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10
11
Line
Line
No.
Item
Item
No.
After-Care
After-Care
Fee
Fee
193. Tibia and fibula, open
2 mos.
150 00
AMPUTATIONS
194. Potts fracture, closed
2 mos.
75 00
275. Arm, disarticulation, uncomplicated
6 wks.
150 00
195. Potts fracture, open
2 mos.
110 00
276. Arm, thru head or neck
6 wks.
100 00
196. Metatarsal bones, closed
3 wks.
30 00
277. Arm, below neck
6 wks.
75 00
197. Metatarsal bones, open
2 mos.
75 00
278. Forearm
6 wks.
75 00
198. Toes - single toe - first toe
3 wks.
20 00
279. Hand at wrist
6 wks.
75 00
199. Toes - single toe - other than first
3 wks.
15 00
280. Carpus
6 wks.
60 00
200. Toes - multiple on same foot
3 wks.
25 00
281. Metacarpus
6 wks.
50 00
201. Sacrum, closed
3 wks.
50 00
282. Phalanx
6 wks.
30 00
202. Pelvis, one bone
3 wks.
50 00
283. Thigh, disarticulation
6 wks.
150 00
203. Pelvis, multiple
3 wks.
75 00
284. Leg at knee
6 wks.
100 00
204. Pelvis, open
A. & A.
285. Patella, excision
6 wks.
75 00
205. OsCalcis, closed
2 mos.
50 00
286. Femur, head and neck
6 wks.
150 00
206. OsCalcis, open
2 mos.
100 00
287. Femur
6 wks.
100 00
207. Astragalus, closed
2 mos.
40 00
288. Knee
6 wks.
100 00
208. Astragalus, open
2 mos.
80 00
289. Tibia or fibula
6 wks.
100 00
209. Tarsal bones, others, closed
2 mos.
30 00
290. Foot at ankle joint
6 wks.
75 CO
210. Tarsal bones, others, open
2 mos.
60 00
291. Foot thru metatarsus
6 wks.
75 00
211. Multiple fractures, not in same hand or
292. OsCalcis (Syme's amp.)
6 wks.
100 00
foot: Add to the greater fee a sum equal
293. Phalanx (toe)
6 wks.
30 00
to 50 per cent of each lesser, not exceed-
294. Astragalectomy
2 mos.
100 00
ing two times the greater.
295. Laminectomy or other osteoplastic
2 mos.
200 00
Multiple injuries treated by one doctor, requiring extensive
296. Coccyx, removal
3 wks.
50 00
12.
surgical dressings or care, are to be charged for the
297. Spinal fusion, involving bone inlay
2 mos.
200 00
greatest plus one-half of the lesser fees but limited to
298. Removal of semi-lunar cartilage
2 mos.
100 00
two times the greatest fee. Superficial injuries not
299. Rib excision or resection
3 wks.
50 CO
requiring extensive attention are not to carry cumulative
charges. This Rule does not apply to multiple x-ray
300. Arthrodesis hip
2 mos.
150 00
or pathological examinations.
301. Arthrodesis wrist
2 mos.
100 00
15.
Proration of scheduled unit fee: When the schedule
302. Arthrodesis knee
2 mos.
100 00
specifies a unit fee for a definite treatment and period
of after-care, and the patient is transferred from one to
303. Arthrodesis shoulder
2 mos.
100 00
another physician, the employer (or carrier) is respon-
304. Bone graft - for non-union of femur including post-
sible for the amount stated in the schedule. If the con-
operative therapy
4 mos.
200 00
cerned physicians agree upon amount of proration they
shall render separate bills accordingly; in the event of
305 Bone graft - for non-union of tibia, including post-
no agreement or disagreement, the matter shall be settled
operative therapy
4 mos.
175 00
by the Board of the local County Medical Society of the
306. Bone graft - humerus, including post-operative
first attending physician, or by an arbitration com-
mittee appointed by without cost to the contestants.
therapy
4 mos.
175 00
22.
If in the course of treatment consultation is necessary,
307.
Bone graft - forearm, including post-operative
authorization in accordance with Section 13-A-5 should
therapy
4 mos.
175 00
be obtained except in emergency.
