Orthopaedics MSP billing codes


Professional Fees

Code Description Amount
51007 OFFICE VISIT - ORTHOPAEDICS $45.83
51008 HOSPITAL VISIT - ORTHOPAEDICS $30.24
51009 PAVLIC HARNESS-CASE MANAGEMENT $45.39
51010 CONSULTATION - ORTHOPAEDICS $102.06
51012 CONSULTATION - REPEAT/LIMITED - ORTHOPAEDICS $56.91
51015 CONSULTATION - SPECIAL - ORTHOPAEDICS $158.00

Professional Fees

Code Description Amount
51007 OFFICE VISIT - ORTHOPAEDICS $45.83
51008 HOSPITAL VISIT - ORTHOPAEDICS $30.24
51009 PAVLIC HARNESS-CASE MANAGEMENT $45.39
51010 CONSULTATION - ORTHOPAEDICS $102.06
51012 CONSULTATION - REPEAT/LIMITED - ORTHOPAEDICS $56.91
51015 CONSULTATION - SPECIAL - ORTHOPAEDICS $158.00

Surgical Assistant

Code Description Amount
00195 SURGICAL ASSIST-LESS THAN $317.00 INCLUSIVE $132.23
00196 SURGICAL ASSIST $317.01 TO 529.00 INCLUSIVE $186.43
00197 SURGICAL ASSISTANCE - OPERATIONS OVER $529.00 $246.57
00198 SURGICAL ASSIST TIME AFTER 3 HRS - PER 15 MINS $27.93
51194 FIRST SURGICAL ASSIST OF THE DAY-ORTHOPEDICS $75.58
70019 CERTIFIED SURGICAL ASSIST $252.83
70020 CERTIFIED SURGICAL ASSIST - TIME FROM 1-3 HOURS $26.40

Surgical Assistant

Code Description Amount
00195 SURGICAL ASSIST-LESS THAN $317.00 INCLUSIVE $132.23
00196 SURGICAL ASSIST $317.01 TO 529.00 INCLUSIVE $186.43
00197 SURGICAL ASSISTANCE - OPERATIONS OVER $529.00 $246.57
00198 SURGICAL ASSIST TIME AFTER 3 HRS - PER 15 MINS $27.93
51194 FIRST SURGICAL ASSIST OF THE DAY-ORTHOPEDICS $75.58
70019 CERTIFIED SURGICAL ASSIST $252.83
70020 CERTIFIED SURGICAL ASSIST - TIME FROM 1-3 HOURS $26.40

Application Of Cast (Incl. External Stimulator)

Code Description Amount
51016 CAST: SHORT ARM $22.89
51017 CAST - LONG ARM $22.89
51018 CAST - SHOULDER SPICA $85.66
51019 CAST - BELOW KNEE $22.89
51020 CAST - LONG LEG CYLINDER $22.89
51021 CAST - LONG LEG $22.89
51022 CAST - HIP SPICA - CHILD $85.66
51023 CAST - HIP SPICA - ADULT $85.66
51024 CAST - BODY $85.66
51025 CAST - CAST BRACE $45.80

Application Of Cast (Includes External Stimulator)

Code Description Amount
51016 CAST: SHORT ARM $22.89
51017 CAST - LONG ARM $22.89
51018 CAST - SHOULDER SPICA $85.66
51019 CAST - BELOW KNEE $22.89
51020 CAST - LONG LEG CYLINDER $22.89
51021 CAST - LONG LEG $22.89
51022 CAST - HIP SPICA - CHILD $85.66
51023 CAST - HIP SPICA - ADULT $85.66
51024 CAST - BODY $85.66
51025 CAST - CAST BRACE $45.80

Miscellaneous

Code Description Amount
51030 REPORT/INTERPRETATION OF FILMS - ORTHOPAEDICS $38.79
51035 SKELETAL TRACTION - APPLICATION $91.98
51036 COMPARTMENT PRESSURE MONITORING - EXTRA $91.59
51037 HARVESTING OF ILIAC CREST GRAFT - EXTRA $91.98
51038 HARVESTING OF SKIN GRAFT - EXTRA $101.16
51065 ILIZAROV INSTRUMENTATION, SIMPLE $1,076.13
51066 ILIZAROV INSTRUMENTATION; COMPLEX, MULTIPLE $1,476.21
51067 ILIZAROV INSTRUMENTATION EXTENSION/REVISION -FRAME $211.54

Miscellaneous Ortho

Code Description Amount
51030 REPORT/INTERPRETATION OF FILMS - ORTHOPAEDICS $38.79
51035 SKELETAL TRACTION - APPLICATION $91.98
51036 COMPARTMENT PRESSURE MONITORING - EXTRA $91.59
51037 HARVESTING OF ILIAC CREST GRAFT - EXTRA $91.98
51038 HARVESTING OF SKIN GRAFT - EXTRA $101.16
51065 ILIZAROV INSTRUMENTATION, SIMPLE $1,076.13
51066 ILIZAROV INSTRUMENTATION; COMPLEX, MULTIPLE $1,476.21
51067 ILIZAROV INSTRUMENTATION EXTENSION/REVISION -FRAME $211.54

Shoulder Girdle, Clavicle And Humerus

Code Description Amount
00757 ASPIRATION OTHER JOINTS $11.54
11200 ARTHROSCOPY- SHOULDER JOINT $294.34
11215 ARTHROTOMY - SHOULDER JOINT/BURSA $183.95
11230 BIOPSY - NEEDLE - SHOULDER JOINT/GA $183.95
11232 ARTHROSCOPY - BIOPSY- SHOULDER $239.13
11245 BIOPSY - SHOULDER JOINT - OPEN $239.13
51039 ASPIRATION - BURSA $22.89
51040 ASPIRATION - JOINT $22.89
52210 INCISION/DRAINAGE - BURSA -GA $183.95
52215 ABSCESS - INCISION/DRAINAGE - GA $183.95
52220 HEMATOMA - INCISION/DRAINAGE - GA $239.13
52225 ARTHROTOMY - SHOULDER JOINT - I AND D $183.95
52250 SOFT TISSUE RELEASE - MUSCLE, TENDON $374.80
52255 SHOULDER CONTRACTURE - MAJOR $533.45
52305 EXCISION - ENDOSCOPIC - REMOVAL OF LOOSE BODY $283.35
52306 EXCISION - ENDOSCOPIC - WITH/WITHOUT LOOSE BODY. $283.35
52307 PINNING - OSTEOCHONDRAL FRAGMENT $344.92
52310 DEBRIDEMENT, SYNOVECTOMY - TOTAL OR SUBTOTAL $404.78
52315 SHOULDER ABRASION $344.92
52320 LABRUM TEAR- EXCISION $239.13
52325 STABILIZATION PROCEDURE $561.05
52330 ACROMIOPLASTY - ENDOSCOPIC $404.78
52335 ARTHROSCOPIC CLAVICLE EXCISION-MEDIAL/LATERAL/EXTR $104.99
52355 EXCISION OF BURSA - SUBACROMIAL - OPEN $211.54
52356 ACROMIONECTOMY, ACROMIOPLASTY $344.92
52357 CLAVICLE EXCISION - OPEN $211.54
52360 ARTHROTOMY - SHOULDER. $400.09
52365 SUBFASCIAL SOFT TISSUE TUMOUR - BENIGN $400.09
52370 BONE TUMOUR - BENIGN $400.09
52380 OSTEOMYELITIS - ACUTE, DECOMPRESSION $183.95
52385 OSTEOMYELITIS - DEBRIDEMENT WITH/WITHOUT RECONSTR $317.32
52405 INJECTION OF JOINT - SHOULDER/CLAVICLE/HUMERUS $11.45
52410 INJECTION - BURSA,TENDON SHEATH- SHOULDER/CLAVICLE $11.45
52415 INT FIXATION DEVICE(S) - REMOVAL - GA $239.13
52420 INT FIXATION DEVICE(S), REMOVAL - WITHOUT GA $68.98
52505 ROTATOR CUFF REPAIR - SIMPLE $427.70
52506 ROTATOR CUFF RECONSTRUCTION - COMPLEX $708.21
52515 STABILIZATION - ACROMIOCLAVICULAR JOINT - ACUTE $266.73
52516 STABILIZATION - ACROMIOCLAVICULAR JOINT - CHRONIC $400.09
52525 SHOULDER INSTABILITY - INFERIOR CAPSULAR SHIFT $561.05
52526 SHOULDER INSTABILITY -BANKART $620.83
52535 SHOULDER INSTABILITY-ANTERIOR REPAIRS $452.97
52540 SHOULDER INSTABILITY - POSTERIOR-GLENOID OSTEOTOMY $708.21
52541 SHOULDER INSTABILITY - POSTERIOR - SOFT TISSUE $588.64
52545 STABILIZATION - SHOULDER INSTABILITY -REVISION, $708.21
52550 TENDON REPAIR, PROXIMAL BICEPS, PECTORALIS MAJOR $427.70
52555 SHOULDER/CLAVICLE/HUMERUS TENDON TRANSFER $505.88
52601 PROXIMAL HUMERUS - REPAIR/REVISION $708.21
52602 CLAVICLE - REPAIR/REVISION $505.98
52603 HEMI-ARTHROPLASTY - SHOULDER $611.64
52604 SHOULDER PROSTHESIS - TOTAL $976.54
52605 SHOULDER PROSTHESIS - REMOVAL $455.28
52606 SHOULDER ARTHROPLASTY/HEMIARTHROPLASTY- TOTAL -REV $791.00
52607 SHOULDER ARTHROPLASTY - TOTAL - REVISION $1,315.54
52651 BONE GRAFTING - PROXIMAL HUMERUS $239.13
52652 BONE GRAFTING - CLAVICLE $147.16
52705 ORIF - CLAVICLE/ACROMION/CORACOID $430.09
52708 CLAVICLE/ACROMION/CORACOID - PRIMARY WOUND CARE $100.75
52709 CLAVICLE/ACROMION/CORACOID - SECONDARY WOUND MANAG $183.95
52710 STERNO-CLAVICULAR JOINT STABILIZATION $505.98
52715 SCAPULA - FRACTURE/DISLOCATION - ORIF $910.57
52718 SCAPULA - OPEN INJURY, PRIMARY WOUND CARE $100.75
52719 SCAPULA - OPEN INJURY, SECONDARY WOUND MANAGEMENT $183.95
52721 GLENOHUMERAL - CLOSED REDUCTION WITHOUT GA $91.98
52722 GLENOHUMERAL - CLOSED REDUCTION WITH GA $239.13
52725 GLENOHUMERAL - OPEN REDUCTION $400.09
52731 PROXIMAL HUMERUS - CLOSED REDUCTION WITH GA $183.95
52732 PROXIMAL HUMERUS-CLOSED RED. WITH GA TRACTION/PIN $183.95
52735 PROXIMAL HUMERUS - ORIF - TWO PART $533.45
52736 PROXIMAL HUMERUS - ORIF - THREE OR MORE PARTS $644.81
52737 PROXIMAL HUMERUS- HEMIPROSTHESIS/WIRING-FRACTURE $791.00
52738 PROXIMAL HUMERUS - OPEN INJURY-PRIMARY WOUND CARE $100.75
52739 PROXIMAL HUMERUS - OPEN INJURY -SECONDARY WOUND $183.95
52741 HUMERUS - SHAFT -CLOSED REDUCTION WITH GA $239.13
52742 HUMERUS - SHAFT-CLOSED REDUCTION-EXTERNAL FIXATION $349.52
52745 HUMERUS- SHAFT - ORIF/INTRAMEDULLARY NAILING $561.05
52748 HUMERUS - SHAFT - OPEN INJURY PRIMARY WOUND CARE $100.75
52749 HUMERUS - SHAFT-OPEN SECONDARY WOUND MANAGEMENT $183.95
52800 MANIPULATION UNDER GA - SHOULDER JOINT $91.98
52810 ARTHRODESIS - SHOULDER JOINT $938.16
52811 ARTHRODESIS - SCAPULA-THORACIC JOINT $735.82
52980 AMPUTATION - SHOULDER DISARTICULATION $763.40
52981 AMPUTATION - FOREQUARTER $910.57
52982 AMPUTATION - HUMERAL SHAFT $533.45
52998 AMPUTATION - PRIMARY WOUND CARE - OPEN INJURY $100.75
52999 AMPUTATION - SECONDARY WOUND MANAGEMENT - OPEN $183.95

