Medicare Benefits Schedule - Note TN.8.127

Patients presenting with hip dysplasia, Perthes Disease and Slipped Upper Femoral Epiphysis (SUFE) are eligible for treatment under items 49366, 49303 and 48424.

Related Items: 48424 49303 49366

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Multiple Operation Rule

Osteotomy of pelvis, in a patient aged less than 18 years, with application of hip spica, including internal fixation (if performed), other than a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H)

(Anaes.) (Assist.)

Fee: $829.10 Benefit: 75% = $621.85

(See para TN.8.127, TN.8.168 of explanatory notes to this Category)

Multiple Operation Rule

Arthrotomy of hip, by open procedure, including any of the following (if performed):

(a) lavage;

(b) drainage;

(c) biopsy

(H)

(Anaes.) (Assist.)

Fee: $601.00 Benefit: 75% = $450.75

(See para TN.8.127 of explanatory notes to this Category)

Multiple Operation Rule

Treatment of hip, by arthroscopic means, including any procedures to treat bone or soft tissue in the same area (if performed), other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing:

(a) a procedure of the hip joint by arthroscopic means; or

(b) surgery for femoroacetabular impingement

(H)

(Anaes.) (Assist.)

Fee: $673.60 Benefit: 75% = $505.20

(See para TN.8.127 of explanatory notes to this Category)