INTRODUCTION AND NOTES

to the

MMA SCHEDULE OF FEES

FIFTH EDITION

GENERAL
1. 2. The Malaysian Medical Association (MMA) first released a Schedule of Fees in 1987. This is the Fifth Edition of the Schedule of Fees (2008). The previous Schedule, Fourth Edition, was published in 2002 and the changes from the Third Edition reflected a 10% increase in consultation and procedural fees as compared with the Third Schedule in 1997. A major part of the Fourth Schedule was incorporated into the Thirteenth Schedule (Regulation 433) of the Private Healthcare Facilities and Services Regulations 2006. This law governs the professional fees of all medical practitioners in Malaysia. This Fifth Schedule is the result of work developed by the Health Insurance Committee (HIC) of the MMA. Advice and suggestions by a large number of medical organisations and societies were taken into account. These were via discussions, consultations, written feedback and review of similar fees guidelines published by sister bodies from within and outside the country. It is recommended that the Schedule of Fees be revised every three years to account for inflation, introduction of new procedures and the changing market profiles.

3.

4.

5.

OBJECTIVES
1. 2. 3. This Schedule aims to provide as guideline of fees which, in the opinion of the MMA, is fair to the consumer (patient), medical professional and third party payors (TPP). This Schedule is intended to be a guide for all stakeholders in healthcare in Malaysia. On occasions, the complexity of the consultation or procedure may warrant charges in excess of the fees recommended in this Schedule. In such situations, the medical practitioner is advised to inform and obtain the agreement of the patient or the TPP. Medical practitioners may continue their practice of reducing fees for patients at their own discretion in exceptional circumstances.

4.

Part A

PRINCIPLES
1. 2. The fees in this Schedule represent only the professional fees of medical practitioners (doctors). The quantum of fees of each service in this Schedule is based on the following factors: 2.1 2.2 2.3 2.4 3. 4. 5. the medical complexity of the service; the level of expertise required; the time expanded in provision of the service; Estimates of current fees charged in the country.

6.

7. 8.

The fees indicated in this Schedule are based on the fees in the previous Schedule. Increases were allowed to reflect inflation over the last six years. The Health Insurance Committee used information and feedback from the various (mostly Malaysian) sources described above in developing the Ringgit values in this Schedule. This Schedule is therefore not a direct adoption of the BUPA Schedule of Procedures as in previous Schedules. Instead, the varying increases for different services and procedures tend to reflect prevailing market profiles in Malaysia. Similarly, the coding system for the different procedures has been expanded to accommodate new procedures. The new coding system is therefore also not a direct adoption of the OPCS Classification of Operations and Surgical Procedures as employed previously. The Five-by-Five Look-up Tables for surgical procedures and anaesthesiology fees have been maintained. Procedures are classified into 25 categories, ranging from MINOR 1 to CMO 5. Various technical aspects in the development of this Schedule involve: 8.1 8.2 8.3 8.4 Deletion of outdated or obscure operations and procedures; Introduction of new procedures; Updating the names of certain procedures; Increases in fees for each procedure have been kept reasonable using limitations set and imposed by the Health Insurance Committee.

SUMMARY OF SCHEDULE CONTENTS

1. 2. 3. This Schedule is divided into two parts Part A and Part B. Part A consists of consultation fees and general procedures. These are mostly non-interventional. Part B consists of (mostly) interventional or operative procedures. These procedures have been classified into 25 categories. Each category has a fee (in Malaysian Ringgit) value for surgeon and anaesthetist attached to it. The two respective Five-by-Five Look-up Tables are printed on Page 44.

Part A

CHARGING FOR PROCEDURES

1. 2. The fee for a procedure shall be the same for all medical practitioners, irrespective of specialty. When two or more procedures are done through the same incision on a patient at a particular time, the fees charged shall be 100 percent of the first (main) procedure and 50 percent of the fees chargeable for each of the lesser procedures. When two or more procedures are done through separate incisions on a patient at a particular time, fees are charged as separate individual operations. Points (2) and (3) above apply to both surgeons and anaesthetists. When a procedure requires the services of a second practitioner (Assistant), the fees charged by the second practitioner (Assistant), shall not exceed 50 percent of the fees charged by the primary (first) practitioner for the procedure(s). This situation is usually met in complex operations requiring two surgeons in the interest of patient safety, operative efficiency and quality of care. Examples include liver resection or complex scoliosis surgery. In such a situation (5), the anaesthetist fees shall be charged based on the fees charged by the primary (first) practitioner. When a procedure requires a second anaesthetist, in the interest of the patient safety and quality of care (e.g. during long and complex procedures) the fees charged by the second anaesthetist shall not exceed 50 percent of the fees charged by the primary (first) anaesthetist for the procedure. For procedures performed under local anaesthesia (LA) or sedation, and when this LA or sedation is administered by the operating practitioner, a charge not exceeding 20 percent of the procedure fee may be levied. Procedure fees apply whether the operation is performed as an elective or emergency procedure.

3. 4. 5.

6. 7.

8.

9.

DISCLAIMER
1. 2. 3. Despite extensive efforts, discrepancies and omissions may exist in a Schedule of this magnitude and diversity. We welcome any comments, especially on anomalies detected in the Schedule, and will endeavour to include these in future editions of the Schedule. If anomalies do occur, we believe that medical practitioners will use their own discretion and goodwill in the application of the Schedule so that the interests of all parties are protected.

Part A

GENERAL PRACTITIONERS
CONSULTATION FEES Initial Consultation (Normal working hours 9.00am 5.00pm) 10010 10011 10012 Minor Case Intermediate Case Complex Case 35 70 125 RM

Subsequent Consultation 10013 Minor Case 10014 Intermediate Case 10015 Complex Case Consultation after stipulated clinic hours is 50% above the normal rate. Post graduate qualification in Family Medicine Fee is 50% additional.

25 45 80

MEDICAL EXAMINATION FEES 10020 Medical Health Fitness Examinations for Life Insurance 10021 Attending Doctors Reports 10022 Routine, Pre-employment, Annual Medical Examination 10023 Fitness, Comprehensive Health Examination (Excluding investigations) 10024 Aviation Medical Examination 10025 Foreign Workers Medical Examination 10026 Health Fitness Certificate for Food Handlers 10030 Examination of Medico-Legal Cases 10040 Disability Evaluation 10050 Participation on Medical Board (per day) 10080 Heavy Goods and Public Vehicle Driving License

80 80 100 80 200 60 60 750 1000 750 50

HOUSE CALLS AND MEDICAL ASSISTANCE FEES 11000 House Calls : Office Hours : After Office Hours 11010 Medical duty for events and functions (per hour up to 8 hours) 11020 Medical attendance or transfer/repatriation of patient (Per day excluding actual expenses incurred in the cost of travel, subsistence and accommodation)

300 450 80 750

LEGAL REPORTS AND COURT APPEARANCES FEES 12001 Qualifying Expenses (Preparation) 12002 Conduct Money (Travel and Accommodation) 12004 Non-Expert Witness (Statement of Facts only) 12005 Expert Witness (Giving Opinion) 12006 Search Fee for Medical Report 12007 Attending Physicians Statement for Lawyers and others 12008 Attending Physicians Statement for Insurance Companies (Claim Form)

500 (Actual) 750 1500 50 100 80

Part A

GENERAL PRACTITIONERS (continued)

PROCEDURES According to the Procedural Fee Schedule in PARTS A and B For Procedural under Local Anaesthesia (LA) and when this LA is administered by the operating practitioner, an additional charge of 20% of the procedure fee is levied.