Shoulder Girdle, Clavicle And Humerus

Code Description Amount
00757 ASPIRATION OTHER JOINTS $11.54
11200 ARTHROSCOPY- SHOULDER JOINT $294.34
11215 ARTHROTOMY - SHOULDER JOINT/BURSA $183.95
11230 BIOPSY - NEEDLE - SHOULDER JOINT/GA $183.95
11232 ARTHROSCOPY - BIOPSY- SHOULDER $239.13
11245 BIOPSY - SHOULDER JOINT - OPEN $239.13
51039 ASPIRATION - BURSA $22.89
51040 ASPIRATION - JOINT $22.89
52210 INCISION/DRAINAGE - BURSA -GA $183.95
52215 ABSCESS - INCISION/DRAINAGE - GA $183.95
52220 HEMATOMA - INCISION/DRAINAGE - GA $239.13
52225 ARTHROTOMY - SHOULDER JOINT - I AND D $183.95
52250 SOFT TISSUE RELEASE - MUSCLE, TENDON $374.80
52255 SHOULDER CONTRACTURE - MAJOR $533.45
52305 EXCISION - ENDOSCOPIC - REMOVAL OF LOOSE BODY $283.35
52306 EXCISION - ENDOSCOPIC - WITH/WITHOUT LOOSE BODY. $283.35
52307 PINNING - OSTEOCHONDRAL FRAGMENT $344.92
52310 DEBRIDEMENT, SYNOVECTOMY - TOTAL OR SUBTOTAL $404.78
52315 SHOULDER ABRASION $344.92
52320 LABRUM TEAR- EXCISION $239.13
52325 STABILIZATION PROCEDURE $561.05
52330 ACROMIOPLASTY - ENDOSCOPIC $404.78
52335 ARTHROSCOPIC CLAVICLE EXCISION-MEDIAL/LATERAL/EXTR $104.99
52355 EXCISION OF BURSA - SUBACROMIAL - OPEN $211.54
52356 ACROMIONECTOMY, ACROMIOPLASTY $344.92
52357 CLAVICLE EXCISION - OPEN $211.54
52360 ARTHROTOMY - SHOULDER. $400.09
52365 SUBFASCIAL SOFT TISSUE TUMOUR - BENIGN $400.09
52370 BONE TUMOUR - BENIGN $400.09
52380 OSTEOMYELITIS - ACUTE, DECOMPRESSION $183.95
52385 OSTEOMYELITIS - DEBRIDEMENT WITH/WITHOUT RECONSTR $317.32
52405 INJECTION OF JOINT - SHOULDER/CLAVICLE/HUMERUS $11.45
52410 INJECTION - BURSA,TENDON SHEATH- SHOULDER/CLAVICLE $11.45
52415 INT FIXATION DEVICE(S) - REMOVAL - GA $239.13
52420 INT FIXATION DEVICE(S), REMOVAL - WITHOUT GA $68.98
52505 ROTATOR CUFF REPAIR - SIMPLE $427.70
52506 ROTATOR CUFF RECONSTRUCTION - COMPLEX $708.21
52515 STABILIZATION - ACROMIOCLAVICULAR JOINT - ACUTE $266.73
52516 STABILIZATION - ACROMIOCLAVICULAR JOINT - CHRONIC $400.09
52517 OPEN OR ARTHROSCOPIC SLAP/BICEPS TENODESIS REPAIR $620.83
52518 SLAP/BICEPS TENODESIS REPAIR OR GLENOHUML/BANKART $901.36
52519 SLAP/BICEPS TENODESIS REPAIR OR BANK AND ROTATOR $1,018.63
52520 SLAP/BICEPS TENODESIS & BANKART,TENDON TRANS & ROT $1,329.04
52521 SLAP/BICEPS & BANK,TENDON TRANS,ROTAT CUFF & GLENO $1,555.53
52525 SHOULDER INSTABILITY - INFERIOR CAPSULAR SHIFT $561.05
52526 SHOULDER INSTABILITY -BANKART $620.83
52535 SHOULDER INSTABILITY-ANTERIOR REPAIRS $452.97
52540 SHOULDER INSTABILITY - POSTERIOR-GLENOID OSTEOTOMY $708.21
52541 SHOULDER INSTABILITY - POSTERIOR - SOFT TISSUE $588.64
52545 STABILIZATION - SHOULDER INSTABILITY -REVISION, $708.21
52550 TENDON REPAIR, PROXIMAL BICEPS, PECTORALIS MAJOR $427.70
52555 SHOULDER/CLAVICLE/HUMERUS TENDON TRANSFER $505.88
52601 PROXIMAL HUMERUS - REPAIR/REVISION $708.21
52602 CLAVICLE - REPAIR/REVISION $505.98
52603 HEMI-ARTHROPLASTY - SHOULDER $611.64
52604 SHOULDER PROSTHESIS - TOTAL $976.54
52605 SHOULDER PROSTHESIS - REMOVAL $455.28
52606 SHOULDER ARTHROPLASTY/HEMIARTHROPLASTY- TOTAL -REV $791.00
52607 SHOULDER ARTHROPLASTY - TOTAL - REVISION $1,315.54
52651 BONE GRAFTING - PROXIMAL HUMERUS $239.13
52652 BONE GRAFTING - CLAVICLE $147.16
52705 ORIF - CLAVICLE/ACROMION/CORACOID $430.09
52708 CLAVICLE/ACROMION/CORACOID - PRIMARY WOUND CARE $100.75
52709 CLAVICLE/ACROMION/CORACOID - SECONDARY WOUND MANAG $183.95
52710 STERNO-CLAVICULAR JOINT STABILIZATION $505.98
52715 SCAPULA - FRACTURE/DISLOCATION - ORIF $910.57
52718 SCAPULA - OPEN INJURY, PRIMARY WOUND CARE $100.75
52719 SCAPULA - OPEN INJURY, SECONDARY WOUND MANAGEMENT $183.95
52721 GLENOHUMERAL - CLOSED REDUCTION WITHOUT GA $91.98
52722 GLENOHUMERAL - CLOSED REDUCTION WITH GA $239.13
52725 GLENOHUMERAL - OPEN REDUCTION $400.09
52731 PROXIMAL HUMERUS - CLOSED REDUCTION WITH GA $183.95
52732 PROXIMAL HUMERUS-CLOSED RED. WITH GA TRACTION/PIN $183.95
52735 PROXIMAL HUMERUS - ORIF - TWO PART $533.45
52736 PROXIMAL HUMERUS - ORIF - THREE OR MORE PARTS $644.81
52737 PROXIMAL HUMERUS- HEMIPROSTHESIS/WIRING-FRACTURE $791.00
52738 PROXIMAL HUMERUS - OPEN INJURY-PRIMARY WOUND CARE $100.75
52739 PROXIMAL HUMERUS - OPEN INJURY -SECONDARY WOUND $183.95
52741 HUMERUS - SHAFT -CLOSED REDUCTION WITH GA $239.13
52742 HUMERUS - SHAFT-CLOSED REDUCTION-EXTERNAL FIXATION $349.52
52745 HUMERUS- SHAFT - ORIF/INTRAMEDULLARY NAILING $561.05
52748 HUMERUS - SHAFT - OPEN INJURY PRIMARY WOUND CARE $100.75
52749 HUMERUS - SHAFT-OPEN SECONDARY WOUND MANAGEMENT $183.95
52800 MANIPULATION UNDER GA - SHOULDER JOINT $91.98
52810 ARTHRODESIS - SHOULDER JOINT $938.16
52811 ARTHRODESIS - SCAPULA-THORACIC JOINT $735.82
52980 AMPUTATION - SHOULDER DISARTICULATION $763.40
52981 AMPUTATION - FOREQUARTER $910.57
52982 AMPUTATION - HUMERAL SHAFT $533.45
52998 AMPUTATION - PRIMARY WOUND CARE - OPEN INJURY $100.75
52999 AMPUTATION - SECONDARY WOUND MANAGEMENT - OPEN $183.95

