$847.30 + Group T8 Surgical Operation Subgroup 17 Spinal Surgery – – 51120 Bone graft, harvesting of autogenous graft, via separate incision or via Fee: subcutaneous approach, in conjunction with spinal fusion, other than for the $235.50 purposes of bone graft obtained from the cervical, thoracic, lumbar or sacral Benefit: spine (H) (Anaes.) TN.8.141 75% = $176.65 Multiple operations rule Anterior lumbar interbody fusion (ALIF) with internal fixation, including XLIF or OLIF single surgeon – Fusion at one motion segment: 51021 + 51041 + 51160 (+ 51120) Group T8 Surgical Operation Subgroup 17 Spinal Surgery – – Fixation of motion segment with vertebral body screw, pedicle screw or Fee: hook instrumentation including sublaminar tapes or wires, one motion $1,281.20 segment, not being a service associated with a service to which item 51020, Benefit: 51022, 51023, 51024, 51025 or 51026 applies (H) (Anaes.) (Assist.) 75% = TN.8.141 TN.8.143 $960.90 Multiple operations rule + Group T8 Surgical Operation Subgroup 17 Spinal Surgery – – 51041 Spinal fusion, anterior column (anterior, direct lateral or posterior Fee: interbody), one motion segment, not being a service associated with a $1,082.70 service to which item 51042, 51043, 51044 or 51045 applies (H) (Anaes.) Benefit: (Assist.) TN.8.141 TN.8.145 75% = $812.05 Multiple operations rule + Group T8 Surgical Operation Subgroup 17 Spinal Surgery – – 51160 Anterior exposure of thoracic or lumbar spine, one motion segment, not Fee: being a service to which item 51165 applies (H) (Anaes.) (Assist.) $1,150.00 TN.8.141 TN.8.149 Benefit: 75% = Multiple operations rule $862.50 + Group T8 Surgical Operation Subgroup 17 Spinal Surgery – – 51120 Bone graft, harvesting of autogenous graft, via separate incision or via Fee: subcutaneous approach, in conjunction with spinal fusion, other than for the $235.50 Benefit:
$847.30 + Group T8 – Surgical Operation Subgroup 17 – Spinal Surgery 51120 Bone graft, harvesting of autogenous graft, via separate incision or via subcutaneous approach, in conjunction with spinal fusion, other than for the purposes of bone graft obtained from the cervical, thoracic, lumbar or sacral spine (H) (Anaes.) TN.8.141 Multiple operations rule Fee: $235.50 Benefit: 75% = $176.65 Anterior lumbar interbody fusion (ALIF) with internal fixation, including XLIF or OLIF – single surgeon Fusion at one motion segment: 51021 + 51041 + 51160 (+ 51120) Group T8 – Surgical Operation Subgroup 17 – Spinal Surgery Fixation of motion segment with vertebral body screw, pedicle screw or hook instrumentation including sublaminar tapes or wires, one motion segment, not being a service associated with a service to which item 51020, 51022, 51023, 51024, 51025 or 51026 applies (H) (Anaes.) (Assist.) TN.8.141 TN.8.143 Multiple operations rule Fee: $1,281.20 Benefit: 75% = $960.90 + Group T8 – Surgical Operation Subgroup 17 – Spinal Surgery 51041 Spinal fusion, anterior column (anterior, direct lateral or posterior interbody), one motion segment, not being a service associated with a service to which item 51042, 51043, 51044 or 51045 applies (H) (Anaes.) (Assist.) TN.8.141 TN.8.145 Multiple operations rule Fee: $1,082.70 Benefit: 75% = $812.05 + Group T8 – Surgical Operation Subgroup 17 – Spinal Surgery 51160 Anterior exposure of thoracic or lumbar spine, one motion segment, not being a service to which item 51165 applies (H) (Anaes.) (Assist.) TN.8.141 TN.8.149 Multiple operations rule Fee: $1,150.00 Benefit: 75% = $862.50 + Group T8 – Surgical Operation Subgroup 17 – Spinal Surgery 51120 Bone graft, harvesting of autogenous graft, via separate incision or via subcutaneous approach, in conjunction with spinal fusion, other than for the Fee: $235.50 Benefit:
Spine%20Surgery%20Case%20Example%20Guide.docx