Chapter 8 / Thorax and intra-thoracic organs

It is common practice with a number of intra-thoracic procedures to perform a rigid bronchoscopy. This should not be separately itemised for billing purposes when this is a routine part of the procedure.

Insertion of a chest drain should not be charged for separately with intra-thoracic surgery.


8.1 - Oesophagus

Code Description Complexity Procedure fees Anaesthetist fees
Unacceptable Combinations



G0100 Oesophagectomy/oesophagogastrectomy with anastomosis in chest Complex £1,900.00 £825.00 Show arrow
G1470 Fibreoptic endoscopic photodynamic therapy (PDT) of lesion of oesophagus Intermediate £400.00 £150.00 Show arrow
G0220 Total oesophagectomy and interposition of intestine Complex £1,900.00 £1,100.00 Show arrow
G0260 Endoscopically assisted oesophagectomy Complex £1,900.00 £825.00 Show arrow
G0300 Sub-total oesophagectomy with anastomosis in neck Complex £1,900.00 £825.00 Show arrow
G0400 Open excision of lesion of oesophagus Major £550.00 £385.00 Show arrow
G0500 Bypass of oesophagus Xmajor £1,000.00 £495.00 Show arrow
G0640 Closure of bypass of oesophagus Major £550.00 £385.00 Show arrow
G0730 Repair of congenital oesophageal atresia (with or without fistula) Complex £1,000.00 £440.00 Show arrow
G0740 Repair of ruptured oesophagus Complex £1,000.00 £440.00 Show arrow
G0920 Oesophagocardiomyotomy (Heller's operation) Major £550.00 £330.00 Show arrow
G1400 VATS excision lesion of oesophagus Xmajor £550.00 £385.00 Show arrow
G2312 Transthoracic repair of paraoesophageal hiatus hernia Xmajor £800.00 £275.00 Show arrow
G2320 Transthoracic repair of diaphragmatic hernia (acquired) Xmajor £650.00 £275.00 Show arrow
G2330 Transabdominal repair of hiatus hernia Major £600.00 £275.00 Show arrow
G2340 Transabdominal repair of diagphragmatic hernia Complex £800.00 £495.00 Show arrow
G2400 Transthoracic fundoplication and gastroplasty Xmajor £800.00 £275.00 Show arrow
G2402 Transthoracic fundoplication Xmajor £800.00 £275.00 Show arrow
G2430 Transabdominal anti-reflux operations Complex £800.00 £385.00 Show arrow
G2590 Revision of anti-reflux procedures Complex £1,000.00 £440.00 Show arrow
A2781 Laparoscopic vagotomy/seromyotomy Major £550.00 £220.00 Show arrow

8.2 - Chest wall

Code Description Complexity Procedure fees Anaesthetist fees
Unacceptable Combinations



E4722 Thoracotomy and closure of broncho-pleural fistula Xmajor £800.00 £440.00 Show arrow
T0110 Thoracoplasty Xmajor £750.00 £330.00 Show arrow
T0132 Excision of chest wall tumour - with chest wall reconstruction Xmajor £650.00 £275.00 Show arrow
T0133 Excision of chest wall tumour - without chest wall reconstruction Xmajor £650.00 £275.00 Show arrow
T0210 Correction of pectus deformity of chest wall (or other congenital defect thereof) complex £800.00 £275.00 Show arrow
T0212 Secondary correction of scolios-related chest wall deformity (posterior costoplasty) (as sole procedure) Complex £800.00 £275.00 Show arrow
T0320 Exploratory thoracotomy Major £550.00 £275.00 Show arrow
T0810 Resection of rib and open drainage of pleural cavity Major £450.00 £275.00 Show arrow
T1500 Repair of rupture of diaphragm complex £800.00 £385.00 Show arrow
T1620 Plication of paralysed diaphragm Xmajor £650.00 £330.00 Show arrow
T1640 Repair of congenital diaphragmatic hernia Xmajor £750.00 £495.00 Show arrow
T2781 Repair of epigastric hernia Intermediate £400.00 £165.00 Show arrow

8.3 - Trachea

Code Description Complexity Procedure fees Anaesthetist fees
Unacceptable Combinations



