Medicare Benefits Schedule - Note TN.8.194

• Correction of a hallux valgus deformity involves realignment of the joint using soft tissue stabilization and osteotomy of the metatarsal as needed. 
• The following items are not to be used on the same joint: arthroscopy (49730 or 49732), bone removal or osteotomy (48430, 48400 or 48403), joint interposition (49821, 49824 or 49783-49788), arthrodesis procedure, ganglion excision, neurolysis (39330), wound debridement (30023) or joint stabilization unless the procedure is performed at a site separate to the 1st metatarsal.

Related Items: 49821 49824 49827 49830 49833 49836 49837 49838

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Multiple Operation Rule

Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joint, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) local tendon transfer;

(e) joint debridement

—one joint (H)

(Anaes.) (Assist.)

Fee: $476.55 Benefit: 75% = $357.45

(See para TN.8.194, TN.8.199, TN.8.201 of explanatory notes to this Category)

Multiple Operation Rule

Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joint, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) local tendon transfer;

(e) joint debridement;

—2 joints (H)

(Anaes.) (Assist.)

Fee: $834.30 Benefit: 75% = $625.75

(See para TN.8.194, TN.8.199 of explanatory notes to this Category)

Multiple Operation Rule

Unilateral correction of hallux valgus or varus deformity of the foot, by local tendon transfer, including any of the following (if performed):

(a) exostectomy;

(b) removal of bursae;

(c) synovectomy;

(d) capsule repair;

(e) capsule or tendon release or transfer

(H)

(Anaes.) (Assist.)

Fee: $518.10 Benefit: 75% = $388.60

(See para TN.8.194, TN.8.196, TN.8.199, TN.8.201, TN.8.223 of explanatory notes to this Category)

Multiple Operation Rule

Bilateral correction of hallux valgus or varus deformity of the foot, by local tendon transfer, including any of the following (if performed):

(a) exostectomy;

(b) removal of bursae;

(c) synovectomy;

(d) capsule repair;

(e) capsule or tendon release or transfer

(H)

(Anaes.) (Assist.)

Fee: $906.70 Benefit: 75% = $680.05

(See para TN.8.194, TN.8.199, TN.8.201, TN.8.223 of explanatory notes to this Category)

Multiple Operation Rule

Unilateral correction of hallux valgus or varus deformity of the foot, by osteotomy of first metatarsal, without internal fixation, including any of the following (if performed):

(a) exostectomy;

(b) removal of bursae;

(c) synovectomy;

(d) capsule repair;

(e) capsule or tendon release or transfer

(H)

(Anaes.) (Assist.)

Fee: $569.95 Benefit: 75% = $427.50

(See para TN.8.194, TN.8.196, TN.8.199, TN.8.201, TN.8.223 of explanatory notes to this Category)

Multiple Operation Rule

Bilateral correction of hallux valgus or varus deformity of the foot by osteotomy of first metatarsal, without internal fixation, including any of the following (if performed):

(a) exostectomy;

(b) removal of bursae;

(c) synovectomy;

(d) capsule repair;

(e) capsule or tendon release or transfer

(H)

(Anaes.) (Assist.)

Fee: $984.50 Benefit: 75% = $738.40

(See para TN.8.194, TN.8.196, TN.8.199, TN.8.201, TN.8.223 of explanatory notes to this Category)

Multiple Operation Rule

Unilateral correction of hallux valgus or varus deformity of the foot, by osteotomy of first metatarsal, with internal fixation, including any of the following (if performed):

(a) exostectomy;

(b) removal of bursae;

(c) synovectomy;

(d) capsule repair;

(e) capsule or tendon release or transfer

(H)

(Anaes.) (Assist.)

Fee: $712.45 Benefit: 75% = $534.35

(See para TN.8.194, TN.8.196, TN.8.199, TN.8.201, TN.8.223 of explanatory notes to this Category)

Multiple Operation Rule

Bilateral correction of hallux valgus or varus deformity of the foot by osteotomy of first metatarsal, with internal fixation or arthrodesis of first metatarsophalangeal  joint, including any of the following (if performed):

(a) exostectomy;

(b) removal of bursae;

(c) synovectomy;

(d) capsule repair;

(e) capsule or tendon release or transfer

(H)

(Anaes.) (Assist.)

Fee: $1,230.30 Benefit: 75% = $922.75

(See para TN.8.194, TN.8.196, TN.8.199, TN.8.201, TN.8.223 of explanatory notes to this Category)