Chapter 7 – Breast

Last updated: April 2021

7.1 Excision/Biopsy

CCSD Specialist Anaesthetist Description Complexity code fee fee

B2800 Excision of breast lump/fibroadenoma Intermediate £300.00 £165.00 B2820 Wide local excision of breast +/- local mobilisation of glandular Intermediate £450.00 £165.00 breast tissue to fill surgical cavity B2830 Re-excision of lesion of breast if resection margins are not clear Intermediate £300.00 £165.00 (as sole procedure) B2831 Re-excision of lesion of breast if resection margins are not clear Intermediate £300.00 £165.00 with local mobilisation B2880 Excision biopsy of breast lesion after localisation Intermediate £500.00 £165.00 B3212 Percutaneous suction core biopsy Minor £150.00 £110.00 B3220 Core biopsy of lesion of breast Minor £150.00 £110.00 T9000 Sentinel node mapping and sampling with blue dye or Intermediate £500.00 £165.00 radioactive probe for breast cancer T9020 Sentinel node mapping and sampling with blue dye and Intermediate £500.00 £165.00 radioactive probe for breast cancer T9030 Intraoperative sentinel node mapping, using One Step Nucleic Intermediate £500.00 £165.00 Acid Amplification (OSNA), for breast cancer

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7.2 Mastectomy (excluding implant/reconstruction)

CCSD Specialist Anaesthetist Description Complexity code fee fee

B2710 Radical mastectomy including block dissection Major £650.00 £275.00 B2742 Modified radical mastectomy including lymph node sampling Major £550.00 £220.00 B2743 Modified radical mastectomy excluding lymph node sampling Major £550.00 £220.00 B2744 Modified radical mastectomy including lymph node clearance Major £550.00 £220.00 B2752 Subcutaneous mastectomy Major £450.00 £220.00 B2760 Skin/Nipple sparing mastectomy (including axillary node biopsy) Major £450.00 £220.00 B2780 Simple mastectomy (including axillary node biopsy) – unilateral Major £450.00 £220.00

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7.3 Reconstruction

CCSD Specialist Anaesthetist Description Complexity code fee fee

B2700 Subcutaneous mastectomy with immediate implant Major £550.00 £275.00 Mastectomy and immediate reconstruction of breast using B2912 Xmajor £1,250.00 £440.00 latissimus dorsi Reconstruction of breast using latissimus dorsi including B2913 Xmajor £800.00 £440.00 implantation of prosthesis (including delayed reconstruction) Mastectomy followed by immediate deep inferior epigastric flap B2914 Complex £4,500.00 £1,800.00 (DIEP) reconstruction - bilateral Reconstruction of breast using extended latissimus dorsi flap B2915 Complex £1,400.00 £550.00 (including delayed reconstruction) Mastectomy and immediate reconstruction of breast using B2916 Xmajor £1,650.00 £440.00 extended latissimus dorsi flap Mastectomy and immediate reconstruction of breast using fixed B2918 Xmajor £750.00 £275.00 prosthesis and acellular dermal matrix (ADM) - unilateral Lumpectomy and immediate partial reconstruction of breast B2921 using pedicled perforator flap (e.g. Lateral Intercostal Artery Xmajor £1,000.00 £500.00 Perforator (LICAP) or Thoraco-Dorsal Artery Perforator (TDAP)) Partial reconstruction of breast using pedicled perforator flap B2922 (e.g. Lateral Intercostal Artery Perforator (LICAP) or Thoraco- Xmajor £1,000.00 £500.00 Dorsal Artery Perforator (TDAP) including delayed reconstruction) B2981 Local mobilisation of glandular breast tissue to fill surgical cavity Intermediate £450.00 £165.00 Reconstruction of breast using pedicled TRAM (including B2984 Complex £1,300.00 £495.00 delayed reconstruction) Reconstruction of breast using free TRAM (including delayed B2985 Complex £1,300.00 £495.00 reconstruction) Reconstruction of breast using deep inferior epigastric B2986 perforator flap (DIEP) (including delayed reconstruction) – Complex £2,750.00 £1,100.00 unilateral (single flap) Reconstruction of breast using Transverse Upper Gracilis (TUG) B2987 Complex £2,750.00 £1,100.00 flap (including delayed reconstruction and nipple reconstruction) Reconstruction of breast using ALT (anteriolateral thigh) flap B2988 Complex £2,750.00 £1,100.00 including delayed reconstruction Mastectomy followed by immediate Deep Inferior Epigastric B2989 Complex £3,000.00 £1,200.00 Flap (DIEP) reconstruction - unilateral Laparoscopic mobilisation of the greater omentum for B2991 Major £550.00 £275.00 reconstruction of breast (including delayed reconstruction) Reconstruction of breast using deep inferior epigastric B2996 perforator flap (DIEP) (including delayed reconstruction) – Complex £4,125.00 £1,650.00 bilateral (single flap per breast)

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Reconstruction of breast using stacked deep inferior epigastric B2999 perforator flap (DIEP) (including delayed reconstruction) - Complex £2,750.00 £1,100.00 unilateral (two flaps) Mastectomy and immediate reconstruction of breast using B3012 Xmajor £550.00 £275.00 expandable prosthesis - unilateral Mastectomy and immediate reconstruction of breast using fixed B3013 Xmajor £550.00 £275.00 prosthesis - unilateral Reconstruction of breast using expandable prosthesis (including B3014 Major £400.00 £220.00 delayed reconstruction) Reconstruction of breast using fixed prosthesis (including B3015 Major £400.00 £220.00 delayed reconstruction) Mastectomy and immediate reconstruction of breast using fat B3016 Xmajor £650.00 £275.00 transfer Reconstruction of breast using fat transfer (including delayed B3017 Major £500.00 £220.00 reconstruction) B3018 Revision reconstruction of breast using fat transfer Intermediate £200.00 £110.00 Removal and replacement of prosthesis into the breast B3036 Intermediate £450.00 £165.00 (including capsulectomy) – unilateral Removal and replacement of prosthesis into the breast B3037 Major £600.00 £165.00 (including capsulectomy) – bilateral Removal and reinsertion of existing prosthesis into the breast B3038 Intermediate £450.00 £165.00 (including capsulectomy) - unilateral Removal and reinsertion of existing prosthesis into the breast B3039 Major £600.00 £165.00 (including capsulectomy) - bilateral B3180 Implantation of prosthesis into breast as sole procedure Intermediate £400.00 £220.00 Nipple areola complex reconstruction +/- liposuction and fat B3580 Major £600.00 £440.00 transfer Removal of port or valve from permanent expandable breast B3700 Minor £150.00 £0.00 prosthesis +/- image guidance Reconstruction of breast using SGAP (superior gluteal artery B3810 Complex £2,500.00 £1,100.00 perforator) flap including delayed reconstruction.

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7.4 Other

CCSD Specialist Anaesthetist Description Complexity code fee fee

B3310 Drainage of breast abscess including haematoma and seroma Minor £200.00 £165.00 B3440 Microdochotomy Intermediate £300.00 £165.00 B3592 Micropigmentation (tattooing) of nipple areola complex Minor £200.00 £0.00 B3593 Microdochectomy or mammodochectomy (Hadfield’s procedure) Intermediate £350.00 £165.00 B3594 Plastic procedures on nipple Intermediate £350.00 £165.00 B3595 Excision of mammary fistula Intermediate £350.00 £165.00

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