1.  The whole of this instrument

1 March 2024.

1 March 2024

30664

Endoscopic retrograde cholangiopancreatography (ERCP), with single operator, single use peroral cholangiopancreatoscopy (POCPS) and biopsy, for the diagnosis of biliary strictures for a patient for whom:

(a) a previous ERCP service has been provided; and

(b) results from guided brush cytology or intraductal biopsy (or both) are indeterminate

Applicable not more than 2 times in a 12 month period, or not more than 3 times in a 12 month period if the patient has been diagnosed with primary sclerosing cholangitis (PSC)

(H) (Anaes.) (Assist.)

644.40

30665

Endoscopic retrograde cholangiopancreatography (ERCP), with single operator, single use peroral cholangiopancreatoscopy (POCPS) and electrohydraulic or laser lithotripsy for the removal of biliary stones that are:

(a) greater than 10mm in diameter; or

(b) proximal to a stricture;

for a patient for whom there has been at least one failed attempt at removal via ERCP extraction techniques

Applicable not more than 2 times per treatment cycle

(H) (Anaes.) (Assist.)

901.35

31537

Insertion of a marker clip into a breast, including axilla, following a breast biopsy and using imaging (but not including the associated imaging), if additional surgery, neoadjuvant systemic therapy, follow up imaging or radiation may be required and the insertion is for any of the following reasons:

(a) to mark the site of a lesion that has been totally or almost completely removed;

(b) to confirm biopsy site if multiple lesions are present;

(c) to confirm biopsy site of an ill‑defined lesion;

(d) future surgery or preoperative localisation is considered to be potentially difficult due to lesion conspicuity;

(e) preoperative localisation is likely to be carried out using a modality different from the biopsy modality;

(f) for correlation across modalities for diagnostic reasons

(Anaes.)

208.50

32118

Treatment of external rectal prolapse, or of symptomatic high grade rectal intussusception (the rectum descends to the level of or into the anal canal, confirmed by diagnostic imaging):

(a) by minimally invasive surgery involving:

(i) ventral dissection of the extra‑peritoneal rectum; and

(ii) suspension of the rectum from the sacral promontory by means of a prosthesis; and

(b) including suspension of the vagina if performed, and any associated repair;

other than a service associated with a service to which item 30390, 35595 or 35597 applies (H) (Anaes.) (Assist.)

1,621.50

37204

Cytoscopy with insertion of prostatic implants for the treatment of benign prostatic hyperplasia (Anaes.)

876.75

37205

Prostate, ablation by water vapour with or without cytoscopy and with or without urethrosocopy (Anaes.)

355.95

291

Professional attendance lasting more than 45 minutes at consulting rooms by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if:

(a) the attendance follows referral of the patient to the consultant, by a medical practitioner in general practice (including a general practitioner, but not a specialist or consultant physician) or a participating nurse practitioner, for an assessment or management; and

(b) during the attendance, the consultant:

(i) if it is clinically appropriate to do so—uses an appropriate outcome tool; and

(ii) carries out a mental state examination; and

(iii) undertakes a comprehensive diagnostic assessment; and

(c) the consultant decides that it is clinically appropriate for the patient to be managed by the referring practitioner without ongoing management by the consultant; and

(d) within 2 weeks after the attendance, the consultant prepares and gives to the referring practitioner a written report, which includes:

(i) the comprehensive diagnostic assessment of the patient; and

(ii) a management plan for the patient for the next 12 months that comprehensively evaluates the patient’s biopsychosocial factors and makes recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and

(e) if clinically appropriate, the consultant explains the diagnostic assessment and management plan, and gives a copy, to:

(i) the patient; and

(ii) the patient’s carer (if any), if the patient agrees; and

(f) in the preceding 12 months, a service to which this item or item 92435 applies has not been provided to the patient

505.70

293

Professional attendance lasting more than 30 minutes, but not more than 45 minutes, at consulting rooms by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if:

(a) the patient is being managed by a medical practitioner or a participating nurse practitioner in accordance with a management plan prepared by the consultant in accordance with item 291 or item 92435; and

(b) the attendance follows referral of the patient to the consultant, by the medical practitioner or participating nurse practitioner managing the patient, for review of the management plan and the associated comprehensive diagnostic assessment; and

(c) during the attendance, the consultant:

(i) if it is clinically appropriate to do so—uses an appropriate outcome tool; and

(ii) carries out a mental state examination; and

(iii) reviews the comprehensive diagnostic assessment and undertakes additional assessment as required; and

(iv) reviews the management plan; and

(d) within 2 weeks after the attendance, the consultant prepares and gives to the referring practitioner a written report, which includes:

(i) the revised comprehensive diagnostic assessment of the patient; and

(ii) a revised management plan including updated recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and

(e) if clinically appropriate, the consultant explains the diagnostic assessment and management plan, and gives a copy, to:

(i) the patient; and

(ii) the patient’s carer (if any), if the patient agrees; and

(f) in the preceding 12 months, a service to which item 291 or item 92435 applies has been provided to the patient; and

(g) in the preceding 12 months, a service to which this item or item 92436 applies has not been provided to the patient

316.15

319

Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 45 minutes at consulting rooms, if:

