Medicare Benefits Schedule - Note TN.8.141

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Category 3 - THERAPEUTIC PROCEDURES

TN.8.141

Application of items 51011 to 51171 (Sub-group 17)

Spinal surgery items 51011 to 51171 cannot be performed in conjunction with any other item (outside of subgroup 17) in Group T8 of the MBS (surgical operation items 30001 to 50952), when that surgical item is related to spinal surgery.

 

Meaning of Motion Segment

Motion segment is defined as including all anatomical structures (including traversing and exiting nerve roots) between and including the top of the pedicle above to the bottom of the pedicle below.

 

Combined Anterior and Posterior Surgery

Combined anterior/ posterior surgery items 51061, 51062, 51063, 51064, 51065 and 51066 cannot be claimed with any item between 51020 and 51045 (i.e. items for spinal instrumentation, posterior bone graft and/or anterior column fusion).

 

Interpretation of Spinal Fusion

Lumbar spinal fusion may not be claimed for chronic low back pain for which a diagnosis has not been made.

Related Items: 51011 51012 51013 51014 51015 51020 51021 51022 51023 51024 51025 51026 51031 51032 51033 51034 51035 51036 51041 51042 51043 51044 51045 51051 51052 51053 51054 51055 51056 51057 51058 51059 51061 51062 51063 51064 51065 51066 51071 51072 51073 51102 51103 51110 51111 51112 51113 51114 51115 51120 51130 51131 51140 51141 51145 51150 51160 51165 51170 51171


Related Items

Category 3 - THERAPEUTIC PROCEDURES

51011

51011 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spinal decompression or exposure via partial or total laminectomy, partial vertebrectomy or posterior spinal release, one motion segment, not being a service associated with a service to which item 51012, 51013, 51014 or 51015 applies

(Anaes.) (Assist.)

Fee: $1,458.45 Benefit: 75% = $1,093.85

(See para TN.8.141, TN.8.142 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51012

51012 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spinal decompression or exposure via partial or total laminectomy, partial vertebrectomy or posterior spinal release, 2 motion segments, not being a service associated with a service to which item 51011, 51013, 51014 or 51015 applies

(Anaes.) (Assist.)

Fee: $1,944.40 Benefit: 75% = $1,458.30

(See para TN.8.141, TN.8.142 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51013

51013 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spinal decompression or exposure via partial or total laminectomy, partial vertebrectomy or posterior spinal release, 3 motion segments, not being a service associated with a service to which item 51011, 51012, 51014 or 51015 applies

(Anaes.) (Assist.)

Fee: $2,430.55 Benefit: 75% = $1,822.95

(See para TN.8.141, TN.8.142 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51014

51014 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spinal decompression or exposure via partial or total laminectomy, partial vertebrectomy or posterior spinal release, 4 motion segments, not being a service associated with a service to which item 51011, 51012, 51013 or 51015 applies

(Anaes.) (Assist.)

Fee: $2,916.65 Benefit: 75% = $2,187.50

(See para TN.8.141, TN.8.142 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51015

51015 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spinal decompression or exposure via partial or total laminectomy, partial vertebrectomy or posterior spinal release, more than 4 motion segments, not being a service associated with a service to which item 51011, 51012, 51013 or 51014 applies

(Anaes.) (Assist.)

Fee: $3,402.75 Benefit: 75% = $2,552.10

(See para TN.8.141, TN.8.142 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51020

51020 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Simple fixation of part of one vertebra (not motion segment) including pars interarticularis, spinous process or pedicle, or simple interspinous wiring between 2 adjacent vertebral levels, not being a service associated with:

(a) interspinous dynamic stabilisation devices; or

(b) a service to which item 51021, 51022, 51023, 51024, 51025 or 51026 applies

(Anaes.) (Assist.)

Fee: $777.70 Benefit: 75% = $583.30

(See para TN.8.141, TN.8.143 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51021

51021 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Fixation of motion segment with vertebral body screw, pedicle screw or hook instrumentation including sublaminar tapes or wires, one motion segment, not being a service associated with a service to which item 51020, 51022, 51023, 51024, 51025 or 51026 applies

(Anaes.) (Assist.)

