E553

PDF page 583 / N3

Autogenous
# E551   - separate incision ........................................................ add                86.30
# E552   - same incision ............................................................. add               58.45
# Z279 - different surgeon ................................................................             193.00
    Homogenous
# E553  - banked bone or bone substitutes............................... add                             25.15
    Allograft
# R200 - cadaver - per long bone, each............................................                      144.80
     Note:
     Other donor allografts are payable at 85% of the listed excision fee.

PDF page 588 / N8

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
HAND AND WRIST
                                                                                                        Asst         Surg         Anae
    AMPUTATION
# R608 Phalanx, metacarpal or metacarpophalangeal joint................                                              269.30          7
# E583   - each additional, to R608 ............................................ add                                  94.60
# R612 Wrist........................................................................................       6         289.50          6
# R629 Revision of amputated finger tip .............................................                      6         241.55          6
    ARTHRODESIS
# R465 Finger-thumb ..........................................................................             6         394.70          7
# R777 Wrist - total or partial arthrodesis............................................                    6         833.45          6
     Payment rules:
     1.R465 and R777 include wrist denervation if performed.
         2.R285, R286, R316, R317, R418 are not eligible for payment with R465 or R777
         3.R777 is only eligible for payment for total wrist arthrodesis or for partial wrist arthrodesis
           involving 2 or more carpal bones
    ARTHROPLASTY
# E564  - revision of arthroplasty....................................... add 35%
    Wrist
# R437 - interposition ........................................................................            6         374.00          7
# R485 - total radio-carpal.................................................................               6        1130.15          6
# R479 - removal only .......................................................................              6         193.00          6
# R489 Single joint - total (arthrodesis and/or arthroplasties) maximum
          of 4 ..................................................................................... 6 358.60 7
# R209 First carpometacarpal joint ligament reconstruction and tendon
          interposition arthroplasty (LRTI) .........................................                6 775.00 7
# R500 Removal - prosthesis without replacement.............................                         6 144.80 6
# R236 Carpal replacement ................................................................           6 322.05 7
     Payment rules:
     1.R485 includes any and all of: carpal bone excision(s), proximal row carpectomy, radio-ulnar
       meniscectomy, intercarpal fusion(s), all tenotomies, division and repair of muscle, and wrist
       denervation, if performed.
         2.R485 is not eligible for payment for carpometacarpal arthroplasty.
         3.R285 and R316 are not eligible for payment with arthrodesis or arthroplasty fee codes for the
           same anatomic location.
         4.R209 includes excision of the trapezium, suspensionplasty of the first metacarpal, ligament
           reconstruction with local tendon graft or allograft or nonbiologic material and interposition of
           soft tissue in the trapezial void and excision of the scaphotrapezoid joint, if performed.
         5.R209 is not eligible for payment for suspensionplasty and/or hematoma-distraction
           arthroplasty alone.
         6.E551, E552, E553, R597, R548 and R601 are not eligible for payment with R209.
         [Commentary:
         Suspensionplasty performed at the time of trapeziectomy without tendon interposition
         arthroplasty is payable as R285 and R597.]

PDF page 607 / N27

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
 SHOULDER, ARM AND CHEST
                                                                                                        Asst   Surg     Anae
    Dislocations
     Acromio-clavicular/sterno-clavicular
# D014 - no reduction........................................................................                   67.80
# D025 - closed with anaesthetic ......................................................                  6     134.55    6
# D023 - open reduction....................................................................              6     326.40    7
# R596 - late......................................................................................      6     350.50    6
     Glenohumeral joint
# D015 - closed reduction without anaesthetic .................................                                 49.20
# D016 - closed reduction with anaesthetic ......................................                              111.40    6
# D017        - open reduction, early..........................................................          6     323.85     6
# R472        - open reduction, late............................................................         6     580.90    10
# R401        - open reduction, recurrent ...................................................            6     524.55    10
# E062        - coracoid transfer (Latarjet) or bone block graft to glenoid, to
                R401............................................................................. add          350.00
# E058          - revision/repair following previous glenohumeral joint
                  surgery, to R401................................................. add 30%
         Payment rules:
         1.E551A, E552A, E553A are not eligible for payment with E062.
         2.R472 is not eligible for payment for open reduction and repair of recurrent glenohumeral
           instability.

Master, record 1249. Record Layout PDF, page 1.

E55320250401999999990000025150000000000000000000000000000000000000000000000

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.