Medicare Benefits Schedule - Note TN.8.223

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Category 3 - THERAPEUTIC PROCEDURES

TN.8.223

Procedures for stabalisation (Items 49734, 48400, 48403, 49809 and 49812)

  • Items for stabilisation of a joint procedure are indicated for use when items 49734, 48400, 48403, 49809 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: 48400 48403 49706 49709 49734 49809 49812 49818 49827 49830 49833 49836 49837 49838 49845 49854


Related Items

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

49809

49809 - Additional Information

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

Open tenotomy or lengthening of foot, by open incision, with or without tenoplasty, including either or both of the following (if performed):

(a) synovial biopsy;

(b) synovectomy;

—one toe

(Anaes.) (Assist.)

Fee: $225.25 Benefit: 75% = $168.95 85% = $191.50

(See para TN.8.204, 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

49818

49818 - Additional Information

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

Release of plantar fascia, including excision of calcaneal spur (if performed) (H)

(Anaes.) (Assist.)

Fee: $284.00 Benefit: 75% = $213.00

(See para TN.8.197, TN.8.223 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

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

49854

49854 - Additional Information

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

Radical plantar fasciotomy or fasciectomy, with extensive incision into foot and excision of fascia, including excision of calcaneal spur (if performed), other than a service associated with a service to which 49818 applies (H)

(Anaes.) (Assist.)

Fee: $391.80 Benefit: 75% = $293.85

(See para TN.8.197, TN.8.223 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49706

49706 - Additional Information

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

Arthrotomy of joint of ankle, for infection, including removal of loose bodies and joint debridement, including release of joint contracture (if performed) (H)

(Anaes.) (Assist.)

Fee: $342.90 Benefit: 75% = $257.20

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

Category 3 - THERAPEUTIC PROCEDURES

49709

49709 - Additional Information

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

Stabilisation of ligament of ankle or subtalar joint (or both), including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) joint debridement;

—one ligament complex, each incision (H)

(Anaes.) (Assist.)

Fee: $734.65 Benefit: 75% = $551.00

(See para TN.8.195, TN.8.223 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)


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