Medicare Benefits Schedule - Note TN.8.116

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Category 3 - THERAPEUTIC PROCEDURES

TN.8.116

Wrist Surgery - (Items 49200 to 49227)

For the purposes of these items, the wrist includes both the radiocarpal joint and the midcarpal joint.

Related Items: 49200 49203 49206 49209 49212 49215 49218 49221 49224 49227


Related Items

Category 3 - THERAPEUTIC PROCEDURES

49200

49200 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Jan-2022
Schedule Fee Updated:
01-Jul-2022

Wrist, arthrodesis of, with synovectomy if performed, with or without internal fixation of the radiocarpal joint (H)

(Anaes.) (Assist.)

Fee: $865.80 Benefit: 75% = $649.35

(See para TN.8.116 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49203

49203 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2022

Limited fusion of wrist, with or without bone graft, including each of the following:

(a) ligament or tendon transfers;

(b) partial or total excision of one or more carpal bones;

(c) rebalancing procedures;

(d) synovectomy

(H)

(Anaes.) (Assist.)

Fee: $820.10 Benefit: 75% = $615.10

(See para TN.8.116 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49206

49206 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2022

Proximal row carpectomy of wrist, including either or both of the following (if performed):

(a) styloidectomy;

(b) synovectomy

(H)

(Anaes.) (Assist.)

Fee: $597.15 Benefit: 75% = $447.90

(See para TN.8.116 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49209

49209 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2022

Prosthetic replacement of wrist or distal radioulnar joint, including either or both of the following (if performed):

(a) ligament realignment;

(b) tendon realignment

(H)

(Anaes.) (Assist.)

Fee: $796.35 Benefit: 75% = $597.30

(See para TN.8.116 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49212

49212 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2022

Arthrotomy of wrist or distal radioulnar joint, for infection, including any of the following (if performed):

(a) joint debridement;

(b) removal of loose bodies;

(c) synovectomy

(H)

(Anaes.) (Assist.)

Fee: $248.95 Benefit: 75% = $186.75

(See para TN.8.116 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49215

49215 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2022

Reconstruction of single or multiple ligaments or capsules of wrist, by open procedure, including any of the following (if performed):

(a) arthrotomy;

(b) ligament harvesting and grafting;

(c) synovectomy;

(d) tendon harvesting and grafting;

(e) insertion of synthetic ligament substitute

(H)

(Anaes.) (Assist.)

Fee: $686.85 Benefit: 75% = $515.15

(See para TN.8.116 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49218

49218 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2022

Wrist, diagnostic arthroscopy of, including radiocarpal or midcarpal joints, or both (including biopsy)—other than a service associated with another arthroscopic procedure of the wrist joint (H)

(Anaes.) (Assist.)

Fee: $288.55 Benefit: 75% = $216.45

(See para TN.8.116 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49221

49221 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2022

Treatment of wrist, by arthroscopic means, including any of the following (if performed):

(a) drilling of defect;

(b) removal of loose bodies;

(c) release of adhesions;

(d) synovectomy;

(e) debridement;

(f) resection of dorsal or volar ganglia;

other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing an arthroscopic procedure of the wrist joint (H)

(Anaes.) (Assist.)

Fee: $646.95 Benefit: 75% = $485.25

(See para TN.8.116 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49224

49224 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2022

Osteoplasty of wrist, by arthroscopic means, including either or both of the following (if performed):

(a) excision of the distal ulna;

(b) total synovectomy;

other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing an arthroscopic procedure of the wrist joint—2 or more distinct areas (H)

(Anaes.) (Assist.)

Fee: $746.40 Benefit: 75% = $559.80

(See para TN.8.116 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49227

49227 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2022

Treatment of wrist by one of the following:

(a) pinning of osteochondral fragment, by arthroscopic means;

(b) stabilisation procedure for ligamentous disruption;

(c) partial wrist fusion or carpectomy, by arthroscopic means;

(d) fracture management;

other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing an arthroscopic procedure of the wrist joint (H)

(Anaes.) (Assist.)

Fee: $746.40 Benefit: 75% = $559.80

(See para TN.8.116 of explanatory notes to this Category)


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change