OTHER COMMON PROCEDURES 1. IM Injection 2. IV Injection/Venesection 3. Intralesional Injection 4. IV Branula 5. Setting up Drip 6. Arterial Puncture 7. Naso Gastric Tube Insertion 8. Catheter Insertion 9. Fundoscopy 10. Simple wound dressing with sterile gauze <3cm 11. Wound dressing with sterile gauze 3 - 6cm 12. Wound dressing with sterile gauze >6cm 13. Bladder Tap 14. Abdominal Tapping 15. ECG 16. Ambulatory BP Recording and Interpretation 17. Vaginal Speculum Examination 18. Banding of Piles (including Proctoscopy) 19. Proctoscopy 20. Peak Flow Meter 21. Blood taking 22. Blood sugar testing 23. Urine for strip testing (FEME) 24. Urine for Microalbuminuria 25. Wound Toilet & Suturing for injuries <3cm 26. Wound Toilet & Suturing for injuries 3 6cm 27. Wound Toilet & Suturing for injuries >6cm 3 areas 28. Staining of the Eye for foreign body 29. Removal of foreign body 30. Irrigation of the Eye 31. For Glaucoma testing 32. Syringing of the Ear 33. Ear Lobe Repair (each Ear) 34. Foreign body removal from Ear/Nose/Throat 35. Taking a Swab from Ear/Nose/Throat 36. Nasal Packing 37. POP Casting (excludes cost of cast) 38. Joint Aspiration 39. Joint Infiltration 40. Paps Smear

RM 8 15 40 30 30 45 30 30 15 10 20 30 30 50 25 100 20 75 20 25 20 10 8 12 50 75 150 20 40 20 20 25 180 35 15 20 75 75 75 35

Part A

SPECIALISTS CONSULTATION AND FOLLOW-UP FEES

CONSULTATION FEES INITIAL CONSULTATION AT WORK PLACE: During Office Hours 20010 Simple 20011 20012 Intermediate Complex RM

70 140 200

After Office Hours 20020 Simple 20021 20022 Intermediate Complex

140 200 300

SUBSEQUENT FOLLOW-UP CONSULTATIONS AT WORK PLACE: During Office Hours 20030 Simple 20031 20032 Intermediate Complex

40 70 140

After Office Hours 20040 Simple 20041 20042 20050 Intermediate Complex Home visits or subsequent consultations at home

80 140 200 500

Part A

SPECIALISTS CONSULTATION AND FOLLOW-UP FEES (continued)

ICU CONSULTATION RM During Office Hours 20013 ICU Initial Consultation 20014 ICU Subsequent Follow-up 300 200

After Office Hours 20015 ICU Consultation 20016 ICU Subsequent Follow-up

500 250

COURT ATTENDANCE 20023 Qualifying Expenses (Preparation) 20024 20025 20026 20027 20028 Conduct Money (Travel and Accommodation) Non-Expert Witness (Statement of Facts only) Expert Witness (Giving Opinion) Comprehensive Medical Report for Insurance Companies, Lawyers and Others Claim Form

500 Actual 1000-2000 3000-5000 200-1000 80

Note: 1.

It is recommended that the fees for ward visits per day should not exceed the total fee of two visits for that day, except when additional visits are at the patients request or when the patients condition deems it necessary. Expert opinions given over the telephone or other electronic media to the patient or for the management of the patient also constitutes a consultation and can be duly charged.

2.

Part A

OCCUPATIONAL MEDICINE
Medical Surveillance (USECHH Regulations) Review of CHRA Report Review of Hygiene Report Review of Past Surveillance Reports Documentation RM

80

History, Physical Examination and Documentation Reports (Inclusive of 5 USECHH forms)

80 40

Laboratory Investigations

(as per Lab cost)

Radiological Investigations X-rays (as per MMA Schedule of Fees)

Spirometry Medical Surveillance Fitness for Respirator user (inclusive of forms and report) 45 55

Audiometry Nerve Conduction Studies Walk through survey Whole Plant Work Unit EHS Committee Meeting Attendance Half day meeting Full day meeting

35 55

200 per hour 200 per hour 200 per hour 300 500

Pre-employment, Pre-placement Fitness Medical Examination

80

USECHH: Use of Standards of Exposure to Chemicals Hazardous to Health CHRA: Chemical Health Risk Assessment

Part A

PSYCHIATRY PSYCHOTHERAPY
RM 2200 Individual Psychotherapy not less than 45 minutes per Session. Includes Behaviour Therapy and Hypnotherapy 300

2201

Group psychotherapy one hour per group of not less than three patients and not more than eight patients per person

75

2202

Marital Therapy per couple per session for a couple together for not less than 45 minutes

300

2203

Family Therapy per family per session not less than three members for not less than 45 minutes

300

2204

Child Psychotherapy per session including relevant family interviews for not less than 30 minutes

300

2205

Each Electroconvulsive Therapy (E.C.T.)

375

2206

Cognitive Behaviour Therapy individual session up to 1 hour

300

2207

Pain Management Program: Cognitive Behaviour Therapy Group Therapy, Not less than 5 persons, not more than 10 persons per person, per day (8 hours)

250

Part A

NEUROLOGY

Transcranial Doppler Nerve Conduction Study Concentric Needle EMG Single Fibre EMG Report of EEG Report of Ambulatory EEG Report Video-Telemetry Report Polysomnography Report of Visual Evoked Potentials Report of Auditory Evoked Potentials Report of Somatosensory Evoked Potentials Intraoperative Evoked Potential Monitoring Lumbar Puncture Lumbar Puncture with continuous drainage Muscle Biopsy Nerve Entrapment Injection Thrombolytic Therapy Infusion for acute stroke

MINOR 5 MINOR 1 MINOR 5 INTER 5 MINOR 1 MINOR 5 INTER 5 INTER 3 MINOR 1 MINOR 1 MINOR 5 MAJOR 2 MINOR 2 INTER 5 INTER 2 MINOR 5 MAJOR 2

BOTULINUM INJECTIONS: Face or Head Neck Limbs Palm or Axilla

MINOR 5 INTER 1 INTER 1 INTER 4

Part A

10

CARDIOLOGY
ECG (Report fee) Exercise ECG Continuous Holter Monitoring Blood Pressure Monitoring } } } } RM 35 165 110

Ambulatory

110

ECHO CARDIOGRAPHY M-Mode 2-Dimentional Doppler Echo Cardiography Colour from mapping Stress Echo Cardiography Trans Oesophageal Echo Cardiography } } } }

330

330 385

ELECTIVE CARDIO VERSION

250

CARDIOPULMONARY RESUSCITATION

275

OTHER GENERAL PROCEDURES: As in section for Anaesthesiology

NON-INVASIVE PROCEDURES Twelve-Lead Electrocardiography, tracing and report Continuous ECG Recording of ambulatory patient for 12 or more hours (including resting ECG and the recording of parameters), not in association with Ambulatory Blood Pressure Monitoring, involving microprocessor based analysis equipment, interpretation and report of recordings by a specialist physician or consultant physician. Multi Channel ECG Monitoring and Recording during exercise (motorised treadmill or cycle ergometer capable of quantifying external workload in watts) or pharmacological stress, involving the continuous attendance of a medical practitioner for not less than 20 minutes, with resting ECG, and with or without continuous blood pressure monitoring and the recording of other parameters, on premises equipped with mechanical respirator and defibrillator. 40

