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Category 3 - THERAPEUTIC PROCEDURES
TN.8.199
Definitions - Foot and Ankle Items
- Ray: From the tip of a digit to the proximal metatarsal base of that digit, including phalanges and metatarsal bones.
- Hindfoot joints: Consist of subtalar, talonavicular and calcaneocuboid joints.
- Hindfoot bones: Consist of the calcaneus, talus, navicular and cuboid.
- Midfoot joints: Consist of naviculocuneiform and tarsometatarsal joints.
- Midfoot bones: Consist of cuneiforms.
- Major ankle tendons: Consist of the Achilles’, tibialis anterior, tibialis posterior, peroneal (both longus and brevis), extensor hallucis longus and flexor hallucis longus tendons.
- Flexor tendon: Both the flexor digitorum longus and flexor digitorum brevis tendons.
- Extensor tendon: Both the extensor digitorum longus and extensor digitorum brevis tendons.
- Reconstruction of a tendon: Treatment of a degenerative tendon where more than end-to-end repair of tendon rupture is involved.
- Transtarsal amputation: Involves amputation of the foot through the tarsal or metatarsal bones, or through the tarsometatarsal joints.
- Joint debridement: Removal of osteophytes, removal of part of the joint, and removal of intervening soft tissue, loose bone ossicles or fragments from one or both sides of a joint.
- Primary treatment: Acute and first management of an injury or pathology.
- Delayed or secondary treatment: Subsequent to primary treatment, or occuring after the normal expected healing time for the relevant tissue.
- Revision procedure: A repeat operation to replace or compensate for a failed implant, correct a painful non-union of fracture or fusion, correct malunion, reconstruct a failed soft tissue procedure, or correct undesirable complications of previous surgery.
- Operative exposure: Includes (if performed) arthrotomy and/or arthroscopy of joint, washout of joint, removal of loose fragments or loose bodies, synovectomy of neurovascular bundle and closure of capsule.
- Radical plantar fasciotomy or fasciectomy: Involves the partial or complete removal of the plantar fascia, but does not involve simple release of the fascia.
Related Items: 44338 44342 44346 44350 44354 44358 44359 44361 44364 47063 47066 47069 47573 47595 47597 47600 47603 47612 47615 47618 47621 47624 47630 47637 47639 47648 47657 47663 47666 47672 47678 47904 47906 47915 47916 47918 48400 48403 48430 48433 48435 49703 49706 49709 49712 49715 49716 49717 49718 49724 49727 49728 49730 49732 49734 49736 49738 49740 49742 49744 49760 49761 49762 49763 49764 49765 49766 49767 49768 49769 49770 49771 49772 49773 49774 49775 49776 49777 49778 49779 49780 49781 49782 49783 49784 49785 49786 49787 49788 49789 49790 49791 49792 49793 49794 49795 49796 49797 49798 49800 49803 49806 49809 49812 49815 49818 49821 49824 49827 49830 49833 49836 49837 49838 49839 49845 49851 49854 49857 49860 49866 49878 49881 49884 49887 49890
Related Items
Category 3 - THERAPEUTIC PROCEDURES
44338 - Additional Information
Amputation of one digit of one foot, distal to metatarsal head, including any of the following (if performed):
(a) resection of bone or joint;
(b) excision of neuroma;
(c) skin cover with homodigital flaps
(H)
(Anaes.) (Assist.)
Fee: $164.10 Benefit: 75% = $123.10
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
44342 - Additional Information
Amputation of 2 digits of one foot, distal to metatarsal head, including any of the following (if performed):
(a) resection of bone or joint;
(b) excision of neuroma;
(c) skin cover with homodigital flaps
(H)
(Anaes.) (Assist.)
Fee: $250.50 Benefit: 75% = $187.90
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
44346 - Additional Information
Amputation of 3 digits of one foot, distal to metatarsal head, including any of the following (if performed):
(a) resection of bone or joint;
(b) excision of neuroma;
(c) skin cover with homodigital flaps
(H)
(Anaes.) (Assist.)
Fee: $289.35 Benefit: 75% = $217.05
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
44350 - Additional Information
Amputation of 4 digits of one foot, distal to metatarsal head, including any of the following (if performed):
(a) resection of bone or joint;
(b) excision of neuroma;
(c) skin cover with homodigital flaps
(H)
(Anaes.) (Assist.)
Fee: $328.30 Benefit: 75% = $246.25
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
44354 - Additional Information
Amputation of 5 digits of one foot, distal to metatarsal head, including any of the following (if performed):
(a) resection of bone or joint;
(b) excision of neuroma;
(c) skin cover with homodigital flaps
(H)
(Anaes.) (Assist.)
Fee: $375.75 Benefit: 75% = $281.85
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
44358 - Additional Information
Amputation of one ray of one foot, proximal to the metatarsal head, including any of the following (if performed):
(a) resection of bone;
(b) excision of neuromas;
(c) skin cover or recontouring with homodigital flaps
(H)
(Anaes.) (Assist.)
Fee: $250.50 Benefit: 75% = $187.90
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
44359 - Additional Information
Amputation of one or more toes of one foot, or amputation at midfoot or hindfoot of one foot, for diabetic or other microvascular disease;
(a) including any of the following (if performed):
(i) resection of bone;
(ii) excision of neuromas;
(iii) excision of one or more bones of the foot;
(iv) treatment of underlying infection;
(v) skin cover or recontouring with homodigital flaps; and
(b) excluding aftercare;
—applicable only once per foot per occasion on which the service is performed (H)
(Anaes.) (Assist.)
Fee: $300.65 Benefit: 75% = $225.50
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
44361 - Additional Information
Amputation of foot, at ankle or hindfoot, including any of the following (if performed):
(a) resection of bone;
(b) excision of neuromas;
(c) skin cover;
(H)
(Anaes.) (Assist.)
