Medicare Benefits Schedule - Note TN.8.144

Items 51031 to 51036 are for services which include local morcellized, artificial or harvested bone graft with or without bone morphogenic protein (BMP).

For posterolateral spinal fusion without instrumentation, if a decompression is combined with the fusion, two items numbers are selected: one from 51011 to 51015 and one from 51031 to 51036.

For posterolateral spinal fusion with instrumentation, two item numbers are selected: one from 51020 to 51026 and one from 51031 to 51036. If decompression is also performed, three items are selected: one from 51011 to 51015, one from 51020 to 51026 and one from 51031 to 51036.

For instrumental spinal fusion with interbody and posterolateral bone graft (with or without cages) and decompression, four item numbers are selected: one from one from 51011 to 51015, one from 51020 to 51026, one from 51031 to 51036 and one from 51041 to 51045.

Related Items: 51031 51032 51033 51034 51035 51036

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Multiple Operation Rule

Spine, posterior and/or posterolateral bone graft to, one motion segment, not being a service associated with a service to which item 51032, 51033, 51034, 51035 or 51036 applies

(Anaes.) (Assist.)

Fee: $1,072.50 Benefit: 75% = $804.40

(See para TN.8.141, TN.8.144 of explanatory notes to this Category)

Multiple Operation Rule

Spine, posterior and/or posterolateral bone graft to, 2 motion segments, not being a service associated with a service to which item 51031, 51033, 51034, 51035 or 51036 applies

(Anaes.) (Assist.)

Fee: $1,287.05 Benefit: 75% = $965.30

(See para TN.8.141, TN.8.144 of explanatory notes to this Category)

Multiple Operation Rule

Spine, posterior and/or posterolateral bone graft to, 3 motion segments, not being a service associated with a service to which item 51031, 51032, 51034, 51035 or 51036 applies

(Anaes.) (Assist.)

Fee: $1,501.60 Benefit: 75% = $1,126.20

(See para TN.8.141, TN.8.144 of explanatory notes to this Category)

Multiple Operation Rule

Spine, posterior and/or posterolateral bone graft to, 4 to 7 motion segments, not being a service associated with a service to which item 51031, 51032, 51033, 51035 or 51036 applies

(Anaes.) (Assist.)

Fee: $1,608.80 Benefit: 75% = $1,206.60

(See para TN.8.141, TN.8.144 of explanatory notes to this Category)

Multiple Operation Rule

Spine, posterior and/or posterolateral bone graft to, 8 to 11 motion segments, not being a service associated with a service to which item 51031, 51032, 51033, 51034 or 51036 applies

(Anaes.) (Assist.)

Fee: $1,716.10 Benefit: 75% = $1,287.10

(See para TN.8.141, TN.8.144 of explanatory notes to this Category)

Multiple Operation Rule

Spine, posterior and/or posterolateral bone graft to, 12 or more motion segments, not being a service associated with a service to which item 51031, 51032, 51033, 51034 or 51035 applies

(Anaes.) (Assist.)

Fee: $1,823.30 Benefit: 75% = $1,367.50

(See para TN.8.141, TN.8.144 of explanatory notes to this Category)