February 2002 Bulletin

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
% chg

97-02
% chg

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%


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