Fee: $1,301.70 Benefit: 75% = $976.30

(See para TN.8.141, TN.8.143 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51022

51022 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Fixation of motion segment with vertebral body screw, pedicle screw or hook instrumentation including sublaminar tapes or wires, 2 motion segments, not being a service associated with a service to which item 51020, 51021, 51023, 51024, 51025 or 51026 applies

(Anaes.) (Assist.)

Fee: $1,619.20 Benefit: 75% = $1,214.40

(See para TN.8.141, TN.8.143 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51023

51023 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Fixation of motion segment with vertebral body screw, pedicle screw or hook instrumentation including sublaminar tapes or wires, 3 or 4 motion segments, not being a service associated with a service to which item 51020, 51021, 51022, 51024, 51025 or 51026 applies

(Anaes.) (Assist.)

Fee: $1,926.95 Benefit: 75% = $1,445.25

(See para TN.8.141, TN.8.143 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51024

51024 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Fixation of motion segment with vertebral body screw, pedicle screw or hook instrumentation including sublaminar tapes or wires, 5 or 6 motion segments, not being a service associated with a service to which item 51020, 51021, 51022, 51023, 51025 or 51026 applies

(Anaes.) (Assist.)

Fee: $2,224.65 Benefit: 75% = $1,668.50

(See para TN.8.141, TN.8.143 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51025

51025 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Fixation of motion segment with vertebral body screw, pedicle screw or hook instrumentation including sublaminar tapes or wires, 7 to 12 motion segments, not being a service associated with a service to which item 51020, 51021, 51022, 51023, 51024 or 51026 applies

(Anaes.) (Assist.)

Fee: $2,600.15 Benefit: 75% = $1,950.15

(See para TN.8.141, TN.8.143 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51026

51026 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Fixation of motion segment with vertebral body screw, pedicle screw or hook instrumentation including sublaminar tapes or wires, more than 12 motion segments, not being a service associated with a service to which item 51020, 51021, 51022, 51023, 51024 or 51025 applies

(Anaes.) (Assist.)

Fee: $2,846.75 Benefit: 75% = $2,135.10

(See para TN.8.141, TN.8.143 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51031

51031 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spine, posterior and/or posterolateral bone graft to, one motion segment, not being a service associated with a service to which item 51032, 51033, 51034, 51035 or 51036 applies

(Anaes.) (Assist.)

Fee: $956.50 Benefit: 75% = $717.40

(See para TN.8.141, TN.8.144 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51032

51032 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spine, posterior and/or posterolateral bone graft to, 2 motion segments, not being a service associated with a service to which item 51031, 51033, 51034, 51035 or 51036 applies

(Anaes.) (Assist.)

Fee: $1,147.85 Benefit: 75% = $860.90

(See para TN.8.141, TN.8.144 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51033

51033 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spine, posterior and/or posterolateral bone graft to, 3 motion segments, not being a service associated with a service to which item 51031, 51032, 51034, 51035 or 51036 applies

(Anaes.) (Assist.)

Fee: $1,339.15 Benefit: 75% = $1,004.40

(See para TN.8.141, TN.8.144 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51034

51034 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spine, posterior and/or posterolateral bone graft to, 4 to 7 motion segments, not being a service associated with a service to which item 51031, 51032, 51033, 51035 or 51036 applies

(Anaes.) (Assist.)

Fee: $1,434.80 Benefit: 75% = $1,076.10

(See para TN.8.141, TN.8.144 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51035

51035 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spine, posterior and/or posterolateral bone graft to, 8 to 11 motion segments, not being a service associated with a service to which item 51031, 51032, 51033, 51034 or 51036 applies

(Anaes.) (Assist.)

Fee: $1,530.40 Benefit: 75% = $1,147.80

(See para TN.8.141, TN.8.144 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51036

51036 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spine, posterior and/or posterolateral bone graft to, 12 or more motion segments, not being a service associated with a service to which item 51031, 51032, 51033, 51034 or 51035 applies

(Anaes.) (Assist.)

Fee: $1,626.10 Benefit: 75% = $1,219.60

(See para TN.8.141, TN.8.144 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51041

51041 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spinal fusion, anterior column (anterior, direct lateral or posterior interbody), one motion segment, not being a service associated with a service to which item 51042, 51043, 51044 or 51045 applies

(Anaes.) (Assist.)

