Medicare Benefits Schedule - Item 49542

Reconstruction of anterior or posterior cruciate ligament of knee, by open or arthroscopic means, including any of the following (if performed):

(a) graft harvest;

(b) donor site repair;

(c) meniscal repair;

(d) collateral ligament repair;

(e) extra-articular tenodesis;

(f) any other associated intra-articular surgery;

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 knee by arthroscopic means (H)

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $1,443.35 Benefit: 75% = $1,082.55

(See para TN.8.182 of explanatory notes to this Category)

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• These items are intended to cover all knee ligament repair and reconstruction procedures and associated intra-articular surgery, including (but not limited to), meniscal surgery, notchplasty, chondroplasty and removal of loose bodies.
• Repair is reattachment of a displaced structure and reconstruction is surgery that modifies or augments underlying anatomy. Each item is intended to cover all aspects of the surgery.
• In rare circumstances, patients may require additional osteotomy or patella-femoral stabilisation and in these instances, the relevant item numbers can also be claimed.

Related Items: 49536 49542