Elbow, Proximal Radius And Ulna

Code Description Amount
00757 ASPIRATION OTHER JOINTS $11.54
11300 ARTHROSCOPY - ELBOW JOINT $264.44
11302 ASPIRATION - BURSA/TENDON SHEATH - DIAGNOSTIC $22.89
11315 ARTHROTOMY - ELBOW JOINT $183.95
11330 BIOPSY - NEEDLE - ELBOW JOINT/GA $183.95
11332 ARTHROSCOPY/BIOPSY- ELBOW JOINT $292.04
11345 BIOPSY - OPEN - ELBOW JOINT $239.13
51039 ASPIRATION - BURSA $22.89
51040 ASPIRATION - JOINT $22.89
53210 ELBOW, PROXIMAL RADIUS/ULNA - I & D $183.95
53215 ELBOW, PROXIMAL RADIUS- ABSCESS I&D UNDER GA $183.95
53220 ELBOW, PROXIMAL RADIUS/ULNA - HEMATOMA UNDER GA $239.13
53225 ELBOW JOINT ARTHROTOMY I AND D $183.95
53250 ELBOW,PROXIMAL RADIUS/ULNA- DECOMPRESSION/NEUROLY $239.13
53255 ELBOW, INCISION-DECOMPRESSION,NEUROLYSIS $400.09
53260 ELBOW, FASCIOTOMY, COMPARTMENT SYNDROME $211.54
53269 ELBOW, INCISION - FASCIOTOMY, SECONDARY WOUND $183.95
53305 ELBOW, EXCISION -REMOVAL LOOSE BODY $328.89
53310 ELBOW, EXCISION - DEBRIDEMENT, SYNOVECTOMY-TOTAL $632.47
53355 ELBOW, EXCISION -THERAPEUTIC - BURSA/GANGLION $211.54
53360 ELBOW ARTHROTOMY - OPEN SYNOVECTOMY $400.09
53365 ELBOW EXCISION BENIGN SOFT TISSUE TUMOR,SUBFACIAL $266.73
53370 ELBOW - BONE TUMOUR, BENIGN $266.73
53380 BONE TUMOUR - ELBOW - OSTEOMYELITIS, ACUTE $183.95
53385 BONE TUMOUR - ELBOW - OSTEOMYELITIS-DEBRIDEMENT $317.32
53386 RADIAL HEAD RESECTION - ELBOW $239.13
53405 INJECTION OF JOINT - ELBOW $11.45
53410 INJECTION OF BURSA/TENDON SHEATH - ELBOW $11.45
53415 INT FIXATION DEVICE(S)-ELBOW-REMOVAL WITH GA $211.54
53420 INT FIXATION DEVICE(S)-ELBOW-REMOVAL/WITHOUT GA $68.98
53505 ELBOW INSTABILITY- CHRONIC $666.81
53510 RECURRENT DISLOCATION - RADIAL HEAD - ELBOW $561.05
53515 TRICEPS TENDON - ACUTE - ELBOW $347.21
53516 TRICEPS TENDON, FASCIAL RECONSTRUCTION - ELBOW $400.09
53520 BICEPS TENDON, LONGHEAD, TENODESIS - ELBOW $266.73
53521 BICEPS TENDON, DISTAL INSERTION - ELBOW $561.05
53530 TENDON TRANSFER - MAJOR - ELBOW $708.21
53531 TENDON TRANSFER- MINOR - ELBOW $427.70
53540 EPICONDYLITIS - FASCIAL STRIPPING - ELBOW $211.54
53601 HUMERAL SHAFT - REPAIR - ELBOW $701.32
53602 DISTAL HUMERUS - REPAIR - ELBOW $708.21
53603 RADIUS SHAFT -REPAIR - ELBOW $586.33
53604 ULNA SHAFT - REPAIR - ELBOW $513.20
53605 RADIUS AND ULNA SHAFTS - REPAIR/REVISION - ELBOW $708.21
53606 EPIPHYSIODESIS - REPAIR/REVISION - ELBOW $266.73
53607 PHYSEAL BAR EXCISION/HARVEST - ELBOW $441.48
53641 ARTHROPLASTY - ELBOW - INTERPOSITION/DISTRACTION $910.57
53642 ARTHROPLASTY- TOTAL ELBOW $976.54
53643 ARTHROPLASTY- TOTAL ELBOW - REVISION $1,315.54
53644 OSTEOCAPSULAR ARTHROPLASTY $910.76
53651 BONE GRAFTING: HUMERUS - ELBOW $239.13
53652 BONE GRAFTING - RADIUS AND/OR ULNA - ELBOW $239.13
53653 BONE GRAFTING - OLECRANON - ELBOW $147.16
53701 HUMERAL EPICONDYLE - FRACTURE/DISLOCATION/GA $239.13
53702 HUMERAL EPICONDYLE - CLOSED REDUCTION $266.73
53705 HUMERAL EPICONDYLE - ORIF $266.73
53708 HUMERAL EPICONDYLE - PRIMARY WOUND CARE $100.75
53709 HUMERAL EPICONDYLE - SECONDARY WOUND $183.95
53711 DISTAL HUMERUS: CLOSED REDUCTION $183.95
53712 DISTAL HUMERUS - CLOSED REDUCTION $380.34
53715 DISTAL HUMERUS - ORIF $438.28
53718 DISTAL HUMERUS - PRIMARY WOUND CARE $100.75
53719 DISTAL HUMERUS - SECONDARY WOUND MANAGEMENT $183.95
53721 DISTAL HUMERUS: INTRA-ARTICULAR - CLOSED RED W/ GA $183.95
53722 DISTAL HUMERUS-CLOSED REDUCTION EXTERNAL FIXATION $349.52
53725 DISTAL HUMERUS - ORIF - UNICONDYLAR $400.09
53726 DISTAL HUMERUS - ORIF - BICONDYLAR $855.38
53727 DISTAL HUMERUS - PRIMARY WOUND CARE $100.75
53728 DISTAL HUMERUS - SECONDARY WOUND MANAGEMENT $183.95
53735 OLECRANON - FRACTURE/DISLOCATION - ORIF $410.57
53738 OLECRANON - PRIMARY WOUND CARE $100.75
53739 OLECRANON - SECONDARY WOUND MANAGEMENT $183.95
53741 RADIAL HEAD/NECK - FRACTURE/DISLOCATION - CLOSED $239.13
53742 RADIAL HEAD/NECK - CLOSED REDUCTION PERCUTANEOUS $266.73
53745 RADIAL HEAD/NECK - ORIF $400.09
53748 RADIAL HEAD/NECK - PRIMARY WOUND CARE $100.75
53749 RADIAL HEAD/NECK - SECONDARY WOUND MANAGEMENT $183.95
53751 ELBOW JOINT - DISLOCATION - CLOSED REDUCTION $147.16
53752 ELBOW JOINT - DISLOCATION - CLOSED REDUCTION/GA $239.13
53755 ELBOW JOINT - DISLOCATION - OPEN REDUCTION $294.34
53761 RADIUS/ULNA SHAFT - FRACTURE/DISLOCATION - CLOSED $91.98
53762 RADIUS/ULNA SHAFT- FRACTURE/DISLOCATION- CLOSED/GA $294.34
53765 RADIUS/ULNA SHAFT - ORIF $533.45
53768 RADIUS/ULNA SHAFT - OPEN INJURY-PRIMARY WOUND CARE $100.75
53769 RADIUS/ULNA SHAFT-SECONDARY WOUND MGMT-OPEN INJURY $183.95
53771 RADIUS OR ULNA SHAFT/MONTEGGIA-CLOSED REDUCTION/GA $266.73
53772 RADIUS OR ULNA SHAFT/MONTEGGIA - CLOSED REDUCTION $266.73
53775 RADIUS OR ULNA SHAFT/MONTEGGIA - ORIF $410.57
53778 RADIUS OR ULNA SHAFT/MONTEGGIA - PRIMARY WOUND $100.75
53779 RADIUS OR ULNA SHAFT/MONTEGGIA - SECONDARY WOUND $183.95
53800 MANIPULATION - UNDER GA - ELBOW JOINT $91.98
53810 ARTHRODESIS - ELBOW JOINT $708.21
53980 AMPUTATION - ELBOW $400.09
53981 AMPUTATION - FOREARM $400.09
53998 AMPUTATION - FOREARM - PRIMARY WOUND CARE $100.75
53999 AMPUTATION - FOREARM - SECONDARY WOUND MANAGEMENT $183.95