Fee: $497.15 Benefit: 75% = $372.90
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
44364 - Additional Information
Amputation of foot, transtarsal, including any of the following (if performed):
(a) resection of bone;
(b) excision of neuromas;
(c) skin cover;
(H)
(Anaes.) (Assist.)
Fee: $336.85 Benefit: 75% = $252.65
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
48400 - Additional Information
Operation on foot:
(a) with either or both of the following:
(i) osteotomy of phalanx or metatarsal for correction of deformity;
(ii) excision of accessory bone or sesamoid bone; and
(b) including any of the following (if performed):
(i) removal of bone;
(ii) excision of surrounding osteophytes;
(iii) synovectomy;
(iv) joint release;
—one bone (H)
(Anaes.) (Assist.)
Fee: $375.45 Benefit: 75% = $281.60
(See para TN.8.168, TN.8.196, TN.8.199, TN.8.200, TN.8.223 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
48403 - Additional Information
Osteotomy of phalanx of first toe or metatarsal, for correction of deformity, with internal fixation, including any of the following (if performed):
(a) removal of bone;
(b) excision of surrounding osteophytes;
(c) synovectomy;
(d) joint release;
—one bone (H)
(Anaes.) (Assist.)
Fee: $589.90 Benefit: 75% = $442.45
(See para TN.8.168, TN.8.196, TN.8.199, TN.8.200, TN.8.223 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
48430 - Additional Information
Excision of one or more osteophytes of the foot or ankle, or simple removal of bunion, including any of the following (if performed):
(a) capsulotomy;
(b) excision of surrounding osteophytes;
(c) release of ligaments;
(d) removal of one or more associated bursae or ganglia;
(e) removal of bone;
(f) synovectomy;
—each incision (H)
(Anaes.) (Assist.)
Fee: $305.65 Benefit: 75% = $229.25
(See para TN.8.196, TN.8.199, TN.8.200, TN.8.201, TN.8.292 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
48433 - Additional Information
Treatment of non-union or malunion, with preservation of the joint, for ankle or hindfoot fracture, with internal or external fixation by any method, including any of the following (if performed):
(a) arthrotomy;
(b) debridement;
(c) excision of surrounding osteophytes;
(d) osteotomy;
(e) release of joint;
(f) removal of bone;
(g) removal of hardware;
(h) synovectomy;
—one bone (H)
(Anaes.) (Assist.)
Fee: $1,217.35 Benefit: 75% = $913.05
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
48435 - Additional Information
Treatment of non-union or malunion, with preservation of the joint, for midfoot or forefoot fracture, with internal or external fixation by any method, including any of the following (if performed):
(a) arthrotomy;
(b) debridement;
(c) excision of surrounding osteophytes;
(d) osteotomy;
(e) release of joint;
(f) removal of bone;
(g) removal of hardware;
(h) synovectomy;
—one bone (H)
(Anaes.) (Assist.)
Fee: $643.50 Benefit: 75% = $482.65
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49783 - Additional Information
Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joints, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) local tendon transfer;
(e) joint debridement;
—3 joints (H)
(Anaes.) (Assist.)
Fee: $863.80 Benefit: 75% = $647.85
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47063 - Additional Information
Treatment of dislocation of ankle or tarsus, by closed reduction
(Anaes.) (Assist.)
Fee: $289.55 Benefit: 75% = $217.20 85% = $246.15
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47066 - Additional Information
Treatment of dislocation of ankle or tarsus, by open reduction, including any of the following (if performed):
(a) arthrotomy;
(b) capsule repair;
(c) removal of loose fragments or intervening soft tissue;
(d) washout of joint
(H)
(Anaes.) (Assist.)
Fee: $386.00 Benefit: 75% = $289.50
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47069 - Additional Information
Treatment of dislocation of toe, by closed reduction—one toe
(Anaes.)
Fee: $80.55 Benefit: 75% = $60.45 85% = $68.50
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47573 - Additional Information
Treatment of proximal or distal intra-articular fracture of shaft of tibia, by open reduction, with or without treatment of fibular fracture, including any of the following (if performed):
(a) arthroscopy;
(b) arthrotomy;
(c) capsule repair;
(d) removal of intervening soft tissue;
(e) removal of loose fragments;
(f) washout of joint;
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 treating a medial malleolus fracture of the distal tibia (H)
(Anaes.) (Assist.)
Fee: $777.60 Benefit: 75% = $583.20
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47595 - Additional Information
Treatment of fracture of ankle joint, hindfoot, midfoot, metatarsals or toes, by non-surgical management—one leg
(Anaes.)
Fee: $183.55 Benefit: 75% = $137.70 85% = $156.05
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47597 - Additional Information
Treatment of fracture of ankle joint, by closed reduction
(Anaes.) (Assist.)
Fee: $370.00 Benefit: 75% = $277.50 85% = $314.50
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47600 - Additional Information
Treatment of fracture of ankle joint:
(a) by internal fixation of the malleolus, fibula or diastasis; and
(b) including any of the following (if performed):
(i) arthrotomy;
(ii) capsule repair;
(iii) removal of loose fragments or intervening soft tissue;
(iv) washout of joint
(H)
(Anaes.) (Assist.)
Fee: $643.50 Benefit: 75% = $482.65
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47603 - Additional Information
Treatment of fracture of ankle joint:
(a) by internal fixation of 2 or more of the malleolus, fibula, diastasis and medial tissue interposition; and
(b) including any of the following (if performed):
(i) arthrotomy;
(ii) capsule repair;
(iii) removal of loose fragments or intervening soft tissue;
(iv) washout of joint
(H)
(Anaes.) (Assist.)
Fee: $811.55 Benefit: 75% = $608.70
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47612 - Additional Information
Treatment of intra-articular fracture of hindfoot, by closed reduction, with or without dislocation—one foot
(Anaes.) (Assist.)