180

200

Part A

11

CARDIOLOGY (continued)
Signal Averaged ECG Recording involving not more than 300 beats, using at least 3 leads with data acquisition at not less than 1000Hz of at least 100 QRS complexes, including analysis, interpretation and report of recording. Ambulatory ECG Monitoring, patient activated event recording Implanted Pacemaker Testing for Single Chamber Pacemaker Implanted Pacemaker Testing for Atrioventricular Synchronous Pacemaker Implanted ECG Loop Recording reporting Up-Right Tilt Table Testing M-Mode and 2 Dimensional Real Time Echo-Cardiographic Examination of the Heart from at least 2 acoustic windows, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, and real time colour flow mapping from at least 2 acoustic windows, with recordings on video tape or digital medium. Exercise Stress Echocardiography performed in conjunction with item CA3, with two-dimensional recordings before exercise (baseline) from at least three acoustic windows and matching recordings from the same windows at, or immediately after, peak exercise. Pharmacological Stress Echocardiography performed in conjunction with item CA3, with two-dimensional recordings before drug infusion (baseline) from at least three acoustic windows and matching recordings from the same windows at least twice during drug infusion, including a recordings on video tape or digital medium. Intra-operative 2 Dimensional Real Time Transoesophageal Echocardiography incorporating Doppler techniques with colour flow mapping and recording into video tape or digital medium, performed during cardiac surgery incorporating sequential assessment of cardiac function before and after the surgical procedure. RM 100

70

50 100 70 220

MINOR 1

MINOR 2

MINOR 2

MINOR 4

Part A

12

RESPIRATORY MEDICINE
RM Medical Pleuroscopy Pleural Biopsy (Abram Needle) Chemical Pleurodesis Spirometry Spirometry (with Bronchodilator) Polysomnography BiPAP (non-invasive ventilation) Full Lung function test (with CO diffusion and plethysmography) 800 500 350 50 100 400 400

250

For other procedures such as allergy testing and invasive procedures, please refer to other sections mainly Part B Cardiothoracic Surgery

Part A

13

GASTROENTEROLOGY AND HEPATOLOGY

COMMON PROCEDURES H2400 T3000 T3100 J1200 Proctoscopy Peritoneal Tap Peritoneal Paracentesis Liver Biopsy MINOR 1 MINOR 1 MINOR 1 MINOR 4

ENDOSCOPIC PROCEDURES DIAGNOSTIC G6500 Gastroscopy G2110 pH/Manometry

MINOR 3 MINOR 4

G1400 G1420 G1440 G1460

THERAPEUTIC (includes fees for diagnostic Gastroscopy) OESOPHAGUS Dilation of Stricture/Tumour/Achalasia Stenting Variceal Banding/Scerotherapy Mucosal Resection

INTER 3 INTER 3 INTER 3 INTER 3

G6510 G6520 G6530 G6540 G6550 G6560 G6570 G6580

STOMACH Injection of Gastric Varices Polypectomy Treatment of Bleeders (Injection/Clip/Therml) Mucosal Resection PEG/PEJ Pyloric Dilatation/Stenting Placement of Gastric Balloon Tumour Ablation

INTER 2 MINOR 4 INTER 3 INTER 4 MAJOR 2 INTER 3 INTER 3 INTER 3

G6610 G6620 G6630 G6640 G6650

DUODENUM Small Bowel Dilatation Stenting Treatment of Bleeders Polypectomy Tumour Ablation

INTER 3 INTER 3 INTER 3 MINOR 4 INTER 3

ENTEROSCOPY G7900 DIAGNOSTIC THERAPEUTIC G7910 a. Treatment of Bleeders G7920 b. Dilatation of Stricture G7930 c. Polypectomy G7940 d. Tumour Ablation

INTER 4 INTER 3 INTER 3 MINOR 4 INTER 3

Part A

14

GASTROENTEROLOGY AND HEPATOLOGY (continued)

ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP) J4300 DIAGNOSTIC THERAPEUTIC (includes fee for Diagnostic ERCP) BILIARY Spincterotomy Dilatation Stenting - Plastic - Metallic Stone Extraction INTER 3

J3900 J3910 J3920 J3930

MAJOR 2 MAJOR 2 MAJOR 2 MAJOR 2 MAJOR 2

J3940 J3950 J3960 J3970

PANCREATIC Spincterotomy Dilatation Stenting Stone Extraction

MAJOR 2 MAJOR 2 MAJOR 2 MAJOR 2

SIGMOIDOSCOPY H2500 DIAGNOSTIC THERAPEUTIC (includes fee for Diagnostic Sigmoidoscopy) H2520 Polypectomy H2530 Dilatation H2540 Stenting H2550 Treatment of Bleeders H2560 Banding of Haemorrhoids H2570 Tumour Ablation

MINOR 5 INTER 1 INTER 1 INTER 1 INTER 1 MINOR 1 INTER 3

COLONOSCOPY H2000 DIAGNOSTIC THERAPEUTIC (includes fee for Diagnostic Colonoscopy) H2110 Polypectomy H2120 Stenting H2130 Treatment of Bleeders H2180 Tumour Ablation H2140 Dilatation H2150 Mucosal Resection

INTER 3 INTER 5 INTER 5 INTER 5 INTER 5 INTER 5 MAJOR 4

ENDOSCOPIC ULTRASOUND DIAGNOSTIC U2000 Diagnostic Evaluation of Submucosal Lesions U2010 Evaluation of Portal Hypertension U2020 Staging of Gastrointestinal Cancers U2030 Staging of Non-Gastrointestinal Cancers U2040 Evaluation of Cystic Lesions U2050 Evaluation of Raised Tumour Markers U2060 Pancreas

INTER 3 INTER 3 INTER 3 INTER 3 INTER 3 INTER 3 INTER 3

Part A

15

GASTROENTEROLOGY AND HEPATOLOGY (continued)

U2070 Therapeutic Fine Needle Aspiration of Lesions MAJOR 1

THERAPEUTIC INTERVENTION U2110 Cyst Gastrostomy U2120 Hepatico Gastrostomy U2130 Coeliac Plexus Block U2140 Pancreatic Pseudocyst Drainage U2150 Intra-Abdominal Abscess Drainage

MAJOR 3 MAJOR 3 MAJOR 3 MAJOR 3 MAJOR 3

Part A

16

NEPHROLOGY
RM

Insertion of temporary vascular access

790

Percutaneous insertion of peritoneal dialysis catheter

790

Renal Biopsy

940

Permanent cathether insertion of HD

1265

Manipulation of perm catheter (brushing etc.)

340

Insertion of Tenchoff cathether

1265

Nephrologist cover and Expertise per chronic HD session

30

Part A

17

DERMATOLOGY AND VENEREOLOGY

DERMATOLOGY PROCEDURES ALLERGY TEST RM 50000 Skin sensitivity tests (intradermal) using up to 20 reagents (excluding cost of reagents) Skin sensitivity tests (patch test) using up to 26 reagents i.e. standard series (excluding cost of reagents) Skin sensitivity tests (patch test) using more than 26 reagents i.e. standard battery plus extras (excluding cost of reagents) Skin sensitivity tests (patch test) using supplementary series i.e. cost per series (excluding cost of reagents) 200

50010

250

50011

300

50012

200

GENERAL DERMATOSURGERY 50040 50041 50050 5006 50080 50081 5009 Excision cysts, scars, benign tumours (simple) Excision cysts, scars, benign tumours (complex) Excision malignant skin tumours requiring wide excision Multiple intralesional steroid injections Cryotherapy less than 5 lesions Cryotherapy more than 5 lesions Cryotherapy malignant tumours requiring wide areas of treatment 500 700 950 200 150 250 500

PHOTOTHERAPY 50100 50101 50102 50103 50104 50105 50106 Phototherapy (UVB)/session Regional Phototherapy (UVB)/session Whole body P.U.V.A./session Regional P.U.V.A./session Whole body Photopatch testing MED phototesting MPD phototesting 60 95 95 120 250 250 250

OTHER DERMATOLOGY PROCEDURES 50110 50111 5012 5018 5019 5020 Wedge excision of toe-nail Matrisectomy of nail DGI examination of specimen Skin biopsy Microscopic examination (Dark ground) Microscopic examination for skin scrapings, smears etc. 400 150 150 300 60 60

