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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)

Multiple Operation Rule

Fee: $1,698.70 Benefit: 75% = $1,274.05

(See para TN.8.199, TN.8.201 of explanatory notes to this Category)

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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)

Multiple Operation Rule

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)

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