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Appendix Table 1. The Adult Top 25 Most Commonly Performed CPT Codes by Residents CPT CPT Code Relative Rank CPT Code Description Practitioner % Resident %a Code Category Rate Femur/ Knee repair, 1 27447 Revision and/or Total knee arthroplasty 3.25 6.01 1.85 Reconstruction Pelvis/ Hip Repair, 2 27130 Revision and/or Total hip arthroplasty 2.72 4.13 1.52 Reconstruction Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including Femur/ Knee 3 29881 debridement/shaving of 3.39 3.41 1.01 Arthroscopy articular cartilage (chondroplasty), same or separate compartment(s), when performed Other Removal of implant, deep (eg, 4 20680 Musculoskeletal - buried wire, pin, screw, metal 2.34 2.41 1.03 Intro or Removal band, nail, rod or plate) Arthroscopy, shoulder, surgical; decompression of subacromial space with partial Shoulder acromioplasty, with 5 29826 2.61 2.31 0.89 Arthroscopy coracoacromial ligament (ie, arch) release, when performed (List separately in addition to code for primary procedure) Nervous System Neuroplasty and/or 6 64721 Spine & Spinal transposition; median nerve at 3.21 1.99 0.62 Cord Neuroplasty carpal tunnel Debridement including removal of foreign material at the site of an open fracture Integumentary and/or an open dislocation (eg, 7 11012 System - 1.73 1.62 0.94 excisional debridement); skin, Incision/Excision subcutaneous tissue, muscle fascia, muscle, and bone Shoulder Arthroscopy, shoulder, 8 29827 2.22 1.62 0.73 Arthroscopy surgical; with rotator cuff repair Arthroscopically aided anterior Femur/ Knee cruciate ligament 9 29888 1.43 1.56 1.09 Arthroscopy repair/augmentation or reconstruction Arthroscopy, knee, surgical; Femur/ Knee debridement/shaving of 10 29877 0.96 1.51 1.57 Arthroscopy articular cartilage (chondroplasty) Pelvis/ Hip Trauma Treatment of intertrochanteric, 11 27245 2.62 1.29 0.49 - Fracture and/or peritrochanteric, or COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 2

CPT CPT Code Relative Rank CPT Code Description Practitioner % Resident %a Code Category Rate Dislocation subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage Open treatment of femoral shaft fracture, with or without Femur/Knee external fixation, with insertion 12 27506 Trauma - Fracture 0.66 1.24 1.89 of intramedullary implant, with and/ or Dislocation or without cerclage and/or locking screws Debridement, bone (includes epidermis, dermis, Integumentary subcutaneous tissue, muscle 13 11044 System - 0.93 1.15 1.24 and/or Incision/Excision fascia, if performed); first 20 sq cm or less Open treatment of tibial shaft fracture (with or without fibular Leg/ Ankle Trauma fracture) by intramedullary 14 27759 - Fracture and/or 0.77 1.15 1.49 implant, with or without Dislocation interlocking screws and/or cerclage. Open treatment of bimalleolar ankle fracture (eg, lateral and Leg/ Ankle Trauma medial malleoli, or lateral and 15 27814 - Fracture and/or posterior malleoli, or medial 0.90 1.11 1.23 Dislocation and posterior malleoli), includes internal fixation, when performed Hand/Fingers Tendon sheath incision (eg, for 16 26055 1.30 1.05 0.81 Incision trigger finger) Open treatment of femoral Pelvis/ Hip Trauma fracture, proximal end, neck, 17 27236 - Fracture and/or internal fixation or prosthetic 1.61 0.87 0.54 Dislocation replacement (direct fracture exposure). Arthroscopy, knee, surgical; for infection, lavage and drainage with meniscectomy (medial AND lateral, including any Femur/ Knee 18 29880 meniscal shaving) including 0.84 0.87 1.03 Arthroscopy debridement/ shaving of articular cartilage, same or separate compartment(s), when performed Femur/ Knee Arthroscopy, knee, diagnostic, 19 29870 0.17 0.81 4.89 Arthroscopy with or without synovial biopsy Arthrodesis, posterior or Spine Arthrodesis/ 20 22614 posterolateral technique, single 0.37 0.80 2.14 Posterior level; each additional COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 3

CPT CPT Code Relative Rank CPT Code Description Practitioner % Resident %a Code Category Rate vertebral segment (List separately in addition to code for primary procedure) Open treatment of distal fibular Leg/ Ankle Trauma fracture (lateral malleolus), 21 27792 - Fracture and/or 0.98 0.75 0.76 with or without internal or Dislocation external fixation. Arthroscopy, shoulder, Shoulder 22 29824 surgical;capsulorrhaphy with 1.03 0.70 0.68 Arthroscopy debridement, extensive Arthrodesis, posterior or posterolateral technique, single Spine Arthrodesis/ 23 22612 level; lumbar (with lateral 0.59 0.69 1.17 Posterior transverse technique, when performed) Other Application of a uniplane (pins 24 20690 Musculoskeletal - or wires in 1 plane), unilateral, 0.76 0.66 0.88 Intro or Removal external fixation system Arthroplasty, glenohumeral Shoulder Repair joint; total shoulder (glenoid 25 23472 Revision and/or 0.61 0.66 1.08 and proximal humeral Reconstruction replacement) Summary Statistics Sum: 38.00 Sum: 40.37 Avg: 1.26 a Sorted by this column.

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Appendix Table 2. The Adult Top 25 Most Commonly Performed CPT Codes by Practitioners CPT CPT Code Relative Rank CPT Code Description Practitioner %a Resident % Code Category Rate Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including Femur/ Knee 1 29881 debridement/shaving of 3.39 3.41 1.01 Arthroscopy articular cartilage (chondroplasty), same or separate compartment(s), when performed Femur/ Knee repair, 2 27447 Revision and/or Total knee arthroplasty 3.25 6.01 1.85 Reconstruction Nervous System Neuroplasty and/or 3 64721 Spine & Spinal transposition; median nerve at 3.21 1.99 0.62 Cord Neuroplasty carpal tunnel Pelvis/ Hip Repair, 4 27130 Revision and/or Total hip replacement 2.72 4.13 1.52 Reconstruction Treatment of intertrochanteric, peritrochanteric, or Pelvis/ Hip Trauma subtrochanteric femoral 5 27245 - Fracture and/or fracture; with intramedullary 2.62 1.29 0.49 Dislocation implant, with or without interlocking screws and/or cerclage Arthroscopy, shoulder, surgical; decompression of subacromial space with partial Shoulder acromioplasty, with 6 29826 2.61 2.31 0.89 Arthroscopy coracoacromial ligament (ie, arch) release, when performed (List separately in addition to code for primary procedure) Other Removal of implant, deep (eg, 7 20680 Musculoskeletal - buried wire, pin, screw, metal 2.34 2.41 1.03 Intro or Removal band, nail, rod or plate) Shoulder Arthroscopy, shoulder, 8 29827 2.22 1.62 0.73 Arthroscopy surgical; with rotator cuff repair Debridement including removal of foreign material at the site of an open fracture Integumentary and/or an open dislocation (eg, 9 11012 System - 1.73 1.62 0.94 excisional debridement); skin, Incision/Excision subcutaneous tissue, muscle fascia, muscle, and bone Pelvis/ Hip Trauma Open treatment of femoral 10 27236 - Fracture and/or fracture, proximal end, neck, 1.61 0.87 0.54 Dislocation internal fixation or prosthetic COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 5

CPT CPT Code Relative Rank CPT Code Description Practitioner %a Resident % Code Category Rate replacement Arthroscopically aided anterior Femur/ Knee cruciate ligament 11 29888 1.43 1.56 1.09 Arthroscopy repair/augmentation or reconstruction Hand/Fingers Tendon sheath incision (eg, for 12 26055 1.30 1.05 0.81 Incision trigger finger). Nervous System Spine & Spinal Cord Posterior Laminectomy, facetectomy and Extradural foraminotomy (unilateral or Laminotomy or bilateral with decompression of Laminectomy for spinal cord, cauda equina and 13 63047 1.05 0.52 0.49 Exploration/Decom /or nerve root(s), (e.g., spinal pression of Neural or lateral recess stenosis), Elements or single vertebral segment, Excision of lumbar Herniated Intervertebral Disc Arthroscopy, shoulder, Shoulder 14 29824 surgical;capsulorrhaphy with 1.03 0.70 0.68 Arthroscopy debridement, extensive Open treatment of distal fibular Leg/ Ankle Trauma fracture (lateral malleolus), 15 27792 - Fracture and/or 0.98 0.75 0.76 with or without internal or Dislocation external fixation. Arthroscopy, shoulder, Shoulder 16 29823 surgical;capsulorrhaphy with 0.96 0.45 0.47 Arthroscopy debridement, limited Arthroscopy, knee, surgical; for Femur/ Knee infection, lavage and drainage 17 29877 0.96 1.51 1.57 Arthroscopy debridement/shaving of articular cartilage Debridement, bone (includes epidermis, dermis, Integumentary subcutaneous tissue, muscle 18 11044 System - 0.93 1.15 1.24 and/or Incision/Excision fascia, if performed); first 20 sq cm or less Shoulder Repair Tenodesis of long tendon of 19 23430 Revision and/or 0.91 0.32 0.35 biceps Reconstruction Open treatment of distal radial Forearm/ Wrist intra-articular fracture or 20 25609 Fracture and/or 0.91 0.60 0.66 epiphyseal separation with Dislocation internal fixation of 3 fragments Leg/ Ankle Trauma Open treatment of bimalleolar 21 27814 - Fracture and/or ankle fracture, with or without 0.90 1.11 1.23 Dislocation internal or external fixation. Integumentary Debridement, muscle and/or 22 11043 0.87 0.64 0.73 System - fascia (includes epidermis, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 6

CPT CPT Code Relative Rank CPT Code Description Practitioner %a Resident % Code Category Rate Incision/Excision dermis, and subcutaneous tissue, if performed); first 20 sq cm or less Arthroscopy, shoulder, Shoulder 23 29822 surgical;capsulorrhaphy with 0.86 0.56 0.65 Arthroscopy synovectomy, complete Arthroscopy, knee, surgical; for infection, lavage and drainage with meniscectomy (medial AND lateral, including any Femur/ Knee 24 29880 meniscal shaving) including 0.84 0.87 1.03 Arthroscopy debridement/ shaving of articular cartilage, same or separate compartment(s), when performed Nervous System Spine & Spinal Laminotomy Cord Posterior (hemilaminectomy). with Extradural decompression of nerve Laminotomy or root(s), including partial Laminectomy for facetectomy, foraminotomy 25 63030 0.79 0.34 0.43 Exploration/Decom and/or excision of herniated pression of Neural intervertebral disc, including Elements or open and edoscopically Excision of assisted approaches, 1 Herniated interspace, lumbar Intervertebral Disc Summary Statistics Sum: 40.42 Sum: 37.79 Avg: 1.51 a Sorted by this column.

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Appendix Table 3. The Pediatric Top 25 Most Commonly Performed CPT Codes by Residents CPT CPT Code Relative Rank CPT Code Description Practitioner % Resident %a Code Category Rate Other Removal of implant, deep (eg, 1 20680 Musculoskeletal - buried wire, pin, screw, metal 4.97 5.19 1.04 Intro or Removal band, nail, rod or plate) Percutaneous skeletal fixation Humerus/ Elbow of supracondylar or 2 24538 Fracture and/or transcondylar humeral fracture, 7.58 4.75 0.63 Dislocation with or without intercondylar extension Tenotomy, percutaneous, 3 27606 Leg/Ankle Incision 0.69 2.05 2.95 Achilles tendon Open treatment of femoral shaft fracture, with or without Femur/Knee external fixation, with insertion 4 27506 Trauma - Fracture 1.13 1.62 1.43 of intramedullary implant, with and/ or Dislocation or without cerclage and/or locking screws Arthrodesis, posterior, for Spine Arthrodesis/ spinal deformity, with or 5 22802 0.54 1.50 2.76 Deformity without cast; 7 to 12 vertebral segments Posterior non-segmental Spine 6 22843 instrumentation 7 to 12 0.54 1.49 2.79 Instrumentation vertebral segments Arthroscopically aided anterior Femur/ Knee cruciate ligament 7 29888 4.08 1.49 0.36 Arthroscopy repair/augmentation or reconstruction Leg/ Ankle Repair, Lengthening or shortening of 8 27685 Revision, and/or tendon, leg or ankle; single 0.36 1.39 3.86 Reconstruction tendon Tenotomy, adductor of hip, 9 27001 Pelvis/ Hip Incision 0.45 1.07 2.37 subcutaneous, open. Osteotomy, intertrochanteric or Pelvis/ Hip Repair, subtrochanteric including 10 27165 Revision and/or 0.38 1.05 2.74 internal or external fixation Reconstruction and/or cast Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including Femur/ Knee 11 29881 debridement/shaving of 2.84 1.02 0.36 Arthroscopy articular cartilage (chondroplasty), same or separate compartment(s), when performed Arthrodesis, posterior or Spine Arthrodesis/ posterolateral technique, single 12 22614 0.04 1.01 28.01 Posterior level; each additional vertebral segment (List COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 8

CPT CPT Code Relative Rank CPT Code Description Practitioner % Resident %a Code Category Rate separately in addition to code for primary procedure) Arthrodesis, posterior, for spinal deformity, with or Spine Arthrodesis/ 13 22804 without cast; 13 or more 0.40 0.95 2.39 Deformity vertebral segments Treatment of slipped femoral Pelvis/ Hip Repair, epiphysis; by traction, without 14 27176 Revision and/or 0.85 0.94 1.11 reduction by single or multiple Reconstruction pinning, in situ Posterior segmental instrumentation (eg, pedicle Spine 15 22844 fixation, dual rods with multiple 0.40 0.92 2.32 Instrumentation hooks and sublaminar wires); 13 or more vertebral segments Debridement including removal of foreign material at the site of an open fracture Integumentary and/or an open dislocation (eg, 16 11012 System - 2.26 0.91 0.40 excisional debridement); skin, Incision/Excision subcutaneous tissue, muscle fascia, muscle, and bone Pelvis/ Hip Injection procedure for hip 17 27095 Introduction or 0.76 0.87 1.15 arthrography; with anesthesia. Removal Leg/ Ankle Repair, Injection procedure for hip 18 27687 Revision, and/or 0.40 0.87 2.18 arthrography; with anesthesia. Reconstruction Foot/ Toes Repair, 19 28300 Revision and/or Gastrocnemius recession 0.35 0.86 2.50 Reconstruction Osteotomy; calcaneus (eg, Other Dwyer or Chambers type 20 20930 Musculoskeletal - 0.61 0.83 1.36 procedure), with or without Intro or Removal internal fixation Open treatment of humeral Humerus/ Elbow condylar fracture, medial or 21 24579 Fracture and/or 1.38 0.83 0.60 lateral, with or without internal Dislocation or external fixation. Femur/ Knee repair, Osteotomy, femur, shaft or 22 27450 Revision and/or 0.19 0.82 4.34 supracondylar; with fixation Reconstruction Autograft for spine surgery Other (includes harvesting the graft); 23 20936 Musculoskeletal - local (eg, ribs, spinous 0.56 0.78 1.39 Intro or Removal process, or laminar fragments) obtained from same incision Integumentary Debridement, bone (includes 24 11044 0.79 0.77 0.98 System - epidermis, dermis, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 9

CPT CPT Code Relative Rank CPT Code Description Practitioner % Resident %a Code Category Rate Incision/Excision subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less Open treatment of radial and Forearm/ Wrist ulnar shaft fractures with 25 25575 Fracture and/or 1.38 0.73 0.53 internal fixation of radius and Dislocation ulna Summary Statistics Sum: 33.93 Sum: 34.71 Avg: 2.82 a Sorted by this column.

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Appendix Table 4. The Pediatric Top 25 Most Commonly Performed CPT Codes by Practitioners CPT CPT Code Relative Rank CPT Code Description Practitioner %a Resident % Code Category Rate Percutaneous skeletal fixation Humerus/ Elbow of supracondylar or 1 24538 Fracture and/or transcondylar humeral fracture, 7.58 4.75 0.63 Dislocation with or without intercondylar extension Other Removal of implant, deep (eg, 2 20680 Musculoskeletal - buried wire, pin, screw, metal 4.97 5.19 1.04 Intro or Removal band, nail, rod or plate) Arthroscopically aided anterior Femur/ Knee cruciate ligament 3 29888 4.08 1.49 0.36 Arthroscopy repair/augmentation or reconstruction Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including Femur/ Knee 4 29881 debridement/shaving of 2.84 1.02 0.36 Arthroscopy articular cartilage (chondroplasty), same or separate compartment(s), when performed Debridement including removal of foreign material at the site of an open fracture Integumentary and/or an open dislocation (eg, 5 11012 System - 2.26 0.91 0.40 excisional debridement); skin, Incision/Excision subcutaneous tissue, muscle fascia, muscle, and bone Arthroscopy, knee, surgical; for Femur/ Knee infection, lavage and drainage 6 29882 2.25 0.58 0.26 Arthroscopy with meniscus repair (medial OR lateral) Forearm/ Wrist Percutaneous skeletal fixation 7 25606 Fracture and/or of distal radial fracture or 1.93 0.53 0.28 Dislocation epiphyseal separation Open treatment of humeral Humerus/ Elbow condylar fracture, medial or 8 24579 Fracture and/or 1.38 0.83 0.60 lateral, with or without internal Dislocation or external fixation. Open treatment of radial and Forearm/ Wrist ulnar shaft fractures with 9 25575 Fracture and/or 1.38 0.73 0.53 internal fixation of radius and Dislocation ulna Percutaneous skeletal fixation Hand/Fingers of unstable phalangeal shaft 10 26727 Fracture and/or fracture, proximal or middle 1.31 0.25 0.19 Dislocation phalanx, finger or thumb, with manipulation, each. COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 11

CPT CPT Code Relative Rank CPT Code Description Practitioner %a Resident % Code Category Rate Open treatment of femoral shaft fracture, with or without Femur/Knee external fixation, with insertion 11 27506 Trauma - Fracture 1.13 1.62 1.43 of intramedullary implant, with and/ or Dislocation or without cerclage and/or locking screws. Arthroscopy, shoulder, Shoulder 12 29806 diagnostic, with or without 1.04 0.18 0.17 Arthroscopy synovial biopsy Hand/Fingers Tendon sheath incision (eg, for 13 26055 0.95 0.73 0.77 Incision trigger finger). Open treatment of clavicular Shoulder Fracture 14 23515 fracture, includes internal 0.90 0.19 0.21 and/or Dislocation fixation, when performe Treatment of slipped femoral Pelvis/ Hip Repair, epiphysis; by traction, without 15 27176 Revision and/or 0.85 0.94 1.11 reduction by single or multiple Reconstruction pinning, in situ Open treatment of distal fibular Leg/ Ankle Trauma fracture (lateral malleolus), 16 27792 - Fracture and/or 0.81 0.27 0.34 with or without internal or Dislocation external fixation. Debridement, bone (includes epidermis, dermis, Integumentary subcutaneous tissue, muscle 17 11044 System - 0.79 0.77 0.98 and/or Incision/Excision fascia, if performed); first 20 sq cm or less Debridement, muscle and/or Integumentary fascia (includes epidermis, 18 11043 System - dermis, and subcutaneous 0.78 0.43 0.55 Incision/Excision tissue, if performed); first 20 sq cm or less Pelvis/ Hip Injection procedure for hip 19 27095 Introduction or 0.76 0.87 1.15 arthrography; with anesthesia. Removal Open treatment of fracture of weight bearing articular Leg/ Ankle Trauma surface/ portion of distal tibia 20 27827 - Fracture and/or 0.76 0.39 0.52 (eg, pilon or tibial plafond), with Dislocation internal or external fixation; of tibia only. Forearm/Wrist Excision of ganglion, wrist 21 25111 0.73 0.23 0.31 Excision (dorsal or volar); primary Tenotomy, Achilles tendon, subcutaneous (separate 22 27606 Leg/Ankle Incision 0.69 2.05 2.95 procedure); general anesthesia. Arthroscopy, knee, surgical; Femur/ Knee 23 29877 debridement/shaving of 0.69 0.38 0.55 Arthroscopy articular cartilage COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 12

CPT CPT Code Relative Rank CPT Code Description Practitioner %a Resident % Code Category Rate (chondroplasty) Arthroscopy, knee, surgical; for Femur/ Knee 24 29875 infection, lavage and drainage 0.68 0.31 0.46 Arthroscopy with synovectomy, limited Open treatment of humeral Humerus/ Elbow epicondylar fracture, medial or 25 24575 Fracture and/or 0.65 0.35 0.53 lateral, with or without internal Dislocation or external fixation. Summary Statistics Sum: 42.19 Sum: 25.99 Avg: 0.67 a Sorted by this column.

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Appendix Table 5. All CPT Codes Used in the Adult Data Analysis Listed with Corresponding CPT Code Descriptions Listed by CPT Code Numeric Order CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Integumentary System Incision and drainage of 10060 0.12 0.04 0.39 Incision & Drainage abscess; simple or single Incision and drainage of Integumentary System 10061 abscess; complicated or 0.13 0.03 0.25 Incision & Drainage multiple Integumentary System Incision and drainage of 10080 0.00 0.00 0.86 Incision & Drainage pilonidal cyst; simple or single Incision and removal of Integumentary System 10120 foreign body, subcutaneous 0.09 0.02 0.28 Incision & Drainage tissues; simple Incision and removal of Integumentary System 10121 foreign body, subcutaneous 0.06 0.02 0.30 Incision & Drainage tissues; complicated Incision and drainage of Integumentary System 10140 hematoma, seroma or fluid 0.08 0.03 0.43 Incision & Drainage collection Puncture aspiration of Integumentary System 10160 abscess, hematoma, bulla, or 0 0 0.98 Incision & Drainage cyst Incision and drainage, Integumentary System 10180 complex, postoperative wound 0.27 0.15 0.57 Incision & Drainage infection Debridement of extensive Integumentary System 11000 eczematous or infected skin; 0.01 0 0.57 Debridement up to 10% of body surface Debridement of extensive eczematous or infected skin; each additional 10% of the Integumentary System 11001 body surface, or part thereof 0 0 6.42 Debridement (List separately in addition to code for primary procedure) Debridement of skin, subcutaneous tissue, muscle, Integumentary System 11004 and fascia for necrotizing soft 0 0 0.99 Debridement tissue infection; external genitalia and perineum Debridement of skin, subcutaneous tissue, muscle, Integumentary System and fascia for necrotizing soft 11005 0.00 0.00 Inf Debridement tissue infection; abdominal wall, with or without fascial closure Debridement of skin, subcutaneous tissue, muscle, Integumentary System and fascia for necrotizing soft 11006 0.00 0.00 1.60 Debridement tissue infection; external genitalia, perineum, and abdominal wall, with or COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 14

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate without fascial closure Debridement including removal of foreign material at the site of an open fracture Integumentary System - 11010 and/or an open dislocation 0.21 0.23 1.08 Incision/Excision (eg, excisional debridement); skin and subcutaneous tissues Debridement including removal of foreign material at the site of an open fracture Integumentary System - 11011 and/or an open dislocation 0.20 0.36 1.82 Incision/Excision (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, and muscle Debridement including removal of foreign material at the site of an open fracture Integumentary System - and/or an open dislocation 11012 1.73 1.62 0.94 Incision/Excision (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone Integumentary System 11040 0.01 0.02 2.75 Debridement Integumentary System 11041 0.01 0.03 5.51 Debridement Debridement, subcutaneous Integumentary System - tissue (includes epidermis and 11042 0.53 0.24 0.45 Incision/Excision dermis, if performed); first 20 sq cm or less Debridement, muscle and/or fascia (includes epidermis, Integumentary System - 11043 dermis, and subcutaneous 0.87 0.64 0.73 Incision/Excision tissue, if performed); first 20 sq cm or less Debridement, bone (includes epidermis, dermis, Integumentary System - subcutaneous tissue, muscle 11044 0.93 1.15 1.24 Incision/Excision and/or fascia, if performed); first 20 sq cm or less Debridement, subcutaneous tissue (includes epidermis and Integumentary System dermis, if performed); each 11045 0.04 0.00 0.03 Debridement additional 20 square cm, or part thereof 20 sq cm or less Debridement, muscle and/or Integumentary System 11046 fascia (includes epidermis, 0.10 0.00 0.02 Debridement dermis, and subcutaneous; COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 15

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate each additional 20 square cm, or part thereof 20 sq cm or less tissue, if performed); first 20 sq cm or less Debridement, muscle and/or fascia (includes epidermis, Integumentary System 11047 dermis, and subcutaneous; 0.07 0.00 0.03 Debridement each additional 20 square cm, or part thereof Integumentary System - 11760 20 sq cm or less 0.23 0.11 0.48 Incision/Excision Integumentary System tissue, if performed); first 20 11900 0.00 0.00 0.24 Introduction sq cm or less Removal of tissue Integumentary System 11971 expander(s) without insertion 0.00 0.00 0.78 Introduction of prosthesis Integumentary System Insertion, non-biodegradable 11981 0.35 0.12 0.36 Introduction drug delivery implant Integumentary System Removal, non-biodegradable 11982 0.17 0.04 0.23 Introduction drug delivery implant Removal with reinsertion, non- Integumentary System 11983 biodegradable drug delivery 0.11 0.03 0.32 Introduction implant Simple repair of superficial Integumentary System wounds of scalp, neck, axillae, 12001 0.06 0.04 0.58 Repair-Simple external genitalia, trunk and/ or extremeities; 2.5 cm or less Simple repair of superficial Integumentary System wounds of scalp, neck, axillae, 12002 0.07 0.06 0.83 Repair-Simple external genitalia, trunk and/ or extremeities; 2.6 - 7.5 cm Simple repair of superficial Integumentary System wounds of scalp, neck, axillae, 12004 0.02 0.02 1.10 Repair-Simple external genitalia, trunk and/ or extremeities; 7.6 - 12.5 cm Simple repair of superficial wounds of scalp, neck, axillae, Integumentary System 12005 external genitalia, trunk and/ 0.02 0.01 0.69 Repair-Simple or extremeities; 12.6 - 20 .0 cm Simple repair of superficial Integumentary System wounds of scalp, neck, axillae, 12006 0.01 0.01 0.87 Repair-Simple external genitalia, trunk and/ or extremeities; 20.1 - 30.0 cm Simple repair of superficial Integumentary System wounds of scalp, neck, axillae, 12007 0.00 0.01 1.44 Repair-Simple external genitalia, trunk and/ or extremeities; over 30 cm Integumentary System Simple repair of superficial 12011 0.00 0.00 3.32 Repair-Simple wounds of scalp, neck, axillae, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 16

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate external genitalia, trunk and/ or extremeities; over 30 cm Simple repair of superficial Integumentary System wounds of face, ears, eyelids, 12013 0.00 0.00 Inf Repair-Simple nose, lips, and/or mucous membranes; 2.6 to 5.0 cm Simple repair of superficial Integumentary System wounds of face, ears, eyelids, 12014 0.00 0.00 Inf Repair-Simple nose, lips, and/or mucous membranes; 5.1 to 7.5 cm Simple repair of superficial Integumentary System wounds of face, ears, eyelids, 12015 0.00 0.00 2.67 Repair-Simple nose, lips, and/or mucous membranes; 7.6 to 12.5 cm Simple repair of superficial Integumentary System wounds of face, ears, eyelids, 12016 0.00 0.00 Inf Repair-Simple nose, lips, and/or mucous membranes; 12.6 to 20.0 cm Simple repair of superficial Integumentary System wounds of face, ears, eyelids, 12017 0.00 0.00 0.96 Repair-Simple nose, lips, and/or mucous membranes; 20.0 to 30.0 cm Simple repair of superficial Integumentary System wounds of face, ears, eyelids, 12018 0.00 0.00 1.82 Repair-Simple nose, lips, and/or mucous membranes; over 30.0 cm Treatment of superficial Integumentary System 12020 wound dehiscence; simple 0.04 0.01 0.24 Repair-Simple closure Treatment of superficial Integumentary System 12021 wound dehiscence; with 0.00 0.00 0.59 Repair-Simple packing Repair, intermediate, wounds Integumentary System of scalp, axillae, trunk and/or 12031 0.02 0.01 0.41 Repair-Intermediate extremities excluding hands and feel; 2.5 cm or less Repair, intermediate, wounds Integumentary System of scalp, axillae, trunk and/or 12032 0.06 0.05 0.76 Repair-Intermediate extremities excluding hands and feel; 2.6 to 7.5 cm Repair, intermediate, wounds Integumentary System of scalp, axillae, trunk and/or 12034 0.04 0.04 0.98 Repair-Intermediate extremities excluding hands and feel; 7.6 to 12.5 cm Repair, intermediate, wounds Integumentary System of scalp, axillae, trunk and/or 12035 0.04 0.04 1.05 Repair-Intermediate extremities excluding hands and feel; 12.6 to 20.0 cm Repair, intermediate, wounds Integumentary System 12036 of scalp, axillae, trunk and/or 0.02 0.02 1.12 Repair-Intermediate extremities excluding hands COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 17

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate and feel; 20.1 to 30.0 cm Repair, intermediate, wounds Integumentary System of scalp, axillae, trunk and/or 12037 0.01 0.01 1.14 Repair-Intermediate extremities excluding hands and feel; over 30.0 cm Repair, intermediate, wounds Integumentary System of neck, hands, feet, and/ or 12041 0.01 0.01 1.39 Repair-Intermediate external genitalia; 2.5 cm or less Repair, intermediate, wounds Integumentary System of neck, hands, feet, and/ or 12042 0.02 0.03 1.68 Repair-Intermediate external genitalia; 2.6 to 7.5 cm Repair, intermediate, wounds Integumentary System of neck, hands, feet, and/ or 12044 0.01 0.01 1.32 Repair-Intermediate external genitalia; 7.6 to 12.5n cm Repair, intermediate, wounds Integumentary System of neck, hands, feet, and/ or 12045 0.00 0.01 1.60 Repair-Intermediate external genitalia; 12.6 to 20.0 cm Repair, intermediate, wounds Integumentary System of neck, hands, feet, and/ or 12046 0.00 0.00 2.14 Repair-Intermediate external genitalia; 20.1 to 30.0 cm Repair, intermediate, wounds Integumentary System of neck, hands, feet, and/ or 12047 0.00 0.00 Inf Repair-Intermediate external genitalia; over 30.0 cm Repair, intermediate, wounds Integumentary System of face, ears, eyelids, nose, 12051 0.00 0.00 1.18 Repair-Intermediate lips and/or mucous membranes; 2.5 cm or less Repair, intermediate, wounds Integumentary System of face, ears, eyelids, nose, 12052 0.00 0.00 1.93 Repair-Intermediate lips and/or mucous membranes; 2.6 to 5.0 cm Repair, intermediate, wounds Integumentary System of face, ears, eyelids, nose, 12054 0.00 0.00 1.50 Repair-Intermediate lips and/or mucous membranes;7.6 to 12.5 cm Repair, intermediate, wounds Integumentary System of face, ears, eyelids, nose, 12055 0.00 0.00 0.46 Repair-Intermediate lips and/or mucous membranes; 12.6 to 20.0 cm Integumentary System Repair, complex, trunk; 1.1 to 13100 0.00 0.00 0.78 Repair-Complex 2.5 cm Integumentary System Repair, complex, trunk; 2.6 to 13101 0.01 0.01 0.66 Repair-Complex 7.5 cm Integumentary System Repair, complex, trunk; each 13102 0.00 0.00 2.66 Repair-Complex additional 5 cm or less COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 18

