PART III IN HOSPITAL ON CALL ANESTHESIA COVERAGE

Anesthesia g) A consultation may not be claimed where the patient is referred to the anesthetist for the sole purpose of providing post-operative Patient Controlled Analgesia. h) Tariff 8406 may not be claimed on the same day as a consultation. 16. REQUIREMENT FOR SECOND ANESTHETIST a) Where clinical circumstances necessitate the attendance of a second anesthetist, such anesthetist shall be remunerated at seventy percent (70%) of the total anesthetic remuneration payable to the first anesthetist. b) Where one anesthetist commences an anesthetic service and is replaced by another anesthetist during the provision of the anesthetic services, the total remuneration shall not exceed the amount payable had the one anesthetist completed the anesthetic service. PART III IN HOSPITAL ON CALL ANESTHESIA COVERAGE Where an anesthetist provides In-Hospital On-Call Anesthesia Coverage remuneration shall be in accordance with this Part. 17. SITES AND SERVICES a) One anesthetist per site is required to provide twenty-four (24) hour per day In-Hospital On-Call Anesthetic Coverage at the following sites and services: Tariff Site Service Benefits [per fifteen (15) minute period or portion thereof] 8201 St. Boniface General Hospital Obstetrics 32.59 8202 Brandon Regional Health Centre Obstetrics and Emergency Surgery 30.32 8203 Health Sciences Centre Obstetrics 32.59 8204 Health Sciences Centre Emergency Surgery 26.53 b) Where an anesthetist is required to provide In-Hospital On-Call Anesthetic Coverage at the following site and service. Tariff Site Service Benefits [per fifteen (15) minute period or portion thereof] 8205 St. Boniface General Hospital Emergency Surgery 26.53 8206 Grace Hospital Emergency Surgery 26.53 18. ANESTHETIC SERVICES a) In-Hospital On-Call Anesthesia Coverage is time based and shall be calculated in fifteen (15) minute periods or portion thereof. b) Where an anesthetist providing coverage under Part III at Brandon Regional Health Centre, Grace Hospital, Health Sciences Centre or St. Boniface General Hospital is required to provide anesthetic services other than obstetrical procedures listed in Rule of Application for Anesthesia 19 a), such anesthetist shall be remunerated in accordance with Rule of Application for Anesthesia Services 20. C-10 April 1, 2012

SPINE ANTERIOR AND POSTERIOR PROCEDURES When anterior and posterior spinal procedures are performed on the same day, same anesthetic, the higher fee is payable at 100% and the lesser fee is payable at 85%. Notwithstanding that the lesser fee is payable at 85%, all procedures that include the word add are to be paid at 100%. SPINE APPROACH 1230 Trans abdominal or retroperitoneal approach to spine... 300.00 Benefit payable when spinal surgical service(s) is performed by a different surgeon. ANTERIOR INSTRUMENTATION Cervical C2-C7 1105 two (2) vertebrae... 1,076.75 24.125 1106 add on per additional vertebra... 204.00 Cervico-Thoracic C7-T4 1107 two (2) vertebrae... 1,000.00 24.125 1108 add on per additional vertebra... 250.00 Dorsal 0645 Anterior Instrumentation of Spine and/or Osteotomy, via chest... 949.00 24.125 0646 via abdomen... 1,006.00 22.750 0647 via chest and abdomen... 1,138.00 24.125 DECOMPRESSION Cervical-Thoracic-Lumbar 5203 Intervertebral discs, excision anterior approach, cervical... 1,029.50 22.750 5205 Laminectomy laminae only for decompression of the spinal cord and nerve roots unilateral first level... 848.90 22.750 ~5200 bilateral, first level... 998.90 24.125 5207 Laminectomy for lesion, laminae only for decompression of spinal cord or meninges unilateral first level... 970.70 22.750 ~5204 bilateral, first level... 1,120.70 24.125 5211 each additional vertebral level (unilateral or bilateral) add to 5205, ~5200, 5207 or ~5204... 150.00 22.750 5209 Laminotomy, cervical... 672.00 22.750 F-6 April 1, 2012

1074 Excision of lumbar intervertebral disc, one (1), all methods, any approach e.g. minimally invasive, includes all associated bone and soft tissue procedures e.g. laminotomy, foraminotomy, laminectomy, facetectomy, fat graft, microscope, fluoroscopy... 926.25 22.750 1073 more than one (1)... 1,182.75 22.750 1109 Vertebrectomy including disc and adjacent end plates, add... 1,487.45 24.125 1110 per additional vertebra, add... 350.00 1111 Total disc excision with end plates for fusion or disc replacement, add... 876.00 24.125 1112 per additional vertebra, add... 225.00 1113 Partial vertebrectomy, add... 565.35 24.125 1114 Posteriolateral decompressions of the vertebral body must include lamina, and complete laminectomy and a portion of facets, pedicles, unilateral first level, add... 992.90 22.750 1115 bilateral, first level, add... 1,247.90 24.125 ~1220 each additional vertebral level unilateral or bilateral, add to 1114 or 1115... 400.00 FUSION-CERVICAL POSTERIOR FUSION 1116 Occipito-cervical fusion (includes wires, screws and graft when necessary)... 1,836.00 22.750 1117 add on per vertebra below C2... 255.00 1118 C1-C2 fusion wires and graft... 600.00 22.750 1119 C1-C2 fusion including transarticular screws and wires... 1,200.00 22.750 1120 add on flat bone graft... 250.00 CERVICO-THORACIC-LUMBAR 0636 Spine, two (2) vertebrae, (e.g. lumbo-sacral)... 825.35 22.750 0635 three (3) to five (5) vertebrae... 888.15 22.750 0642 More than five (5) vertebrae... 1,200.00 22.750 1121 Posterior or Posteriolateral fusion with instrumentation including pedicle screws, two (2) vertebrae... 1,361.60 22.750 1122 add on per additional vertebra... 255.00 1123 add on per Sacral vertebra (maximum per patient $3,000.00)... 306.00 ALIF OR PLIF Alif-(anteriorlumbar interbody fusion) Plif-(posteriorlumbar interbody fusion) 1124 Vertebra Replacement with autogenous or allograft bone, cement, tri-cortical bone and/or cage per vertebra, add... 357.00 24.125 ~1219 Partial vertebral replacement with autogenous or allograft bone, cement, tricortical bone and/or cage per vertebra, add... 185.00 April 1, 2012 F-7

