E599

PDF page 599 / N19

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
 ELBOW AND FOREARM
                                                                                                     Asst   Surg     Anae
    RECONSTRUCTION
    Fascia
     Repair fascial defects
# R476 - small ...................................................................................    6     144.80    7
# R478 - large with or without synthetic graft or rotation flap ............                          6     290.55    7
    Ligaments
# R597 Simple/single repair ................................................................          6     325.45    7
# R548 Extensive/multiple repair.........................................................             6     511.45    7
       Tendons
      Suture flexor tendon excluding distal biceps tendon repair and/or reconstruction
# R585 - single .................................................................................. 6 433.10           7
# E581    - each additional........................................................... add           181.55
# R183 Distal biceps tendon repair .....................................................              6     700.00    7
# R184 Distal triceps tendon repair .....................................................             6     500.00    7
# E061   - Delayed repair requiring use of tendon graft, to R183 or
           R184 .................................................................. add 50%
         Payment rules:
         1.R183 and R184 includes mobilization of muscle, tenolysis, tendon repair as well as reduction
           and fixation of bony injury if required.
         2.E061 is only eligible for payment for surgical repair performed more than 6 weeks from the
           date of injury.
         3.E061 is only eligible for payment for irreparable tears requiring the use of tendon graft.
         4.E061 includes extensive muscle and tendon mobilization, tendon lengthening or other
           tenoplasty and the use and/or harvest of allograft or autograft tendon.
         5.E061 is not eligible for payment for chronic biceps or triceps tears that are directly repairable
           without the use of a tendon graft.
         [Commentary:
         Suture of extensor tendons of forearm may be claimed using fee codes from hand/wrist
         section.]
      Tenoplasty
# R557 - single ..................................................................................    6     223.65    7
# E050    - each additional.......................................................... add                    77.05
      Tenolysis
# R556 - single ..................................................................................    6     202.25    6
# E599    - each additional .......................................................... add                   87.20
      Transposition/transplantation/transfer
# R563 - single ..................................................................................    6     376.05    7
# E056    - each additional .......................................................... add                   91.90
# R583 Steindler flexoplasty................................................................          6     344.85    7

PDF page 636 / N56

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
FOOT AND ANKLE
                                                                                                        Asst         Surg         Anae
# R430 Claw or hammer or overlapping 5th toe ..................................                            6         287.70          6
# E594          - each additional hammer toe....................................... add                               56.55
# R355 Hallux valgus reconstruction...................................................                     6         446.40          7
# R360 Major forefoot reconstruction, must include the first MP joint
         and a minimum of 2 other MP joints ...................................                            6         711.15          7
         Payment rules:
         1.R355 includes first metatarsal bunionectomy, tenotomy(ies),soft tissue releases and
           plications, and may include metatarsophalangeal synovectomy/debridement if performed.
         2.Excisional arthroplasty for treatment of hallux valgus should be claimed as R309 or E587
           and is not eligible for payment as R355.
    Club Foot
# R408 Posterior or medial release.....................................................                    6         312.70          7
# R448 Posteromedial release, lateral shortening, tendon transfers
          and fusion...........................................................................            6         371.20          7
# R313 Complex reconstruction or revision of previous club foot repair
          (not to include simple tendon releases)..............................                            6         468.65          6
# R546 Plantar fascia release (Steindler)............................................                      6         248.95          6
    Ligaments
      Ankle
# R185 - one .....................................................................................         6         346.85          7
# R744 - extensive/multiple...............................................................                 6         588.20          7
    Tendons
# R640 Exploration - tendon sheath....................................................                     6         200.90          7
      Tenolysis - extensive release
# R556 - one .....................................................................................         6         202.25          6
# E599    - each additional digit ................................................... add                             87.20
      Tendon transfer foot and ankle
# R565 - single ..................................................................................         6         253.30          7
# E055    - each additional........................................................... add                            94.60
# R572 Tenodesis................................................................................           6         338.10          7
# R560 Graft........................................................................................       6         253.30          6
# E053   - each additional........................................................... add                             94.60
      Lengthening or shortening
# R557 - one .....................................................................................         6         223.65          7
# E050    - each additional........................................................... add                            77.05
      Suture extensor tendon
# R578 - one .....................................................................................         6         276.10          7
# E580    - each additional........................................................... add                           119.40
     Suture flexor tendon
# R585 - one .....................................................................................         6         433.10          7

Master, record 1295. Record Layout PDF, page 1.

E59920250401999999990000087200000000000000000000000000000000000000000000000

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.