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Integumentary System Repair, complex, scalp, arms, 13120 0.02 0.01 0.42 Repair-Complex legs; 1.1 to 2.5 cm Integumentary System Repair, complex, scalp, arms, 13121 0.14 0.07 0.52 Repair-Complex legs; 2.6 to 7.5 cm Repair, complex, scalp, arms, Integumentary System 13122 legs; each additional 5 cm or 0.07 0.06 0.88 Repair-Complex less Repair, complex, forehead, Integumentary System cheeks, chin, nouth, neck, 13131 0.02 0.01 0.38 Repair-Complex axillae, genitalia, hands, feet; 1.1 cm to 2.5 cm Repair, complex, forehead, Integumentary System cheeks, chin, nouth, neck, 13132 0.05 0.02 0.46 Repair-Complex axillae, genitalia, hands, feet; 2.6 to 7.5 cm Repair, complex, forehead, Integumentary System cheeks, chin, nouth, neck, 13133 0.02 0.01 0.44 Repair-Complex axillae, genitalia, hands, feet; each additional 5 cm or less Repair, complex, eyelids, Integumentary System 13152 nose, ears and/ or lips; 2.6 to 0.00 0.00 0.37 Repair-Complex 7.5 cm Secondary closure of surgical Integumentary System 13160 wound or dehiscence, 0.25 0.09 0.36 Repair-Complex extensive or complicated Surgical preparation or creation of recipient site by excision of open wounds, burn Integumentary System Skin eschar, or scar, or incisional 15002 0.05 0.02 0.38 Grafts release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of bady area for infants and children Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar, or incisional Integumentary System Skin 15003 release of scar contracture, 0.01 0.01 2.06 Grafts trunk, arms, legs; each additional 100 sq cm or each additional 1% of bady area for infants and children Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar, or incisional Integumentary System Skin 15004 release of scar contracture, 0.05 0.01 0.17 Grafts face, scalp, eyelids,mouth, neck , ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or 1% of COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 19

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate bady area for infants and children Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar, or incisional release of scar contracture, Integumentary System Skin face, scalp, eyelids,mouth, 15005 0.00 0.00 2.10 Grafts neck , ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm or each additional 1% of bady area for infants and children Harvest of skin for tissue Integumentary System Skin 15040 cultured autograft, 100 sq cm 0.00 0.00 2.99 Grafts or less Pinch graft, single or multiple, to cover small ulcer, tip of Integumentary System Skin 15050 digit, or other minimal open 0.01 0.00 0.21 Grafts area (except on face), up to defect size 2 cm diameter Split-thickness autograft, Integumentary System Skin trunk, arms, legs,; first 100 sq 15100 0.12 0.17 1.46 Grafts cm or less, or 1% of body area of infants and children Split-thickness autograft, trunk, arms, legs; each Integumentary System Skin 15101 additional 100 sq cm or less, 0.03 0.07 2.77 Grafts or each additional 1% of body area of infants and children Epidermal autograft, trunk, Integumentary System Skin arms, legs; first 100 sq cm or 15110 0.00 0.00 Inf Grafts less, or 1% of body area of infants and children Epidermal autograft, trunk, arms, legs; each additional Integumentary System Skin 15111 100 sq cm or less, or each 0.00 0.01 22.03 Grafts additional 1% of body area of infants and children Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, Integumentary System Skin 15115 feet, and/or multiple digits; 0.00 0.00 1.44 Grafts first 100 sq cm or less, or 1% of body area of infants and children Epidermal autograft, face, Integumentary System Skin scalp, eyelids, mouth, neck, 15116 0.00 0.00 Inf Grafts ears, orbits, genitalia, hands, feet, and/or multiple digits; COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 20

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate each additional 100 sq cm or less, or each additional 1% of body area of infants and children Split thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, Integumentary System Skin 15120 feet, and/or multiple digits; 0.02 0.03 1.53 Grafts first 100 sq cm or less, or 1% of body area of infants and children Split thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, Integumentary System Skin feet, and/or multiple digits; 15121 0.00 0.01 10.27 Grafts each additional 100 sq cm or less, or each additional 1% of body area of infants and children Dermal autograft, trunk, arms, Integumentary System Skin legs; first 100 sq cm or less, 15130 0.00 0.00 Inf Grafts or 1% of body area of infants and children Dermal autograft, trunk, arms, legs; each additional 100 sq Integumentary System Skin 15131 cm or less, or each additional 0.00 0.00 Inf Grafts 1% of body area of infants and children Dermal autograft, face, scalp, eyelids, mouth, neck, ears, Integumentary System Skin orbits, genitalia, hands, feet, 15135 0.00 0.00 1.46 Grafts and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children Integumentary System Skin 15170 0.00 0.00 Inf Grafts Integumentary System Skin 15171 0.00 0.00 Inf Grafts Integumentary System Skin 15175 0.00 0.00 Inf Grafts Full thickness graft, free, Integumentary System Skin including direct closure of 15200 0.00 0.00 4.44 Grafts donor site, trunk; 20 sq cm or less Full thickness graft, free, including direct closure of Integumentary System Skin 15201 donor site, trunk; each 0.00 0.00 Inf Grafts additional 20 sq cm or part thereof Integumentary System Skin Full thickness graft, free, 15220 0.01 0.01 0.72 Grafts including direct closure of COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 21

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate donor site, scalp, arms and/ or legs; 20 sq cm or less Full thickness graft, free, including direct closure of Integumentary System Skin 15221 donor site, scalp arms and/ or 0.00 0.00 5.78 Grafts legs; each additional 20 sq cm or part thereof Full thickness graft, free, including direct closure of Integumentary System Skin donor site, forehead, cheeks, 15240 0.03 0.02 0.63 Grafts chin, mouth, neck, axillae, genitalia,hands and/or feet; 20 sq cm or less Full thickness graft, free, including direct closure of donor site, forehead, cheeks, Integumentary System Skin 15241 chin, mouth, neck, axillae, 0.00 0.00 4.38 Grafts genitalia,hands and/or feet; each additional 20 sq cm or part thereof Full thickness graft, free, Integumentary System Skin including direct closure of 15260 0.00 0.00 Inf Grafts donor site, nose, ears, eyelids and/ or lips; 20 sq cm or less Application of skin substitute graft to trunk, arms legs, total Integumentary System Skin 15271 wound surface area up to 100 0.02 0.00 0.00 Grafts sq cm; first 25 sq cm or less wound surface area Application of skin substitute graft to trunk, arms legs, total Integumentary System Skin 15272 wound surface area up to 100 0.00 0.00 0.00 Grafts sq cm; each additional 25 sq cm wound surface area Application of skin substitute graft to trunk, arms legs, total Integumentary System Skin wound surface area greater 15273 0.00 0.00 0.00 Grafts than or equal to 100 sq cm; first 100 sq cm or less wound surface area Application of skin substitute graft to trunk, arms legs, total wound surface area greater than or equal to 100 sq cm; Integumentary System Skin 15275 each additional 100 sq cm 0.02 0.00 0.00 Grafts wound surface area, or part thereof, or each additional 1% of body area of infants and children Integumentary System Formation of direct or tubed 15570 0.00 0.00 0.96 Flaps pedicle, with or without COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 22

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate transfer; trunk Formation of direct or tubed Integumentary System 15572 pedicle, with or without 0.00 0.00 5.99 Flaps transfer; scalp, arms, or legs Formation of direct or tubed pedicle, with or without Integumentary System 15574 transfer; forehead, cheeks, 0.01 0.00 0.66 Flaps chin, neck, axillae, genitalia, hands or feet Integumentary System Delay of flap or sectioning of 15600 0.00 0.00 4.28 Flaps flap; at trunk Integumentary System Delay of flap or sectioning of 15610 0.00 0.00 0.98 Flaps flap; at scalp, arms, or legs Delay of flap or sectioning of Integumentary System flap; at forehead, cheeks, 15620 0.01 0.01 0.59 Flaps chin, neck, axillae, genitalia, hands or feet Integumentary System Transfer, intermediate, of an 15650 0.00 0.00 Inf Flaps pedicle flap, any location Muscle, myocutaneous, or Integumentary System 15732 fasciocutaneous flap; head 0.00 0.00 0.37 Flaps and neck Integumentary System Muscle, myocutaneous, or 15734 0.00 0.00 1.84 Flaps fasciocutaneous flap; trunk Muscle, myocutaneous, or Integumentary System 15736 fasciocutaneous flap; head 0.01 0.01 0.91 Flaps and neck Muscle, myocutaneous, or Integumentary System 15738 fasciocutaneous flap; head 0.02 0.04 1.99 Flaps and neck Flap; island pedicle requiring Integumentary System identification and dissection fo 15740 0.01 0.01 1.54 Flaps an anatomically names axial vessel Integumentary System 15750 Flap; neurovascular pedicle 0.01 0.01 1.38 Flaps Free muscle or myocutaneous Integumentary System 15756 flap with microvascual 0.00 0.01 3.80 Flaps anastomosis Integumentary System Free skin flap with 15757 0.00 0.00 1.14 Flaps microvascular anastomosis Integumentary System Free fascial flap with 15758 0.00 0.00 Inf Flaps microvascular anastomosis Integumentary System Graft; composite, including 15760 0.00 0.00 0.80 Flaps primary closure, donor area Integumentary System 15770 Graft; derma-fat-fascia 0.00 0.00 Inf Flaps Implantation of biologic Integumentary System 15777 implant for soft tissue 0.00 0.00 0.00 Flaps reinforcement 20103 Other Musculoskeletal - Exploration of penetrating 0.16 0.03 0.21 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 23

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Other wound extremity Excision of epiphyseal bar, Other Musculoskeletal with or without autogenous 20150 0.00 0.00 Inf Excision soft tissue graft obtained thorugh same fascial incision Other Musculoskeletal 20200 Biopsy, muscle, superficial 0.00 0.00 1.66 Excision Other Musculoskeletal 20205 Biopsy, muscle, deep 0.01 0.02 2.79 Excision Other Musculoskeletal Biopsy, muscle, percutaneous 20206 0.00 0.00 7.97 Excision needle Other Musculoskeletal Biopsy, bone, trocar, or 20220 0.00 0.01 1.64 Excision needle; superficial Other Musculoskeletal Biopsy, bone, trocar, or 20225 0.02 0.03 1.85 Excision needle; deep Other Musculoskeletal Biopsy, bone, open; 20240 0.03 0.02 0.80 Excision superficial Other Musculoskeletal 20245 Biopsy, bone, open; deep 0.12 0.14 1.14 Excision Other Musculoskeletal Biopsy, vertebral body, open; 20250 0.00 0.00 0.24 Excision thoracic Other Musculoskeletal Biopsy, vertebral body, open; 20251 0.00 0.00 0.40 Excision cervical or lumbar Other Musculoskeletal Injection of sinus tract; 20501 0.00 0.00 Inf Introduction or Removal therapeutic Other Musculoskeletal Biopsy, bone, open; 20520 0.06 0.02 0.37 Introduction or Removal diagnostic Removal of foreign body in Other Musculoskeletal 20525 muscle or tendon sheath; 0.08 0.02 0.30 Introduction or Removal simple Removal of foreign body in Other Musculoskeletal 20526 muscle or tendon sheath; 0.03 0.04 1.20 Introduction or Removal deep or complicated Injection, enzyme (eg Other Musculoskeletal 20527 collagenase), palmar fascial 0.00 0.00 0.08 Introduction or Removal cord Injection(s); single tendon Other Musculoskeletal 20550 sheath, or ligament, 0.07 0.05 0.71 Introduction or Removal aponeurosis Other Musculoskeletal Injection(s); single tendon 20551 0.02 0.01 0.47 Introduction or Removal origin/insertion Injection(s); single or multiple Other Musculoskeletal 20552 trigger point(s), 1 or 2 0.00 0.01 5.59 Introduction or Removal muscle(s) Arthrocentesis, aspiration Other Musculoskeletal 20600 and/or injection; small joint or 0.07 0.04 0.63 Introduction or Removal bursa Arthrocentesis, aspiration Other Musculoskeletal 20605 and/or injection; intermediate 0.07 0.14 2.06 Introduction or Removal joint or bursa 20610 Other Musculoskeletal Arthrocentesis, aspiration 0.36 0.82 2.26 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 24

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Introduction or Removal and/or injection; major joint or bursa Other Musculoskeletal Aspiration and/or injection of 20612 0.00 0.01 1.23 Introduction or Removal ganglion cyst(s) any location Other Musculoskeletal Aspiration and injection for 20615 0.00 0.00 Inf Introduction or Removal treatment of bone cyst Insertion of wire or pin with Other Musculoskeletal 20650 application of skeletal traction, 0.09 0.18 1.98 Introduction or Removal including removal Application of cranial tongs, Other Musculoskeletal 20660 caliper, or stereotactic frame, 0.02 0.05 2.39 Introduction or Removal including removal Other Musculoskeletal Application of halo, including 20661 0.01 0.03 5.35 Introduction or Removal removal, cranial Removal of implant; Other Musculoskeletal 20670 superficial (eg buried wire, pin 0.19 0.18 0.94 Introduction or Removal or rod) Removal of implant; deep (eg Other Musculoskeletal 20680 buried wire, pin, screw, metal 2.34 2.41 1.03 Introduction or Removal band, nail, rod or plate) Application of uniplane (pins Other Musculoskeletal 20690 or wires in 1 plane), unilateral, 0.76 0.66 0.88 Introduction or Removal external fixation system Application of multiplane (pins or wires in more than 1 plane), Other Musculoskeletal 20692 unilateral, external fixation 0.25 0.29 1.14 Introduction or Removal system (eg Ilizarov, Monticelli type) Other Musculoskeletal Adjustment or revision of 20693 0.13 0.11 0.83 Introduction or Removal external fixation system Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation system with stereotactic computer-assisted adjustment Other Musculoskeletal 20696 (eg spatial frame), including 0.02 0.03 1.17 Introduction or Removal imaging; intiial and subsequent alignment(s), assessments and computations of adjusment schedule Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation system with stereotactic Other Musculoskeletal computer-assisted adjustment 20697 0.01 0.02 3.81 Introduction or Removal (eg spatial frame), including imaging; intiial and subsequent alignment(s), assessments and computations of adjusment COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 25

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate schedule; exchange Replantation, arm (includes Other Musculoskeletal surgical neck of humerus 20802 Repair, Revision, or 0.00 0.00 Inf through elbow joint, complete Reconstruction amputation Replantation, forearm Other Musculoskeletal (includes radius and ulna to 20805 Repair, Revision, or 0.00 0.00 Inf radial carpal joint), complete Reconstruction amputation Replantation, hand (includes Other Musculoskeletal hand through 20808 Repair, Revision, or 0.00 0.00 2.03 metacarpophalangeal joints), Reconstruction complete Replantation, digit, excluding Other Musculoskeletal thumb (includes 20816 Repair, Revision, or metacarophalangel joint to 0.00 0.01 3.62 Reconstruction insertion of flexor sublimis tendon), complete amputation Replantation, digit, excluding Other Musculoskeletal thumb (includes distal tip to 20822 Repair, Revision, or 0.00 0.01 4.57 sublimis tendon insertion), Reconstruction complete amputation Other Musculoskeletal Replantation, thumb, 20824 Repair, Revision, or 0.00 0.00 1.82 complete amputation Reconstruction Other Musculoskeletal Replantation thumb (includes 20827 Repair, Revision, or 0.00 0.00 2.27 distal tip to MP joint) Reconstruction Other Musculoskeletal Bone graft, any area; minor or 20900 Repair, Revision, or 0.12 0.09 0.72 small Reconstruction Other Musculoskeletal Bone graft, any area; major or 20902 Repair, Revision, or 0.14 0.19 1.38 large Reconstruction Other Musculoskeletal 20910 Repair, Revision, or Cartilage graft; costochondral 0.00 0.00 Inf Reconstruction Other Musculoskeletal 20922 Repair, Revision, or Fascia lata graft; by incision 0.00 0.00 Inf Reconstruction Other Musculoskeletal 20924 Repair, Revision, or Tendon graft, from a distance 0.02 0.02 1.00 Reconstruction Other Musculoskeletal 20926 Repair, Revision, or Tissue grafts, other 0.00 0.01 2.26 Reconstruction Allograft, morselized, or Other Musculoskeletal placement of osteopromotive 20930 0.43 0.15 0.35 Other Procedures material, for spine surgery only 20931 Other Musculoskeletal Allograft, structural, for spine 0.34 0.10 0.29 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 26

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Other Procedures surgery only Autograft for spine surgery Other Musculoskeletal 20936 only; local; obtained from 0.44 0.20 0.45 Other Procedures same incision Autograft for spine surgery Other Musculoskeletal 20937 only; local; obtained through 0.16 0.13 0.80 Other Procedures separate incision Autograft for spine surgery Other Musculoskeletal 20938 only; local; structural, 0.03 0.03 1.24 Other Procedures bicortical or tricortical Monitoring of interstitial fluid Other Musculoskeletal pressure in detection of 20950 0.01 0.02 2.87 Other Procedures muscle compartment syndrome Other Musculoskeletal Bone graft with microvascular 20955 0.00 0.01 7.53 Other Procedures anastomosis; fibula Other Musculoskeletal Bone graft with microvascular 20956 0.00 0.01 3.36 Other Procedures anastomosis; iliac crest Free osteocutaneous flap with Other Musculoskeletal microvascular anastomsis; 20969 0.00 0.00 1.46 Other Procedures other than iliac creast, metatarsal, or great toe Free osteocutaneous flap with Other Musculoskeletal 20970 microvascular anastomsis; 0.00 0.00 0.39 Other Procedures iliac crest Other Musculoskeletal Electrical stimulation to aid 20974 0.00 0.00 2.14 Other Procedures bone healing; noninvasive Other Musculoskeletal Electrical stimulation to aid 20975 0.00 0.01 Inf Other Procedures bone healing; invasive Ablation, bone tumor, Other Musculoskeletal 20982 radiofrequency, percutaneous, 0.00 0.00 3.15 Other Procedures including CT-guidance Computer-assisted surgical Other Musculoskeletal navigational procedure for 20985 0.14 0.03 0.22 Other Procedures musculoskeletal procedures, image-less Other Musculoskeletal 20986 0.00 0.00 Inf Other Procedures Other Musculoskeletal 20987 0.00 0.00 Inf Other Procedures Unlisted procedure, Other Musculoskeletal 20999 musculoskeletal system, 0.01 0.01 2.38 Other Procedures general Osteotomy of spine, posterior or posterolateral approach, 22206 Spine Osteotomy three columns, one vertebral 0.00 0.00 0.73 segment (eg, pedicle/vertebral body subtraction); thoracic Osteotomy of spine, posterior 22207 Spine Osteotomy or posterolateral approach, 0.01 0.00 0.35 three columns, one vertebral COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 27

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate segment (eg, pedicle/vertebral body subtraction); lumbar Osteotomy of spine, posterior or posterolateral approach, three columns, one vertebral 22208 Spine Osteotomy 0.00 0.00 1.93 segment (eg, pedicle/vertebral body subtraction); each additional vertebral segment Osteotomy of spine, posterior 22210 Spine Osteotomy or posterolateral approach, 1 0.00 0.00 13.58 vertebral segment; cervical Osteotomy of spine, posterior or posterolateral approach, 22212 Spine Osteotomy 0.01 0.01 1.13 one vertebral segment; thoracic Osteotomy of spine, posterior or posterolateral approach, 22214 Spine Osteotomy 0.02 0.03 1.45 one vertebral segment; lumbar Osteotomy of spine, posterior or posterolateral approach, 22216 Spine Osteotomy 0.02 0.04 2.51 one vertebral segment; each additional vertebral segment Osteotomy of spine, including discectomy, anterior 22220 Spine Osteotomy 0.00 0.00 5.45 approach, single vertebral segment; cervical Osteotomy of spine, including discectomy, anterior 22222 Spine Osteotomy 0.00 0.00 6.63 approach, single vertebral segment; thoracic Osteotomy of spine, including discectomy, anterior 22224 Spine Osteotomy 0.00 0.01 24.28 approach, single vertebral segment; lumbar Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; each additional 22226 Spine Osteotomy 0.00 0.00 14.33 vertebral segment (List separately in addition to code for primary procedure) Spine Fracture and/or Closed treatment of vertebral 22305 0.00 0.06 199.99 Dislocation process fracture(s) Closed treatment of vertebral Spine Fracture and/or body fracture(s), without 22310 0.00 0.14 97.96 Dislocation manipulation, requiring and including casting or bracing Spine Fracture and/or Closed treatment of vertebral 22315 0.00 0.04 13.15 Dislocation fracture(s) and/or COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 28

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate dislocation(s) requiring casting or bracing, with and including casting and/or bracing by manipulation or traction Open treatment and/or reduction of odontoid fracture Spine Fracture and/or and or dislocation, anterior 22318 0.00 0.00 4.28 Dislocation approach, including placement of internal fixation; without grafting Open treatment and/or reduction of vertebral Spine Fracture and/or fracture(s) and/or 22325 0.03 0.03 1.22 Dislocation dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar Open treatment and/or reduction of vertebral fracture(s) and/or Spine Fracture and/or 22326 dislocation(s), posterior 0.02 0.03 1.41 Dislocation approach, 1 fractured vertebra or dislocated segment; cervical Open treatment and/or reduction of vertebral fracture(s) and/or Spine Fracture and/or 22327 dislocation(s), posterior 0.03 0.03 1.27 Dislocation approach, 1 fractured vertebra or dislocated segment; thoracic Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or Spine Fracture and/or 22328 dislocated segment; each 0.01 0.02 1.94 Dislocation additional fractured vertebra or dislocated segment (List separately in addition to code for primary procedure) Arthrodesis, anterior transoral or extraoral technique, clivus- 22548 Spine Arthrodesis/ Anterior C1-C2 (atlas-axis), with or 0.00 0.00 4.71 without excision of odontoid process Arthrodesis, anterior 22551 Spine Arthrodesis/ Anterior 0.67 0.00 0.01 interbody, including disc COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 29

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate space preparation, discectomy, osteophytectomy and decompression of spinal cord and /or nerve roots; cervical below C2 Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord 22552 Spine Arthrodesis/ Anterior 0.30 0.00 0.01 and/or nerve roots; cervical below C2, each additional interspace (List separately in addition to code for separate procedure) Arthrodesis, anterior interbody technique, including minimal discectomy to prepare 22554 Spine Arthrodesis/ Anterior 0.09 0.42 4.55 interspace (other than for decompression) cervical below C2 Arthrodesis, anterior interbody technique, including minimal 22556 Spine Arthrodesis/ Anterior discectomy to prepare 0.01 0.02 2.10 interspace (other than for decompression); thoracic Arthrodesis, anterior interbody technique, including minimal 22558 Spine Arthrodesis/ Anterior discectomy to prepare 0.23 0.18 0.82 interspace (other than for decompression) lumbar Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for 22585 Spine Arthrodesis/ Anterior decompression); each 0.11 0.26 2.40 additional interspace (List separately in addition to code for primary procedure) Arthrodesis, posterior 22590 Spine Arthrodesis/ Posterior technique, craniocervical 0.01 0.01 1.67 (occiput-C2) Arthrodesis, posterior 22595 Spine Arthrodesis/ Posterior 0.01 0.02 1.91 technique, Atlas-axis (C1-C2) Arthrodesis, posterior or posterolateral technique, 22600 Spine Arthrodesis/ Posterior 0.16 0.16 0.99 single level, cervical below C- 2 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 30

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Arthodesis, posterior or posterolateral technique, 22610 Spine Arthrodesis/ Posterior single level : thoracic (with or 0.09 0.11 1.23 without lateral transverse technique ) Arthrodesis, Posterior or posterolateral technique, 22612 Spine Arthrodesis/ Posterior single level, lumbar (with or 0.59 0.69 1.17 without lateral trasverse technique) Arthrodesis, posterior or posterolateral technique, single level; each additional 22614 Spine Arthrodesis/ Posterior 0.37 0.80 2.14 vertebral segment (List separately in addition to code for primary procedure) Arthrodesis, posterior interbody technique, including laminectomy and /or 22630 Spine Arthrodesis/ Posterior discectomy to prepare 0.12 0.29 2.35 interspace (other than for decompression), single interspace: lumbar Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other 22632 Spine Arthrodesis/ Posterior 0.02 0.16 8.64 than for decompression), single interspace; each additional interspace (List separately in addition to code for primary procedure) Arthodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and /or 22633 Spine Arthrodesis/ Posterior 0.23 0.00 0.00 discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment, lumbar Arthodesis, combined posterior or posterolateral technique with posterior interbody technique including 22634 Spine Arthrodesis/ Posterior 0.03 0.00 0.00 laminectomy and /or discectomy sufficient to prepare interspace (other than for decompression), each COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 31

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate interspace and segment, lumbar Arthrodesis, posterior, for Spine Arthrodesis/ spinal deformity, with or 22800 0.01 0.04 5.04 Deformity without cast; up to 6 vertebral segments (levels) Arthrodesis, posterior, for Spine Arthrodesis/ spinal deformity, with or 22802 0.02 0.05 2.49 Deformity without cast; 7 to 12 vertebral segments (levels) Arthrodesis, posterior, for Spine Arthrodesis/ spinal deformity, with or 22804 0.01 0.02 2.00 Deformity without cast; 13 or more vertebral segments (levels) Arthrodesis, anterior, for Spine Arthrodesis/ spinal deformity, with or 22808 0.00 0.02 4.87 Deformity without cast; 4 to 7 vertebral segments (levels) Arthrodesis, anterior, for Spine Arthrodesis/ spinal deformity, with or 22810 0.00 0.01 31.01 Deformity without cast; 4 to 7 vertebral segments Arthrodesis, anterior, for Spine Arthrodesis/ spinal deformity, with or 22812 0.00 0.00 3.24 Deformity without cast; 8 or more vertebral segments (levels) Kyphectomy, circumferential exposure of spine and Spine Arthrodesis/ 22818 resection of vertebral 0.00 0.00 0.30 Deformity segments; single or 2 segments Kyphectomy, circumferential exposure of spine and Spine Arthrodesis/ 22819 resection of vertebral 0.00 0.00 Inf Deformity segments; 3 or more segments Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across one 22840 Spine Instrumentation 0.47 0.20 0.43 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) Internal spinal fixation by 22841 Spine Instrumentation 0.00 0.01 1.87 wiring of spinous processes Posterior segmental instrumentation (eg, pedicle 22842 Spine Instrumentation fixation, dual rods with 0.47 0.54 1.14 multiple hooks and sublaminar wires); 3 to 6 vertebral COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 32

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate segments Posterior segmental instrumentation (eg, pedicle fixation, dual rods with 22843 Spine Instrumentation 0.08 0.10 1.28 multiple hooks and sublaminar wires); 7 to 12 vertebral segments Posterior segmental instrumentation (eg, pedicle fixation, dual rods with 22844 Spine Instrumentation 0.01 0.03 2.07 multiple hooks and sublaminar wires); 13 or more vertebral segments Anterior instrumentation; 2 to 22845 Spine Instrumentation 0.67 0.30 0.45 3 vertebral segments Anterior instrumentation; 4 to 22846 Spine Instrumentation 0.09 0.04 0.38 7 vertebral segments Anterior instrumentation; 8 or 22847 Spine Instrumentation 0.00 0.00 2.41 more vertebral segments Pelvic fixation (attachment of caudal end of instrumentation 22848 Spine Instrumentation 0.03 0.04 1.19 to pelvic bony structures) other than sacrum Reinsertion of spinal fixation 22849 Spine Instrumentation 0.03 0.02 0.90 device Removal of posterior non- 22850 Spine Instrumentation 0.02 0.02 1.07 segmental instrumentation Application of intervertebral biomechanical device(s) (eg, 22851 Spine Instrumentation synthetic cage[s], 0.74 0.32 0.43 methylmethacrylate) to vertebral defect or interspace. Removal of posterior 22852 Spine Instrumentation 0.04 0.11 2.75 segmental instrumentation Removal of anterior 22855 Spine Instrumentation 0.02 0.02 0.98 instrumentation Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation 22856 Spine Instrumentation 0.02 0.01 0.42 (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical Total disc arthroplasty (artificial disc), anterior 22857 Spine Instrumentation approach, including 0.00 0.01 1.97 discectomy with end plate preparation COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 33

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, lumbar Revision including replacement of total disc arthroplasty (artificial disc), 22861 Spine Instrumentation 0.00 0.00 Inf anterior approach, single interspace; cervical Removal of total disc arthroplasty (artificial disc), 22864 Spine Instrumentation anterior approach, single 0.00 0.00 0.86 interspace; cervical Removal of subdeltoid 23000 Shoulder Incision 0.00 0.00 0.98 calcareous deposits, open 23020 Shoulder Incision Capsular contracture release 0.02 0.01 0.97 Incision and drainage, 23030 Shoulder Incision shoulder area; deep abscess 0.04 0.06 1.23 or hematoma Incision and drainage, 23031 Shoulder Incision 0.00 0.01 2.04 shoulder area; infected bursa Incision, bone cortex, 23035 Shoulder Incision 0.01 0.01 1.38 shoulder area Arthrotomy, glemohumeral joint, including exploration, 23040 Shoulder Incision 0.04 0.03 0.77 drainage, or removal of foreign body Arthorotomy, acromioclavicular, sternoclavicular joint, 23044 Shoulder Incision 0.01 0.01 0.67 including exploration, drainage, or removal of foreign body Biopsy, soft tissue of shoulder 23065 Shoulder Excision 0.00 0.00 4.46 area; superficial Biopsy, soft tissue of shoulder 23066 Shoulder Excision 0.00 0.02 5.63 area; deep Excision, tumor, soft tissue of 23071 Shoulder Excision shoulder area, subcutaneous; 0.01 0.00 0.03 3 cm or greater Excision, tumor, soft tissue of 23073 Shoulder Excision shoulder area, subfascial; 0.01 0.00 0.09 5cm or greater Excision, tumor, soft tissue of 23075 Shoulder Excision shoulder area, subcutaneous; 0.01 0.02 3.73 less than 3 cm Excision, tumor, soft tissue of 23076 Shoulder Excision 0.01 0.04 5.26 shoulder area, subfascial; less COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 34

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate than 5 cm Radical resection of tumor, 23077 Shoulder Excision soft tissue of shoulder area; 0.00 0.01 7.77 less than 5 cm Radical resection of tumor, 23078 Shoulder Excision soft tissue of shoulder area; 5 0.00 0.00 0.07 cm or greater Arthrotomy, glemohumeral 23100 Shoulder Excision 0.00 0.00 1.50 joint, including biopsy Arthrotomy, acromioclavicular joint or sternoclavicular joint, 23101 Shoulder Excision 0.00 0.01 1.77 including biopsu and/or excision of torn cartilage Arthrotomy; glenojumeral 23105 Shoulder Excision joint, with synovectomy, with 0.00 0.00 2.41 or without biopsy Arthrotomy; sternoclavicular 23106 Shoulder Excision joint, with synovectomy, with 0.00 0.00 1.98 or without biopsy Arthrotomy, glenohumeral joint, with joint exploration, 23107 Shoulder Excision 0.00 0.01 1.40 with or without removal of loose or foreign body 23120 Shoulder Excision Claviculectomy; partial 0.22 0.13 0.60 23125 Shoulder Excision Claviculectomy; total 0.00 0.00 1.02 Acromioplasty or acromionectomy, partial, with 23130 Shoulder Excision 0.03 0.14 4.93 or without coracoacromial ligament release Excision or curettage of bone 23140 Shoulder Excision cyst or benign tumor of 0.00 0.01 3.67 clavicle or scapula Excision or curettage of bone cyst or benign tumor of 23145 Shoulder Excision clavicle or scapula; with 0.00 0.00 0.64 autograft (includes obtaining graft) Excision or curettage of bone cyst or benign tumor of 23146 Shoulder Excision 0.00 0.00 5.45 clavicle or scapula; with allograft Excision or curettage of bone 23150 Shoulder Excision cyst or benign tumor of 0.01 0.01 1.98 proximal humerus; Excision or curettage of bone cyst or benign tumor of 23155 Shoulder Excision proximal humerus; with 0.00 0.00 4.28 autograft (includes obtaining graft) Excision or curettage of bone 23156 Shoulder Excision 0.00 0.01 3.66 cyst or benign tumor of COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 35

