.114 1,384.70 1,762.30 2,517.60 840.70 13.136 -

1,678.50 13.114 2,769.50 3,524.90 5,035.50 1,681.40 13.136 - 655.70 13.114 1,081.90 1,377.00 1,967.10 656.80 13.136 -

354.00 13.114 584.10 743.40 1,062.00 354.60 13.136 - 183.50 13.114 302.80 385.40 550.50 183.90 13.136 - 721.20 13.114 1,190.00 1,514.50 2,163.60 722.40 13.136 - 3,723.00 13.114 6,143.00 7,818.30 11,169.00 3,729.30 13.136 -

1,363.80 13.114 2,250.30 2,864.00 4,091.40 1,366.10 13.136 -

721.20 13.114 1,190.00 1,514.50 2,163.60 722.40 13.136 - 1,235.30 13.114 2,038.20 2,594.10 3,705.90 1,237.40 13.136 - 1,180.20 13.114 1,947.30 2,478.40 3,540.60 1,182.20 13.136 - 2,950.60 13.114 4,868.50 6,196.30 8,851.80 2,955.60 13.136 - 2,032.60 13.114 3,353.80 4,268.50 6,097.80 2,036.00 13.136 - 3,606.30 13.114 5,950.40 7,573.20 10,818.90 3,612.40 13.136 -

2,098.20 13.114 3,462.00 4,406.20 6,294.60 2,101.70 13.136 - 393.40 13.114 649.10 826.10 1,180.20 394.00 13.136 - 1,311.40 13.114 2,163.80 2,753.90 3,934.20 1,313.60 13.136 -

655.70 13.114 1,081.90 1,377.00 1,967.10 656.80 13.136 -

393.40 13.114 649.10 826.10 1,180.20 394.00 13.136 -

1,796.60 13.114 2,964.40 3,772.90 5,389.80 1,799.60 13.136 -

760.60 13.114 1,255.00 1,597.30 2,281.80 761.80 13.136 -

655.70 13.114 1,081.90 1,377.00 1,967.10 656.80 13.136 - 655.70 13.114 1,081.90 1,377.00 1,967.10 656.80 13.136 -

Base Rate Base Rate

Contracted Base Rate

ContractedRCF

of 30




Units R R

Average Duration

ProfessionalPrivate

Tariff


FedHealth GEMS


R R R R R R R R R

Base Rate Base Rate


ContractedRCF

327.80 13.114 540.90 688.40 983.40 328.40 13.136 -

of 30




Units R R

Average Duration

ProfessionalPrivate

Tariff



1413 141 6,559.00 46.518



1687 381.3 17,737.30 46.518






FedHealth GEMS


R R R R R R R R R

Base Rate Base Rate


ContractedRCF

196.70 13.114 324.60 413.10 590.10 197.00 13.136 - 7,081.50 13.114 11,684.50 14,871.20 21,244.50 7,093.40 13.136 -

7,789.70 13.114 12,853.00 16,358.40 23,369.10 7,802.70 13.136 - 3,344.00 13.114 5,517.60 7,022.40 10,032.00 3,349.60 13.136 - 3,934.20 13.114 6,491.40 8,261.80 11,802.60 3,940.80 13.136 - 5,822.60 13.114 9,607.30 12,227.50 17,467.80 5,832.30 13.136 - 3,462.00 13.114 5,712.30 7,270.20 10,386.00 3,467.90 13.136 - 4,209.50 13.114 6,945.70 8,840.00 12,628.50 4,216.60 13.136 - 2,203.10 13.114 3,635.10 4,626.50 6,609.30 2,206.80 13.136 - 3,462.00 13.114 5,712.30 7,270.20 10,386.00 3,467.90 13.136 - 1,193.30 13.114 1,968.90 2,505.90 3,579.90 1,195.30 13.136 -

1,849.00 13.114 3,050.90 3,882.90 5,547.00 1,852.10 13.136 -

3,239.10 13.114 5,344.50 6,802.10 9,717.30 3,244.50 13.136 - 2,902.10 13.114 4,788.50 6,094.40 8,706.30 2,906.90 13.136 - 852.40 13.114 1,406.50 1,790.00 2,557.20 853.80 13.136 - 4,130.90 13.114 6,816.00 8,674.90 12,392.70 4,137.80 13.136 - 2,098.20 13.114 3,462.00 4,406.20 6,294.60 2,101.70 13.136 - 4,065.30 13.114 6,707.70 8,537.10 12,195.90 4,072.10 13.136 - 3,934.20 13.114 6,491.40 8,261.80 11,802.60 3,940.80 13.136 -