Part A

18

DERMATOLOGY AND VENEREOLOGY (continued)

OTHER DERMATOLOGY PROCEDURES (continued) RM 5021 5022 5023 5027 5028 5035 5036 5037 Electrosurgery keratosis, warts, angiomas, etc. (<5 lesions) Electrosurgery keratosis, warts, angiomas, etc. (5-20 lesions) Electrosurgery keratosis, warts, angiomas, etc. (>20 lesions) Chemical cautery - keratosis, warts, angiomas etc. Chemical cautery - keratosis, warts, angiomas etc.(5 lesions) Electrolysis of hair/per session Iontophoresis per session (e.g. For hyperhidrosis) Transdermal Iontophoresis (e.g. Drug delivery) 250 500 700 150 300 300 200 250

CUTANEOUS LASER PROCEDURES 50400 50401 50402 50410 50411 50412 50413 50414 50420 50421 50422 50430 50431 50440 50441 50442 50443 Cutaneous laser ablation of skin tumours (<5 lesions) Cutaneous laser ablation of skin tumours (5-20 lesions) Cutaneous laser ablation of skin tumours (>20 lesions) Pigment laser treatment of skin pigmentation and tattoos small area (<9cm2) Pigment laser treatment of skin pigmentation and tattoos medium sized area (9 50cm2) Pigment laser treatment of skin pigmentation and tattoos - large area (>50cm2) Pigment laser treatment of tattoo of eyebrows Pigment laser treatment of tattoo of eyelids Vascular laser treatment of vascular lesion small area (<9cm2) Vascular laser treatment of vascular lesion medium sized area - (9 50cm2) Vascular laser treatment of vascular lesion large area (>50cm2) Laser resurfacing (ablative) of one cosmetic unit Laser resurfacing (non-ablative) of one cosmetic unit Laser/IPL assisted hair removal small area (<9cm2) Laser/IPL assisted hair removal medium area (9 50cm2) Laser/IPL assisted hair removal large area (>50cm2) Intense Pulse Light (IPL) treatment whole face 500 750 1000 500 750 1000 500 750 500 750 1000 1000 750 500 750 1000 800

CHEMICAL PEELING 5050 5051 5052 Chemical peeling of lesion of skin superficial peel Chemical peeling of lesion of skin medium depth Chemical peeling of lesion of skin deep peel 300 500 1000

MISCELLANEOUS PROCEDURES 5060 5061 5063 5070 5071 Comedone extract/per session Paring of hyperkeratosis, corns, etc. Milia extraction Day care skin nursing/session Whole body wrap dressing e.g. atopic eczema 250 250 250 200 500

Part A

19

DERMATOLOGY AND VENEREOLOGY (continued)

MISCELLANEOUS PROCEDURES (continued) RM 5080 5081 5090 5100 Microdermabrasion - face Microdermabrasion - body Botulinum toxin injection of one cosmetic unit Fillers injection of one cosmetic unit 300 500 600 500

Part A

20

HAEMATOLOGY
PROCEDURES Haema-Therapeutic Apheresis Haema-Donor Haemapheresis Haema- In Vitro Harvesting, Processing of Blood or Marrow Haema-Harvesting of Marrow Haema-Administration of Blood Haema-Stem Cell Transplant, Autologous Haema-Stem Cell Transplant, Allogeneic Haema-Stem Cell Transplant, Mini-Allogeneic Haema-Immunotherapy Chemo-Intra Venous - Simple Chemo-Intra Venous - Intermediate Chemo-Intra Venous - Complex Chemo-Intra Venous - Subsequent Days Chemo-Intra Arterial - Simple Chemo-Intra Arterial - Intermediate Chemo-Intra Arterial - Complex Chemo-Intra Arterial - Subsequent Days Chemo-Specialised Procedure/Delivery-Intrathecal Chemo-Specialised Procedure/Delivery-Intravesical Chemo-Specialised Procedure/Delivery-Intraperitoneal Chemo-Specialised Procedure/Delivery-Intrapleural Chemo-Specialised Procedure/Delivery-Chemoport Delivery/Access Prior to Chemotherapy Chemo-Specialised Procedure/Delivery-Ambulatory Drug Delivery Device, Loading of Chemo-Specialised Procedure/Delivery-Implanted Pump or Reservoir Chemo-Biologic Therapy-Immunotherapy Chemo-Biologic Therapy-Cytokines Chemo-Biologic Therapy-Oral Chemotherapy Insertion of IV Line Lumbar Puncture Bone Marrow Aspirate Bone Marrow Biopsy Intravenous Infusion Venesection Chemotherapy Planning and Counselling Removal of Hickmanns Cathether Flushing of Hickmanns Flushing of Chemoport RM 1200 480 1000 1380 180 6000 7500 7000 900 600 700 800 200 600 700 800 200 600 600 600 600 120 140 220 850 380 280 70 500 400 480 120 180 300 200 50 100

Part A

21

PATHOLOGY
ANATOMICAL PATHOLOGY UNCOMPLICATED EXCISION SPECIMENS e.g. Appendix, fallopian tubes, vas, tonsils, adenoids, sebaceous cyst, nasal polyp, heart valve RM 60-70

MORE COMPLICATED EXCISION SPECIMENS Diagnostic Biopsy (wedge/punch/trucut) (1 paraffin block) Medium Sized Specimens e.g. Eye, salivary gland, thyroid, breast lump, gall bladder, prostatic chips, splenectomy, simple hysterectomy, ovarian cyst, excised diabetic ulcer, excised tumour < 10cm, diagnostic biopsy sent as 2-3 separate specimens Large Specimens e.g. Laryngectomy, pneumonectomy, simple mastectomy, breast hookwire with margins, gastrectomy, gut resection, nephrectomy, THBSO, cone biopsy, amputated limb (except for diabetes), excised tumour > 10cm, diagnostic biopsy sent as 4-10 separate specimens Radical Specimens e.g. Radical neck dissection, mastectomy with axillary clearance, Whipple's Wertheim's, vulvectomy with lymphadenectomy, any other radical dissections requiring margins and lymph node status 110-130 160-200

320-380

400-450

SPECIALISED HISTOPATHOLOGY Liver for non-neoplastic conditions (including special stains) Muscle (including special stains) Renal biopsy (including special stains and immunofluorescence) Lymphoproliferative disorders (including immunohistophenotyping of lymphomas) Frozen section (with follow-up paraffin section report) AUTOPSY Visit to scene of crime Procedure and report Histopathology reporting CYTOPATHOLOGY Gynaecological smear report Non-gynaecological smear report Aspiration Cytology Procedure Aspiration Cytology Report 45-50 80-90 MINOR 1 150-200 380-650 650-2000 50-500 190-220 260-315 380-450 260-315 380-510

Part A

22

PATHOLOGY (continued)
HAEMATOLOGY AND TRANSFUSION Report based on blood film Bone marrow aspiration Procedure Bone marrow aspiration Report Bone marrow trephine Procedure Bone marrow trephine Report Report on Coagulation tests Report on special haematological investigations (e.g. folate-B12 status, Coomb's test, Hb analysis, cytochemistry etc.) Basic Transfusion Report e.g. Discrepancies of grouping and incompatibility of blood/blood products Report on transfusion problems Pheresis Harvesting of bone marrow Grafting of bone marrow RM 40-65 MINOR 4 125-250 MINOR 5 125-250 65-130 65-130

40-65

125-250 INTER 3 INTER 5 INTER 5

GENETICS Chromosomes study immunodofluorescence Immunophenotyping DNA content (ploidy) Gene rearrangement studies Lymphocyte subsets Report on other molecular genetic studies Paternity testing Human Leucocyte Antigen (HLA) typing 125-380 125-380 125-380 125-380 125-380 125-380 125-380 125-380