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate proximal humerus; with allograft Sequestrectomy (eg, for 23170 Shoulder Excision osteomyelitis or bone 0.00 0.00 0.82 abscess), clavicle Sequestrectomy (eg, for 23172 Shoulder Excision osteomyelitis or bone 0.00 0.00 0.64 abscess), scapula Sequestrectomy (eg, for osteomyelitis or bone 23174 Shoulder Excision 0.00 0.00 0.60 abscess), humeral head to surgical neck Partial excision (craterization, saucerization, or 23180 Shoulder Excision 0.01 0.04 3.66 diaphysectomy) bone (eg, osteomyelitis), clavicle Partial excision (craterization, saucerization, or 23182 Shoulder Excision 0.00 0.00 2.17 diaphysectomy) bone (eg, osteomyelitis), scapula Partial excision (craterization, saucerization, or 23184 Shoulder Excision diaphysectomy) bone (eg, 0.00 0.00 1.29 osteomyelitis), proximal humerus Ostectomy of scapula, partial 23190 Shoulder Excision 0.00 0.00 3.40 (eg, superior medial angle) 23195 Shoulder Excision Resection, humeral head 0.00 0.00 1.39 Radical resection of tumor; 23200 Shoulder Excision 0.00 0.00 1.75 clavicle Radical resection of tumor; 23210 Shoulder Excision 0.00 0.01 5.12 scapula Radical resection of tumor; 23220 Shoulder Excision 0.01 0.01 1.11 proximal humerus Shoulder Repair Revision Muscle transfer, any type, 23395 0.01 0.02 3.19 and/or Reconstruction shoulder or upper arn; single Shoulder Repair Revision 23397 multiple 0.00 0.01 2.33 and/or Reconstruction Shoulder Repair Revision 23400 Scapulopexy 0.00 0.00 3.42 and/or Reconstruction Shoulder Repair Revision Tenotomy, shoulder area, 23405 0.15 0.10 0.65 and/or Reconstruction single tendon Shoulder Repair Revision multiple tendons through 23406 0.00 0.01 6.49 and/or Reconstruction same incision Repair of ruptured Shoulder Repair Revision 23410 musculoteninous cuff, open; 0.11 0.19 1.68 and/or Reconstruction acute Shoulder Repair Revision 23412 chronic 0.15 0.32 2.07 and/or Reconstruction Shoulder Repair Revision Coracoacromial ligament 23415 0.00 0.01 1.89 and/or Reconstruction release, with or without COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 36

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate acromioplasty Reconstruction of complete Shoulder Repair Revision shoulder (rotator) cuff 23420 0.04 0.05 1.35 and/or Reconstruction avulsion, chronic (includes acromioplasty) Shoulder Repair Revision Tenodesis of long tendon of 23430 0.91 0.32 0.35 and/or Reconstruction biceps Shoulder Repair Revision Resection or transplantation 23440 0.06 0.06 1.01 and/or Reconstruction of long tendon of biceps Capsulorrhaphy, anterior; Shoulder Repair Revision 23450 Putti-Platt procedure or 0.00 0.01 1.63 and/or Reconstruction Magnuson type operation Shoulder Repair Revision 23455 with labral repair 0.04 0.22 5.06 and/or Reconstruction Shoulder Repair Revision Capsulorrhaphy, anterior, any 23460 0.01 0.01 1.04 and/or Reconstruction type; with bone block Shoulder Repair Revision with coracoid process 23462 0.02 0.03 1.08 and/or Reconstruction transfer] Capsulorrhaphy, Shoulder Repair Revision 23465 glenohumeral joint, posterior, 0.01 0.02 2.94 and/or Reconstruction with or without bone block Capsulorrhaphy, Shoulder Repair Revision 23466 glenohumeral joint, any type 0.01 0.02 2.51 and/or Reconstruction multi-directional instability Shoulder Repair Revision Arthroplasty, glenohumeral 23470 0.10 0.24 2.47 and/or Reconstruction joint; hemiarthroplasty Arthroplasty, glenohumeral Shoulder Repair Revision joint; total shoulder (glenoid 23472 0.61 0.66 1.08 and/or Reconstruction and proximal humeral replacement) Revison of total shoulder Shoulder Repair Revision arthoplasty, including allograft 23473 0.01 0.00 0.00 and/or Reconstruction when performed, humeral or glenoid component Revision of total shoulder arthroplasty, including Shoulder Repair Revision 23474 allograft when performed; 0.01 0.00 0.00 and/or Reconstruction humeral and glenoid component Shoulder Repair Revision Osteotomy, clavicle, with or 23480 0.00 0.03 6.23 and/or Reconstruction without internal fixation with bone graft for Shoulder Repair Revision nonunion or malunion 23485 0.02 0.03 1.44 and/or Reconstruction (includes obtaining graft and/or necessary fixation) Prophylactic treatment Shoulder Repair Revision (nailing, pinning,plating, or 23490 0.00 0.01 9.41 and/or Reconstruction wiring_ with or without methylmethacrylate; clavicle Shoulder Repair Revision 23491 Proximal humerus 0.00 0.01 1.94 and/or Reconstruction COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 37

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Open treatment of clavicular Shoulder Fracture and/or 23515 fracture, includes internal 0.60 0.33 0.56 Dislocation fixation, when performe Open treatment of Shoulder Fracture and/or 23530 sternoclavicular dislocation, 0.00 0.01 2.41 Dislocation acute or chronic; Open treatment of Shoulder Fracture and/or sternoclavicular dislocation, 23532 0.00 0.00 1.22 Dislocation acute or chronic; with fascial graft (includes obtaining graft) Open treatment of Shoulder Fracture and/or 23550 acromioclavicular dislocation, 0.06 0.06 0.89 Dislocation acute or chronic; Open treatment of Shoulder Fracture and/or acromioclavicular dislocation, 23552 0.04 0.04 0.99 Dislocation acute or chronic; with fascial graft (includes obtaining graft) Open treatment of scapular Shoulder Fracture and/or fracture (body, glenoid or 23585 0.04 0.05 1.31 Dislocation acromion) includes internal fixation, when performed Open treatment of proximal humeral (surgical or anatomical neck) fracture, Shoulder Fracture and/or 23615 includes internal fixation, 0.46 0.34 0.73 Dislocation when performed, includes repair of tuberosity(s), when performed Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, Shoulder Fracture and/or 23616 when performed, includes 0.08 0.08 1.00 Dislocation repair of tuberosity(s), when performed; with proximal humeral prosthetic replacement Open treatment of greater Shoulder Fracture and/or humeral tuberosity fracture, 23630 0.06 0.05 0.74 Dislocation includes internal fixation, when performed Shoulder Fracture and/or Open treatment of acute 23660 0.01 0.01 1.54 Dislocation shoulder dislocation Closed treatment of shoulder dislocation, with fracture of Shoulder Fracture and/or 23665 greater humeral tuberosity, 0.01 0.03 3.64 Dislocation includes internal fixation, when performed Open treatment of shoulder Shoulder Fracture and/or 23670 dislocation, with fracture of 0.02 0.01 0.69 Dislocation greater humeral tuberosity, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 38

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate includes internal fixation, when performed Open treatment of shoulder dislocation, with surgical or Shoulder Fracture and/or 23680 anatomical neck fracture, 0.01 0.01 1.13 Dislocation includes internal fixation, when performed Manipulation under anesthesia, shoulder joint, 23700 Shoulder Manipulation including application of 0.10 0.10 0.98 fixation apparatus (dislocation excluded) 23929 Shoulder Arthroscopy unlisted procedure, shoulder 0.01 0.06 7.32 Incision and drainage, upper 23930 Humerus/Elbow Incision arm or elbow area; deep 0.06 0.07 1.11 abscess or hematoma Incision and drainage, upper 23931 Humerus/Elbow Incision 0.04 0.04 0.83 arm or elbow area; bursa Incision, deep, with opening of 23935 Humerus/Elbow Incision bone cortex, humerus or 0.01 0.02 1.63 elbow Arthrotomy, elbow, including 24000 Humerus/Elbow Incision exploration, drainage, or 0.05 0.05 0.92 removal of foreign body Arthrotomy of the elbow, with 24006 Humerus/Elbow Incision capsular excision for capsular 0.02 0.03 1.58 release Biopsy, soft tissue of upper 24065 Humerus/Elbow Excision 0.00 0.00 2.05 arm or elbow area; superficial Biopsy, soft tissue of upper 24066 Humerus/Elbow Excision arm or elbow area; deep 0.01 0.02 2.74 (subfascial or intramuscular) Excision, tumor, soft tissue of upper arm or elbow area, 24071 Humerus/Elbow Excision 0.01 0.00 0.02 subcutaneous; 3 cm or greater Excision, tumor, soft tissue of upper arm or elbow area, 24073 Humerus/Elbow Excision 0.01 0.00 0.05 subfascial (eg, intramuscular); 5 cm or greater Excision, tumor, soft tissue of 24075 Humerus/Elbow Excision upper arm or elbow area, 0.03 0.02 0.85 subcutaneous; less than 3 cm Excision, tumor, soft tissue of upper arm or elbow area, 24076 Humerus/Elbow Excision 0.02 0.04 2.73 subfascial (eg, intramuscular); less than 5 cm Radical resection of tumor (eg, sarcoma), soft tissue of 24077 Humerus/Elbow Excision 0.00 0.01 8.06 upper arm or elbow area; less than 5 cm COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 39

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Radical resection of tumor (eg, sarcoma), soft tissue of 24079 Humerus/Elbow Excision 0.00 0.00 0.09 upper arm or elbow area; 5 cm or greater Arthrotomy, elbow; with 24100 Humerus/Elbow Excision 0.00 0.00 0.64 synovial biopsy only Arthrotomy, elbow; with joint exploration, with or without 24101 Humerus/Elbow Excision biopsy, with or without 0.03 0.03 0.98 removal of loose or foreign body Arthrotomy, elbow; with 24102 Humerus/Elbow Excision 0.01 0.01 1.98 synovectomy 24105 Humerus/Elbow Excision Excision, olecranon bursa 0.16 0.06 0.39 Excision or curettage of bone 24110 Humerus/Elbow Excision cyst or benign tumor, 0.00 0.02 4.02 humerus; Excision or curettage of bone cyst or benign tumor, 24115 Humerus/Elbow Excision 0.00 0.00 Inf humerus; with autograft (includes obtaining graft) Excision or curettage of bone 24116 Humerus/Elbow Excision cyst or benign tumor, 0.00 0.01 5.61 humerus; with allog Excision or curettage of bone cyst or benign tumor of head 24120 Humerus/Elbow Excision 0.02 0.01 0.45 or neck of radius or olecranon process; Excision or curettage of bone cyst or benign tumor of head 24125 Humerus/Elbow Excision or neck of radius or olecranon 0.00 0.00 Inf process; with autograft (includes obtaining graft) Excision or curettage of bone cyst or benign tumor of head 24126 Humerus/Elbow Excision 0.00 0.00 2.73 or neck of radius or olecranon process; with allograft 24130 Humerus/Elbow Excision Excision, radial head 0.01 0.02 2.32 Sequestrectomy (eg, for osteomyelitis or bone 24134 Humerus/Elbow Excision 0.00 0.00 0.67 abscess), shaft or distal humerus Sequestrectomy (eg, for 24138 Humerus/Elbow Excision osteomyelitis or bone 0.00 0.00 0.41 abscess), radial head or neck Sequestrectomy (eg, for 24140 Humerus/Elbow Excision osteomyelitis or bone 0.01 0.01 2.31 abscess), olecranon process Partial excision (craterization, 24145 Humerus/Elbow Excision saucerization, or 0.00 0.00 5.40 diaphysectomy) bone (eg, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 40

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate osteomyelitis), humerus Partial excision (craterization, saucerization, or 24147 Humerus/Elbow Excision diaphysectomy) bone (eg, 0.02 0.01 0.69 osteomyelitis), radial head or neck Partial excision (craterization, saucerization, or 24149 Humerus/Elbow Excision diaphysectomy) bone (eg, 0.02 0.05 2.03 osteomyelitis), olecranon process Radical resection of capsule, soft tissue, and heterotopic 24150 Humerus/Elbow Excision 0.00 0.01 2.21 bone, elbow, with contracture release (separate procedure) Radical resection of tumor, 24151 Humerus/Elbow Excision 0.00 0.00 Inf shaft or distal humerus Radical resection of tumor, 24152 Humerus/Elbow Excision 0.00 0.00 1.18 radial head or neck Resection of elbow joint 24155 Humerus/Elbow Excision 0.00 0.00 5.45 (arthrectomy) Humerus/ Elbow Repair, Manipulation; elbow; under 24300 Revision and/or 0.04 0.04 0.98 anesthesia Reconstruction Humerus/ Elbow Repair, Muscle or tendon transfer, any 24301 Revision and/or type, upper arm or elbow, 0.01 0.01 1.26 Reconstruction single Humerus/ Elbow Repair, Tendon lengthening, upper 24305 Revision and/or 0.01 0.02 1.10 arm or elbow, single, each Reconstruction Humerus/ Elbow Repair, Tenotomy, open elbow to 24310 Revision and/or 0.00 0.00 1.00 shoulder, single, each Reconstruction Tenoplasty, with muscle Humerus/ Elbow Repair, transfer, with or without free 24320 Revision and/or graft, elbow to shoulder, 0.00 0.00 2.03 Reconstruction single (Seddon‐ Brookes type procedure) Humerus/ Elbow Repair, Flexor‐plasty, elbow, (eg, 24330 Revision and/or 0.00 0.00 2.22 Steindler type advancement) Reconstruction Humerus/ Elbow Repair, with extensor 24331 Revision and/or 0.00 0.00 Inf advancement Reconstruction Humerus/ Elbow Repair, 24332 Revision and/or Tenolysis, triceps 0.00 0.00 2.22 Reconstruction Humerus/ Elbow Repair, Tenodesis of biceps tendon at 24340 Revision and/or 0.02 0.02 0.97 elbow, separate procedure Reconstruction 24341 Humerus/ Elbow Repair, Repair, tendon or muscle, 0.11 0.07 0.60 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 41

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Revision and/or upper arm or elbow, each Reconstruction tendon or muscle, primary or secondary (excludes rotator cuff) Reinsertion of ruptured biceps Humerus/ Elbow Repair, tendon, distal, with or without 24342 Revision and/or 0.37 0.14 0.38 tendon graft (includes Reconstruction obtaining graft) Humerus/ Elbow Repair, Repair lateral collateral 24343 Revision and/or ligament, elbow, with local 0.13 0.08 0.63 Reconstruction tissue Humerus/ Elbow Repair, Repair lateral collateral 24344 Revision and/or ligament, elbow, with tendon 0.01 0.02 1.62 Reconstruction graft, including graft harvest Humerus/ Elbow Repair, Repair medial collateral 24345 Revision and/or ligament, elbow, with local 0.02 0.02 1.11 Reconstruction tissue Humerus/ Elbow Repair, Repair medial collateral 24346 Revision and/or ligament, elbow, with tendon 0.01 0.03 2.34 Reconstruction graft, including graft harvest Humerus/ Elbow Repair, Percutaneous medial or 24350 Revision and/or 0.00 0.01 Inf lateral epicondyle tenotomy Reconstruction Humerus/ Elbow Repair, debridement,soft tissue 24351 Revision and/or 0.00 0.01 Inf and/or bone, open Reconstruction Humerus/ Elbow Repair, Arthroplasty, elbow, with 24354 Revision and/or 0.00 0.00 Inf membrane or fascia Reconstruction Humerus/ Elbow Repair, Arthroplasty, elbow, with distal 24356 Revision and/or humeral prosthetic 0.00 0.01 Inf Reconstruction replacement Humerus/ Elbow Repair, Arthroplasty, elbow, with 24357 Revision and/or implant and fascia lata 0.01 0.01 1.14 Reconstruction ligament reconstruction Arthroplasty, elbow, with distal Humerus/ Elbow Repair, humeral and proximal ulnar 24358 Revision and/or 0.08 0.05 0.61 prosthetic replacement; total Reconstruction elbow Humerus/ Elbow Repair, 24359 Revision and/or Arthroplasty, radial head 0.08 0.04 0.51 Reconstruction Humerus/ Elbow Repair, 24360 Revision and/or with implant 0.00 0.00 2.37 Reconstruction Revision of total elbow Humerus/ Elbow Repair, arthroplasty, including 24361 Revision and/or 0.00 0.00 2.76 allograft when performed; Reconstruction humeral OR ulnar component Humerus/ Elbow Repair, humeral AND ulnar 24362 0.00 0.00 Inf Revision and/or component COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 42

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Reconstruction Humerus/ Elbow Repair, Osteotomy, humerus, with or 24363 Revision and/or 0.02 0.06 2.49 without internal fixation Reconstruction Multiple osteotomies with Humerus/ Elbow Repair, realignment on intramedullary 24365 Revision and/or 0.01 0.01 1.61 rod, humeral shaft (Sofield Reconstruction type procedure) Humerus/ Elbow Repair, 24366 Revision and/or Osteoplasty, humerus 0.03 0.05 1.46 Reconstruction Humerus/ Elbow Repair, Repair of nonunion or 24400 Revision and/or malunion, humerus; without 0.01 0.01 1.47 Reconstruction graft Humerus/ Elbow Repair, with iliac or other autograft 24410 Revision and/or 0.00 0.00 0.64 (includes obtaining graft) Reconstruction Humerus/ Elbow Repair, 24420 Revision and/or Hemiepiphyseal arrest 0.00 0.00 1.93 Reconstruction Humerus/ Elbow Repair, Decompression fasciotomy, 24430 Revision and/or forearm, with brachial artery 0.03 0.03 1.05 Reconstruction exploration Prophylactic treatment Humerus/ Elbow Repair, (nailing, plating, pinnig, or 24435 Revision and/or wiring), with or without 0.02 0.03 1.39 Reconstruction methylmethacrylate, humeral shaft Humerus/ Elbow Repair, Hemiepiphyseal arrest (eg, for 24470 Revision and/or cubitus varus or valgus, distal 0.00 0.00 Inf Reconstruction humerus). Humerus/ Elbow Repair, Decompression fasciotomy, 24495 Revision and/or forearm, with brachial artery 0.00 0.00 0.86 Reconstruction exploration. Prophylactic treatment Humerus/ Elbow Repair, (nailing, pinning, plating or 24498 Revision and/or 0.00 0.01 2.86 wiring), with or without Reconstruction methylmethacrylate, humerus. Open treatment of humeral Humerus/ Elbow Fracture shaft fracture with 24515 0.24 0.33 1.38 and/or Dislocation plate/screws, with or without cerclage. Open treatment of humeral shaft fracture, with insertion of Humerus/ Elbow Fracture 24516 intramedullary implant, with or 0.06 0.09 1.54 and/or Dislocation without cerclage and/or locking screws. Percutaneous skeletal fixation Humerus/ Elbow Fracture of supracondylar or 24538 0.00 0.04 41.14 and/or Dislocation transcondylar humeral fracture, with or without COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 43

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate intercondylar extension. Open treatment of humeral supracondylar or Humerus/ Elbow Fracture transcondylar fracture, with or 24545 0.09 0.07 0.78 and/or Dislocation without internal or external fixation; without intercondylar extension. Open treatment of humeral supracondylar or Humerus/ Elbow Fracture transcondylar fracture, with or 24546 0.09 0.15 1.61 and/or Dislocation without internal or external fixation; with intercondylar extension. Percutaneous skeletal fixation Humerus/ Elbow Fracture of humeral epicondylar 24566 0.00 0.00 6.74 and/or Dislocation fracture, medial or lateral, with manipulation. Open treatment of humeral Humerus/ Elbow Fracture epicondylar fracture, medial or 24575 0.02 0.02 1.31 and/or Dislocation lateral, with or without internal or external fixation. Open treatment of humeral Humerus/ Elbow Fracture condylar fracture, medial or 24579 0.05 0.05 1.17 and/or Dislocation lateral, with or without internal or external fixation. Percutaneous skeletal fixation Humerus/ Elbow Fracture of humeral condylar fracture, 24582 0.00 0.00 3.80 and/or Dislocation medial or lateral, with manipulation. Open treatment of periarticular fracture and/or Humerus/ Elbow Fracture dislocation of the elbow 24586 0.04 0.07 2.03 and/or Dislocation (fracture distal humerus and proximal ulna and/ or proximal radius);. Open treatment of periarticular fracture and/or dislocation of the elbow Humerus/ Elbow Fracture 24587 (fracture distal humerus and 0.00 0.01 3.59 and/or Dislocation proximal ulna and/ or proximal radius); with implant arthroplasty. Treatment of closed elbow Humerus/ Elbow Fracture 24605 dislocation; requiring 0.03 0.07 2.13 and/or Dislocation anesthesia. Humerus/ Elbow Fracture Open treatment of acute or 24615 0.03 0.04 1.20 and/or Dislocation chronic elbow dislocation. Open treatment of Monteggia Humerus/ Elbow Fracture type of fracture dislocation at 24635 0.05 0.07 1.20 and/or Dislocation elbow (fracture proximal end of ulna with dislocation of COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 44

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate radial head), with or without internal or external fixation. Open treatment of radial head Humerus/ Elbow Fracture or neck fracture, with or 24665 0.10 0.07 0.73 and/or Dislocation without internal fixation or radial head excision;. Open treatment of radial head or neck fracture, with or Humerus/ Elbow Fracture without internal fixation or 24666 0.13 0.07 0.54 and/or Dislocation radial head excision; with radial head prosthetic replacement. Open treatment of ulnar fracture proximal end Humerus/ Elbow Fracture 24685 (olecranon process), with or 0.45 0.38 0.85 and/or Dislocation without internal or external fixation. Tendon sheath incision; at 25000 Forearm/Wrist Incision radial styloid (eg, for 0.31 0.17 0.54 deQuervain's disease). Incision, flexor tendon sheath, 25001 Forearm/Wrist Incision 0.00 0.01 1.52 wrist ( eg, flexor carpi radialis Decompression fasciotomy, forearm and/or wrist; flexor or extensor compartment; 25020 Forearm/Wrist Incision 0.03 0.03 1.09 without debridement of nonviable muscle and/or nerve Decompression fasciotomy, forearm and/or wrist; with 25023 Forearm/Wrist Incision 0.01 0.02 1.45 debridement of nonviable muscle and/or nerve. Decompression fasciotomy, forearm and/or wrist, flexor AND extensor compartment; 25024 Forearm/Wrist Incision 0.01 0.02 1.61 without debridement of nonviable muscle and/or nerve Decompression fasciotomy, forearm and/or wrist, flexor 25025 Forearm/Wrist Incision AND extensor compartment; 0.01 0.02 1.66 with debridement of nonviable muscle and/or nerve Incision and drainage, forearm 25028 Forearm/Wrist Incision and/or wrist; deep abscess or 0.11 0.10 0.90 hematoma. Incision and drainage, forearm 25031 Forearm/Wrist Incision 0.01 0.02 2.86 and/or wrist; infected bursa. Incision, deep, with opening of 25035 Forearm/Wrist Incision bone cortex (eg, for 0.01 0.01 1.23 osteomyelitis or bone COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 45

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate abscess), forearm and/or wrist. Arthrotomy, radiocarpal or midcarpal joint, with 25040 Forearm/Wrist Incision 0.04 0.01 0.39 exploration, drainage, or removal of foreign body. Biopsy, soft tissue of forearm 25065 Forearm/Wrist Excision 0.00 0.01 1.61 and/or wrist; superficial Biopsy, soft tissue of forearm 25066 Forearm/Wrist Excision and/or wrist; deep (subfascial 0.01 0.02 2.99 or intramuscular) Excision, tumor, soft tissue of forearm and/or wrist area, 25071 Forearm/Wrist Excision 0.01 0.00 0.02 subcutaneous; 3 cm or greater Excision, tumor, soft tissue of forearm and/or wrist area, 25073 Forearm/Wrist Excision 0.01 0.00 0.04 subfascial (eg, intramuscular); 3 cm or greater Excision, tumor, soft tissue of 25075 Forearm/Wrist Excision forearm and/or wrist area, 0.03 0.03 0.97 subcutaneous; less than 3 cm Excision, tumor, soft tissue of forearm and/or wrist area, 25076 Forearm/Wrist Excision 0.03 0.05 1.72 subfascial (eg, intramuscular); less than 3 cm Radical resection of tumor (eg, sarcoma), soft tissue of 25077 Forearm/Wrist Excision 0.00 0.01 6.27 forearm and/or wrist area; less than 3 cm Capsulotomy, wrist (eg, 25085 Forearm/Wrist Excision 0.00 0.00 1.13 contracture) Arthrotomy, wrist joint; with 25100 Forearm/Wrist Excision 0.00 0.00 1.16 biopsy Arthrotomy, wrist joint; with joint exploration, with or 25101 Forearm/Wrist Excision without biopsy, with or without 0.02 0.01 0.64 removal of loose or foreign body Arthrotomy, wrist joint; with 25105 Forearm/Wrist Excision 0.01 0.01 0.97 synovectomy Arthrotomy, distal radioulnar 25107 Forearm/Wrist Excision joint including repair of 0.02 0.01 0.51 triangular cartilage, complex Excision of tendon, forearm 25109 Forearm/Wrist Excision and/or wrist, floexor or 0.00 0.00 0.26 extensor, each Excision, lesion of tendon 25110 Forearm/Wrist Excision 0.01 0.01 0.69 sheath, forearm and/or wrist Excision of ganglion, wrist 25111 Forearm/Wrist Excision 0.53 0.29 0.54 (dorsal or volar); primary COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 46

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Excision of ganglion, wrist 25112 Forearm/Wrist Excision 0.03 0.03 0.83 (dorsal or volar); recurrent Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, 25115 Forearm/Wrist Excision 0.03 0.02 0.49 tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); flexor Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or 25116 Forearm/Wrist Excision 0.02 0.01 0.49 other granulomas, rheumatoid arthritis); extensors, with or without transposition of dorsal retinaculum Synovectomy, extensor 25118 Forearm/Wrist Excision tendon sheath, wrist, single 0.05 0.03 0.62 compartment; Synovectomy, extensor tendon sheath, wrist, single 25119 Forearm/Wrist Excision 0.00 0.00 8.02 compartment; with resection of distal ulna Excision or curettage of bone cyst or benign tumor of radius 25120 Forearm/Wrist Excision or ulna (excluding head or 0.01 0.01 1.97 neck of radius and olecranon process); Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or 25125 Forearm/Wrist Excision 0.00 0.00 5.56 neck of radius and olecranon process); with autograft (includes obtaining graft) Excision or curettage of bone cyst or benign tumor of radius 25126 Forearm/Wrist Excision or ulna (excluding head or 0.00 0.01 2.63 neck of radius and olecranon process); with allograft Excision or curettage of bone 25130 Forearm/Wrist Excision cyst or benign tumor of carpal 0.02 0.01 0.63 bones; Excision or curettage of bone cyst or benign tumor of carpal 25135 Forearm/Wrist Excision 0.00 0.00 1.48 bones; with autograft (includes obtaining graft) Excision or curettage of bone 25136 Forearm/Wrist Excision cyst or benign tumor of carpal 0.00 0.00 4.17 bones; with allograft Sequestrectomy (eg, for 25145 Forearm/Wrist Excision 0.00 0.00 1.18 osteomyelitis or bone COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 47

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate abscess), forearm and/or wrist Partial excision (craterization, saucerization, or 25150 Forearm/Wrist Excision 0.00 0.01 1.75 diaphysectomy) of bone (eg, for osteomyelitis); ulna Partial excision (craterization, saucerization, or 25151 Forearm/Wrist Excision 0.01 0.00 0.62 diaphysectomy) of bone (eg, for osteomyelitis); radius Radical resection of tumor, 25170 Forearm/Wrist Excision 0.00 0.01 2.63 radius or ulna 25210 Forearm/Wrist Excision Carpectomy; 1 bone 0.07 0.05 0.71 Carpectomy; all bones of 25215 Forearm/Wrist Excision 0.04 0.05 1.52 proximal row Radial styloidectomy 25230 Forearm/Wrist Excision 0.02 0.01 0.90 (separate procedure) Excision distal ulna partial or 25240 Forearm/Wrist Excision complete (eg, Darrach type or 0.02 0.03 1.50 matched resection) Repair, tendon or muscle, Forearm/ Wrist Repair, flexor, forearm and/or wrist; 25260 Revision and/or 0.09 0.19 2.16 primary, single, each tendon Reconstruction or muscle Forearm/ Wrist Repair, secondary, single, each 25263 Revision and/or 0.00 0.01 2.96 tendon or muscle Reconstruction Forearm/ Wrist Repair, secondary, with free graft 25265 Revision and/or 0.00 0.00 1.91 (includes obtaining Reconstruction Repair, tendon or muscle, Forearm/ Wrist Repair, extensor, forearm and/or 25270 Revision and/or 0.06 0.10 1.62 wrist; primary, single, each Reconstruction tendon or muscle Forearm/ Wrist Repair, secondary, single, each 25272 Revision and/or 0.01 0.01 1.06 tendon or muscle Reconstruction Forearm/ Wrist Repair, secondary, with free graft 25274 Revision and/or 0.00 0.00 1.24 (includes obtaining Reconstruction Repair, tendon sheath, Forearm/ Wrist Repair, extensor, forearm and or 25275 Revision and/or 0.01 0.01 0.75 wrist, with free graft includes Reconstruction graft harvest Lengthening or shortening of Forearm/ Wrist Repair, flexor or extensor tendon, 25280 Revision and/or 0.02 0.02 1.08 forearm and/or wrist, single, Reconstruction each tendon Tenotomy, open flexor or Forearm/ Wrist Repair, extensor tendon, forearm 25290 Revision and/or 0.05 0.02 0.44 and/or wrist, single, each Reconstruction tendon COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 48

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Forearm/ Wrist Repair, Tenolysis, flexor or extensor 25295 Revision and/or tendon, forearm and/or wrist, 0.02 0.05 2.08 Reconstruction single, each tendon Forearm/ Wrist Repair, Tenodesis at wrist; flexors of 25300 Revision and/or 0.00 0.00 1.90 fingers Reconstruction Forearm/ Wrist Repair, 25301 Revision and/or extensors of fingers 0.00 0.00 1.82 Reconstruction Tendon transplantation or Forearm/ Wrist Repair, transfer, flexor or extensor, 25310 Revision and/or 0.09 0.09 1.02 forearm and/or wrist, single; Reconstruction each tendon Forearm/ Wrist Repair, with tendon graft(s) 25312 Revision and/or (includes obtaining graft), 0.00 0.01 2.45 Reconstruction each tendon Flexor origin slide (eg, for Forearm/ Wrist Repair, cerebral palsy, Volkmann 25315 Revision and/or 0.00 0.00 5.61 contracture), forearm and/or Reconstruction wrist Forearm/ Wrist Repair, 25316 Revision and/or with tendon transfer 0.00 0.00 4.06 Reconstruction Forearm/ Wrist Repair, Capsulorrhaphy or 25320 Revision and/or reconstruction, wrist, any 0.09 0.06 0.59 Reconstruction method open Arthroplasty, wrist, with or Forearm/ Wrist Repair, without interposition, with or 25332 Revision and/or 0.00 0.01 2.34 wtihout external or internal Reconstruction fixation Forearm/ Wrist Repair, Centralization of wrist on ulna 25335 Revision and/or 0.00 0.00 Inf eg, radial club hand) Reconstruction Reconstruction for stabilization of unstable distal Forearm/ Wrist Repair, radioulnar joint, secondary by 25337 Revision and/or 0.01 0.02 1.90 soft tissue stabilization with or Reconstruction without open reduction of distal radioulnar joint Forearm/ Wrist Repair, 25350 Revision and/or Osteotomy, radius; distal third 0.02 0.03 1.76 Reconstruction Forearm/ Wrist Repair, 25355 Revision and/or middle or proximal third 0.00 0.00 1.76 Reconstruction Forearm/ Wrist Repair, 25360 Revision and/or Osteotomy; ulna 0.02 0.04 1.90 Reconstruction Forearm/ Wrist Repair, 25365 Revision and/or radius and ulna 0.00 0.00 2.67 Reconstruction COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 49