Hand And Wrist

Code Description Amount
00757 ASPIRATION OTHER JOINTS $11.54
06218 AMPUTATION - TRANSMETACARPAL $251.13
06219 AMPUTATION - FINGER $251.13
07055 GANGLIA - WRIST $179.56
11400 ARTHROSCOPY - WRIST JOINT $283.35
11402 ASPIRATION - BURSA/SYNOVIAL SHEATH, ETC. $22.89
11415 ARTHROTOMY - WRIST JOINT $183.95
11416 ARTHROTOMY - MP/PIP/DIP JOINTS $183.95
11430 BIOPSY - NEEDLE - WRIST JOINT/GA $183.95
11432 ARTHROSCOPY/BIOPSY - WRIST /HAND JOINT(S) $183.95
11445 BIOPSY - OPEN - HAND/WRIST $239.13
51039 ASPIRATION - BURSA $22.89
51040 ASPIRATION - JOINT $22.89
54305 REMOVAL OF LOOSE BODY - HAND/WRIST $239.13
54310 DEBRIDEMENT/ SYNOVECTOMY- HAND/WRIST - TOTAL $319.62
54315 TRIANGULAR FIBRO CARTILAGE COMPLEX (TFCC) $319.62
54350 FOREIGN BODY REMOVAL - HAND/WRIST/GA $211.54
54351 EXCISION - OPEN - MENISCUS/RADIOCARPAL $319.62
54372 BONE TUMOR - BENIGN - CARPALS/DISTAL RADIUS $319.62
54380 OSTEOMYELITIS, ACUTE - CARPALS, DISTAL/RADIUS $183.95
54385 OSTEOMYELITIS/DEBRIDEMENT - CARPALS/DISTAL RADIUS $317.32
54386 STYLOID - RADIAL/ULNAR - EXCISION $211.54
54387 CARPECTOMY - PROXIMAL ROW $533.45
54405 INJECTION - THERAPEUTIC - HAND/WRIST JOINT $22.89
54410 INJECTION - THERAPEUTIC - BURSA/TENDON SHEATH $22.89
54415 INT FIXATION DEVICE(S) AND/WRIST- REMOVAL/GA $211.54
54420 INT FIXATION DEVICE(S) - HAND/WRIST -REMOVAL $45.99
54505 CARPAL INSTABILITY - ACUTE $588.64
54510 CARPAL INSTABILITY: CHRONIC $648.43
54515 DISTAL RADIO-ULNAR INSTABILITY - CHRONIC $480.57
54601 OSTEOTOMY - DISTAL RADIUS $648.43
54602 OSTEOTOMY - DISTAL ULNA $321.92
54603 CARPAL BONE (SCAPHOID) - REPAIR/REVISION $533.45
54604 OSTEOTOMY - EPIPHYSIODESIS/EPIPHYSIOPLASTY/RADIUS/ $400.09
54631 ARTHROPLASTY - ULNA - DISTAL EXCISION $239.13
54632 JOINT REPLACEMENT - TOTAL WRIST $708.21
54633 ARTHROPLASTY- SILASTIC WRIST $533.45
54634 WRIST PROSTHESIS - REMOVAL $266.73
54635 ARTHROPLASTY - TOTAL WRIST - REVISION $938.16
54651 BONE GRAFTING - DISTAL RADIUS/ULNA $239.13
54652 BONE GRAFTING - METACARPAL/PHALANX $119.56
54701 RADIUS - FRACTURE/DISLOCATION-CLOSED REDUCTION $248.34
54702 RADIUS - CLOSED REDUCTION/GA $294.34
54703 RADIUS - EXTERNAL/PERCUTANEOUS FIXATION. $321.92
54705 RADIUS - ORIF $510.48
54708 RADIUS - PRIMARY WOUND CARE $50.37
54709 RADIUS - SECONDARY WOUND MANAGEMENT $91.98
54715 CARPAL BONE FRACTURE(SCAPHOID) - OPEN REDUCTION $427.70
54721 CARPUS-DISLOCATION-W/WO FRACTURE-CLOSED REDUCTION $248.34
54722 CARPUS - CLOSED REDUCTION/PERCUTANEOUS FIXATION $294.34
54725 CARPUS - ORIF $588.64
54728 CARPUS - PRIMARY WOUND CARE $50.37
54729 CARPUS - SECONDARY WOUND MANAGEMENT $91.98
54800 MANIPULATION - HAND/WRIST JOINT UNDER GA $91.98
54810 ARTHRODESIS - WRIST - LIMITED OR TOTAL $648.43

Pelvis, Hip And Femur

Code Description Amount
11501 ASPIRATION - HIP JOINT $22.89
11502 ASPIRATION - HIP -BURSA/TENDON SHEATH, ETC. $11.45
11515 ARTHROTOMY - HIP JOINT $294.34
11530 BIOPSY - NEEDLE- HIP/GA $183.95
11532 ARTHROSCOPY/BIOPSY - HIP $510.48
11545 ARTHROTOMY/BIOPSY - HIP $239.13
11546 BIOPSY - HIP - SOFT TISSUE/BONE $239.13
51039 ASPIRATION - BURSA $22.89
51040 ASPIRATION - JOINT $22.89
55210 PELVIS/HIP/FEMUR- INCISION/DRAINAGE/GA $183.95
55215 ABSCESS - PELVIS/HIP/FEMUR -INCISION/DRAINAGE/GA $183.95
55220 HEMATOMA - PELVIS/HIP/FEMUR - DRAINAGE UNDER GA $294.34
55225 ARTHROTOMY - HIP JOINT - I AND D $317.32
55255 SOFT TISSUE RELEASE - HIP- PERCUTANEOUS $266.73
55270 MINOR RELEASE - HIP - ONE TENDON $294.34
55275 MAJOR RELEASE - TWO OR MORE - HIP $400.09
55305 LOOSE BODY - HIP - REMOVAL $372.50
55310 DEBRIDEMENT/SYNOVECTOMY - HIP - TOTAL $588.64
55355 EXCISION - OPEN - HIP - BURSA/TROCHANTERIC $211.54
55360 ARTHROTOMY - HIP - OPEN SYNOVECTOMY - TOTAL $561.05
55365 SOFT TISSUE TUMOUR - BENIGN -HIP - SUBFASCIAL $400.09
55370 BONE TUMOUR, BENIGN - HIP $427.70
55371 HETEROTOPIC BONE RESECTION $508.28
55380 OSTEOMYELITIS, ACUTE - HIP - DECOMPRESSION $183.95
55385 OSTEOMYELITIS, DEBRIDEMENT - HIP $317.32
55405 INJECTION OF JOINT - HIP $11.45
55410 INJECTION OF BURSA/TENDON SHEATH - HIP $11.45
55415 INT FIXATION DEVICE(S) - REMOVAL - HIP/GA $239.13
55420 INT FIXATION DEVICE(S) - REMOVAL - HIP/WITHOUT G $68.98
55505 SOFT TISSUE REPAIR - HIP INSTABILITY $643.84
55510 TENDON-MUSCLE TRANSFER - HIP $648.43
55515 TENDON AVULSION REPAIR - HIP $321.92
55601 OSTEOTOMY - PELVIS - ADULT $735.82
55602 OSTEOTOMY - PELVIS - PAEDIATRIC $588.64
55603 OSTEOTOMY - PROXIMAL FEMUR - ADULT $735.82
55604 OSTEOTOMY - PROXIMAL FEMUR - PAEDIATRIC $735.82
55605 OSTEOTOMY - FEMORAL SHAFT - ADULT $763.40
55606 OSTEOTOMY - FEMORAL SHAFT - PAEDIATRIC $763.40
55607 OSTEOTOMY - MULTIPLE FOR OSTEOGENESIS IMPERFECTA $878.37
55631 PELVIS: NON-UNION OR MALUNION $1,342.86
55632 NONUNION OR MALUNION - ACETABULUM $1,821.13
55633 NONUNION OR MALUNION - PROXIMAL FEMUR $882.99
55634 NONUNION OR MALUNION - SHAFT FEMUR $763.40
55635 NONUNION OR MALUNION - FEMORAL LENGTHENING, OPEN $882.99
55636 NONUNION OR MALUNION - FEMORAL SHORTENING, CLOSED $882.99
55651 BONE GRAFTING - FEMUR $266.73
55652 BONE GRAFTING - EPIPHYSIODESIS, GREATER TROCHANTER $321.92
55661 ARTHROPLASTY - RESECTION - HIP $482.87
55662 HEMI-ARTHROPLASTY - HIP $559.19
55663 TOTAL HIP PROSTHESIS $791.00
55671 REVISION TOTAL HIP ARTHROPLASTY: COMPONENTS $791.00
55672 TOTAL HIP ARTHROPLASTY- EXCHG OF MODULAR COMPONENT $427.70
55673 REVISION - FEMUR OR ACETABULUM $974.95
55674 REVISION - FEMUR AND ACETABULUM,INCLUDES PROSTALAC $1,287.66
55675 PROXIMAL FEMORAL REPLACEMENT $1,609.59
55701 FRACTURE-PELVIS-CLOSED REDUCTION-SKELETAL TRACTION $91.98
55702 PELVIS - CLOSED REDUCTION - EXTERNAL FIXATION $487.48
55705 PELVIS - EXTERNAL FIXATION/ORIF $1,076.13
55706 PELVIS -ORIF- ANTERIOR OR POSTERIOR $754.20
55707 PELVIS -ORIF - ANTERIOR AND POSTERIOR $1,154.30
55711 HIP - DISLOCATION - TRAUMATIC $91.98
55712 REDUCTION - HIP/GA $183.95
55715 REDUCTION - HIP - OPEN $482.87
55721 DISLOCATION- CONGENITAL- HIP- CLOSED REDUCTION/GA $266.73
55725 DISLOCATION - CONGENITAL - OPEN REDUCTION -HIP $703.62
55726 HIP DISLOC.OPEN REDUCTION FEM OR PELVIC OSTEOTOMY $1,032.42
55727 HIP DISLOC. OPEN REDUCTION FEM & PELVIC OSTEOTOMY $1,299.17
55731 HIP - FRACTURE/DISLOCATION - REDUCTION $91.98
55732 HIP - REDUCTION/GA $183.95
55735 HIP - OPEN REDUCTION $482.87
55736 HIP - ORIF $938.16
55738 HIP - PRIMARY WOUND CARE $100.75
55739 HIP - SECONDARY WOUND MANAGEMENT $183.95
55741 ACETABULUM - FRACTURE- CLOSED REDUCTION $183.95
55745 ACETABULUM - ORIF - ONE APPROACH $1,287.66
55746 ACETABULUM - TWO/EXTENSILE APPROACH $1,821.13
55751 FEMORAL NECK/SUBCAPITAL -FRACTURE-CLOSED REDUCTION $510.48
55755 FEMORAL NECK/SUBCAPITAL - ORIF $818.59
55758 FEMORAL NECK/SUBCAPITAL - PRIMARY WOUND CARE $100.75
55759 FRAC. FEMORAL NECK OR SUBCAPITAL: OPEN -SEC. WOUND $183.95
55760 FEMORAL NECK/SUBCAPITAL - SCFE INSITU FIXATION $510.48
55761 HIP - INTERTROCHANTERIC - REDUCTION $643.84
55768 HIP FRACTURE INTERTROCHANTERIC PRIMARY WOUND CARE $100.75
55769 HIP-INTERTROCHANTERIC - SECONDARY WOUND MANAGEMENT $183.95
55771 HIP: SUBTROCHANTERIC - INTERNAL FIXATION $878.37
55778 SUBTROCHANTERIC - PRIMARY WOUND CARE $100.75
55779 SUBTROCHANTERIC - SECONDARY WOUND MANAGEMENT $183.95
55780 FEMUR/SHAFT - CAST/TRACTION - CLOSED REDUCTION $119.56
55781 FEMUR/SHAFT - CLOSED REDUCTION/GA $211.54
55782 FEMUR/SHAFT - EXTERNAL SKELETAL FIXATION $349.52
55783 FEMUR/SHAFT - CLOSED REDUCTION, IM NAIL $763.40
55785 FEMUR/SHAFT - ORIF $763.40
55788 FEMUR/SHAFT - PRIMARY WOUND CARE $100.75
55789 FEMUR/SHAFT - SECONDARY WOUND MANAGEMENT $183.95
55800 MANIPULATION - HIP JOINT UNDER GA $91.98
55810 ARTHRODESIS - HIP JOINT $1,209.49
55980 AMPUTATION - HEMICORPECTOMY $2,409.77
55981 AMPUTATION - HEMIPELVECTOMY $1,342.86
55982 AMPUTATION - HIP DISARTICULATION $1,020.94
55983 AMPUTATION - ABOVE KNEE $643.84
55984 AMPUTATION - KNEE DISARTICULATION $643.84
55985 REVISION,AMPUTATION, BELOW KNEE $510.48
55998 AMPUTATION - PRIMARY WOUND CARE - ABOVE KNEE $100.75
55999 AMPUTATION - SECONDARY WOUND MANAGEMENT-ABOVE KNEE $183.95