E3900 Partial excision of trachea with reconstruction Complex £1,000.00 £660.00 Show arrow
E4030 Tracheoplasty Major £500.00 £220.00 Show arrow
E4032 Tracheoplasty for congenital conditions Complex £500.00 £220.00 Show arrow
E4100 Insertion of voice prosthesis (TOF) Major £500.00 £275.00 Show arrow
E4210 Tracheostomy Intermediate £300.00 £220.00 Show arrow
E4230 Mini-tracheostomy (percutaneous) Minor £200.00 £165.00 Show arrow

8.4 - Fibreoptic endoscopic procedures (GA or LA)

Code Description Complexity Procedure fees Anaesthetist fees
Unacceptable Combinations



E4510 Fibreoptic examination of trachea including biopsy/removal of foreign body Minor £200.00 £165.00 Show arrow
E4800 Therapeutic bronchoscopy (including laser, cryotherapy, lavage, snare, dilatation of stricture, insertion of stent) Minor £250.00 £165.00 Show arrow
E4840 Dilatation of tracheal stricture including insertion of stent Intermediate £250.00 £165.00 Show arrow
E4850 Therapeutic bronchoscopy for removal of foreign body Minor £200.00 £165.00 Show arrow
E5180* Diagnostic bronchoscopy +/- biopsy Minor £300.00 £165.00 Show arrow

8.5 - Bronchi/lungs/pleura

Code Description Complexity Procedure fees Anaesthetist fees
Unacceptable Combinations



E4400 Carinal resection +/- pneumonectomy Complex £1,900.00 £1,100.00 Show arrow
E4600 Sleeve resection of bronchus or pulmonary artery with pulmonary resection Complex £1,600.00 £495.00 Show arrow
E5410 Pneumonectomy Complex £1,300.00 £495.00 Show arrow
E5430 Pulmonary lobectomy including segmental resection Complex £1,600.00 £495.00 Show arrow
E5480 Lung resection with resection of chest wall Complex £1,600.00 £550.00 Show arrow
E5520 Open excision of lesion of lung Complex £800.00 £440.00 Show arrow
E5532 Thoracotomy and lung biopsy as sole procedure Intermediate £400.00 £275.00 Show arrow
E5533 Percutaneous radiofrequency ablation of malignant neoplasm of lung Complex £1,900.00 £275.00 Show arrow
E5700 Thoractomy lung volume reduction - bilateral Complex £1,300.00 £660.00 Show arrow
E5702 Thoracotomy lung volume reduction - unilateral Complex £800.00 £440.00 Show arrow
E5703 Thoracotomy bullectomy - bilateral Complex £1,300.00 £660.00 Show arrow
E5704 Thoracotomy bullectomy - unilateral +/- pleurodesis in presence of emphysema Xmajor £800.00 £440.00 Show arrow
E5705 Thoracotomy pleurectomy/pleurodesis +/- ligation of bullae for pneumothorax Xmajor £700.00 £330.00 Show arrow
E5910 Needle biopsy of lung Minor £150.00 £110.00 Show arrow
T0710 Decortication of pleura of lung Complex £1,000.00 £385.00 Show arrow
T0910 Open pleural biopsy as sole procedure Xmajor £750.00 £275.00 Show arrow
E5540 Laser resection of lung metastases Complex £1,000.00 £500.00
T1220 Drainage of pleural cavity Minor £200.00 £110.00 Show arrow
T1240 Insertion of tube drain into pleural cavity Minor £200.00 £110.00 Show arrow
T1300 Introduction of substance into pleural cavity with chest drain Minor £100.00 £100.00 Show arrow
T1410 Needle biopsy of pleura Minor £200.00 £110.00 Show arrow
E5100 Endobronchial ultrasound (as sole procedure) Minor £200.00 £165.00 Show arrow
T1480 Insertion of pleuro-peritoneal shunt Intermediate £350.00 £220.00 Show arrow

8.6 - Mediastinum

Code Description Complexity Procedure fees Anaesthetist fees
Unacceptable Combinations