4,589.90 13.114 7,573.30 9,638.80 13,769.70 4,597.60 13.136 - 4,262.00 13.114 7,032.30 8,950.20 12,786.00 4,269.20 13.136 - 4,917.70 13.114 8,114.20 10,327.20 14,753.10 4,926.00 13.136 - 1,311.40 13.114 2,163.80 2,753.90 3,934.20 1,313.60 13.136 - 1,442.50 13.114 2,380.10 3,029.30 4,327.50 1,444.90 13.136 - 721.20 13.114 1,190.00 1,514.50 2,163.60 722.40 13.136 - 639.30 13.114 1,054.80 1,342.50 1,917.90 640.30 13.136 - 1,934.30 13.114 3,191.60 4,062.00 5,802.90 1,937.50 13.136 - 2,622.80 13.114 4,327.60 5,507.90 7,868.40 2,627.20 13.136 - 4,305.30 13.114 7,103.70 9,041.10 12,915.90 4,312.50 13.136 - 3,147.30 13.114 5,193.00 6,609.30 9,441.90 3,152.60 13.136 - 3,211.60 13.114 5,299.10 6,744.40 9,634.80 3,217.00 13.136 - 2,794.50 13.114 4,610.90 5,868.50 8,383.50 2,799.20 13.136 - 2,428.70 13.114 4,007.40 5,100.30 7,286.10 2,432.70 13.136 - 2,250.30 13.114 3,713.00 4,725.60 6,750.90 2,254.10 13.136 - 1,180.20 13.114 1,947.30 2,478.40 3,540.60 1,182.20 13.136 - 393.40 13.114 649.10 826.10 1,180.20 394.00 13.136 - 786.80 13.114 1,298.20 1,652.30 2,360.40 788.10 13.136 - 4,267.20 13.114 7,040.90 8,961.10 12,801.60 4,274.40 13.136 - 4,713.10 13.114 7,776.60 9,897.50 14,139.30 4,721.00 13.136 - 5,114.40 13.114 8,438.80 10,740.20 15,343.20 5,123.00 13.136 - 2,570.30 13.114 4,241.00 5,397.60 7,710.90 2,574.60 13.136 - 2,348.70 13.114 3,875.40 4,932.30 7,046.10 2,352.60 13.136 - 2,098.20 13.114 3,462.00 4,406.20 6,294.60 2,101.70 13.136 - 639.30 13.114 1,054.80 1,342.50 1,917.90 640.30 13.136 -

5,000.30 13.114 8,250.50 10,500.60 15,000.90 5,008.70 13.136 -

5,835.70 13.114 9,628.90 12,255.00 17,507.10 5,845.50 13.136 - 5,367.50 13.114 8,856.40 11,271.80 16,102.50 5,376.50 13.136 - 3,934.20 13.114 6,491.40 8,261.80 11,802.60 3,940.80 13.136 - 1,967.10 13.114 3,245.70 4,130.90 5,901.30 1,970.40 13.136 - 1,140.90 13.114 1,882.50 2,395.90 3,422.70 1,142.80 13.136 - 2,622.80 13.114 4,327.60 5,507.90 7,868.40 2,627.20 13.136 - 1,376.90 13.114 2,271.90 2,891.50 4,130.70 1,379.20 13.136 - 876.00 13.114 1,445.40 1,839.60 2,628.00 877.40 13.136 - 1,573.60 13.114 2,596.40 3,304.60 4,720.80 1,576.30 13.136 - 1,180.20 13.114 1,947.30 2,478.40 3,540.60 1,182.20 13.136 - 7,396.20 13.114 12,203.70 15,532.00 22,188.60 7,408.70 13.136 - 4,957.00 13.114 8,179.10 10,409.70 14,871.00 4,965.40 13.136 -

of 30




Units R R

Average Duration

ProfessionalPrivate

Tariff


FedHealth GEMS


R R R R R R R R R

Base Rate Base Rate


ContractedRCF

18,370.00 13.114 30,310.50 38,577.00 55,110.00 18,400.90 13.136 - 2,950.60 13.114 4,868.50 6,196.30 8,851.80 2,955.60 13.136 -

of 30




Units R R

Average Duration

ProfessionalPrivate

Tariff




1810 350 16,281.30 46.518




5060 232 10,792.20 46.518

5110 128 5,954.30 46.518

5111 206 8,370.20 40.632

5112 117 4,753.90 40.632

5113 117 4,753.90 40.632

5114 178 7,232.50 40.632




FedHealth GEMS


R R R R R R R R R

Base Rate Base Rate


ContractedRCF

3,344.00 13.114 5,517.60 7,022.40 10,032.00 3,349.60 13.136 -

1,388.70 13.114 2,291.40 2,916.30 4,166.10 1,391.10 13.136 - 9,242.70 13.114 15,250.50 19,409.70 27,728.10 9,258.20 13.136 -

590.10 13.114 973.70 1,239.20 1,770.30 591.10 13.136 - 2,570.30 13.114 4,241.00 5,397.60 7,710.90 2,574.60 13.136 -

4,589.90 13.114 7,573.30 9,638.80 13,769.70 4,597.60 13.136 -

3,257.50 13.114 5,374.90 6,840.80 9,772.50 3,262.90 13.136 - 1,639.20 13.114 2,704.70 3,442.30 4,917.60 1,642.00 13.136 - 1,180.20 13.114 1,947.30 2,478.40 3,540.60 1,182.20 13.136 - 1,311.40 13.114 2,163.80 2,753.90 3,934.20 1,313.60 13.136 - 2,032.60 13.114 3,353.80 4,268.50 6,097.80 2,036.00 13.136 - 3,121.10 13.114 5,149.80 6,554.30 9,363.30 3,126.30 13.136 - 1,223.50 13.114 2,018.80 2,569.40 3,670.50 1,225.50 13.136 - 1,835.90 13.114 3,029.20 3,855.40 5,507.70 1,839.00 13.136 - 2,187.40 13.114 3,609.20 4,593.50 6,562.20 2,191.00 13.136 - 1,009.70 13.114 1,666.00 2,120.40 3,029.10 1,011.40 13.136 - 5,507.80 13.114 9,087.90 11,566.40 16,523.40 5,517.10 13.136 - 786.80 13.114 1,298.20 1,652.30 2,360.40 788.10 13.136 - 1,237.90 13.114 2,042.50 2,599.60 3,713.70 1,240.00 13.136 - 2,452.30 13.114 4,046.30 5,149.80 7,356.90 2,456.40 13.136 - 3,514.50 13.114 5,798.90 7,380.50 10,543.50 3,520.40 13.136 - 2,622.80 13.114 4,327.60 5,507.90 7,868.40 2,627.20 13.136 - 3,488.30 13.114 5,755.70 7,325.40 10,464.90 3,494.10 13.136 - 3,658.80 13.114 6,037.00 7,683.50 10,976.40 3,664.90 13.136 - 3,606.30 13.114 5,950.40 7,573.20 10,818.90 3,612.40 13.136 -