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Multiple osteotomies, with Forearm/ Wrist Repair, realignment on intramedullary 25370 Revision and/or 0.00 0.00 Inf rod (Sofield type procedure); Reconstruction radius OR ulna Forearm/ Wrist Repair, 25375 Revision and/or radius AND ulna 0.00 0.00 0.43 Reconstruction Forearm/ Wrist Repair, Osteoplasty, radius OR ulna; 25390 Revision and/or 0.03 0.03 0.99 shortening Reconstruction Forearm/ Wrist Repair, 25391 Revision and/or lengthening with autograft 0.00 0.00 1.75 Reconstruction Forearm/ Wrist Repair, Osteoplasty, radius AND ulna; 25392 Revision and/or 0.00 0.00 1.39 shortening (excluding 64876) Reconstruction Forearm/ Wrist Repair, 25393 Revision and/or lengthening with autograft 0.00 0.00 2.14 Reconstruction Forearm/ Wrist Repair, Osteoplasty, carpal bone, 25394 Revision and/or 0.00 0.00 2.67 shortening Reconstruction Forearm/ Wrist Repair, Repair of nonunion or 25400 Revision and/or malunion, radius OR ulna; 0.03 0.03 0.79 Reconstruction without graft Forearm/ Wrist Repair, with autograft (includes 25405 Revision and/or 0.03 0.04 1.46 obtaining graft) Reconstruction Forearm/ Wrist Repair, Repair of nonunion or 25415 Revision and/or malunion, radius AND ulna; 0.00 0.00 1.10 Reconstruction without graft Forearm/ Wrist Repair, with autograft (includes 25420 Revision and/or 0.00 0.01 2.19 obtaining graft) Reconstruction Forearm/ Wrist Repair, Repair of defect with 25425 Revision and/or 0.00 0.00 1.62 autograft; radius OR ulna Reconstruction Forearm/ Wrist Repair, 25426 Revision and/or radius AND ulna 0.00 0.00 0.50 Reconstruction Forearm/ Wrist Repair, Insertion vascular pedicle into 25430 Revision and/or 0.01 0.00 0.47 carpal bone Reconstruction Repair of carpal bone Forearm/ Wrist Repair, nonunion other than scaphoid, 25431 Revision and/or 0.00 0.01 4.08 each, including graft and Reconstruction fixation,each bone Repair of nonunion, scaphoid Forearm/ Wrist Repair, navicular bone, with or without 25440 Revision and/or 0.06 0.06 1.00 radial styloidectomy (includes Reconstruction obtaining graft and necessary COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 50

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate fixation Forearm/ Wrist Repair, Arthroplasty with prosthetic 25441 Revision and/or 0.00 0.00 Inf replacement, distal radius Reconstruction Forearm/ Wrist Repair, 25442 Revision and/or distal ulna 0.00 0.01 11.23 Reconstruction Forearm/ Wrist Repair, scaphoid carpal 25443 Revision and/or 0.00 0.00 Inf (navicular) Reconstruction Forearm/ Wrist Repair, 25445 Revision and/or trapezium 0.00 0.01 14.44 Reconstruction Forearm/ Wrist Repair, distal radius and partial or 25446 Revision and/or 0.00 0.00 3.14 entire carpus (total wrist) Reconstruction Forearm/ Wrist Repair, Interposition arthroplasty, 25447 Revision and/or intercarpal or 0.27 0.24 0.90 Reconstruction carpometacarpal joints Forearm/ Wrist Repair, Revision of arthroplasty, 25449 Revision and/or including removal of implant, 0.00 0.00 1.58 Reconstruction wrist joint Forearm/ Wrist Repair, Epiphyseal arrest by 25450 Revision and/or epiphysiodesis or stapling; 0.00 0.00 1.71 Reconstruction distal radius OR ulna Forearm/ Wrist Repair, 25455 Revision and/or distal radius AND ulna 0.00 0.00 Inf Reconstruction Prophylactic treatment Forearm/ Wrist Repair, (nailing, pinning, plating or 25490 Revision and/or 0.00 0.00 2.17 wiring) with or without methyl Reconstruction methacrylate; radius Forearm/ Wrist Repair, 25491 Revision and/or ulna 0.00 0.00 3.64 Reconstruction Forearm/ Wrist Repair, 25492 Revision and/or radius AND ulna 0.00 0.00 Inf Reconstruction Open treatment of radial shaft Forearm/ Wrist Fracture 25515 fracture, includes internal 0.11 0.12 1.10 and/or Dislocation fixation Open treatment of radial shaft Forearm/ Wrist Fracture fracture, includes internal 25525 0.05 0.06 1.30 and/or Dislocation fixation and closed treatment of dislocation of DRUJ Open treatment of radial shaft Forearm/ Wrist Fracture fracture, includes internal 25526 0.01 0.01 1.71 and/or Dislocation fixaiton and open treatment of dislocation of DRUJ Forearm/ Wrist Fracture Open treatment of ulnar shaft 25545 0.16 0.18 1.12 and/or Dislocation fracture, includes internal COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 51

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate fixation Open treatment of radial and Forearm/ Wrist Fracture ulnar shaft fractures with 25574 0.05 0.07 1.54 and/or Dislocation internal fixation of radius or ulna Open treatment of radial and Forearm/ Wrist Fracture ulnar shaft fractures with 25575 0.21 0.31 1.47 and/or Dislocation internal fixation of radius and ulna Percutaneous skeletal fixation Forearm/ Wrist Fracture 25606 of distal radial fracture or 0.10 0.13 1.29 and/or Dislocation epiphyseal separation Open treatment of distal radial Forearm/ Wrist Fracture extra-articular fracture or 25607 0.62 0.31 0.50 and/or Dislocation epiphyseal separation with internal fixation Open treatment of distal radial Forearm/ Wrist Fracture intra-articular fracture or 25608 0.55 0.39 0.71 and/or Dislocation epiphyseal separation with internal fixation of 2 fragments Open treatment of distal radial Forearm/ Wrist Fracture intra-articular fracture or 25609 0.91 0.60 0.66 and/or Dislocation epiphyseal separation with internal fixation of 3 fragments Forearm/ Wrist Fracture 25611 0.00 0.01 Inf and/or Dislocation Forearm/ Wrist Fracture 25620 0.01 0.05 4.19 and/or Dislocation Open treatment of carpal Forearm/ Wrist Fracture 25628 scaphoid fracture, internal 0.14 0.15 1.04 and/or Dislocation fixation Open treatment of carpal Forearm/ Wrist Fracture 25645 bone fracture (excludes 0.03 0.02 0.72 and/or Dislocation scaphoid) Forearm/ Wrist Fracture Percutaneous skeletal fixation 25651 0.01 0.01 0.58 and/or Dislocation of ulnar stylod fracture Forearm/ Wrist Fracture Open treatment of ulnar 25652 0.05 0.03 0.58 and/or Dislocation styloid fracture Open treatment of radiocarpal Forearm/ Wrist Fracture 25670 or intercarpal dislocation, 1 or 0.03 0.02 0.77 and/or Dislocation more bones Forearm/ Wrist Fracture Percutaneous skeletal fixation 25671 0.03 0.02 0.54 and/or Dislocation of DRUJ Forearm/ Wrist Fracture Open treatment of DRUJ 25676 0.02 0.02 0.92 and/or Dislocation dislocation Open treatment of trans- Forearm/ Wrist Fracture 25685 scaphoiperilunate type of 0.02 0.02 1.10 and/or Dislocation fracture dislocation Forearm/ Wrist Fracture Open treatment of lunate 25695 0.01 0.02 1.70 and/or Dislocation dislocation 25800 Forearm/ Wrist Arthrodesis Arthrodesis, wrist; complete, 0.01 0.03 3.24 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 52

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate without bone graft (includes radiocarpal and/or intercarpal and/or carpometacarpal joints) Arthrodesis, wrist; with sliding 25805 Forearm/ Wrist Arthrodesis 0.00 0.00 0.89 graft Arthrodesis, wrist; with iliac or 25810 Forearm/ Wrist Arthrodesis other autograft (includes 0.02 0.02 1.08 obtaining graft) Arthrodesis, wrist; limited, 25820 Forearm/ Wrist Arthrodesis without bone graft (eg, 0.01 0.03 3.46 intercarpal or radiocarpa Arthrodesis, wrist; with 25825 Forearm/ Wrist Arthrodesis autograft (includes obtaining 0.03 0.04 1.45 graft) Arthrodesis, distal radioulnar joint with segmental resection 25830 Forearm/ Wrist Arthrodesis of ulna, with or without bone 0.00 0.01 3.51 graft (eg, Sauve-Kapandji procedure Drainage of finger abscess; 26010 Hand/Fingers Incision 0.06 0.07 1.26 simple. Drainage of finger abscess; 26011 Hand/Fingers Incision 0.13 0.12 0.91 complicated (eg, felon). Drainage of tendon sheath, 26020 Hand/Fingers Incision 0.16 0.10 0.62 one digit and/or palm. Drainage of palmar bursa; 26025 Hand/Fingers Incision 0.03 0.02 0.73 single, ulnar or radial. Drainage of palmar bursa; 26030 Hand/Fingers Incision 0.01 0.02 1.47 multiple or complicated. Incision, deep, with opening of bone cortex (eg, for 26034 Hand/Fingers Incision 0.04 0.03 0.76 osteomyelitis or bone abscess), hand or finger. Decompression fingers and/or 26035 Hand/Fingers Incision hand, injection injury (eg, 0.01 0.01 0.99 grease gun). Decompressive fasciotomy, 26037 Hand/Fingers Incision 0.02 0.02 1.57 hand (excludes 26035). Fasciotomy, palmar, for 26040 Hand/Fingers Incision Dupuytren's contracture; 0.02 0.02 0.86 percutaneous. Fasciotomy, palmar, for 26045 Hand/Fingers Incision Dupuytren's contracture; 0.02 0.09 6.20 open, partial. Tendon sheath incision (eg, 26055 Hand/Fingers Incision 1.30 1.05 0.81 for trigger finger). Tenotomy, percutaneous, 26060 Hand/Fingers Incision 0.00 0.00 4.97 single, each digit. Arthrotomy, with exploration, 26070 Hand/Fingers Incision drainage, or removal of 0.01 0.01 1.13 foreign body; carpometacarpal COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 53

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate joint. Arthrotomy, with exploration, drainage, or removal of 26075 Hand/Fingers Incision 0.08 0.04 0.50 foreign body; metacarpophalangeal joint. Arthrotomy, with exploration, drainage, or removal of 26080 Hand/Fingers Incision 0.10 0.04 0.35 foreign body; interphalangeal joint, each. Arthrotomy with biopsy; 26100 Hand/Fingers Excision 0.00 0.00 8.13 carpometacarpal joint, each Arthrotomy with synovial 26105 Hand/Fingers Excision biopsy; metacarpophalangeal 0.00 0.00 0.76 joint. Arthrotomy with synovial 26110 Hand/Fingers Excision biopsy; interphalangeal joint, 0.02 0.01 0.34 each. Excision, tumor or vascular malformation, soft tissue of 26111 Hand/Fingers Excision 0.05 0.00 0.02 hand or finger, subcutaneous; 1.5 cm or greater Excision, tumor, soft tissue, or vascular malformation, of 26113 Hand/Fingers Excision hand or finger, subfascial (eg, 0.03 0.00 0.02 intramuscular); 1.5 cm or greater Excision, tumor or vascular malformation, soft tissue of 26115 Hand/Fingers Excision 0.23 0.13 0.59 hand or finger, subcutaneous; less than 1.5 cm Excision, tumor, soft tissue, or vascular malformation, of 26116 Hand/Fingers Excision hand or finger, subfascial (eg, 0.09 0.11 1.17 intramuscular); less than 1.5 cm Radical resection of tumor 26117 Hand/Fingers Excision (eg, sarcoma), soft tissue of 0.00 0.01 1.32 hand or finger; less than 3 cm Radical resection of tumor 26121 Hand/Fingers Excision (eg, sarcoma), soft tissue of 0.02 0.03 1.46 hand or finger; 3 cm or greater Fasciectomy, palm only, with or without Z-plasty, other local 26123 Hand/Fingers Excision tissue rearrangement, or skin 0.10 0.08 0.78 grafting (includes obtaining graft). Fasciectomy, partial palmar with release of single digit 26125 Hand/Fingers Excision including proximal 0.03 0.04 1.61 interphalangeal joint, with or without Z-plasty, other local COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 54

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate tissue rearrangement, or skin grafting (includes obtaining graft);. Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or 26130 Hand/Fingers Excision without Z-plasty, other local 0.00 0.00 2.03 tissue rearrangement, or skin grafting (includes obtaining graft); each additional digit (List separately in addition. Synovectomy, 26135 Hand/Fingers Excision 0.01 0.01 1.11 carpometacarpal joint. Synovectomy, metacarpophalangeal joint 26140 Hand/Fingers Excision including intrinsic release and 0.01 0.01 0.96 extensor hood reconstruction, each digit. Synovectomy, proximal interphalangeal joint, including 26145 Hand/Fingers Excision 0.05 0.05 1.09 extensor reconstruction, each interphalangeal joint. Synovectomy tendon sheath, radical (tenosynovectomy), 26160 Hand/Fingers Excision 0.44 0.28 0.63 flexor, palm or finger, single, each digit. Excision of lesion of tendon sheath or capsule (eg, cyst, 26170 Hand/Fingers Excision 0.01 0.00 0.75 mucous cyst, or ganglion), hand or finger. Excision of tendon, palm, 26180 Hand/Fingers Excision flexor, single (separate 0.02 0.01 0.42 procedure), each. Excision of tendon, finger, 26185 Hand/Fingers Excision 0.00 0.00 2.17 flexor (separate procedure). Sesamoidectomy, thumb or 26200 Hand/Fingers Excision 0.01 0.02 2.78 finger (separate procedure). Excision or curettage of bone 26205 Hand/Fingers Excision cyst or benign tumor of 0.00 0.00 2.18 metacarpal;. Excision or curettage of bone cyst or benign tumor of 26210 Hand/Fingers Excision 0.04 0.06 1.52 metacarpal; with autograft (includes obtaining graft). Excision or curettage of bone cyst or benign tumor of 26215 Hand/Fingers Excision 0.00 0.01 1.83 proximal, middle, or distal phalanx of finger;. Excision or curettage of bone 26230 Hand/Fingers Excision 0.01 0.01 1.28 cyst or benign tumor of COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 55

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate proximal, middle, or distal phalanx of finger; with autograft (includes obtaining graft). Partial excision (craterization, saucerization, or 26235 Hand/Fingers Excision 0.01 0.01 0.72 diaphysectomy) of bone (eg, for osteomyelitis); metacarpal. Partial excision (craterization, saucerization, or 26236 Hand/Fingers Excision diaphysectomy) of bone (eg, 0.02 0.01 0.53 for osteomyelitis); proximal or middle phalanx of finger. Partial excision (craterization, saucerization, or 26250 Hand/Fingers Excision diaphysectomy) of bone (eg, 0.00 0.00 4.92 for osteomyelitis); distal phalanx of finger. Radical resection (ostectomy) 26255 Hand/Fingers Excision 0.00 0.00 Inf for tumor, metacarpal;. Radical resection (ostectomy) 26260 Hand/Fingers Excision for tumor, proximal or middle 0.00 0.00 1.64 phalanx of finger;. Radical resectin of tumor, 26261 Hand/Fingers Excision 0.00 0.00 Inf distal phalanx of finger Manipulation finger joint under 26262 Hand/Fingers Excision 0.00 0.00 3.10 anesthesia, each joint Hand/Fingers Reapir, Manipulation, palmar fascial 26340 Revision and/or cord, post enzyme injection, 0.04 0.03 0.78 Reconstruction single cord Repair or advancement, flexor Hand/Fingers Reapir, tendon, not in zone 2 digital 26341 Revision and/or flexor tendon sheath; primary 0.01 0.00 0.07 Reconstruction or secondary without free graft, each tendon Hand/Fingers Reapir, secondary with free graft, 26350 Revision and/or 0.09 0.12 1.35 each tendon Reconstruction Repair or advancement, flexor Hand/Fingers Reapir, tendon, in zone 2 digital flexor 26352 Revision and/or 0.01 0.01 1.24 tendon sheath; primary Reconstruction without free graft, each tendon Hand/Fingers Reapir, secondary without free 26356 Revision and/or 0.16 0.17 1.12 graft, each tendon Reconstruction Hand/Fingers Reapir, secondary with free graft, 26357 Revision and/or 0.01 0.02 3.06 each tendon Reconstruction Hand/Fingers Reapir, Repair or advancement of 26358 Revision and/or profundus tendon, with intact 0.00 0.01 1.99 Reconstruction superficialis tendon; primary, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 56

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate each tendon Hand/Fingers Reapir, secondary with free graft, 26370 Revision and/or 0.05 0.03 0.61 each tendon Reconstruction Hand/Fingers Reapir, secondary without free 26372 Revision and/or 0.00 0.01 2.98 graft, each tendon Reconstruction Flexor tendon excision, Hand/Fingers Reapir, implantation of plastic tube or 26373 Revision and/or 0.00 0.00 0.40 rod for delayed tendon graft, Reconstruction hand or finger, each rod Removal of tube or rod and Hand/Fingers Reapir, insertion of flexor tendon graft 26390 Revision and/or 0.01 0.01 1.36 (includes obtaining graft), Reconstruction hand or finger Extensor tendon repair, Hand/Fingers Reapir, dorsum of hand, single, 26392 Revision and/or 0.00 0.00 0.98 primary or secondary; without Reconstruction free graft, each tendon Hand/Fingers Reapir, with free graft, (includes 26410 Revision and/or 0.16 0.11 0.68 obtaining graft), each tendon Reconstruction Extensor tendon excision, Hand/Fingers Reapir, implantation of plastic tube or 26412 Revision and/or 0.00 0.01 1.44 rod for delayed tendon graft, Reconstruction hand or finger, each rod Removal of tube or rod and Hand/Fingers Reapir, insertion of extensor tendon 26415 Revision and/or 0.00 0.00 2.46 graft (includes obtaining graft), Reconstruction hand or finger Hand/Fingers Reapir, Extensor tendon repair, finger, 26416 Revision and/or primary or secondary; without 0.00 0.00 3.48 Reconstruction free graft, each tendon Hand/Fingers Reapir, with free graft, (includes 26418 Revision and/or 0.21 0.14 0.66 obtaining graft), each tendon Reconstruction Extensor tendon repair, Hand/Fingers Reapir, central slip repair, secondary 26420 Revision and/or (boutonniere deformity); using 0.00 0.01 2.65 Reconstruction local tissues, including lateral band(s), each finger Hand/Fingers Reapir, with free graft, (includes 26426 Revision and/or 0.02 0.04 2.66 obtaining graft), each finger Reconstruction Closed treatment of distal Hand/Fingers Reapir, extensor tendon insertion, 26428 Revision and/or 0.00 0.00 5.53 with or without percutaneous Reconstruction pinning Hand/Fingers Reapir, Repair of extensor tendon, 26432 Revision and/or distal insetionk promary or 0.02 0.01 0.66 Reconstruction secondary; without graft COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 57

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Hand/Fingers Reapir, with free graft, (includes 26433 Revision and/or 0.02 0.04 1.55 obtaining graft) Reconstruction Hand/Fingers Reapir, Realignment of extensor 26434 Revision and/or 0.00 0.00 1.66 tendon, hand, each tendon Reconstruction Hand/Fingers Reapir, Tenolysis, flexor tendon; palm 26437 Revision and/or 0.02 0.02 1.02 OR finger, each tendon Reconstruction Hand/Fingers Reapir, palm AND finger, each 26440 Revision and/or 0.05 0.05 1.16 tendon Reconstruction Hand/Fingers Reapir, Tenolysis, extensor tendon, 26442 Revision and/or 0.01 0.03 2.22 hand or finger, each tendon Reconstruction Hand/Fingers Reapir, Tenolysis, complex, extensor 26445 Revision and/or tendon, finger, including 0.05 0.06 1.20 Reconstruction forearm, each tendon Hand/Fingers Reapir, Tenotomy, flexor, palm, open, 26449 Revision and/or 0.01 0.01 2.15 each Reconstruction Hand/Fingers Reapir, Tenotomy, flexor finger, , 26450 Revision and/or 0.00 0.00 1.08 open, each Reconstruction Hand/Fingers Reapir, Tenotomy, extensor hand or 26455 Revision and/or 0.00 0.01 2.41 finger, single, open, each Reconstruction Hand/Fingers Reapir, Tenodesis; for proximal 26460 Revision and/or interphalangeal joint 0.01 0.01 1.50 Reconstruction stabilization Hand/Fingers Reapir, 26471 Revision and/or of distal joint, each joint 0.00 0.01 4.58 Reconstruction Hand/Fingers Reapir, Tendon lengthening, extensor, 26474 Revision and/or 0.00 0.00 4.03 hand or finger, single, each Reconstruction Hand/Fingers Reapir, Tendon shortening, extensor, 26476 Revision and/or 0.00 0.00 6.10 hand or finger, single, each Reconstruction Hand/Fingers Reapir, Tendon lengthening, flexor, 26477 Revision and/or 0.00 0.00 1.58 hand or finger, single, each Reconstruction Hand/Fingers Reapir, Tendon shortening, flexor, 26478 Revision and/or 0.00 0.01 2.28 hand or finger, single, each Reconstruction Tendon transfer or transplant, Hand/Fingers Reapir, carpometacarpal area or 26479 Revision and/or 0.00 0.00 0.93 dorsum of hand, single; Reconstruction without free graft, each Hand/Fingers Reapir, with free tendon graft 26480 0.15 0.05 0.36 Revision and/or (includes obtaining graft), COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 58

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Reconstruction each tendon Hand/Fingers Reapir, Tendon transfer or transplant, 26483 Revision and/or palmar, single, each tendon; 0.01 0.01 2.30 Reconstruction without free tendon graft Hand/Fingers Reapir, with free tendon graft 26485 Revision and/or (includes obtaining graft), 0.01 0.01 1.31 Reconstruction each tendon Hand/Fingers Reapir, Opopnensplasty, superficialis 26489 Revision and/or tendon transfer type, each 0.00 0.00 4.04 Reconstruction tendon Hand/Fingers Reapir, tendon transfer with graft 26490 Revision and/or (includes obtaining graft), 0.00 0.00 2.17 Reconstruction each tendon Hand/Fingers Reapir, hypothenar muscle 26492 Revision and/or 0.00 0.00 13.48 transfer Reconstruction Hand/Fingers Reapir, 26494 Revision and/or other methods 0.00 0.00 Inf Reconstruction Hand/Fingers Reapir, Transfer of tendon to restore 26496 Revision and/or intrinsic function; ring and 0.00 0.00 1.93 Reconstruction small finger Hand/Fingers Reapir, 26497 Revision and/or all 4 fingers 0.00 0.00 12.41 Reconstruction Hand/Fingers Reapir, Correction claw finger, other 26498 Revision and/or 0.00 0.00 11.44 methods Reconstruction Hand/Fingers Reapir, Tendon pulley reconstruction, 26499 Revision and/or with local tissues separate 0.00 0.00 2.78 Reconstruction procedure Hand/Fingers Reapir, with tendon or fascial graft 26500 Revision and/or (includes obtaining graft) 0.01 0.01 1.72 Reconstruction separate procedure Hand/Fingers Reapir, Tendon pulley reconstruction; 26502 Revision and/or with tendon prosthesis 0.01 0.01 1.13 Reconstruction (separate procedure). Hand/Fingers Reapir, Thenar muscle release for 26508 Revision and/or 0.00 0.00 1.21 thumb contracture Reconstruction Hand/Fingers Reapir, Cross intrinsic transfer, each 26510 Revision and/or 0.00 0.00 3.32 tendon Reconstruction Hand/Fingers Reapir, Capsulodesis M‐P joint; single 26516 Revision and/or 0.01 0.01 1.07 digit Reconstruction Hand/Fingers Reapir, 26517 Revision and/or 2 digits 0.00 0.00 1.07 Reconstruction Hand/Fingers Reapir, 26518 3 or 4 digits 0.00 0.00 Inf Revision and/or COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 59

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Reconstruction Capsulectomy or Hand/Fingers Reapir, capsulotomy; 26520 Revision and/or 0.02 0.03 1.55 metacarpophalangeal joint, Reconstruction single, each Hand/Fingers Reapir, interphalangeal joint, 26525 Revision and/or 0.04 0.04 0.97 single each Reconstruction Hand/Fingers Reapir, Arthroplasty, 26530 Revision and/or metacarpophalangeal joint; 0.00 0.04 18.09 Reconstruction single, each Hand/Fingers Reapir, with prosthetic implant, 26531 Revision and/or 0.01 0.05 4.61 single, each Reconstruction Hand/Fingers Reapir, Arthroplasty, interphalangeal 26535 Revision and/or 0.01 0.02 2.24 joint; single, each Reconstruction Hand/Fingers Reapir, with prosthetic implant, 26536 Revision and/or 0.01 0.02 1.88 single, each Reconstruction Hand/Fingers Reapir, Repair of collateral ligament, 26540 Revision and/or metacarpophalangeal or 0.15 0.06 0.44 Reconstruction interphalangeal joint Reconstruction, collateral Hand/Fingers Reapir, ligament, 26541 Revision and/or metacarpophalangeal joint, 0.02 0.02 1.09 Reconstruction singel; with tendon or fascial graft (includes obtaining graft) Hand/Fingers Reapir, 26542 Revision and/or with local tissue 0.01 0.03 3.84 Reconstruction Reconstruction, collateral Hand/Fingers Reapir, ligament, interphalangeal 26545 Revision and/or 0.01 0.01 1.72 joint, single, including graft, Reconstruction each joint Repair nonunion, metacarpal Hand/Fingers Reapir, or phalanx, including bone 26546 Revision and/or 0.02 0.01 0.56 graft with or without internal or Reconstruction external fixation Hand/Fingers Reapir, Repair and reconstruction, 26548 Revision and/or finger volar plate, 0.02 0.02 1.37 Reconstruction interphalangeal joint Hand/Fingers Reapir, 26550 Revision and/or Pollicization of a digit 0.00 0.00 Inf Reconstruction Transfer, toe-to-hand with Hand/Fingers Reapir, microvascular anastomosis; 26551 Revision and/or 0.00 0.00 Inf great toe wrap-around with Reconstruction bone graft Hand/Fingers Reapir, other than great toe, 26553 0.00 0.00 Inf Revision and/or single COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 60

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Reconstruction Hand/Fingers Reapir, other than great toe, 26554 Revision and/or 0.00 0.00 Inf double Reconstruction Hand/Fingers Reapir, Transfer, finger to another 26555 Revision and/or position without microvascualr 0.00 0.00 Inf Reconstruction anastomosis Hand/Fingers Reapir, Transfer, free toe joint with 26556 Revision and/or 0.00 0.00 Inf microvascular anastomosis Reconstruction Hand/Fingers Reapir, Repair of syndactyly web 26560 Revision and/or finger each web space; with 0.00 0.00 Inf Reconstruction skin flaps Hand/Fingers Reapir, 26561 Revision and/or with skin flaps and grafts 0.00 0.00 Inf Reconstruction Hand/Fingers Reapir, complex, involving bone, 26562 Revision and/or 0.00 0.00 7.70 nails, etc Reconstruction Hand/Fingers Reapir, 26565 Revision and/or Osteotomy; metacarpal, each 0.01 0.02 1.47 Reconstruction Hand/Fingers Reapir, 26567 Revision and/or phalanx of finger, each 0.01 0.01 1.06 Reconstruction Hand/Fingers Reapir, 26568 Revision and/or Osteotomy; metacarpal, each 0.00 0.00 2.89 Reconstruction Hand/Fingers Reapir, 26580 Revision and/or Repair cleft hand 0.00 0.00 Inf Reconstruction Hand/Fingers Reapir, Reconstruction of 26587 Revision and/or polydactylous digit, soft tissue 0.00 0.00 4.65 Reconstruction and bone Hand/Fingers Reapir, Repair macrodacylia, each 26590 Revision and/or 0.00 0.00 Inf digit Reconstruction Hand/Fingers Reapir, Repair, intrinsic muscles of 26591 Revision and/or 0.01 0.01 0.39 hand, each muscle Reconstruction Hand/Fingers Reapir, Release, intrinsic muscles of 26593 Revision and/or 0.01 0.02 3.28 hand Reconstruction Hand/Fingers Reapir, Excision of constricting ring of 26596 Revision and/or 0.00 0.00 Inf finger, with multiple Z‐plasties Reconstruction Closed treatment of Hand/Fingers Fracture metacarpal fracture, with 26607 0.01 0.03 3.69 and/or Dislocation manipulation, with internal or external fixation, each bone. 26608 Hand/Fingers Fracture Percutaneous skeletal fixation 0.27 0.19 0.73 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 61

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate and/or Dislocation of metacarpal fracture, each bone. Open treatment of metacarpal Hand/Fingers Fracture fracture, single, with or without 26615 0.35 0.29 0.82 and/or Dislocation internal or external fixation, each bone. Percutaneous skeletal fixation of carpometacarpal fracture Hand/Fingers Fracture dislocation, thumb (Bennett 26650 0.04 0.04 0.92 and/or Dislocation fracture), with manipulation, with or without external fixation. Open treatment of carpometacarpal fracture Hand/Fingers Fracture 26665 dislocation, thumb (Bennett 0.03 0.03 1.09 and/or Dislocation fracture), with or without internal or external fixation. Closed treatment of carpometacarpal dislocation, Hand/Fingers Fracture other than thumb (Bennett 26675 0.00 0.01 3.83 and/or Dislocation fracture), single, with manipulation; requiring anesthesia. Percutaneous skeletal fixation of carpometacarpal Hand/Fingers Fracture 26676 dislocation, other than thumb 0.06 0.05 0.74 and/or Dislocation (Bennett fracture), single, with manipulation. Open treatment of carpometacarpal dislocation, Hand/Fingers Fracture other than thumb (Bennett 26685 0.03 0.03 1.11 and/or Dislocation fracture); single, with or without internal or external fixation. Open treatment of carpometacarpal dislocation, Hand/Fingers Fracture 26686 other than thumb (Bennett 0.02 0.02 0.98 and/or Dislocation fracture); complex, multiple or delayed reduction. Percutaneous skeletal fixation Hand/Fingers Fracture of metacarpophalangeal 26706 0.01 0.01 2.41 and/or Dislocation dislocation, single, with manipulation. Open treatment of metacarpophalangeal Hand/Fingers Fracture 26715 dislocation, single, with or 0.02 0.02 1.04 and/or Dislocation without internal or external fixation. Percutaneous skeletal fixation Hand/Fingers Fracture 26727 of unstable phalangeal shaft 0.26 0.17 0.67 and/or Dislocation fracture, proximal or middle COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 62