Femur, Knee Joint, Tibia And Fibula

Code Description Amount
00757 ASPIRATION OTHER JOINTS $11.54
11600 ARTHROSCOPY - KNEE JOINT $211.54
11602 ASPIRATION - KNEE JOINT - BURSA/TENDON SHEATH, E $22.89
11615 ARTHROTOMY - KNEE JOINT $239.13
11630 BIOPSY - NEEDLE - KNEE JOINT/GA $183.95
11632 ARTHROSCOPY/BIOPSY - KNEE JOINT $211.54
11645 BIOPSY - OPEN - KNEE JOINT $239.13
51039 ASPIRATION - BURSA $22.89
51040 ASPIRATION - JOINT $22.89
56210 FEMUR, KNEE JOINT/TIBIA/FIBULA - I & D/GA $183.95
56215 FEMUR/KNEE JOINT/TIBIA/FIBULA - ABSCESS I & D/GA $183.95
56220 HEMATOMA - FEMUR/KNEE JOINT/TIBIA/FIBULA $294.34
56225 ARTHROTOMY - KNEE JOINT $183.95
56250 DECOMPRESSION - KNEE JOINT $211.54
56260 FASCIOTOMY, COMPARTMENT SYNDROME - KNEE JOINT $231.72
56269 KNEE JOINT - SECONDARY WOUND CLOSURE $183.95
56270 SOFT TISSUE RELEASE - KNEE - MINOR $340.32
56275 SOFT TISSUE RELEASE - KNEE - MAJOR $480.57
56280 KNEE LIBERATION/MAJOR RELEASE $758.80
56285 QUADRICEPS PLASTY - KNEE $616.24
56290 RETINACULAR RELEASE - LATERAL/MEDIAL KNEE - OPEN $239.13
56305 REMOVAL SYMPTOMATIC LOOSE BODY - KNEE $283.35
56306 KNEE - PINNING/DRILLING OSTEOCHONDRAL FRAGMENT $404.78
56310 SYNOVECTOMY KNEE, TOTAL $480.68
56315 RESECTION 'PLICA' $283.35
56320 MENISECTOMY - KNEE $283.35
56321 ARTHROPLASTY - KNEE - ARTHROSCOPIC $283.35
56322 ABRASION DEBRIDEMENT, EXTRA - FIRST 15 MIN. $141.67
56323 ABRASION DEBRIDEMENT,EXTRA-EACH ADDITIONAL 15 MIN. $70.84
56325 MENISCAL REPAIR $404.78
56330 ABRASION/DEBRIDEMENT - KNEE $283.35
56335 LATERAL/MEDIAL RELEASE - ENDOSCOPIC KNEE $283.35
56353 GANGLION/CYST - KNEE $211.54
56354 POPLITEAL CYST - KNEE $294.34
56355 OPEN EXCISION - KNEE - BURSA/PREPATELLAR $211.54
56356 ARTHROTOMY - REMOVAL OF LOOSE BODY - KNEE $239.13
56357 ARTHROTOMY KNEE - PINNING/DRILLING $347.21
56360 SYNOVECTOMY - KNEE, TOTAL $457.58
56361 MENISECTOMY - KNEE $239.13
56362 MENISCAL REPAIR - KNEE $347.21
56365 SOFT TISSUE TUMOUR - BENIGN - KNEE $321.92
56370 BONE TUMOUR - BENIGN - KNEE $266.73
56380 OSTEOMYELITIS ACUTE - KNEE - DECOMPRESSION $183.95
56385 OSTEOMYELITIS/DEBRIDEMENT - KNEE. $211.54
56390 PATELLECTOMY $321.92
56405 INJECTION OF JOINT - KNEE $22.89
56410 INJECTION - BURSA/TENDON SHEATH - KNEE $22.89
56415 KNEE - REMOVAL OF INT FIXATION DEVICE(S)/GA $239.13
56420 KNEE - REMOVAL OF INTERNAL FIXATION DEVICE(S) $68.98
56505 KNEE LIGAMENT INSTABILITY - ONE REPAIR $607.18
56510 KNEE LIGAMENT INSTABILITY - POSTERIOR CRUCIATE $735.82
56515 KNEE LIGAMENT INSTABILITY - TWO LIGAMENTS $707.95
56520 KNEE LIGAMENT INSTABILITY - THREE LIGAMENTS $823.19
56525 REVISION OF KNEE LIGAMENT RECONSTRUCTION $708.21
56528 KNEE LIGAMENT - OPEN INJURY - PRIMARY WOUND CARE $100.75
56529 KNEE LIGAMENT - OPEN INJURY - SECONDARY WOUND CARE $183.95
56530 RECUR. SUBLUX./DISLOC. PATELLA-EXTENSOR REALIGNMEN $427.70
56531 RECURR. SUBLUX./DISLOC. PATELLA-LATERAL RELEASE $239.13
56540 RECURR. SUBLUX./DISLOC. QUAD. TENDON RUPTURE,ACUTE $340.32
56541 RECURR. SUBLUX./DISLOC. QUAD. TENDON RUPT.-CHRONIC $482.87
56542 PATELLAR TENDON REPAIR $473.76
56545 TENDON TRANSFER, TRANSPLANT - PATELLA $321.92
56601 OSTEOTOMY DISTAL FEMUR - NON-UNION/MALUNION $791.00
56602 OSTEOTOMY PROXIMAL TIBIA - NON-UNION/MALUNION $561.05
56603 OSTEOTOMY TIBIA/SHAFT/FIBULA - NON-UNION/MALUNION $735.82
56604 OSTEOTOMY FIBULA -NON-UNION/MALUNION $266.73
56651 FEMUR - BONE GRAFTING $266.73
56652 BONE GRAFTING - TIBIA $266.73
56653 BONE GRAFTING - EPIPHYSIODESIS $294.34
56654 BONE GRAFTING - PHYSEAL BAR EXCISION $501.28
56661 ARTHROPLASTY - KNEE JOINT $791.00
56662 TOTAL KNEE REPLACEMENT $791.00
56663 TOTAL KNEE, REMOVAL PROSTHESIS, INCLUDES PROSTALAC $482.87
56664 REVISION - TOTAL KNEE $1,087.60
56665 REVISION - PATELLAR COMPONENT $400.09
56701 FRAC./DISLOC. FEMUR (SUPRACOND) -CLOSED W/O GA $119.56
56702 FRAC./DISLOC. FEMUR (SUPRACOND) - CLOSED W/ GA $211.54
56703 FRAC./DISLOC. FEMUR (SUPRACOND)-CLOSED, EXTERN FIX $349.52
56704 FRAC./DISLOC. FEMUR (SUPRACOND)- CLOSED W/ IM NAIL $763.40
56705 FRAC./DISLOC. FEMUR (SUPRACONDYLAR) - ORIF $763.40
56708 FRAC./DISLOC. FEMUR (SUPRACOND)- PRIM. WOUND CARE $100.75
56709 FRAC./DISLOC. FEMUR (SUPRACOND)- SEC. WOUND CARE $183.95
56711 FRAC./DISLOC. FEMUR COND./INTRACOND-CLOSED W/O GA $91.98
56712 FRAC./DISLOC. FEMUR COND./INTRACOND.-CLOSED W/ GA $183.95
56713 FRAC./DISLOC. FEMUR COND/INTRACOND-CLOSED EX FIX $349.52
56715 FRAC/DISLOC FEMUR COND/INTRACOND-ORIF-UNICONDYLAR $763.40
56716 FRAC/DISLOC FEMUR COND/INTRACOND-ORIF-BICONDYLAR $1,099.12
56718 FRAC/DISLOC FEMUR CON/INTRACOND-OP PRIM WOUND CARE $100.75
56719 FRAC/DISLOC FEMUR COND/INTRACOND-OP SEC WOUND CARE $183.95
56725 PATELLAR DISLOCATION - OPEN REDUCTION & REPAIR $239.13
56728 PATELLAR DISLOCATION - OPEN - PRIMARY WOUND CARE $100.75
56729 PATELLAR DISLOCATION - OPEN -SEC. WOUND MANAGEMENT $183.95
56734 PATELLECTOMY - PATELLA FRACTURE $321.92
56735 PATELLAR FRACTURE - ORIF $455.28
56738 PATELLAR FRACTURE - OPEN - PRIMARY WOUND CARE $100.75
56739 PATELLAR FRACTURE - OPEN - SEC. WOUND MANAGEMENT $183.95
56741 TIBIAL PLATEAU FRACTURE - CLOSED RED. W/ GA $183.95
56742 TIBIAL PLATEAU FRACTURE - CLOSED RED, EXTERN FIX $377.10
56745 TIBIAL PLATEAU FRACTURE - ORIF - UNICONDYLAR $643.84
56746 TIBIAL PLATEAU FRACTURE - ORIF - BICONDYLAR $910.57
56748 TIBIAL PLATEAU FRACTURE - OPEN - PRIM. WOUND CARE $100.75
56749 TIBIAL PLATEAU FRACTURE - OPEN - SEC. WOUND MANAGE $183.95
56751 TIBIAL SHAFT FRACTURE - CLOSED RED. W/O GA $91.98
56752 TIBIAL SHAFT FRACTURE - CLOSED RED. W/ GA $211.54
56753 TIBIAL SHAFT FRACTURE - CLOSED RED. EXTERN FIX $349.52
56754 TIBIAL SHAFT FRACTURE - CLOSED REDUCTION IM NAIL $676.01
56755 TIBIAL SHAFT FRACTURES - ORIF $561.05
56758 TIBIAL SHAFT FRACTURE - OPEN - PRIM. WOUND CARE $100.75
56759 TIBIAL SHAFT FRACTURE - OPEN - SEC. WOUND MANAG. $183.95
56769 FIBULAR SHAFT FRACTURE - OPEN - PRIM. WOUND CARE $183.95
56800 MANIPULATION - KNEE JOINT W/ GA $91.98
56810 ARTHRODESIS - KNEE JOINT $791.00
56980 AMPUTATION - BELOW THE KNEE $510.48
56998 AMPUTATION: BELOW KNEE - OPEN - PRIM. WOUND CARE $100.75
56999 AMPUTATION: BELOW KNEE - OPEN - SEC. WOUND MANA $183.95