(a) the formulation of the patient’s clinical presentation indicates intensive psychotherapy is a clinically appropriate and indicated treatment; and

(b) that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 91873 and 92437 applies have not exceeded 160 attendances in a calendar year for the patient

205.20

341

An interview, lasting not more than 15 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of:

(a) initial diagnostic evaluation; or

(b) continuing management of the patient;

if that service and another service to which this item or any of items 343, 345, 347, 349, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient

48.40

343

An interview, lasting more than 15 minutes but not more than 30 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of:

(a) initial diagnostic evaluation; or

(b) continuing management of the patient;

if that service and another service to which this item or any of items 341, 345, 347, 349, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient

96.60

345

An interview, lasting more than 30 minutes but not more than 45 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of:

(a) initial diagnostic evaluation; or

(b) continuing management of the patient;

if that service and another service to which this item or any of items 341, 343, 347, 349, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient

148.70

347

An interview, lasting more than 45 minutes but not more than 75 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of:

(a) initial diagnostic evaluation; or

(b) continuing management of the patient;

if that service and another service to which this item or any of items 341, 343, 345, 349, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient

205.20

349

An interview, lasting more than 75 minutes, of a person other than the patient when the patient is not in attendance, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner, for the purposes of:

(a) initial diagnostic evaluation; or

(b) continuing management of the patient;

if that service and another service to which this item or any of items 341, 343, 345, 347, 91874 to 91878 and 91882 to 91884 applies have not exceeded 15 services in a calendar year in relation to the patient

238.15

63019

MRI—scan of head (including MRA if performed) for the assessment of suitability for the treatment of medically refractory essential tremor with magnetic resonance imaging‑guided focused ultrasound

Applicable once per patient per lifetime (R) (Anaes.) (Contrast)

426.50

63020

MRI—scan of head (including MRA if performed) for the post‑procedure assessment of the patient following magnetic resonance imaging‑guided focused ultrasound for the treatment of medically refractory essential tremor

Applicable once per patient per lifetime (R) (Anaes.) (Contrast)

426.50

22052

Transfusion of blood by an anaesthetist, including collection from donor, when used for intra‑operative normovolaemic haemodilution, where the service is provided on the same occasion as the administration of anaesthesia by the same anaesthetist, other than a service associated with a service to which item 13703 applies

6 base units

22053

Insertion of lumbar cerebrospinal fluid drain, by an anaesthetist at the request of the treating specialist, where the service is provided on the same occasion as the administration of anaesthesia by the same anaesthetist, other than a service associated with a service to which item 40018 applies

6 base units

22054

Intraoperative two‑dimensional or three‑dimensional real time transoesophageal echocardiography by an anaesthetist, where the service:

(a) is provided on the same day as a service to which item 38477, 38484, 38499, 38516 or 38517 applies; and

(b) includes Doppler techniques with colour flow mapping and recordings on digital media; and

(c) is performed during cardiac valve surgery (replacement or repair); and

(d) incorporates sequential assessment of cardiac function and valve competence before and after the surgical procedure; and

(e) is not associated with a service to which item 21936, 22051, 55118, 55130 or 55135 applies; and

(f) is provided on the same occasion as the administration of anaesthesia by the same anaesthetist

18 base units

40804

Magnetic resonance imaging—scan of head (including magnetic resonance angiography if performed) by a radiologist on request by a specialist or consultant physician, for the sole purpose of guiding focused ultrasound for the treatment of medically refractory essential tremor in association with the services described in items 40805 and 40806, including:

(a) stereotactic scan of brain, with frame in place; and

(b) assistance with computerised planning; and

(c) interpretation of intraprocedural imaging

Applicable once per patient per lifetime (H) (Anaes.)

1,035.55

40805

Neurological assessment and evaluation during the treatment of medically refractory essential tremor with magnetic resonance imaging‑guided focused ultrasound, performed by a neurologist in association with the services described in items 40804 and 40806, including:

(a) assistance with target localisation incorporating anatomical and physiological techniques; and

(b) continuous intraprocedural neurological assessment and evaluation

Applicable once per patient per lifetime (H) (Anaes.)

2,139.70

40806

Treatment of medically refractory essential tremor with magnetic resonance imaging‑guided focused ultrasound, performed by a neurosurgeon in association with the services described in items 40804 and 40805, including:

(a) computer assisted anatomical localisation; and

(b) frame placement; and

(c) target verification using anatomical and physiological techniques; and

(d) delivery of treatment with lesion production in the basal ganglia, brain stem, thalamus or deep white matter tracts

Applicable once per patient per lifetime (H) (Anaes.)