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate phalanx, finger or thumb, with manipulation, each. Open treatment of phalangeal shaft fracture, proximal or Hand/Fingers Fracture 26735 middle phalanx, finger or 0.23 0.19 0.83 and/or Dislocation thumb, with or without internal or external fixation, each. Open treatment of articular fracture, involving Hand/Fingers Fracture metacarpophalangeal or 26746 0.16 0.07 0.42 and/or Dislocation interphalangeal joint, with or without internal or external fixation, each. Percutaneous skeletal fixation Hand/Fingers Fracture 26756 of distal phalangeal fracture, 0.07 0.05 0.68 and/or Dislocation finger or thumb, each. Open treatment of distal Hand/Fingers Fracture phalangeal fracture, finger or 26765 0.14 0.06 0.39 and/or Dislocation thumb, with or without internal or external fixation, each. Closed treatment of interphalangeal joint Hand/Fingers Fracture 26770 dislocation, single, with 0.00 0.02 17.59 and/or Dislocation manipulation; without anesthesia Closed treatment of interphalangeal joint Hand/Fingers Fracture 26775 dislocation, single, with 0.01 0.01 2.21 and/or Dislocation manipulation; requiring anesthesia Percutaneous skeletal fixation Hand/Fingers Fracture of interphalangeal joint 26776 0.02 0.02 1.05 and/or Dislocation dislocation, single, with manipulation. Open treatment of interphalangeal joint Hand/Fingers Fracture 26785 dislocation, with or without 0.04 0.04 0.79 and/or Dislocation internal or external fixation, single. Fusion in opposition, thumb, 26820 Hand/ Fingers Arthrodesis with autogenous graft 0.00 0.00 2.49 (includes obtaining graft). Arthrodesis, carpometacarpal 26841 Hand/ Fingers Arthrodesis joint, thumb, with or without 0.01 0.02 3.24 internal fixation;. Arthrodesis, carpometacarpal joint, thumb, with or without 26842 Hand/ Fingers Arthrodesis 0.00 0.01 5.82 internal fixation; with autograft (includes obtaining graft). Arthrodesis, carpometacarpal 26843 Hand/ Fingers Arthrodesis 0.00 0.01 4.83 joint, digits, other than thumb;. COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 63

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Arthrodesis, carpometacarpal joint, digits, other than thumb; 26844 Hand/ Fingers Arthrodesis 0.00 0.01 4.06 with autograft (includes obtaining graft). Arthrodesis, metacarpophalangeal joint, 26850 Hand/ Fingers Arthrodesis 0.02 0.03 1.20 with or without internal fixation;. Arthrodesis, metacarpophalangeal joint, 26852 Hand/ Fingers Arthrodesis with or without internal 0.01 0.01 1.38 fixation; with autograft (includes obtaining graft). Arthrodesis, interphalangeal 26860 Hand/ Fingers Arthrodesis joint, with or without internal 0.10 0.11 1.04 fixation;. Arthrodesis, interphalangeal joint, with or without internal 26861 Hand/ Fingers Arthrodesis 0.01 0.02 1.72 fixation; each additional interphalangeal joint. Arthrodesis, interphalangeal joint, with or without internal 26862 Hand/ Fingers Arthrodesis 0.01 0.02 1.97 fixation; with autograft (includes obtaining graft). Arthrodesis, interphalangeal joint, with or without internal 26863 Hand/ Fingers Arthrodesis fixation; with autograft 0.00 0.00 5.13 (includes obtaining graft), each additional joint. Amputation, metacarpal, with finger or thumb (ray 26910 Hand/Fingers Amputation 0.03 0.04 1.28 amputation), single, with or without interosseous transfer. Amputation, finger or thumb, primary or secondary, any 26951 Hand/Fingers Amputation joint or phalanx, single, 0.31 0.29 0.93 including neurectomies; with direct closure. Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, 26952 Hand/Fingers Amputation 0.07 0.05 0.66 including neurectomies; with local advancement flaps (V-Y, hood). Incision and drainage, pelvis 26990 Pelvis/ Hip Incision or hip joint area; deep 0.11 0.16 1.43 abscess or hematoma. Incision and drainage, pelvis 26991 Pelvis/ Hip Incision or hip joint area; infected 0.00 0.01 3.82 bursa. 26992 Pelvis/ Hip Incision Incision, deep, with opening of 0.02 0.03 1.99 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 64

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate bone cortex (eg, for osteomyelitis or bone abscess), pelvis and/or hip joint. Tenotomy, adductor of hip, 27000 Pelvis/ Hip Incision subcutaneous, closed 0.00 0.01 12.35 (separate procedure). Tenotomy, adductor of hip, 27001 Pelvis/ Hip Incision 0.01 0.01 1.42 subcutaneous, open. Tenotomy, adductor, 27003 Pelvis/ Hip Incision subcutaneous, open, with 0.00 0.00 7.81 obturator neurectomy. Tenotomy, iliopsoas, open 27005 Pelvis/ Hip Incision 0.01 0.01 0.78 (separate procedure). Tenotomy, abductors of hip, 27006 Pelvis/ Hip Incision 0.01 0.01 1.26 open (separate procedure). Fasciotomy, hip or thigh, any 27025 Pelvis/ Hip Incision 0.01 0.00 0.52 type. Decompression 27027 Pelvis/ Hip Incision fasciotomy(ies), pelvic 0.00 0.00 0.55 (buttock) compartment(s) Arthrotomy, hip, for infection, 27030 Pelvis/ Hip Incision 0.08 0.08 0.91 with drainage. Arthrotomy, hip, with 27033 Pelvis/ Hip Incision exploration or removal of 0.02 0.03 1.87 loose or foreign body. Hip joint denervation, intrapelvic or extrapelvic intra- 27035 Pelvis/ Hip Incision 0.00 0.00 3.74 articular branches of sciatic, femoral, or obturator nerves. Capsulectomy or capsulotomy of hip, with or without excision of heterotopic bone, with release of hip flexor muscles 27036 Pelvis/ Hip Incision 0.02 0.03 1.69 (ie, gluteus medius, gluteus minimus, tensor fascia latae, rectus femoris, sartorius, iliopsoas). Biopsy, soft tissue of pelvis 27040 Pelvis/ Hip Excision 0.00 0.00 3.56 and hip area; superficial. Biopsy, soft tissue of pelvis 27041 Pelvis/ Hip Excision 0.01 0.03 3.66 and hip area; deep. Excision, tumor, pelvis and hip 27045 Pelvis/ Hip Excision area; subcutaneous, 3 cm or 0.01 0.00 0.04 greater. Excision, tumor, pelvis and hip 27047 Pelvis/ Hip Excision area; deep, subfascial, 0.00 0.01 2.64 intramuscular, 5 cm or greater Excision, tumor, pelvis and hip 27048 Pelvis/ Hip Excision area; subcutaneous, less than 0.00 0.04 13.33 3 cm COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 65

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Excision, tumor, pelvis and hip 27049 Pelvis/ Hip Excision area; deep, subfascial, 0.00 0.02 12.57 intramuscular, less than 5 cm Radical resection of tumor (eg, malignant neoplasm), soft 27050 Pelvis/ Hip Excision 0.00 0.00 0.75 tissue of pelvis and hip area, less than 5 cm. Arthrotomy, with biopsy; 27052 Pelvis/ Hip Excision 0.00 0.01 1.90 sacroiliac joint. Arthrotomy, with biopsy; hip 27054 Pelvis/ Hip Excision 0.00 0.02 5.47 joint. Arthrotomy with synovectomy, 27057 Pelvis/ Hip Excision 0.00 0.00 1.55 hip joint. Decompression fasciotomy(ies), pelvic 27059 Pelvis/ Hip Excision (buttock) compartment(s) with 0.01 0.00 0.09 debridement of nonviable muscle, unilateral Radical resection of tumor (eg, malignant neoplasm), soft 27060 Pelvis/ Hip Excision 0.00 0.00 0.47 tissue of pelvis and hip area 5 cm or greater. 27062 Pelvis/ Hip Excision Excision; ischial bursa. 0.03 0.02 0.73 Excision; trochanteric bursa or 27065 Pelvis/ Hip Excision 0.00 0.01 3.46 calcification. Excision of bone cyst or benign tumor; superficial (wing of ilium, symphysis 27066 Pelvis/ Hip Excision 0.01 0.03 3.38 pubis, or greater trochanter of femur) with or without autograft. Excision of bone cyst or 27067 Pelvis/ Hip Excision benign tumor; deep, with or 0.00 0.00 10.91 without autograft. Excision of bone cyst or 27070 Pelvis/ Hip Excision benign tumor; with autograft 0.00 0.01 2.29 requiring separate incision. Partial excision (craterization, saucerization) (eg, for osteomyelitis); superficial (eg, 27071 Pelvis/ Hip Excision 0.02 0.03 1.27 wing of ilium, symphysis pubis or greater trochanter of femur). Partial excision (craterization, 27075 Pelvis/ Hip Excision saucerization) (eg, for 0.00 0.01 3.12 osteomyelitis); deep. Radical resection of tumor or infection; wing of ilium, one 27076 Pelvis/ Hip Excision 0.00 0.01 4.90 pubic or ischial ramus or symphysis pubis. 27077 Pelvis/ Hip Excision Radical resection of tumor or 0.00 0.00 3.18 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 66

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate infection; ilium, including acetabulum, both pubic rami, or ischium and acetabulum. Radical resection of tumor or 27078 Pelvis/ Hip Excision infection; innominate bone, 0.00 0.00 2.42 total. Radical resection of tumor or infection; ischial tuberosity 27079 Pelvis/ Hip Excision 0.00 0.00 Inf and greater trochanter of femur. Radical resection of tumor or infection; ischial tuberosity 27080 Pelvis/ Hip Excision 0.00 0.01 2.67 and greater trochanter of femur, with skin flaps. Pelvis/ Hip Introduction or 27086 Coccygectomy, primary. 0.00 0.00 6.58 Removal Removal of foreign body, Pelvis/ Hip Introduction or 27087 pelvis or hip; subcutaneous 0.01 0.02 3.56 Removal tissue. Pelvis/ Hip Introduction or Removal of foreign body, 27090 0.01 0.04 3.08 Removal pelvis or hip; deep. Pelvis/ Hip Introduction or Removal of hip prosthesis; 27091 0.08 0.10 1.24 Removal (separate procedure). Removal of hip prosthesis; Pelvis/ Hip Introduction or complicated, including "total 27093 0.01 0.01 1.09 Removal hip" and methylmethacrylate, when applicable. Injection procedure for hip Pelvis/ Hip Introduction or 27095 arthrography; without 0.03 0.02 0.69 Removal anesthesia. Pelvis/ Hip Introduction or Injection procedure for hip 27096 0.02 0.00 0.21 Removal arthrography; with anesthesia. Injection procedure for sacroiliac joint, Pelvis/ Hip Repair, Revision 27097 anesthetic/steroid, with image 0.00 0.00 1.85 and/or Reconstruction guidance including arthrography when performed Pelvis/ Hip Repair, Revision Release or recession, 27098 0.00 0.00 Inf and/or Reconstruction hamstring, proximal Pelvis/ Hip Repair, Revision 27100 Transfer, adductor to ischium 0.00 0.00 0.32 and/or Reconstruction Transfer external oblique Pelvis/ Hip Repair, Revision muscle to greater trochanter 27110 0.00 0.00 Inf and/or Reconstruction including fascial or tendon extension (graft) Pelvis/ Hip Repair, Revision Transfer iliopsoas; to greater 27111 0.00 0.00 Inf and/or Reconstruction trochanter of femur Pelvis/ Hip Repair, Revision 27120 to femoral neck 0.00 0.02 7.53 and/or Reconstruction Pelvis/ Hip Repair, Revision Acetabuloplasty; (eg, 27122 0.03 0.05 1.76 and/or Reconstruction Whitman, Colonna, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 67

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Haygroves, or cup type) Pelvis/ Hip Repair, Revision resection, femoral head 27125 0.41 0.61 1.48 and/or Reconstruction (eg, Girdlestone procedure) Hemiarthroplasty, hip, partial Pelvis/ Hip Repair, Revision 27130 (eg, femoral stem prosthesis, 2.72 4.13 1.52 and/or Reconstruction bipolar arthroplasty) Arthroplasty, acetabular and proximal femoral prosthetic Pelvis/ Hip Repair, Revision 27132 replacement (total hip 0.18 0.08 0.46 and/or Reconstruction arthroplasty), with or without autograft or allograft Conversion of previous hip Pelvis/ Hip Repair, Revision surgery to total hip 27134 0.26 0.41 1.58 and/or Reconstruction arthroplasty, with or without autograft or allograft Revision of total hip Pelvis/ Hip Repair, Revision arthroplasty; both 27137 0.14 0.23 1.64 and/or Reconstruction components, with or without autograft or allograft acetabular component Pelvis/ Hip Repair, Revision 27138 only, with or without autograft 0.10 0.10 1.04 and/or Reconstruction or allograft Pelvis/ Hip Repair, Revision femoral component only, 27140 0.01 0.01 2.48 and/or Reconstruction with or without allograft Osteotomy and transfer of Pelvis/ Hip Repair, Revision 27146 greater trochanter of femur 0.00 0.02 12.28 and/or Reconstruction (separate procedure) Pelvis/ Hip Repair, Revision Osteotomy, iliac, acetabular or 27147 0.00 0.00 2.09 and/or Reconstruction innominate bone; Pelvis/ Hip Repair, Revision 27151 with open reduction of hip 0.00 0.00 3.85 and/or Reconstruction Pelvis/ Hip Repair, Revision 27156 with femoral osteotomy 0.00 0.00 8.34 and/or Reconstruction Pelvis/ Hip Repair, Revision with femoral osteotomy 27158 0.00 0.00 1.39 and/or Reconstruction and with open reduction of hip Pelvis/ Hip Repair, Revision Osteotomy, pelvis, bilateral 27161 0.00 0.02 10.52 and/or Reconstruction (eg, congenital malformation) Pelvis/ Hip Repair, Revision Osteotomy, femoral neck 27165 0.01 0.02 1.98 and/or Reconstruction (separate procedure) Osteotomy, intertrochanteric Pelvis/ Hip Repair, Revision or subtrochanteric including 27170 0.01 0.03 2.58 and/or Reconstruction internal or external fixation and/or cast Bone graft, femoral head, Pelvis/ Hip Repair, Revision neck, intertrochanteric or 27175 0.00 0.00 Inf and/or Reconstruction subtrochanteric area (includes obtaining bone graft) Treatment of slipped femoral Pelvis/ Hip Repair, Revision 27176 epiphysis; by traction, without 0.00 0.00 Inf and/or Reconstruction reduction 27177 Pelvis/ Hip Repair, Revision by single or multiple 0.00 0.00 Inf COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 68

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate and/or Reconstruction pinning, in situ Open treatment of slipped Pelvis/ Hip Repair, Revision femoral epiphysis; single or 27178 0.00 0.00 5.35 and/or Reconstruction multiple pinning or bone graft (includes obtaining graft) Pelvis/ Hip Repair, Revision closed manipulation with 27179 0.00 0.01 Inf and/or Reconstruction single or multiple pinning osteoplasty of femoral Pelvis/ Hip Repair, Revision 27181 neck (Heyman type 0.00 0.00 1.07 and/or Reconstruction procedure) Pelvis/ Hip Repair, Revision osteotomy and internal 27185 0.00 0.00 1.18 and/or Reconstruction fixation Epiphyseal arrest by Pelvis/ Hip Repair, Revision 27187 epiphysiodesis or stapling, 0.03 0.03 1.34 and/or Reconstruction greater trochanter of femur Prophylactic treatment (nailing, pinning, plating or Pelvis/ Hip Trauma - 27194 wiring) with or without 0.04 0.03 0.96 Fracture and/or Dislocation methylmethacrylate, femoral neck and proximal femur Closed treatment of pelvic ring fracture, dislocation, diastasis Pelvis/ Hip Trauma - 27202 or subluxation; with 0.00 0.00 2.03 Fracture and/or Dislocation manipulation, requiring more than local anesthesia. Pelvis/ Hip Trauma - Open treatment of coccygeal 27215 0.01 0.02 1.69 Fracture and/or Dislocation fracture. Open treatment of iliac spine(s), tuberosity avulsion, Pelvis/ Hip Trauma - or iliac wing fracture(s) (eg, 27216 0.19 0.21 1.09 Fracture and/or Dislocation pelvic fracture(s) which do not disrupt the pelvic ring), with internal fixation. Percutaneous skeletal fixation of posterior pelvic ring fracture Pelvis/ Hip Trauma - 27217 and/or dislocation (includes 0.12 0.16 1.36 Fracture and/or Dislocation ilium, sacroiliac joint and/or sacrum). Open treatment of anterior Pelvis/ Hip Trauma - ring fracture and/or dislocation 27218 0.04 0.09 2.08 Fracture and/or Dislocation with internal fixation (includes pubic symphysis and/or rami). Open treatment of posterior ring fracture and/or dislocation Pelvis/ Hip Trauma - 27226 with internal fixation (includes 0.07 0.12 1.68 Fracture and/or Dislocation ilium, sacroiliac joint and/ or sacrum). Open treatment of posterior or Pelvis/ Hip Trauma - 27227 anterior acetabular wall 0.07 0.18 2.53 Fracture and/or Dislocation fracture, with internal fixation. 27228 Pelvis/ Hip Trauma - Open treatment of acetabular 0.12 0.16 1.29 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 69

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Fracture and/or Dislocation fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across the acetabulum, with internal fixation. Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes T-fracture and both Pelvis/ Hip Trauma - 27235 column fracture with complete 0.60 0.30 0.49 Fracture and/or Dislocation articular detachment, or single column or transverse fracture with associated acetabular wall fracture, wit. Percutaneous skeletal fixation of femoral fracture, proximal Pelvis/ Hip Trauma - 27236 end, neck, undisplaced, mildly 1.61 0.87 0.54 Fracture and/or Dislocation displaced, or impacted fracture. Open treatment of femoral fracture, proximal end, neck, Pelvis/ Hip Trauma - 27244 internal fixation or prosthetic 0.30 0.43 1.45 Fracture and/or Dislocation replacement (direct fracture exposure). Open treatment of intertrochanteric, pertrochanteric, or Pelvis/ Hip Trauma - 27245 subtrochanteric femoral 2.62 1.29 0.49 Fracture and/or Dislocation fracture; with plate/screw type implant, with or without cerclage. Open treatment of intertrochanteric, pertrochanteric, or Pelvis/ Hip Trauma - subtrochanteric femoral 27248 0.05 0.04 0.85 Fracture and/or Dislocation fracture; with intramedullary implant, with or without interlocking screws and/or cerclage. Open treatment of greater Pelvis/ Hip Trauma - trochanteric fracture, with or 27253 0.01 0.02 1.74 Fracture and/or Dislocation without internal or external fixation. Open treatment of hip Pelvis/ Hip Trauma - 27254 dislocation, traumatic, without 0.01 0.04 2.76 Fracture and/or Dislocation internal fixation. Open treatment of hip dislocation, traumatic, with Pelvis/ Hip Trauma - 27256 acetabular wall and femoral 0.00 0.00 14.54 Fracture and/or Dislocation head fracture, with or without internal or external fixation. COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 70

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Treatment of spontaneous hip dislocation (developmental, including congenital or Pelvis/ Hip Trauma - 27257 pathological), by abduction, 0.00 0.00 3.66 Fracture and/or Dislocation splint or traction; without anesthesia, without manipulation. Treatment of spontaneous hip dislocation (developmental, including congenital or Pelvis/ Hip Trauma - 27258 pathological), by abduction, 0.00 0.00 2.41 Fracture and/or Dislocation splint or traction; with manipulation, requiring anesthesia. Open treatment of spontaneous hip dislocation (developmental, including Pelvis/ Hip Trauma - 27259 congenital or pathological), 0.00 0.00 1.87 Fracture and/or Dislocation replacement of femoral head in acetabulum (including tenotomy, etc);. Open treatment of spontaneous hip dislocation (developmental, including Pelvis/ Hip Trauma - congenital or pathological), 27265 0.01 0.03 2.17 Fracture and/or Dislocation replacement of femoral head in acetabulum (including tenotomy, etc); with femoral shaft shortening. Closed treatment of post hip Pelvis/ Hip Trauma - 27266 arthroplasty dislocation; 0.17 0.09 0.55 Fracture and/or Dislocation requiring anesthesia Closed treatment of femoral Pelvis/ Hip Trauma - 27267 fracture, proximal end, head; 0.00 0.00 0.36 Fracture and/or Dislocation without manipulation Closed treatment of femoral Pelvis/ Hip Trauma - 27268 fracture, proximal end, head; 0.00 0.00 1.82 Fracture and/or Dislocation with manipulation Open treatment of femoral Pelvis/ Hip Trauma - fracture, proximal end, head, 27269 0.03 0.01 0.30 Fracture and/or Dislocation includes internal fixation, when performed Pelvis/ Hip Other Unlisted procedure, pelvis or 27299 0.05 0.18 3.55 Procedures hip joint Incision and drainage of deep abscess, infected bursa, or 27301 Femur/ Knee Incision 0.22 0.24 1.07 hematoma, thigh or knee region. Incision, deep, with opening of 27303 Femur/ Knee Incision bone cortex (eg, for 0.03 0.06 2.06 osteomyelitis or bone COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 71

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate abscess), femur or knee. Fasciotomy, iliotibial 27305 Femur/ Knee Incision 0.01 0.01 0.99 (tenotomy), open. Tenotomy, subcutaneous, 27306 Femur/ Knee Incision closed, adductor or hamstring, 0.00 0.00 0.76 (separate procedure); single. Tenotomy, subcutaneous, closed, adductor or hamstring, 27307 Femur/ Knee Incision 0.00 0.00 2.91 (separate procedure); multiple. Arthrotomy, knee, for infection, with exploration, 27310 Femur/ Knee Incision 0.32 0.31 0.98 drainage or removal of foreign body. Biopsy, soft tissue of thigh or 27323 Femur/ Knee Excision 0.00 0.01 2.96 knee area; superficial. Biopsy, soft tissue of thigh or 27324 Femur/ Knee Excision 0.02 0.07 3.32 knee area; deep. Neurectomy, hamstring 27325 Femur/ Knee Excision 0.00 0.00 0.43 muscle Neurectomy, popliteal 27326 Femur/ Knee Excision 0.00 0.00 0.86 (gastrocnemius) Excision, tumor, thigh or knee 27327 Femur/ Knee Excision area; subcutaneous less than 0.02 0.03 1.59 3 cm Excision, tumor, thigh or knee 27328 Femur/ Knee Excision area; deep, subfascial, or 0.02 0.13 7.44 intramuscular less than 5 cm Radical resection of tumor (eg, malignant neoplasm), soft 27329 Femur/ Knee Excision 0.01 0.06 8.62 tissue of thigh or knee area less than 5 cm Arthrotomy, knee; with 27330 Femur/ Knee Excision 0.01 0.00 0.69 synovial biopsy only. Arthrotomy, knee; with joint exploration, with or without 27331 Femur/ Knee Excision biopsy, with or without 0.04 0.06 1.63 removal of loose or foreign bodies. Arthrotomy, knee, with excision of semilunar cartilage 27332 Femur/ Knee Excision 0.01 0.01 1.29 (meniscectomy); medial OR lateral. Arthrotomy, knee, with excision of semilunar cartilage 27333 Femur/ Knee Excision 0.00 0.00 7.38 (meniscectomy); medial AND lateral. Arthrotomy, knee, with 27334 Femur/ Knee Excision synovectomy; anterior OR 0.03 0.05 1.54 posterior. 27335 Femur/ Knee Excision Arthrotomy, knee, with 0.01 0.02 1.52 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 72

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate synovectomy; anterior AND posterior including popliteal area. Excision, tumor, thigh or knee 27337 Femur/ Knee Excision area; subcutaneous 3 cm or 0.01 0.00 0.03 greater Excision, tumor, thigh or knee 27339 Femur/ Knee Excision area; deep, subfascial, or 0.02 0.00 0.07 intramuscular5 cm or greater 27340 Femur/ Knee Excision Excision, prepatellar bursa. 0.06 0.03 0.47 Excision of synovial cyst of 27345 Femur/ Knee Excision 0.01 0.02 2.31 popliteal space (Baker's cyst). Excision of lesion of meniscus 27347 Femur/ Knee Excision 0.02 0.01 0.47 or capsule, knee Patellectomy or 27350 Femur/ Knee Excision 0.02 0.02 1.06 hemipatellectomy. Excision or curettage of bone 27355 Femur/ Knee Excision cyst or benign tumor of 0.02 0.05 2.06 femur;. Excision or curettage of bone 27356 Femur/ Knee Excision cyst or benign tumor of femur; 0.01 0.03 4.36 with allograft. Excision or curettage of bone cyst or benign tumor of femur; 27357 Femur/ Knee Excision 0.00 0.00 4.88 with autograft (includes obtaining graft). Excision or curettage of bone cyst or benign tumor of femur; 27358 Femur/ Knee Excision with internal fixation (list in 0.01 0.01 2.61 addition to 27355, 27356, or 27357). Partial excision (craterization, saucerization, or 27360 Femur/ Knee Excision diaphysectomy) of bone (eg, 0.04 0.04 0.90 for osteomyelitis), femur, proximal tibia and/ or fibula. Radical resection of tumor (eg, malignant neoplasm), soft 27364 Femur/ Knee Excision 0.02 0.00 0.06 tissue of thigh or knee area 5 cm or greater Radical resection of tumor, 27365 Femur/ Knee Excision 0.02 0.06 3.40 bone, femur or knee. Femur/ Knee repair, Removal of foreign body, 27380 Revision and/or deep, thigh region or knee 0.18 0.16 0.87 Reconstruction area. Femur/ Knee repair, Suture of infrapatellar tendon; 27381 Revision and/or 0.02 0.03 1.76 primary Reconstruction Femur/ Knee repair, secondary reconstruction, 27385 Revision and/or including fascial or tendon 0.21 0.18 0.83 Reconstruction graft COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 73

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Femur/ Knee repair, Suture of quadriceps or 27386 Revision and/or hamstring muscle rupture; 0.01 0.02 1.64 Reconstruction primary Femur/ Knee repair, secondary reconstruction, 27390 Revision and/or including fascial or tendon 0.00 0.00 Inf Reconstruction graft Femur/ Knee repair, Tenotomy, open, hamstring, 27391 Revision and/or 0.00 0.01 5.00 knee to hip; single tendon Reconstruction Femur/ Knee repair, 27392 Revision and/or multiple tendons, one leg 0.00 0.00 4.92 Reconstruction Femur/ Knee repair, 27393 Revision and/or multiple tendons, bilateral 0.00 0.00 2.25 Reconstruction Femur/ Knee repair, Lengthening of hamstring 27394 Revision and/or 0.00 0.00 3.03 tendon; single tendon Reconstruction Femur/ Knee repair, 27395 Revision and/or multiple tendons, one leg 0.00 0.00 1.84 Reconstruction Femur/ Knee repair, 27396 Revision and/or multiple tendons, bilateral 0.00 0.00 2.03 Reconstruction Femur/ Knee repair, Transplant or transfer (with 27397 Revision and/or muscle redirection or 0.00 0.00 2.50 Reconstruction rerouting), thigh; single tendon Femur/ Knee repair, 27400 Revision and/or multiple tendons 0.00 0.00 2.62 Reconstruction Femur/ Knee repair, Transfer, tendon or muscle, 27403 Revision and/or 0.08 0.05 0.61 hamstrings to femur Reconstruction Femur/ Knee repair, Arthrotomy with meniscus 27405 Revision and/or 0.05 0.07 1.41 repair, knee Reconstruction Femur/ Knee repair, Repair, primary, torn ligament 27407 Revision and/or and/or capsule, knee; 0.00 0.02 5.43 Reconstruction collateral Femur/ Knee repair, 27409 Revision and/or cruciate 0.00 0.02 4.84 Reconstruction Femur/ Knee repair, collateral and cruciate 27412 Revision and/or 0.01 0.02 4.08 ligaments Reconstruction Femur/ Knee repair, Autologous chondrocyte 27415 Revision and/or 0.01 0.03 2.34 implantation, knee Reconstruction Femur/ Knee repair, Osteohondral allograft, knee, 27416 Revision and/or 0.00 0.01 1.05 open Reconstruction COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 74

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Femur/ Knee repair, Osteochondral, knee, open 27418 Revision and/or (includes harvesting of 0.03 0.04 1.55 Reconstruction autografts) Femur/ Knee repair, 27420 Revision and/or Anterior tibial tubercleplasty 0.03 0.03 1.23 Reconstruction Femur/ Knee repair, Reconstruction of dislocating 27422 Revision and/or 0.04 0.05 1.55 patella Reconstruction Femur/ Knee repair, with extensor realignment 27424 Revision and/or and/or muscle advancement 0.00 0.00 2.17 Reconstruction or release Femur/ Knee repair, 27425 Revision and/or with patellectomy 0.02 0.04 2.50 Reconstruction Femur/ Knee repair, Lateral retinacular release, 27427 Revision and/or 0.09 0.09 1.01 open Reconstruction Femur/ Knee repair, Ligamentous reconstruction 27428 Revision and/or (augmentation), knee; extra- 0.01 0.02 2.34 Reconstruction articular Femur/ Knee repair, 27429 Revision and/or intra-articular (open) 0.01 0.02 4.11 Reconstruction Femur/ Knee repair, intra-articular (open) and 27430 Revision and/or 0.01 0.03 1.78 extra-articular Reconstruction Femur/ Knee repair, Quadricepsplasty (eg, Bennett 27435 Revision and/or 0.00 0.01 3.37 or Thompson type) Reconstruction Femur/ Knee repair, Capsulotomy, posterior 27437 Revision and/or 0.01 0.00 0.42 capsular release, knee Reconstruction Femur/ Knee repair, Arthroplasty, patella; without 27438 Revision and/or 0.02 0.04 2.28 prosthesis Reconstruction Femur/ Knee repair, 27440 Revision and/or with prosthesis 0.00 0.00 14.97 Reconstruction Femur/ Knee repair, Arthoroplasty, knee, tibial 27441 Revision and/or 0.00 0.01 33.05 plateau Reconstruction Femur/ Knee repair, with debridement and 27442 Revision and/or 0.00 0.03 7.17 partial synovectomy Reconstruction Femur/ Knee repair, Arthroplasty, femoral condyles 27443 Revision and/or 0.00 0.01 7.24 or tibial plateay(s), knee Reconstruction Femur/ Knee repair, with debridement and 27445 Revision and/or 0.01 0.04 3.38 partial synovectomy Reconstruction COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 75

