Medicare Benefits Schedule - Note TN.8.285

Item 49521 is for a complex primary arthroplasty of the knee where revision components to either the tibia or the femur are used.

Item 49524 is for a complex primary arthroplasty of the knee where revision components to both the tibia and the femur are used.

Item 49524 may also be used in rare circumstances where an anatomic-specific allograft is required as part of a complex primary arthroplasty of the knee.

Related Items: 49521 49524

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Multiple Operation Rule

Complex primary arthroplasty of knee, using revision femoral or tibial components, including either or both of the following (if performed):

(a) ligament reconstruction;

(b) patellar resurfacing;

other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H)

(Anaes.) (Assist.)

Fee: $1,823.45 Benefit: 75% = $1,367.60

(See para TN.8.117, TN.8.285 of explanatory notes to this Category)

Multiple Operation Rule

Complex primary arthroplasty of knee:

(a) using revision femoral and tibial components; or

(b) using revision femoral or tibial components including anatomic specific allograft of femur or tibia;

including either or both of the following (if performed):

(c) ligament reconstruction;

(d) patellar resurfacing;

other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H)

(Anaes.) (Assist.)

Fee: $2,145.15 Benefit: 75% = $1,608.90

(See para TN.8.117, TN.8.285 of explanatory notes to this Category)