Schedule Subgroup 1 — General - Health Insurance (1995-96 Diagnostic Imaging Services Table) Regulations - Subgroup 1 — General

Subgroup 1 — General

<table cellspacing="0" cellpadding="0" style="border-collapse:collapse"><thead><tr><td style="width:37.15pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableColHead"><span>Item</span></p></td><td colspan="3" style="width:251.45pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableColHead"><span>Diagnostic imaging service</span></p></td><td colspan="3" style="width:45.9pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableColHead"><span>Fee</span></p></td></tr></thead><tbody><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>55028</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; font-size:11pt"><span>Head, ultrasound scan of, performed by, or on behalf of, a medical practitioner, if:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the first mentioned practitioner is a member (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$98.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55029</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Head, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$34.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55030</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Orbital contents, ultrasound scan of, performed by, or on behalf of, a medical practitioner, if:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the first mentioned practitioner is a member (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$98.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55031</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Orbital contents, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$34.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span>55032</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; page-break-after:avoid; font-size:11pt"><span>Neck, 1 or more structures of, ultrasound scan of, performed by, or on behalf of, a medical practitioner, if:</span></p><p class="TableP1a" style="margin-bottom:3pt; page-break-after:avoid"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies; and</span></p><p class="TableP1a" style="page-break-after:avoid"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the first mentioned practitioner is a member (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span>$98.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55033</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Neck, 1 or more structures of, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$34.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55034</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Breast, 1 or both, ultrasound scan of, performed by, or on behalf of, a medical practitioner, if:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the first mentioned practitioner is a member (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$98.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55035</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Breast, 1 or both, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$34.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55036</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Abdomen, ultrasound scan of, including scan of urinary tract when undertaken, performed by, or on behalf of, a medical practitioner, if:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the first mentioned practitioner is a member (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$98.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55037</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableText" style="margin-top:12pt"><span>Abdomen, ultrasound scan of, including scan of urinary tract when undertaken, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span></span><span>$34.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55038</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Urinary tract, ultrasound scan of, performed by, or on behalf of, a medical practitioner, if:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which item 55055 or an item in Subgroup 2 or 3 of this Group applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the first mentioned practitioner is a member (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$98.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55039</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Urinary tract, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$34.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55040</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Pelvis or abdomen, pregnancy related or pregnancy complication, ultrasound scan of, by any or all approaches, performed by, or on behalf of, a medical practitioner, if:</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies; and</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$98.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span></span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableP1a" style="page-break-after:avoid"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the first mentioned practitioner is a member (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span></span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55041</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Pelvis or abdomen, pregnancy related or pregnancy complication, ultrasound scan of, by any or all approaches, if the patient is not referred by a medical practitioner for ultrasonic examination</span><span> </span><span>— each ultrasonic examination, not exceeding 2 examinations in any 1 pregnancy, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$34.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span>55042</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Pelvis, female, ultrasound scan of, by any or all approaches, performed by, or on behalf of, a medical practitioner, if:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the first mentioned practitioner is a member (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$98.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55043</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Pelvis, female, ultrasound scan of, by any or all approaches, if the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$34.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55044</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Pelvis, male, ultrasound scan of, by any or all approaches, performed by, or on behalf of, a medical practitioner, if:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies; and</span></p><p class="TableP1a"><span></span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$98.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span></span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableP1a" style="page-break-after:avoid"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the first mentioned practitioner is a member (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span></span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55045</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Pelvis, male, ultrasound scan of, by any or all approaches, if the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$34.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span>55048</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Scrotum, ultrasound scan of, performed by, or on behalf of, a medical practitioner, if:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the first mentioned practitioner is a member (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$99.15</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55049</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableText" style="margin-top:12pt"><span>Scrotum, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$34.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55050</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Musculo-skeletal, 1 or more regions, ultrasound scan of, performed by, or on behalf of, a medical practitioner, if:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the first mentioned practitioner is a member (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$99.15</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span>55051</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span>Musculo-skeletal, 1 or more regions, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055,or an item in Subgroup 2 or 3 of this Group, applies (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span>$34.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55052</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Joint, 1 or more, ultrasound scan of, performed by, or on behalf of, a medical practitioner, if:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for ultrasonic examination, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the referring medical practitioner is not a member of a group of practitioners of which the first mentioned practitioner is a member (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$98.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55053</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Joint, 1 or more, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$34.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55054</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Ultrasonic cross-sectional echography, in conjunction with a surgical procedure, using interventional techniques, not being a service associated with a service to which any other item in this Group applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$98.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55055</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Orbital contents, ultrasonic echography of, unidimensional, not being a service associated with a service to which another item in this Group applies (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$59.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55056</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Ultrasound scan not otherwise specified, not being a service associated with a service to which item 55055, or an item in Subgroups 2 or 3 of this Group, applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$5.20</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span>55057</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Ultrasound scan not otherwise specified, not being a service associated with a service to which item 55055, or an item in Subgroups 2 or 3 of this Group, applies (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$5.20</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55058</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Measurement of umbilical blood flow using pulsed wave or continuous wave Doppler techniques after the 26th week of gestation, if:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>the patient is referred by a medical practitioner for this procedure; and</span></p><p class="TableP1a"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>there is reason to suspect intrauterine growth retardation or a significant risk of foetal death; not being a service associated with a service to which an item in this Group applies</span><span> </span><span>— examination and report (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$26.95</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 2</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Cardiac</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55102</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>M-Mode and 2-dimensional real time echocardiographic examination of the heart from at least 2 thoracic windows:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>that is performed using a mechanical sector scanner or phased array transducer, with measurement of blood flow velocities across the cardiac valves; and</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>that uses pulsed wave and continuous wave Doppler techniques; and</span></p><p class="TableP1a" style="margin-bottom:6pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>with recordings on video tape;</span></p><p class="TableText"><span>not being a service associated with a service to which an item in Subgroup 1 (except item 55054) or 4 of this Group applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$162.05</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:18pt; page-break-inside:avoid; font-size:11pt"><span>55105</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:18pt; margin-bottom:3pt; page-break-inside:avoid; font-size:11pt"><span>M-Mode and 2-dimensional real time echocardiographic examination of the heart from at least 2 thoracic windows:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>that is performed using a mechanical sector scanner or phased array transducer; and</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>with measurement of cardiac dimensions; and</span></p><p class="TableP1a" style="margin-bottom:6pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>with recordings on video tape;</span></p><p class="TableText"><span>not being a service associated with a service to which an item in Subgroup 1 (except item 55054) or 4 of this Group applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:18pt; page-break-inside:avoid; font-size:11pt"><span>$91.