Table 2: 1992-2002 Medicare Fee Schedule Non-Facility Payment Comparison
of Top 20 Orthopaedic Facility Procedures
(*Ranking is based on Orthopaedic total Medicare allowed charges for each code, not on individual claim payment)
|
Surgical conversion factor |
$31.00 |
$40.96 |
$36.69 |
$34.73 |
$36.61 |
$38.26 |
$36.20 |
17% |
-12% |
|||
|
Non-surgical conversion factor |
$31.00 |
$33.85 |
$36.69 |
$34.73 |
$36.61 |
$38.26 |
$36.20 |
17% |
7% |
|||
|
Non-Fac Rank* |
CPT |
Descriptor |
Glob |
1992 |
1997 |
1998 |
1999 |
2000 |
2001 |
2002 |
92-02 |
97-02 |
|
2 |
20550 |
Injection; tendon sheath, ligament, ganglion cyst |
0 |
$51 |
$43 |
$47 |
$55 |
$73 |
$95 |
$64 |
25% |
48% |
|
11 |
20600 |
Arthrocentesis, aspiration and/or injection; small joint, bursa or ganglion cyst (eg, fingers, toes) |
0 |
$39 |
$48 |
$43 |
$47 |
$57 |
$71 |
$50 |
30% |
4% |
|
5 |
20605 |
Arthrocentesis, aspiration and/or injection; intermediate joint, bursa or ganglion cyst(eg, temporomandibular, acromioclavi-cular, wrist, elbow or ankle, olecra-non bursa) |
0 |
$39 |
$48 |
$43 |
$49 |
$63 |
$81 |
$55 |
42% |
14% |
|
1 |
20610 |
Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, sub-acromial bursa) |
0 |
$42 |
$44 |
$47 |
$56 |
$73 |
$98 |
$66 |
57% |
52% |
|
12 |
20670 |
Removal of implant; super-ficial, (eg, buried wire, pin or rod) (separate procedure) |
10 |
$83 |
$104 |
$95 |
$122 |
$172 |
$241 |
$279 |
237% |
168% |
|
19 |
22310 |
Closed treatment of vertebral body fracture(s), without manipu-lation, requiring and including casting or bracing |
90 |
$231 |
$208 |
$214 |
$211 |
$227 |
$266 |
$281 |
21% |
35% |
|
6 |
23600 |
Closed treatment of proximal humeral (surgical or anatomical neck) fracture; without manipulation |
90 |
$199 |
$249 |
$230 |
$235 |
$264 |
$313 |
$325 |
63% |
30% |
|
4 |
25600 |
Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphy-seal separation, with or without fracture of ulnar styloid; without manipulation |
90 |
$187 |
$235 |
$216 |
$233 |
$276 |
$270 |
$271 |
45% |
15% |
|
3 |
25605 |
Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphy-seal separation, with or without fracture of ulnar styloid; with manipulation |
90 |
$326 |
$406 |
$380 |
$407 |
$487 |
$522 |
$536 |
64% |
32% |
|
14 |
26600 |
Closed treatment of metacarpal fracture, single; without manipu-lation, each bone |
90 |
$117 |
$146 |
$136 |
$164 |
$217 |
$217 |
$230 |
98% |
57% |
|
15 |
27193 |
Closed treatment of pelvic ring fracture, disloca-tion, diastasis or subluxation; with-out manipulation |
90 |
n/a |
$305 |
$307 |
$323 |
$388 |
$467 |
$488 |
n/a |
60% |
|
18 |
27520 |
Closed treatment of patellar frac-ture, without manipulation |
90 |
$202 |
$253 |
$233 |
$255 |
$305 |
$309 |
$316 |
56% |
25% |
|
20 |
27530 |
Closed treatment of tibial fracture, proximal (pla-teau); without manipulation |
90 |
$234 |
$292 |
$282 |
$303 |
$358 |
$368 |
$372 |
59% |
27% |
|
7 |
27786 |
Closed treatment of distal fibular fracture (lateral malleolus); with-out manipulation |
90 |
$181 |
$228 |
$211 |
$236 |
$292 |
$300 |
$311 |
71% |
37% |
|
8 |
28470 |
Closed treatment of metatarsal fracture; without manipulation, each |
90 |
$123 |
$155 |
$147 |
$172 |
$222 |
$231 |
$245 |
99% |
58% |
|
9 |
29075 |
Application, cast; elbow to finger (short arm) |
0 |
$48 |
$61 |
$54 |
$81 |
$114 |
$76 |
$70 |
44% |
15% |
|
13 |
29405 |
Application of short leg cast (below knee to toes); |
0 |
$58 |
$72 |
$65 |
$90 |
$122 |
$80 |
$73 |
26% |
0% |
|
16 |
29425 |
Application of short leg cast(below knee to toes); walking or ambulatory type |
0 |
$69 |
$87 |
$78 |
$100 |
$127 |
$87 |
$80 |
16% |
-8% |
|
10 |
62311 |
Injection, single (not via indwel-ling catheter), not including neurolytic sub-stances, with or without contrast (for either local-ization or epidur-ography), of diag-nostic or thera- peutic sub-stance(s) (including ane-sthetic, antispas-modic, opioid, steroid, other solution), epidural or suba-rachnoid; lumbar, sacral (caudal) |
0 |
n/a |
n/a |
n/a |
n/a |
$200 |
$211 |
$212 |
n/a |
6% |
|
17 |
64721 |
Neuroplasty and/ or transposition; median nerve at carpal tunnel |
90 |
$317 |
$398 |
$361 |
$350 |
$365 |
$406 |
$415 |
31% |
4% |