SURGICAL PROCEDURES
DISLOCATIONS
INCISION
250. Tempero-mandibular
10 00
251. Spine, open
6 mos.
150 00
325. Incision for superficial abscess as furuncle or boil
3 00
252. Spine, closed
2 mos.
100 00
326. Incision for abscess, carbuncle with multiple pockets.
00
3 wks.
327. Incision of deep abscess or infection
25 00
253. Shoulder
40 00
254. Shoulder, recurrent - operation
A. & A.
328. Paronychia
5 00
3 wks.
35 00
329. Laparotomy, exploratory only
3 wks.
100 00
255. Elbow, closed
256. Elbow, open
3 wks.
75 00
330. Operation on viscera
A. & A.
5 00
331. Simple bowel resection
3 wks.
150 00
257. Finger, reduction and splint
258. Finger, open
3 wks.
40 00
332. Encephalogram
A. & A.
259. Hip
3 wks.
75 00
333. Osteomyelitis
A. & A.
260. Knee
3 wks.
60 00
EXCISION
261. Ankle
3 wks.
40 00
262. Astragalus, closed
3 wks.
50 00
350. Removal of nail, finger or toe, including local
263. Astragalus, open
2 mos.
100 00
anaesthetic
5 00
264. OsCalcis, closed
3 wks.
50 00
351. Excision of sub-deltoid bursa
3 wks.
50 00
265. OsCalcis, open
2 mos.
100 00
352. Excision of pre-patellar bursa
3 wks.
35 00
266. Toe, reduction and splint
5 00
353. Pilonidal cyst
A. & A.
267. Wrist closed
3 wks.
35 00
354. Ganglion by excision
3 wks.
35 00
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"ocrText": "10\n11\nLine\nLine\nNo.\nItem\nItem\nNo.\nAfter-Care\nAfter-Care\nFee\nFee\n193. Tibia and fibula, open\n2 mos.\n150 00\nAMPUTATIONS\n194. Potts fracture, closed\n2 mos.\n75 00\n275. Arm, disarticulation, uncomplicated\n6 wks.\n150 00\n195. Potts fracture, open\n2 mos.\n110 00\n276. Arm, thru head or neck\n6 wks.\n100 00\n196. Metatarsal bones, closed\n3 wks.\n30 00\n277. Arm, below neck\n6 wks.\n75 00\n197. Metatarsal bones, open\n2 mos.\n75 00\n278. Forearm\n6 wks.\n75 00\n198. Toes - single toe - first toe\n3 wks.\n20 00\n279. Hand at wrist\n6 wks.\n75 00\n199. Toes - single toe - other than first\n3 wks.\n15 00\n280. Carpus\n6 wks.\n60 00\n200. Toes - multiple on same foot\n3 wks.\n25 00\n281. Metacarpus\n6 wks.\n50 00\n201. Sacrum, closed\n3 wks.\n50 00\n282. Phalanx\n6 wks.\n30 00\n202. Pelvis, one bone\n3 wks.\n50 00\n283. Thigh, disarticulation\n6 wks.\n150 00\n203. Pelvis, multiple\n3 wks.\n75 00\n284. Leg at knee\n6 wks.\n100 00\n204. Pelvis, open\nA. & A.\n285. Patella, excision\n6 wks.\n75 00\n205. OsCalcis, closed\n2 mos.\n50 00\n286. Femur, head and neck\n6 wks.\n150 00\n206. OsCalcis, open\n2 mos.\n100 00\n287. Femur\n6 wks.\n100 00\n207. Astragalus, closed\n2 mos.\n40 00\n288. Knee\n6 wks.\n100 00\n208. Astragalus, open\n2 mos.\n80 00\n289. Tibia or fibula\n6 wks.\n100 00\n209. Tarsal bones, others, closed\n2 mos.\n30 00\n290. Foot at ankle joint\n6 wks.\n75 CO\n210. Tarsal bones, others, open\n2 mos.\n60 00\n291. Foot thru metatarsus\n6 wks.\n75 00\n211. Multiple fractures, not in same hand or\n292. OsCalcis (Syme's amp.)\n6 wks.\n100 00\nfoot: Add to the greater fee a sum equal\n293. Phalanx (toe)\n6 wks.\n30 00\nto 50 per cent of each lesser, not exceed-\n294. Astragalectomy\n2 mos.\n100 00\ning two times the greater.\n295. Laminectomy or other osteoplastic\n2 mos.