1,763.10 18.559 2,909.10 3,702.50 5,289.30 1,767.40 18.605 -

2,264.20 18.559 3,735.90 4,754.80 6,792.60 2,269.80 18.605 - 749.30 12.488 1,236.30 1,573.50 2,247.90 751.20 12.520 - 1,639.20 12.488 2,704.70 3,442.30 4,917.60 1,643.30 12.520 - 4,305.70 18.559 7,104.40 9,042.00 12,917.10 4,316.30 18.605 -

4,305.70 18.559 7,104.40 9,042.00 12,917.10 4,316.30 18.605 -

1,598.50 12.488 2,637.50 3,356.90 4,795.50 1,602.50 12.520 -

2,572.50 12.488 4,244.60 5,402.30 7,717.50 2,579.10 12.520 -

1,461.10 12.488 2,410.80 3,068.30 4,383.30 1,464.80 12.520 -

1,461.10 12.488 2,410.80 3,068.30 4,383.30 1,464.80 12.520 -

2,222.90 12.488 3,667.80 4,668.10 6,668.70 2,228.50 12.520 -

of 30




Units R R

Average Duration

ProfessionalPrivate

Tariff








FedHealth GEMS


R R R R R R R R R

Base Rate Base Rate


ContractedRCF

406.50 13.114 670.70 853.70 1,219.50 407.20 13.136 - 727.80 13.114 1,200.90 1,528.40 2,183.40 729.00 13.136 - 651.70 13.114 1,075.30 1,368.60 1,955.10 652.80 13.136 - 546.80 13.114 902.20 1,148.30 1,640.40 547.70 13.136 - 1,429.40 13.114 2,358.50 3,001.70 4,288.20 1,431.80 13.136 - 1,610.30 13.114 2,657.00 3,381.60 4,830.90 1,613.10 13.136 - 594.00 13.114 980.10 1,247.40 1,782.00 595.00 13.136 - 2,451.00 13.114 4,044.20 5,147.10 7,353.00 2,455.10 13.136 - 1,581.50 13.114 2,609.50 3,321.20 4,744.50 1,584.20 13.136 - 524.50 13.114 865.40 1,101.50 1,573.50 525.40 13.136 - 1,235.30 13.114 2,038.20 2,594.10 3,705.90 1,237.40 13.136 - 1,449.00 13.114 2,390.90 3,042.90 4,347.00 1,451.50 13.136 - 531.10 13.114 876.30 1,115.30 1,593.30 532.00 13.136 - 538.90 13.114 889.20 1,131.70 1,616.70 539.80 13.136 - 958.60 13.114 1,581.70 2,013.10 2,875.80 960.20 13.136 - 692.40 13.114 1,142.50 1,454.00 2,077.20 693.50 13.136 - 1,614.30 13.114 2,663.60 3,390.00 4,842.90 1,617.00 13.136 - 1,375.60 13.114 2,269.70 2,888.80 4,126.80 1,377.90 13.136 -

of 30







Procedures




0314 104 4,837.90 46.518



1206 50 2,325.90 46.518

1207 30 1,395.50 46.518

1208 137 6,373.00 46.518

1209 58 2,698.00 46.518


Average Duration

ProfessionalPrivate

Tariff








KeyHealth POLMED Other

Base Rate RCF DPA Base Rate RCF 150% 130% 145%

R R R R R R R R R R R R R

329.80 21.993 476.00 332.50 22.167 432.20 482.10 325.80 21.720 328.94 21.929 325.40 21.696 329.80 21.993 476.00 332.50 22.167 432.20 482.10 325.80 21.720 328.94 21.929 325.40 21.696 263.90 21.993 381.00 266.40 22.200 346.30 386.20 260.70 21.725 263.19 21.933 260.30 21.696 109.90 21.993 159.00 110.80 22.160 144.00 160.60 108.60 21.720 109.61 21.922 108.40 21.696 197.90 21.993 285.50 199.70 22.189 259.60 289.50 195.70 21.744 197.34 21.927 195.20 21.696 131.90 21.993 190.40 133.00 22.167 172.90 192.80 130.40 21.733 131.27 21.878 130.10 21.696 175.90 21.993 253.80 177.30 22.163 230.40 257.00 173.70 21.713 175.45 21.931 173.00 21.625 307.90 21.993 444.20 310.30 22.164 403.30 449.90 304.00 21.714 209.26 14.947 303.70 21.696 - - - 397.700 - - - - - - - - - 329.80 21.993 539.70 377.20 25.147 490.30 546.90 369.10 24.607 372.80 24.854 562.70 37.513 659.70 21.993 539.70 377.20 12.573 490.30 546.90 369.10 12.303 372.80 12.427 562.70 18.757 989.60 21.993 539.70 377.20 8.382 490.30 546.90 369.10 8.202 372.80 8.285 562.70 12.504

- - - - - - - - - - - - - 329.80 21.993 539.70 377.20 25.147 490.30 546.90 369.10 24.607 372.80 24.854 562.70 37.513 659.70 21.993 539.70 377.20 12.573 490.30 546.90 369.10 12.303 372.80 12.427 562.70 18.757 989.60 21.993 539.70 377.20 8.382 490.30 546.90 369.10 8.202 372.80 8.285 562.70 12.504 471.30 21.993 680.30 475.30 22.179 617.80 689.10 369.10 17.224 469.94 21.929 464.90 21.696

1,184.90 13.620 1,711.40 1,195.00 13.736 1,553.50 1,732.70 1,169.90 13.448 1,181.50 13.581 1,103.30 12.682 3,187.00 13.620 4,602.90 3,214.20 13.736 4,178.40 4,660.50 3,146.80 13.448 3,177.90 13.581 2,967.50 12.682 871.60 13.620 1,258.80 879.10 13.736 1,142.80 1,274.60 860.60 13.448 869.10 13.581 811.60 12.682