Fee: $466.60 Benefit: 75% = $349.95 85% = $396.65
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47615 - Additional Information
Treatment of fracture of hindfoot, by open reduction, with or without dislocation, including any of the following (if performed):
(a) arthrotomy;
(b) capsule repair;
(c) removal of loose fragments or intervening soft tissue;
(d) washout of joint
—one hindfoot bone
(Anaes.) (Assist.)
Fee: $536.25 Benefit: 75% = $402.20 85% = $455.85
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47618 - Additional Information
Treatment of intra-articular fracture of hindfoot, by open reduction, with or without dislocation, including any of the following (if performed):
(a) arthrotomy;
(b) capsule repair;
(c) removal of loose fragments or intervening soft tissue;
(d) washout of joint
—one hindfoot bone (H)
(Anaes.) (Assist.)
Fee: $670.30 Benefit: 75% = $502.75
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47621 - Additional Information
Treatment of intra-articular fracture of midfoot, by closed reduction, with or without dislocation—one foot
(Anaes.) (Assist.)
Fee: $466.60 Benefit: 75% = $349.95 85% = $396.65
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47624 - Additional Information
Treatment of fracture of tarso-metatarsal, by open reduction, with or without dislocation, including any of the following (if performed):
(a) arthrotomy;
(b) capsule or ligament repair;
(c) removal of loose fragments or intervening soft tissue;
(d) washout of joint
—one joint (H)
(Anaes.) (Assist.)
Fee: $643.50 Benefit: 75% = $482.65
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47630 - Additional Information
Treatment of fracture of cuneiform, by open reduction, with or without dislocation, including any of the following (if performed):
(a) arthrotomy;
(b) capsule or ligament repair;
(c) removal of loose fragments or intervening soft tissue;
(d) washout of joint
—one bone
(Anaes.) (Assist.)
Fee: $386.00 Benefit: 75% = $289.50 85% = $328.10
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47637 - Additional Information
Treatment of fractures of metatarsal, by closed reduction—one or more metatarsals of one foot
(Anaes.) (Assist.)
Fee: $218.55 Benefit: 75% = $163.95 85% = $185.80
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47639 - Additional Information
Treatment of fracture of metatarsal, by open reduction, including removal of loose fragments or intervening soft tissue (if performed)—one metatarsal of one foot
(Anaes.) (Assist.)
Fee: $257.45 Benefit: 75% = $193.10 85% = $218.85
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47648 - Additional Information
Treatment of fracture of metatarsal, by open reduction, including removal of loose fragments or intervening soft tissue (if performed)—2 metatarsals of one foot (H)
(Anaes.) (Assist.)
Fee: $342.95 Benefit: 75% = $257.25
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47657 - Additional Information
Treatment of fracture of metatarsal, by open reduction, including removal of loose fragments or intervening soft tissue (if performed)—3 or more metatarsals of one foot (H)
(Anaes.) (Assist.)
Fee: $536.25 Benefit: 75% = $402.20
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47663 - Additional Information
Treatment of fracture of phalanx of toe, by closed reduction—one toe
(Anaes.)
Fee: $160.85 Benefit: 75% = $120.65 85% = $136.75
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47666 - Additional Information
Treatment of fracture or dislocation of phalanx of great toe, by open reduction, including any of the following (if performed):
(a) arthrotomy;
(b) capsule repair;
(c) removal of loose fragments;
(d) removal of intervening soft tissue;
(e) washout of joint
— one great toe
(Anaes.)
Fee: $268.25 Benefit: 75% = $201.20 85% = $228.05
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47672 - Additional Information
Treatment of fracture or dislocation of phalanx of toe, by open reduction, including any of the following (if performed):
(a) arthrotomy;
(b) capsule repair;
(c) removal of loose fragments;
(d) removal of intervening soft tissue;
(e) washout of joint
—one toe (other than great toe) of one foot
(Anaes.)
Fee: $128.55 Benefit: 75% = $96.45 85% = $109.30
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47678 - Additional Information
Treatment of fracture or dislocation of phalanx of toe, by open reduction, including any of the following (if performed):
(a) arthrotomy;
(b) capsule repair;
(c) removal of loose fragments;
(d) removal of intervening soft tissue;
(e) washout of joint
—2 or more toes (other than great toe) of one foot
(Anaes.)
Fee: $193.10 Benefit: 75% = $144.85 85% = $164.15
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47904 - Additional Information
Digital nail of toe, removal of, not being a service to which item 47906 applies
(Anaes.)
Fee: $64.35 Benefit: 75% = $48.30 85% = $54.70
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47906 - Additional Information
Digital nail of toe, removal of, in the operating theatre of a hospital (H)
(Anaes.)
Fee: $128.55 Benefit: 75% = $96.45
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47915 - Additional Information
Wedge resection for ingrowing nail of toe:
(a) including each of the following:
(i) removal of segment of nail;
(ii) removal of ungual fold;
(iii) excision and partial ablation of germinal matrix and portion of nail bed; and
(b) including phenolisation (if performed)
(Anaes.) (Assist.)
Fee: $193.10 Benefit: 75% = $144.85 85% = $164.15
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47916 - Additional Information
Partial resection for ingrowing nail of toe, including phenolisation
(Anaes.)
Fee: $97.00 Benefit: 75% = $72.75 85% = $82.45
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
47918 - Additional Information
Complete ablation of nail germinal matrix:
(a) including each of the following:
(i) removal of segment of nail;
(ii) removal of ungual fold;
(iii) excision and ablation of germinal matrix and portion of nail bed; and
(b) including phenolisation (if performed)
(Anaes.) (Assist.)
Fee: $268.25 Benefit: 75% = $201.20 85% = $228.05
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49703 - Additional Information
Surgery of ankle joint, by arthroscopic means, including any of the following (if performed):
(a) cartilage treatment;
(b) removal of loose bodies;
(c) synovectomy;
(d) excision of joint osteophytes;
other than a service associated with a service to which another item in this Group applies if the service described in the other item is for the purpose of performing a procedure on the ankle by arthroscopic means (H)
(Anaes.) (Assist.)
