Medicare Benefits Schedule - Note TN.8.147

Only one of these items should be billed for any appropriate combined anterior and posterior surgeries which are completed under one anaesthetic. The appropriate item is determined by the number of motion segments to which grafting and fusion occur.

These items cannot be claimed with any item between 51020 to 51026, 51031 to 51036 and 51041 to 51045.

If a laminectomy is included, an item from 51011 to 51015 can also be used appropriate to the level of decompression.

If spinal osteotomy or vertebrectomy (>50%) is performed as part of the combined anterior/posterior approach, it is appropriate to claim one item between 51051 to 51056 in addition to an item between 51061 to 51066.

Related Items: 51061 51062 51063 51064 51065 51066

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Multiple Operation Rule

Spinal fusion, anterior and posterior, including spinal instrumentation at one motion segment, posterior and/or posterolateral bone graft, and anterior column fusion, not being a service associated with a service to which item 51062, 51063, 51064, 51065 or 51066 applies

(Anaes.) (Assist.)

Fee: $3,120.10 Benefit: 75% = $2,340.10

(See para TN.8.141, TN.8.147 of explanatory notes to this Category)

Multiple Operation Rule

Spinal fusion, anterior and posterior, including spinal instrumentation at 2 motion segments, posterior and/or posterolateral bone graft, and anterior column fusion, not being a service associated with a service to which item 51061, 51063, 51064, 51065 or 51066 applies

(Anaes.) (Assist.)

Fee: $4,044.35 Benefit: 75% = $3,033.30

(See para TN.8.141, TN.8.147 of explanatory notes to this Category)

Multiple Operation Rule

Spinal fusion, anterior and posterior, including spinal instrumentation at 3 motion segments, posterior and/or posterolateral bone graft, and anterior column fusion, not being a service associated with a service to which item 51061, 51062, 51064, 51065 or 51066 applies

(Anaes.) (Assist.)

Fee: $4,898.45 Benefit: 75% = $3,673.85

(See para TN.8.141, TN.8.147 of explanatory notes to this Category)

Multiple Operation Rule

Spinal fusion, anterior and posterior, including spinal instrumentation at 4 to 7 motion segments, posterior and/or posterolateral bone graft, and anterior column fusion, not being a service associated with a service to which item 51061, 51062, 51063, 51065 or 51066 applies

(Anaes.) (Assist.)

Fee: $5,451.60 Benefit: 75% = $4,088.70

(See para TN.8.141, TN.8.147 of explanatory notes to this Category)

Multiple Operation Rule

Spinal fusion, anterior and posterior, including spinal instrumentation at 8 to 11 motion segments, posterior and/or posterolateral bone graft, and anterior column fusion, not being a service associated with a service to which item 51061, 51062, 51063, 51064 or 51066 applies

(Anaes.) (Assist.)

Fee: $6,029.50 Benefit: 75% = $4,522.15

(See para TN.8.141, TN.8.147 of explanatory notes to this Category)

Multiple Operation Rule

Spinal fusion, anterior and posterior, including spinal instrumentation at 12 or more motion segments, posterior and/or posterolateral bone graft, and anterior column fusion not being a service associated with a service to which item 51061, 51062, 51063, 51064 or 51065 applies

(Anaes.) (Assist.)

Fee: $6,348.35 Benefit: 75% = $4,761.30

(See para TN.8.141, TN.8.147 of explanatory notes to this Category)