Fee: $1,100.00 Benefit: 75% = $825.00

(See para TN.8.141, TN.8.145 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51042

51042 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spinal fusion, anterior column (anterior, direct lateral or posterior interbody), 2 motion segments, not being a service associated with a service to which item 51041, 51043, 51044 or 51045 applies

(Anaes.) (Assist.)

Fee: $1,540.05 Benefit: 75% = $1,155.05

(See para TN.8.141, TN.8.145 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51043

51043 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spinal fusion, anterior column (anterior, direct lateral or posterior interbody), 3 motion segments, not being a service associated with a service to which item 51041, 51042, 51044 or 51045 applies

(Anaes.) (Assist.)

Fee: $1,925.05 Benefit: 75% = $1,443.80

(See para TN.8.141, TN.8.145 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51044

51044 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spinal fusion, anterior column (anterior, direct lateral or posterior interbody), 4 motion segments, not being a service associated with a service to which item 51041, 51042, 51043 or 51045 applies

(Anaes.) (Assist.)

Fee: $2,090.05 Benefit: 75% = $1,567.55

(See para TN.8.141, TN.8.145 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51045

51045 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spinal fusion, anterior column (anterior, direct lateral or posterior interbody), 5 or more motion segments, not being a service associated with a service to which item 51041, 51042, 51043 or 51044 applies

(Anaes.) (Assist.)

Fee: $2,200.05 Benefit: 75% = $1,650.05

(See para TN.8.141, TN.8.145 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51051

51051 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Pedicle subtraction osteotomy, one motion segment, not being a service associated with:

(a) anterior column fusion when at the same motion segment; or

(b) a service to which item 51052, 51053, 51054, 51055, 51056, 51057, 51058 or 51059 applies

(Anaes.) (Assist.)

Fee: $1,879.60 Benefit: 75% = $1,409.70

(See para TN.8.141, TN.8.146 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51052

51052 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Pedicle subtraction osteotomy, 2 motion segments, not being a service associated with:

(a) anterior column fusion when at the same motion segment; or

(b) a service to which item 51051, 51053, 51054, 51055, 51056, 51057, 51058 or 51059 applies

(Anaes.) (Assist.)

Fee: $2,286.00 Benefit: 75% = $1,714.50

(See para TN.8.141, TN.8.146 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51053

51053 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Vertebral column resection osteotomy performed through single posterior approach, one motion segment, not being a service associated with:

(a) anterior column fusion when at the same motion segment; or

(b) a service to which item 51051, 51052, 51054, 51055, 51056, 51057, 51058 or 51059 applies

(Anaes.) (Assist.)

Fee: $2,600.95 Benefit: 75% = $1,950.75

(See para TN.8.141, TN.8.146 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51054

51054 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Vertebral body, piecemeal or subtotal excision of (where piecemeal or subtotal excision is defined as removal of more than 50% of the vertebral body), one vertebra, not being a service associated with:

(a) anterior column fusion when at the same motion segment; or

(b) a service to which item 51051, 51052, 51053, 51055, 51056, 51057, 51058 or 51059 applies

(Anaes.) (Assist.)

Fee: $1,386.85 Benefit: 75% = $1,040.15

(See para TN.8.141, TN.8.146 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51055

51055 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Vertebral body, piecemeal or subtotal excision of (where piecemeal or subtotal excision is defined as removal of more than 50% of the vertebral body), 2 vertebrae, not being a service associated with:

(a) anterior column fusion when at the same motion segment; or

(b) a service to which item 51051, 51052, 51053, 51054, 51056, 51057, 51058 or 51059 applies

(Anaes.) (Assist.)

Fee: $2,080.25 Benefit: 75% = $1,560.20

(See para TN.8.141, TN.8.146 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51056

51056 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Vertebral body, piecemeal or subtotal excision of (where piecemeal or subtotal excision is defined as removal of more than 50% of the vertebral body), 3 or more vertebrae, not being a service associated with:

(a) anterior column fusion when at the same motion segment; or

(b) a service to which item 51051, 51052, 51053, 51054, 51055, 51057, 51058 or 51059 applies

(Anaes.) (Assist.)

Fee: $2,426.95 Benefit: 75% = $1,820.25

(See para TN.8.141, TN.8.146 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51057

51057 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Vertebral body, en bloc excision of (complete spondylectomy), one vertebra, not being a service associated with:

(a) anterior column fusion when at the same motion segment; or

(b) a service to which item 51051, 51052, 51053, 51054, 51055, 51056, 51058 or 51059 applies

(Anaes.) (Assist.)

