Medicare Benefits Schedule - Note TN.8.149

If the spine surgeon performs their own exposure to the thoracic or lumbar spine then 51160 or 51165 can be added to the claim for the overall surgery.  If an assisting surgeon is used at any time during the procedure, then 51160 or 51165 should be used in isolation by the assisting surgeon. If the assisting surgeon needs to perform complex non-spinal surgery, they may use a more appropriate item but not in combination with 51160 or 51165.  If an exposure surgeon claims a number from any section of the MBS schedule, the spinal surgeon cannot claim 51160 or 51165.

Related Items: 51160 51165

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Multiple Operation Rule

Anterior exposure of thoracic or lumbar spine, one motion segment, not being a service to which item 51165 applies

(Anaes.) (Assist.)

Fee: $1,265.80 Benefit: 75% = $949.35

(See para TN.8.141, TN.8.149 of explanatory notes to this Category)

Multiple Operation Rule

Anterior exposure of thoracic or lumbar spine, more than one motion segment, excluding vertebral body tethering for the treatment of scoliosis and not being a service to which item 51160 applies (H)

(Anaes.) (Assist.)

Fee: $1,596.05 Benefit: 75% = $1,197.05

(See para TN.8.141, TN.8.149 of explanatory notes to this Category)