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:18pt; page-break-inside:avoid; font-size:11pt"><span>55112</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:18pt; margin-bottom:3pt; page-break-inside:avoid; font-size:11pt"><span>M-Mode and 2-dimensional real time echocardiographic examination of the heart from at least 2 thoracic windows:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>that is performed using a mechanical sector scanner or phased array transducer; and</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>with measurement of blood flow velocities across the cardiac valves using:</span></p><p class="TableP2i" style="margin-bottom:3pt"><span style="width:25.87pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.15pt; text-indent:0pt; display:inline-block"> </span><span>pulsed wave and continuous wave Doppler techniques; and</span></p><p class="TableP2i" style="margin-bottom:3pt"><span style="width:22.81pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.15pt; text-indent:0pt; display:inline-block"> </span><span>real time colour flow mapping from at least 2 thoracic windows; and</span></p><p class="TableP2i" style="margin-bottom:6pt"><span style="width:19.76pt; text-indent:0pt; display:inline-block"></span><span>(iii)</span><span style="width:7.15pt; text-indent:0pt; display:inline-block"> </span><span>recordings on video tape;</span></p><p class="TableText"><span>not being a service associated with a service to which an item in Subgroup 1 (except item 55054) or 4 of this Group applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:18pt; page-break-inside:avoid; font-size:11pt"><span>$250.60</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55118</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Heart, 2 dimensional real time transoesophageal examination of, from at least 2 oesophageal windows:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>that is performed using a mechanical sector scanner or phased array transducer; and</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>with measurement of blood flow velocities across the cardiac valves using:</span></p><p class="TableP2i" style="margin-bottom:3pt"><span style="width:25.87pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.15pt; text-indent:0pt; display:inline-block"> </span><span>pulsed wave and continuous Doppler techniques; and</span></p><p class="TableP2i" style="margin-bottom:3pt"><span style="width:22.81pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.15pt; text-indent:0pt; display:inline-block"> </span><span>real time colour flow mapping from at least 2 oesophageal windows; and</span></p><p class="TableP2i" style="margin-bottom:6pt"><span style="width:19.76pt; text-indent:0pt; display:inline-block"></span><span>(iii)</span><span style="width:7.15pt; text-indent:0pt; display:inline-block"> </span><span>recordings on video tape;</span></p><p class="TableText"><span>not being a service associated with a service to which an item in Subgroup 1 (except item 55054) or 4 of this Group applies (R) (Anaes. 17708 = 6B + 2T)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$250.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span>55130</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Intra-operative 2-dimensional real time transoesophageal echocardiography incorporating:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>Doppler techniques with colour flow mapping; and</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>recording onto video tape; and</span></p><p class="TableP1a"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>sequential assessment of cardiac function before and after the surgical procedure (R) (Anaes. 17710</span><span> </span><span>= 6B + 4T)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$357.15</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="ScheduleHeading"><span style="font-weight:normal; font-style:italic">Subgroup 3</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Vascular</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55201</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>carotid vessels (with or without vertebral arteries); or</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>peripheral vessels (excluding the cavernosal artery and dorsal artery of the penis) (with or without intra-abdominal studies necessary for views of the lower aorta); or</span></p><p class="TableP1a" style="margin-bottom:6pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>intra-thoracic or intra-abdominal vascular structures (excluding cardiac and pregnancy related studies);</span></p><p class="TableText"><span>not being a service associated with a service to which an item in Subgroup 1 (except item 55054) or 4 of this Group applies</span><span> </span><span>— 1 examination and report (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$170.60</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:9pt; margin-bottom:9pt; font-size:11pt"><span>55204</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:9pt; margin-bottom:9pt; font-size:11pt"><span>2 or more examinations of the kind referred to in item 55201 and report</span><span> </span><span>— not being a service associated with a service to which an item in Subgroups 1 (except item 55054) or 4 of this Group applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:9pt; margin-bottom:9pt; font-size:11pt"><span>$293.20</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:9pt; margin-bottom:9pt; font-size:11pt"><span>55207</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:9pt; margin-bottom:9pt; font-size:11pt"><span>Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of the cavernosal artery of the penis following intracavernosal administration of a vasoactive agent, performed during the period of pharmacological activity of the injected agent, to confirm a diagnosis of vascular aetiology for impotence, where a specialist in diagnostic radiology, urology or general surgery (sub-specialising in vascular surgery) attends the patient in person at the practice location where the service is rendered, immediately prior to or for a period during the rendering of the service, and that specialist interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup 1 (except item 55054) or 4 of this Group applies—examination and report (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:9pt; margin-bottom:9pt; font-size:11pt"><span>$170.60</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55210</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of cavernosal tissue of the penis to confirm a diagnosis and, where indicated, assess the progress and management of:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>apriapism; or</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>fibrosis of any type; or</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>fracture of the tunica; or</span></p><p class="TableP1a" style="margin-bottom:6pt"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(d)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>arteriovenous malformations;</span></p><p class="TableText"><span>where a specialist in diagnostic radiology, urology or general surgery (sub-specialising in vascular surgery) attends the patient in person at the practice location where the service is rendered, immediately prior to or for a period during the rendering of the service, and that specialist interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup 1 (except item 55054) or 4 of this Group applies-examination and report (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$170.60</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55225</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of carotid vessels, with oculoplethysmography, not being a service associated with a service to which an item in Subgroup 1 (except item 55054) or 4 of this Group applies</span><span> </span><span>— examination and report (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$204.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span>55231</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span>Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis, of peripheral vessels (excluding the cavernosal artery and dorsal artery of the penis) and carotid vessels, with oculoplethysmography, not being a service associated with a service to which an item in Subgroups 1 (with the exception of item 55054) or 4 of this Group applies</span><span> </span><span>— examination and report (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span>$330.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55234</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis, of peripheral vessels (excluding the cavernosal artery and dorsal artery of the penis), including a service referred to in item 11603, 11606 or 11609, not being a service associated with a service to which an item in Subgroup 1 (except item 55054) or 4 of this Group applies</span><span> </span><span>— examination and report (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$198.30</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55237</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of peripheral vessels before measured exercise using treadmill or bicycle ergometer, and measurement of pressure:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>after exercise for 10 minutes; or</span></p><p class="TableP1a" style="margin-bottom:6pt"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>until pressure is normal (unilateral or bilateral);</span></p><p class="TableText"><span>not being a service associated with a service to which an item in Subgroup 1 (except mitem 55054) or 4 of this Group applies</span><span> </span><span>— examination and report (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$218.55</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="ScheduleHeading"><span style="font-weight:normal; font-style:italic">Subgroup 4</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Urological</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>55300</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Prostate, bladder base and urethra, transrectal ultrasound scan of, if performed:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>personally by a medical practitioner (not being the medical practitioner who assessed a patient referred to in paragraph (c)), using a transducer probe or probes with a nominal frequency of 7 to 7.5 megahertz or a nominal frequency range that:</span></p><p class="TableP2i" style="margin-bottom:3pt"><span style="width:25.87pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.15pt; text-indent:0pt; display:inline-block"> </span><span>includes frequencies of 7 to 7.5 megahertz; and</span></p><p class="TableP2i" style="margin-bottom:3pt"><span style="width:22.81pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.15pt; text-indent:0pt; display:inline-block"> </span><span>can obtain both axial and sagittal scans in 2 planes at right angles; and</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>following a digital rectal examination of the prostate by that medical practitioner; and</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>on a patient who has been assessed by a specialist in urology, radiation oncology or medical oncology or a consultant physician in medical oncology who has:</span></p><p class="TableP2i" style="margin-bottom:3pt"><span style="width:25.87pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.15pt; text-indent:0pt; display:inline-block"> </span><span>examined the patient in the 60 days prior to the scan; and</span></p><p class="TableP2i"><span style="width:22.81pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.15pt; text-indent:0pt; display:inline-block"> </span><span>recommended the scan for the management of the patient’s current prostatic disease (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:9pt; font-size:11pt"><span>$98.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:9pt; font-size:11pt"><span>55303</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span>Prostate, bladder base and urethra, transrectal ultrasound scan of, if performed:</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(a)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>personally by a medical practitioner who undertook the assessment referred to in paragraph (c) using a transducer probe, or probes, with a nominal frequency of 7 to 7.5 megahertz or a nominal frequency range that:</span></p><p class="TableP2i" style="margin-bottom:3pt"><span style="width:25.87pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.15pt; text-indent:0pt; display:inline-block"> </span><span>includes frequencies of 7 to 7.5 megahertz; and</span></p><p class="TableP2i" style="margin-bottom:3pt"><span style="width:22.81pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.15pt; text-indent:0pt; display:inline-block"> </span><span>can obtain both axial and sagittal scans in 2 planes at right angles; and</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:7.57pt; text-indent:0pt; display:inline-block"></span><span>(b)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>following a digital rectal examination of the prostate by that medical practitioner; and</span></p><p class="TableP1a" style="margin-bottom:3pt"><span style="width:8.19pt; text-indent:0pt; display:inline-block"></span><span>(c)</span><span style="width:6.25pt; text-indent:0pt; display:inline-block"> </span><span>on a patient who has been assessed by a specialist in urology, radiation oncology or medical oncology or a consultant physician in medical oncology who has:</span></p><p class="TableP2i" style="margin-bottom:3pt"><span style="width:25.87pt; text-indent:0pt; display:inline-block"></span><span>(i)</span><span style="width:7.15pt; text-indent:0pt; display:inline-block"> </span><span>examined the patient in the 60 days prior to the scan; and</span></p><p class="TableP2i"><span style="width:22.81pt; text-indent:0pt; display:inline-block"></span><span>(ii)</span><span style="width:7.15pt; text-indent:0pt; display:inline-block"> </span><span>recommended the scan for the management of the patient’s current prostatic disease (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:9pt"><span>$98.75</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:70.9pt; text-indent:-70.9pt"><span>Group I2</span><span style="width:13.34pt; text-indent:0pt; display:inline-block"> </span><span>Computerised tomography (excluding magnetic resonance imaging)</span></p></td><td style="vertical-align:top"></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 1</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Computerised tomography on a body scanner and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>56000</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of brain with or without scan of internal auditory meatus without intravenous contrast medium, not being a service to which item 57000 or 57100 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$147.