Fee: $2,438.40 Benefit: 75% = $1,828.80

(See para TN.8.141, TN.8.146 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51058

51058 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Vertebral body, en bloc excision of (complete spondylectomy), 2 vertebrae, not being a service associated with:

(a) anterior column fusion when at the same motion segment; or

(b) a service to which item 51051, 51052, 51053, 51054, 51055, 51056, 51057 or 51059 applies

(Anaes.) (Assist.)

Fee: $2,743.70 Benefit: 75% = $2,057.80

(See para TN.8.141, TN.8.146 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51059

51059 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Vertebral body, en bloc excision of (complete spondylectomy), 3 or more vertebrae, not being a service associated with:

(a) anterior column fusion when at the same motion segment; or

(b) a service to which item 51051, 51052, 51053, 51054, 51055, 51056, 51057 or 51058 applies

(Anaes.) (Assist.)

Fee: $3,352.80 Benefit: 75% = $2,514.60

(See para TN.8.141, TN.8.146 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51061

51061 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spine 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: $2,880.00 Benefit: 75% = $2,160.00

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

Category 3 - THERAPEUTIC PROCEDURES

51062

51062 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spine 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: $3,733.15 Benefit: 75% = $2,799.90

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

Category 3 - THERAPEUTIC PROCEDURES

51063

51063 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spine 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: $4,521.55 Benefit: 75% = $3,391.20

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

Category 3 - THERAPEUTIC PROCEDURES

51064

51064 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spine 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: $5,032.10 Benefit: 75% = $3,774.10

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

Category 3 - THERAPEUTIC PROCEDURES

51065

51065 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spine 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: $5,565.45 Benefit: 75% = $4,174.10

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

Category 3 - THERAPEUTIC PROCEDURES

51066

51066 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spine 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: $5,859.80 Benefit: 75% = $4,394.85

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

Category 3 - THERAPEUTIC PROCEDURES

51071

51071 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Removal of intradural lesion, not being a service associated with a service to which item 51072 or 51073 applies

(Anaes.) (Assist.)

Fee: $2,540.00 Benefit: 75% = $1,905.00

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

Category 3 - THERAPEUTIC PROCEDURES

51072

51072 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Craniocervical junction lesion, transoral approach for, not being a service associated with a service to which item 51071 or 51073 applies

(Anaes.) (Assist.)

Fee: $2,641.60 Benefit: 75% = $1,981.20

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

Category 3 - THERAPEUTIC PROCEDURES

51073

51073 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Removal of intramedullary tumour or arteriovenous malformation, not being a service associated with a service to which item 51071 or 51072 applies

(Anaes.) (Assist.)

Fee: $3,352.80 Benefit: 75% = $2,514.60

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

Category 3 - THERAPEUTIC PROCEDURES

51102

51102 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Thoracoplasty in combination with thoracic scoliosis correction—3 or more ribs

(Anaes.) (Assist.)

Fee: $1,202.35 Benefit: 75% = $901.80

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

Category 3 - THERAPEUTIC PROCEDURES

51103

51103 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Odontoid screw fixation

(Anaes.) (Assist.)

Fee: $2,113.05 Benefit: 75% = $1,584.80

(See para TN.8.141, TN.8.148 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51110

51110 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Spine, treatment of fracture, dislocation or fracture dislocation, with immobilisation by calipers or halo, not including application of skull tongs or calipers as part of operative positioning

(Anaes.)

Fee: $765.30 Benefit: 75% = $574.00 85% = $681.90

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

Category 3 - THERAPEUTIC PROCEDURES

51111

51111 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Skull calipers or halo, insertion of, as an independent procedure

(Anaes.)

Fee: $325.25 Benefit: 75% = $243.95

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

Category 3 - THERAPEUTIC PROCEDURES

51112

51112 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Plaster jacket, application of, as an independent procedure

(Anaes.)

Fee: $219.95 Benefit: 75% = $165.00 85% = $187.00

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

Category 3 - THERAPEUTIC PROCEDURES

51113

51113 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Halo, application of, in addition to spinal fusion for scoliosis, or other conditions

(Anaes.)