Fee: $697.20 Benefit: 75% = $522.90
(See para TN.8.196, TN.8.199, TN.8.202 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49706 - Additional Information
Category 3 - THERAPEUTIC PROCEDURES
49709 - Additional Information
Stabilisation of ligament of ankle or subtalar joint (or both), including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) joint debridement;
—one ligament complex, each incision (H)
(Anaes.) (Assist.)
Fee: $804.30 Benefit: 75% = $603.25
(See para TN.8.195, TN.8.199, TN.8.223 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49712 - Additional Information
Arthrodesis of ankle, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of osteophytes at joint
(H)
(Anaes.) (Assist.)
Fee: $1,072.50 Benefit: 75% = $804.40
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49715 - Additional Information
Total replacement of ankle, with prosthetic replacement of ankle joint, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of osteophytes at joint
(H)
(Anaes.) (Assist.)
Fee: $1,286.90 Benefit: 75% = $965.20
(See para TN.8.199, TN.8.201 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49716 - Additional Information
Revision of total ankle replacement:
(a) including either:
(i) exchange of tibial or talar components (or both) or plastic inserts; or
(ii) removal of tibial or talar components (or both) and plastic inserts; and
(b) including any of the following (if performed):
(i) insertion of cement spacer for infection;
(ii) capsulotomy;
(iii) joint release;
(iv) neurolysis;
(v) debridement of cysts;
(vi) synovectomy;
(vii) joint debridement
other than a service associated with a service to which item 30023 applies (H)
(Anaes.) (Assist.)
Fee: $1,698.70 Benefit: 75% = $1,274.05
(See para TN.8.199, TN.8.201 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49717 - Additional Information
Revision of total ankle replacement:
(a) including either:
(i) exchange of tibial and talar components; or
(ii) removal of tibial and talar components and conversion to ankle arthrodesis; and
(b) including both of the following
(iii) internal or external fixation, by any means;
(iv) major bone grafting; and
(c) including any of the following (if performed):
(i) capsulotomy;
(ii) joint release;
(iii) neurolysis;
(iv) debridement and extensive grafting of cysts;
(v) synovectomy;
(vi) joint debridement;
other than a service associated with a service to which item 30023, 48245, 48248, 48251, 48254 or 48257 applies that is performed at the same site (H)
(Anaes.) (Assist.)
Fee: $2,038.50 Benefit: 75% = $1,528.90
(See para TN.8.199, TN.8.201, TN.8.283 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49718 - Additional Information
Primary repair of major tendon of ankle, by any method, including either or both of the following (if performed):
(a) synovial biopsy;
(b) synovectomy
—one tendon (H)
(Anaes.) (Assist.)
Fee: $428.95 Benefit: 75% = $321.75
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49724 - Additional Information
Reconstruction of major tendon of ankle, by any method, including any of the following (if performed):
(a) synovial biopsy;
(b) synovectomy;
(c) adjacent tendon transfer;
(d) turn down flaps;
other than a service associated with a service to which item 49718 applies (H)
(Anaes.) (Assist.)
Fee: $750.90 Benefit: 75% = $563.20
(See para TN.8.199, TN.8.204 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49727 - Additional Information
Category 3 - THERAPEUTIC PROCEDURES
49728 - Additional Information
Lengthening of Achilles’ tendon, by any method, with gastro-soleus lengthening for the correction of equinous deformity, including either or both of the following (if performed):
(a) synovial biopsy;
(b) synovectomy;
other than a service associated with a service to which item 49727 applies (H)
(Anaes.) (Assist.)
Fee: $643.35 Benefit: 75% = $482.55
(See para TN.8.199, TN.8.204 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49740 - Additional Information
Revision of arthrodesis of ankle, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of osteophytes at joint;
(e) removal of hardware;
(f) neurolysis;
(g) osteotomy of non-union or malunion;
other than a service associated with a service to which item 30023 applies that is performed at the same site
(H)
(Anaes.) (Assist.)
Fee: $1,608.90 Benefit: 75% = $1,206.70
(See para TN.8.199, TN.8.200, TN.8.283 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49742 - Additional Information
Arthrodesis of extended ankle and hindfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of osteophytes at joint
(H)
(Anaes.) (Assist.)
Fee: $1,518.80 Benefit: 75% = $1,139.10
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49744 - Additional Information
Revision of arthrodesis of extended ankle and hindfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of osteophytes at joint;
(e) removal of hardware;
(f) neurolysis;
(g) osteotomy of non-union or malunion;
other than a service associated with a service to which item 30023 applies that is performed at the same site
(H)
(Anaes.) (Assist.)
Fee: $2,278.25 Benefit: 75% = $1,708.70
(See para TN.8.199, TN.8.200, TN.8.283 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49771 - Additional Information
Synovectomy of major tendon of ankle, for extensive synovitis by any method, including any of the following (if performed):
(a) tenolysis;
(b) debridement of ligament or tendon (or both);
(c) release of ligament or tendon (or both);
(d) excision of tubercule or osteophyte;
(e) reconstruction of tendon retinaculum;
(f) neurolysis;
other than a service associated with a service to which item 30023 applies that is performed at the same site—each incision (H)
(Anaes.) (Assist.)
Fee: $423.25 Benefit: 75% = $317.45
(See para TN.8.199, TN.8.283 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49782 - Additional Information
Revision of total ankle replacement, including:
(a) bone grafting of perioperative cysts to the tibia or talus (or both); and
(b) retention of implants; and
(c) any of the following (if performed):
(i) capsulotomy;
(ii) joint release;
(iii) neurolysis;
(iv) debridement and grafting of cysts;
(v) synovectomy;
(vi) joint debridement;
other than a service associated with a service to which item 30023 applies that is performed at the same site (H)
(Anaes.) (Assist.)
