ORAL & MAXILLOFACIAL
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ORAL & MAXILLOFACIAL
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| GROUP O9 - TREATMENT OF FRACTURES |
53400
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MAXILLA, unilateral or bilateral, treatment of fracture of, not requiring splinting
(See para OM4.10 of explanatory notes to this Category)
Fee: $129.20 Benefit: 75% = $96.90 85% = $109.85
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53403
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MANDIBLE, treatment of fracture of, not requiring splinting
(See para OM4.10 of explanatory notes to this Category)
Fee: $157.85 Benefit: 75% = $118.40 85% = $134.20
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53406
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MAXILLA, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (Anaes.) (Assist.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $406.65 Benefit: 75% = $305.00 85% = $345.70
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53409
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MANDIBLE, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (Anaes.) (Assist.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $406.65 Benefit: 75% = $305.00 85% = $345.70
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53410
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ZYGOMATIC BONE, treatment of fracture of, not requiring surgical reduction
(See para OM4.10 of explanatory notes to this Category)
Fee: $85.65 Benefit: 75% = $64.25 85% = $72.85
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53411
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ZYGOMATIC BONE, treatment of fracture of, requiring surgical reduction by a temporal, intra-oral or other approach (Anaes.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $238.80 Benefit: 75% = $179.10 85% = $203.00
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53412
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ZYGOMATIC BONE, treatment of fracture of, requiring surgical reduction and involving internal or external fixation at 1 site (Anaes.) (Assist.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $392.10 Benefit: 75% = $294.10 85% = $333.30
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53413
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ZYGOMATIC BONE, treatment of fracture of, requiring surgical reduction and involving internal or external fixation or both at 2 sites (Anaes.) (Assist.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $480.35 Benefit: 75% = $360.30 85% = $408.30
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53414
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ZYGOMATIC BONE, treatment of fracture of, requiring surgical reduction and involving internal or external fixation or both at 3 sites (Anaes.) (Assist.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $551.85 Benefit: 75% = $413.90 85% = $475.65
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53415
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MAXILLA, treatment of fracture of, requiring open reduction (Anaes.) (Assist.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $435.65 Benefit: 75% = $326.75 85% = $370.35
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53416
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MANDIBLE, treatment of fracture of, requiring open reduction (Anaes.) (Assist.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $435.65 Benefit: 75% = $326.75 85% = $370.35
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53418
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MAXILLA, treatment of fracture of, requiring open reduction and internal fixation not involving plate(s) (Anaes.) (Assist.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $566.35 Benefit: 75% = $424.80 85% = $490.15
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53419
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MANDIBLE, treatment of fracture of, requiring open reduction and internal fixation not involving plate(s) (Anaes.) (Assist.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $566.35 Benefit: 75% = $424.80 85% = $490.15
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53422
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MAXILLA, treatment of fracture of, requiring open reduction and internal fixation involving plate(s) (Anaes.) (Assist.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $718.75 Benefit: 75% = $539.10 85% = $642.55
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53423
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MANDIBLE, treatment of fracture of, requiring open reduction and internal fixation involving plate(s) (Anaes.) (Assist.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $718.75 Benefit: 75% = $539.10 85% = $642.55
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ORAL & MAXILLOFACIAL
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ORAL & MAXILLOFACIAL
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53424
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MAXILLA, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction not involving plate(s) (Anaes.) (Assist.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $616.65 Benefit: 75% = $462.50 85% = $540.45
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53425
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MANDIBLE, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction not involving plate(s) (Anaes.) (Assist.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $616.65 Benefit: 75% = $462.50 85% = $540.45
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53427
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MAXILLA, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction involving the use of plate(s) (Anaes.) (Assist.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $842.25 Benefit: 75% = $631.70 85% = $766.05
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53429
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MANDIBLE, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction involving the use of plate(s) (Anaes.) (Assist.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $842.25 Benefit: 75% = $631.70 85% = $766.05
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53439
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MANDIBLE, treatment of a closed fracture of, involving a joint surface (Anaes.)
(See para OM4.10 of explanatory notes to this Category)
Fee: $238.80 Benefit: 75% = $179.10 85% = $203.00
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53453
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ORBITAL CAVITY, reconstruction of a wall or floor with or without foreign implant (Anaes.) (Assist.)
Fee: $483.25 Benefit: 75% = $362.45 85% = $410.80
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53455
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ORBITAL CAVITY, bone or cartilage graft to orbital wall or floor including reduction of prolapsed or entrapped orbital contents (Anaes.) (Assist.)
Fee: $567.65 Benefit: 75% = $425.75 85% = $491.45
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53458
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NASAL BONES, treatment of fracture of, not being a service to which item 53459 or 53460 applies
Fee: $43.05 Benefit: 75% = $32.30 85% = $36.60
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53459
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NASAL BONES, treatment of fracture of, by reduction (Anaes.)
Fee: $235.50 Benefit: 75% = $176.65 85% = $200.20
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53460
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NASAL BONES, treatment of fractures of, by open reduction involving osteotomies (Anaes.) (Assist.)
Fee: $480.35 Benefit: 75% = $360.30 85% = $408.30
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