1,743.30 13.620 2,517.80 1,758.20 13.736 2,285.60 2,549.30 1,721.30 13.448 1,738.30 13.581 1,623.20 12.682 681.00 13.620 983.60 686.80 13.736 892.80 995.80 672.40 13.448 679.00 13.581 634.10 12.682

367.70 13.620 531.00 370.80 13.736 482.00 537.60 363.00 13.448 366.60 13.581 342.40 12.682 190.60 13.620 275.30 192.30 13.736 249.90 278.80 188.20 13.448 190.10 13.581 177.50 12.682 749.10 13.620 1,081.80 755.40 13.736 982.00 1,095.30 739.60 13.448 746.90 13.581 697.50 12.682 3,866.70 13.620 5,584.50 3,899.60 13.736 5,069.40 5,654.40 3,817.80 13.448 3,855.60 13.581 3,600.40 12.682

1,416.40 13.620 2,045.70 1,428.50 13.736 1,857.00 2,071.30 1,398.50 13.448 1,412.40 13.581 1,318.90 12.682

749.10 13.620 1,081.80 755.40 13.736 982.00 1,095.30 739.60 13.448 746.90 13.581 697.50 12.682 1,283.00 13.620 1,853.00 1,293.90 13.736 1,682.00 1,876.10 1,266.80 13.448 1,279.30 13.581 1,194.60 12.682 1,225.80 13.620 1,770.30 1,236.20 13.736 1,607.00 1,792.40 1,210.30 13.448 1,222.20 13.581 1,141.30 12.682 3,064.50 13.620 4,425.90 3,090.60 13.736 4,017.70 4,481.30 3,025.80 13.448 3,055.70 13.581 2,853.40 12.682 2,111.10 13.620 3,048.90 2,129.00 13.736 2,767.70 3,087.00 2,084.40 13.448 2,105.00 13.581 1,965.70 12.682 3,745.50 13.620 5,409.50 3,777.40 13.736 4,910.60 5,477.20 3,698.20 13.448 3,734.70 13.581 3,487.50 12.682

2,179.20 13.620 3,147.30 2,197.70 13.736 2,857.00 3,186.60 2,151.60 13.448 2,172.90 13.581 2,029.10 12.682 408.60 13.620 590.10 412.00 13.736 535.60 597.40 403.40 13.448 407.40 13.581 380.40 12.682 1,362.00 13.620 1,967.10 1,373.60 13.736 1,785.60 1,991.70 1,344.80 13.448 1,358.10 13.581 1,268.20 12.682

681.00 13.620 983.60 686.80 13.736 892.80 995.80 672.40 13.448 679.00 13.581 634.10 12.682

408.60 13.620 590.10 412.00 13.736 535.60 597.40 403.40 13.448 407.40 13.581 380.40 12.682

1,865.90 13.620 2,694.90 1,881.80 13.736 2,446.30 2,728.60 1,842.30 13.448 1,860.50 13.581 1,737.40 12.682

789.90 13.620 1,140.90 796.60 13.736 1,035.50 1,155.00 779.90 13.448 787.60 13.581 735.50 12.682

681.00 13.620 983.60 686.80 13.736 892.80 995.80 672.40 13.448 679.00 13.581 634.10 12.682 681.00 13.620 983.60 686.80 13.736 892.80 995.80 672.40 13.448 679.00 13.581 634.10 12.682

POLMED DPA

POLMED DPA

BestMed Base Rate

BestMedRCF

Medihelp Base Rate Medihelp RCF

ProfmedBase Rate

Profmed RCF

of 30




Units R R

Average Duration

ProfessionalPrivate

Tariff





POLMED DPA

POLMED DPA

BestMed Base Rate

BestMedRCF


ProfmedBase Rate

Profmed RCF

340.50 13.620 491.70 343.40 13.736 446.40 497.90 336.20 13.448 339.50 13.581 317.00 12.682

of 30




Units R R

Average Duration

ProfessionalPrivate

Tariff



1413 141 6,559.00 46.518



1687 381.3 17,737.30 46.518









POLMED DPA

POLMED DPA

BestMed Base Rate

BestMedRCF


ProfmedBase Rate

Profmed RCF

204.30 13.620 295.10 206.00 13.736 267.80 298.70 201.70 13.448 203.70 13.581 190.20 12.682 7,354.80 13.620 10,622.30 7,417.40 13.736 9,642.60 10,755.20 7,261.90 13.448 7,333.70 13.581 6,848.20 12.682

8,090.20 13.620 11,684.60 8,159.10 13.736 10,606.80 11,830.60 7,988.10 13.448 8,067.10 13.581 7,533.10 12.682 3,473.10 13.620 5,016.00 3,502.60 13.736 4,553.30 5,078.70 3,429.20 13.448 3,463.10 13.581 3,233.90 12.682 4,086.00 13.620 5,901.30 4,120.80 13.736 5,357.00 5,975.10 4,034.40 13.448 4,074.30 13.581 3,804.60 12.682 6,047.20 13.620 8,733.90 6,098.70 13.736 7,928.30 8,843.10 5,970.90 13.448 6,029.90 13.581 5,630.80 12.682 3,595.60 13.620 5,193.00 3,626.30 13.736 4,714.10 5,258.10 3,550.20 13.448 3,585.30 13.581 3,348.00 12.682 4,372.00 13.620 6,314.30 4,409.20 13.736 5,731.90 6,393.30 4,316.80 13.448 4,359.50 13.581 4,070.90 12.682 2,288.10 13.620 3,304.70 2,307.60 13.736 2,999.80 3,346.00 2,259.20 13.448 2,281.60 13.581 2,130.50 12.682 3,595.60 13.620 5,193.00 3,626.30 13.736 4,714.10 5,258.10 3,550.20 13.448 3,585.30 13.581 3,348.00 12.682 1,239.40 13.620 1,790.00 1,249.90 13.736 1,624.80 1,812.30 1,223.70 13.448 1,235.80 13.581 1,154.00 12.682