IMMUNOLOGY Report on general immunology test e.g. Autoimmune disease screen, auto-antibodies screen Report on special immunological investigations e.g. Serum protein electrophoresis, CSF electrophoresis, immunotyping of monoclonal proteins, immunophenotyping of immune disorders, investigations of proteinuria, cellular function studies 40-70

65-250

Part A

23

PATHOLOGY (continued)
MEDICAL MICROBIOLOGY Report on routine culture and sensitivity Report on special cultures Report on direct smears examination (Gram/AFB) Report on serological tests Report on special serological tests Report on antimicrobial susceptibility testing by MIC (per test) Consultation on patient management (investigation and empirical therapy) Positive blood culture smear examination and preliminary report with consultation on patient management Consultation on infection control Report on antigen detection (immunoflurescene, ELISA, Latex/Coagglutination) RM 12-18 65-130 40-55 40-55 65-130 95-190 95-130 130-190

130-190 65-95

CHEMICAL PATHOLOGY Report on General Chemistry Profiles e.g. Liver, Bone, Cardiac Report on General Chemistry Screen including Executive Screen Report on Special Chemistry investigations e.g. Metabolic studies (lipid, bone) endocrine disorders, toxicology studies, therapeutic drug monitoring, maternal and fetal health assessment Report on Dynamic Studies e.g. Function studies (GI, Endocrine, Renal) Consultation for: Investigation strategy Non-analytical variation Drug interferences Correlation between clinical data and clinical information provided 40-60

60-180 60-360

120-400

100-150 80-140 80-140 80-140

MISCELLANEOUS Electron Microscopy Second opinion: Data interpretation and bone marrow slides Histopathology and Cytopathology Autopsy findings 320-380

130-260 260-700 300-1500

Part A

24

PAEDIATRICS
NEONATOLOGY Exchange Transfusion Percutaneous insertion peripheral venous catheter Lumbar puncture Cardiopulmonary resuscitation Umbilical artery catheterization Ventricular tap Peripheral arterial cannulation Umbilical vein catheterization Newborn resuscitation (office hours) Newborn resuscitation (after office hours) Ventilator setup Ultrasound brain Arterial puncture Suprapubic tap Neonatal venepuncture Lumbar puncture RM 700 250 200 250 400 300 250 300 200 350 150 200 150 200 100 300

RESPIRATORY Plethysmosgraphy test Walking stress test Exercise challenge tests Tracheostomy nursing care technique and ventilation through tracheostomy Pulmonary rehabilitation or management counseling (max. 1 hour) Challenge test e.g. Histamine, Metacholine, etc. DLCO test 6 minute walk tests Non-invasive Bilevel Positive Airway Pressure ventilator application and technique Non-invasive CPAP (continuous positive airway pressure) ventilator application Application of non-invasive ventilator Bilevel Positive Airway Pressure (BIPAP) Continuous Positive Airway Pressure (CPAP) Lung Function Test Others: e.g. CO diffusion capacity (DLCO) Pulmonary Rehabilitation Counselling Spirometry Overnight continuous pulse oximetry Overnight end tidal carbon dioxide monitoring Skin allergy testing intradermal (max 20 reagents) Skin sensitivity test Challenges test e.g. Metacholine, Histamine, Saline, etc. Continuous pulse oximetry with end-tidal carbon dioxide monitoring Peak expiratory flow manometry Continuous pulse oximetry Polysomnography 400 400 400 350 250 200 200 200 500 400 200 200 200 200 200 200 90 100 100 180 100 200 60 50 50 400

Part A

25

PAEDIATRICS (continued)
CARDIOLOGY Fetal echo with colour and wave Doppler Paediatric cardiac catheterization Paediatric percutaneous transluminal occlusion of coronary fistula/AV malformation Paediatric percutaneous transluminal valvuloplasty Percutaneous transluminal prosthetic occlusion of patent ductus arteriosus (PDA) Percutaneous transcoronary myocardial alcohol septal ablation for hepartrophic cardiomyopathy Percutaneous transluminal modification of atrioventricular node (by Electrophysiology) RM 500 1400 2800 2800 2800 2800 1800

ENDOCRINOLOGY Water deprivation test Overnight low dose dexamethasone suppression test Prolonged fasting test Low dose dexamethasone suppression test High dose dexamethasone suppression test Luteinizing Hormone Releasing Hormone (LHRH) test Oral glucose tolerance test (OGTT) Growth hormone (GH) stimulation provocative test e.g. Insulin, glucagons, arginine Human chorionic gonadotrophin (HCG) stimulation test Renin/aldosterone postural test Adrenocorticotropin (ACTH) stimulation test 400 300 300 200 200 200 200 250 250 250 250

GENETIC-METABOLIC Exercise tolerance test Forearm ischaemia test Glucose challenge test Allopurinol challenge test Genetic Counselling Planning for metabolic diet 400 400 400 200 200 300

RHEUMATOLOGY Intra-articular Injection 275

Part A

26

PAEDIATRICS (continued)
NEPHROLOGY Continuous Ambulatory Peritoneal Dialysis (CAPD) first month CAPD subsequent months/per month Plasmapheresis per treatment CRRT per day Insertion of cuffed hemodialysis catheter Insertion of temporary peritoneal dialysis catheter Insertion of temporary hemodialysis catheter Renal biopsy (ultrasound guided) Acute hemodialysis in ICU Acute hemodialysis Stab cystostomy Acute hemodialysis in hemodialysis unit (weight > 15 kg) Acute hemodialysis in hemodialysis unit (weight < 15 kg) Intermittent peritoneal dialysis per day Chronic hemodialysis (body weight > 15 kg) Chronic hemodialysis (body weight < 15 kg) Stab cystotomy Urinary catheterization RM 4000 2000 2500 2500 1015 635 635 755 450 450 275 315 400 200 215 300 275 100

GENERAL IV line Blood C and S Trephine biopsy Bone Marrow Aspiration Umbilical Artery catheterization Umbilical Vein catheterization Lumbar puncture Thoracocentensis 24 hours pH study Jugular Venous puncture Arterial puncture Venepuncture Suprapubic tap Immunisation Peak Flow Meter Urinary catheterization Subdural tap Ventricular tap Developmental screening Resuscitation and Stabilisation Intraossesous infusion Umbilical granuloma cauterization Administer bronchodilator via nebulizer Removal of skin tag in newborn

30 30 250 250 400 300 295 100 60 85 40 30 75 25 25 40 150 200 100 500 175 100 50 100

COMMUNITY AND ADVANCED Family counseling (therapy) session per day Individual counseling of child or teenager per hour Disability and education assessment per hour Planning services for a disabled child per hour Report on child or adolescent (for parent or non-Agency) for disability, abuse

300 300 400 300 300

Part A

27

OBSTETRICS AND GYNAECOLOGY

INVASIVE PROCEDURES Amniocentesis Chorionic villus sampling (CVS) Fetal Blood Sampling (FBS) Fetal procedures (transfusion, biopsies, shunts etc.) INTER 1 INTER 2 INTER 3 INTER 4

ULTRASOUND Transvaginal scan/Follicular tracking 1st Trimester/Nuchal Scan Fetal Anomaly Scan (2nd/3rd Trimester) Fetal Anomaly Scan (2nd/3rd Trimester) with 3D/4D Fetal Dopler studies

RM 150 200 350 400 150

PREGNANCY AND CONFINEMENT/INTRAPARTUM Normal Delivery Assisted Delivery Forceps/Ventouse/Twins Caesarean Delivery with complications } } } Refer to Part B