B1690 Mediastinal parathyroidectomy with sternotomy Complex £750.00 £275.00 Show arrow
B1800 Thymectomy for myasthenia gravis Major £600.00 £495.00 Show arrow
E6100 Open resection of invasive mediastinal tumour Complex £1,200.00 £825.00 Show arrow
E6110 Open excision of mediastinal tumour including congenital cysts/posterior chest wall lesions Xmajor £650.00 £550.00 Show arrow
E6300 Diagnostic mediastinoscopy Intermediate £450.00 £165.00 Show arrow
E6310 Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for mediastinal masses Major £500.00 £165.00 Show arrow

8.7 - Video assisted thoracic surgery (VATS)

Code Description Complexity Procedure fees Anaesthetist fees
Unacceptable Combinations



A7560 VATS sympathectomy - unilateral Major £700.00 £275.00 Show arrow
A7561 VATS sympathectomy - bilateral Xmajor £1,000.00 £440.00 Show arrow
E5432 VATS lobectomy Major £600.00 £440.00 Show arrow
E5442 VATS wedge resection of lung Major £600.00 £440.00 Show arrow
E5590 VATS bullectomy - unilateral Major £300.00 £165.00 Show arrow
E5591 VATS bullectomy - bilateral Complex £450.00 £275.00 Show arrow
E5592 VATS lung volume reduction - unilateral Complex £500.00 £275.00 Show arrow
E5593 VATS lung volume reduction - bilateral Complex £750.00 £275.00 Show arrow
E5594 VATS debridement of empyema Major £500.00 £220.00 Show arrow
E5932 VATS lung biopsy Intermediate £350.00 £165.00 Show arrow
E6200 VATS excision lesion of mediastinum including thymectomy Xmajor £600.00 £165.00 Show arrow
G0922 VATS oesophageal / oesophagogastric myotomy Major £600.00 £330.00 Show arrow
G1400 VATS excision lesion of oesophagus Xmajor £550.00 £385.00 Show arrow
G2331 Laparoscopic repair of hiatus hernia with anti-reflux procedure (eg fundoplication) Major £800.00 £440.00 Show arrow
T1030 VATS pleurodesis/pleurectomy Major £700.00 £330.00 Show arrow
T1032 Thoracoscopy and drainage and chemical pleurodesis Intermediate £350.00 £165.00 Show arrow
T1100 Diagnostic thoracoscopy (+/- biopsy) Minor £350.00 £165.00 Show arrow

8.8 - Heart – cardiac surgery

Code Description Complexity Procedure fees Anaesthetist fees
Unacceptable Combinations



We will provide benefit for surgeon and anaesthetist standby during coronary angioplasty provided the surgeon and anaesthetist are physically present and have no other obligations at that time. There is a code AA588 for this purpose. Please note, however, should surgery become necessary we will not also reimburse a charge for standby.

The benefit for therapeutic interventional procedures such as angioplasty with stenting or ablation includes an amount for any diagnostic procedure performed on the same day. Transoesophageal echocardiography should not be charged as an addition with valve procedures.

We will not pay additional amounts for supervision of post-operative care by cardiologists. In exceptional circumstances we will consider charges but these must be justified and agreed with us before they are invoiced.

We acknowledge that the procedure K3580 - Trans catheter aortic valve implantation (TAVI) requires a multidisciplinary approach from a cardiologist and a cardio-thoracic surgeon. The fee we publish for K3580 is payable to the team so invoices may either be submitted by one specialist for the full amount or by both specialists for 50% of the published fee. The fee of £2300 is not claimable by both specialists.