Fee: $644.15 Benefit: 75% = $483.15
(See para TN.8.199, TN.8.283 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49884 - Additional Information
Complete excision of one or more ganglia or bursae:
(a) including excision of bony prominence or mucinous cyst of ankle, hindoot or midfoot joint and surrounding tissues; and
(b) including any of the following (if performed):
(i) arthrotomy;
(ii) synovectomy;
(iii) osteophyte resections;
(iv) neurolysis;
(v) capsular or ligament repair;
(vi) skin closure, by any method;
other than a service associated with a service to which item 30023 applies that is performed at the same site—each incision (H)
(Anaes.) (Assist.)
Fee: $423.25 Benefit: 75% = $317.45
(See para TN.8.199, TN.8.283 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49890 - Additional Information
Revision of complete excision of one or more ganglia or bursae:
(a) including excision of bony prominence or mucinous cyst of ankle, hindfoot or midfoot joint and surrounding tissues; and
(b) including any of the following (if performed):
(i) arthrotomy;
(ii) synovectomy;
(iii) osteophyte resections;
(iv) neurolysis;
(v) capsular or ligament repair;
(vi) skin closure, by any method;
other than a service associated with:
(c) a service to which item 49884 applies; or
(d) a service to which item 30023 applies that is performed at the same site
—each incision (H)
(Anaes.) (Assist.)
Fee: $571.30 Benefit: 75% = $428.50
(See para TN.8.199, TN.8.283 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49730 - Additional Information
Surgery of joint of hindfoot (other than ankle) or first metatarsophalangeal joint, by arthroscopic means, including any of the following (if performed):
(a) cartilage treatment;
(b) removal of loose bodies;
(c) synovectomy;
(d) excision of joint osteophytes;
other than a service associated with a service to which another item of this Schedule applies if the service described in the other item is for the purpose of performing a procedure on the ankle by arthroscopic means—one joint (H)
(Anaes.) (Assist.)
Fee: $697.20 Benefit: 75% = $522.90
(See para TN.8.199, TN.8.201, TN.8.202 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49732 - Additional Information
Endoscopy of large tendons of foot, including any of the following (if performed):
(a) debridement of tendon and sheath;
(b) removal of loose bodies;
(c) synovectomy;
(d) excision of tendon impingement;
other than a service associated with a service to which item 49718 or 49724 applies (H)
(Anaes.) (Assist.)
Fee: $697.20 Benefit: 75% = $522.90
(See para TN.8.199, TN.8.201, TN.8.202 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49734 - Additional Information
Arthrotomy of hindfoot, midfoot or metatarsophalangeal joint, including:
(a) removal of loose bodies; and
(b) either or both of the following:
(i) joint debridement;
(ii) release of joint contracture;
—each incision (H)
(Anaes.) (Assist.)
Fee: $375.45 Benefit: 75% = $281.60
(See para TN.8.199, TN.8.201, TN.8.223 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49736 - Additional Information
Transfer of major tendon of foot and ankle, including:
(a) split or whole transfer to contralateral side of foot; and
(b) passage of posterior or anterior tendon to, or through, interosseous membrane; and
(c) any of the following (if performed):
(i) synovial biopsy;
(ii) synovectomy;
(iii) tendon lengthening;
(iv) insetting of tendon
(H)
(Anaes.) (Assist.)
Fee: $750.90 Benefit: 75% = $563.20
(See para TN.8.199, TN.8.204 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49738 - Additional Information
Stabilisation of ligament of talonavicular or metatarsophalangeal joint, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) local tendon transfer;
(e) joint debridement
(H)
(Anaes.) (Assist.)
Fee: $536.25 Benefit: 75% = $402.20
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49760 - Additional Information
Category 3 - THERAPEUTIC PROCEDURES
49761 - Additional Information
Stabilisation of metatarsophalangeal joint at metatarsal, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) osteotomy, with or without fixation;
(e) local tendon transfer;
(f) local tendon lengthening or release;
(g) ligament repair;
(h) joint debridement;
—one metatarsal (H)
(Anaes.) (Assist.)
Fee: $589.90 Benefit: 75% = $442.45
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49762 - Additional Information
Stabilisation of metatarsophalangeal joint at metatarsals, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) osteotomy, with or without fixation;
(e) local tendon transfer;
(f) local tendon lengthening or release;
(g) ligament repair;
(h) joint debridement;
—2 metatarsals (H)
(Anaes.) (Assist.)
Fee: $884.80 Benefit: 75% = $663.60
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49763 - Additional Information
Stabilisation of metatarsophalangeal joint at metatarsals, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) osteotomy, with or without fixation;
(e) local tendon transfer;
(f) local tendon lengthening or release;
(g) ligament repair;
(h) joint debridement;
—3 metatarsals (H)
(Anaes.) (Assist.)
Fee: $1,032.30 Benefit: 75% = $774.25
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49764 - Additional Information
Stabilisation of metatarsophalangeal joint at metatarsals, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) osteotomy, with or without fixation;
(e) local tendon transfer;
(f) local tendon lengthening or release;
(g) ligament repair;
(h) joint debridement;
—4 metatarsals (H)
(Anaes.) (Assist.)
Fee: $1,179.75 Benefit: 75% = $884.85
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49765 - Additional Information
Stabilisation of metatarsophalangeal joint at metatarsals, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) osteotomy, with or without fixation;
(e) local tendon transfer;
(f) local tendon lengthening or release;
(g) ligament repair;
(h) joint debridement;
—5 metatarsals (H)
(Anaes.) (Assist.)
Fee: $1,327.30 Benefit: 75% = $995.50
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49766 - Additional Information
Stabilisation of metatarsophalangeal joint at metatarsals, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) osteotomy, with or without fixation;
(e) local tendon transfer;
(f) local tendon lengthening or release;
(g) ligament repair;
(h) joint debridement;
—6 metatarsals (H)
(Anaes.) (Assist.)
Fee: $1,474.70 Benefit: 75% = $1,106.05
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49767 - Additional Information
Stabilisation of metatarsophalangeal joint at metatarsals, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) osteotomy, with or without fixation;
(e) local tendon transfer;
(f) local tendon lengthening or release;
(g) ligament repair;
(h) joint debridement;
—7 metatarsals (H)
(Anaes.) (Assist.)