3,295.85

11732

Multi‑channel electrocardiogram monitoring and recording during exercise (motorised treadmill or cycle ergometer capable of quantifying external workload in watts), performed by a cardiologist with relevant expertise in genetic heart disease, if:

(a) the patient is:

(i) under investigation or treatment for long QT syndrome, catecholaminergic polymorphic ventricular tachycardia or arrhythmogenic cardiomyopathy; or

(ii) a first degree relative of a person with confirmed long QT syndrome, catecholaminergic polymorphic ventricular tachycardia, arrhythmogenic cardiomyopathy or unexplained sudden cardiac death at 40 years of age or younger; and

(b) the monitoring and recording:

(i) is for at least 20 minutes; and

(ii) includes resting electrocardiogram; and

(c) the cardiologist produces a report that includes interpretation of the monitoring and recording data (commenting on the significance of the data) and discussion of the relationship of the data to clinical decision making for the patient in the clinical context; and

(d) the service is not provided on the same occasion as a service to which item 11704, 11705, 11707, 11714, 11729 or 11730 applies

Applicable once per day

167.55

38325

Use of intravascular ultrasound (IVUS) during transluminal insertion of stents, to optimise procedural strategy, appropriate stent size and assessment of stent apposition, for a patient documented with:

(a) one or more left main coronary artery lesions; or

(b) one or more lesions at least 28mm in length in other locations;

if performed in association with a service to which item 38307, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies

Applicable once per episode of care (for one or more lesions) (H) (Anaes.)

508.70

Leadless permanent cardiac pacemaker, single‑chamber ventricular, percutaneous retrieval and replacement of, including cardiac electrophysiological services, during the same percutaneous procedure, if:

(a) the service is performed by a specialist or consultant physician who has undertaken training to perform the service; and

(b) if the service is performed at least 4 weeks after the pacemaker was inserted—the service is performed in a facility where cardiothoracic surgery is available and a thoracotomy can be performed immediately and without transfer; and

(c) if the service is performed by an interventional cardiologist at least 4 weeks after the pacemaker was inserted—a cardiothoracic surgeon is in attendance during the service;

other than a service associated with a service to which item 38350 applies (H) (Anaes.)

Leadless permanent cardiac pacemaker, single‑chamber ventricular, percutaneous retrieval of, if:

(a) the service is performed by a specialist or consultant physician who has undertaken training to perform the service; and

(b) if the service is performed at least 4 weeks after the pacemaker was inserted—the service is performed in a facility where cardiothoracic surgery is available and a thoracotomy can be performed immediately and without transfer; and

(c) if the service is performed by an interventional cardiologist at least 4 weeks after the pacemaker was inserted—a cardiothoracic surgeon is in attendance during the service

(H) (Anaes.)

Endoscopic resection of endobronchial tumours for relief of obstruction including any associated endoscopic procedures, other than a service associated with a service to which another item in Group T8 applies (H) (Anaes.) (Assist.)

Thoracoscopy, with or without division of pleural adhesions, with or without biopsy, including insertion of intercostal catheter where necessary, other than a service associated with:

(a) a service to which item 18258, 18260 or 38828 applies; or

(b) a service to which item 38816 applies that is performed on the same lung

(H) (Anaes.) (Assist.)

Thoracotomy, exploratory, with or without biopsy, including insertion of an intercostal catheter where necessary, other than a service associated with:

(a) a service to which item 18258, 18260 or 38828 applies; or

(b) a service to which item 38815 applies that is performed on the same lung

(H) (Anaes.) (Assist.)

Nerve trunk, delayed repair of, using microsurgical techniques, including either or both of the following (if performed):

(a) neurolysis;

(b) transposition of nerve or nerve transfer to facilitate repair;

other than a service associated with:

(c) a service to which item 39321 applies; or

(d) a service to which item 30023 applies that is performed at the same site

(H) (Anaes.) (Assist.)

Nerve trunk, nerve graft to, by cable graft, using microsurgical techniques, including any of the following (if performed):

(a) harvesting of nerve graft;

(b) proximal and distal anastomosis of nerve graft;

(c) transposition of nerve to facilitate grafting;

(d) neurolysis;

other than a service associated with:

(e) a service to which item 39330 applies; or

(f) a service to which item 30023 applies that is performed at the same site

(H) (Anaes.) (Assist.)

Extensive neurolysis of radial, median or ulnar nerve trunk nerve in the forearm or arm, other than a service associated with:

(a) a service to which item 39303, 39309, 39312, 39315, 39318, 39324 or 39327 applies; or

(b) a service to which item 30023 applies that is performed at the same site

(Anaes.) (Assist.)

Neurolysis by open operation without transposition, other than a service associated with:

(a) a service to which item 39321, 39328, 39329, 39332, 39336, 39339, 39342, 39345, 49774 or 49775 applies; or

(b) a service to which item 30023 applies that is performed at the same site

(H) (Anaes.) (Assist.)

Carpal tunnel release, including division of transverse carpal ligament or release of median nerve, by any method, including either or both of the following (if performed):

(a) synovectomy;

(b) neurolysis;

other than a service associated with:

(c) a service to which item 46339 applies; or

(d) a service to which item 30023 applies that is performed at the same site

(Anaes.) (Assist.)

Revision of carpal tunnel release, including division of transverse carpal ligament or release of median nerve, by any method, including either or both of the following (if performed):

(a) synovectomy;

(b) neurolysis;

other than a service associated with:

(c) a service to which item 46339 applies; or

(d) a service to which item 30023 applies that is performed at the same site

(Anaes.) (Assist.)

Excisional arthroplasty of carpometacarpal joint, including any of the following (if performed):

(a) ligament and tendon transfers;

(b) realignment procedures;

(c) excision of adjacent trapezoid

(H) (Anaes.) (Assist.)

