Arthroscopy - General Shoulder

Knee (Arthroscopy) Open Rotator Cuff Repair (Shoulder) Knee with lateral release or micro fracture Tenodesis of long tendon of biceps (Arthroscopy) Repair, tendon or muscle, upper arm or elbow, each Shoulder (Arthroscopy) tendon or muscle, primary or secondary (excludes Elbow (Arthroscopy) rotator cuff) (Shoulder) Wrist (Arthroscopy) Bankhart Stabilization (Shoulder) Excision, tumor, soft tissue of shoulder area, Hip (Arthroscopy) subcutaneous; 3 cm or greater Ankle (Arthroscopy) Distal Clavicle Excision (Shoulder) Distal Clavicle Excision (Shoulder) Knee Bankhart Stabilization (Shoulder)

Arthroscopic debridement shoulder Arthroscopy, knee, diagnostic, with or without synovial biopsy Arthroscopic rotator cuff repair shoulder Anterior cruciate ligament repair (Knee) Extensive debridement Posterior cruciate ligament repair (Knee) Distal Clavicle Excision Medial Collateral Ligament (Knee) Subacromial decompression Tibial Tubercle Osteotomy (Knee) Total Shoulder Arthroplasty / Replacement Complete Synovectomy (Knee) Reverse Total Shoulder Arthroplasty Chondroplasty (Knee) Shoulder Hemiarthroplasty Med & lateral Meniscectomy (Knee) Shoulder Arthroscopy without repair Med OR lateral Meniscectomy (Knee) Shoulder Arthroscopy with repair Total Replacement/Arthroplasty, Unilateral Shoulder Reconstruction- clavicle,cuff,labrum Total Knee Arthroplasty Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft ACL Repair/Reconstruction ORIF scaphoid fracture, ORIF distal radius fracture ACL Repair/Reconstruction with Autograft ORIF MCP or IP joint Knee Scope without repair Knee Scope with repair Elbow Arthroscopy of knee with Anterior Ligament Repair

Arthroscopy knee with or without meniscetomy Ulnar Nerve Transposition / Epicondylectomy Elbow Arthroplasty Fractures Miscellaneous Closed Reduction and Casting Percutaneous Pinning - finger 1-2 pins Manipulation under anesthesia with block Open treatment of patellar fracture, with internal Manipulation shoulder / anesthesia fixation and/or partial or complete patellectomy and Porta-cath removal soft tissue repair Laparoscopic Diagnostic and Therapeutic Simple (includes rodding Humerus/Tibia/Femur) Supplies & Materials Complex (includes rodding Humerus/Tibia/Femur) Fluorsoscopic Guidance & Localization of Needle or Cath Injection, Anesthestic Agent Hardware Removal Central IV Access Port Simple Complex

Wrist/Hand Feet

Carpal Tunnel Release Repair of nail bed Dupuytrens Contracture Bunion (hallux valgus) Trigger Finger Hammertoe (1) Excision of lesion of tendon sheath or joint capsule (eg, Arthrodesis, great toe; metatarsophalangeal joint cyst, mucous cyst, or ganglion), hand or finger Plantar fasciotomy / tarsal tunnel Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or Osteotomy partial excision without Z-plasty, other local tissue rearrangement, Osteotomy, with or without lengthening, shortening or or skin grafting angular correction, metatarsal; first metatarsal Ganglion Excision Osteotomy Synovectomy, tendon sheath, radical Hammertoe (2) (tenosynovectomy), flexor tendon, palm and/or Hammertoe (3) finger, each tendon Suspenionplasty, Arthroplasty, interposition, intercarpal Hallux rigidus correction with cheilectomy, debridement or carpometacarpal joints and capsular release of the first metatarsophalangeal joint ORIF phalangeal shaft fracture Palmer fasciotomy or fasciectomy Gastrocnemius Recession deQuervains disease (incision, extensor tendon sheath, Plantar Fasciotomy wrist) Neuroma Excision Wrist arthroplasty Arthroplasty with prosthetic replacement, distal Bunionectomy radius/ulna Double Osteotomy (hallux valgus) Arthroplasty interposition, intercarpal or CMP joints Ostectomy, partial excision, fifth metatarsal head (bunionette) Tenotomy, open, extensor, foot or toe, Excision, tumor, soft tissue of forearm and/or wrist area each tendon up to two Radical resection of tumor, soft tissue of forearm and/or Osteotomy; calcaneus (eg, Dwyer or Chambers type wrist area procedure), with or without internal fixationTransfer Open Carpal Tunnel or transplant of single tendon (with muscle Tendon sheath incision (trigger finger repair) redirection or rerouting); deep (eg, anterior tibial or Endoscopic Carpal Tunnel posterior tibial through interosseous space, flexor Total wrist replacement digitorum longus, flexor tendon to midfoot or