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Femur/ Knee repair, Arthroplasty, knee, hinge 27446 Revision and/or 0.16 0.26 1.65 prosthesis Reconstruction Femur/ Knee repair, Arthroplasty, knee, condyle 27447 Revision and/or and plateau; medial OR lateral 3.25 6.01 1.85 Reconstruction compartment medial AND lateral Femur/ Knee repair, compartments with or without 27448 Revision and/or 0.00 0.00 0.98 parella resurfacing (total knee Reconstruction arthroplasty) Femur/ Knee repair, Osteotomy, femur, shaft or 27450 Revision and/or 0.01 0.03 4.24 supracondylar; without fixation Reconstruction Femur/ Knee repair, 27454 Revision and/or with fixation 0.00 0.00 2.52 Reconstruction Femur/ Knee repair, Osteotomy, multiple, with 27455 Revision and/or realignment on intramedullary 0.00 0.00 1.86 Reconstruction rod, femoral shaft Osteotomy, proximal tibia, including fibular excision or Femur/ Knee repair, osteotomy (includes 27457 Revision and/or correction of genu varus 0.02 0.04 2.47 Reconstruction [bowleg] or genu valgus [knock knee]); before epiphyseal closure Femur/ Knee repair, 27465 Revision and/or after epiphyseal closure 0.00 0.00 4.24 Reconstruction Femur/ Knee repair, 27466 Revision and/or Osteoplasty, femyr;shortening 0.00 0.00 1.60 Reconstruction Femur/ Knee repair, 27468 Revision and/or lengthening 0.00 0.00 3.64 Reconstruction Femur/ Knee repair, combined, lengthing and 27470 Revision and/or shortening with femoral 0.02 0.04 1.68 Reconstruction segment transfer Femur/ Knee repair, Repair, nonunion or malunion, 27472 Revision and/or femyr, distal to head and 0.03 0.06 1.91 Reconstruction neck: without graft Femur/ Knee repair, with iliac or other 27475 Revision and/or autogenous bone graft 0.00 0.00 2.51 Reconstruction (includes obtaining graft) Femur/ Knee repair, Arrest, epiphyseal, any 27477 Revision and/or 0.00 0.00 0.98 method; distal femur Reconstruction Femur/ Knee repair, 27479 Revision and/or tibial and fibula, proximal 0.00 0.00 Inf Reconstruction 27485 Femur/ Knee repair, combined distal femur, 0.00 0.00 1.98 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 76

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Revision and/or proximal tibial or fibula Reconstruction Femur/ Knee repair, Arrest, hemiepiphyseal, distal 27486 Revision and/or femur or proximal tibia or 0.16 0.21 1.28 Reconstruction fibula Femur/ Knee repair, Revison of total knee 27487 Revision and/or arthroplasty, with or without 0.30 0.49 1.61 Reconstruction allograft; 1 component Femur/ Knee repair, femoral and entire tibial 27488 Revision and/or 0.14 0.20 1.38 component Reconstruction Removal of prosthesis, including total knee Femur/ Knee repair, prosthesis, 27495 Revision and/or 0.03 0.05 1.57 methylmethacrylate with or Reconstruction without insertion of spacer, knee Prophylactic treatment Femur/ Knee repair, (nailing, pinning, plating,or 27496 Revision and/or 0.00 0.00 1.08 wiring) with or without Reconstruction methylmethacrylate, femur Decompression fasciotomy, Femur/ Knee repair, thigh and/or knee, one 27497 Revision and/or 0.00 0.00 1.45 compartment (flexor or Reconstruction extensor or adductor); Femur/ Knee repair, with debridement of 27498 Revision and/or nonviable muscle and/or 0.01 0.01 1.75 Reconstruction nerve Femur/ Knee repair, Decompression fasciotomy, 27499 Revision and/or thigh and/or knee, multiple 0.00 0.01 9.14 Reconstruction compartments; with debridement of Femur/Knee Trauma - 27506 nonviable muscle and/or 0.66 1.24 1.89 Fracture and/ or Dislocation nerve Open treatment of femoral shaft fracture, with or without Femur/Knee Trauma - external fixation, with insertion 27507 0.13 0.16 1.18 Fracture and/ or Dislocation of intramedullary implant, with or without cerclage and/or locking screws. Open treatment of femoral Femur/Knee Trauma - shaft fracture with 27509 0.01 0.05 5.52 Fracture and/ or Dislocation plate/screws, with or without cerclage. Percutaneous skeletal fixation of femoral fracture, distal end, medial or lateral condyle, or Femur/Knee Trauma - 27511 supracondylar or 0.16 0.16 1.01 Fracture and/ or Dislocation transcondylar, with or without intercondylar extension, or distal femoral epiphyseal COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 77

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate separation. Open treatment of femoral supracondylar or Femur/Knee Trauma - transcondylar fracture without 27513 0.14 0.21 1.57 Fracture and/ or Dislocation intercondylar extension, with or without internal or external fixation. Open treatment of femoral supracondylar or Femur/Knee Trauma - transcondylar fracture with 27514 0.10 0.10 1.05 Fracture and/ or Dislocation intercondylar extension, with or without internal or external fixation. Open treatment of femoral Femur/Knee Trauma - fracture, distal end, medial or 27519 0.00 0.00 8.07 Fracture and/ or Dislocation lateral condyle, with or without internal or external fixation. Open treatment of distal Femur/Knee Trauma - femoral epiphyseal 27524 0.30 0.35 1.14 Fracture and/ or Dislocation separation, with or without internal or external fixation. Open treatment of patellar fracture, with internal fixation Femur/Knee Trauma - 27535 and/or partial or complete 0.35 0.41 1.15 Fracture and/ or Dislocation patellectomy and soft tissue repair. Open treatment of tibial Femur/Knee Trauma - fracture, proximal (plateau); 27536 0.27 0.40 1.45 Fracture and/ or Dislocation unicondylar, with or without internal or external fixation. Open treatment of tibial Femur/Knee Trauma - fracture, proximal (plateau); 27540 0.04 0.02 0.41 Fracture and/ or Dislocation bicondylar, with or without internal fixation. Open treatment of intercondylar spine(s) and/or Femur/Knee Trauma - 27552 tuberosity fracture(s) of the 0.02 0.03 1.40 Fracture and/ or Dislocation knee, with or without internal or external fixation. Closed treatment of knee Femur/Knee Trauma - 27556 dislocation; requiring 0.01 0.01 1.90 Fracture and/ or Dislocation anesthesia. Open treatment of knee dislocation, with or without Femur/Knee Trauma - internal or external fixation; 27557 0.00 0.01 1.87 Fracture and/ or Dislocation without primary ligamentous repair or augmentation/reconstruction. Open treatment of knee Femur/Knee Trauma - 27558 dislocation, with or without 0.00 0.01 2.93 Fracture and/ or Dislocation internal or external fixation; COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 78

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate with primary ligamentous repair. Open treatment of knee dislocation, with or without Femur/Knee Trauma - internal or external fixation; 27562 0.00 0.00 1.95 Fracture and/ or Dislocation with primary ligamentous repair, with augmentation/reconstruction. Closed treatment of patellar Femur/Knee Trauma - 27566 dislocation; requiring 0.00 0.01 4.20 Fracture and/ or Dislocation anesthesia. Open treatment of patellar Femur/ Knee Trauma - 27570 dislocation, with or without 0.24 0.26 1.11 Manipulation partial or total patellectomy. Manipulation of knee joint under general anesthesia 27590 Femur/ Knee Amputation (includes application of 0.06 0.11 1.80 traction or other fixation devices). Amputation, thigh, through 27591 Femur/ Knee Amputation 0.00 0.01 17.97 femur, any level;. Amputation, thigh, through femur, any level; immediate 27592 Femur/ Knee Amputation 0.01 0.01 1.77 fitting technique including first cast. Amputation, thigh, through 27594 Femur/ Knee Amputation femur, any level; open, 0.01 0.02 1.81 circular (guillotine). Amputation, thigh, through 27596 Femur/ Knee Amputation femur, any level; secondary 0.02 0.03 1.65 closure or scar revision. Amputation, thigh, through 27598 Femur/ Knee Amputation femur, any level; re- 0.01 0.02 1.60 amputation. Femur/ Knee Other 27599 Disarticulation at knee. 0.03 0.11 3.44 Procedures Decompression fasciotomy, 27600 Leg/Ankle Incision leg; anterior and/or lateral 0.03 0.05 1.49 compartments only. Decompression fasciotomy, 27601 Leg/Ankle Incision leg; posterior compartment(s) 0.02 0.01 0.44 only. Decompression fasciotomy, 27602 Leg/Ankle Incision leg; anterior and/or lateral, 0.10 0.12 1.25 and posterior compartment(s). Incision and drainage, leg or 27603 Leg/Ankle Incision ankle; deep abscess or 0.16 0.26 1.60 hematoma. Incision and drainage, leg or 27604 Leg/Ankle Incision 0.01 0.02 2.50 ankle; infected bursa. 27605 Leg/Ankle Incision Tenotomy, Achilles tendon, 0.01 0.01 0.87 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 79

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate subcutaneous (separate procedure); local anesthesia. Tenotomy, Achilles tendon, subcutaneous (separate 27606 Leg/Ankle Incision 0.05 0.11 1.95 procedure); general anesthesia. Incision, deep, with opening of bone cortex (eg, for 27607 Leg/Ankle Incision 0.03 0.08 2.42 osteomyelitis or bone abscess), leg or ankle. Arthrotomy, ankle, for infection, with exploration, 27610 Leg/Ankle Incision 0.07 0.06 0.88 drainage, or removal of foreign body. Arthrotomy, ankle, posterior capsular release, with or 27612 Leg/Ankle Incision 0.00 0.01 2.81 without Achilles tendon lengthening. Biopsy, soft tissue of leg or 27613 Leg/Ankle Excision 0.00 0.01 3.41 ankle area; superficial. Biopsy, soft tissue of leg or 27614 Leg/Ankle Excision 0.01 0.03 3.34 ankle area; deep. Radical resection of tumor (eg, malignant neoplasm), soft 27615 Leg/Ankle Excision 0.00 0.02 5.06 tissue of leg or ankle area less than 5 cm Radical resection of tumor (eg, malignant neoplasm), soft 27616 Leg/Ankle Excision 0.01 0.00 0.09 tissue of leg or ankle area 5 cm or greater Excision, tumor, leg or ankle 27618 Leg/Ankle Excision area; subcutaneous; less than 0.01 0.02 1.64 3 cm Excision, tumor, leg or ankle 27619 Leg/Ankle Excision area; deep, subfascial or 0.01 0.05 4.57 intramuscular; less than 5 cm Arthrotomy, ankle, with joint exploration, with or without 27620 Leg/Ankle Excision biopsy, with or without 0.03 0.05 1.41 removal of loose or foreign body. Arthrotomy, ankle, with 27625 Leg/Ankle Excision 0.01 0.01 1.27 synovectomy;. Arthrotomy, ankle, with 27626 Leg/Ankle Excision synovectomy; including 0.01 0.01 0.51 tenosynovectomy. Excision of lesion of tendon 27630 Leg/Ankle Excision sheath or capsule (eg, cyst or 0.03 0.03 0.82 ganglion), leg and/or ankle. Excision, tumor, leg or ankle 27632 Leg/Ankle Excision 0.01 0.00 0.02 area; subcutaneous; 3 cm or COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 80

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate greater Excision, tumor, leg or ankle 27634 Leg/Ankle Excision area; deep, subfascial or 0.01 0.00 0.06 intramuscular; 5 cm or greater Excision or curettage of bone 27635 Leg/Ankle Excision cyst or benign tumor, tibia or 0.05 0.05 0.88 fibula;. Excision or curettage of bone cyst or benign tumor, tibia or 27637 Leg/Ankle Excision 0.00 0.01 3.46 fibula; with autograft (includes obtaining graft). Excision or curettage of bone 27638 Leg/Ankle Excision cyst or benign tumor, tibia or 0.01 0.03 2.77 fibula; with allograft. Partial excision (craterization, saucerization, or 27640 Leg/Ankle Excision diaphysectomy) of bone (eg, 0.07 0.08 1.13 for osteomyelitis or exostosis); tibia. Partial excision (craterization, saucerization, or 27641 Leg/Ankle Excision diaphysectomy) of bone (eg, 0.02 0.02 0.83 for osteomyelitis or exostosis); fibula. Radical resection of tumor, 27645 Leg/Ankle Excision 0.00 0.01 2.90 bone; tibia. Radical resection of tumor, 27646 Leg/Ankle Excision 0.00 0.00 2.14 bone; fibula. Radical resection of tumor, 27647 Leg/Ankle Excision 0.00 0.00 1.44 bone; talus or calcaneus. Leg/ Ankle Repair, Repair, primary, open or 27650 Revision, and/or percutaneous, ruptured 0.38 0.26 0.69 Reconstruction Achilles tendon; Leg/ Ankle Repair, with graft (includes 27652 Revision, and/or 0.02 0.03 1.54 obtaining graft) Reconstruction Leg/ Ankle Repair, Repair, secondary, Achilles 27654 Revision, and/or 0.08 0.06 0.75 tendon, with or without graft Reconstruction Leg/ Ankle Repair, 27656 Revision, and/or Repair, fascial defect of leg 0.00 0.00 1.21 Reconstruction Leg/ Ankle Repair, Repair, flexor tendon, leg; 27658 Revision, and/or primary, without graft, each 0.06 0.03 0.58 Reconstruction tendon Leg/ Ankle Repair, secondary, with or without 27659 Revision, and/or 0.03 0.01 0.35 graft, each tendon Reconstruction Leg/ Ankle Repair, Repair, extensor tendon, leg; 27664 Revision, and/or primary, without graft, each 0.03 0.03 0.91 Reconstruction tendon COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 81

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Leg/ Ankle Repair, secondary, with or without 27665 Revision, and/or 0.02 0.01 0.26 graft, each tendon Reconstruction Leg/ Ankle Repair, Repair, dislocating peroneal 27675 Revision, and/or tendons; without fibular 0.04 0.05 1.18 Reconstruction osteotomy Leg/ Ankle Repair, 27676 Revision, and/or with fibular osteotomy 0.02 0.02 0.88 Reconstruction Leg/ Ankle Repair, Tenolysis, flexor or extensor 27680 Revision, and/or tendon, leg and/or ankle; 0.11 0.05 0.45 Reconstruction single, each tendon Leg/ Ankle Repair, multiple tendons (through 27681 Revision, and/or 0.00 0.01 1.08 separate incision[s]) Reconstruction Leg/ Ankle Repair, Lengthening or shortening of 27685 Revision, and/or tendon, leg or ankle; single 0.06 0.07 1.14 Reconstruction tendon Leg/ Ankle Repair, multiple tendons (through 27686 Revision, and/or 0.00 0.02 5.58 same incision[s]) Reconstruction Leg/ Ankle Repair, 27687 Revision, and/or Gastrocnemius recession 0.15 0.14 0.91 Reconstruction Transfer or transplant of Leg/ Ankle Repair, single tendon (with muscle 27690 Revision, and/or 0.03 0.04 1.29 redirection or rerouting); Reconstruction superficial Leg/ Ankle Repair, 27691 Revision, and/or deep 0.17 0.14 0.83 Reconstruction Leg/ Ankle Repair, 27692 Revision, and/or each additional tendon 0.01 0.02 1.36 Reconstruction Leg/ Ankle Repair, Repair, primary, disrupted 27695 Revision, and/or 0.09 0.09 1.07 ligament, ankle; collateral Reconstruction Leg/ Ankle Repair, 27696 Revision, and/or both collateral ligaments 0.04 0.02 0.65 Reconstruction Leg/ Ankle Repair, Repair, secondary, disrupted 27698 Revision, and/or ligament, ankle, collateral (eg, 0.12 0.08 0.69 Reconstruction Watson-Jones procedure) Leg/ Ankle Repair, 27700 Revision, and/or Arthroplasty, ankle 0.00 0.01 3.56 Reconstruction Leg/ Ankle Repair, 27702 Revision, and/or with implant (total ankle) 0.03 0.05 1.72 Reconstruction Leg/ Ankle Repair, 27703 revision, total ankle 0.00 0.01 3.28 Revision, and/or COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 82

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Reconstruction Leg/ Ankle Repair, 27704 Revision, and/or Removla of ankle implant 0.01 0.13 11.98 Reconstruction Leg/ Ankle Repair, 27705 Revision, and/or Osteotomy; tibial 0.02 0.06 2.92 Reconstruction Leg/ Ankle Repair, 27707 Revision, and/or fibula 0.02 0.03 1.78 Reconstruction Leg/ Ankle Repair, 27709 Revision, and/or tibia and fibula 0.01 0.03 2.76 Reconstruction Leg/ Ankle Repair, multiple, with realignment 27712 Revision, and/or 0.00 0.00 5.24 on intramedullary rod Reconstruction Leg/ Ankle Repair, Osteoplasty, tibia and fibula, 27715 Revision, and/or 0.01 0.01 1.86 lengthening or shortening Reconstruction Leg/ Ankle Repair, Repair of nonunion or 27720 Revision, and/or 0.03 0.06 1.81 malunion, tibia: without graft Reconstruction Leg/ Ankle Repair, 27722 Revision, and/or with sliding graft 0.00 0.01 5.81 Reconstruction Leg/ Ankle Repair, with iliac or other autograft 27724 Revision, and/or 0.04 0.10 2.25 (includes obtaining graft) Reconstruction Leg/ Ankle Repair, by synostosis, with fibula, 27725 Revision, and/or 0.00 0.01 26.84 any method Reconstruction Leg/ Ankle Repair, Repair of fibula nonunion 27726 Revision, and/or and/or malunion with internal 0.02 0.01 0.61 Reconstruction fixation Leg/ Ankle Repair, Repair of congenital 27727 Revision, and/or 0.00 0.00 Inf pseudarthrosis, tibia Reconstruction Leg/ Ankle Repair, Arrest, epiphyseal 27730 Revision, and/or (epiphysiodesis), open; distal 0.00 0.00 Inf Reconstruction tibia Leg/ Ankle Repair, 27732 Revision, and/or distal fibula 0.00 0.00 0.64 Reconstruction Leg/ Ankle Repair, 27734 Revision, and/or distal tibia and fibula 0.00 0.00 0.96 Reconstruction Arrest, epiphyseal Leg/ Ankle Repair, (epiphysiodesis), any method, 27740 Revision, and/or 0.00 0.00 Inf combined, proximal and distal Reconstruction tibia and fibula 27742 Leg/ Ankle Repair, and distal femur 0.00 0.00 Inf COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 83

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Revision, and/or Reconstruction Prophylactic treatment Leg/ Ankle Repair, (nailing, pinning, plating or 27745 Revision, and/or 0.01 0.01 2.36 wiring) with or without Reconstruction methylmethacrylate, tibia Percutaneous skeletal fixation Leg/ Ankle Trauma - of tibial shaft fracture (with or 27756 0.01 0.11 8.05 Fracture and/or Dislocation without fibular fracture) (eg, pins or screws). Open treatment of tibial shaft fracture, (with or without Leg/ Ankle Trauma - 27758 fibular fracture) with 0.15 0.24 1.59 Fracture and/or Dislocation plate/screws, with or without cerclage. Open treatment of tibial shaft fracture (with or without fibular Leg/ Ankle Trauma - fracture) by intramedullary 27759 0.77 1.15 1.49 Fracture and/or Dislocation implant, with or without interlocking screws and/or cerclage. Open treatment of medial Leg/ Ankle Trauma - malleolus fracture, with or 27766 0.24 0.25 1.05 Fracture and/or Dislocation without internal or external fixation. Open treatment of posterior Leg/ Ankle Trauma - malleous fracture,includes 27769 0.03 0.01 0.23 Fracture and/or Dislocation internal fixation, when performed Open treatment of proximal Leg/ Ankle Trauma - fibula or shaft fracture, with or 27784 0.06 0.05 0.79 Fracture and/or Dislocation without internal or external fixation. Open treatment of distal Leg/ Ankle Trauma - fibular fracture (lateral 27792 0.98 0.75 0.76 Fracture and/or Dislocation malleolus), with or without internal or external fixation. Open treatment of bimalleolar Leg/ Ankle Trauma - 27814 ankle fracture, with or without 0.90 1.11 1.23 Fracture and/or Dislocation internal or external fixation. Open treatment of trimalleolar ankle fracture, with or without Leg/ Ankle Trauma - internal or external fixation, 27822 0.45 0.25 0.56 Fracture and/or Dislocation medial and/or lateral malleolus; without fixation of posterior lip. Open treatment of trimalleolar ankle fracture, with or without Leg/ Ankle Trauma - 27823 internal or external fixation, 0.16 0.15 0.96 Fracture and/or Dislocation medial and/or lateral malleolus; with fixation of COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 84

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate posterior lip. Open treatment of fracture of weight bearing articular Leg/ Ankle Trauma - surface/ portion of distal tibia 27826 0.04 0.04 1.06 Fracture and/or Dislocation (eg, pilon or tibial plafond), with internal or external fixation; of fibula only. Open treatment of fracture of weight bearing articular Leg/ Ankle Trauma - surface/ portion of distal tibia 27827 0.19 0.24 1.25 Fracture and/or Dislocation (eg, pilon or tibial plafond), with internal or external fixation; of tibia only. Open treatment of fracture of weight bearing articular surface/ portion of distal tibia Leg/ Ankle Trauma - 27828 (eg, pilon or tibial plafond), 0.19 0.28 1.48 Fracture and/or Dislocation with internal or external fixation; of both tibia and fibula. Open treatment of distal Leg/ Ankle Trauma - tibiofibular joint (syndesmosis) 27829 0.73 0.48 0.66 Fracture and/or Dislocation disruption, with or without internal or external fixation. Closed treatment of proximal Leg/ Ankle Trauma - 27831 tibiofibular joint dislocation; 0.00 0.00 0.82 Fracture and/or Dislocation requiring anesthesia. Open treatment of proximal tibiofibular joint dislocation, Leg/ Ankle Trauma - 27832 with or without internal or 0.00 0.01 1.19 Fracture and/or Dislocation external fixation, or with excision of proximal fibula. Closed treatment of ankle Leg/ Ankle Trauma - dislocation; requiring 27842 0.02 0.07 3.16 Fracture and/or Dislocation anesthesia, with or without percutaneous skeletal fixation. Open treatment of ankle dislocation, with or without Leg/ Ankle Trauma - 27846 percutaneous skeletal fixation; 0.01 0.03 2.03 Fracture and/or Dislocation without repair or internal fixation. Open treatment of ankle dislocation, with or without Leg/ Ankle Trauma - 27848 percutaneous skeletal fixation; 0.03 0.09 3.46 Fracture and/or Dislocation with repair or internal or external fixation. Arthrodesis, ankle, any 27870 Leg/ Ankle Arthrodesis 0.09 0.22 2.39 method. Arthrodesis, tibiofibular joint, 27871 Leg/ Ankle Arthrodesis 0.01 0.02 2.23 proximal or distal. 27880 Leg/ Ankle Amputation Amputation, leg, through tibia 0.16 0.22 1.33 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 85

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate and fibula;. Amputation, leg, through tibia and fibula; with immediate 27881 Leg/ Ankle Amputation 0.01 0.02 2.26 fitting technique including application of first cast. Amputation, leg, through tibia 27882 Leg/ Ankle Amputation and fibula; open, circular 0.03 0.03 1.13 (guillotine). Amputation, leg, through tibia 27884 Leg/ Ankle Amputation and fibula; secondary closure 0.02 0.03 1.53 or scar revision. Amputation, leg, through tibia 27886 Leg/ Ankle Amputation 0.04 0.05 1.35 and fibula; re-amputation. Amputation, ankle, through malleoli of tibia and fibula (Syme, Pirogoff type 27888 Leg/ Ankle Amputation 0.00 0.01 3.39 procedures), with plastic closure and resection of nerves. 27889 Leg/ Ankle Amputation Ankle disarticulation. 0.00 0.00 1.46 Decompression fasciotomy, leg; anterior and/or lateral Leg/ Ankle Other 27892 compartments only, with 0.01 0.01 1.50 Procedures debridement of nonviable muscle and/or nerve Decompression fasciotomy, leg; posterior compartments Leg/ Ankle Other 27893 only, with debridement of 0.00 0.00 1.41 Procedures nonviable muscle and/or nerve Decompression fasciotomy, leg; anterior and/or lateral Leg/ Ankle Other 27894 compartments only, with 0.02 0.05 3.08 Procedures debridement of nonviable muscle and/or nerve Leg/ Ankle Other Unlisted procedure, leg or 27899 0.02 0.12 7.22 Procedures ankle Incision and drainage, 28001 Foot/ Toes Incision 0.00 0.02 3.94 infected bursa, foot. Deep dissection below fascia, for deep infection of foot, with 28002 Foot/ Toes Incision or without tendon sheath 0.04 0.03 0.76 involvement; single bursal space, specify. Deep dissection below fascia, for deep infection of foot, with 28003 Foot/ Toes Incision 0.03 0.07 2.76 or without tendon sheath involvement; multiple areas. Incision, deep, with opening of 28005 Foot/ Toes Incision bone cortex (eg, for 0.04 0.05 1.27 osteomyelitis or bone COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 86

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate abscess), foot. 28008 Foot/ Toes Incision Fasciotomy, foot and/or toe. 0.01 0.02 1.80 Tenotomy, subcutaneous, toe; 28010 Foot/ Toes Incision 0.01 0.02 2.76 single. Tenotomy, subcutaneous, toe; 28011 Foot/ Toes Incision 0.01 0.02 1.93 multiple. Arthrotomy, with exploration, drainage, or removal of loose 28020 Foot/ Toes Incision 0.01 0.01 0.72 or foreign body; intertarsal or tarsometatarsal joint. Arthrotomy, with exploration, drainage, or removal of loose 28022 Foot/ Toes Incision 0.01 0.01 0.65 or foreign body; metatarsophalangeal joint. Arthrotomy, with exploration, drainage, or removal of loose 28024 Foot/ Toes Incision 0.00 0.01 1.04 or foreign body; interphalangeal joint. Neurectomy of intrinsic 28035 Foot/ Toes Incision 0.02 0.03 1.28 musculature of foot. Tarsal tunnel release 28039 Foot/ Toes Excision (posterior tibial nerve 0.01 0.00 0.02 decompression). Excision, tumor, foot; 28041 Foot/ Toes Excision subcutaneous; 1.5 cm or 0.01 0.00 0.02 greater Excision, tumor, foot; deep, 28043 Foot/ Toes Excision subfascial, intramuscular; 1.5 0.01 0.03 1.88 cm or greater Excision, tumor, foot; 28045 Foot/ Toes Excision subcutaneous; less than1.5 0.01 0.03 3.77 cm Excision, tumor, foot; deep, 28046 Foot/ Toes Excision subfascial, intramuscular; less 0.00 0.00 2.55 than 1.5 cm Radical resection of tumor 28050 Foot/ Toes Excision (eg, malignant neoplasm), soft 0.00 0.00 1.16 tissue of foot; 3 cm or greater Arthrotomy for synovial 28052 Foot/ Toes Excision biopsy; intertarsal or 0.00 0.00 4.17 tarsometatarsal joint. Arthrotomy for synovial 28054 Foot/ Toes Excision biopsy; metatarsophalangeal 0.00 0.00 1.78 joint. Arthrotomy for synovial 28055 Foot/ Toes Excision 0.00 0.00 2.89 biopsy; interphalangeal joint. Neurectomy, intrinsic 28060 Foot/ Toes Excision 0.02 0.03 1.12 musculature of foot Fasciectomy, excision of 28062 Foot/ Toes Excision plantar fascia; partial 0.00 0.00 1.43 (separate procedure). COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 87

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Fasciectomy, excision of 28070 Foot/ Toes Excision plantar fascia; radical 0.00 0.00 0.69 (separate procedure). Synovectomy; intertarsal or 28072 Foot/ Toes Excision 0.00 0.01 1.18 tarsometatarsal joint, each. Synovectomy; 28080 Foot/ Toes Excision metatarsophalangeal joint, 0.04 0.06 1.52 each. Excision of interdigital 28086 Foot/ Toes Excision (Morton) neuroma, single, 0.02 0.01 0.61 each. Synovectomy, tendon sheath, 28088 Foot/ Toes Excision 0.00 0.00 1.65 foot; flexor. Synovectomy, tendon sheath, 28090 Foot/ Toes Excision 0.04 0.04 1.03 foot; extensor. Excision of lesion of tendon or fibrous sheath or capsule 28092 Foot/ Toes Excision 0.01 0.01 1.00 (including synovectomy) (cyst or ganglion); foot. Excision of lesion of tendon or fibrous sheath or capsule 28100 Foot/ Toes Excision 0.02 0.02 1.03 (including synovectomy) (cyst or ganglion); toes. Excision or curettage of bone 28102 Foot/ Toes Excision cyst or benign tumor, talus or 0.00 0.00 5.78 calcaneus;. Excision or curettage of bone cyst or benign tumor, talus or 28103 Foot/ Toes Excision calcaneus; with iliac or other 0.00 0.01 1.71 autograft (includes obtaining graft). Excision or curettage of bone 28104 Foot/ Toes Excision cyst or benign tumor, talus or 0.01 0.01 1.44 calcaneus; with allograft. Excision or curettage of bone cyst or benign tumor, tarsal or 28106 Foot/ Toes Excision 0.00 0.00 1.26 metatarsal bones, except talus or calcaneus;. Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal bones, except 28107 Foot/ Toes Excision 0.00 0.00 2.33 talus or calcaneus; with iliac or other autograft (includes obtaining graft). Excision or curettage of bone cyst or benign tumor, tarsal or 28108 Foot/ Toes Excision metatarsal bones, except 0.01 0.01 2.03 talus or calcaneus; with allograft. Excision or curettage of bone 28110 Foot/ Toes Excision 0.01 0.02 1.83 cyst or benign tumor, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 88

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate phalanges of foot. Ostectomy, partial excision, fifth metatarsal head 28111 Foot/ Toes Excision 0.00 0.01 7.91 (bunionette) (separate procedure). Ostectomy, complete 28112 Foot/ Toes Excision 0.01 0.04 2.73 excision; first metatarsal head. Ostectomy, complete 28113 Foot/ Toes Excision excision; other metatarsal 0.01 0.02 2.52 head (second, third or fourth). Ostectomy, complete 28114 Foot/ Toes Excision 0.01 0.01 1.46 excision; fifth metatarsal head. Ostectomy, complete excision; all metatarsal heads, with partial proximal 28116 Foot/ Toes Excision 0.01 0.01 1.65 phalangectomy, excluding first metatarsal (Clayton type procedure). Ostectomy, excision of tarsal 28118 Foot/ Toes Excision 0.07 0.06 0.84 coalition. 28119 Foot/ Toes Excision Ostectomy, calcaneus;. 0.01 0.02 1.66 Ostectomy, calcaneus; for 28120 Foot/ Toes Excision spur, with or without plantar 0.11 0.07 0.62 fascial release. Partial excision (craterization, saucerization, sequestrectomy, or 28122 Foot/ Toes Excision 0.06 0.05 0.84 diaphysectomy) of bone (eg, for osteomyelitis or talar bossing), talus or calcaneus. Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, 28124 Foot/ Toes Excision for osteomyelitis or tarsal 0.02 0.02 1.01 bossing), tarsal or metatarsal bone, except talus or calcaneus. Partial excision (craterization, saucerization, or 28126 Foot/ Toes Excision diaphysectomy) of bone (eg, 0.00 0.01 2.66 for osteomyelitis or dorsal bossing), phalanx of toe. Resection, partial or complete, 28130 Foot/ Toes Excision phalangeal base, single toe, 0.00 0.00 5.63 each. 28140 Foot/ Toes Excision Talectomy (astragalectomy). 0.00 0.00 1.06 28150 Foot/ Toes Excision Metatarsectomy. 0.00 0.00 4.92 Phalangectomy of toe, single, 28153 Foot/ Toes Excision 0.00 0.01 10.03 each. Resection, head of phalanx, 28160 Foot/ Toes Excision 0.01 0.01 1.58 toe. COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 89

