E564

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 596 / N16

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
ELBOW AND FOREARM
                                                                                                       Asst         Surg          Anae
    AMPUTATION
# R613 Through radius and ulna.........................................................                   6         351.05          7
# R614 Elbow disarticulation ...............................................................              6         289.50          6
    ARTHRODESIS
# R466 Elbow ......................................................................................       6         833.45          6
    ARTHROPLASTY
# E564 revision of elbow arthroplasty ................................... add 35%
# R281 Ulna replacement (lower end).................................................                      6         296.90           6
# R288 Implant radial head .................................................................              6         452.00           6
# R499 Removal of total replacement .................................................                     6         402.75           7
# R438 Humeral Prosthesis ................................................................                6         676.90          10
# R486 Complete arthroplasty replacement........................................                          6        1205.95           8
# R510 Interposition arthroplasty ........................................................                6         435.20           7
    ARTHROSCOPY
# R683 Elbow arthroscopy setup, includes when rendered
          debridement, synovectomy, synovial biopsy, removal of
          loose body(ies) and/or screw, drilling of defect or
          microfracture, and/or arthroscopic epicondylar release .....                                    6         400.00          7
         Note:
         1.An elbow procedure listed in the Elbow section of the Schedule performed arthroscopically is
           eligible for payment in addition to R683 if that procedure is not described as a component of
           R683 or described by an E-add-on code to R683.
         2.Arthroscopic E-add-on codes listed below are not eligible for payment in addition to R683
           when the service described by the E-code is a generally accepted component of a procedure
           described in Note #1.
# E478 Pinning of osteochondral fragment, to R683 .................... 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 R683
          ..................................................................................... add                 500.00
# E482 Soft tissue capsular release for contractures without bone
         procedure, to R683....................................................... add                              251.55
# E483 Synovectomy for inflammatory arthritis requiring a minimum of
          90 minutes to resect, to R683 ...................................... add 326.55
      Payment rules:
      1.Only one of E481, E482 or E483 is eligible for payment same patient same day.
         2.Synovectomy less then 90 minutes in duration is included in R683.
         3.Osteochondroplasty less than 2 hours in duration is included in R683.

PDF page 632 / N52

ARTHROPLASTY
# E564  - revision of arthroplasty....................................... add 35%
# R493 Ankle - total replacement ........................................................                 8        1204.50         10
# R694 Ankle - liner replacement ........................................................                 8         353.25         10
     Note:
     E564 is not eligible for payment with R694.
# R479 Removal of prosthesis without replacement ...........................                              6         193.00          6

Master, record 1260. Record Layout PDF, page 1.

E56420130701999999990000000010000000000000000000000000000000000000000000000

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.