Synovectomy of digital extensor tendons of hand, distal to wrist, for diagnosed inflammatory arthritis, including any of the following (if performed):

(a) reconstruction of extensor retinaculum;

(b) removal of tendon nodules;

(c) tenolysis;

(d) tenoplasty;

other than a service associated with:

(e) a service to which item 39330 applies; or

(f) a service to which item 30023 applies that is performed at the same site

Applicable once per hand per occasion on which the service is performed (Anaes.) (Assist.)

Synovectomy of digital flexor tendons at wrist level, for diagnosed inflammatory arthritis, including either or both of the following (if performed):

(a) tenolysis;

(b) release of median nerve and carpal tunnel;

other than a service associated with:

(c) a service to which item 39330 or 39331 applies; or

(d) a service to which item 30023 applies that is performed at the same site

Applicable once per wrist per occasion on which the service is performed (H) (Anaes.) (Assist.)

Synovectomy of wrist flexor or extensor tendons of hand or wrist, for diagnosed inflammatory tenosynovitis, including any of the following (if performed):

(a) reconstruction of flexor or extensor retinaculum;

(b) removal of tendon nodules;

(c) tenolysis;

(d) tenoplasty;

other than a service associated with:

(e) a service to which item 39330 applies; or

(f) if this service is performed on the wrist flexor tendons—a service to which item 39331 applies; or

(g) a service to which item 30023 applies that is performed at the same site

—one or more compartments per limb (H) (Anaes.) (Assist.)

Synovectomy of wrist flexor or extensor tendons of hand or wrist, for non‑inflammatory tenosynovitis or post traumatic synovitis, including any of the following (if performed):

(a) reconstruction of flexor or extensor retinaculum;

(b) removal of tendon nodules;

(c) tenolysis;

(d) tenoplasty;

other than a service associated with:

(e) a service to which item 39330 applies; or

(f) if this service is performed on the wrist flexor tendons—a service to which item 39331 applies; or

(g) a service to which item 30023 applies that is performed at the same site

—one or more compartments per limb (H) (Anaes.) (Assist.)

Flexor tenosynovectomy of hand, distal to lumbrical origin, including any of the following (if performed):

(a) removal of intratendinous nodules;

(b) tenolysis;

(c) tenoplasty;

other than a service associated with:

(d) a service to which item 30023 applies that is performed at the same site; or

(e) a service to which item 46363 applies that is performed on the same ray

—one ray (H) (Anaes.) (Assist.)

Flexor tenosynovectomy of hand, distal to lumbrical origin, including any of the following (if performed):

(a) removal of intratendinous nodules;

(b) tenolysis;

(c) tenoplasty;

other than a service associated with:

(d) a service to which item 30023 applies that is performed at the same site; or

(e) a service to which item 46363 applies that is performed on one of the same rays

—2 rays of one hand (H) (Anaes.) (Assist.)

Flexor tenosynovectomy of hand, distal to lumbrical origin, including any of the following (if performed):

(a) removal of intratendinous nodules;

(b) tenolysis;

(c) tenoplasty;

other than a service associated with:

(d) a service to which item 30023 applies that is performed at the same site; or

(e) a service to which item 46363 applies that is performed on one of the same rays

—3 rays of one hand (H) (Anaes.) (Assist.)

Flexor tenosynovectomy of hand, distal to lumbrical origin, including any of the following (if performed):

(a) removal of intratendinous nodules;

(b) tenolysis;

(c) tenoplasty;

other than a service associated with:

(d) a service to which item 30023 applies that is performed at the same site; or

(e) a service to which item 46363 applies that is performed on one of the same rays

—4 rays of one hand (H) (Anaes.) (Assist.)

Flexor tenosynovectomy of hand, distal to lumbrical origin, including any of the following (if performed):

(a) removal of intratendinous nodules;

(b) tenolysis;

(c) tenoplasty;

other than a service associated with:

(d) a service to which item 30023 applies that is performed at the same site; or

(e) a service to which item 46363 applies that is performed on one of the same rays

—5 rays of one hand (H) (Anaes.) (Assist.)

Digital sympathectomy of hand, using microsurgical techniques, other than a service associated with:

(a) a service to which item 46363 applies; or

(b) a service to which item 30023 applies that is performed at the same site

—one digit or palmer arch (or both) or radial or ulnar artery (or both) (Anaes.)(Assist.)

Excision of ganglion of flexor tendon sheath of hand, including any of the following (if performed):

(a) flexor tenosynovectomy;

(b) sheath excision;

(c) skin closure by any method;

other than a service associated with:

(d) a service to which item 30107 applies; or

(e) a service to which item 46363 applies that is performed on the same ray

(Anaes.) (Assist.)

47577

Treatment of fracture of fibula proximal to ankle, by open reduction, with internal fixation, including any of the following (if performed):

(a) internal fixation;

(b) arthrotomy;

(c) capsule repair;

(d) removal of loose fragments or intervening soft tissue;

(e) washout of joint

(H) (Anaes.)(Assist.)

621.75

47795

Joint stabilisation procedure of scapulothoracic joint, other than a service associated with a service to which another item in this Group (other than item 38828 or 48406) applies (H) (Anaes.) (Assist.)

