Medicare Benefits Schedule - Note TN.8.200

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Category 3 - THERAPEUTIC PROCEDURES

TN.8.200

Procedure for arthrodesis

  • An arthrodesis consists of joint preparation, removal of surrounding osteophytes, intraarticular joint correction and fixation by any means.
  • Bone procedures items (48430, 48400, 48403, 48406, 48409, 48418, or 48421) are not to be claimed unless performed at a separate site to the arthrodesis.
  • Neurolysis (39330), wound debridement (30023) and ganglion excision (30107) items are not to be claimed unless performed at a site separate to the arthrodesis site.

Related Items: 30023 39330 48400 48403 48406 48409 48421 48430 49712 49740 49742 49744 49760 49776 49777 49778 49779 49780 49781 49789 49790 49791 49792 49793 49794 49795 49796 49797 49798 49814 49815 49845 49851 50118


Related Items

Category 3 - THERAPEUTIC PROCEDURES

39330

39330 - Additional Information

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

Neurolysis by open operation without transposition, other than a service associated with a service to which item 30023, 39321, 39328, 39329, 39332, 39336, 39339, 39342, 39345, 49774 or 49775 applies (H)

 

 

      

(Anaes.) (Assist.)

Fee: $288.00 Benefit: 75% = $216.00

(See para TN.8.196, TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49760

49760 - Additional Information

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

Arthroereisis of subtalar joint, including any of the following (if performed):

(a) capsulotomy;

(b) synovectomy;

(c) joint debridement

(H)

(Anaes.) (Assist.)

Fee: $367.35 Benefit: 75% = $275.55

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49776

49776 - Additional Information

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

Revision of arthrodesis of joint of hindfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint;

(e) removal of hardware;

(f) neurolysis;

(g) osteotomy of non‑union or malunion;

other than a service associated with a service to which item 30023 applies—may only be claimed once per joint (H)

(Anaes.) (Assist.)

Fee: $1,223.00 Benefit: 75% = $917.25

(See para TN.8.200, TN.8.224 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49777

49777 - Additional Information

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

Arthrodesis of joint of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint;

—one joint (H)

(Anaes.) (Assist.)

Fee: $724.15 Benefit: 75% = $543.15

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49778

49778 - Additional Information

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

Arthrodesis of joints of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joints;

—2 joints (H)

(Anaes.) (Assist.)

Fee: $1,086.25 Benefit: 75% = $814.70

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49779

49779 - Additional Information

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

Arthrodesis of joints of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joints;

—3 joints (H)

(Anaes.) (Assist.)

Fee: $1,267.25 Benefit: 75% = $950.45

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49780

49780 - Additional Information

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

Arthrodesis of joints of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joints;

—4 joints (H)

(Anaes.) (Assist.)

Fee: $1,448.30 Benefit: 75% = $1,086.25

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49781

49781 - Additional Information

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

Revision of arthrodesis of joint of midfoot, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of ostephytes at joint;

(e) removal of hardware;

(f) osteotomy of non-union or malunion;

—one joint (H)

(Anaes.) (Assist.)

Fee: $1,086.25 Benefit: 75% = $814.70

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49789

49789 - Additional Information

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

Bilateral arthrodesis of first metatarsophalangeal joint, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint

(H)

(Anaes.) (Assist.)

Fee: $1,163.05 Benefit: 75% = $872.30

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49790

49790 - Additional Information

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

Revision of arthrodesis of first metatarsophalangeal joint, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of exostosis at joint;

(e) removal of hardware;

(f) osteotomy of non-union or malunion

(H)

(Anaes.) (Assist.)

Fee: $1,010.20 Benefit: 75% = $757.65

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49791

49791 - Additional Information

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

Arthrodesis of hallux interphalangeal or lesser metatarsophalangeal joint, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint

(H)

(Anaes.) (Assist.)

Fee: $458.00 Benefit: 75% = $343.50

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49792

49792 - Additional Information

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

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) joint release;

(d) synovectomy;

(e) removal of osteophytes at joints;

—one or 2 toes (H)

(Anaes.) (Assist.)

Fee: $514.45 Benefit: 75% = $385.85

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49793

49793 - Additional Information

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

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) joint release;

(d) synovectomy;

(e) removal of osteophytes at joints;

—3 toes (H)

(Anaes.) (Assist.)

Fee: $600.20 Benefit: 75% = $450.15

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49794

49794 - Additional Information

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

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) joint release;

(d) synovectomy;

(e) removal of osteophytes at joints;

—4 toes (H)

(Anaes.) (Assist.)

Fee: $685.90 Benefit: 75% = $514.45

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49795

49795 - Additional Information

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

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) joint release;

(d) synovectomy;

(e) removal of osteophytes at joints;

—5 toes (H)

(Anaes.) (Assist.)

Fee: $771.65 Benefit: 75% = $578.75

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49796

49796 - Additional Information

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

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) joint release;

(d) synovectomy;

(e) removal of osteophytes at joints;

—6 toes (H)

(Anaes.) (Assist.)

Fee: $857.40 Benefit: 75% = $643.05

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49797

49797 - Additional Information

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

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) joint release;

(d) synovectomy;

(e) removal of osteophytes at joints;

—7 toes (H)

(Anaes.) (Assist.)

Fee: $943.10 Benefit: 75% = $707.35

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49798

49798 - Additional Information

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

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) joint release;

(d) synovectomy;

(e) removal of osteophytes at joints;

—8 toes (H)

(Anaes.) (Assist.)

Fee: $1,028.85 Benefit: 75% = $771.65

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49815

49815 - Additional Information

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

Triple arthrodesis of hindfoot joints, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joints

(H)

(Anaes.) (Assist.)