1,920.40 13.620 2,773.50 1,936.70 13.736 2,517.70 2,808.20 1,896.10 13.448 1,914.90 13.581 1,788.10 12.682

3,364.10 13.620 4,858.70 3,392.70 13.736 4,410.50 4,919.40 3,321.60 13.448 3,354.50 13.581 3,132.40 12.682 3,014.10 13.620 4,353.20 3,039.70 13.736 3,951.60 4,407.50 2,976.00 13.448 3,005.40 13.581 2,806.50 12.682 885.30 13.620 1,278.60 892.80 13.736 1,160.60 1,294.50 874.10 13.448 882.70 13.581 824.30 12.682 4,290.30 13.620 6,196.40 4,326.80 13.736 5,624.80 6,273.80 4,236.10 13.448 4,278.00 13.581 3,994.80 12.682 2,179.20 13.620 3,147.30 2,197.70 13.736 2,857.00 3,186.60 2,151.60 13.448 2,172.90 13.581 2,029.10 12.682 4,222.20 13.620 6,098.00 4,258.10 13.736 5,535.50 6,174.20 4,168.80 13.448 4,210.10 13.581 3,931.40 12.682 4,086.00 13.620 5,901.30 4,120.80 13.736 5,357.00 5,975.10 4,034.40 13.448 4,074.30 13.581 3,804.60 12.682

4,767.00 13.620 6,884.90 4,807.60 13.736 6,249.80 6,971.00 4,706.80 13.448 4,753.30 13.581 4,438.70 12.682 4,426.50 13.620 6,393.00 4,464.20 13.736 5,803.40 6,473.00 4,370.60 13.448 4,413.80 13.581 4,121.60 12.682 5,107.50 13.620 7,376.60 5,151.00 13.736 6,696.30 7,468.90 5,043.00 13.448 5,092.80 13.581 4,755.70 12.682 1,362.00 13.620 1,967.10 1,373.60 13.736 1,785.60 1,991.70 1,344.80 13.448 1,358.10 13.581 1,268.20 12.682 1,498.20 13.620 2,163.80 1,510.90 13.736 1,964.10 2,190.80 1,479.20 13.448 1,493.90 13.581 1,395.00 12.682 749.10 13.620 1,081.80 755.40 13.736 982.00 1,095.30 739.60 13.448 746.90 13.581 697.50 12.682 663.90 13.620 959.00 669.60 13.736 870.40 970.90 655.50 13.448 662.00 13.581 618.20 12.682 2,008.90 13.620 2,901.50 2,026.00 13.736 2,633.80 2,937.70 1,983.50 13.448 2,003.10 13.581 1,870.50 12.682 2,724.00 13.620 3,934.20 2,747.20 13.736 3,571.30 3,983.40 2,689.60 13.448 2,716.20 13.581 2,536.40 12.682 4,471.40 13.620 6,458.00 4,509.50 13.736 5,862.30 6,538.70 4,414.90 13.448 4,458.60 13.581 4,163.50 12.682 3,268.80 13.620 4,721.00 3,296.60 13.736 4,285.50 4,780.00 3,227.50 13.448 3,259.40 13.581 3,043.60 12.682 3,335.50 13.620 4,817.40 3,363.90 13.736 4,373.00 4,877.60 3,293.40 13.448 3,325.90 13.581 3,105.80 12.682 2,902.40 13.620 4,191.80 2,927.10 13.736 3,805.20 4,244.20 2,865.70 13.448 2,894.10 13.581 2,702.50 12.682 2,522.40 13.620 3,643.10 2,543.90 13.736 3,307.00 3,688.60 2,490.50 13.448 2,515.20 13.581 2,348.70 12.682 2,337.10 13.620 3,375.50 2,357.00 13.736 3,064.10 3,417.60 2,307.60 13.448 2,330.40 13.581 2,176.20 12.682 1,225.80 13.620 1,770.30 1,236.20 13.736 1,607.00 1,792.40 1,210.30 13.448 1,222.20 13.581 1,141.30 12.682 408.60 13.620 590.10 412.00 13.736 535.60 597.40 403.40 13.448 407.40 13.581 380.40 12.682 817.20 13.620 1,180.20 824.10 13.736 1,071.30 1,194.90 806.80 13.448 814.80 13.581 760.90 12.682 4,431.90 13.620 6,400.80 4,469.60 13.736 5,810.40 6,480.90 4,375.90 13.448 4,419.20 13.581 4,126.70 12.682 4,895.00 13.620 7,069.70 4,936.70 13.736 6,417.70 7,158.20 4,833.20 13.448 4,881.00 13.581 4,557.90 12.682 5,311.80 13.620 7,671.60 5,357.00 13.736 6,964.10 7,767.60 5,244.70 13.448 5,296.50 13.581 4,945.90 12.682 2,669.50 13.620 3,855.50 2,692.20 13.736 3,499.80 3,903.60 2,635.80 13.448 2,661.80 13.581 2,485.60 12.682 2,439.30 13.620 3,523.10 2,460.10 13.736 3,198.10 3,567.10 2,408.50 13.448 2,432.30 13.581 2,271.30 12.682 2,179.20 13.620 3,147.30 2,197.70 13.736 2,857.00 3,186.60 2,151.60 13.448 2,172.90 13.581 2,029.10 12.682 663.90 13.620 959.00 669.60 13.736 870.40 970.90 655.50 13.448 662.00 13.581 618.20 12.682