518.10

47968

Open tenotomy of one or more tendons of shoulder, with or without tenoplasty, to restore shoulder function, other than a service to which another item in this Group applies—applicable once per joint per occasion on which this service is performed (Anaes.)

238.30

47970

Open tenotomy of one or more tendons of scapula, with or without tenoplasty, to restore scapula function, other than a service to which another item in this Group applies—applicable once per joint per occasion on which this service is performed (Anaes.)

238.30

47973

Open tenotomy of one or more tendons of elbow, with or without tenoplasty, to restore elbow function, other than a service to which another item in this Group applies—applicable once per joint per occasion on which this service is performed (Anaes.)

238.30

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.)

48436

Excision of one or more exostoses of the hand, distal to the wrist, including any of the following (if performed):

(a) excision of surrounding osteophytes;

(b) release of ligaments;

(c) removal of one or more associated bursae or ganglia;

(d) removal of bone;

(e) synovectomy;

other than a service associated with a service to which another item in this Schedule applies that:

(f) is an arthroscopic procedure, arthrodesis, arthroplasty or osteotomy, or involves the removal of hardware; and

(g) is performed on the same joint or bone;

—each incision (H) (Anaes.) (Assist.)

295.30

48438

Excision of one or more exostoses in the wrist 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;

other than:

(g) a service to which 48436 applies; or

(h) a service associated with a service to which another item in this Schedule applies that:

(i) is an arthroscopic procedure, arthrodesis, arthroplasty or osteotomy, or involves the removal of hardware; and

(ii) is performed on the same joint or bone;

—each incision (H) (Anaes.) (Assist.)

295.30

48440

Excision of one or more exostoses in the arm or shoulder, including the radius, ulna, humerus, acromion, clavicle, or scapula, 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;

other than:

(g) a service to which 48438 applies; or

(h) a service associated with a service to which another item in this Schedule applies that:

(i) is an arthroscopic procedure, arthrodesis, arthroplasty or osteotomy, or involves the removal of hardware; and

(ii) is performed on the same joint or bone;

—each incision (H) (Anaes.) (Assist.)

295.30

48442

Excision of one or more exostoses in the hip, including pelvis and femur, including any of 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;

other than:

(g) a service to which 48444 applies; or

(h) a service associated with a service to which another item in this Schedule applies that:

(i) is an arthroscopic procedure, arthrodesis, arthroplasty or osteotomy, or involves the removal of hardware; and

(ii) is performed on the same joint or bone;

—each incision (H) (Anaes.) (Assist.)

295.30

48444

Excision of one or more exostoses in the knee, tibia or fibula, including any of 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;

other than:

(g) a service to which item 48430 applies; or

(h) a service associated with a service to which another item in this Schedule applies that:

(i) is an arthroscopic procedure, arthrodesis, arthroplasty or osteotomy, or involves the removal of hardware; and

(ii) is performed on the same joint or bone;

—each incision (H) (Anaes.) (Assist.)

295.30

48446

Treatment of non‑union or malunion of fracture of pelvis, including bone graft, and including any of the following (if performed):

(a) arthrotomy;

(b) debridement;

(c) osteotomy;

(d) removal of hardware;

(e) internal fixation;

other than a service associated with a service to which item 48245, 48248, 48251, 48254, 48257 or 47929 applies that is performed on the same bone

—one bone (H) (Anaes.) (Assist.)

1,328.20

48448

Treatment of non‑union or malunion of fracture of femur, including bone graft, and including any of the following (if performed):

(a) arthrotomy;

(b) debridement;

(c) osteotomy;

(d) removal of hardware;

(e) internal fixation;

other than a service associated with a service to which item 48245, 48248, 48251, 48254, 48257 or 47929 applies that is performed on the same bone

—one bone (H) (Anaes.) (Assist.)

1,328.20

48450

Treatment of non‑union or malunion of fracture of tibia or fibula, proximal to ankle, including bone graft, and including any of the following (if performed):

(a) arthrotomy;

(b) debridement;

(c) osteotomy;

(d) removal of hardware;

(e) internal fixation;

other than a service associated with a service to which item 48245, 48248, 48251, 48254, 48257 or 47929 applies that is performed on the same bone

—one bone (H) (Anaes.) (Assist.)

1,203.80

48452

Treatment of non‑union or malunion of fracture of humerus, including bone graft, and including any of the following (if performed):

(a) arthrotomy;

(b) debridement;

(c) osteotomy;

(d) removal of hardware;

(e) internal fixation;

other than a service associated with a service to which item 48245, 48248, 48251, 48254, 48257 or 47929 applies that is performed on the same bone

—one bone (H) (Anaes.) (Assist.)

1,203.80

48454

Treatment of non‑union or malunion of fracture of radius, ulna, or carpus including bone graft, and including any of the following (if performed):

(a) arthrotomy;

(b) debridement;

(c) osteotomy;

(d) removal of hardware;

(e) internal fixation;

other than a service associated with a service to which item 48245, 48248, 48251, 48254, 48257 or 47929 applies that is performed on the same bone

—one bone (H) (Anaes.) (Assist.)