Fee: $1,622.20 Benefit: 75% = $1,216.65
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49768 - Additional Information
Stabilisation of metatarsophalangeal joint at metatarsals, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) osteotomy, with or without fixation;
(e) local tendon transfer;
(f) local tendon lengthening or release;
(g) ligament repair;
(h) joint debridement;
—8 metatarsals (H)
(Anaes.) (Assist.)
Fee: $1,769.65 Benefit: 75% = $1,327.25
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49769 - Additional Information
Unilateral correction of hallux valgus or varus deformity, by osteotomy of first metatarsal and proximal phalanx of first toe, with internal fixation of both bones, including any of the following (if performed):
(a) exostectomy;
(b) removal of bursae;
(c) synovectomy;
(d) capsule repair;
(e) capsule or tendon release or transfer
(H)
(Anaes.) (Assist.)
Fee: $1,032.30 Benefit: 75% = $774.25
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49770 - Additional Information
Bilateral correction of hallux valgus or varus deformity, by osteotomy of first metatarsal and proximal phalanx of first toe, with internal fixation of both bones, including any of the following (if performed):
(a) exostectomy;
(b) removal of bursae;
(c) synovectomy;
(d) capsule repair;
(e) capsule or tendon release or transfer
(H)
(Anaes.) (Assist.)
Fee: $1,715.85 Benefit: 75% = $1,286.90
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49772 - Additional Information
Excision of rheumatoid nodules or gouty tophi, excluding aftercare, including any of the following (if performed):
(a) capsulotomy;
(b) debridement of ligament or tendon (or both);
(c) release of ligament or tendon (or both);
(d) excision of tubercle or osteophyte;
—each incision (H)
(Anaes.) (Assist.)
Fee: $373.55 Benefit: 75% = $280.20
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49773 - Additional Information
Revision of excision of intermetatarsal or digital neuroma, including any of the following (if performed):
(a) release of tissues;
(b) excision of bursae;
(c) neurolysis;
other than a service associated with a service to which item 30023 applies that is performed at the same site—one web space (H)
(Anaes.) (Assist.)
Fee: $462.95 Benefit: 75% = $347.25
(See para TN.8.199, TN.8.283 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49774 - Additional Information
Release of tarsal tunnel, including any of the following (if performed):
(a) release of ligaments;
(b) synovectomy;
(c) neurolysis;
other than a service associated with a service to which item 30023 applies that is performed at the same site—one foot (H)
(Anaes.) (Assist.)
Fee: $315.30 Benefit: 75% = $236.50
(See para TN.8.199, TN.8.283 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49775 - Additional Information
Revision of release of tarsal tunnel, including any of the following (if performed):
(a) release of ligaments;
(b) synovectomy;
(c) neurolysis;
other than a service associated with a service to which item 30023 applies that is performed at the same site—one foot (H)
(Anaes.) (Assist.)
Fee: $425.70 Benefit: 75% = $319.30
(See para TN.8.199, TN.8.283 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49776 - Additional Information
Revision of arthrodesis of joint of hindfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of osteophytes at joint;
(e) removal of hardware;
(f) neurolysis;
(g) osteotomy of non‑union or malunion;
other than a service associated with a service to which item 30023 applies that is performed at the same site—may only be claimed once per joint (H)
(Anaes.) (Assist.)
Fee: $1,339.05 Benefit: 75% = $1,004.30
(See para TN.8.199, TN.8.200, TN.8.224, TN.8.283 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49777 - Additional Information
Arthrodesis of joint of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of osteophytes at joint;
—one joint (H)
(Anaes.) (Assist.)
Fee: $792.85 Benefit: 75% = $594.65
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49778 - Additional Information
Arthrodesis of joints of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of osteophytes at joints;
—2 joints (H)
(Anaes.) (Assist.)
Fee: $1,189.30 Benefit: 75% = $892.00
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49779 - Additional Information
Arthrodesis of joints of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of osteophytes at joints;
—3 joints (H)
(Anaes.) (Assist.)
Fee: $1,387.45 Benefit: 75% = $1,040.60
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49780 - Additional Information
Arthrodesis of joints of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of osteophytes at joints;
—4 joints (H)
(Anaes.) (Assist.)
Fee: $1,585.60 Benefit: 75% = $1,189.20
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49781 - Additional Information
Revision of arthrodesis of joint of midfoot, with internal or external fixation by any method, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of ostephytes at joint;
(e) removal of hardware;
(f) osteotomy of non-union or malunion;
—one joint (H)
(Anaes.) (Assist.)
Fee: $1,189.30 Benefit: 75% = $892.00
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49784 - Additional Information
Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joints, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) local tendon transfer;
(e) joint debridement;
—4 joints (H)
(Anaes.) (Assist.)
Fee: $987.20 Benefit: 75% = $740.40
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49785 - Additional Information
Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joints, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) local tendon transfer;
(e) joint debridement;
—5 joints (H)
(Anaes.) (Assist.)
Fee: $1,110.50 Benefit: 75% = $832.90
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49786 - Additional Information
Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joints, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) local tendon transfer;
(e) joint debridement;
—6 joints (H)
(Anaes.) (Assist.)
Fee: $1,233.80 Benefit: 75% = $925.35
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49787 - Additional Information
Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joints, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) local tendon transfer;
(e) joint debridement;
—7 joints (H)
(Anaes.) (Assist.)
Fee: $1,357.10 Benefit: 75% = $1,017.85
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49788 - Additional Information
Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joints, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) local tendon transfer;
(e) joint debridement;
—8 joints (H)
(Anaes.) (Assist.)
Fee: $1,480.40 Benefit: 75% = $1,110.30
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49789 - Additional Information
Bilateral arthrodesis of first metatarsophalangeal joint, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of osteophytes at joint
(H)
(Anaes.) (Assist.)