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56003</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of brain with or without scan of internal auditory meatus with intravenous contrast medium, not being a service to which item 57003 or 57103 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$204.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56006</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of brain with or without scan of internal auditory meatus without intravenous contrast medium (minimum of 8 slices) with intravenous contrast medium, not being a service to which item 57006 or 57106 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$241.90</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56009</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of pituitary fossa by multiple thin slices (including reconstructions) with or without intravenous contrast medium or brain scan (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$489.35</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56012</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of orbits by multiple thin slices (including reconstructions), with or without intravenous contrast medium or brain scan (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$483.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56015</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of middle ear and temporal bone, unilateral or bilateral, detailed study by multiple thin slices (including reconstructions) with or without intravenous contrast medium or brain scan (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$472.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56018</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of temporal bones with air study (including reconstructions), including intrathecal injection but not including an associated brain scan (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$380.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56021</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of 1 or more regions of facial bones, sinuses and salivary glands without intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$264.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56024</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of 1 or more regions of facial bones, sinuses and salivary glands with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$281.20</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56027</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of 1 or more regions of facial bones, sinuses and salivary glands without and with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$399.30</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56100</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of 1 or more regions of soft tissues of the neck, including larynx, pharynx and upper oesophagus (not associated with cervical spine) without intravenous contrast medium, not being a service to which item 56900 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$380.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56103</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan 1 or more regions of soft tissues of the neck, including larynx, pharynx and upper oesophagus (not associated with cervical spine), with intravenous contrast medium, not being a service to which item 56903 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$410.55</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56106</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan 1 or more regions of soft tissues of the neck, including larynx, pharynx and upper oesophagus (not associated with cervical spine), without and with intravenous contrast medium, not being a service to which item 56906 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$449.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56200</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of spine, 1 or more regions, 25 slices or less without intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$186.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56203</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of spine, 1 or more regions, 25 slices or less with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$218.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56206</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of spine, 1 or more regions, 25 slices or less without and with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$292.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56209</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of spine, 1 or more regions, 26 or more slices without intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$264.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56212</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of spine, 1 or more regions, 26 or more slices with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$292.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>6215</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of spine, 1 or more regions, 26 or more slices without and with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>$410.55</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56218</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of spine, 1 or more regions with intrathecal contrast medium, not including the preparation by intrathecal injection of contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$264.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56300</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of chest, including lungs, mediastinum and pleura, without intravenous contrast medium, not being a service to which item 56700, 56800, 56900, 57000 or 57100 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$264.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56303</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of chest, including lungs, mediastinum and pleura, with intravenous contrast medium, not being a service to which item 56703, 56803, 56903, 57003 or 57103 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$303.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56306</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of chest, including lungs, mediastinum and pleura, without intravenous contrast medium (minimum of 8 slices) and with intravenous contrast medium, not being a service to which item 56706, 56806, 56906, 57006 or 57106 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$382.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56400</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of upper abdomen (diaphragm to iliac crest) or pelvis without intravenous contrast medium, not being a service to which item 56700, 56800, 56900 or 57100 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$147.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56403</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of upper abdomen (diaphragm to iliac crest) or pelvis with intravenous contrast medium, not being a service to which item 56703, 56803, 56903 or 57103 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$180.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56406</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of upper abdomen (diaphragm to iliac crest) or pelvis without intravenous contrast medium (minimum of 8 slices) and with intravenous contrast medium, not being a service to which item 56706, 56806, 56906 or 57106 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$292.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56500</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of upper abdomen and pelvis without intravenous contrast medium, not being a service to which item 56700, 56800, 56900 or 57100 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$226.05</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56503</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of upper abdomen and pelvis with intravenous contrast medium, not being a service to which item 56703, 56803, 56903 or 57103 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$269.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56506</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of upper abdomen and pelvis without intravenous contrast medium (minimum of 8 slices) and with intravenous contrast medium, not being a service to which item 56706, 56806, 56906 or 57106 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$382.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56600</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of extremities, 1 or more regions involving up to 20 slices without intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$147.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56603</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of extremities, 1 or more regions involving up to 20 slices with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$180.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56606</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of extremities, 1 or more regions involving up to 20 slices without and with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$218.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56609</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of extremities, 1 or more regions involving more than 20 slices but not more than 40 slices without intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$186.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56612</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of extremities, 1 or more regions involving more than 20 slices but not more than 40 slices with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$218.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56615</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of extremities, 1 or more regions involving more than 20 slices but not more than 40 slices without and with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$292.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56618</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of extremities, 1 or more regions involving more than 40 slices without intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$264.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56621</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of extremities, 1 or more regions involving more than 40 slices with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$292.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56624</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of extremities, 1 or more regions involving more than 40 slices without and with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$371.15</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56700</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of chest and upper abdomen (from lung apices to iliac crest) without intravenous contrast medium, not being a service to which item 56800, 56900 or 57100 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$264.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56703</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of chest and upper abdomen (from lung apices to iliac crest) with intravenous contrast medium, not being a service to which item 56803, 56903 or 57103 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$309.30</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56706</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of chest and upper abdomen (from lung apices to iliac crest) without and with intravenous contrast medium, not being a service to which item 56806, 56906 or 57106 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$388.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56800</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of chest, abdomen and pelvis without intravenous contrast medium, not being a service to which item 56900 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$344.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56803</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of chest, abdomen and pelvis with intravenous contrast medium, not being a service to which item 56903 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$388.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56806</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of chest, abdomen and pelvis without and with intravenous contrast medium, not being a service to which item 56906 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$545.55</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56900</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of neck, chest, abdomen and pelvis without intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$497.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56903</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of neck, chest, abdomen and pelvis with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$545.55</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>56906</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of neck, chest, abdomen and pelvis without and with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$658.05</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57000</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of brain and chest without intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$264.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57003</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of brain and chest with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$309.30</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57006</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of brain and chest without and with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$427.