5,193.30 13.620 7,500.50 5,237.50 13.736 6,808.70 7,594.30 5,127.70 13.448 5,178.40 13.581 4,835.60 12.682

6,060.90 13.620 8,753.60 6,112.50 13.736 7,946.20 8,863.10 5,984.30 13.448 6,043.50 13.581 5,643.40 12.682 5,574.60 13.620 8,051.30 5,622.10 13.736 7,308.70 8,152.00 5,504.20 13.448 5,558.70 13.581 5,190.70 12.682 4,086.00 13.620 5,901.30 4,120.80 13.736 5,357.00 5,975.10 4,034.40 13.448 4,074.30 13.581 3,804.60 12.682 2,043.00 13.620 2,950.70 2,060.40 13.736 2,678.50 2,987.50 2,017.20 13.448 2,037.10 13.581 1,902.30 12.682 1,184.90 13.620 1,711.40 1,195.00 13.736 1,553.50 1,732.70 1,169.90 13.448 1,181.50 13.581 1,103.30 12.682 2,724.00 13.620 3,934.20 2,747.20 13.736 3,571.30 3,983.40 2,689.60 13.448 2,716.20 13.581 2,536.40 12.682 1,430.10 13.620 2,065.40 1,442.20 13.736 1,874.80 2,091.10 1,412.00 13.448 1,426.00 13.581 1,331.60 12.682 909.80 13.620 1,314.00 917.50 13.736 1,192.70 1,330.30 898.30 13.448 907.20 13.581 847.10 12.682 1,634.40 13.620 2,360.40 1,648.30 13.736 2,142.70 2,390.00 1,613.70 13.448 1,629.70 13.581 1,521.80 12.682 1,225.80 13.620 1,770.30 1,236.20 13.736 1,607.00 1,792.40 1,210.30 13.448 1,222.20 13.581 1,141.30 12.682 7,681.60 13.620 11,094.30 7,747.10 13.736 10,071.20 11,233.20 7,584.60 13.448 7,659.60 13.581 7,152.60 12.682 5,148.30 13.620 7,435.50 5,192.20 13.736 6,749.80 7,528.60 5,083.30 13.448 5,133.60 13.581 4,793.70 12.682

of 30




Units R R

Average Duration

ProfessionalPrivate

Tariff





POLMED DPA

POLMED DPA

BestMed Base Rate

BestMedRCF


ProfmedBase Rate

Profmed RCF

19,078.80 13.620 27,555.00 19,241.30 13.736 25,013.60 27,899.80 18,837.90 13.448 19,024.20 13.581 17,764.90 12.682 3,064.50 13.620 4,425.90 3,090.60 13.736 4,017.70 4,481.30 3,025.80 13.448 3,055.70 13.581 2,853.40 12.682

of 30




Units R R

Average Duration

ProfessionalPrivate

Tariff




1810 350 16,281.30 46.518




5060 232 10,792.20 46.518

5110 128 5,954.30 46.518

5111 206 8,370.20 40.632

5112 117 4,753.90 40.632

5113 117 4,753.90 40.632

5114 178 7,232.50 40.632







POLMED DPA

POLMED DPA

BestMed Base Rate

BestMedRCF


ProfmedBase Rate

Profmed RCF

3,473.10 13.620 5,016.00 3,502.60 13.736 4,553.30 5,078.70 3,429.20 13.448 3,463.10 13.581 3,233.90 12.682

1,442.30 13.620 2,083.10 1,454.60 13.736 1,890.90 2,109.10 1,424.10 13.448 1,438.20 13.581 1,343.00 12.682 9,599.30 13.620 13,864.10 9,681.10 13.736 12,585.40 14,037.50 9,478.10 13.448 9,571.80 13.581 8,938.20 12.682

612.90 13.620 885.20 618.10 13.736 803.50 896.20 605.10 13.448 611.10 13.581 570.60 12.682 2,669.50 13.620 3,855.50 2,692.20 13.736 3,499.80 3,903.60 2,635.80 13.448 2,661.80 13.581 2,485.60 12.682

4,767.00 13.620 6,884.90 4,807.60 13.736 6,249.80 6,971.00 4,706.80 13.448 4,753.30 13.581 4,438.70 12.682