1126 Intervertebral disc replacement any type for radical disc excision tricortical strut graft, autograft, allograft, bone cement prosthetic with or without cage, per vertebra, add... 430.05 24.125 1171 Artificial disc insertion... 1006.00 24.125 1179 each additional level replaced, add... 350.00 24.125 Anterior Release includes discectomy and section of longitudinal ligament including open or thoroscopic approach, through posterior or posteriolateral approach 1128 one (1) intervertebral disc space... 700.00 22.750 1129 two (2) three (3) intervertebral disc spaces... 1,050.00 22.750 1130 four (4) six (6) intervertebral disc spaces... 2,609.80 22.750 1131 Greater than six (6) intervertebral disc spaces (per disc space) (maximum per patient including fusion $3,000.00), add... 153.00 22.750 1132 Fusion with anterior release with morsellized non-structural bone graft per intervertebral disc space, add... 150.00 22.750 BONE GRAFT Procurement and application of graft from remote site ~1100 Morsellized bone graft (allograft, not synthetic bone graft), to one or more sites, add... 216.45 1133 Onlay graft for posterior lateral fusion, add... 255.00 22.750 MISCELLANEOUS 1134 Laminoplasty... 800.00 22.750 1135 add on per additional vertebra... 200.00 1136 Odontoidectomy, transoral with microscope... 1,500.00 24.125 1139 Open Vertebroplasty, posterior approach with augmentation of bone with autograft, bone cement or bone substitute... 1,200.00 24.125 1140 Odontoid fracture open reduction and interior fixation with screw... 1,200.00 24.125 1146 Multi vertebral level saucerization of spinal wound with re-opening of the initial incision down to the spine for major infection, drainage of hematoma, including debridement, add... 500.00 24.125 1) Where required, re-instrumentation may be claimed in addition to Tariff 1146. 2) Payable in the post operative period. 1147 Intra-operative ultrasound, add... 150.00 1148 MEP/SSEP electro-physiological monitoring, primary spine surgeon, add... 85.00 1169 MEP/SSEP electro-physiological monitoring, non-operating physician per hour or major portion... 170.00 F-8 April 1, 2012

Renal Transplants P RENAL TRANSPLANTS These benefits cannot be correctly interpreted without reference to the Rules of Application. 5883 Renal transplant... 1,836.00 24.125 5884 Cadaver nephrectomy single for local implant or export... 336.00 22.750 5885 Cadaver nephrectomy double for local implants or export... 829.65 22.750 5886 Live donor nephrectomy... 962.20 22.750 ~5881 Laparoscopic live donor nephrectomy... 1,300.00 22.750 5887 Rejection transplant nephrectomy... 550.00 22.750 5888 Pre-transplant nephrectomy (recipient) unilateral... 490.00 22.750 5889 bilateral... 859.00 22.750 5882 Marsupialization of post transplant lymphocele... 498.40 22.750 The above fees represent the total fees of those surgeons in actual attendance and will be divided among the team in accordance with their involvement. They do not include Nephrologists fees which are listed below. NEPHROLOGISTS BENEFITS 5898 Donor related services; including the nephrological management of organ procurement, management of the neurologically dead donor on life support systems, the assessment of renal functions pre-nephrectomy, immunotherapy prenephrectomy, and assessment of potential recipients, etc.... 281.00 5899 Recipient related services; including nephrological management of transplantation including examination. Supervision of osmotic loading, tissue typing, and interpretation of cytotoxicity tests, timing of initial suppression and detention in the operative theatre and complete patient care for the first three (3) days... 435.10 5894 Subsequent postoperative routine care at daily care rates, per day...52.35 5895 Management of rejection crises, care ordinarily equivalent to that of the first three (3) postoperative days, per day...44.40 5896 Management of rejection crises requiring dialysis; as for acute renal failure (includes daily care by a Nephrologist); equivalent to repeat hemodialysis in acute renal failure, per dialysis See existing schedule... 148.50 5897 Dialysis without rejection crises, care equivalent to that for chronic renal failure on repeat hemodialysis, per dialysis See existing schedule...39.65 The above fees represent the total fees for those Nephrologists directly involved with the transplant and will be divided amongst them according to the involvement of each. April 1, 2012 P-1