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Hemiphalangectomy or 28171 Foot/ Toes Excision interphalangeal joint excision, 0.00 0.00 1.50 toe, single, each. Radical resection of tumor, 28173 Foot/ Toes Excision bone; tarsal (except talus or 0.00 0.00 Inf calcaneus). Radical resection of tumor, 28175 Foot/ Toes Excision 0.00 0.00 Inf bone; metatarsal. Foot/ Toes Repair, Revision Radical resection of tumor, 28200 0.03 0.02 0.73 and/or Reconstruction bone; phalanx of toe. Repair, tendon, flexor, foot; Foot/ Toes Repair, Revision 28202 primary or secondary, without 0.00 0.00 5.78 and/or Reconstruction free graft, each tendon Repair, tendon, flexor, foot; Foot/ Toes Repair, Revision secondary with free graft, 28208 0.04 0.03 0.99 and/or Reconstruction each tendon (includes obtaining graft) Repair, tendon, extensor, foot; Foot/ Toes Repair, Revision 28210 primary or secondary, each 0.00 0.00 2.06 and/or Reconstruction tendon Repair, tendon, extensor, foot; Foot/ Toes Repair, Revision secondary with free graft, 28220 0.00 0.01 3.41 and/or Reconstruction each tendon (includes obtaining graft) Foot/ Toes Repair, Revision Tenolysis, flexor, foot; single 28222 0.00 0.01 3.18 and/or Reconstruction tendon Foot/ Toes Repair, Revision Tenolysis, flexor, foot; multiple 28225 0.01 0.01 1.27 and/or Reconstruction tendons Foot/ Toes Repair, Revision Tenolysis, extensor, foot; 28226 0.00 0.00 3.06 and/or Reconstruction single tendon Foot/ Toes Repair, Revision Tenolysis, extensor, foot; 28230 0.02 0.03 2.03 and/or Reconstruction multiple tendons Tenotomy, open, tendon Foot/ Toes Repair, Revision 28232 flexor; foot, single or multiple 0.04 0.03 0.95 and/or Reconstruction tendon(s) Foot/ Toes Repair, Revision Tenotomy, open, tendon 28234 0.03 0.05 1.67 and/or Reconstruction flexor; toe single tendon Foot/ Toes Repair, Revision Tenotomy, open, extensor, 28238 0.02 0.03 1.45 and/or Reconstruction foot or toe, each tendon Reconstruction (advancement), posterior tibial Foot/ Toes Repair, Revision 28240 tendon with excision of 0.00 0.00 0.84 and/or Reconstruction accessory tarsal navicular bone Tenotomy, lengthening, or Foot/ Toes Repair, Revision 28250 release, abductor hallucis 0.02 0.02 1.18 and/or Reconstruction muscle Division of plantar fascia and Foot/ Toes Repair, Revision 28260 muscle (eg, Steindler 0.00 0.00 1.43 and/or Reconstruction stripping) 28261 Foot/ Toes Repair, Revision Capsulotomy, midfoot; medial 0.00 0.00 3.46 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 90

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate and/or Reconstruction release only Foot/ Toes Repair, Revision Capsulotomy, midfoot; with 28262 0.00 0.00 Inf and/or Reconstruction tendon lengthening Capsulotomy, midfoot; Foot/ Toes Repair, Revision extensive, including posterior 28264 0.00 0.00 2.32 and/or Reconstruction talotibial capsulotomy and tendon(s) lengthening Foot/ Toes Repair, Revision Capsulotomy, midtarsal (eg, 28270 0.08 0.08 1.03 and/or Reconstruction Heyman type procedure) Capsulotomy; Foot/ Toes Repair, Revision metatarsophalangeal joint, 28272 0.00 0.02 9.30 and/or Reconstruction with or without tenorrhaphy, each joint Foot/ Toes Repair, Revision Capsulotomy; interphalangeal 28280 0.00 0.00 16.47 and/or Reconstruction joint, each joint Syndactylization, toes (eg, Foot/ Toes Repair, Revision 28285 webbing or Kelikian type 0.19 0.39 2.01 and/or Reconstruction procedure) Correction, hammertoe (eg, Foot/ Toes Repair, Revision 28286 interphalangeal fusion, partial 0.00 0.00 Inf and/or Reconstruction or total phalangectomy) Correction, cock-up fifth toe, Foot/ Toes Repair, Revision 28288 with plastic skin closure (eg, 0.02 0.06 2.60 and/or Reconstruction Ruiz-Mora type procedure) Ostectomy, partial, Foot/ Toes Repair, Revision exostectomy or condylectomy, 28289 0.09 0.08 0.95 and/or Reconstruction metatarsal head, each metatarsal head Hallux rigidus correction with Foot/ Toes Repair, Revision cheilectomy, debridement and 28290 0.02 0.03 1.49 and/or Reconstruction capsular release of the first metatarsophalangeal joint Hallux rigidus correction with cheilectomy, debridement and Foot/ Toes Repair, Revision 28292 capsular release of the first 0.05 0.09 1.82 and/or Reconstruction metatarsophalangeal joint, with implant Correction, hallux valgus, with sesamoidectomy, when Foot/ Toes Repair, Revision 28293 performed; with resection of 0.00 0.00 0.67 and/or Reconstruction proximal phalanx base, when performed, any method Correction, hallux valgus, with sesamoidectomy, when Foot/ Toes Repair, Revision 28294 performed; with proximal 0.00 0.00 Inf and/or Reconstruction metatarsal osteotomy, any method Correction, hallux valgus, with Foot/ Toes Repair, Revision sesamoidectomy, when 28296 0.09 0.21 2.37 and/or Reconstruction performed; with distal metatarsal osteotomy, any COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 91

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate method Correction, hallux valgus, with sesamoidectomy, when Foot/ Toes Repair, Revision performed; with first 28297 0.03 0.06 2.11 and/or Reconstruction metatarsal and medial cuneiform joint arthrodesis, any method Correction, hallux valgus, with Foot/ Toes Repair, Revision sesamoidectomy, when 28298 0.02 0.04 2.03 and/or Reconstruction performed; with phalanx osteotomy, any method Correction, hallux valgus, with Foot/ Toes Repair, Revision sesamoidectomy, when 28299 0.03 0.02 0.77 and/or Reconstruction performed; with double osteotomy, any method Osteotomy; calcaneus (eg, Foot/ Toes Repair, Revision Dwyer or Chambers type 28300 0.10 0.16 1.50 and/or Reconstruction procedure), with or without internal fixation Foot/ Toes Repair, Revision 28302 Osteotomy; talus 0.00 0.01 3.85 and/or Reconstruction Foot/ Toes Repair, Revision Osteotomy, tarsal bones, 28304 0.01 0.02 1.58 and/or Reconstruction other than calcaneus or talus Osteotomy, tarsal bones, Foot/ Toes Repair, Revision 28305 other than calcaneus or talus; 0.00 0.01 2.66 and/or Reconstruction with autograft Osteotomy, with or without Foot/ Toes Repair, Revision lengthening, shortening or 28306 0.05 0.05 1.15 and/or Reconstruction angular correction, metatarsal; first metatarsal Osteotomy, with or without lengthening, shortening or Foot/ Toes Repair, Revision 28307 angular correction, metatarsal; 0.00 0.01 2.93 and/or Reconstruction first metatarsal with autograft (other than first toe) Osteotomy, with or without lengthening, shortening or Foot/ Toes Repair, Revision 28308 angular correction, metatarsal; 0.11 0.11 1.05 and/or Reconstruction first metatarsal with autograft (other than first toe) Osteotomy, with or without Foot/ Toes Repair, Revision lengthening, shortening or 28309 0.00 0.01 2.70 and/or Reconstruction angular correction, metatarsal; multiple Osteotomy, shortening, Foot/ Toes Repair, Revision angular or rotational 28310 0.01 0.03 1.78 and/or Reconstruction correction; proximal phalanx, first toe Osteotomy, shortening, Foot/ Toes Repair, Revision 28312 angular or rotational 0.00 0.03 8.94 and/or Reconstruction correction; other phalanges, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 92

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate any toe Reconstruction, angular Foot/ Toes Repair, Revision 28313 deformity of toe, soft tissue 0.03 0.02 0.57 and/or Reconstruction procedures only Foot/ Toes Repair, Revision Sesamoidectomy, first toe 28315 0.02 0.02 0.69 and/or Reconstruction (separate procedure) Foot/ Toes Repair, Revision Repair, nonunion or malunion; 28320 0.01 0.01 1.03 and/or Reconstruction tarsal bones Repair, nonunion or malunion; Foot/ Toes Repair, Revision 28322 metatarsal, with or without 0.02 0.01 0.57 and/or Reconstruction bone graft Reconstruction, toe, Foot/ Toes Repair, Revision 28340 macrodactyly; soft tissue 0.00 0.00 Inf and/or Reconstruction resection Reconstruction, toe, Foot/ Toes Repair, Revision 28341 macrodactyly; requiring bone 0.00 0.00 Inf and/or Reconstruction resection Foot/ Toes Repair, Revision Reconstruction, toe(s); 28344 0.00 0.00 Inf and/or Reconstruction polydactyly Reconstruction, toe(s); Foot/ Toes Repair, Revision 28345 syndactyly, with or without 0.00 0.00 Inf and/or Reconstruction skin graft(s), each web Foot/ Toes Repair, Revision 28360 Reconstruction, cleft foot 0.00 0.00 0.75 and/or Reconstruction Percutaneous skeletal fixation Foot/ Toes Trauma - 28406 of calcaneal fracture, with 0.03 0.04 1.44 Fracture and/ or Dislocation manipulation Open treatment of calcaneal Foot/ Toes Trauma - 28415 fracture, includes internal 0.20 0.23 1.14 Fracture and/ or Dislocation fixation, when performed Open treatment of calcaneal fracture, includes internal Foot/ Toes Trauma - 28420 fixation, when performed; with 0.00 0.02 5.87 Fracture and/ or Dislocation primary iliac or other autogenous bone graft Percutaneous skeletal fixation Foot/ Toes Trauma - 28436 of talus fracture, with 0.00 0.01 2.50 Fracture and/ or Dislocation manipulation Open treatment of talus fracture, includes internal Foot/ Toes Trauma - 28445 fixation, when performed; with 0.12 0.16 1.42 Fracture and/ or Dislocation primary iliac or other autogenous bone graft Foot/ Toes Trauma - Open osteochondral allograft, 28446 0.00 0.01 3.58 Fracture and/ or Dislocation talus (includes obtaining graft) Treatment of tarsal bone Foot/ Toes Trauma - fracture (except talus and 28450 0.01 0.02 1.15 Fracture and/ or Dislocation calcaneus); without manipulation, each Foot/ Toes Trauma - Treatment of tarsal bone 28455 0.01 0.01 1.21 Fracture and/ or Dislocation fracture (except talus and COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 93

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate calcaneus); with manipulation, each Percutaneous skeletal fixation Foot/ Toes Trauma - of tarsal bone fracture (except 28456 0.00 0.01 3.22 Fracture and/ or Dislocation talus and calcaneus), with manipulation, each Open treatment of tarsal bone Foot/ Toes Trauma - fracture (except talus and 28465 0.05 0.06 1.25 Fracture and/ or Dislocation calcaneus), includes internal fixation, when performed Percutaneous skeletal fixation Foot/ Toes Trauma - 28476 of metatarsal fracture, with 0.05 0.08 1.48 Fracture and/ or Dislocation manipulation Open treatment of metatarsal Foot/ Toes Trauma - 28485 fracture, includes internal 0.15 0.18 1.16 Fracture and/ or Dislocation fixation, when performed Percutaneous skeletal fixation Foot/ Toes Trauma - of fracture of great toe, 28496 0.02 0.02 0.93 Fracture and/ or Dislocation phalanx or phalanges, with manipulation Open treatment of fracture, Foot/ Toes Trauma - great toe, phalanx or 28505 0.03 0.02 0.76 Fracture and/ or Dislocation phalanges, includes internal fixation, when performed Open treatment of fracture, phalanx or phalanges, other Foot/ Toes Trauma - 28525 than great toe, includes 0.02 0.02 1.18 Fracture and/ or Dislocation internal fixation, when performed, each Open treatment of sesamoid Foot/ Toes Trauma - 28531 fracture, with or without 0.00 0.00 2.39 Fracture and/ or Dislocation internal fixation Percutaneous skeletal fixation Foot/ Toes Trauma - of tarsal bone dislocation, 28546 0.00 0.01 1.49 Fracture and/ or Dislocation other than talotarsal, with manipulation Open treatment of tarsal bone Foot/ Toes Trauma - 28555 dislocation, includes internal 0.03 0.04 1.09 Fracture and/ or Dislocation fixation, when performed Percutaneous skeletal fixation Foot/ Toes Trauma - 28576 of talotarsal joint dislocation, 0.01 0.01 1.00 Fracture and/ or Dislocation with manipulation. Open treatment of talotarsal Foot/ Toes Trauma - joint dislocation, with or 28585 0.02 0.03 1.23 Fracture and/ or Dislocation without internal or external fixation. Percutaneous skeletal fixation Foot/ Toes Trauma - 28606 of tarsometatarsal joint 0.03 0.03 1.02 Fracture and/ or Dislocation dislocation, with manipulation. Foot/ Toes Trauma - Open treatment of 28615 0.14 0.15 1.09 Fracture and/ or Dislocation tarsometatarsal joint COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 94

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate dislocation, with or without internal or external fixation. Percutaneous skeletal fixation Foot/ Toes Trauma - 28636 of metatarsophalangeal joint 0.01 0.01 2.15 Fracture and/ or Dislocation dislocation, with manipulation. Open treatment of Foot/ Toes Trauma - metatarsophalangeal joint 28645 0.02 0.03 1.94 Fracture and/ or Dislocation dislocation, with or without internal or external fixation. Percutaneous skeletal fixation Foot/ Toes Trauma - 28666 of interphalangeal joint 0.00 0.01 2.45 Fracture and/ or Dislocation dislocation, with manipulation. Open treatment of Foot/ Toes Trauma - interphalangeal joint 28675 0.01 0.01 1.40 Fracture and/ or Dislocation dislocation, with or without internal or external fixation. 28705 Foot/ Toes Arthrodesis Pantalar arthrodesis. 0.01 0.03 4.50 28715 Foot/ Toes Arthrodesis Triple arthrodesis. 0.04 0.11 2.89 28725 Foot/ Toes Arthrodesis Subtalar arthrodesis. 0.09 0.19 2.22 Arthrodesis, midtarsal or 28730 Foot/ Toes Arthrodesis tarsometatarsal, multiple or 0.08 0.09 1.16 transverse;. Arthrodesis, midtarsal or tarsometatarsal, multiple or 28735 Foot/ Toes Arthrodesis 0.01 0.03 5.09 transverse; with osteotomy as for flatfoot correction. Arthrodesis, midtarsal navicular-cuneiform, with 28737 Foot/ Toes Arthrodesis tendon lengthening and 0.00 0.00 1.71 advancement (Miller type procedure). Arthrodesis, midtarsal or 28740 Foot/ Toes Arthrodesis 0.05 0.07 1.40 tarsometatarsal, single joint. Arthrodesis, great toe; 28750 Foot/ Toes Arthrodesis 0.12 0.16 1.30 metatarsophalangeal joint. Arthrodesis, great toe; 28755 Foot/ Toes Arthrodesis 0.02 0.03 2.01 interphalangeal joint. Arthrodesis, great toe, interphalangeal joint, with 28760 Foot/ Toes Arthrodesis extensor hallucis longus 0.00 0.01 2.10 transfer to first metatarsal neck (Jones type procedure). Amputation, foot; midtarsal 28800 Foot/ Toes Amputation 0.01 0.01 1.32 (Chopart type procedure). Amputation, foot; 28805 Foot/ Toes Amputation 0.04 0.06 1.49 transmetatarsal. Amputation, metatarsal, with 28810 Foot/ Toes Amputation 0.07 0.07 1.08 toe, single. Amputation, toe; 28820 Foot/ Toes Amputation 0.10 0.12 1.19 metatarsophalangeal joint. 28825 Foot/ Toes Amputation Amputation, toe; 0.06 0.07 1.05 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 95

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate interphalangeal joint. Arthroscopy, shoulder, 29805 Shoulder Other Procedures diagnostic, with or without 0.13 0.49 3.71 synovial biopsy Arthroscopy, shoulder, 29806 Shoulder Arthroscopy 0.52 0.28 0.54 surgical;capsulorrhaphy 29807 Shoulder Arthroscopy with repair of SLAP lesion 0.33 0.52 1.56 with removal of loose or 29819 Shoulder Arthroscopy 0.09 0.06 0.65 foreign body 29820 Shoulder Arthroscopy with synovectomy, partial 0.06 0.09 1.54 with synovectomy, 29821 Shoulder Arthroscopy 0.04 0.02 0.59 complete 29822 Shoulder Arthroscopy with debridement, limited 0.86 0.56 0.65 with debridement, 29823 Shoulder Arthroscopy 0.96 0.45 0.47 extensive with distal claviculectomy 29824 Shoulder Arthroscopy including distal articular 1.03 0.70 0.68 surface (Mumford procedure) with lysis and resection of 29825 Shoulder Arthroscopy adhesions, with or without 0.15 0.14 0.89 manipulation with decompression of subacromial space with partial 29826 Shoulder Arthroscopy acromioplasty, with 2.61 2.31 0.89 coracoacromial ligament release, whem performed 29827 Shoulder Arthroscopy with rotator cuff repair 2.22 1.62 0.73 29828 Shoulder Arthroscopy with biceps tenodesis 0.46 0.14 0.30 Arthroscopy, elbow, Humerus/ Elbow 29830 diagnostic,with or without 0.00 0.02 4.61 Arthroscopy synovial biopsy Arthroscopy, elbow, surgical; Humerus/ Elbow 29834 with removal of loose or 0.04 0.04 1.22 Arthroscopy foreign body Humerus/ Elbow 29835 with synovectomy, partial 0.01 0.01 1.38 Arthroscopy Humerus/ Elbow with synovectomy, 29836 0.01 0.01 1.32 Arthroscopy complete Humerus/ Elbow 29837 with debridement, limited 0.02 0.03 1.27 Arthroscopy Humerus/ Elbow with debridement, 29838 0.04 0.05 1.34 Arthroscopy extensive Arthroscopy, wrist, diagnostic, 29840 Forearm/ Wrist Arthroscopy 0.02 0.06 3.53 with or without synovial biopsy Arthroscopy, wrist, surgical; 29843 Forearm/ Wrist Arthroscopy for infection, lavage and 0.00 0.00 2.16 drainage 29844 Forearm/ Wrist Arthroscopy with synovectomy, partial 0.03 0.04 1.48 with synovectomy, 29845 Forearm/ Wrist Arthroscopy 0.01 0.01 0.90 complete COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 96

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate with excision and/or repair 29846 Forearm/ Wrist Arthroscopy of triangular fibrocartilage 0.14 0.17 1.19 and/or joint debridement with internternal fixation 29847 Forearm/ Wrist Arthroscopy 0.01 0.01 1.38 for fracture or instability Endoscopy, wrist, surgical, 29848 Forearm/ Wrist Arthroscopy with release of transverse 0.57 0.23 0.41 carpal ligament Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity 29850 Femur/ Knee Arthroscopy 0.00 0.00 1.27 fracture(s) of the knee, with or without manipulation; without internal or external fixation with internal or external 29851 Femur/ Knee Arthroscopy 0.00 0.01 1.20 fixation Arthroscopically aided treatment of tibial fracture, 29855 Femur/ Knee Arthroscopy proximal (plateau); 0.01 0.01 0.77 unicondylar, includes internal fixation, when perforned bicondylar, in cludes 29856 Femur/ Knee Arthroscopy internal fixation, when 0.00 0.00 2.97 performed Arthroscopy,hip, 29860 Pelvis/ Hip Arthroscopy diagnostic,with or without 0.01 0.03 2.69 synovial biopsy Arthroscopy, hip, surgical; 29861 Pelvis/ Hip Arthroscopy with removal of loose or 0.02 0.01 0.72 foreign body with debridement/shaving of articular cartilage 29862 Pelvis/ Hip Arthroscopy (chondroplasty), abrasion 0.08 0.20 2.61 arthroplasty, and/or resection of labrum 29863 Pelvis/ Hip Arthroscopy with synovectomy 0.03 0.03 1.07 Arthroscopy, knee, surgical; osteochondral autograft(s) 29866 Femur/ Knee Arthroscopy 0.01 0.02 2.70 (includes harvesting of the autograft[s]) 29867 Femur/ Knee Arthroscopy osteochodral allograft 0.00 0.01 3.59 meniscal translplantation, 29868 Femur/ Knee Arthroscopy 0.00 0.02 4.11 medial or lateral Arthroscopy, knee, diagnostic, 29870 Femur/ Knee Arthroscopy 0.17 0.81 4.89 with or without synovial biopsy Arthroscopy, knee, surgical; 29871 Femur/ Knee Arthroscopy for infection, lavage and 0.17 0.12 0.71 drainage 29873 Femur/ Knee Arthroscopy with lateral release 0.09 0.15 1.71 for removal of loose or 29874 Femur/ Knee Arthroscopy 0.36 0.28 0.78 foreign body COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 97

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate 29875 Femur/ Knee Arthroscopy with synovectomy, limited 0.43 0.42 0.98 with synovectomy, major, 29876 Femur/ Knee Arthroscopy 0.23 0.25 1.12 2 or more compartments debridement/shaving of 29877 Femur/ Knee Arthroscopy 0.96 1.51 1.57 articular cartilage abrasion arthoplasty (includes chondroplsty where 29879 Femur/ Knee Arthroscopy 0.29 0.37 1.28 necessary) or multiple drilling or microfracture with meniscectomy (medial AND lateral, including any meniscal shaving) including debridement/ 29880 Femur/ Knee Arthroscopy 0.84 0.87 1.03 shaving of articular cartilage, same or separate compartment(s), when performed with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/ 29881 Femur/ Knee Arthroscopy 3.39 3.41 1.01 shaving of articular cartilage, same or separate compartment(s), when performed with meniscus repair 29882 Femur/ Knee Arthroscopy 0.50 0.41 0.82 (medial OR lateral) with meniscus repair 29883 Femur/ Knee Arthroscopy 0.04 0.07 1.61 (medial AND lateral) with lysis of adhesions, 29884 Femur/ Knee Arthroscopy 0.08 0.11 1.41 with or with out manipulation driling for ostiochondritis dissecans with bone grafting, 29885 Femur/ Knee Arthroscopy withour without internal 0.01 0.02 2.54 fixation (including debridement of base of lesion) drilling for intact 29886 Femur/ Knee Arthroscopy ostiochondritis dissecans 0.01 0.03 4.59 lesion drilling for intact 29887 Femur/ Knee Arthroscopy ostiochondritis dissecans 0.02 0.03 1.44 lesion with internal fixation Arthroscopically aided anterior cruciate ligament repair/ 29888 Femur/ Knee Arthroscopy 1.43 1.56 1.09 augmentation or reconstruction Arthroscopically aided posterior cruciate ligament 29889 Femur/ Knee Arthroscopy 0.02 0.06 2.57 repair/ augmentation or reconstruction 29891 Leg/ Ankle Arthroscopy Arthroscopy, ankle, surgical, 0.12 0.05 0.42 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 98

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate excision of osteochondral defect of talus and/or tibia, including drilling of the defect Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome 29892 Leg/ Ankle Arthroscopy 0.01 0.01 1.10 fracture, or tibial plafond fracture, with or without internal fixation Endoscopic plantar 29893 Leg/ Ankle Arthroscopy 0.01 0.00 0.18 fasciotomy Arthroscopy, ankle, surgical; 29894 Leg/ Ankle Arthroscopy with removal of loose or 0.04 0.05 1.41 foreign body 29895 Leg/ Ankle Arthroscopy with synovectomy, partial 0.03 0.05 1.62 29897 Leg/ Ankle Arthroscopy with debridement, limited 0.07 0.13 1.91 with debridement, 29898 Leg/ Ankle Arthroscopy 0.18 0.15 0.86 extensive 29899 Leg/ Ankle Arthroscopy with ankle arthrodesis 0.01 0.02 2.68 Arthroscopy, metatarsophalangeal joint, 29900 Foot/ Toes Arthroscopy 0.00 0.00 4.71 diagnostic, includes synovial biopsy Arthroscopy, 29901 Foot/ Toes Arthroscopy metatarsophalangeal joint, 0.00 0.01 5.03 surgical; with debridement with reduction of displaced 29902 Foot/ Toes Arthroscopy 0.00 0.00 Inf ulnar collateral ligament Arthroscopy, subtalar joint, 29904 Foot/ Toes Arthroscopy surgical; with removal of loose 0.00 0.00 1.25 or foreign body 29905 Foot/ Toes Arthroscopy with synovectomy 0.00 0.00 0.70 29906 Foot/ Toes Arthroscopy with debridement 0.01 0.00 0.78 29907 Foot/ Toes Arthroscopy with subtalar arthrodesis 0.00 0.00 0.86 29914 Pelvis/ Hip Arthroscopy with femoroplasty 0.25 0.00 0.02 29915 Pelvis/ Hip Arthroscopy with acetabuloplasty 0.14 0.00 0.02 29916 Pelvis/ Hip Arthroscopy with labral repair 0.25 0.00 0.01 unlisted procedure, 29999 Foot/ Toes Arthroscopy 0.23 0.08 0.33 arthroscopy Nervous System Spine & Laminectomy with exploration Spinal Cord Posterior and /or decompression of Extradural Laminotomy or spinal cord and/or cauda Laminectomy for 63001 equina, without facetectomy, 0.01 0.03 3.30 Exploration/Decompression foraminotomy or discectomy of Neural Elements or (e.g., spinal stenosis), 1 or 2 Excision of Herniated vertebral segments, cervical Intervertebral Disc Nervous System Spine & Laminectomy with exploration Spinal Cord Posterior and /or decompression of 63003 0.01 0.01 1.73 Extradural Laminotomy or spinal cord and/or cauda Laminectomy for equina, without facetectomy, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 99

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Exploration/Decompression foraminotomy or discectomy of Neural Elements or (e.g., spinal stenosis), 1 or 2 Excision of Herniated vertebral segments, thoracic Intervertebral Disc Nervous System Spine & Laminectomy with exploration Spinal Cord Posterior and /or decompression of Extradural Laminotomy or spinal cord and/or cauda Laminectomy for equina, without facetectomy, 63005 0.03 0.20 6.96 Exploration/Decompression foraminotomy or discectomy of Neural Elements or (e.g., spinal stenosis), 1 or 2 Excision of Herniated vertebral segments, lumbar, Intervertebral Disc except for spondylolistheseis Nervous System Spine & Laminectomy with exploration Spinal Cord Posterior and/or decompression of Extradural Laminotomy or spinal cord and/or cauda Laminectomy for 63011 equina, without facetectomy, 0.01 0.01 1.60 Exploration/Decompression foraminotomy or discectomy of Neural Elements or (eg, spinal stenosis), 1 or 2 Excision of Herniated vertebral segments; sacral Intervertebral Disc Nervous System Spine & Laminectomy with removal of Spinal Cord Posterior abnormal facets and/or pars Extradural Laminotomy or inter-articularis with Laminectomy for 63012 decompression of cauda 0.04 0.03 0.94 Exploration/Decompression equina and nerve roots for of Neural Elements or spondylolisthesis, lumbar (Gill Excision of Herniated type procedure) Intervertebral Disc Nervous System Spine & Laminectomy with exploration Spinal Cord Posterior and /or decompression of Extradural Laminotomy or spinal cord and /or cauda Laminectomy for equina, without facetectomy, 63015 0.03 0.04 1.58 Exploration/Decompression foraminotomy or discectomy of Neural Elements or (e.g., spinal stenosis), more Excision of Herniated than 2 vertebral segments, Intervertebral Disc cervical Nervous System Spine & Laminectomy with exploration Spinal Cord Posterior and /or decompression of Extradural Laminotomy or spinal cord and /or cauda Laminectomy for equina, without facetectomy, 63016 0.00 0.01 4.07 Exploration/Decompression foraminotomy or discectomy of Neural Elements or (e.g., spinal stenosis), more Excision of Herniated than 2 vertebral segments, Intervertebral Disc thoracic Nervous System Spine & Laminectomy with exploration Spinal Cord Posterior and /or decompression of Extradural Laminotomy or spinal cord and /or cauda 63017 Laminectomy for equina, without facetectomy, 0.01 0.16 12.57 Exploration/Decompression foraminotomy or discectomy of Neural Elements or (e.g., spinal stenosis), more Excision of Herniated than 2 vertebral segments, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 100

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Intervertebral Disc lumbar Laminotomy Nervous System Spine & (hemilaminectomy). with Spinal Cord Posterior decompression of nerve Extradural Laminotomy or root(s), including partial Laminectomy for facetectomy, foraminotomy 63020 0.03 0.02 0.89 Exploration/Decompression and/or excision of herniated of Neural Elements or intervertebral disc, including Excision of Herniated open and edoscopically Intervertebral Disc assisted approaches, 1 interspace, cervical Laminotomy Nervous System Spine & (hemilaminectomy). with Spinal Cord Posterior decompression of nerve Extradural Laminotomy or root(s), including partial Laminectomy for facetectomy, foraminotomy 63030 0.79 0.34 0.43 Exploration/Decompression and/or excision of herniated of Neural Elements or intervertebral disc, including Excision of Herniated open and edoscopically Intervertebral Disc assisted approaches, 1 interspace, lumbar Laminotomy (hemilaminectomy), with decompression of nerve Nervous System Spine & root(s), including Spinal Cord Posterior partial facetectomy, Extradural Laminotomy or foraminotomy and/or excision Laminectomy for 63035 of herniated intervertebral 0.09 0.07 0.86 Exploration/Decompression disc; of Neural Elements or each additional interspace, Excision of Herniated cervical or lumbar (List Intervertebral Disc separately in addition to code for primary procedure) Laminotomy Nervous System Spine & (hemilaminectomy), with Spinal Cord Posterior decompression of nerve Extradural Laminotomy or root(s), including Laminectomy for partial facetectomy, 63040 0.01 0.01 1.48 Exploration/Decompression foraminotomy and/or excision of Neural Elements or of herniated intervertebral Excision of Herniated disc, Intervertebral Disc reexploration, single interspace; cervical Nervous System Spine & Laminotomy Spinal Cord Posterior (hemilaminectomy), with Extradural Laminotomy or decompression of nerve 63042 Laminectomy for root(s), including 0.12 0.13 1.07 Exploration/Decompression partial facetectomy, of Neural Elements or foraminotomy and/or excision Excision of Herniated of herniated intervertebral COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 101

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Intervertebral Disc disc, reexploration, single interspace; lumbar Laminotomy (hemilaminectomy), with decompression of nerve Nervous System Spine & root(s), including Spinal Cord Posterior partial facetectomy, Extradural Laminotomy or foraminotomy and/or excision Laminectomy for of herniated intervertebral 63043 0.00 0.01 7.59 Exploration/Decompression disc, of Neural Elements or reexploration, single Excision of Herniated interspace; each additional Intervertebral Disc cervical interspace (List separately in addition to code for primary procedure) Laminotomy (hemilaminectomy), with decompression of nerve Nervous System Spine & root(s), including Spinal Cord Posterior partial facetectomy, Extradural Laminotomy or foraminotomy and/or excision Laminectomy for of herniated intervertebral 63044 0.02 0.06 2.96 Exploration/Decompression disc, of Neural Elements or reexploration, single Excision of Herniated interspace; each additional Intervertebral Disc lumbar interspace (List separately in addition to code for primary procedure) Nervous System Spine & Laminectomy, facetectomy Spinal Cord Posterior and foraminotomy (unilateral Extradural Laminotomy or or bilateral with Laminectomy for decompression of spinal cord, 63045 0.10 0.04 0.44 Exploration/Decompression cauda equina and /or nerve of Neural Elements or root(s), (e.g., spinal or lateral Excision of Herniated recess stenosis), single Intervertebral Disc vertebral segment, cervical Nervous System Spine & Laminectomy, facetectomy Spinal Cord Posterior and foraminotomy (unilateral Extradural Laminotomy or or bilateral with Laminectomy for decompression of spinal cord, 63046 0.03 0.02 0.62 Exploration/Decompression cauda equina and/or nerve of Neural Elements or root[s], [eg, spinal or lateral Excision of Herniated recess stenosis]), single Intervertebral Disc vertebral segment; thoracic Nervous System Spine & Laminectomy, facetectomy Spinal Cord Posterior and foraminotomy (unilateral 63047 1.05 0.52 0.49 Extradural Laminotomy or or bilateral with Laminectomy for decompression of spinal cord, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 102