Part A

28

OPHTHALMOLOGY
PROCEDURES 1. 2. 3. 4. 5. 6. 7. Fundus Fluorescein Angiogram Anterior/Fundus Photography Automated Perimetry Hess Chart Keratometry Corneal Topography Ultrasonography: A-Scan B-Scan 8. 9. Pachymetry Gonioscopy 135 275 135 65 65 65 30 RM 300 75 275 135 65 275

10. Indirect Ophthalmoscopy 11. Refraction 12. Schirmers test 13. Electrophysiology: ERG/EOG/VER: With Report Without Report 14. Syringing 15. Dressing 16. Irrigation

400 275 135 35 65

Part A

29

ANAESTHESIOLOGY
1. INTRODUCTION Anaesthetists fee for provision of the anaesthetic services shall follow the Anaesthetists category listed in Part B of the Schedule of Fees, the corresponding fee in the Look Up Table in Part A. 2. CONSULTATION AND PREOPERATIVE ASSESSMENT FEES These fees shall follow the Schedule for the Specialists Consultation and Follow Up fees in Part A. (Refer pages 6-7) 3. ANAESTHETISTS CATEGORY IN PART B The fee is for the administration of anaesthesia and is inclusive of induction, maintenance and reversal of anaesthesia and all necessary support and monitoring activities intraoperatively that may be required normally for that particular procedure. It also includes fees for post anaesthesia care in the post anaesthesia care unit (PACU) and recovery room/ward. The fee shall also apply for monitored anaesthesia care. Any procedures done for specialized monitoring may be charged separately (e.g. Swan Ganz catheter, somatosensory evoked potential monitoring, Transoesophageal Echocardiography monitoring etc.) 4. REGIONAL ANAESTHESIA When regional anaesthesia (infiltration, nerve blocks, plexus blocks, central neural blocks) is established as the principle means of anaesthesia for a surgical procedure, the fee charged shall follow the same category in Part B. 5. ANAESTHESIA FOR MULTIPLE SURGICAL PROCEDURES When multiple surgical procedures are performed during the same anaesthetic, the fees charged shall be as given in the section CHARGING FOR PROCEDURES in Part A (Refer page 3). When a procedure requires a second anaesthetists in the interest of patient safety and quality of care (e.g. during long and complex procedures) the fees charged by the second anaesthetist shall not exceed 50 percent of the fees charged by the primary (first) anaesthetist for the procedure. 6. POST ANAESTHESIA CARE Continued post anaesthesia care in the ward or intensive care unit shall follow the schedule for the Specialists Consultation and Follow Up fees in Part A. (Refer pages 6-7). 7. DIAGNOSTIC/ INTERVENTIONAL RADIOLOGY PROCEDURES Refer to fees in the appropriate section in Part B. 8. INTENSIVE CARE CODE DESCRIPTION ANAESTHETISTS CATEGORY/FEE MAJOR 2

AN 10101

First Consultation, assessment, and initiation of treatment (intubation and ventilation including non invasive procedures like application of BIPAP, CPAP ventilation) during office hours. First Consultation, assessment, and initiation of treatment (intubation and ventilation including non invasive procedures like application of BIPAP, CPAP ventilation) after office hours. Subsequent follow-up during office hours Subsequent follow-up after office hours

AN 10102

MAJOR 4

AB 10103 AN 10104

RM200 RM250

Part A

30

ANAESTHESIOLOGY (continued)
9. OBSTETRIC ANALGESIA SERVICES AN 10201 Epidural/Spinal (includes assessment and initiation of procedure) during office hours Epidural/Spinal (includes assessment and initiation of procedure) after office hours Attendance during delivery (on request) Post delivery visit, removal of catheter INTER 5

AN 10202

MAJOR 2

AN 10203 AN 10204

INTER 3 RM70

10. PAIN MANAGEMENT AN 10301 Patient Controlled Analgesia with intravenous drugs for acute pain/post operative Pain Management (Assessment and initiation) Placement of Epidural catheter for post operative Pain Management (Assessment and initiation) Placement of Catheter for neural blockade of peripheral nerves, plexuses MINOR

AN 10302

INTER 5

AN 10302

INTER 4

Refer to Part B Pages 9-10 for other Pain Management procedures. If the procedure is done by the Anaesthetists then the Surgeons category of fees shall apply. If the procedure requires an anaesthetic to be given for the procedure to be done by another practitioner then the Anaesthetists category of fees shall apply for the anaesthetist providing the anaesthetic.

11. GENERAL PROCEDURES AN 10401 AN 10402 AN 10403 Venesection Arterial canulation, setting up monitoring system Central venous line canulation including femoral vein, setting up monitoring system Right heart balloon catheter, insertion for measurement of pulmonary wedge pressure and cardiac output Cardiopulmonary Resuscitation, including ACLS Trans oesophageal echo cardiography RM30 RM325 RM325

AN 10404

RM450

AN 10405 AN 10406

RM450 RM385

Part A

31

ONCOLOGY
RADIOTHERAPY 1. PALLIATIVE RADIOTHERAPY Short course radiotherapy with aim to relieve symptoms a. 1 Fraction b. 5 Fraction c. 10 Fractions Fields : Planning : Duration : 1 2 Fields, 2 Dimensional One day 2 weeks RM

900 1000 1200

2. ADJUVANT RADIOTHERAPY Radiotherapy given following surgery to improve local control rates and possibly survival a. Minor Fractions: Fields : Planning : Duration : b. Major Fractions: Fields : Planning : Duration : 1500 15 20# 1 2 Fields, 2 Dimensional 3 4 weeks 1800 21 30# >2 Fields, 3 Dimensional 4 6 weeks

3. RADICAL AND RE-TREATMENT RADIOTHERAPY Radical radiotherapy is radiation given in high doses with the aim to cure patients of cancer a. Complex 2 Dimensional Fractions: 25 45 Fractions Fields : >2 Fields, Planning : 3 Dimensional Duration : 5 9 weeks b. Complex 3 Dimensional Fractions: 25 45 Fractions Fields : >2 Fields, Planning : 3 Dimensional Duration : 5 9 weeks 2250

2500

Part A

32

ONCOLOGY (continued)
4. SPECIALISED RADIOTHERAPY A. IMRT (INTENSITY MODULATED RADIOTHERAPY) IMRT, IGRT Fractions: 20 45 Fractions Fields : 5 9 Fields Planning : 3 Dimensional Inverse Planning Duration : 4 9 weeks Treatment time per fraction: 20 25 minutes each RM 5000

B. STEREOTACTIC RADIATION a. Stereotactic Radiosurgery (SRS) (Single Fraction) b. Fractionated (SRS) (Multiple Fractions) c. Fractionated Stereotactic Radiotherapy (SRT) 4000

5000

5000

5. BRACHYTHERAPHY a. Low Dose Rate (LDR) Brachytherapy b. High Dose Rate (HDR) Brachytherapy Intra-Cavitary (Single Fraction) c. High Dose Rate Intraluminal (Single Fraction) Intraluminal (Multiple Fractions) d. e. High Dose Rate Implants Radionuclide Therapy Low Dose < 30mCi or (out-patient procedure) High Dose < 30mCi or (requires in patient radiation shielded room) 1000

1500

1000 1500 2500

550 1000

Part A

33

ONCOLOGY (continued)
CHEMOTHERAPY 1. INFUSIONAL CHEMOTHERAPY a. IV Infusion b. IV Prolonged Infusion c. IV Progressive Chemotherapy RM

600 800 200 per day

2. NON-INFUSIONAL CHEMOTHERAPY a. Intra-Peritoneal/Intrathecal Chemotherapy b. Molecular Targeted Therapy IV c. Hormonal Therapy Implant