K0400 Correction of tetralogy of Fallot Complex £1,900.00 £1,100.00 Show arrow
K0500 Atrial inversion for transposition of great vessels Complex £1,900.00 £1,100.00
K0530 Double switch procedure (atrial and arterial) Complex £1,900.00 £1,100.00
K4610 Minimally invasive direct coronary artery bypass (MIDCAB) including harvesting of graft Complex £2,300.00 £1,100.00
K0700 Correction of total anomalous pulmonary venous connection Complex £1,900.00 £1,100.00
K0900 Repair of complete atrioventricular septal defect Complex £1,900.00 £1,100.00 Show arrow
K0930 Closure of partial atrioventricular septal defect Complex £1,900.00 £1,100.00 Show arrow
K1000 Closure of defect of interatrial septum (secundum Atrial Septal Defect or Patent Foramen Ovale) Complex £1,900.00 £990.00 Show arrow
K1100 Closure of defect of interventricular septum Complex £1,900.00 £990.00
K1180 Endovascular closure of perimembranous ventricular septal defect Complex £800.00 £990.00 Show arrow
K1200 Norwood stage 1 procedure Complex £1,900.00 £1,100.00
K1600 Therapeutic transluminal operations on atrial septum of heart Complex £800.00 £825.00 Show arrow
K1680 Transluminal closure of atrial septal defect / patent foramen ovale Complex £800.00 £495.00 Show arrow
K1800 Placement of valve to cardiac conduit Complex £1,900.00 £1,100.00 Show arrow
K1850 Revision placement of valve to cardiac conduit Complex £1,900.00 £1,100.00 Show arrow
K2310 Excision of cardiac tumour Complex £1,900.00 £1,100.00 Show arrow
K2540 Replacement of mitral valve with sub-valve preservation (including biopsies) Complex £2,000.00 £990.00 Show arrow
K2542 Revision replacement of mitral valve Complex £2,000.00 £990.00 Show arrow
K2580 Repair of mitral valve Complex £2,000.00 £990.00 Show arrow
K2600 Replacement or repair of aortic valve Complex £1,900.00 £990.00 Show arrow
K2602 Minimally invasive replacement of aortic valve Complex £1,900.00 £990.00 Show arrow
K2610 Ross procedure Complex £1,900.00 £1,100.00 Show arrow
K2612 Replacement of aortic valve with homograft or stentless porcine Complex £1,900.00 £990.00 Show arrow
K2613 Revision of aortic valve replacement Complex £1,900.00 £990.00 Show arrow
K2700 Replacement of tricuspid valve (including valvuloplasty) Complex £1,900.00 £1,100.00 Show arrow
K2780 Repair of tricuspid valve, eg for Ebstein's disease Complex £1,900.00 £990.00 Show arrow
K2800 Replacement of pulmonary valve (including valvuloplasty/valvotomy) Complex £1,900.00 £990.00 Show arrow
K2810 Percutaneous replacement/implantation of pulmonary valve Complex £2,300.00 £880.00 Show arrow
K3100 Open valvotomy Complex £1,900.00 £990.00 Show arrow
K3210 Closed mitral valvotomy Complex £1,300.00 £825.00 Show arrow
K3500 Therapeutic transluminal operation(s) on valve of heart Xmajor £750.00 £660.00 Show arrow
K3580 Trans catheter aortic valve implantation (TAVI) Complex £2,300.00 £880.00 Show arrow
K4100 Bypass for coronary artery(ies) including harvesting of grafts and endarterectomy Complex £1,900.00 £1,100.00 Show arrow
L2720 Endovascular aneurysm repair (EVAR) of suprarenal aorta, with insertion of fenestrated graft (up to two orifices) Complex £1,300.00 £495.00 Show arrow
L2780 Endovascular aneurysm repair (EVAR) of suprarenal aorta, with insertion of fenestrated graft (three to four orifices) Complex £1,500.00 £495.00
L2710 Endovascular aneurysm repair (EVAR) of infrarenal aorta Complex £1,300.00 £495.00 Show arrow
K4410 Revision bypass for coronary artery(ies) (including harvesting of grafts) Complex £2,000.00 £1,100.00 Show arrow
K4600 Off-pump coronary artery bypass (OPCAB) Complex £1,900.00 £1,100.00 Show arrow
K4880 Correction of anomalous coronary arteries Complex £1,900.00 £1,100.00
K5120 Intravascular ultrasound of coronary arteries (as sole procedure) Major £400.00 £250.00 Show arrow
K5283 Complex Cox lesion set maze operation Complex £1,900.00 £1,100.00 Show arrow
K5330 Repair of post infarction ventricular septal defect Complex £1,900.00 £1,100.00 Show arrow
K5380 Repair of ventricular aneurysm Complex £1,900.00 £990.00 Show arrow
K6180 Short-term circulatory support with left ventricular assist device Complex £1,000.00 £550.00
K6700 Pericardiectomy Complex £1,000.00 £385.00 Show arrow
K6810 Decompression of cardiac tamponade or re-exploration for bleeding Xmajor £650.00 £330.00
L0110 Correction of truncus arteriosus Complex £1,300.00 £1,100.00
L0610 Formation of atriopulmonary connection (or any modification of Fontan type procedure) Complex £1,600.00 £660.00
L2360 Repair of interrupted aortic arch Complex £1,900.00 £1,100.00
L2382 Aortic root replacement with valve conduit or homograft and/or remodelling Complex £1,900.00 £550.00 Show arrow
L2560* Percutaneous or open placement of intra-aortic balloon (including subsequent removal) Intermediate £500.00 £220.00 Show arrow