Tibial Metaphysis (Distal), Ankle And Foot

Code Description Amount
00757 ASPIRATION OTHER JOINTS $11.54
11700 ARTHROSCOPY - ANKLE /SUBTALAR JOINT $183.95
11702 ASPIRATION - ANKLE JOINT - BURSA/TENDON SHEATH, ET $22.89
11715 ANKLE JOINT - INCISION -DIAGNOSTIC $183.95
11716 SUBTALAR JOINT - INCISION - DIAGNOSTIC $183.95
11717 MIDTARSAL JOINT - INCISION - DIAGNOSTIC $183.95
11718 TARSO-METATAR/METATAR-PHALANG/INTERPHALANG JOINTS $183.95
11730 TIBIAL METAPHYSIS/ANKLE/FOOT - NEEDLE BIOPSY W/ GA $183.95
11745 TIBIAL METAPHYSIS/ANKLE/FOOT - OPEN BIOPSY W/ GA $239.13
51039 ASPIRATION - BURSA $22.89
51040 ASPIRATION - JOINT $22.89
57210 TIBIAL METAPHYSIS/ANKLE/FOOT: I&D BURSA W/ GA $183.95
57215 TIBIAL METAPHYSIS/ANKLE/FOOT - I&D ABSCESS W/ GA $183.95
57220 TIBIAL METAPHYSIS/ANKLE/FOOT-HEMATOMA DRAIN. W/ GA $294.34
57225 ANKLE/FOOT JOINT - I&D W/ GA $183.95
57250 TIBIAL METAPHYSIS/ANKLE/FOOT-DECOMP/NEUROLYS NERVE $294.34
57260 TIBIAL METAPHYSIS/ANKLE/FOOT- FACIOTOMY,COMPAR SYN $211.54
57269 TIBIAL METAPHYSIS/ANKLE/FOOT-FACIOTOMY,SEC CLOSURE $183.95
57270 PLANTAR FASCIA: OPEN RELEASE OR PARTIAL EXCISION $266.73
57275 PLANTAR FASCIECTOMY - TOTAL $400.09
57280 ACHILLES TENDON LENGTHENING, PERCUTANEOUS $211.54
57285 POSTERIOR HINDFOOT RELEASE $427.70
57286 POSTEROMEDIAL RELEASE (CLUB FOOT/VERTICAL TALUS) $708.21
57290 TIBIAL METAPHYSIS/ANKLE/FOOT -TENDON LENGTH.- OPEN $266.73
57295 TIBIAL METAPHYSIS/ANKLE/FOOT - TENOSYNOVECTOMY $266.73
57305 REMOVAL OF LOOSE BODY-TIBIAL METAPHYSIS/ANKLE/FOOT $283.35
57306 PINNING/DRILLING FRAGMENTS: TIBIAL/ANKLE FOOT $404.78
57310 SYNOVECTOMY - ANKLE, TOTAL $455.38
57330 ABRASION/DEBRIDEMENT- TIBIAL METAPHYSIS/ANKLE/FOOT $283.35
57354 GANGLION - TIBIAL METAPHYSIS/ANKLE/FOOT $211.54
57355 EXCISION BURSA - ACHILLES $211.54
57356 NEUROMA - TIBIAL METAPHYSIS/ANKLE/FOOT $211.54
57360 TOTAL SYNOVECTOMY-TIBIAL METAPHYSIS/ANKLE/FOOT $349.52
57365 BENIGN SOFT TISSUE TUMOUR - TIBIAL/ANKLE/FOOT $211.54
57370 BENIGN BONE TUMOUR - TIBIAL/ANKLE/FOOT $347.21
57371 TARSAL COALITION - ANKLE/FOOT $347.21
57372 SESAMOIDECTOMY - TIBIAL METAPHYSIS/ANKLE/FOOT $239.13
57373 ACCESSORY NAVICULAR - TIBIAL METAPHYSIS/ANKLE/FOOT $239.13
57374 TALECTOMY - TIBIAL METAPHYSIS/ANKLE/FOOT $533.45
57375 EXCISION - NAIL BED - ANKLE/FOOT/GA $211.54
57380 OSTEOMYELITIS, ACUTE- TIBIAL METAPHYSIS/ANKLE/FOOT $183.95
57385 OSTEOMYELITIS,DEBRIDEMENT- TIBIAL/ANKLE/FOOT $317.32
57405 INJECTION OF JOINT - TIBIAL METAPHYSIS/ANKLE/FOOT $11.45
57410 INJECTION OF BURSA - TIBIAL METAPHYSIS/ANKLE/FOOT $11.45
57415 REM. OF INT. FIX. DEV(S) - ANKLE/FOOT W/ GA $211.54
57420 REM. OF INT. FIX. DEV(S) - ANKLE/FOOT W/O GA $45.99
57505 ANKLE INSTABILITY: CAPSULE/LIGAMENT REPAIR $239.13
57510 ANKLE INSTABILITY - RECONSTRUCTION $374.80
57515 TENDO-ACHILLES REPAIR, ACUTE (W/IN 6 WKS POST-INJ) $347.21
57516 TENDO-ACHILLES REPAIR, CHRONIC (> 6 WKS POST-INJ) $533.45
57520 FLEXOR TENDON REPAIR - ANKLE/FOOT, SINGLE/MULTI $347.21
57525 EXTENSOR TENDON REPAIR - ANKLE/FOOT/WITHOUT GA $119.56
57526 EXTENSOR TENDON REPAIR - ANKLE/FOOT - SINGLE/GA $239.13
57527 EXTENSOR TENDON REPAIR - ANKLE/FOOT - MULTIPLE/GA $331.11
57535 REPAIR/RECONSTRUCTION - TENDON SHEATH $374.80
57550 TENDON TRANSFER- TIBIAL METAPHYSIS/ANKLE/FOOT $427.70
57555 JONES PROCEDURE- TIBIAL METAPHYSIS/ANKLE/FOOT $321.92
57601 OSTEOTOMY/MALUNION - DISTAL TIBIAL $639.23
57602 OSTEOTOMY/MALUNION - MALLEOLUS $427.70
57603 CALCANEAL OSTEOTOMY $513.25
57604 MIDTARSAL OSTEOTOMY $588.64
57605 OSTEOTOMY/MALUNION - METATARSALS $347.21
57606 OSTEOTOMY - OPEN - PHALANGES $239.13
57631 OSTEOTOMY/NON-UNION - DISTAL TIBIAL $533.45
57632 OSTEOTOMY/NON-UNION - MALLEOLUS, LATERAL/MEDIAL $321.92
57633 OSTEOTOMY/NON-UNION - TARSALS $374.80
57634 OSTEOTOMY/NON-UNION - METATARSALS $211.54
57635 OSTEOTOMY/NON-UNION - PHALANGES (FOOT) $211.54
57636 OSTEOTOMY/NON-UNION - EPIPHYSIODESIS $294.34
57637 OSTEOTOMY/NON-UNION - PHYSEAL BAR EXCISION $400.09
57651 BONE GRAFTING - DISTAL TIBIA $239.13
57662 TOTAL ANKLE ARTHROPLASTY- REVISION $1,315.54
57663 TOTAL ANKLE ARTHROPLASTY - REMOVAL $183.95
57671 EXCISION ARTHROPLASTY GREAT TOE (KELLER'S) $266.73
57672 METATARSAL/PHALANGEAL JOINT RESECTION/RECONSTRUCT. $294.34
57673 OSTEOTOMY - DISTAL METATARSAL $294.34