892.90

48456

Treatment of non‑union or malunion of fracture of hand, distal to wrist, including bone graft, and including any of the following (if performed):

(a) arthrotomy;

(b) debridement;

(c) osteotomy;

(d) removal of hardware;

(e) internal fixation;

other than a service associated with a service to which item 48245, 48248, 48251, 48254, 48257 or 47929 applies that is performed on the same bone

—one bone (H) (Anaes.) (Assist.)

892.90

48919

Anatomic or reverse total shoulder replacement with bone graft, including any of the following (if performed):

(a) associated rotator cuff repair;

(b) biceps tenodesis;

(c) tuberosity osteotomy;

other than a service associated with:

(d) a service to which another item in this Schedule applies that is performed on the shoulder region by open or arthroscopic means; or

(e) a service to which item 48245, 48248, 48251, 48254 or 48257 applies that is performed on the same joint

(H) (Anaes.) (Assist.)

1,877.60

48925

Arthroplasty of shoulder, other than:

(a) a service to which another item applies; or

(b) a service associated with a service to which any of items 48900 to 48909, 48948, 48951, or 48960 applies that is performed on the same joint

(H) (Anaes.) (Assist.)

773.25

48932

Arthroplasty of acromioclavicular joint or sternoclavicular joint, other than:

(a) a service to which another item applies; or

(b) a service associated with a service to which another item in this Schedule applies that is performed on the same joint by arthroscopic means

—one joint (H) (Anaes.) (Assist.)

773.25

48943

Arthrodesis of acromioclavicular or sternoclavicular joint, including either or both of the following (if performed):

(a) joint debridement;

(b) synovectomy

—one joint (H) (Anaes.) (Assist.)

518.10

48944

Arthrodesis of scapulothoracic joint, including either or both of the following (if performed):

(a) joint debridement;

(b) synovectomy

—one joint (H) (Anaes.) (Assist.)

518.10

48952

Surgery of acromioclavicular joint or sternoclavicular 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 that is performed on the same joint by arthroscopic means (H) (Anaes.) (Assist.)

673.60

48953

Surgery of scapulothoracic 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 that is performed on the same joint by arthroscopic means (H) (Anaes.) (Assist.)

673.60

48959

Latarjet procedure by open or arthroscopic means, including any of the following (if performed) but excluding removal of hardware:

(a) labral repair or reattachment;

(b) bone grafting;

(c) tendon transfer;

other than a service associated with a service to which another item in this Schedule applies that is performed on the shoulder region by arthroscopic means (H) (Anaes.) (Assist.)

1,664.15

49113

Removal of radial head prosthesis (H) (Anaes.) (Assist.)

773.25

49114

Revision of radial head replacement (H) (Anaes.) (Assist.)

773.25

49127

Elbow joint, arthroplasty of, other than a service to which another item applies (H) (Anaes.) (Assist.)

773.25

Diagnostic arthroscopy of hip, with synovial biopsy, other than a service associated with a service to which another item in this Schedule applies that is performed on the hip joint by arthroscopic means (H) (Anaes.) (Assist.)

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.)

49592

Excision of heterotopic ossification, myositis ossificans or post‑traumatic ossification in the hip, including pelvis and proximal femur (H) (Anaes.) (Assist.)

1,256.50

49594

Excision of heterotopic ossification, myositis ossificans or post‑traumatic ossification in the knee, including distal femur, proximal fibula and proximal tibia (H) (Anaes.) (Assist.)

1,005.20

49596

Excision of heterotopic ossification, myositis ossificans or post‑traumatic ossification in the lower leg, other than a service to which item 49594 applies (H) (Anaes.) (Assist.)

753.90

Examination or closed reduction (or both) of hip for a patient under the age of 18 years, including any of the following (if performed):

(a) diagnostic injection;

(b) arthrography;

(c) application or reapplication of a hip spica

(H) (Anaes.) (Assist.)

