Medicare Benefits Schedule - Note TN.8.223

• 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

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Multiple Operation Rule

Operation on foot:

(a) with either or both of the following:

(i) osteotomy of phalanx or metatarsal for correction of deformity;

(ii) excision of accessory bone or sesamoid bone; and

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

(i) removal of bone;

(ii) excision of surrounding osteophytes;

(iii) synovectomy;

(iv) joint release;

—one bone (H)

(Anaes.) (Assist.)

Fee: $362.75 Benefit: 75% = $272.10

(See para TN.8.168, TN.8.196, TN.8.199, TN.8.200, TN.8.223 of explanatory notes to this Category)

Multiple Operation Rule

Osteotomy of phalanx of first toe or metatarsal, 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: $569.95 Benefit: 75% = $427.50

(See para TN.8.168, TN.8.196, TN.8.199, TN.8.200, TN.8.223 of explanatory notes to this Category)

Multiple Operation Rule

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

(Anaes.) (Assist.)

Fee: $362.75 Benefit: 75% = $272.10

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

Multiple Operation Rule

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: $777.10 Benefit: 75% = $582.85

(See para TN.8.195, TN.8.199, TN.8.223 of explanatory notes to this Category)

Multiple Operation Rule

Arthrotomy of hindfoot, midfoot or metatarsophalangeal joint, 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: $362.75 Benefit: 75% = $272.10

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

Multiple Operation Rule

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: $238.30 Benefit: 75% = $178.75 85% = $202.60

(See para TN.8.199, TN.8.204, TN.8.223 of explanatory notes to this Category)

Multiple Operation Rule

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: $476.55 Benefit: 75% = $357.45

(See para TN.8.199, TN.8.201, TN.8.204, TN.8.223 of explanatory notes to this Category)

Multiple Operation Rule

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

(Anaes.) (Assist.)

Fee: $300.45 Benefit: 75% = $225.35

(See para TN.8.197, TN.8.199, TN.8.223 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)

Multiple Operation Rule

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: $712.45 Benefit: 75% = $534.35

(See para TN.8.199, TN.8.200, TN.8.223 of explanatory notes to this Category)

Multiple Operation Rule

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: $414.45 Benefit: 75% = $310.85

(See para TN.8.197, TN.8.199, TN.8.223 of explanatory notes to this Category)