Medicare Benefits Schedule - Note TN.8.116

For the purposes of these items, the wrist includes both the radiocarpal joint and the midcarpal joint.

Related Items: 49200 49203 49206 49209 49212 49215 49218 49221 49224 49227

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Multiple Operation Rule

Wrist, arthrodesis of, with synovectomy if performed, with or without internal fixation of the radiocarpal joint (H)

(Anaes.) (Assist.)

Fee: $901.45 Benefit: 75% = $676.10

(See para TN.8.116 of explanatory notes to this Category)

Multiple Operation Rule

Limited fusion of wrist, with or without bone graft, including each of the following:

(a) ligament or tendon transfers;

(b) partial or total excision of one or more carpal bones;

(c) rebalancing procedures;

(d) synovectomy

(H)

(Anaes.) (Assist.)

Fee: $853.85 Benefit: 75% = $640.40

(See para TN.8.116 of explanatory notes to this Category)

Multiple Operation Rule

Proximal row carpectomy of wrist, including either or both of the following (if performed):

(a) styloidectomy;

(b) synovectomy

(H)

(Anaes.) (Assist.)

Fee: $621.75 Benefit: 75% = $466.35

(See para TN.8.116 of explanatory notes to this Category)

Multiple Operation Rule

Prosthetic replacement of wrist or distal radioulnar joint, including either or both of the following (if performed):

(a) ligament realignment;

(b) tendon realignment

(H)

(Anaes.) (Assist.)

Fee: $829.10 Benefit: 75% = $621.85

(See para TN.8.116 of explanatory notes to this Category)

Multiple Operation Rule

Arthrotomy of wrist or distal radioulnar joint, including any of the following (if performed):

(a) joint debridement;

(b) removal of loose bodies;

(c) synovectomy

(H)

(Anaes.) (Assist.)

Fee: $259.20 Benefit: 75% = $194.40

(See para TN.8.116 of explanatory notes to this Category)

Multiple Operation Rule

Reconstruction of single or multiple ligaments or capsules of wrist, including any of the following (if performed):

(a) arthrotomy;

(b) ligament harvesting and grafting;

(c) synovectomy;

(d) tendon harvesting and grafting;

(e) insertion of synthetic ligament substitute

(H)

(Anaes.) (Assist.)

Fee: $715.15 Benefit: 75% = $536.40

(See para TN.8.116 of explanatory notes to this Category)

Multiple Operation Rule

Wrist, diagnostic arthroscopy of, including radiocarpal or midcarpal joints, or both (including biopsy)—other than a service associated with another arthroscopic procedure of the wrist joint (H)

(Anaes.) (Assist.)

Fee: $300.45 Benefit: 75% = $225.35

(See para TN.8.116 of explanatory notes to this Category)

Multiple Operation Rule

Treatment of wrist, by arthroscopic means, including any of the following (if performed):

(a) drilling of defect;

(b) removal of loose bodies;

(c) release of adhesions;

(d) synovectomy;

(e) debridement;

(f) resection of dorsal or volar ganglia;

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 an arthroscopic procedure of the wrist joint (H)

(Anaes.) (Assist.)

Fee: $673.60 Benefit: 75% = $505.20

(See para TN.8.116 of explanatory notes to this Category)

Multiple Operation Rule

Osteoplasty of wrist, by arthroscopic means, including either or both of the following (if performed):

(a) excision of the distal ulna;

(b) total synovectomy;

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 an arthroscopic procedure of the wrist joint—2 or more distinct areas (H)

(Anaes.) (Assist.)

Fee: $777.10 Benefit: 75% = $582.85

(See para TN.8.116 of explanatory notes to this Category)

Multiple Operation Rule

Treatment of wrist by one of the following:

(a) pinning of osteochondral fragment, by arthroscopic means;

(b) stabilisation procedure for ligamentous disruption;

(c) partial wrist fusion or carpectomy, by arthroscopic means;

(d) fracture management;

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 an arthroscopic procedure of the wrist joint (H)

(Anaes.) (Assist.)

Fee: $777.10 Benefit: 75% = $582.85

(See para TN.8.116 of explanatory notes to this Category)