3,383.20 13.620 4,886.30 3,412.00 13.736 4,435.60 4,947.40 3,340.40 13.448 3,373.50 13.581 3,150.20 12.682 1,702.50 13.620 2,458.80 1,717.00 13.736 2,232.10 2,489.60 1,681.00 13.448 1,697.60 13.581 1,585.20 12.682 1,225.80 13.620 1,770.30 1,236.20 13.736 1,607.00 1,792.40 1,210.30 13.448 1,222.20 13.581 1,141.30 12.682 1,362.00 13.620 1,967.10 1,373.60 13.736 1,785.60 1,991.70 1,344.80 13.448 1,358.10 13.581 1,268.20 12.682 2,111.10 13.620 3,048.90 2,129.00 13.736 2,767.70 3,087.00 2,084.40 13.448 2,105.00 13.581 1,965.70 12.682 3,241.50 13.620 4,681.70 3,269.10 13.736 4,249.80 4,740.10 3,200.60 13.448 3,232.20 13.581 3,018.30 12.682 1,270.70 13.620 1,835.30 1,281.50 13.736 1,665.90 1,858.10 1,254.60 13.448 1,267.10 13.581 1,183.20 12.682 1,906.80 13.620 2,753.90 1,923.00 13.736 2,499.90 2,788.30 1,882.70 13.448 1,901.30 13.581 1,775.40 12.682 2,271.80 13.620 3,281.10 2,291.10 13.736 2,978.40 3,322.00 2,243.10 13.448 2,265.30 13.581 2,115.30 12.682 1,048.70 13.620 1,514.60 1,057.60 13.736 1,374.80 1,533.50 1,035.40 13.448 1,045.70 13.581 976.50 12.682 5,720.40 13.620 8,261.70 5,769.10 13.736 7,499.80 8,365.10 5,648.10 13.448 5,704.00 13.581 5,326.40 12.682 817.20 13.620 1,180.20 824.10 13.736 1,071.30 1,194.90 806.80 13.448 814.80 13.581 760.90 12.682 1,285.70 13.620 1,856.90 1,296.60 13.736 1,685.50 1,880.00 1,269.40 13.448 1,282.00 13.581 1,197.10 12.682 2,546.90 13.620 3,678.50 2,568.60 13.736 3,339.10 3,724.40 2,514.70 13.448 2,539.60 13.581 2,371.50 12.682 3,650.10 13.620 5,271.80 3,681.20 13.736 4,785.50 5,337.70 3,604.00 13.448 3,639.70 13.581 3,398.70 12.682 2,724.00 13.620 3,934.20 2,747.20 13.736 3,571.30 3,983.40 2,689.60 13.448 2,716.20 13.581 2,536.40 12.682 3,622.90 13.620 5,232.50 3,653.70 13.736 4,749.80 5,297.80 3,577.10 13.448 3,612.50 13.581 3,373.40 12.682 3,799.90 13.620 5,488.20 3,832.30 13.736 4,981.90 5,556.80 3,751.90 13.448 3,789.00 13.581 3,538.20 12.682 3,745.50 13.620 5,409.50 3,777.40 13.736 4,910.60 5,477.20 3,698.20 13.448 3,734.70 13.581 3,487.50 12.682

1,832.80 19.293 2,644.70 1,848.50 19.458 2,403.00 2,680.30 1,809.10 19.044 - - 1,804.00 18.989

2,353.70 19.293 3,396.30 2,373.80 19.458 3,085.90 3,442.00 2,323.30 19.044 - - 2,316.70 18.989 778.90 12.983 1,124.00 785.60 13.094 1,021.20 1,139.10 769.00 12.818 776.80 12.947 766.70 12.778 1,704.10 12.983 2,458.80 1,718.70 13.094 2,234.30 2,492.10 1,682.40 12.818 1,699.40 12.947 1,677.20 12.778 4,475.90 19.293 6,458.60 4,514.20 19.458 5,868.40 6,545.50 4,418.20 19.044 - - 4,405.40 18.989

4,475.90 19.293 6,458.60 4,514.20 19.458 5,868.40 6,545.50 4,418.20 19.044 - - 4,405.40 18.989

1,661.80 12.983 2,397.80 1,676.00 13.094 2,178.80 2,430.20 1,640.70 12.818 1,657.20 12.947 1,635.60 12.778

2,674.40 12.983 3,858.80 2,697.30 13.094 3,506.40 3,911.00 2,640.50 12.818 2,667.00 12.947 2,632.30 12.778

1,519.00 12.983 2,191.70 1,531.90 13.094 1,991.40 2,221.20 1,499.70 12.818 1,514.70 12.947 1,495.00 12.778

1,519.00 12.983 2,191.70 1,531.90 13.094 1,991.40 2,221.20 1,499.70 12.818 1,514.70 12.947 1,495.00 12.778

2,310.90 12.983 3,334.40 2,330.70 13.094 3,029.90 3,379.50 2,281.60 12.818 2,304.50 12.947 2,274.50 12.778

of 30




Units R R

Average Duration

ProfessionalPrivate

Tariff











POLMED DPA

POLMED DPA

BestMed Base Rate

BestMedRCF


ProfmedBase Rate

Profmed RCF

422.20 13.620 609.80 425.80 13.736 553.50 617.40 416.80 13.448 421.00 13.581 393.10 12.682 755.90 13.620 1,091.70 762.30 13.736 990.90 1,105.30 746.30 13.448 753.70 13.581 703.80 12.682 676.90 13.620 977.60 682.60 13.736 887.30 989.70 668.30 13.448 674.90 13.581 630.20 12.682 567.90 13.620 820.20 572.70 13.736 744.50 830.40 560.70 13.448 566.30 13.581 528.80 12.682 1,484.50 13.620 2,144.10 1,497.20 13.736 1,946.30 2,170.90 1,465.80 13.448 1,480.30 13.581 1,382.30 12.682 1,672.50 13.620 2,415.50 1,686.70 13.736 2,192.70 2,445.70 1,651.40 13.448 1,667.70 13.581 1,557.30 12.682 616.90 13.620 891.00 622.20 13.736 808.80 902.10 609.10 13.448 615.20 13.581 574.40 12.682 2,545.50 13.620 3,676.50 2,567.20 13.736 3,337.30 3,722.40 2,513.40 13.448 2,538.20 13.581 2,370.20 12.682 1,642.50 13.620 2,372.30 1,656.50 13.736 2,153.40 2,401.90 1,621.80 13.448 1,637.80 13.581 1,529.40 12.682 544.80 13.620 786.80 549.40 13.736 714.20 796.60 537.90 13.448 543.20 13.581 507.20 12.682 1,283.00 13.620 1,853.00 1,293.90 13.736 1,682.00 1,876.10 1,266.80 13.448 1,279.30 13.581 1,194.60 12.682 1,505.00 13.620 2,173.50 1,517.80 13.736 1,973.10 2,200.80 1,486.00 13.448 1,500.70 13.581 1,401.30 12.682 551.60 13.620 796.70 556.30 13.736 723.10 806.60 544.60 13.448 550.00 13.581 513.60 12.682 559.70 13.620 808.40 564.50 13.736 733.80 818.50 552.70 13.448 558.10 13.581 521.20 12.682 995.60 13.620 1,437.90 1,004.10 13.736 1,305.30 1,455.90 983.00 13.448 992.70 13.581 927.00 12.682 719.10 13.620 1,038.60 725.20 13.736 942.70 1,051.50 710.00 13.448 717.00 13.581 669.60 12.682 1,676.60 13.620 2,421.50 1,690.90 13.736 2,198.10 2,451.80 1,655.40 13.448 1,671.80 13.581 1,561.10 12.682 1,428.70 13.620 2,063.40 1,440.90 13.736 1,873.10 2,089.30 1,410.60 13.448 1,424.60 13.581 1,330.30 12.682