hindfoot) hallucis longus, or peroneal; Ankle Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first Achilles Repair metatarsal Tenolysis, flexor or extensor tendon, leg and/or ankle; Morton's Neuroma and Hammertoe single, each tendon Osteotomy, with or without lengthening, shortening or Ankle scope w rem loose body angular correction, metatarsal; other than first Brostrum Repair, secondary, disrupted ligament, ankle, metatarsal collateral Ankle Arthroplasty Breast Ankle Repair Repair, open or percutaneous, Achilles tendon, with or Excision Benign Lesion without graft Mass - Excision / Biospy Gastrocnemius recession (eg, Strayer procedure) Mastectomy Open treatment of distal fibular fracture (lateral Mastectomy with or without Node Dissection malleolus), includes internal fixation, when 1st stage: reconstruction w/expanders performed Single Bilateral Ear, Nose & Throat 2nd stage: w/ implant placement, single

Thyroidectomy 2nd stage: w/implant placement, bilateral Tonsillectomy and Andenoidecomty Hemorrhoidectomy Spine Cardiovascular Microdiscectomy Cardiac pacemaker device replacement w/o MCC Lumbar Laminectomy Cardiac defibrillator implant w/cardiac cath w AMI/HF/shock w/o MCC Anterior Cervical Discectomy with fusion 1 level Carotid artery stent procedure w/ MCC Anterior Cervical Discectomy with fusion 2 level Coronary bypass w cardiac cath w/ MCC Total Disc Arthroplasty Anterior including Discectomy 1 level Cardiac pacemaker device replacement w/ MCC Total Disc Arthroplasty Anterior including Discectomy 2 Cardiac pacemaker revision except device replacement level w/ MCC Spinal fusion surgery (anterior including minimal Perc cardiovascular proc w/drug-eluting stent w/o MCC discectomy, cervical) Cardiac defibrillator implant w cardiac cath w/o AMI/HF/shock w MCC Pain Carotid artery stent procedure w CC Coronary bypass w cardiac cath w/o MCC Lumbar Epidural Steroid Perc cardiovascular proc w non-drug-eluting stent w Cervical Epidural MCC or 4+ ves/stents Cardiac pacemaker revision except device replacement Lumbar Sympathetic w CC Stellate Ganglion Block Cardiac defibrillator implant w/cardiac cath w/o Reblock for Acute Postop pain AMI/HF/shock w/o MCC Epidural Blood Patch Carotid artery stent procedure w/o CC/MCC Sacroiliac Joint Injection Coronary bypass w/o cardiac cath w/ MCC Cardiac Pacemaker Revision except devise replacement Lumbar Epidural for back pain w/o MCC Pacemaker Implantation Hip Pacemaker Battery Replacement Angioplasty Total Replacement/Arthroscopy Hip Arthroscopy without repair Opthamology Hip Arthroscopy with repair

Hip Arthroplasty Cataract and lens implant (and its related surgeries)

Glaucoma (and its related surgeries) GI Glaucoma (and its related surgeries) Hemorrhoidectomy Glaucoma (and its related surgeries) Corneal Transplants Colonoscopy with or without biopsy Retinal Treatment Upper GI Endoscopy Colonoscopy General Surgery

Cholecystectomy GU Hernia Repair Inguincal Ventral Femoral Umbilical HIFU for prostate cancer Incisional Transurethral Resection of the Prostate (TURP) Varicose Vein Laser Treatment Excision Pilonidal Cyst Gynecology Vein Stripping - single Breast Reconstruction Vein Stripping - right and left Total Mastectomy Laparoscopic Hysterectomy including overnight Vaginal Hysterectomy Breast Reconstruction Partial Mastectomy