Medicare Benefits Schedule - Note TN.8.191

Search Results for Note TN.8.191

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Category 3 - THERAPEUTIC PROCEDURES

TN.8.191

Procedure for hip arthroplasty (Items 49318, 49319, 49372 - 49398)

For the purpose of acetabular bone grafting:

  1. Minor bone grafting is intended to cover Paprosky 1 and 2A defects (i.e. minor acetabular derangement / bone loss). 
  2. Major bone grafting is intended to cover Paprosky 2B, 2C, 3A and 3B defects (i.e. major acetabular derangement / bone loss). Outside of the acetabulum, a major bone graft is considered to be structural in nature, such as a substantive impaction femoral graft, a strut allograft, or equivalent.

Related Items: 49318 49319 49372 49374 49376 49378 49380 49382 49384 49386 49388 49390 49392 49394 49396 49398


Related Items

Category 3 - THERAPEUTIC PROCEDURES

49318

49318 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Total arthroplasty of hip, including minor bone grafting (if performed), other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H)

(Anaes.) (Assist.)

Fee: $1,501.30 Benefit: 75% = $1,126.00

(See para TN.8.191, TN.8.286 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49319

49319 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Bilateral total arthroplasty of hip, including minor bone grafting (if performed), other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H)

(Anaes.) (Assist.)

Fee: $2,637.70 Benefit: 75% = $1,978.30

(See para TN.8.191 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49372

49372 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Revision arthroplasty of hip, with exchange of head or liner (or both) (H)

(Anaes.) (Assist.)

Fee: $1,050.85 Benefit: 75% = $788.15

(See para TN.8.191 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49374

49374 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Revision arthroplasty of hip, with exchange of head and acetabular shell or cup, including minor bone grafting (if performed) (H)

(Anaes.) (Assist.)

Fee: $1,951.65 Benefit: 75% = $1,463.75

(See para TN.8.191 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49376

49376 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Revision arthroplasty of hip, with exchange of head and acetabular shell or cup, including major bone grafting (if performed) (H)

(Anaes.) (Assist.)

Fee: $2,402.10 Benefit: 75% = $1,801.60

(See para TN.8.191 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49378

49378 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Revision arthroplasty of hip, with revision of femoral component (if there is no requirement for femoral osteotomy), including minor bone grafting (if performed) (H) 

(Anaes.) (Assist.)

Fee: $2,101.65 Benefit: 75% = $1,576.25

(See para TN.8.191 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49380

49380 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Revision arthroplasty of hip, with revision of femoral and acetabular components (if femoral osteotomy is not required), including minor bone grafting (if performed) (H)

(Anaes.) (Assist.)

Fee: $2,552.15 Benefit: 75% = $1,914.15

(See para TN.8.191 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49382

49382 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Revision arthroplasty of hip, with revision of femoral and acetabular components (if femoral osteotomy is not required), including major bone grafting (H)

(Anaes.) (Assist.)

Fee: $3,302.85 Benefit: 75% = $2,477.15

(See para TN.8.191 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49384

49384 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Revision arthroplasty of hip, for pelvic discontinuity, with revision of acetabular component (H)

(Anaes.) (Assist.)

Fee: $3,903.30 Benefit: 75% = $2,927.50

(See para TN.8.191 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49386

49386 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Revision arthroplasty of hip, with revision of femoral component with femoral osteotomy, including minor bone grafting (if performed) (H)

(Anaes.) (Assist.)

Fee: $2,702.35 Benefit: 75% = $2,026.80

(See para TN.8.191 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49388

49388 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Revision arthroplasty of hip, including:

(a) revision of both of the following:

(i) femoral component with femoral osteotomy;

(ii) acetabular component; and

(b) minor bone grafting (if performed)

(H)

(Anaes.) (Assist.)

Fee: $3,152.70 Benefit: 75% = $2,364.55

(See para TN.8.191 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49390

49390 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Revision arthroplasty of hip, including:

(a) revision of both of the following:

(i) femoral component with femoral osteotomy;

(ii) acetabular component; and

(b) major bone grafting

(H)

(Anaes.) (Assist.)

Fee: $3,753.20 Benefit: 75% = $2,814.90

(See para TN.8.191 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49392

49392 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Revision arthroplasty of hip, including:

(a) either:

(i) revision of femoral component with femoral osteotomy; or

(ii) proximal femoral replacement; and

(b) revision of acetabular component for pelvic discontinuity

(H)

(Anaes.) (Assist.)

Fee: $5,254.50 Benefit: 75% = $3,940.90

(See para TN.8.191 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49394

49394 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Revision arthroplasty of hip, including:

(a) replacement of proximal femur; and

(b) revision of the acetabular component; and

(c) bone grafting (if performed)

(H)

(Anaes.) (Assist.)

Fee: $4,503.80 Benefit: 75% = $3,377.85

(See para TN.8.191 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49396

49396 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Revision arthroplasty of hip, including:

(a) removal of prosthesis as stage 1 of a 2-stage revision arthroplasty or as a definitive stage procedure; and

(b) insertion of temporary prosthesis (if performed)

(H)

(Anaes.) (Assist.)

Fee: $3,002.55 Benefit: 75% = $2,251.95

(See para TN.8.191 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

49398

49398 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Revision arthroplasty of hip, including:

(a) revision of femoral component for periprosthetic fracture; and

(b) internal fixation; and

(c) bone grafting (if performed)

(H)

(Anaes.) (Assist.)

Fee: $2,251.95 Benefit: 75% = $1,689.00

(See para TN.8.191 of explanatory notes to this Category)


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change