Medicare Benefits Schedule - Note TN.8.201

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Category 3 - THERAPEUTIC PROCEDURES

TN.8.201

Procedures for excisional and interpositional arthroplasty

  • Items for excisional or interposition arthroplasty procedures are indicated for use when items 49734, 48430, 49860, or 49812 do not represent the complete procedure performed.
  • Not to be used on the same joint undergoing arthroscopy (49730 or 49732), bunion correction (49827, 49830, 49833, 49836, 49837 or 49838) or an arthrodesis procedure for stabilisation.

Related Items: 48430 49715 49716 49717 49730 49732 49734 49812 49821 49827 49830 49833 49836 49837 49838 49839 49857 49860


Related Items

Category 3 - THERAPEUTIC PROCEDURES

49730

49730 - Additional Information

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

Surgery of joint of hindfoot (other than ankle) or first metatarsophalangeal joint, by arthroscopic means, including any of the following (if performed):

(a) cartilage treatment;

(b) removal of loose bodies;

(c) synovectomy;

(d) excision of joint osteophytes;

other than a service associated with a service to which another item of this Schedule applies if the service described in the other item is for the purpose of performing a procedure on the ankle by arthroscopic means—one joint (H)

(Anaes.) (Assist.)

Fee: $636.75 Benefit: 75% = $477.60

(See para TN.8.201, TN.8.202 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49732

49732 - Additional Information

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

Endoscopy of large tendons of foot, including any of the following (if performed):

(a) debridement of tendon and sheath;

(b) removal of loose bodies;

(c) synovectomy;

(d) excision of tendon impingement;

other than a service associated with a service to which item 49718 or 49724 applies (H)

(Anaes.) (Assist.)

Fee: $636.75 Benefit: 75% = $477.60

(See para TN.8.201, TN.8.202 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49734

49734 - Additional Information

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

Arthrotomy of hindfoot, midfoot or metatarsophalangeal joint, for infection, including:

(a) removal of loose bodies; and

(b) either or both of the following:

(i) joint debridement;

(ii) release of joint contracture;

—each incision (H)

(Anaes.) (Assist.)

Fee: $342.90 Benefit: 75% = $257.20

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

Category 3 - THERAPEUTIC PROCEDURES

49812

49812 - Additional Information

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

Advancement of tendon or ligament transfer of foot, including:

(a) side to side transfer, harvesting and transfer for ligament or minor foot tendon reconstruction; and

(b) either or both of the following (if performed):

(i) synovial biopsy;

(ii) synovectomy;

—one major tendon or toe (H)

(Anaes.) (Assist.)

Fee: $450.50 Benefit: 75% = $337.90

(See para TN.8.201, TN.8.204, TN.8.223 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49821

49821 - Additional Information

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

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: $450.50 Benefit: 75% = $337.90

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

Category 3 - THERAPEUTIC PROCEDURES

49827

49827 - Additional Information

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

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: $489.75 Benefit: 75% = $367.35

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

Category 3 - THERAPEUTIC PROCEDURES

49830

49830 - Additional Information

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

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: $857.15 Benefit: 75% = $642.90

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

Category 3 - THERAPEUTIC PROCEDURES

49833

49833 - Additional Information

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

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: $538.80 Benefit: 75% = $404.10

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

Category 3 - THERAPEUTIC PROCEDURES

49836

49836 - Additional Information

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

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: $930.65 Benefit: 75% = $698.00

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

Category 3 - THERAPEUTIC PROCEDURES

49837

49837 - Additional Information

Item Start Date:
01-May-2000
Description Updated:
01-Nov-2021
Schedule Fee Updated:
01-Jul-2021

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: $673.45 Benefit: 75% = $505.10

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

Category 3 - THERAPEUTIC PROCEDURES

49838

49838 - Additional Information

Item Start Date:
01-May-2000
Description Updated:
01-Nov-2021
Schedule Fee Updated:
01-Jul-2021

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

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

Category 3 - THERAPEUTIC PROCEDURES

49839

49839 - Additional Information

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

Total replacement of first metatarsophalangeal joint, with replacement of both joint surfaces, including any of the following (if performed):

(a) capsulotomy;

(b) synovectomy;

(c) joint debridement

(H)

(Anaes.) (Assist.)

Fee: $538.80 Benefit: 75% = $404.10

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

Category 3 - THERAPEUTIC PROCEDURES

49857

49857 - Additional Information

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

Hemi joint replacement of first or lesser metatarsophalangeal joint, including any of the following (if performed):

(a) capsulotomy;

(b) synovectomy;

(c) joint debridement

(H)

(Anaes.) (Assist.)

Fee: $362.45 Benefit: 75% = $271.85

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

Category 3 - THERAPEUTIC PROCEDURES

49860

49860 - Additional Information

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

Synovectomy of metatarsophalangeal joints, including any of the following (if performed):

(a) capsulotomy;

(b) debridement;

(c) release of ligament or tendon (or both);

—one or more joints on one foot (H)

(Anaes.) (Assist.)

Fee: $338.45 Benefit: 75% = $253.85

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

Category 3 - THERAPEUTIC PROCEDURES

49715

49715 - Additional Information

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

Total replacement of ankle, with prosthetic replacement of ankle joint, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint

(H)

(Anaes.) (Assist.)

Fee: $1,175.40 Benefit: 75% = $881.55

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

Category 3 - THERAPEUTIC PROCEDURES

49716

49716 - Additional Information

Item Start Date:
01-Nov-2006
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2021

Revision of total ankle replacement:

(a) including either:

(i) exchange of tibial or talar components (or both) and plastic inserts; or

(ii) removal of tibial or talar components (or both) and plastic inserts; and

(b) including any of the following (if performed):

(i) insertion of cement spacer for infection;

(ii) capsulotomy;

(iii) joint release;

(iv) neurolysis;

(v) debridement of cysts;

(vi) synovectomy;

(vii) joint debridement

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

(H)

(Anaes.) (Assist.)

Fee: $1,551.55 Benefit: 75% = $1,163.70

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

Category 3 - THERAPEUTIC PROCEDURES

49717

49717 - Additional Information

Item Start Date:
01-Nov-2006
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2021

Revision of total ankle replacement:

(a) including either:

(i) exchange of tibial and talar components; or

(ii) removal of tibial and talar components and conversion to ankle arthrodesis; and

(b) including both of the following

(iii) internal or external fixation, by any means;

(iv) major bone grafting; and

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

(i) capsulotomy;

(ii) joint release;

(iii) neurolysis;

(iv) debridement and extensive grafting of cysts;

(v) synovectomy;

(vi) joint debridement;

other than a service associated with a service to which item 30023, 48245, 48248, 48251, 48254 or 48257 applies (H)

(Anaes.) (Assist.)

Fee: $1,861.85 Benefit: 75% = $1,396.40

(See para TN.8.201 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