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57100</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of chest and upper abdomen (from lung apices to iliac crest) and scan of brain without intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$380.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57103</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of chest and upper abdomen (from lung apices to iliac crest) and scan of brain with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$427.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57106</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of chest and upper abdomen (from lung apices to iliac crest) and scan of brain without and with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$545.55</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57200</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— pelvimetry (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$147.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57300</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— dynamic scan of region, not being a service associated with a service to which another item in this Group applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$180.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57303</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— dynamic scan of region, being a service associated with a service to which another item in this Group applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Amount under rule 10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57340</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which another item in this table applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$266.55</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 2</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Computerised tomography on a brain scanner and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>57400</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of brain without intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$74.90</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57403</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of brain with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$91.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57406</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Computerised tomography</span><span> </span><span>— scan of brain without and with intravenous contrast medium (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$141.75</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt"><span>Group I3</span><span style="width:14.44pt; display:inline-block"> </span><span>Diagnostic radiology</span></p></td><td style="vertical-align:top"></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 1</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Radiographic examination of extremities and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span>57500</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span>Digits or phalanges</span><span> </span><span>— all or any of either hand or either foot (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; page-break-after:avoid; font-size:11pt"><span>$30.85</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57503</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digits or phalanges</span><span> </span><span>— all or any of either hand or either foot (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$41.15</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57506</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Hand, wrist, forearm, elbow or arm (elbow to shoulder) (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$30.85</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57509</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Hand, wrist, forearm, elbow or arm (elbow to shoulder) (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$41.15</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57512</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Hand, wrist and lower forearm or upper forearm and elbow or elbow and arm (elbow to shoulder) (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$41.90</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57515</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Hand, wrist and lower forearm or upper forearm and elbow or elbow and arm (elbow to shoulder) (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$55.90</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57518</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Foot, ankle, lower leg, upper leg, knee or thigh (femur) (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$33.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57521</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Foot, ankle, lower leg, upper leg, knee or thigh (femur) (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$44.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57524</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Foot, ankle and lower leg or upper leg and knee (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$51.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57527</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Foot, ankle and lower leg or upper leg and knee (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$68.10</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 2</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Radiographic examination of shoulder or pelvis and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>57700</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Shoulder or scapula (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$41.90</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57703</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Shoulder or scapula (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$55.90</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57706</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Clavicle (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$33.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57709</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Clavicle (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$44.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57712</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Hip joint (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$48.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57715</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Pelvic girdle (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$62.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57718</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Sacro-iliac joints (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$62.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>57721</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>Femur, internal fixation of neck or intertrochanteric (pertrochanteric) fracture (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>$102.75</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 3</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Radiographic examination of head and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>57900</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Skull (calvarium) (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$66.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57903</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Sinuses (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$48.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57906</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Mastoids (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$66.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57909</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Petrous temporal bones (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$66.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57912</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Facial bones</span><span> </span><span>— orbit, maxilla or malar, any or all (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$48.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57915</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Mandible (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$48.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57918</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Salivary calculus (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$48.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57921</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Nose (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$48.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57924</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Eye (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$48.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57927</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Temporo-mandibular joints (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$51.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57930</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Teeth</span><span> </span><span>— single area (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$34.05</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57933</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Teeth</span><span> </span><span>— full mouth (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$80.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57936</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Teeth</span><span> </span><span>— orthopantomography (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$49.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57939</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Palato-pharyngeal studies with fluoroscopic screening (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$66.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57942</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Palato-pharyngeal studies without fluoroscopic screening (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$51.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>57945</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Larynx (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$44.95</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 4</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Radiographic examination of spine and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>58100</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Spine</span><span> </span><span>— cervical (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$66.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58103</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Spine</span><span> </span><span>— thoracic (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$57.15</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58106</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Spine</span><span> </span><span>— lumbo-sacral (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$78.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58109</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Spine</span><span> </span><span>— sacro-coccygeal (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$48.20</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58112</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Spine</span><span> </span><span>— 2 regions (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$98.90</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58115</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Spine</span><span> </span><span>— 3 or more regions (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$136.20</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58118</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Spine</span><span> </span><span>— functional views of 1 area (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$21.35</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 5</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Bone age study and skeletal survey and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>58300</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Bone age study, wrist and knee (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$48.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58303</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Bone age study, wrist (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$41.15</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58306</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Skeletal survey involving 4 or more regions (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$92.55</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 6</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Radiographic examination of thoracic region and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>58500</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Chest (lung fields) by direct radiography (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$36.60</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58503</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Chest (lung fields) by direct radiography (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$48.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58506</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Chest (lung fields) by direct radiography with fluoroscopic screening (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$62.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58509</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Thoracic inlet or trachea (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$41.15</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58512</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Chest by miniature radiography (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$22.65</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58515</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cardiac examination (including barium swallow) (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$47.