E490

PDF page 616 / N36

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
PELVIS AND HIP
                                                                                                         Asst         Surg         Anae
    AMPUTATION
# R631 Hemipelvectomy - hindquarter................................................                        10         796.20         15
# R630 Hip disarticulation ...................................................................             10         753.50         10
    ARTHRODESIS
# R469 Sacro-iliac joint .......................................................................            6         395.25          7
# R514 Symphysis pubis.....................................................................                 6         387.00          7
# R470 Hip ..........................................................................................       6         703.45          8
    ARTHROPLASTY
# R439 Unipolar ..................................................................................          6         641.15         10
# R440 Total hip replacement - acetabulum and femur.......................                                  8         708.70         10
# R553 Total hip replacement with take down of fusion ......................                                8         972.90         15
    Revision total arthroplasty hip - one or both components
# R241 - acetabular or femoral .........................................................                    9        1304.80         15
# E589    - bone graft to acetabulum ........................................... add                                  101.25
# E593    - acetabular reconstruction (extensive, including bone
            grafts)......................................................................... add                      194.00
# R481 Reattachment of greater trochanter (late)...............................                             6         290.55          8
    Removal only
# R443 - non-cemented ....................................................................                  6         447.30          8
# R488 - cemented............................................................................               6         557.75          8
# R491 Replacement acetabular liner and/or femoral head................                                     8         532.30         10
    ARTHROSCOPY
# R686 Hip arthroscopy set up, includes when rendered debridement,
         synovectomy, removal of loose body(ies) and/or screw,
         drilling of defect, microfracture, abrasion arthroplasty, and/
         or synovial biopsy...............................................................                  6         669.80         10
# E487 Resection of labrum, to R686 ........................................... add                                   240.00
# E488 Repair of labrum, to R686................................................. add                                 350.00
# E482 Soft tissue capsular release without bone procedure, to R686
          ..................................................................................... add                   251.55
# E490 Osteochondroplasty (extensive bone and arthrofibrotic tissue
         removal requiring a minimum of 2 hours to resect), to R686
          ..................................................................................... add                   500.00
         Payment rules:
         1.E487 is not eligible for payment in addition to E488.
         2.Only one of E482 or E490 is eligible for payment same patient same day.
         3.Osteochondroplasty requiring less than 2 hours is included in R686.

Master, record 1187. Record Layout PDF, page 1.

E49020250401999999990000500000000000000000000000000000000000000000000000000

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.