Fee: $1,426.85 Benefit: 75% = $1,070.15

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49845

49845 - Additional Information

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

Unilateral arthrodesis of first metatarsophalangeal joint, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joints

(H)

(Anaes.) (Assist.)

Fee: $673.45 Benefit: 75% = $505.10

(See para TN.8.200, TN.8.223 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49851

49851 - Additional Information

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

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal (or both) joints of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) tendon lengthening;

(d) joint release;

(e) synovectomy;

(f) removal of osteophytes at joints;

—one toe (H)

(Anaes.) (Assist.)

Fee: $450.50 Benefit: 75% = $337.90

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

30023

30023 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-2005
Schedule Fee Updated:
01-Jul-2021

WOUND OF SOFT TISSUE, traumatic, deep or extensively contaminated, debridement of, under general anaesthesia or regional or field nerve block, including suturing of that wound when performed

(Anaes.) (Assist.)

Fee: $339.25 Benefit: 75% = $254.45 85% = $288.40

(See para TN.8.6, TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

50118

50118 - Additional Information

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

Arthrodesis of joint of hindfoot, by any method, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joints;

—one joint (H)

(Anaes.) (Assist.)

Fee: $815.30 Benefit: 75% = $611.50

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49712

49712 - Additional Information

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

Arthrodesis of ankle, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint

(H)

(Anaes.) (Assist.)

Fee: $979.60 Benefit: 75% = $734.70

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49740

49740 - Additional Information

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

Revision of arthrodesis of ankle, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint;

(e) removal of hardware;

(f) neurolysis;

(g) osteotomy of non-union or malunion;

other than a service associated with a service to which 30023 applies

(H)

(Anaes.) (Assist.)

Fee: $1,469.50 Benefit: 75% = $1,102.15

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49742

49742 - Additional Information

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

Arthrodesis of extended ankle and hindfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint

(H)

(Anaes.) (Assist.)

Fee: $1,387.20 Benefit: 75% = $1,040.40

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49744

49744 - Additional Information

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

Revision of arthrodesis of extended ankle and hindfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint;

(e) removal of hardware;

(f) neurolysis;

(g) osteotomy of non-union or malunion;

other than a service associated with a service to which 30023 applies

(H)

(Anaes.) (Assist.)

Fee: $2,080.85 Benefit: 75% = $1,560.65

(See para TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49814

49814 - Additional Information

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

Reconstruction of major tendon of ankle, by any method, including:

(a) osteotomy of hindfoot, with internal fixation; and

(b) lengthening of major tendon of ankle; and

(c) any of the following (if performed):

(i) synovial biopsy;

(ii) synovectomy;

(iii) adjacent tendon transfer;

(iv) turn down flaps;

other than a service associated with a service to which item 49718 applies (H)

(Anaes.) (Assist.)

Fee: $1,028.70 Benefit: 75% = $771.55

(See para TN.8.200, TN.8.204 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

48400

48400 - Additional Information

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

Osteotomy of phalanx or metatarsal of foot, for correction of deformity, excision of accessory bone or sesamoid bone, including any of the following (if performed):

(a) removal of bone;

(b) excision of surrounding osteophytes;

(c) synovectomy;

(d) joint release;

—one bone (H)

(Anaes.) (Assist.)

Fee: $342.90 Benefit: 75% = $257.20

(See para TN.8.168, TN.8.196, TN.8.200, TN.8.223 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

48403

48403 - Additional Information

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

Osteotomy of phalanx or metatarsal of first toe of foot, for correction of deformity, with internal fixation, including any of the following (if performed):

(a) removal of bone;

(b) excision of surrounding osteophytes;

(c) synovectomy;

(d) joint release;

—one bone (H)

(Anaes.) (Assist.)

Fee: $538.80 Benefit: 75% = $404.10

(See para TN.8.168, TN.8.196, TN.8.200, TN.8.223 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

48406

48406 - Additional Information

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

Osteotomy of fibula, radius, ulna, clavicle, scapula (other than acromion), rib, tarsus or carpus, for correction of deformity, including any of the following (if performed):

(a) removal of bone;

(b) excision of surrounding osteophytes;

(c) synovectomy;

(d) joint release;

—one bone (H)

(Anaes.) (Assist.)

Fee: $342.90 Benefit: 75% = $257.20

(See para TN.8.168, TN.8.196, TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

48409

48409 - Additional Information

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

Osteotomy of fibula, radius, ulna, clavicle, scapula (other than acromion), rib, tarsus or carpus, for correction of deformity, with internal fixation, including any of the following (if performed):

(a) removal of bone;

(b) excision of surrounding osteophytes;

(c) synovectomy;

(d) joint release;

—one bone (H)

(Anaes.) (Assist.)

Fee: $538.80 Benefit: 75% = $404.10

(See para TN.8.168, TN.8.196, TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

48421

48421 - Additional Information

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

Osteotomy of proximal tibia, to alter lower limb alignment or rotation (or both), with internal or external fixation (or both) (H)

(Anaes.) (Assist.)

Fee: $956.30 Benefit: 75% = $717.25

(See para TN.8.168, TN.8.196, TN.8.200 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

48430

48430 - Additional Information

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

Excision of one or more osteophytes of the foot or ankle, or simple removal of bunion, including any of the following (if performed):

(a) capsulotomy;

(b) excision of surrounding osteophytes;

(c) release of ligaments;

(d) removal of one or more associated bursae or ganglia;

(e) removal of bone;

(f) synovectomy;

—each incision (H)

(Anaes.) (Assist.)

Fee: $279.20 Benefit: 75% = $209.40

(See para TN.8.196, TN.8.200, TN.8.201 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