Fee: $243.90 Benefit: 75% = $182.95

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

Category 3 - THERAPEUTIC PROCEDURES

51114

51114 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Halo thoracic orthosis—application of both halo and thoracic jacket

(Anaes.)

Fee: $430.55 Benefit: 75% = $322.95

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

Category 3 - THERAPEUTIC PROCEDURES

51115

51115 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Halo femoral traction, as an independent procedure

(Anaes.)

Fee: $430.55 Benefit: 75% = $322.95 85% = $366.00

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

Category 3 - THERAPEUTIC PROCEDURES

51120

51120 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Bone graft, harvesting of autogenous graft, via separate incision or via subcutaneous approach, in conjunction with spinal fusion, other than for the purposes of bone graft obtained from the cervical, thoracic, lumbar or sacral spine

(Anaes.)

Fee: $239.25 Benefit: 75% = $179.45

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

Category 3 - THERAPEUTIC PROCEDURES

51130

51130 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Lumbar artificial intervertebral total disc replacement, at one motion segment only, including removal of disc and marginal osteophytes:

(a) for a patient who:

(i) has not had prior spinal fusion surgery at the same lumbar level; and

(ii) does not have vertebral osteoporosis; and

(iii) has failed conservative therapy; and

(b) not being a service associated with a service to which item 51011, 51012, 51013, 51014 or 51015 applies

(Anaes.) (Assist.)

Fee: $1,822.35 Benefit: 75% = $1,366.80

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

Category 3 - THERAPEUTIC PROCEDURES

51131

51131 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Cervical artificial intervertebral total disc replacement, at one motion segment only, including removal of disc and marginal osteophytes, for a patient who:

(a) has not had prior spinal surgery at the same cervical level; and

(b) is skeletally mature; and

(c) has symptomatic degenerative disc disease with radiculopathy; and

(d) does not have vertebral osteoporosis; and

(e) has failed conservative therapy

(Anaes.) (Assist.)

Fee: $1,100.00 Benefit: 75% = $825.00

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

Category 3 - THERAPEUTIC PROCEDURES

51140

51140 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Previous spinal fusion, re-exploration for, involving adjustment or removal of instrumentation up to 3 motion segments, not being a service associated with a service to which item 51141 applies

(Anaes.) (Assist.)

Fee: $449.55 Benefit: 75% = $337.20

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

Category 3 - THERAPEUTIC PROCEDURES

51141

51141 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Previous spinal fusion, re-exploration for, involving adjustment or removal of instrumentation more than 3 motion segments, not being a service associated with a service to which item 51140 applies

(Anaes.) (Assist.)

Fee: $831.65 Benefit: 75% = $623.75

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

Category 3 - THERAPEUTIC PROCEDURES

51145

51145 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Wound debridement or excision for post operative infection or haematoma following spinal surgery

(Anaes.)

Fee: $449.55 Benefit: 75% = $337.20

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

Category 3 - THERAPEUTIC PROCEDURES

51150

51150 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Coccyx, excision of

(Anaes.) (Assist.)

Fee: $452.55 Benefit: 75% = $339.45

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

Category 3 - THERAPEUTIC PROCEDURES

51160

51160 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

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

(Anaes.) (Assist.)

Fee: $1,168.40 Benefit: 75% = $876.30

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

Category 3 - THERAPEUTIC PROCEDURES

51165

51165 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Anterior exposure of thoracic or lumbar spine, more than one motion segment, not being a service to which item 51160 applies

(Anaes.) (Assist.)

Fee: $1,473.20 Benefit: 75% = $1,104.90

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

Category 3 - THERAPEUTIC PROCEDURES

51170

51170 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Syringomyelia or hydromyelia, craniotomy for, with or without duraplasty, intradural dissection, plugging of obex or local cerebrospinal fluid shunt

(Anaes.) (Assist.)

Fee: $2,219.55 Benefit: 75% = $1,664.70

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

Category 3 - THERAPEUTIC PROCEDURES

51171

51171 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Syringomyelia or hydromyelia, treatment by direct cerebrospinal fluid shunt (for example, syringosubarachnoid shunt, syringopleural shunt or syringoperitoneal shunt)

(Anaes.) (Assist.)

Fee: $932.10 Benefit: 75% = $699.10

(See para TN.8.141 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