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58518</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cardiac examination (including barium swallow) (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$62.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58521</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Sternum or ribs on 1 side (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$44.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58524</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Sternum and ribs on 1 side or ribs on both sides (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$58.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58527</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Sternum and ribs on both sides (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$71.95</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 7</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Radiographic examination of urinary tract and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>58700</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Plain renal only (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$48.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58703</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Drip-infusion pyelography (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$136.20</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58706</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Intravenous pyelography, including preliminary plain film (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$128.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58709</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Intravenous pyelography, including preliminary plain film and limited tomography, involving up to 3 tomographic cuts (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$159.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58712</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Intravenous pyelography, including preliminary plain film with delayed examination for the cysto-ureteric reflux (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$161.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58715</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Antegrade or retrograde pyelography including preliminary plain film (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$102.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58718</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Retrograde cystography or retrograde urethrography (R) (Anaes. 17705 = 3B + 2T)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$68.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58721</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Retrograde micturating cysto-urethrography (R) (Anaes. 17705 = 3B + 2T)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$80.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58724</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Retro-peritoneal pneumogram (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$51.40</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 8</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Radiographic examination of alimentary tract and biliary system and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>58900</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Plain abdominal only, not being a service associated with a service to which item 58909, 58912, 58915 or 58924 applies (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$36.60</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58903</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Plain abdominal only, not being a service associated with a service to which item 58909, 58912, 58915 or 58924 applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$48.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58906</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Oesophagus, with or without examination for foreign body or barium swallow (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$69.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58909</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Barium or other opaque meal of oesophagus, stomach and duodenum, with or without screening of chest and with or without preliminary plain film (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$95.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58912</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Barium or other opaque meal of oesophagus, stomach, duodenum and follow through to colon, with or without screening of chest and with or without preliminary plain film (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$113.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58915</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Barium or other opaque meal, small bowel series only, with or without preliminary plain film (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$80.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58918</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Opaque enema (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$95.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58921</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Opaque enema, including air contrast study (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$113.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58924</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Graham’s test (cholecystography), including preliminary abdominal radiography (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$80.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58927</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cholegraphy direct</span><span> </span><span>— operative or post-operative (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$78.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58930</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cholegraphy</span><span> </span><span>— intravenous (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$113.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58933</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cholegraphy</span><span> </span><span>— percutaneous transhepatic (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$92.55</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>58936</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cholegraphy</span><span> </span><span>— drip infusion (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$154.20</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 9</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Radiographic examination for localisation of foreign bodies and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>59100</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Foreign body in eye (special method, Sweet’s or other) (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$68.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59103</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Foreign body, localisation of and report, not being a service to which another item in this Group applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Amount under rule</span><span> </span><span>11</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 10</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Radiographic examination of breasts and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>59300</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Radiographic examination of both breasts (with or without thermography) and report where the patient is referred with a specific request for this procedure and there is reason to suspect the presence of malignancy in the breasts because of the past occurrence of breast malignancy in the patient or members of the patient’s family or because symptoms or indications of malignancy were found on an examination of the patient by a medical practitioner (R) (S)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$80.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59303</span></p></td><td colspan="4" style="width:254.1pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Radiographic examination of one breast (with or without thermography) and report where the patient is referred with a specific request for this procedure and there is reason to suspect the presence of malignancy in the breast because of the past occurrence of breast malignancy in the patient or members of the patient’s family or because symptoms or indications of malignancy were found on an examination of the patient by a medical practitioner (R) (S)</span></p></td><td colspan="2" style="width:43.25pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$48.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59306</span></p></td><td colspan="4" style="width:254.1pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Mammary ductogram (galactography)</span><span> </span><span>— 1 breast (R)</span></p></td><td colspan="2" style="width:43.25pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$93.35</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59309</span></p></td><td colspan="4" style="width:254.1pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Mammary ductogram (galactography)</span><span> </span><span>— 2 breasts (R)</span></p></td><td colspan="2" style="width:43.25pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$186.75</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 11</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Radiographic examination in connection with pregnancy and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>59500</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Pregnant uterus (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$50.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59503</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Pelvimetry or placentography (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$92.55</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59506</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Control X-rays in conjunction with intrauterine foetal blood transfusion (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$68.10</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 12</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Radiographic examination with opaque or contrast media and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>59700</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Discography</span><span> </span><span>— 1 disc (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$71.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59703</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Dacryocystography</span><span> </span><span>— 1 side (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$48.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59706</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Encephalography (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$106.65</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59709</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cerebral ventriculography (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$92.55</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59712</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Hysterosalpingography (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$69.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59715</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Bronchography</span><span> </span><span>— 1 side (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$102.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59718</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Phlebography</span><span> </span><span>— 1 side (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$102.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59721</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Splenography (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$102.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59724</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Myelography</span><span> </span><span>— 1 region (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$123.35</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59727</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Myelography</span><span> </span><span>— 2 regions (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$205.60</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59730</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Myelography</span><span> </span><span>— 3 regions (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$276.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59733</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Sialography</span><span> </span><span>— 1 side (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$69.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59736</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Vasoepididymography</span><span> </span><span>— 1 side (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$69.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59739</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Sinuses and fistulae (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Amount under rule 11</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59742</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Laryngography with contrast media (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$51.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59745</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Pneumoarthrography (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$43.