600 800 400

Part A

34

RADIOLOGY
(Doctors Professional Fees)

PLAIN RADIOGRAPHS CHEST 100000 Chest (Single view) 100001 Chest (Two views) 100002 Chest (Three views) 100003 Chest (Four views)

RM 15 25 30 35

ABDOMEN 100010 100011 100012 100013 100014 100015

Abdomen (Single view) Abdomen (Two views) Abdomen (Three views) Kidney, Ureter and Bladder (KUB) (Single view) Lateral pelvimetry AP & Lateral pelvimetry

15 25 30 15 15 30

SPINE 100020 100021 100022 100023 100024 100030 100031 100032 100040 100041 100042 100043 100044

Cervical spine (Single view) Cervical spine (Two views) Cervical spine (Three views) Cervical spine (Four views) Cervical spine (Five views) Thoracic spine (Single view) Thoracic spine (Two views) Thoracic spine (Three views) Lumbo-sacral spine (Single view) Lumbo-sacral spine (Two views) Lumbo-sacral spine (Three views) Lumbo-sacral spine (Four views) Skeletal survey

15 25 30 35 40 15 25 30 15 25 30 35 70

SKULL 100070 100071 100072 100073

Skull (Single view) Skull (Two views) Skull (Three views) Skull (Four views)

15 25 30 35

FACIAL BONES 100080 Facial Bones (Single view) 100081 Facial Bones (Two views) 100082 Facial Bones (Three views) 100090 Nasal bones (Single view)

15 25 30 15

MANDIBLE 100100 100101 100102

Mandible (Single view) Mandible (Two views) Mandible (Three views)

15 25 30

Part A

35

RADIOLOGY (continued)
(Doctors Professional Fees)

TEMPORO-MANDIBULAR JOINTS 100103 Temporo-mandibular Joints (Single view) 100104 Temporo-mandibular Joints (Two views) 100105 Temporo-mandibular Joints (Three views) 100106 Temporo-mandibular Joints (Four views)

RM 15 25 30 35

MASTOIDS 100110 100111 100112 100113

Mastoids (Single view) Mastoids (Two views) Mastoids (Three views) Mastoids (Four views)

15 25 30 40

PARANASAL SINUSES 100120 Paranasal Sinuses (Single view) 100121 Paranasal Sinuses (Two views) 100122 Paranasal Sinuses (Three views)

15 25 30

ORBITS 100140 100141 100142

Orbits (Two views) Orbits (Three views) Orbits (Four views)

15 25 30

EXTREMITIES UPPER EXTREMITY SHOULDER 100160 100161 100162 100163 100164

Shoulder (Single view) Shoulder (Two views) Shoulder (Three views) Shoulder (Four views) Acriomo-clavicular joints - Both weight bearing

15 25 30 35 15

ARM (Humerus) 100170 Arm (Single view) 100171 Arm (Two views)

15 25

ELBOW JOINT 100180 Elbow Joint (Single view) 100181 Elbow Joint (Two views) 100182 Elbow Joint (Three views) 100183 Elbow Joint (Four views)

15 25 30 35

FOREARM (Radius/Ulna) 100190 Forearm (Single view) 100191 Forearm (Two views)

15 25

Part A

36

RADIOLOGY (continued)
(Doctors Professional Fees) RM WRIST JOINT 100200 100201 100202 100203 Wrist Joint (Single view) Wrist Joint (Two views) Wrist Joint (Three views) Wrist Joint (Four views) 15 25 30 35

HAND 100210 100211 100212 100213 100214 100215 100216

Hand (Single - One view) Hand (Single - Two views) Hand (Single - Three views) Hand (Both - One view) Hand (Both - Two views) Hand (Both - Three views) Left Hand for bone age

15 25 30 15 25 30 15

THUMB OR SINGLE DIGIT 100220 Thumb or Single digit (Single view) 100221 Thumb or Single digit (Two views)

10 15

CLAVICLE 100230 100231

Clavicle (Single view) Clavicle (Two views)

15 25

STERNO-CLAVICULAR JOINT 100232 Sterno - Clavicular Joint (Single view) 100233 Sterno - Clavicular Joint (Two views) 100234 Sterno - Clavicular Joint (Three views) 100235 Sternum - (Single view)

15 25 30 15

SCAPULA 100240 100241 100250

Scapula (Single view) Scapula (Two views) Scaphoid views (4 views)

15 25 30

LOWER EXTREMITY PELVIS 100050 Pelvis (Single view) 100051 Pelvis (Two views) 100052 Pelvis (Three views)

15 25 30

HIP JOINT 100270 100271 100272 100273 100274

Hip Joint (Single view) Hip Joint (Two views) Hip Joint (Three views) Hip Joint (Four views) Hip Joint (Five views)

15 25 30 35 40

Part A

37

RADIOLOGY (continued)
(Doctors Professional Fees) RM FEMUR (THIGH) 100280 Femur (Single view) 100281 Femur (Two views)

15 25

KNEE 100290 100291 100292 100293 100294

Knee (Single view) Knee (Two views) Knee (Three views) Knee (Four views) Knee (Five views)

15 25 30 35 40

LOWER LEG TIB/FIB 100300 Lower leg (Single view) 100301 Lower leg (Two views)

15 25

ANKLE 100310 100311 100312 100313 100314

Ankle (Single view) Ankle (Two views) Ankle (Three views) Ankle (Four views) Ankle (Five views)

15 25 30 35 40

FOOT 100330 100331 100332

Foot (Single view) Foot (Two views) Foot (Three views)

15 25 30

BOTH FEET 100334 100335

Both Feet (Two views) Both Feet (Three views)

25 30

SUBTALAR JOINTS 100320 Subtalar Joints (Single view) 100321 Subtalar Joints (Two views) 100322 Subtalar Joints (Three views) 100323 Subtalar Joints (Four views)

15 25 30 35

CALCANEUM 100340 Calcaneum (Single view) 100341 Calceneum (Two views)

15 25

BONE DENSITOMETRY 100350 Dexa 100351 Ultrasound

50 40

Part A

38

RADIOLOGY (continued)
(Doctors Professional Fees) RM RADIOGRAPHIC CONTRAST EXAMINATION 100360 Barium swallow 100361 Barium meal (double contrast) 100362 Barium meal and follow through 100363 Small bowel enema 100364 Gastrograffin or non-ionic contrast upper gastro-intestinal study 100365 Barium enema (single or double contrast) 100366 Gastrograffin or non-ionic contrast enema 100367 Loopogram 100368 Duodenal intubation 100380 100381 100382 100383 100384 100385 100386 100387 100390 100400 100401 100411 100413 100420 100430 100431 Cystogram Ascending urethrogram Micturating cystourethrogram Retrograde pyelogram: one side Retrograde pyelogram: both side Ileal conduit study Nephrostomy: one side Nephrostomy: both side IVU standard dose contrast T-Tube cholangiogram Operative cholangiogram Hysterosalpingogram reporting only Hysterosalpingogram with cannulation Sinogram Sialogram: Parotid one side Sialogram: Parotid bilateral

50 75 90 90 90 90 90 90 80 100 90 90 90 120 90 60 90 90 50 50 50 200 90 125 250

MAMMOGRAM 100470 Mammography (Unilateral) 100471 Mammography (Bilateral)

60 80

CT SCANS 100500 100501 100510 100511 100512 100520 100521 100530 100531

Brain (without contrast) Brain (with contrast) Abdomen (without contrast) Abdomen single phase (with iv contrast) Abdomen multiple phases (with iv contrast) Pelvis (without contrast) Pelvis (with iv contrast) Spines: Cervical or Lumbar (without iv contrast) Spines: Cervical or Lumbar (with iv contrast)