57674 OSTEOTOMY - PROXIMAL METATARSAL/DISTAL REALIGNMENT $427.70
57675 IMPLANT ARTHROPLASTY - METATARSAL PHALANGEAL JOINT $294.34
57676 INTERPHALANGEAL JOINT ARTHROPLASTY, SINGLE/MULTI $266.73
57677 RECONSTRUCTION - MINOR FOREFOOT (LESSER TOES) $374.80
57678 RECONSTRUCTION - MAJOR FOREFOOT $586.33
57701 FRAC/DISLOC ANKLE - CLOSED REDUC. W/ GA $183.95
57702 FRAC/DISLOC ANKLE - EXTERNAL FIXATION $482.87
57705 FRAC/DISLOC ANKLE - ORIF $882.99
57708 FRAC/DISLOC ANKLE - OPEN - PRIMARY WOUND CARE $100.75
57709 FRAC/DISLOC ANKLE - OPEN - SECOND. WOUND CARE $183.95
57711 FRAC/DISLOC ANKLE(MALLEOLAR) - CLOSED RED. W/O GA $91.98
57712 FRAC/DISLOC ANKLE(MALLEOLAR) - CLOSED RED. W/ GA $266.73
57713 FRAC/DISLOC ANKLE(MALLEOLAR) - CLOSED RED. EX FIX $266.73
57715 FRAC/DISLOC ANKLE(MALLEOLAR) - ORIF - ONE $347.21
57716 FRAC/DISLOC ANKLE(MALLEOLAR) - ORIF - TWO OR MORE $400.09
57718 FRAC/DISLOC ANKLE(MALLEOLAR) - PRIM. WOUND CARE $100.75
57719 FRAC/DISLOC ANKLE(MALLEOLAR) - SECOND. WOUND CARE $183.95
57721 HINDFOOT/MIDFOOT/LISFRANC DISLOC - CLOSED W/O GA $91.98
57722 HINDFOOT/MIDFOOT/LISFRANC DISLOC - CLOSED W/ GA $183.95
57723 HINDFOOT/MIDFOOT/LISFRANC DISLOC - CLOSED W/ FIXAT $294.34
57725 HINDFOOT/MIDFOOT/LISFRANC DISLOC - OPEN REDUCTION $468.50
57728 HINDFOOT/MIDFOOT/LISFRANC DISLOC - PRIM.WOUND CARE $100.75
57729 HINDFOOT/MIDFOOT/LISFRANC DISLOC - SEC.WOUND CARE $183.95
57732 OS CALCIS FRACTURE - CLOSED REDUCTION W/ GA $183.95
57733 OS CALCIS FRACTURE - CLOSED REDUCTION W/ FIXATION $294.34
57735 OS CALCIS FRACTURE - ORIF $616.24
57738 OS CALCIS FRACTURE - OPEN - PRIM. WOUND CARE $100.75
57739 OS CALCIS FRACTURE - OPEN - SEC. WOUND CARE $183.95
57741 TALUS FRACTURE - CLOSED REDUCTION W/O GA $91.98
57742 TALUS FRACTURE - CLOSED REDUCTION W/ GA $183.95
57743 TALUS FRACTURE - CLOSED REDUCTION, FIXATION $321.92
57745 TALUS FRACTURE - ORIF $480.57
57748 TALUS FRACTURE - OPEN - PRIM. WOUND CARE $100.75
57749 TALUS FRACTURE - OPEN - SEC. WOUND CARE $183.95
57751 TARSAL FRACTURE - CLOSED REDUCTION W/O GA $91.98
57752 TARSAL FRACTURE - CLOSED REDUCTION W/ GA $183.95
57753 TARSAL FRACTURE - CLOSED REDUCTION, FIXATION $294.34
57755 TARSAL FRACTURE - ORIF $321.92
57758 TARSAL FRACTURE - OPEN - PRIM. WOUND CARE $100.75
57759 TARSAL FRACTURE - OPEN - SEC. WOUND CARE $183.95
57761 METATARSAL FRACTURE - CLOSED REDUCTION, FIXATION $266.73
57765 METATARSAL FRACTURE - ORIF - ONE $294.34
57766 METATARSAL FRACTURE - ORIF - TWO OR MORE $347.21
57768 METATARSAL FRACTURE - OPEN - PRIMARY WOUND CARE $100.75
57769 METATARSAL FRACTURE - OPEN - SECONDARY WOUND CARE $183.95
57771 METATARSO-PHALANGEAL DISLOC.- CLOSED RED. W/O GA $91.98
57772 METATARSO-PHALANGEAL DISLOC. - CLOSED RED. W/ GA $183.95
57773 METATARSO-PHALANGEAL DISLOC. - CLOSED RED, FIX $211.54
57775 METATARSO-PHALANGEAL DISLOC. - ORIF $294.34
57778 METATARSO-PHALANGEAL DISLOC. - OPEN - PRIM. WOUND $100.75
57779 METATARSO-PHALANGEAL DISLOC. - OPEN - SEC. WOUND $183.95
57781 PHALANGEAL FRACTURE - CLOSED REDUCTION, FIXATION $266.73
57785 PHALANGEAL FRACTURE - ORIF $294.34
57788 PHALANGEAL FRACTURE - OPEN - PRIM. WOUND CARE $50.37
57789 PHALANGEAL FRACTURE - OPEN - SEC. WOUND CARE $91.98
57791 INTERPHALANGEAL DISLOC. - CLOSED RED. W/O GA $45.99
57792 INTERPHALANGEAL DISLOC. - CLOSED RED. W/ GA $183.95
57793 INTERPHALANGEAL DISLOC. - CLOSED RED. FIXATION $266.73
57795 INTERPHALANGEAL DISLOC. - OPEN RED. W/WO FIXATION $294.34
57798 INTERPHALANGEAL DISLOC. - OPEN - PRIM.WOUND CARE $50.37
57799 INTERPHALANGEAL DISLOC. - OPEN - SEC.WOUND CARE $91.98
57800 MANIPULATION - ANKLE/FOOT W/ GA $91.98
57810 ARTHRODESIS - TIBIOCALCANEAL $588.64
57811 ARTHRODESIS - PANTALAR $827.78
57812 ARTHRODESIS - ANKLE JOINT $708.21
57813 ARTHRODESIS - SUBTALAR JOINT/TRIPLE $706.36
57814 ARTHRODESIS - MIDTARSAL JOINT $533.45
57815 ARTHRODESIS - TARSO-METATARSAL JOINTS $648.43
57816 ARTHRODESIS - METATARSOPHALANGEAL $347.21
57817 ARTHRODESIS - INTERPHANGEAL, SINGLE OR MULTIPLE $266.73
57980 AMPUTATION - SYME $524.25
57981 AMPUTATION - MIDTARSAL $482.87
57982 AMPUTATION - TRANSMETATARSAL $400.09
57983 AMPUTATION - SINGLE METATARSAL/RAY RESECTION $349.52
57984 AMPUTATION - TOE $183.95
57998 AMPUTATION - OPEN INJURY, PRIMARY WOUND CARE $50.37
57999 AMPUTATION - OPEN INJURY, SECONDARY WOUND CARE $91.98

