R500

PDF page 581 / N1

PREAMBLE
  A. The removal of a wire or pin or other device when used for traction or external fixation (except for
     rigid external fixators) in the treatment of a fracture or other orthopaedic procedure is to be included
     in the procedural fee (unless otherwise stated in the Schedule) unless a general anaesthetic is
     required, in which case a fee may be claimed. Removal of devices used for internal fixation more
     than 30 days after insertion may be claimed for in addition to the procedural benefit.
  B. The benefit for total joint replacement also includes denervation of the joint, all tenotomies and
     division and repair of muscle.
  C. The benefit for obtaining a bone graft is not to be claimed in cases of pseudoarthrosis repair,
     arthrodesis or for listings in which bone grafting is included.
  D. For the supervision of limb fitting and 6 months post-operative care following amputation, claim visit
     fees. Amputation with immediate fitting to include supervision of final limb fitting, add 40% (E586).
                                           Note:
                                           Reconstruction or Arthroplasty Procedures: If other procedures are claimed, same joint, same
                                           time, e.g. debridement, synovectomy, tendon release etc., the Medical Consultant will assess
                                           the surgeon's claim.
  # E554                                                               - synovectomy requiring a minimum of 30 minutes to resect,
                                                                         to R236, R240, R241, R244, R281, R288, R437, R438,
                                                                         R439, R440, R441, R442, R443, R453, R454, R456,
                                                                         R479, R481, R482, R483, R485, R486, R487, R488,
                                                                         R491, R493, R496, R497, R498, R499, R500, R509, R510
                                                                         ................................................................................... add   175.00
                                           Payment rules:
                                           Synovectomy codes other than E554 are not eligible for payment when rendered in addition to
                                           the codes listed above.

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 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 4728. Record Layout PDF, page 1.

R50020260401999999990000144800000000774600000000000000000095760000000957600

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.