E477

PDF page 633 / N53

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
 FOOT AND ANKLE
                                                                                                     Asst   Surg     Anae
      Metatarsophalyngeal interposition
# R456 - single ..................................................................................    6     144.80    6
# E538    - each additional........................................................... add                   38.00
# R453 Metatarsophalyngeal (Swansons, etc.)...................................                        6     376.60    7
# R454 - multiple ...............................................................................     6     387.00    7
# R500 Removal - prosthesis without replacement.............................                          6     144.80    6
    ARTHROSCOPY
# R688 Ankle arthroscopy setup, includes when rendered
         debridement, synovectomy, removal of loose body(ies) and/
         or screw, drilling of defect or microfracture and/or synovial
         biopsy .................................................................................     6     400.00    7
         Note:
         1.An ankle procedure listed in the Foot and Ankle section of the Schedule performed
           arthroscopically is eligible for payment in addition to R688 if that procedure is not described
           as a component of R688 or described by an E-add-on code to R688.
         2.Arthroscopic E-add-on codes listed below are not eligible for payment in addition to R688
           when the service described by the E-code is a generally accepted component of a procedure
           described in Note #1.
# E477 Arthroscopy of subtalar and/or intratarsal joint(s), through
          separate portals, to R688 ............................................. add                       192.00
# E478 Pinning of osteochondral fragment, to R688 .................... add          251.55
      Note:
      F-prefix fracture procedures are not eligible for payment with E478 for the same fracture.
# E481 Osteochondroplasty (extensive bone and arthrofibrotic tissue
         removal requiring a minimum of 2 hours to resect),
          to R688........................................................................ add               500.00
# E483 Synovectomy for inflammatory arthritis requiring a minimum of
         90 minutes to resect, to R688 ...................................... add                           326.55
# R689 Excision of Os Trigonum (sole procedure).............................. 6 230.00                                7
     Payment rules:
     1.Only one of E481 or E483 is eligible for payment same patient same day.
         2.R688 is not eligible for payment in addition to R689.

Master, record 1174. Record Layout PDF, page 1.

E47720250401999999990000192000000000000000000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.