1

Item 20100

109.00

5 base units

2

Item 20102

130.80

6 base units

3

Item 20104

87.20

4 base units

4

Item 20120

109.00

5 base units

5

Item 20124

87.20

4 base units

6

Item 20140

109.00

5 base units

7

Item 20142

109.00

5 base units

8

Item 20143

130.80

6 base units

9

Item 20144

152.60

7 base units

10

Item 20145

152.60

7 base units

11

Item 20146

109.00

5 base units

12

Item 20147

130.80

6 base units

13

Item 20148

87.20

4 base units

14

Item 20160

130.80

6 base units

15

Item 20162

152.60

7 base units

16

Item 20164

87.20

4 base units

17

Item 20170

130.80

6 base units

18

Item 20172

152.60

7 base units

19

Item 20174

196.20

9 base units

20

Item 20176

218.00

10 base units

21

Item 20190

109.00

5 base units

22

Item 20192

218.00

10 base units

23

Item 20210

327.00

15 base units

24

Item 20212

109.00

5 base units

25

Item 20214

196.20

9 base units

26

Item 20216

436.00

20 base units

27

Item 20220

218.00

10 base units

28

Item 20222

130.80

6 base units

29

Item 20225

261.60

12 base units

30

Item 20230

261.60

12 base units

31

Item 20300

109.00

5 base units

32

Item 20305

327.00

15 base units

33

Item 20320

130.80

6 base units

34

Item 20321

218.00

10 base units

35

Item 20330

174.40

8 base units

36

Item 20350

218.00

10 base units

37

Item 20352

109.00

5 base units

38

Item 20355

261.60

12 base units

39

Item 20400

65.40

3 base units

40

Item 20401

87.20

4 base units

41

Item 20402

109.00

5 base units

42

Item 20403

109.00

5 base units

43

Item 20404

130.80

6 base units

44

Item 20405

174.40

8 base units

45

Item 20406

283.40

13 base units

46

Item 20410

87.20

4 base units

47

Item 20420

109.00

5 base units

48

Item 20440

87.20

4 base units

49

Item 20450

109.00

5 base units

50

Item 20452

130.80

6 base units

51

Item 20470

130.80

6 base units

52

Item 20472

218.00

10 base units

53

Item 20474

283.40

13 base units

54

Item 20475

218.00

10 base units

55

Item 20500

327.00

15 base units

56

Item 20520

130.80

6 base units

57

Item 20522

87.20

4 base units

58

Item 20524

87.20

4 base units

59

Item 20526

218.00

10 base units

60

Item 20528

174.40

8 base units

61

Item 20540

283.40

13 base units

62

Item 20542

327.00

15 base units

63

Item 20546

327.00

15 base units

64

Item 20548

327.00

15 base units

65

Item 20560

436.00

20 base units

66

Item 20600

218.00

10 base units

67

Item 20604

283.40

13 base units

68

Item 20620

218.00

10 base units

69

Item 20622

283.40

13 base units

70

Item 20630

174.40

8 base units

71

Item 20632

152.60

7 base units

72

Item 20634

218.00

10 base units

73

Item 20670

283.40

13 base units

74

Item 20680

65.40

3 base units

75

Item 20690

109.00

5 base units

76

Item 20700

65.40

3 base units

77

Item 20702

87.20

4 base units

78

Item 20703

87.20

4 base units

79

Item 20704

218.00

10 base units

80

Item 20706

152.60

7 base units

81

Item 20730

109.00

5 base units

82

Item 20740

109.00

5 base units

83

Item 20745

152.60

7 base units

84

Item 20750

109.00

5 base units

85

Item 20752

130.80

6 base units

86

Item 20754

152.60

7 base units

87

Item 20756

196.20

9 base units

88

Item 20770

327.00

15 base units

89

Item 20790

174.40

8 base units

90

Item 20791

218.00

10 base units

91

Item 20792

283.40

13 base units

92

Item 20793

327.00

15 base units

93

Item 20794

261.60

12 base units

94

Item 20798

218.00

10 base units

95

Item 20799

130.80

6 base units

96

Item 20800

65.40

3 base units

97

Item 20802

109.00

5 base units

98

Item 20803

87.20

4 base units

99

Item 20804

218.00

10 base units

100

Item 20806

152.60

7 base units

101

Item 20810

87.20

4 base units

102

Item 20815

130.80

6 base units

103

Item 20820

109.00

5 base units

104

Item 20830

87.20

4 base units

105

Item 20832

130.80

6 base units

106

Item 20840

130.80

6 base units

107

Item 20841

174.40

8 base units

108

Item 20842

87.20

4 base units

109

Item 20844

218.00

10 base units

110

Item 20845

218.00

10 base units

111

Item 20846

218.00

10 base units

112

Item 20847

218.00

10 base units

113

Item 20848

218.00

10 base units

114

Item 20850

261.60

12 base units

115

Item 20855

327.00

15 base units

116

Item 20860

130.80

6 base units

117

Item 20862

152.60

7 base units

118

Item 20863

218.00

10 base units

119

Item 20864

218.00

10 base units

120

Item 20866

218.00

10 base units

121

Item 20867

218.00

10 base units

122

Item 20868

218.00

10 base units

123

Item 20880

327.00

15 base units

124

Item 20882

218.00

10 base units

125

Item 20884

109.00

5 base units

126

Item 20886

130.80

6 base units

127

Item 20900

65.40

3 base units

128

Item 20902

87.20

4 base units

129

Item 20904

152.60

7 base units

130

Item 20905

218.00

10 base units

131

Item 20906

87.20

4 base units

132

Item 20910

87.20

4 base units

133

Item 20911

109.00

5 base units

134

Item 20912

109.00

5 base units

135

Item 20914

152.60

7 base units

136

Item 20916

152.60

7 base units

137

Item 20920

87.20

4 base units

138

Item 20924

87.20

4 base units

139

Item 20926

87.20

4 base units

140

