R597

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 592 / N12

Ligaments
# R597 Simple/single repair - wrist......................................................               6         325.45          7
# R548 Extensive/multiple repair - wrist ..............................................                 6         511.45          7
# R601 Metacarpal phalangeal repair .................................................                   6         371.05          7
      Note:
      Reconstruction - Nerve - see page X13.

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

Master, record 4824. Record Layout PDF, page 1.

R59720260401999999990000325450000000774600000000000000000111720000001117200

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.