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59748</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Arthrography</span><span> </span><span>— contrast (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$51.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59751</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Arthrography</span><span> </span><span>— double contrast (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$89.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59754</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lymphangiography, including follow up radiography (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$68.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59757</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Pneumomediastinum (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$62.95</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 13</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Angiography and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>59900</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Serial angiocardiography (rapid cassette changing)</span><span> </span><span>— each series (R) (Anaes. 17711 = 7B + 4T)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$86.60</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59903</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Serial angiocardiography (single plane)</span><span> </span><span>— each series (R) (Anaes. 17711 = 7B + 4T)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$119.20</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59906</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Serial angiocardiography (bi-plane)</span><span> </span><span>— each series (R) (Anaes. 17711 = 7B + 4T)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$119.20</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59912</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Selective coronary arteriography (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$314.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59915</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cerebral angiography</span><span> </span><span>— 1 side (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$80.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59918</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Arteriography, peripheral</span><span> </span><span>— 1 side (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$102.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59921</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Aortography (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$102.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>59924</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Selective arteriography</span><span> </span><span>— per injection and film or data acquisition run (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$102.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60000</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of head and neck with or without arch aortography, 1 to 3 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$522.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60003</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of head and neck with or without arch aortography, 4 to 6 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$767.65</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60006</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of head and neck with or without arch aortography, 7 to 9 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$1,092.85</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60009</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of head and neck with or without arch aortography, 10 or more data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$1,279.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60012</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of thorax, 1 to 3 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$522.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60015</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of thorax, 4 to 6 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$767.65</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60018</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of thorax, 7 to 9 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$1,092.85</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60021</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of thorax, 10 or more data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$1,279.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60024</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of abdomen, 1 to 3 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$522.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60027</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of abdomen, 4 to 6 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$767.65</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60030</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of abdomen, 7 to 9 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$1,092.85</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60033</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of abdomen, 10 or more data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$1,279.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60036</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of upper limb or limbs, 1 to 3 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$522.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60039</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of upper limb or limbs, 4 to 6 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$767.65</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60042</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of upper limb or limbs, 7 to 9 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$1,092.85</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60045</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of upper limb or limbs, 10 or more data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$1,279.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60048</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of lower limb or limbs, 1 to 3 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$522.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60051</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of lower limb or limbs, 4 to 6 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$767.65</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60054</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of lower limb or limbs, 7 to 9 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$1,092.85</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60057</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of lower limb or limbs, 10 or more data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$1,279.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60060</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of aorta and lower limb or limbs, 1 to 3 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$522.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60063</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of aorta and lower limb or limbs, 4 to 6 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$767.65</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60066</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of aorta and lower limb or limbs, 7 to 9 data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$1,092.85</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60069</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Digital subtraction angiography, examination of aorta and lower limb or limbs, 10 or more data acquisition runs (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$1,279.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60072</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Selective arteriography or selective venography by digital subtraction angiography technique, 1 vessel (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$44.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60075</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Selective arteriography or selective venography by digital subtraction angiography technique, 2 vessels (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$89.60</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60078</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Selective arteriography or selective venography by digital subtraction angiography technique, 3 or more vessels (NR)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$134.35</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 14</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Tomography and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>60100</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Tomography of any region and report (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$62.95</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 15</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Stereoscopic examination and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>60300</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Stereoscopic examination of any region and report (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Amount under rule</span><span> </span><span>11</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 16</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Fluoroscopic examination and report</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>60500</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Fluoroscopy, with general anaesthesia, not being a service associated with a radiographic examination (R) (Anaes. 17707 = 5B + 2T)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$44.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60503</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Fluoroscopy without general anaesthesia, not being a service associated with a radiographic examination (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$30.85</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60506</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Fluoroscopy using a mobile image intensifier, in conjunction with a surgical procedure lasting less than 1 hour, not being a service associated with a service to which another item in this table applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$66.05</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60509</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Fluoroscopy using a mobile image intensifier, in conjunction with a surgical procedure lasting 1 hour or more, not being a service associated with a service to which another item in this table applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$102.35</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 17</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Examination and report to which no other Item applies</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>60700</span></p></td><td colspan="3" style="width:251.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Radiographic examination of region and report not being a service to which another item in this Group applies (R)</span></p></td><td colspan="3" style="width:45.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$5.20</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 18</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Preparation for radiological procedure</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>60900</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Encephalography (NR) (Anaes. 17711 = 7B + 4T)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$187.55</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60903</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cerebral angiography, 1 side</span><span> </span><span>— percutaneous, catheter or open exposure (NR) (Anaes. 17710 = 5B + 5T)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$132.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60906</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cerebral ventriculography (NR) (Anaes. 17710 =</span><br><span>5B + 5T)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$180.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60909</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Dacryocystography</span><span> </span><span>— 1 side (NR)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$41.15</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60912</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Bronchography</span><span> </span><span>— 1 or both sides (NR) (Anaes.</span><br><span>17709 = 6B + 3T)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$62.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60915</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Aortography (NR) (Anaes. 17709 = 5B + 4T)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$73.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60918</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Arteriography (peripheral) or phlebography</span><span> </span><span>— 1 vessel (NR) (Anaes. 17708 = 5B + 3T)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$54.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60921</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Splenography (NR) (Anaes. 17708 = 5B + 3T)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$45.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60924</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Retroperitoneal pneumogram (NR)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$48.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60927</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Selective arteriogram or phlebogram (NR) (Anaes. 17708 = 5B + 3T)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$45.