Item 20928

130.80

6 base units

141

Item 20930

87.20

4 base units

142

Item 20932

87.20

4 base units

143

Item 20934

130.80

6 base units

144

Item 20936

174.40

8 base units

145

Item 20938

87.20

4 base units

146

Item 20940

87.20

4 base units

147

Item 20942

109.00

5 base units

148

Item 20943

87.20

4 base units

149

Item 20944

130.80

6 base units

150

Item 20946

174.40

8 base units

151

Item 20948

87.20

4 base units

152

Item 20950

109.00

5 base units

153

Item 20952

87.20

4 base units

154

Item 20954

218.00

10 base units

155

Item 20956

87.20

4 base units

156

Item 20958

109.00

5 base units

157

Item 20960

152.60

7 base units

158

Item 21100

65.40

3 base units

159

Item 21110

109.00

5 base units

160

Item 21112

87.20

4 base units

161

Item 21114

109.00

5 base units

162

Item 21116

130.80

6 base units

163

Item 21120

130.80

6 base units

164

Item 21130

65.40

3 base units

165

Item 21140

327.00

15 base units

166

Item 21150

218.00

10 base units

167

Item 21155

218.00

10 base units

168

Item 21160

87.20

4 base units

169

Item 21170

174.40

8 base units

170

Item 21195

65.40

3 base units

171

Item 21199

87.20

4 base units

172

Item 21200

87.20

4 base units

173

Item 21202

87.20

4 base units

174

Item 21210

130.80

6 base units

175

Item 21212

218.00

10 base units

176

Item 21214

218.00

10 base units

177

Item 21215

327.00

15 base units

178

Item 21216

305.20

14 base units

179

Item 21220

87.20

4 base units

180

Item 21230

130.80

6 base units

181

Item 21232

109.00

5 base units

182

Item 21234

174.40

8 base units

183

Item 21260

87.20

4 base units

184

Item 21270

174.40

8 base units

185

Item 21272

87.20

4 base units

186

Item 21274

130.80

6 base units

187

Item 21275

218.00

10 base units

188

Item 21280

327.00

15 base units

189

Item 21300

65.40

3 base units

190

Item 21321

87.20

4 base units

191

Item 21340

87.20

4 base units

192

Item 21360

109.00

5 base units

193

Item 21380

65.40

3 base units

194

Item 21382

87.20

4 base units

195

Item 21390

65.40

3 base units

196

Item 21392

87.20

4 base units

197

Item 21400

87.20

4 base units

198

Item 21402

152.60

7 base units

199

Item 21403

218.00

10 base units

200

Item 21404

109.00

5 base units

201

Item 21420

65.40

3 base units

202

Item 21430

87.20

4 base units

203

Item 21432

109.00

5 base units

204

Item 21440

174.40

8 base units

205

Item 21445

218.00

10 base units

206

Item 21460

65.40

3 base units

207

Item 21461

87.20

4 base units

208

Item 21462

65.40

3 base units

209

Item 21464

87.20

4 base units

210

Item 21472

109.00

5 base units

211

Item 21474

109.00

5 base units

212

Item 21480

87.20

4 base units

213

Item 21482

109.00

5 base units

214

Item 21484

109.00

5 base units

215

Item 21486

152.60

7 base units

216

Item 21490

65.40

3 base units

217

Item 21500

174.40

8 base units

218

Item 21502

130.80

6 base units

219

Item 21520

87.20

4 base units

220

Item 21522

109.00

5 base units

221

Item 21530

327.00

15 base units

222

Item 21532

174.40

8 base units

223

Item 21535

218.00

10 base units

224

Item 21600

65.40

3 base units

225

Item 21610

109.00

5 base units

226

Item 21620

87.20

4 base units

227

Item 21622

109.00

5 base units

228

Item 21630

109.00

5 base units

229

Item 21632

130.80

6 base units

230

Item 21634

196.20

9 base units

231

Item 21636

327.00

15 base units

232

Item 21638

218.00

10 base units

233

Item 21650

174.40

8 base units

234

Item 21652

218.00

10 base units

235

Item 21654

174.40

8 base units

236

Item 21656

218.00

10 base units

237

Item 21670

87.20

4 base units

238

Item 21680

65.40

3 base units

239

Item 21682

87.20

4 base units

240

Item 21685

218.00

10 base units

241

Item 21700

65.40

3 base units

242

Item 21710

87.20

4 base units

243

Item 21712

109.00

5 base units

244

Item 21714

109.00

5 base units

245

Item 21716

109.00

5 base units

246

Item 21730

65.40

3 base units

247

Item 21732

87.20

4 base units

248

Item 21740

109.00

5 base units

249

Item 21756

130.80

6 base units

250

Item 21760

152.60

7 base units

251

Item 21770

174.40

8 base units

252

Item 21772

130.80

6 base units

253

Item 21780

87.20

4 base units

254

Item 21785

218.00

10 base units

255

Item 21790

327.00

15 base units

256

Item 21800

65.40

3 base units

257

Item 21810

87.20

4 base units

258

Item 21820

65.40

3 base units

259

Item 21830

87.20

4 base units

260

Item 21832

152.60

7 base units

261

Item 21834

87.20

4 base units

262

Item 21840

174.40

8 base units

263

Item 21842

130.80

6 base units

264

Item 21850

87.20

4 base units

265

Item 21860

65.40

3 base units

266

Item 21865

218.00

10 base units

267

Item 21870

327.00

15 base units

268

Item 21872

174.40

8 base units

269

Item 21878

65.40

3 base units

270

Item 21879

109.00

5 base units

271

Item 21880

152.60

7 base units

272

Item 21881

196.20

9 base units

273

Item 21882

239.80

11 base units

274

Item 21883

283.40

13 base units

275

Item 21884

327.00

15 base units

276

Item 21885

370.60

17 base units

277

Item 21886

414.20

19 base units

278