Fee: $1,273.35 Benefit: 75% = $955.05
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49790 - Additional Information
Revision of arthrodesis of first metatarsophalangeal joint, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of exostosis at joint;
(e) removal of hardware;
(f) osteotomy of non-union or malunion
(H)
(Anaes.) (Assist.)
Fee: $1,106.00 Benefit: 75% = $829.50
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49791 - Additional Information
Arthrodesis of hallux interphalangeal or lesser metatarsophalangeal joint, with internal or external fixation by any method, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of osteophytes at joint
(H)
(Anaes.) (Assist.)
Fee: $501.45 Benefit: 75% = $376.10
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49792 - Additional Information
Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):
(a) internal fixation, by any method;
(b) capsulotomy;
(c) joint release;
(d) synovectomy;
(e) removal of osteophytes at joints;
—one or 2 toes (H)
(Anaes.) (Assist.)
Fee: $563.25 Benefit: 75% = $422.45
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49793 - Additional Information
Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):
(a) internal fixation, by any method;
(b) capsulotomy;
(c) joint release;
(d) synovectomy;
(e) removal of osteophytes at joints;
—3 toes (H)
(Anaes.) (Assist.)
Fee: $657.10 Benefit: 75% = $492.85
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49794 - Additional Information
Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):
(a) internal fixation, by any method;
(b) capsulotomy;
(c) joint release;
(d) synovectomy;
(e) removal of osteophytes at joints;
—4 toes (H)
(Anaes.) (Assist.)
Fee: $750.95 Benefit: 75% = $563.25
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49795 - Additional Information
Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):
(a) internal fixation, by any method;
(b) capsulotomy;
(c) joint release;
(d) synovectomy;
(e) removal of osteophytes at joints;
—5 toes (H)
(Anaes.) (Assist.)
Fee: $844.80 Benefit: 75% = $633.60
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49796 - Additional Information
Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):
(a) internal fixation, by any method;
(b) capsulotomy;
(c) joint release;
(d) synovectomy;
(e) removal of osteophytes at joints;
—6 toes (H)
(Anaes.) (Assist.)
Fee: $938.70 Benefit: 75% = $704.05
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49797 - Additional Information
Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):
(a) internal fixation, by any method;
(b) capsulotomy;
(c) joint release;
(d) synovectomy;
(e) removal of osteophytes at joints;
—7 toes (H)
(Anaes.) (Assist.)
Fee: $1,032.55 Benefit: 75% = $774.45
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49798 - Additional Information
Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):
(a) internal fixation, by any method;
(b) capsulotomy;
(c) joint release;
(d) synovectomy;
(e) removal of osteophytes at joints;
—8 toes (H)
(Anaes.) (Assist.)
Fee: $1,126.45 Benefit: 75% = $844.85
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49800 - Additional Information
Primary repair of flexor or extensor tendon of foot, including either or both of the following (if performed):
(a) synovial biopsy;
(b) synovectomy;
—one toe
(Anaes.) (Assist.)
Fee: $150.15 Benefit: 75% = $112.65 85% = $127.65
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49803 - Additional Information
Category 3 - THERAPEUTIC PROCEDURES
49806 - Additional Information
Category 3 - THERAPEUTIC PROCEDURES
49809 - Additional Information
Open tenotomy or lengthening of foot, by open incision, with or without tenoplasty, including either or both of the following (if performed):
(a) synovial biopsy;
(b) synovectomy;
—one toe
(Anaes.) (Assist.)
Fee: $246.65 Benefit: 75% = $185.00 85% = $209.70
(See para TN.8.199, TN.8.204, TN.8.223 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49812 - Additional Information
Advancement of tendon or ligament transfer of foot, including:
(a) side to side transfer, harvesting and transfer for ligament or minor foot tendon reconstruction; and
(b) either or both of the following (if performed):
(i) synovial biopsy;
(ii) synovectomy;
—one major tendon or toe (H)
(Anaes.) (Assist.)
Fee: $493.25 Benefit: 75% = $369.95
(See para TN.8.199, TN.8.201, TN.8.204, TN.8.223 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49815 - Additional Information
Triple arthrodesis of hindfoot joints, with internal or external fixation by any method, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of osteophytes at joints
(H)
(Anaes.) (Assist.)
Fee: $1,562.25 Benefit: 75% = $1,171.70
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49818 - Additional Information
Category 3 - THERAPEUTIC PROCEDURES
49821 - Additional Information
Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joint, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) local tendon transfer;
(e) joint debridement
—one joint (H)
(Anaes.) (Assist.)
Fee: $493.25 Benefit: 75% = $369.95
(See para TN.8.194, TN.8.199, TN.8.201 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49824 - Additional Information
Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joint, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) local tendon transfer;
(e) joint debridement;
—2 joints (H)
(Anaes.) (Assist.)
Fee: $863.50 Benefit: 75% = $647.65
(See para TN.8.194, TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49827 - Additional Information
Unilateral correction of hallux valgus or varus deformity of the foot, by local tendon transfer, including any of the following (if performed):
(a) exostectomy;
(b) removal of bursae;
(c) synovectomy;
(d) capsule repair;
(e) capsule or tendon release or transfer
(H)
(Anaes.) (Assist.)
Fee: $536.25 Benefit: 75% = $402.20
(See para TN.8.194, TN.8.196, TN.8.199, TN.8.201, TN.8.223 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49830 - Additional Information
Bilateral correction of hallux valgus or varus deformity of the foot, by local tendon transfer, including any of the following (if performed):
(a) exostectomy;
(b) removal of bursae;
(c) synovectomy;
(d) capsule repair;
(e) capsule or tendon release or transfer
(H)
(Anaes.) (Assist.)
