Patient: ______________________________________________ DOB: ______________________
RIGHT / LEFT
Anesthesia: General Regional Local Mac Spinal Cut Times: 10min 30min 45min 60min 90min
Procedure: ______________________________________________________________________
| SHOULDER | KNEE | ||||
|---|---|---|---|---|---|
| Open | Scope | Procedure | Open | Scope | Procedure |
| 29805 | Diagnostic Scope | 29870 | Knee scope diagnostic/ w or w/o synovial biopsy | ||
| 23700 | Manipulation under anesthesia | 27332 | 29881 | Meniscectomy medial or lateral | |
| 23120 | 29824 | Distal Clavicle excision/Mumford | 27333 | 29880 | Meniscectomy medial + lateral |
| 29826 | Subacromial decompression | 29877 | Chondroplasty/ debridement | ||
| 23410 | 29827 | RTC repair – acute (chronic tear 23412) | |||
| 23430 | 29828 | Bicep Tenodesis | 27425 | 29873 | Lateral release |
| 29823 | Debridement-extensive | 29879 | Microfracture/Drilling (Bone Marrow Stimulation) | ||
| 29822 | Debridement – limited | 27447 | TKA (Total knee arthroplasty/replacement) | ||
| 29820 | Partial synovectomy-limited | 27535 | Proximal tibial (plateau) ORIF | ||
| 29821 | Complete synovectomy | 27310 | I & D Knee | ||
| 29807 | SLAP repair | 27570 | Manipulation under anesthesia | ||
| 23455 | 29806 | Labral repair, Capsulorrhaphy, Capsular Reconstruction, Bankart Repair, Remplissage | 29874 | Loose body/ foreign body removal | |
| 23462 | Laterjet | 29883 | Meniscus repair medial + lateral | ||
| 29819 | Removal of loose or foreign body | 27403 | 29882 | Meniscus repair medial or lateral (incl. root repair) | |
| 23472 | Total Shoulder Arthroplasty – Anatomic vs Reverse | 29875 | Scope, synovectomy, limited (2 or more components CPT 29876) | ||
| 23470 | Hemi Arthroplasty | 27428 | 29888 | ACL reconstruction (standard or BEAR implant) | |
| 23515 | Clavicle ORIF | 27422 | MPFL Reconstruction w/ extensor realignment | ||
| 23615 | Proximal Humerus ORIF | 27385 | Quad / hamstring tendon repair, primary | ||
| 23530 | Sternoclavicular joint resection & stabilization | 29889 | PCL reconstruction | ||
| 23532 | Sternoclavicular joint resection & stabilization With graft | 27380 | Patellar tendon repair, primary | ||
| 23550 | CC ligament repair/ augmentation, tx of AC dislocation | ||||
| HIP | ||
|---|---|---|
| Open | Scope | Procedure |
| 27130 | Total hip arthroplasty/replacement (THA) | |
| 27299 | Abductor tendon Repair (gluteus medius) – unlisted, comp 27385 | |
| 29999 | Bursectomy, trochanteric – arthroscopic (unlisted, comp 27062) | |
| 27385 | Proximal hamstring repair, primary | |
EQUIPMENT: Arthrex · Arthrex Twin Tail Tightrope · Arthrex Anchors · Arthrex Suture Tack Anchor · Acumed · Arthrex Dermal Graft · Biomet · Catalyst · Regenten-Smith & Nephew · Stryker · Depuy/Attune CR/PS · Depuy · Lima Materialise · Microport Prophecy · Ct for Total Joint · Big C-Arm · Mini C-Arm
Patient: ______________________________________________ DOB: ______________________
RIGHT / LEFT
Anesthesia: General Regional Local Mac Spinal Cut Times: 10min 30min 45min 60min 90min
Procedure: ______________________________________________________________________
| ELBOW | ||
|---|---|---|
| Open | Scope | Procedure |
| 24105 | Excision of olecranon bursa | |
| 24358 | Epicondylar debridement (Tendon repair or reattachment 24359) | |
| 24342 | Distal Bicep or Tricep repair w or w/o graft | |
| 24341 | Pectoralis major repair | |
| 24685 | Ulnar proximal end ORIF | |
| 24665 | Radial head/elbow ORIF | |
| 64718 | Cubital tunnel release | |
| WRIST | HAND / FINGERS | ||||
|---|---|---|---|---|---|
| Open | Scope | Procedure | Open | Scope | Procedure |
| 29843 | Diagnostic wrist scope | 26160 | Excision mucous cyst, ganglion on hand/finger | ||
| 25107 | Open TFCC repair | 26040 | Dupuytrens release/percutaneous (needle aponeurotomy) | ||
| 29846 | Scope/debridement or excision/repair of TFCC | 26045 | Dupuytrens release - open | ||
| 25111 | Excision ganglion cyst (recurrent cyst 25112) | 26055 | Trigger release | ||
| 64721 | Carpal tunnel release | 26432 | Mallet finger closed treatment w/or w/o pinning | ||
| 64728 | Carpal tunnel release — Sonex (ultrasound-guided, minimally invasive) | ||||
| 64719 | Ulnar nerve transposition at wrist (Guyon Canal Release) | 26433 | Repair extensor tendon for mallet finger | ||
| 25000 | DeQuervains release | 26540 | Collateral ligament Repair MCP or IP (UCL repair thumb/finger) | ||
| 25390 | Open wafer procedure-ulnar shortening osteotomy | 25447 | CMC arthroplasty | ||
| 25515 | Distal radius SHAFT ORIF | 26615 | Metacarpal ORIF | ||
| 25606 | Distal radius (closed reduction perc pinning) CRPP | 26608 | Closed reduction and perc pinning of metacarpal | ||
| 25607 | Distal radius, EXTRA-ARTICULAR fx ORIF – end of radius/joint | 26735 | Phalangeal shaft fx, proximal or middle phalanx, finger/thumb ORIF | ||
| 25608 | Distal radius INTRA-ARTICULAR fx, ORIF of 2 fragments | ||||
| FOOT & ANKLE | ||
|---|---|---|
| Open | Scope | Procedure |
| 27650 | Achilles tendon repair – acute, primary (w/ graft 27652; chronic/secondary 27654) | |
| 27698 | Brostrom lateral ankle ligament repair / stabilization (ATFL/CFL) | |
| 28118 | Haglund's deformity – calcaneal exostectomy (Achilles debridement add 28200) | |
| 27658 | Peroneal tendon repair / debridement – primary (secondary or w/ graft 27659) | |
EQUIPMENT: Arthrex · Arthrex Anchors · Acumed · Biomet Hand Innovations · Biomet · Stryker · Big C-Arm · Mini C-Arm · Depuy