8.9 - Heart – cardiology

Code Description Complexity Procedure fees Anaesthetist fees
Unacceptable Combinations



K1690 Non-surgical reduction of myocardial septum (e.g. alcohol septal ablation) Complex £1,000.00 £495.00 Show arrow
K6581 Coronary angioplasty following angiography with fractional flow study on the same day, +/- insertion of stent Complex £1,300.00 £600.00 Show arrow
K5720 Ablation of AV nodal re-entry tachycardia (including mapping) Complex £1,400.00 £495.00 Show arrow
K5770 Ablation of arrhythmia in complex congenital heart disease (including mapping) Complex £1,400.00 £495.00 Show arrow
K5790 Ablation of left atrial tachycardia (including mapping) Complex £1,400.00 £495.00 Show arrow
K2280 Percutaneous occlusion of left atrial appendage Xmajor £800.00 £750.00 Show arrow
K6105 Insertion of dual chamber implantable cardioverter defibrillator (ICD) Complex £1,250.00 £350.00 Show arrow
K6060 Lead replacement for Pacemaker or implantable cardioverter defibrillator (ICD) Major £650.00 £200.00 Show arrow
K6050 Replacement implantable cardioverter defibrillator (ICD), without lead change Intermediate £400.00 £220.00 Show arrow
K6582* Adult cardiac catheterisation - radial access (including coronary arteriography/catheterisation of right/left side of heart/contrast radiology) - with pressure wire (including fractional flow reserve measurement) Intermediate £400.00 £0.00 Show arrow
K6584* Adult cardiac catheterisation - femoral access (including coronary arteriography/catheterisation of right/left side of heart/contrast radiology) - with pressure wire (including fractional flow reserve measurement) Intermediate £400.00 £0.00
K6513* Adult cardiac catheterisation - radial access (including coronary arteriography/ catheterisation of right/left side of heart/contrast radiology) Intermediate £400.00 £0.00
K4900 Percutaneous transluminal angioplasty of coronary artery(ies) (including laser) Complex £900.00 £495.00 Show arrow
K4902 Percutaneous transluminal angioplasty of coronary artery(ies) with intravascular ultrasound (including laser) Complex £900.00 £495.00 Show arrow
K4910 Percutaneous transluminal angioplasty of coronary artery(ies) with stent insertion Complex £1,100.00 £495.00 Show arrow
K4912 Percutaneous transluminal angioplasty of coronary artery(ies) with stent insertion and intravascular ultrasound Complex £1,100.00 £495.00 Show arrow
K5280 Map guided surgery for ventricular arrhythmias (including mapping) Xmajor £1,000.00 £825.00 Show arrow
K5710 Ablation of atrio-ventricular junction (including mapping) Xmajor £850.00 £330.00 Show arrow
K5730 Ablation of atrial arrhythmia (including mapping) Complex £1,400.00 £495.00 Show arrow
K5740 Ablation of ventricular arrhythmia (including mapping) Complex £750.00 £330.00 Show arrow
K5750* Internal cardioversion Intermediate £250.00 £110.00 Show arrow
K5760 Ablation of atrial fibrillation by isolation of the pulmonary veins (including mapping) Complex £1,300.00 £450.00 Show arrow
K5780 Ablation of accessory pathway or selected modification of AV node (including mapping) Complex £1,400.00 £495.00 Show arrow
K5810 Diagnostic intracardiac electrophysiological study including characterisation of intracardiac conduction and any testing of anti-arrhythmic drug efficacy by programmed stimulation Major £450.00 £275.00 Show arrow
K6511* Adult cardiac catheterisation - femoral access (including coronary arteriography/ catheterisation of right/left side of heart/contrast radiology) Intermediate £400.00 £0.00 Show arrow