Medical fees
Each surgical and medical procedure has a unique code and
description, called a CCSD code, which are used as a common term of reference
within the private medical industry.
These codes are listed in our fee schedule below along with the
amount of benefit we will pay towards the cost of your specialist charges.
You can use the fee schedule to search by code or procedure name to
find out what we would pay for a particular procedure.
For a single procedure we will pay the 100% customary and
reasonable Surgeon and Anaesthetist fees according to the required CCSD code
and its recognised complexity.
If multiple procedures are carried out during one theatre
admission, we will pay:
- Primary procedure - up to 100% of the listed fee price
- 2nd procedure - up to 50% in addition to the primary procedure
- 3rd procedure - up to 25% in addition to the primary and second procedure
For bilateral procedures not identified within a specific CCSD code
we will pay 100% of the actual procedure plus an additional 66%
For further advice please see either the Guide to Patients or the
Guide to Consultants.
The prices indicated in our fee schedule are independent of any other insurer, and are subject to annual review, based on data detailing payment trends, complexity and independent medical review where disputes or new procedures require implementation. It is important to note that these rates are correct as of November 2007. Changes may be made from time to time and will be updated when this is the case.
Cover is comprehensive and flexible, with swift access to treatment at over 300 hospitals across the U.K.