140 180 140 200 250 140 180 140 180

Part A

39

RADIOLOGY (continued)
(Doctors Professional Fees)

CT SCANS 100540 100541 100550 100551 100553 100554 100555 100556 100557 100558 100560 100561 100570 100571 100580 100581 100590 100591 100600 100601 100650 100640 100641 100643 100644 100645 100646 100610 100612 100620 100621 100623 100630 100631

Spines: Thoracic (without contrast) Spines: Thoracic (with iv contrast) Chest (without contrast) Chest (with iv contrast) Low dose screening CT of the chest HRCT - inspiratory HRCT - inspiratory + expiratory Chest and Upper abdomen (with iv contrast) CT Coronary angiogram CT Cardiac for calcium scoring Neck/Thyroid (without contrast) Neck/Thyroid (with non-ionic contrast) Postnasal space and neck (without contrast) Postnasal space and neck (with iv contrast) Orbits (without contrast) Orbits (with iv contrast) Pituitary fossa (without contrast) Pituitary fossa (with iv contrast) I.A.M. (without contrast) I.A.M. (without iv contrast) Total Body Scan (Brain, Neck, Chest, Abdomen & Pelvis) Chest, Abdomen and Pelvis (without contrast) Chest, Abdomen and Pelvis (with iv contrast) CTU (plain) CT Bronchogram CTU single phase (with iv contrast) CTU multiphase (with iv contrast) Single plane high resolution CT of the parasanal sinuses for sinusitis (without contrast) Single plane CT of the parasanal sinuses (with iv contrast) Abdomen, Pelvis (without contrast) Abdomen, Pelvis (with iv contrast) CT Colonoscopy Chest, Upper Abdomen (without contrast) Chest, Upper Abdomen (with iv contrast)

RM 140 180 140 180 140 140 200 250 600 150 140 180 140 180 75 125 75 125 75 125 300 200 300 140 180 250 300

100 180 200 300 500 250 300

Part A

40

RADIOLOGY (continued)
(Doctors Professional Fees) RM CT SCANS 100670 100671 100673 100674 CT Extremitres (without contrast - one region) CT Extremitres (with iv contrast - one region) 3D CT (additional professional fees only) CTA (additional processional fees only) 140 180 200 200

ULTRASOUND 100700 Upper Abdomen 100701 Pelvis 100702 Ultrasound Abdomen and Pelvis 100703 Kidneys and Bladder 100704 Kidneys and Bladder + residual urine volume estimation 100710 100720 100730 100740 100750 100760 100761 100762 100763 100764 100765 100766 100770 100780 100781 100790 100810 100811 100840 100841 Brain (neonatal) Detailed ultrasound scan of foetus Thyroid Breast Doppler ultrasound of extra-cranial carotids Doppler ultrasound of arteries per region Doppler ultrasound of veins single limb Doppler ultrasound of veins two limbs Doppler ultrasound of arteries for single limb Doppler ultrasound of arteries for two limbs Doppler ultrasound for varicose veins Doppler ultrasound transcranial Musculoskeletal ultrasound per region (joint) Ultrasound scrotum Ultrasound scrotum with doppler Doppler ultrasound for other organs (per organ) not listed above Endocavitary ultrasound Ultrasound chest Surcharge for each portable ultrasound payable to radiologist during normal working hours Surcharge for each portable ultrasound payable to radiologist after normal working hours

60 60 75 60 70 60 250 60 60 150 90 90 150 180 280 180 180 100 60 90 90 100 50

100 200

SCREENING 100850 100852

Endoscopic Retrograde Cholangio Pancreatography (screening and reporting only) Fluroscopy for other procedures (professional fee only)

100 100

Part A

41

RADIOLOGY (continued)
(Doctors Professional Fees) RM MRI 100900 100901 100902 100903 100904 100905 100915 100920 100921 100922 100930 100931 100932 100933

Brain (without contrast) Brain (with iv contrast) Brain with MRA/MRV(intracranial) Brain + MRA + iv Contrast Brain + MRA + Bilateral Carotids + Contrast MRA intracranial or extracranial carotids Brain MRV sequence only Pituitary (without contrast) Pituitary (with iv contrast) Pituitary (with iv contrast dynamic) I.A.M (without contrast) I.A.M (with iv contrast) I.A.M + Brain (without contrast) I.A.M + Brain (with iv contrast)

240 315 420 480 630 240 100 240 315 420 240 315 420 480

ORBITS 100940 100941 100942 100943

Orbits (without contrast) Orbits (with iv contrast) Orbits and Brain (without contrast) Orbits and Brain (with iv contrast)

240 315 420 480

NECK 100950 100951 100952 100953 100954 100955

Neck (without contrast) Neck (with iv contrast) Neck and Brain (without contrast) Neck and Brain (with iv contrast) Brachial plexus (without contrast) Brachial plexus (with iv contrast)

240 315 450 510 285 360

THORAX 100960 100961

Mediastinum (without contrast) Mediastinum (with iv contrast)

240 315

BREAST 100962 100963

Breast (without contrast) Breast (with iv contrast)

240 315

CARDIAC 100970 100971 100972 100973 100975 100976

Cardiac MRI Morphology Cardiac MRI Coronary Cardiac MRI Functional Cardiac MRI Comprehensive Thoracic MRA Pulmonary MRA

315 315 315 600 315 315

Part A

42

RADIOLOGY (continued)
(Doctors Professional Fees) RM UPPER ABDOMEN 100980 Upper abdomen plain 100981 Upper abdomen (with iv contrast) 100983 100984 100985 Magnetic resonance cholangio-pancreaticography (MRCP) Magnetic resonance Urography (MRU) Abdomen MRA 315 360 240 240 315

PELVIS 100990 100991 100993 100994 100995

Pelvis - plain Pelvis (with iv contrast) MRI Pelvimetry Abdomen and pelvis plain Abdomen and pelvis (with iv contrast)

315 360 150 450 550

SPINE 101000 101001 101002 101003 101004 101005 101006 101007

MRI whole spine (without contrast) MRI whole spine (with iv contrast) MRI cervical spine (without contrast) MRI cervical spine (with iv contrast) MRI thoracic spine (without contrast) MRI thoracic spine (with iv contrast) MRI lumbar spine (without contrast) MRI lumbar spine (with iv contrast)

485 555 315 420 315 420 315 420

EXTREMITIES (Joints = Shoulder, sternoclavicular, elbow, wrist, hip, sacro-iliac, knee, ankle, sub-tarsal) 101010 MRI Single joint (without contrast) 101011 MRI Single joint (with iv contrast) (Region=arm, forearm, hand, thigh, lower leg-calf, foot) 101012 MRI Single region (without contrast) 101013 MRI Single region (with iv contrast) 101015 101020 MR Spectoroscopy (Additional Radiologist fee) MRI additional sequence

315 420

360 450 300 100

Part A

43

LOOK UP TABLE

SURGEONS
MINOR

1
RM325

2
RM400

3
RM425

4
RM500

5
RM600

INTER

RM800

RM900

RM1100

RM1250

RM1400

MAJOR

RM1700

RM1900

RM2050

RM2250

RM2400

MAJOR PLUS

RM2500

RM2750

RM2900

RM3000

RM3200

COMPLEX MAJOR

RM3500

RM4000

RM5250

RM6500

RM7750

ANAESTHETISTS
MINOR

1
RM275

2
RM275

3
RM275

4
RM275

5
RM275

INTER

RM345

RM385

RM450

RM475

RM550

MAJOR

RM625

RM675

RM750

RM825

RM900

MAJOR PLUS

RM1025

RM1100

RM1250

RM1450

RM1700

COMPLEX MAJOR

RM2000

RM2300

RM2750

RM3250

RM3600

Part A

44