0215 3604 4076 3620 001714 77 19.1 50 7.5

Clin. Pro Radiology Clin. Path UltraBankmed 2017 12.563 17.797 14.523 11.975 20.197 Bankmed 2018 13.191 18.697 15.249 12.574 21.409 Bonitas - Network 2017 12.330 17.530 14.200 11.800 Bonitas - Network 2018 13.128 18.567 12.516 21.213 Discovery 2017 12.199 17.281 13.708 11.629 22.380 Discovery 2018 12.809 18.145 14.393 12.210 23.499 Discovery - GP Network 2017 12.604 17.527 13.903 11.795 22.380 Discovery - GP Network 2018 12.991 18.403 14.598 12.385 FedHealth 2017 12.340 17.480 14.160 11.780 FedHealth 2018 13.114 18.559 10.094 12.488 21.160 GEMS (non) - GP 2017 11.860 16.815 13.710 11.312 19.187 GEMS (non) - Paeds 2017 12.193 17.287 14.099 11.632 19.707 GEMS (non) - Gyn 2017 12.193 17.287 14.099 11.632 19.707

2017 12.193 17.287 14.099 11.632 19.707 GEMS (Con) - GP 2017 12.620 17.903 14.619 12.050 20.413 GEMS (Con) - Paeds 2017 16.200 22.948 18.728 15.440 26.187 GEMS (Con) - Gyn 2017 16.200 22.948 18.728 15.440 26.187

2017 16.200 22.948 14.400 15.440 26.187 GEMS (non) - GP 2018 12.513 17.723 14.469 11.922 20.226 GEMS (non) - Paeds 2018 12.863 18.220 14.858 12.260 20.773 GEMS (non) - Gyn 2018 12.863 18.220 14.858 12.260 20.773

2018 13.136 18.605 15.183 12.520 21.240 GEMS (Con) - GP 2018 13.300 18.860 15.404 12.698 21.520 GEMS (Con) - Paeds 2018 17.064 24.187 19.738 16.274 27.600 GEMS (Con) - Gyn 2018 17.064 24.187 19.738 16.274 27.600

GEMS (non)- 17 -18- 19- 20- 21- 31 (assumed Rate)

GEMS (Con)- 17 -18- 19- 20- 21- 31

GEMS (non)- 17 -18- 19- 20- 21- 31 (assumed Rate)

2018 17.064 24.187 15.183 16.274 27.600 GEMS 2017 12.460 17.652 14.403 11.877 20.147 GEMS 2018 13.136 18.605 15.183 12.520 21.240 KeyHealth 2017 12.825 18.167 14.826 12.225 KeyHealth 2018 13.620 19.293 15.745 12.983 Polmed 2017 12.920 18.360 14.880 12.370 Polmed 2018 13.736 19.458 10.581 13.094 - Bestmed 2017 13.110 18.570 15.100 12.250 Bestmed 2018 13.448 19.044 13.366 12.818 21.720 Medihelp 2017 12.850 18.200 14.850 12.250 Medihelp 2018 13.581 12.947 ProfMed 2017 12.682 17.965 14.661 12.089 22.958 ProfMed 2018 12.682 18.989 15.496 12.778 24.266 HealthMan - Specialists 2017 43.679HealthMan - Specialists 2018 46.518HealthMan - Psychiatry 2017HealthMan - Psychiatry 2018HealthMan - GP 2017 32.368HealthMan - GP 2018 34.471

BestMed Network 2017BestMed Network 2018 13.964 19.777 10.770 13.310 22.547 Bonitas - non Network 2017Bonitas - non Network 2018 12.385 17.545 11.808 20.013 Discovery ICU - Non Network 2017Discovery ICU - Non Network 2018Discovery ICU - Network 2017Discovery ICU - Network 2018

GEMS (Con)- 17 -18- 19- 20- 21- 31

4561 Conults 2614 (New) 2615 (New) 8.9

Anat. Cy 16.748 17.585 16.520

15.808 16.598 16.033 16.935 16.490 17.471 15.831 16.269 16.269

16.269 16.870 21.600 21.600

16.600 16.685 17.149 17.149

17.500 - - - - - - - - 17.786 22.760 22.760

GP Consults

MPS (Obs Potrion)

Ave Deliveies

p/a

Schem Units2614

Schem Units2615

17.507 16.620 17.500 17.099 20.709 23.216 18.159 21.993 24.656 17.310 12.164 17.490 11.760 17.130

16.909 20.478 22.958 17.872 21.696 24.266

36.092 35.837 675,330 155.0 282.0 267.0 39.239 38.995 776,629 155.0 282.0 267.0

31.520 43.416 675,330 155.0 225.6 213.6 31.886 31.799 776,629 155.0 282.0 267.0

12.216

- - -

SAMA Units 2614

SAMA Units 2615

Unique ICU RCF

462.0 447.0 462.0 447.0

369.9 259.6 462.0 447.0

12.140

12.930

· XLS file · Web view · 2018-02-05394 13.135999999999999 0 408.6...

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