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60930</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Percutaneous injection of radio-opaque material into renal pelvis or into a renal cyst (including aspiration of the cyst) for antegrade pyelography (NR)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$62.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60933</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Pneumoarthrography or pneumoperitoneum (NR)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$50.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60936</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>A single or double contrast arthrography excluding arthography of the joints between articular processes of the vertebrae (NR)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$50.20</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60939</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Drip-infusion pyelography or drip-infusion cholegraphy (NR)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$37.65</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60942</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Retrograde micturating cystourethrography (NR)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$70.65</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60945</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Hysterosalpingography (NR) (Anaes. 17705 = 3B + 2T)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$62.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60948</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Discography</span><span> </span><span>— 1 disc (NR) (Anaes. 17707 = 5B + 2T)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$41.15</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60954</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Intra-osseous venography (NR)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$46.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60957</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Myelography (NR) (Anaes. 17712 = 7B + 5T)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$123.35</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60963</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cisternal puncture (NR)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$80.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60966</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Sinus or fistula injection into (NR)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$21.35</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60969</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Sialography (NR)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$56.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60972</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lymphangiography - 1 side (NR)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$123.35</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60975</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Laryngography (NR)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$62.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60978</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Pneumomediastinum (NR)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$80.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>60981</span></p></td><td colspan="2" style="width:246.45pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cholegram, percutaneous transhepatic (NR) (Anaes. 17709 = 4B + 5T)</span></p></td><td colspan="4" style="width:50.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$123.35</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt; font-size:12pt"><span style="font-weight:normal; font-style:italic">Subgroup 19</span><span style="font-weight:normal; font-style:italic"> </span><span style="font-weight:normal; font-style:italic">— Interventional techniques</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>61109</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Fluoroscopy in an angiography suite with image intensification, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which another item in this table applies (R)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$266.55</span></p></td></tr><tr><td colspan="6" style="width:354.3pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="SchedulePart" style="margin-left:0pt; text-indent:0pt"><span>Group I4</span><span style="width:14.44pt; display:inline-block"> </span><span>Nuclear medicine imaging</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>61300</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>Myocardial perfusion study using thallium</span><span> </span><span>— single study for stress or reperfusion (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>$379.20</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61301</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Myocardial perfusion study using thallium</span><span> </span><span>— single study for stress or reperfusion (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$281.30</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61304</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Myocardial perfusion study using thallium</span><span> </span><span>— combined study for stress and reperfusion (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$599.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61305</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Myocardial perfusion study using thallium</span><span> </span><span>— combined study for stress and reperfusion (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$446.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61308</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Myocardial infarct-avid imaging study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$222.65</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61309</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Myocardial infarct-avid imaging study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$166.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61312</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Gated cardiac blood pool (equilibrium) study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$256.90</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61315</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Gated cardiac blood pool study with intervention (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$318.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61318</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cardiac first pass blood flow study, cardiac shunt study or cardiac output study, not being a service associated with a service to which another item in this Group applies (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$193.30</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61319</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cardiac first pass blood flow study, cardiac shunt study or cardiac output study, not being a service associated with a service to which another item in this Group applies (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$144.35</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>61322</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>Cardiac first pass blood flow study, cardiac shunt study or cardiac output study, being a service associated with a service to which another item in this Group applies (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>Amount under rule 15</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61323</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cardiac first pass blood flow study, cardiac shunt study or cardiac output study, being a service associated with a service to which another item in this Group applies (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Amount under rule 15</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61326</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lung perfusion study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$183.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61327</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lung perfusion study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$137.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61330</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lung ventilation study using Xe127 gas (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$305.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61331</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lung ventilation study using Xe127 gas (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$230.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61334</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lung ventilation study using Xe133 gas (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$171.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61335</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lung ventilation study using Xe133 gas (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$127.20</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61338</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lung ventilation study using aerosol (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$212.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61339</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lung ventilation study using aerosol (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$159.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61342</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lung perfusion study and lung ventilation study using either Xe127 or Xe133 gas (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$330.30</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61343</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lung perfusion study and lung ventilation study using either Xe127 or Xe133 gas (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$244.65</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61346</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lung perfusion study and lung ventilation study using aerosol (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$367.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61347</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lung perfusion study and lung ventilation study using aerosol (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$275.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61350</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Liver and spleen study (colloid) (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$217.75</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61351</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Liver and spleen study (colloid) (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$163.90</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61354</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Red blood cell spleen or liver study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$222.65</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61355</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Red blood cell spleen or liver study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$166.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61358</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Hepatobiliary study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$354.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61359</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Hepatobiliary study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$263.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61362</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Bowel haemorrhage study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$409.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61363</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Bowel haemorrhage study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$305.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>1366</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Meckel’s diverticulum study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$188.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61367</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Meckel’s diverticulum study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$141.90</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61370</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Salivary study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$188.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61371</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Salivary study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$141.90</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61374</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Gastro-oesophageal reflux study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$403.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61375</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Gastro-oesophageal reflux study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$299.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61378</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Oesophageal clearance study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$121.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61379</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Oesophageal clearance study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$90.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61382</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Gastric emptying study using single tracer (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$599.