\n200 00\nMultiple injuries treated by one doctor, requiring extensive\n296. Coccyx, removal\n3 wks.\n50 00\n12.\nsurgical dressings or care, are to be charged for the\n297. Spinal fusion, involving bone inlay\n2 mos.\n200 00\ngreatest plus one-half of the lesser fees but limited to\n298. Removal of semi-lunar cartilage\n2 mos.\n100 00\ntwo times the greatest fee. Superficial injuries not\n299. Rib excision or resection\n3 wks.\n50 CO\nrequiring extensive attention are not to carry cumulative\ncharges. This Rule does not apply to multiple x-ray\n300. Arthrodesis hip\n2 mos.\n150 00\nor pathological examinations.\n301. Arthrodesis wrist\n2 mos.\n100 00\n15.\nProration of scheduled unit fee: When the schedule\n302. Arthrodesis knee\n2 mos.\n100 00\nspecifies a unit fee for a definite treatment and period\nof after-care, and the patient is transferred from one to\n303. Arthrodesis shoulder\n2 mos.\n100 00\nanother physician, the employer (or carrier) is respon-\n304. Bone graft - for non-union of femur including post-\nsible for the amount stated in the schedule. If the con-\noperative therapy\n4 mos.\n200 00\ncerned physicians agree upon amount of proration they\nshall render separate bills accordingly; in the event of\n305 Bone graft - for non-union of tibia, including post-\nno agreement or disagreement, the matter shall be settled\noperative therapy\n4 mos.\n175 00\nby the Board of the local County Medical Society of the\n306. Bone graft - humerus, including post-operative\nfirst attending physician, or by an arbitration com-\nmittee appointed by without cost to the contestants.\ntherapy\n4 mos.\n175 00\n22.\nIf in the course of treatment consultation is necessary,\n307.\nBone graft - forearm, including post-operative\nauthorization in accordance with Section 13-A-5 should\ntherapy\n4 mos.\n175 00\nbe obtained except in emergency.\nSURGICAL PROCEDURES\nDISLOCATIONS\nINCISION\n250. Tempero-mandibular\n10 00\n251. Spine, open\n6 mos.\n150 00\n325. Incision for superficial abscess as furuncle or boil\n3 00\n252. Spine, closed\n2 mos.\n100 00\n326. Incision for abscess, carbuncle with multiple pockets.\n00\n3 wks.\n327. Incision of deep abscess or infection\n25 00\n253. Shoulder\n40 00\n254. Shoulder, recurrent - operation\nA. & A.\n328. Paronychia\n5 00\n3 wks.\n35 00\n329. Laparotomy, exploratory only\n3 wks.\n100 00\n255. Elbow, closed\n256. Elbow, open\n3 wks.\n75 00\n330. Operation on viscera\nA. & A.\n5 00\n331. Simple bowel resection\n3 wks.\n150 00\n257. Finger, reduction and splint\n258. Finger, open\n3 wks.\n40 00\n332. Encephalogram\nA. & A.\n259. Hip\n3 wks.\n75 00\n333. Osteomyelitis\nA. & A.\n260. Knee\n3 wks.\n60 00\nEXCISION\n261. Ankle\n3 wks.\n40 00\n262. Astragalus, closed\n3 wks.\n50 00\n350. Removal of nail, finger or toe, including local\n263. Astragalus, open\n2 mos.\n100 00\nanaesthetic\n5 00\n264. OsCalcis, closed\n3 wks.\n50 00\n351. Excision of sub-deltoid bursa\n3 wks.\n50 00\n265. OsCalcis, open\n2 mos.\n100 00\n352. Excision of pre-patellar bursa\n3 wks.\n35 00\n266. Toe, reduction and splint\n5 00\n353. Pilonidal cyst\nA. & A.\n267. Wrist closed\n3 wks.\n35 00\n354. Ganglion by excision\n3 wks.\n35 00"
}