Vertebra, Facette And Spine

Code Description Amount
00757 ASPIRATION OTHER JOINTS $11.54
03155 LAMINECTOMY FOR HAEMATOMA, TUMOR OR VASULAR MALFOR $934.78
03160 LAMINECTOMY, TETHERED SPINAL CORD OR CONGENITAL $1,339.45
03161 LAMINECTOMY FOR LOCALIZED SPINAL STENOSIS $777.42
03162 LAMINECTOMY FOR GENERALIZED SPINAL STENOSIS $1,195.96
03167 SKULL TONGS - INSERTION $124.41
03180 LAMINECTOMY FOR CERVICAL CORD, MULTIPLE LEVEL $1,409.51
11830 BIOPSY - NEEDLE - THORACIC SPINE/GA $211.54
11831 BIOPSY - NEEDLE - LUMBAR SPINE/GA $183.95
11845 BIOPSY - SPINE - OPEN $239.13
51039 ASPIRATION - BURSA $22.89
58205 INJECTION/ASPIRATION - FACET JOINT $91.59
58210 DISCOGRAM $91.59
58250 ABSCESS/HEMATOMA - EXTRASPINAL/GA $183.95
58305 DISCECTOMY $266.73
58370 DISCECTOMY - CERVICAL, SINGLE LEVEL $616.24
58375 DISCECTOMY - CERVICAL - >2 LEVELS $795.60
58376 DISCECTOMY - THORACOLUMBAR $1,421.02
58385 VERTEBRAL BODY RESECTION - CERVICAL $1,609.59
58386 VERTEBRAL BODY RESECTION - THORACOLUMBAR $1,876.30
58410 SPINAL INSTRUMENTATION - REMOVAL $505.88
58605 STABILIZATION - POSTERIOR - CERVICAL $533.45
58610 STABILIZATION - SEGMENTAL - CERVICAL $1,071.52
58615 STABILIZATION THORACOLUMBAR/WITHOUT INSTRUMENTATIO $482.87
58620 STABILIZATION THORACOLUMBAR/SIMPLE INSTRUMENTATION $763.40
58625 STABILIZATION - THORACOLUMBAR/SEGMENTAL INSTRUMENT $1,232.48
58630 STABILIZATION THORACOLUMBAR, FUSION/DECOMPRESSION $1,554.39
58635 THORACOLUMBAR FUSION/DECOMPRESSION/MULTIPLE LEVELS $1,821.13
58640 STABILIZATION - ANTERIOR: CERVICAL $496.66
58645 STABILIZATION - CERVICAL - PLATES/DISCECTOMY $974.95
58650 STABILIZATION - CERVICAL - PLATES/VERTEBRECTOMY $1,742.95
58655 STABILIZATION - ANTERIOR - THORACOLUMBAR $938.16
58660 STABILIZATION; ANTERIOR, THORACOLUMBAR/INSTRUMENT $2,009.66
58670 DEFORMITY CORRECTION - THORACOLUMBAR $1,421.02
58675 DEFORMITY CORRECTION - THORACOLUMBAR/ANTERIOR INST $1,687.76
58680 DEFORMITY CORRECTION - CERVICAL $2,409.77
58685 OSTEOTOMY - THORACOLUMBAR- POSTERIOR $2,409.77
58690 DEFORMITY; INSTRUMENTATION/FUSION/POSTERIOR, ADULT $1,742.95
58695 DEFORMITY; INSTRUMENTATION/FUSION/POSTERIOR, CHILD $1,421.02
58710 APPLICATION OF HALO - C-SPINE FRACTURE/DISLOCATION $183.95
58715 CERVICAL SPINE - ORIF $993.34
58725 FRACTURE/DISLOCATION, THORACOLUMBAR SPINE/FIXATION $1,287.66
58726 THORACOLUMBAR SPINE; ORIF/FIXATION + DECOMPRESSION $1,554.39

Musculoskeletal Oncology

Code Description Amount
51051 MALIGNANT SUBFASCIAL SOFT TISSUE TUMOUR -SIMPLE $588.64
51052 MALIGNANT SUBFASCIAL SOFT TISSUE TUMOUR - COMPLEX $1,260.06
51053 MALIGNANT BONE TUMOUR - LIMB $1,066.94
51054 SKELETAL DEFECT - RECONSTRUCTION $1,076.13
51055 MALIGNANT GIRDLE TUMOUR - SCAPULA $1,066.94
51056 MALIGNANT GIRDLE TUMOUR - PELVIS/SACRUM $1,600.39
51057 SHOULDER/PELVIS/SACRUM - RECONSTRUCTION $1,076.13
51058 MALIGNANT TUMOR/ROTATION PLASTY - RESECTION $2,143.04

Minor Procedures

Code Description Amount
13610 MINOR LACERATION OR FOREIGN BODY - NO ANAESTHESIA $34.50
13611 MINOR LACERATION/FOREIGN BODY REQUIRING ANAES. $64.26
13612 EXTENSIVE LACERATION GREATER THAN 5CM $12.89
13620 EXCISION TUMOR OF SKIN/SCAR UP TO 5CM $64.26
13630 PARONYCHIA $34.41
13631 NAIL REMOVAL - SIMPLE $34.41
13632 NAIL REMOVAL WITH DESTRUCTION OF NAIL BED $69.63
13633 WEDGE EXCISION OF ONE NAIL $61.43

Peripheral Nerve

Code Description Amount
03196 PERIPHERAL NERVE - MOBILIZATION AND TRANSPOSITION $277.30
03198 NEURECTOMY OF MAJOR PERIPHERAL NERVE $219.12
06258 PERIPHERAL NERVE/NEUROLYSIS - EXPLORATION $252.85

Spinal

Code Description Amount
03151 STEREOTAXIC SURGERY $779.42
03152 MYELOTOMY, BISCHOFF`S $922.20
03153 LAMINECTOMY WITH DREZ LESION FOR PAIN $1,387.77
03155 LAMINECTOMY FOR HAEMATOMA, TUMOR OR VASULAR MALFOR $934.78
03156 LAMINECTOMY FOR CERVICAL DISC - ONE LEVEL $725.84
03157 LAMINECTOMY FOR CERVICAL DISC - MULTIPLE LEVELS $796.45
03158 LAMINECTOMY FOR LUMBAR DISC - ONE LEVEL $660.99
03159 LAMINECTOMY FOR LUMBAR DISC - MULTIPLE LEVELS $658.13
03160 LAMINECTOMY, TETHERED SPINAL CORD OR CONGENITAL $1,339.45
03161 LAMINECTOMY FOR LOCALIZED SPINAL STENOSIS $777.42
03162 LAMINECTOMY FOR GENERALIZED SPINAL STENOSIS $1,195.96
03163 DISCECTOMY, ANTERIOR CERVICAL - ONE LEVEL $796.45
03164 DISCECTOMY, ANTERIOR CERVICAL - MULTIPLE LEVELS $1,027.91
03166 THORACIC DISC, REMOVAL $849.31
03167 SKULL TONGS - INSERTION $124.41
03168 LAMINECTOMY FOR INTRADURAL SPINAL CORD $1,984.09
03169 SPINE FRACTURE WITHOUT CORD INJURY $676.54
03180 LAMINECTOMY FOR CERVICAL CORD, MULTIPLE LEVEL $1,409.51
03185 POSTERO-LATERAL MICROSURGICAL THORACIC DISCECTOMY $1,270.47
03231 REPAIR OF SPINAL CSF LEAK OR PSEUDOMENINGOCOELE $590.06

Skin Grafts

Code Description Amount
06015 REMOVAL OF EXTENSIVE SCARS PER CM OVER 5 CM $8.41
06016 REMOVAL OF TUMOR OR SCAR UNDER GA, UP TO 5 CM $125.82
06017 REMOVAL OF TUMOUR; 5 CM TO 10 CM $258.01
06018 REMOVAL OF TUMOR - MORE THAN 10 CM $445.84
06019 SKIN GRAFTS - SINGLE OR MULTIPLE FLAPS < 2CM $156.02
06050 SKIN GRAFTS - REGIONS OF MAJOR JOINTS AND HANDS $426.23
06051 SKIN GRAFTS - FUNCTIONAL AREAS - FINGER TIP $247.00
07055 GANGLIA - WRIST $179.56

Debridement Of Soft Tissues For Necrotizing Infections Or Severe Trauma

Code Description Amount
70158 DEBRIDEMENT SKIN/SUBCUTANEOUS TISSUE,UP TO 5% BODY SURFACE AREA $232.23
70159 DEBRIDEMENT SKIN/SUBCUTANEOUS TISSUE; EACH SUB 5% OF BODY SURFACE AREA $116.11
70162 DEBRIDEMENT SKIN/SUB/NECROTIC FASCIA / 1ST 5% OF BODY SURFACE AREA $258.04
70163 DEBRIDEMENT SKIN/SUB/NECROTIC FASCIA/EACH SUB 5% OF BODY SURFACE AREA $129.02
70165 DEBRIDEMENT SKIN/FASCIA/MUSCLE/BONE;UP TO 1ST 5% OF BODY SURFACE AREA $283.83
70166 DEBRIDEMENT SKIN/FASCIA/MUSCLE/BONE; EACH SUB 5% OF BODY SURFACE AREA $141.92
70168 ACTIVE WOUND MGMT-ACUTE PHASE AFTER DEBRIDEMENT $77.41
70169 ACTIVE WOUND MGMT/IN OR ACUTE PHASE AFT DEBRIDEMNT $123.85

Other

Code Description Amount
11500 ARTHROSCOPY - HIP JOINT $510.48
57652 BONE GRAFTING - MALLEOLUS, MEDIAL/LATERAL-TARSALS $147.16
57661 TOTAL ANKLE PROSTHESIS $976.54