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61385</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Gastric emptying study using dual tracer (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$642.20</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61388</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Renal study with or without dynamic flow study and with or without computer extraction of functional parameters (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$275.25</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61391</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Renal study with intervention (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$336.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61392</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Renal study with intervention (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$250.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61395</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cystoureterogram (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$207.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61396</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cystoureterogram (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$156.60</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61399</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Testicular study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$137.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61400</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Testicular study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$102.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61403</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Brain study with blood brain barrier agent (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$185.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61404</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Brain study with blood brain barrier agent (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$139.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61407</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cerebro-spinal fluid transport study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$727.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61408</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cerebro-spinal fluid transport study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$544.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61411</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cerebro-spinal fluid shunt patency study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$190.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61412</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Cerebro-spinal fluid shunt patency study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$141.90</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61415</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Dynamic blood flow study or regional blood volume quantitative study, not being a service associated with a service to which another item in this Group applies (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$100.30</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61416</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Dynamic blood flow study or regional blood volume quantitative study, not being a service associated with a service to which another item in this Group applies (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$74.60</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61419</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Bone study</span><span> </span><span>— whole body (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$403.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61420</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Bone study</span><span> </span><span>— whole body (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$299.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>61423</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>Bone study</span><span> </span><span>— whole body and dynamic blood flow or regional blood volume quantitative study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>$501.55</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61424</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Bone study</span><span> </span><span>— whole body and dynamic blood flow or regional blood volume quantitative study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$379.20</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61427</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Whole body study using iodine (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$458.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61428</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Whole body study using iodine (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$342.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61431</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Whole body study using gallium (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$458.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61432</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Whole body study using gallium (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$342.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61435</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Whole body study using cells labelled with technetium (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$409.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61436</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Whole body study using cells labelled with technetium (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$305.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61439</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Bone marrow study</span><span> </span><span>— whole body (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$403.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61440</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Bone marrow study</span><span> </span><span>— whole body (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$299.70</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61443</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Repeat of a whole body study on a different occasion using the same administration of radiopharmaceutical (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$185.95</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61444</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Repeat of a whole body study on a different occasion using the same administration of radiopharmaceutical (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$139.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61447</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Localised bone or joint study including flow and blood pool studies (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$281.30</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61448</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Localised bone or joint study including flow and blood pool studies (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$210.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61451</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Localised bone, joint, tumour, infection or inflammation seeking study using gallium (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$336.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61452</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Localised bone, joint, tumour, infection or inflammation seeking study using gallium (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$250.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61455</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Localised bone, joint, tumour, infection or inflammation seeking study using cells labelled with technetium (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$287.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61456</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Localised bone, joint, tumour, infection or inflammation seeking study using cells labelled with technetium (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$215.30</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>61459</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>Repeat of a localised bone, joint, tumour, infection or inflammation seeking study on a different occasion using the same administration of radiopharmaceutical (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>$124.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61460</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Repeat of a localised bone, joint, tumour, infection or inflammation seeking study on a different occasion using the same administration of radiopharmaceutical (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$93.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61463</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Venography (including blood pool study, active uptake study or dynamic blood flow study) (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$222.65</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61464</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Venography (including blood pool study, active uptake study or dynamic blood flow study) (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$166.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61467</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lymphoscintigraphy (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$287.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61468</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Lymphoscintigraphy (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$215.30</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61471</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Thyroid Study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$127.20</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61472</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Thyroid Study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$95.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61475</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Thyroid uptake study performed on gamma camera (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$62.35</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61476</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Thyroid uptake study performed on gamma camera (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$46.45</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61479</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Parathyroid (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$318.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61482</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Adrenal study using selenocholesterol (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$734.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61483</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Adrenal study using selenocholesterol (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$550.50</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61486</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Adrenal study, not being a service to which item 61482 or 61483 applies (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$373.10</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61487</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Adrenal study, not being a service to which item 61482 or 61483 applies (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$281.30</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61490</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Single photon emission tomography being a service associated with a service to which another item in this Group applies (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Amount under rule 16</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61493</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Tear duct study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$188.40</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61494</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Tear duct study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$141.90</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61497</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Particle perfusion study (intra-arterial) or Le Veen Shunt study (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$212.80</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>61498</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>Particle perfusion study (intra-arterial) or Le Veen Shunt study (R) (NC)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>$159.00</span></p></td></tr><tr><td style="width:37.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>61501</span></p></td><td style="width:244.35pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Study of region or organ, not being a service to which another item in this Group applies (R) (C)</span></p></td><td colspan="5" style="width:53pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>$5.20</span></p></td></tr><tr><td style="width:37.15pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>61502</span></p></td><td style="width:244.35pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>Study of region or organ, not being a service to which another item in this Group applies (R) (NC)</span></p></td><td colspan="5" style="width:53pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; page-break-after:avoid; font-size:11pt"><span>$5.20</span></p></td></tr><tr style="height:0pt"><td style="width:47.95pt"></td><td style="width:255.15pt"></td><td style="width:2.1pt"></td><td style="width:5pt"></td><td style="width:2.65pt"></td><td style="width:52.25pt"></td><td style="width:1.8pt"></td></tr></tbody></table>
Subgroup 1 — GeneralSubgroup 1 — General

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Subgroup 1 — General