Fee: $938.45 Benefit: 75% = $703.85
(See para TN.8.194, TN.8.199, TN.8.201, TN.8.223 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49833 - Additional Information
Unilateral correction of hallux valgus or varus deformity of the foot, by osteotomy of first metatarsal, without internal fixation, including any of the following (if performed):
(a) exostectomy;
(b) removal of bursae;
(c) synovectomy;
(d) capsule repair;
(e) capsule or tendon release or transfer
(H)
(Anaes.) (Assist.)
Fee: $589.90 Benefit: 75% = $442.45
(See para TN.8.194, TN.8.196, TN.8.199, TN.8.201, TN.8.223 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49836 - Additional Information
Bilateral correction of hallux valgus or varus deformity of the foot by osteotomy of first metatarsal, without internal fixation, including any of the following (if performed):
(a) exostectomy;
(b) removal of bursae;
(c) synovectomy;
(d) capsule repair;
(e) capsule or tendon release or transfer
(H)
(Anaes.) (Assist.)
Fee: $1,018.95 Benefit: 75% = $764.25
(See para TN.8.194, TN.8.196, TN.8.199, TN.8.201, TN.8.223 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49837 - Additional Information
Unilateral correction of hallux valgus or varus deformity of the foot, by osteotomy of first metatarsal, with internal fixation, including any of the following (if performed):
(a) exostectomy;
(b) removal of bursae;
(c) synovectomy;
(d) capsule repair;
(e) capsule or tendon release or transfer
(H)
(Anaes.) (Assist.)
Fee: $737.40 Benefit: 75% = $553.05
(See para TN.8.194, TN.8.196, TN.8.199, TN.8.201, TN.8.223 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49838 - Additional Information
Bilateral correction of hallux valgus or varus deformity of the foot by osteotomy of first metatarsal, with internal fixation or arthrodesis of first metatarsophalangeal joint, including any of the following (if performed):
(a) exostectomy;
(b) removal of bursae;
(c) synovectomy;
(d) capsule repair;
(e) capsule or tendon release or transfer
(H)
(Anaes.) (Assist.)
Fee: $1,273.35 Benefit: 75% = $955.05
(See para TN.8.194, TN.8.196, TN.8.199, TN.8.201, TN.8.223 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49839 - Additional Information
Total replacement of first metatarsophalangeal joint, with replacement of both joint surfaces, including any of the following (if performed):
(a) capsulotomy;
(b) synovectomy;
(c) joint debridement
(H)
(Anaes.) (Assist.)
Fee: $589.90 Benefit: 75% = $442.45
(See para TN.8.199, TN.8.201 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49845 - Additional Information
Unilateral arthrodesis of first metatarsophalangeal joint, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):
(a) capsulotomy;
(b) joint release;
(c) synovectomy;
(d) removal of osteophytes at joints
(H)
(Anaes.) (Assist.)
Fee: $737.40 Benefit: 75% = $553.05
(See para TN.8.199, TN.8.200, TN.8.223 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49851 - Additional Information
Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal (or both) joints of lesser toe, including any of the following (if performed):
(a) internal fixation, by any method;
(b) capsulotomy;
(c) tendon lengthening;
(d) joint release;
(e) synovectomy;
(f) removal of osteophytes at joints;
—one toe (H)
(Anaes.) (Assist.)
Fee: $493.25 Benefit: 75% = $369.95
(See para TN.8.199, TN.8.200 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49854 - Additional Information
Radical plantar fasciotomy or fasciectomy, with extensive incision into foot and excision of fascia, including excision of calcaneal spur (if performed), other than a service associated with a service to which 49818 applies (H)
(Anaes.) (Assist.)
Fee: $428.95 Benefit: 75% = $321.75
(See para TN.8.197, TN.8.199, TN.8.223 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49857 - Additional Information
Category 3 - THERAPEUTIC PROCEDURES
49860 - Additional Information
Synovectomy of metatarsophalangeal joints, including any of the following (if performed):
(a) capsulotomy;
(b) debridement;
(c) release of ligament or tendon (or both);
—one or more joints on one foot (H)
(Anaes.) (Assist.)
Fee: $370.60 Benefit: 75% = $277.95
(See para TN.8.199, TN.8.201 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49866 - Additional Information
Excision of intermetatarsal or digital neuroma, including any of the following (if performed):
(a) release of metatarsal or digital ligament;
(b) excision of bursae;
(c) neurolysis;
other than a service associated with a service to which item 30023 applies that is performed at the same site—one web space (H)
(Anaes.) (Assist.)
Fee: $342.95 Benefit: 75% = $257.25
(See para TN.8.199, TN.8.283 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49878 - Additional Information
Talipes equinovarus, calcaneo valgus or metatarsus varus, treatment by cast, splint or manipulation—each attendance
(Anaes.)
Fee: $64.35 Benefit: 75% = $48.30 85% = $54.70
(See para TN.8.199 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49881 - Additional Information
Complete excision of one or more ganglia or bursae:
(a) including excision of bony prominence or mucinous cyst of interphalangeal or metatarsophalangeal joint and surrounding tissues; and
(b) including any of the following (if performed):
(i) arthrotomy;
(ii) synovectomy;
(iii) osteophyte resections;
(iv) neurolysis;
(v) skin closure, by any local method;
other than a service associated with a service to which item 30023 applies that is performed at the same site—each incision (H)
(Anaes.) (Assist.)
Fee: $250.50 Benefit: 75% = $187.90
(See para TN.8.199, TN.8.283 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
49887 - Additional Information
Revision of complete excision of one or more ganglia or bursae:
(a) including excision of bony prominence or mucinous cyst of interphalangeal or metatarsophalangeal joint and surrounding tissues; and
(b) including any of the following (if performed):
(i) arthrotomy;
(ii) synovectomy;
(iii) osteophyte resections;
(iv) neurolysis;
(v) skin closure, by any method;
other than a service associated with:
(c) a service to which item 49881 applies; or
(d) a service to which item 30023 applies that is performed at the same site
—each incision (H)
(Anaes.) (Assist.)
Fee: $338.35 Benefit: 75% = $253.80
(See para TN.8.199, TN.8.283 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