Medicare Benefits Schedule - Item 49515

Removal of cemented or uncemented knee prosthesis, performed as the first stage of a 2-stage procedure; including:

(a) removal of associated cement; and

(b) insertion of spacer (if required)

(H)

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $965.30 Benefit: 75% = $724.00

(See para TN.8.117 of explanatory notes to this Category)

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The Medical Services Advisory Committee (MSAC) evaluated the available evidence and did not support public funding for matrix-induced autologous chondrocyte implantation (MACI) or autologous chondrocyte implantation (ACI) for the treatment of chondral defects in the knee and other joints, due to the increased cost compared to existing procedures and the lack of evidence showing short term or long-term improvements in clinical outcomes. Medicare benefits are not payable in association with this technology as per GN.13.33.

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