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Exploration/Decompression cauda equina and /or nerve of Neural Elements or root(s), (e.g., spinal or lateral Excision of Herniated recess stenosis), single Intervertebral Disc vertebral segment, lumbar Laminectomy, facetectomy and foraminotomy (unilateral Nervous System Spine & or bilateral with Spinal Cord Posterior decompression of spinal cord, Extradural Laminotomy or cauda equina and/or nerve Laminectomy for root[s], [eg, spinal or lateral 63048 0.61 0.46 0.75 Exploration/Decompression recess stenosis]), single of Neural Elements or vertebral segment; each Excision of Herniated additional segment, cervical, Intervertebral Disc thoracic, or lumbar (List separately in addition to code for primary procedure) Nervous System Spine & Spinal Cord Posterior Extradural Laminotomy or Laminoplasty, cervical, with Laminectomy for decompression of the spinal 63050 0.01 0.00 0.61 Exploration/Decompression cord, 2 or more vertebral of Neural Elements or segments; Excision of Herniated Intervertebral Disc Laminoplasty, cervical, with decompression of the spinal Nervous System Spine & cord, 2 or more vertebral Spinal Cord Posterior segments; with reconstruction Extradural Laminotomy or of the posterior bony elements Laminectomy for 63051 (including the 0.02 0.02 1.11 Exploration/Decompression application of bridging bone of Neural Elements or graft and non-segmental Excision of Herniated fixation devices [eg, wire, Intervertebral Disc suture, mini-plates], when performed) Nervous System Spine & Discectomy, anterior, with Spinal Cord Anterior or decompression of spinal cord 63075 Anterolateral Approach for and/or nerve root(s), 0.06 0.25 4.22 Extradural including osteophytectomy; Exploration/Decompression cervical, single interspace Discectomy, anterior, with decompression of spinal cord Nervous System Spine & and/or nerve root(s), Spinal Cord Anterior or including osteophytectomy; 63076 Anterolateral Approach for 0.02 0.16 6.84 cervical, each additional Extradural interspace (List separately in Exploration/Decompression addition to code for primary procedure) Nervous System Spine & Discectomy, anterior, with 63077 Spinal Cord Anterior or decompression of spinal cord 0.00 0.01 4.49 Anterolateral Approach for and/or nerve root(s), COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 103

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Extradural including osteophytectomy; Exploration/Decompression thoracic, single interspace Discectomy, anterior, with decompression of spinal cord Nervous System Spine & and/or nerve root(s), Spinal Cord Anterior or including osteophytectomy; 63078 Anterolateral Approach for 0.00 0.01 13.96 thoracic, each additional Extradural interspace (List separately in Exploration/Decompression addition to code for primary procedure) Vertebral corpectomy Nervous System Spine & (vertebral body resection), Spinal Cord Anterior or partial or complete, anterior 63081 Anterolateral Approach for approach with decompression 0.06 0.05 0.82 Extradural of spinal cord and/or nerve Exploration/Decompression root(s); cervical, single segment Vertebral corpectomy (vertebral body resection), Nervous System Spine & partial or complete, anterior Spinal Cord Anterior or approach with decompression 63082 Anterolateral Approach for of spinal cord and/or nerve 0.02 0.03 1.57 Extradural root(s); cervical, each Exploration/Decompression additional segment (List separately in addition to code for primary procedure) Vertebral corpectomy Nervous System Spine & (vertebral body resection), Spinal Cord Anterior or partial or complete, 63085 Anterolateral Approach for transthoracic approach with 0.01 0.01 1.02 Extradural decompression of spinal cord Exploration/Decompression and/or nerve root(s); thoracic, single segment Vertebral corpectomy Nervous System Spine & (vertebral body resection), Spinal Cord Anterior or partial or complete, 63086 Anterolateral Approach for transthoracic approach with 0.00 0.00 1.54 Extradural decompression of spinal cord Exploration/Decompression and/or nerve root(s); thoracic, each additional segment Vertebral corpectomy (vertebral body resection), Nervous System Spine & partial or complete, combined Spinal Cord Anterior or thoracolumbar approach with 63087 Anterolateral Approach for 0.00 0.01 2.55 decompression of spinal cord, Extradural cauda equina or nerve Exploration/Decompression root(s), lower thoracic or lumbar; single segment Nervous System Spine & Vertebral corpectomy 63088 Spinal Cord Anterior or (vertebral body resection), 0.00 0.01 3.21 Anterolateral Approach for partial or complete, combined COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 104

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Extradural thoracolumbar approach with Exploration/Decompression decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each additional segment (List separately in addition to code for primary procedure) Vertebral corpectomy (vertebral body resection), Nervous System Spine & partial or complete, Spinal Cord Anterior or transperitoneal 63090 Anterolateral Approach for or retroperitoneal approach 0.01 0.01 0.86 Extradural with decompression of spinal Exploration/Decompression cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; single segment Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal Nervous System Spine & or retroperitoneal approach Spinal Cord Anterior or with decompression of spinal 63091 Anterolateral Approach for 0.00 0.00 1.45 cord, cauda equina or nerve Extradural root(s), lower thoracic, lumbar, Exploration/Decompression or sacral; each additional segment (List separately in addition to code for primary procedure) Nervous System Spine & Neuroplasty; digital, 1 or both, 64702 0.04 0.02 0.60 Spinal Cord Neuroplasty same digit Nervous System Spine & Neuroplasty; nerve of hand or 64704 0.02 0.02 1.55 Spinal Cord Neuroplasty foot Neuroplasty, major peripheral Nervous System Spine & 64708 nerve, arm or leg, open; other 0.08 0.09 1.09 Spinal Cord Neuroplasty than specified Neuroplasty, major peripheral Nervous System Spine & 64712 nerve, arm or leg, open; 0.02 0.03 1.54 Spinal Cord Neuroplasty sciatic nerve Neuroplasty, major peripheral Nervous System Spine & 64713 nerve, arm or leg, open; 0.01 0.02 2.64 Spinal Cord Neuroplasty brachial plexus Neuroplasty, major peripheral Nervous System Spine & 64714 nerve, arm or leg, open; 0.00 0.00 0.67 Spinal Cord Neuroplasty lumbar plexus Neuroplasty and/or Nervous System Spine & 64718 transposition; ulnar nerve at 0.77 0.50 0.65 Spinal Cord Neuroplasty elbow Neuroplasty and/or Nervous System Spine & 64719 transposition; ulnar nerve at 0.07 0.05 0.77 Spinal Cord Neuroplasty wrist COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 105

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Neuroplasty and/or Nervous System Spine & 64721 transposition; median nerve at 3.21 1.99 0.62 Spinal Cord Neuroplasty carpal tunnel Nervous System Spine & Decompression; unspecified 64722 0.02 0.05 2.68 Spinal Cord Neuroplasty nerve(s) (specify) Nervous System Spine & Decompression; plantar digital 64726 0.00 0.00 2.65 Spinal Cord Neuroplasty nerve Internal neurolysis, requiring use of operating microscope Nervous System Spine & (List separately in addition 64727 0.01 0.02 2.63 Spinal Cord Neuroplasty to code for neuroplasty) (Neuroplasty includes external neurolysis) Nervous System Spine & Suture of digital nerve, hand 64831 0.20 0.12 0.63 Spinal Cord Neurorrhaphy or foot; 1 nerve Suture of digital nerve, hand or foot; each additional digital Nervous System Spine & 64832 nerve (List separately in 0.02 0.04 2.05 Spinal Cord Neurorrhaphy addition to code for primary procedure) Nervous System Spine & Suture of 1 nerve; hand or 64834 0.03 0.02 0.71 Spinal Cord Neurorrhaphy foot, common sensory nerve Nervous System Spine & Suture of 1 nerve; median 64835 0.00 0.01 1.76 Spinal Cord Neurorrhaphy motor thenar Nervous System Spine & 64836 Suture of 1 nerve; ulnar motor 0.01 0.01 1.73 Spinal Cord Neurorrhaphy Suture of each additional nerve, hand or foot (List Nervous System Spine & 64837 separately in addition to code 0.00 0.00 1.47 Spinal Cord Neurorrhaphy for primary procedure) Nervous System Spine & 64840 Suture of posterior tibial nerve 0.00 0.00 0.56 Spinal Cord Neurorrhaphy Suture of major peripheral Nervous System Spine & 64856 nerve, arm or leg, except 0.02 0.02 0.81 Spinal Cord Neurorrhaphy sciatic; including transposition Suture of major peripheral Nervous System Spine & 64857 nerve, arm or leg, except 0.05 0.04 0.95 Spinal Cord Neurorrhaphy sciatic; without transposition Suture of each additional Nervous System Spine & major peripheral nerve (List 64859 0.01 0.01 0.81 Spinal Cord Neurorrhaphy separately in addition to code for primary procedure) Suture of nerve; requiring extensive mobilization, or Nervous System Spine & 64861 transposition of nerve (List 0.00 0.00 7.17 Spinal Cord Neurorrhaphy separately in addition to code for nerve suture) Suture of nerve; requiring Nervous System Spine & 64874 extensive mobilization, or 0.00 0.01 4.57 Spinal Cord Neurorrhaphy transposition of nerve (List COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 106

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate separately in addition to code for nerve suture)

a Sorted by this column.

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Appendix Table 6. All CPT Codes Used in the Pediatric Data Analysis Listed with Corresponding CPT Code Descriptions Listed by CPT Code Numeric Order CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Integumentary System Incision and drainage of 10060 0.10 0.06 0.55 Incision & Drainage abscess; simple or single Incision and drainage of Integumentary System 10061 abscess; complicated or 0.08 0.04 0.46 Incision & Drainage multiple Integumentary System Incision and drainage of 10080 0.00 0.00 Inf Incision & Drainage pilonidal cyst; simple or single Incision and removal of Integumentary System 10120 foreign body, subcutaneous 0.18 0.04 0.23 Incision & Drainage tissues; simple Incision and removal of Integumentary System 10121 foreign body, subcutaneous 0.12 0.03 0.28 Incision & Drainage tissues; complicated Incision and drainage of Integumentary System 10140 hematoma, seroma or fluid 0.04 0.03 0.67 Incision & Drainage collection Puncture aspiration of Integumentary System 10160 abscess, hematoma, bulla, or 0.00 0.01 2.08 Incision & Drainage cyst Incision and drainage, Integumentary System 10180 complex, postoperative wound 0.16 0.13 0.83 Incision & Drainage infection Debridement of extensive Integumentary System 11000 eczematous or infected skin; 0.00 0.00 0.67 Debridement up to 10% of body surface Debridement of extensive eczematous or infected skin; each additional 10% of the Integumentary System 11001 body surface, or part thereof 0.00 0.00 Inf Debridement (List separately in addition to code for primary procedure) Debridement of skin, subcutaneous tissue, muscle, Integumentary System 11004 and fascia for necrotizing soft 0.00 0.00 Inf Debridement tissue infection; external genitalia and perineum Debridement of skin, subcutaneous tissue, muscle, Integumentary System and fascia for necrotizing soft 11005 0.00 0.00 Inf Debridement tissue infection; abdominal wall, with or without fascial closure Debridement of skin, subcutaneous tissue, muscle, Integumentary System and fascia for necrotizing soft 11006 0.00 0.00 Inf Debridement tissue infection; external genitalia, perineum, and abdominal wall, with or without COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 108

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate fascial closure Debridement including removal of foreign material at the site of an open fracture Integumentary System - 11010 and/or an open dislocation 0.35 0.20 0.57 Incision/Excision (eg, excisional debridement); skin and subcutaneous tissues Debridement including removal of foreign material at the site of an open fracture Integumentary System - 11011 and/or an open dislocation 0.23 0.24 1.03 Incision/Excision (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, and muscle Debridement including removal of foreign material at the site of an open fracture Integumentary System - and/or an open dislocation 11012 2.26 0.91 0.40 Incision/Excision (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone Integumentary System 11040 0.01 0.02 2.24 Debridement Integumentary System 11041 0.00 0.04 14.61 Debridement Debridement, subcutaneous Integumentary System - tissue (includes epidermis and 11042 0.50 0.21 0.42 Incision/Excision dermis, if performed); first 20 sq cm or less Debridement, muscle and/or fascia (includes epidermis, Integumentary System - 11043 dermis, and subcutaneous 0.78 0.43 0.55 Incision/Excision tissue, if performed); first 20 sq cm or less Debridement, bone (includes epidermis, dermis, Integumentary System - subcutaneous tissue, muscle 11044 0.79 0.77 0.98 Incision/Excision and/or fascia, if performed); first 20 sq cm or less Debridement, subcutaneous tissue (includes epidermis and Integumentary System dermis, if performed); each 11045 0.02 0.00 0.04 Debridement additional 20 square cm, or part thereof 20 sq cm or less Debridement, muscle and/or Integumentary System 11046 fascia (includes epidermis, 0.09 0.00 0.00 Debridement dermis, and subcutaneous; COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 109

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate each additional 20 square cm, or part thereof 20 sq cm or less tissue, if performed); first 20 sq cm or less Debridement, muscle and/or fascia (includes epidermis, Integumentary System 11047 dermis, and subcutaneous; 0.06 0.00 0.01 Debridement each additional 20 square cm, or part thereof Excision, benign lesion Integumentary System including margins, except skin 11400 0.02 0.01 0.65 Excision-Benign tag , trunk, arms or legs; excise diameter 0.5 cm or less Excision, benign lesion including margins, except skin Integumentary System 11401 tag , trunk, arms or legs; 0.01 0.00 0.30 Excision-Benign excised diameter 0.6 to 1.0 cm Excision, benign lesion including margins, except skin Integumentary System 11402 tag , trunk, arms or legs; 0.01 0.01 1.13 Excision-Benign excised diameter 1.1 to 2.0 cm Excision, benign lesion including margins, except skin Integumentary System 11403 tag , trunk, arms or legs; 0.02 0.01 0.57 Excision-Benign excised diameter 2.1 to 3.0 cm Excision, benign lesion including margins, except skin Integumentary System 11404 tag , trunk, arms or legs; 0.01 0.01 0.96 Excision-Benign excised diameter 3.1 to 4.0 cm Excision, benign lesion Integumentary System including margins, except skin 11406 0.02 0.01 0.57 Excision-Benign tag , trunk, arms or legs; excised diameter over 4.0 cm Excision, benign lesion including margins, except skin Integumentary System 11420 tag, scalp, neck, hands, feet, 0.02 0.01 0.58 Excision-Benign genitalia; excised diameter 0.5 cm or less Excision, benign lesion Integumentary System including margins, except skin 11421 0.01 0.01 0.80 Excision-Benign tag, scalp, neck, hands, feet, genitalia Excision, benign lesion Integumentary System including margins, except skin 11422 0.01 0.01 0.87 Excision-Benign tag, scalp, neck, hands, feet, genitalia COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 110

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Excision, benign lesion Integumentary System including margins, except skin 11423 0.00 0.01 2.00 Excision-Benign tag, scalp, neck, hands, feet, genitalia Excision, benign lesion Integumentary System including margins, except skin 11424 0.00 0.00 Inf Excision-Benign tag, scalp, neck, hands, feet, genitalia Excision, benign lesion Integumentary System including margins, except skin 11426 0.00 0.00 Inf Excision-Benign tag, scalp, neck, hands, feet, genitalia Excision, other benign lesion including margins, except skin Integumentary System 11440 tag, face, ears, eyelids, nose, 0.00 0.00 Inf Excision-Benign lips, mucous membrane; excised diameter Excision, other benign lesion including margins, except skin Integumentary System 11441 tag, face, ears, eyelids, nose, 0.00 0.00 Inf Excision-Benign lips, mucous membrane; excised diameter Excision, other benign lesion including margins, except skin Integumentary System 11442 tag, face, ears, eyelids, nose, 0.00 0.00 Inf Excision-Benign lips, mucous membrane; excised diameter Excision, other benign lesion including margins, except skin Integumentary System 11443 tag, face, ears, eyelids, nose, 0.00 0.00 Inf Excision-Benign lips, mucous membrane; excised diameter Excision, other benign lesion including margins, except skin Integumentary System 11444 tag, face, ears, eyelids, nose, 0.00 0.00 Inf Excision-Benign lips, mucous membrane; excised diameter Excision, other benign lesion including margins, except skin Integumentary System 11446 tag, face, ears, eyelids, nose, 0.00 0.00 Inf Excision-Benign lips, mucous membrane; excised diameter Integumentary System - 11760 20 sq cm or less 0.66 0.29 0.44 Incision/Excision Integumentary System tissue, if performed); first 20 11900 0.00 0.00 Inf Introduction sq cm or less Integumentary System Removal of tissue expander(s) 11971 0.00 0.00 0.45 Introduction without insertion of prosthesis Integumentary System Insertion, non-biodegradable 11981 0.07 0.02 0.22 Introduction drug delivery implant 11982 Integumentary System Removal, non-biodegradable 0.05 0.01 0.13 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 111

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Introduction drug delivery implant Removal with reinsertion, non- Integumentary System 11983 biodegradable drug delivery 0.03 0.00 0.15 Introduction implant Simple repair of superficial Integumentary System wounds of scalp, neck, axillae, 12001 0.10 0.06 0.58 Repair-Simple external genitalia, trunk and/ or extremeities; 2.5 cm or less Simple repair of superficial Integumentary System wounds of scalp, neck, axillae, 12002 0.09 0.05 0.53 Repair-Simple external genitalia, trunk and/ or extremeities; 2.6 - 7.5 cm Simple repair of superficial Integumentary System wounds of scalp, neck, axillae, 12004 0.03 0.02 0.59 Repair-Simple external genitalia, trunk and/ or extremeities; 7.6 - 12.5 cm Simple repair of superficial wounds of scalp, neck, axillae, Integumentary System 12005 external genitalia, trunk and/ 0.01 0.01 0.79 Repair-Simple or extremeities; 12.6 - 20 .0 cm Simple repair of superficial Integumentary System wounds of scalp, neck, axillae, 12006 0.00 0.00 1.78 Repair-Simple external genitalia, trunk and/ or extremeities; 20.1 - 30.0 cm Simple repair of superficial Integumentary System wounds of scalp, neck, axillae, 12007 0.00 0.00 1.34 Repair-Simple external genitalia, trunk and/ or extremeities; over 30 cm Simple repair of superficial Integumentary System wounds of scalp, neck, axillae, 12011 0.00 0.00 0.52 Repair-Simple external genitalia, trunk and/ or extremeities; over 30 cm Simple repair of superficial Integumentary System wounds of face, ears, eyelids, 12013 0.00 0.00 Inf Repair-Simple nose, lips, and/or mucous membranes; 2.6 to 5.0 cm Simple repair of superficial Integumentary System wounds of face, ears, eyelids, 12015 0.00 0.00 Inf Repair-Simple nose, lips, and/or mucous membranes; 5.1 to 7.5 cm Simple repair of superficial Integumentary System wounds of face, ears, eyelids, 12017 0.00 0.00 Inf Repair-Simple nose, lips, and/or mucous membranes; 7.6 to 12.5 cm Simple repair of superficial Integumentary System wounds of face, ears, eyelids, 12018 0.00 0.00 Inf Repair-Simple nose, lips, and/or mucous membranes; 12.6 to 20.0 cm Integumentary System Treatment of superficial 12020 0.05 0.01 0.20 Repair-Simple wound dehiscence; simple COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 112

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate closure Treatment of superficial Integumentary System 12021 wound dehiscence; with 0.00 0.00 0.74 Repair-Simple packing Repair, intermediate, wounds Integumentary System of scalp, axillae, trunk and/or 12031 0.05 0.02 0.30 Repair-Intermediate extremities excluding hands and feel; 2.5 cm or less Repair, intermediate, wounds Integumentary System of scalp, axillae, trunk and/or 12032 0.09 0.04 0.41 Repair-Intermediate extremities excluding hands and feel; 2.6 to 7.5 cm Repair, intermediate, wounds Integumentary System of scalp, axillae, trunk and/or 12034 0.06 0.03 0.60 Repair-Intermediate extremities excluding hands and feel; 7.6 to 12.5 cm Repair, intermediate, wounds Integumentary System of scalp, axillae, trunk and/or 12035 0.07 0.03 0.40 Repair-Intermediate extremities excluding hands and feel; 12.6 to 20.0 cm Repair, intermediate, wounds Integumentary System of scalp, axillae, trunk and/or 12036 0.02 0.01 0.89 Repair-Intermediate extremities excluding hands and feel; 20.1 to 30.0 cm Repair, intermediate, wounds Integumentary System of scalp, axillae, trunk and/or 12037 0.01 0.01 0.73 Repair-Intermediate extremities excluding hands and feel; over 30.0 cm Repair, intermediate, wounds Integumentary System of neck, hands, feet, and/ or 12041 0.04 0.02 0.63 Repair-Intermediate external genitalia; 2.5 cm or less Repair, intermediate, wounds Integumentary System of neck, hands, feet, and/ or 12042 0.05 0.03 0.48 Repair-Intermediate external genitalia; 2.6 to 7.5 cm Repair, intermediate, wounds Integumentary System of neck, hands, feet, and/ or 12044 0.01 0.01 0.80 Repair-Intermediate external genitalia; 7.6 to 12.5n cm Repair, intermediate, wounds Integumentary System of neck, hands, feet, and/ or 12045 0.01 0.01 0.62 Repair-Intermediate external genitalia; 12.6 to 20.0 cm Repair, intermediate, wounds Integumentary System of neck, hands, feet, and/ or 12046 0.00 0.00 0.67 Repair-Intermediate external genitalia; 20.1 to 30.0 cm Repair, intermediate, wounds Integumentary System 12047 of neck, hands, feet, and/ or 0.00 0.00 0.22 Repair-Intermediate external genitalia; over 30.0 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 113

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate cm Repair, intermediate, wounds Integumentary System of face, ears, eyelids, nose, 12051 0.00 0.00 Inf Repair-Intermediate lips and/or mucous membranes; 2.5 cm or less Repair, intermediate, wounds Integumentary System of face, ears, eyelids, nose, 12052 0.00 0.00 Inf Repair-Intermediate lips and/or mucous membranes; 2.6 to 5.0 cm Repair, intermediate, wounds Integumentary System of face, ears, eyelids, nose, 12054 0.00 0.00 0.07 Repair-Intermediate lips and/or mucous membranes;7.6 to 12.5 cm Repair, intermediate, wounds Integumentary System of face, ears, eyelids, nose, 12055 0.00 0.00 0.30 Repair-Intermediate lips and/or mucous membranes; 12.6 to 20.0 cm Integumentary System Repair, complex, trunk; 1.1 to 13100 0.00 0.00 Inf Repair-Complex 2.5 cm Integumentary System Repair, complex, trunk; 2.6 to 13101 0.00 0.01 2.89 Repair-Complex 7.5 cm Integumentary System Repair, complex, trunk; each 13102 0.00 0.01 Inf Repair-Complex additional 5 cm or less Integumentary System Repair, complex, scalp, arms, 13120 0.03 0.01 0.30 Repair-Complex legs; 1.1 to 2.5 cm Integumentary System Repair, complex, scalp, arms, 13121 0.17 0.05 0.26 Repair-Complex legs; 2.6 to 7.5 cm Repair, complex, scalp, arms, Integumentary System 13122 legs; each additional 5 cm or 0.07 0.02 0.37 Repair-Complex less Repair, complex, forehead, Integumentary System cheeks, chin, nouth, neck, 13131 0.04 0.02 0.54 Repair-Complex axillae, genitalia, hands, feet; 1.1 cm to 2.5 cm Repair, complex, forehead, Integumentary System cheeks, chin, nouth, neck, 13132 0.09 0.02 0.25 Repair-Complex axillae, genitalia, hands, feet; 2.6 to 7.5 cm Repair, complex, forehead, Integumentary System cheeks, chin, nouth, neck, 13133 0.02 0.00 0.27 Repair-Complex axillae, genitalia, hands, feet; each additional 5 cm or less Repair, complex, eyelids, Integumentary System 13152 nose, ears and/ or lips; 2.6 to 0.00 0.00 Inf Repair-Complex 7.5 cm Secondary closure of surgical Integumentary System 13160 wound or dehiscence, 0.23 0.06 0.25 Repair-Complex extensive or complicated Adjacent tissue transfer or Integumentary System 14000 rearrangement, trunk; defect 0.00 0.00 Inf Adjacent Tissue Transfer 10 cm or less COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 114

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Adjacent tissue transfer or Integumentary System 14001 rearrangement, trunk; defect 0.00 0.00 Inf Adjacent Tissue Transfer 10 cm or more Adjacent tissue transfer or Integumentary System rearrangement, scalp, arms 14020 0.03 0.02 0.53 Adjacent Tissue Transfer and/or legs; defect 10 cm or less Adjacent tissue transfer or Integumentary System 14021 rearrangement, scalp, arms 0.01 0.01 0.73 Adjacent Tissue Transfer and/or legs Adjacent tissue transfer or Integumentary System rearrangement, forehead, 14040 0.20 0.08 0.38 Adjacent Tissue Transfer cheeks, chin, mouth, neck, axillae, genitalia Adjacent tissue transfer or Integumentary System rearrangement, forehead, 14041 0.00 0.01 2.89 Adjacent Tissue Transfer cheeks, chin, mouth, neck, axillae, genitalia Adjacent tissue transfer or Integumentary System 14060 rearrangement, eyelids, nose, 0.00 0.00 Inf Adjacent Tissue Transfer ears and/or lips Integumentary System 14300 0.00 0.00 Inf Adjacent Tissue Transfer Integumentary System Adjacent tissue transfer or 14301 0.00 0.00 0.00 Adjacent Tissue Transfer rearrangement, any area Integumentary System 14350 Filleted finger or toe flap 0.00 0.00 0.59 Adjacent Tissue Transfer Surgical preparation or creation of recipient site by excision of open wounds, burn Integumentary System Skin eschar, or scar, or incisional 15002 0.03 0.02 0.53 Grafts release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of bady area for infants and children Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar, or incisional Integumentary System Skin 15003 release of scar contracture, 0.01 0.00 0.40 Grafts trunk, arms, legs; each additional 100 sq cm or each additional 1% of bady area for infants and children Surgical preparation or creation of recipient site by excision of open wounds, burn Integumentary System Skin 15004 eschar, or scar, or incisional 0.02 0.01 0.57 Grafts release of scar contracture, face, scalp, eyelids,mouth, neck , ears, orbits, genitalia, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 115

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate hands, feet, and/or multiple digits; first 100 sq cm or 1% of bady area for infants and children Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar, or incisional release of scar contracture, Integumentary System Skin face, scalp, eyelids,mouth, 15005 0.00 0.01 Inf Grafts neck , ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm or each additional 1% of bady area for infants and children Harvest of skin for tissue Integumentary System Skin 15040 cultured autograft, 100 sq cm 0.00 0.00 Inf Grafts or less Pinch graft, single or multiple, to cover small ulcer, tip of Integumentary System Skin 15050 digit, or other minimal open 0.01 0.00 0.45 Grafts area (except on face), up to defect size 2 cm diameter Split-thickness autograft, Integumentary System Skin trunk, arms, legs,; first 100 sq 15100 0.10 0.06 0.66 Grafts cm or less, or 1% of body area of infants and children Split-thickness autograft, trunk, arms, legs; each Integumentary System Skin 15101 additional 100 sq cm or less, 0.02 0.03 1.53 Grafts or each additional 1% of body area of infants and children Epidermal autograft, trunk, Integumentary System Skin arms, legs; first 100 sq cm or 15110 0.00 0.00 Inf Grafts less, or 1% of body area of infants and children Epidermal autograft, trunk, arms, legs; each additional Integumentary System Skin 15111 100 sq cm or less, or each 0.00 0.00 Inf Grafts additional 1% of body area of infants and children Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, Integumentary System Skin 15115 feet, and/or multiple digits; first 0.00 0.00 Inf Grafts 100 sq cm or less, or 1% of body area of infants and children Integumentary System Skin Split thickness autograft, face, 15120 0.01 0.02 1.32 Grafts scalp, eyelids, mouth, neck, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 116

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children Split thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, Integumentary System Skin feet, and/or multiple digits; 15121 0.00 0.00 Inf Grafts each additional 100 sq cm or less, or each additional 1% of body area of infants and children Dermal autograft, trunk, arms, Integumentary System Skin legs; first 100 sq cm or less, or 15130 0.00 0.00 Inf Grafts 1% of body area of infants and children Dermal autograft, trunk, arms, legs; each additional 100 sq Integumentary System Skin 15131 cm or less, or each additional 0.00 0.00 Inf Grafts 1% of body area of infants and children Dermal autograft, face, scalp, eyelids, mouth, neck, ears, Integumentary System Skin orbits, genitalia, hands, feet, 15135 0.00 0.00 Inf Grafts and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children Integumentary System Skin 15170 0.00 0.00 Inf Grafts Integumentary System Skin 15171 0.00 0.00 Inf Grafts Integumentary System Skin 15175 0.00 0.00 Inf Grafts Full thickness graft, free, Integumentary System Skin including direct closure of 15200 0.00 0.01 Inf Grafts donor site, trunk; 20 sq cm or less Full thickness graft, free, including direct closure of Integumentary System Skin 15201 donor site, trunk; each 0.00 0.00 Inf Grafts additional 20 sq cm or part thereof Full thickness graft, free, Integumentary System Skin including direct closure of 15220 0.01 0.02 2.13 Grafts donor site, scalp, arms and/ or legs; 20 sq cm or less Full thickness graft, free, Integumentary System Skin including direct closure of 15221 0.00 0.00 Inf Grafts donor site, scalp arms and/ or legs; each additional 20 sq cm COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 117

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate or part thereof Full thickness graft, free, including direct closure of Integumentary System Skin donor site, forehead, cheeks, 15240 0.03 0.05 1.85 Grafts chin, mouth, neck, axillae, genitalia,hands and/or feet; 20 sq cm or less Full thickness graft, free, including direct closure of donor site, forehead, cheeks, Integumentary System Skin 15241 chin, mouth, neck, axillae, 0.00 0.01 Inf Grafts genitalia,hands and/or feet; each additional 20 sq cm or part thereof Full thickness graft, free, Integumentary System Skin including direct closure of 15260 0.00 0.00 Inf Grafts donor site, nose, ears, eyelids and/ or lips; 20 sq cm or less Application of skin substitute graft to trunk, arms legs, total Integumentary System Skin 15271 wound surface area up to 100 0.01 0.00 0.01 Grafts sq cm; first 25 sq cm or less wound surface area Application of skin substitute graft to trunk, arms legs, total Integumentary System Skin 15272 wound surface area up to 100 0.01 0.00 0.02 Grafts sq cm; each additional 25 sq cm wound surface area Application of skin substitute graft to trunk, arms legs, total Integumentary System Skin wound surface area greater 15273 0.00 0.00 0.00 Grafts than or equal to 100 sq cm; first 100 sq cm or less wound surface area Application of skin substitute graft to trunk, arms legs, total wound surface area greater than or equal to 100 sq cm; Integumentary System Skin 15275 each additional 100 sq cm 0.01 0.00 0.00 Grafts wound surface area, or part thereof, or each additional 1% of body area of infants and children Other Musculoskeletal - Exploration of penetrating 20103 0.22 0.03 0.13 Other wound extremity Excision of epiphyseal bar, Other Musculoskeletal with or without autogenous 20150 0.05 0.04 0.81 Excision soft tissue graft obtained thorugh same fascial incision Other Musculoskeletal 20200 Biopsy, muscle, superficial 0.01 0.02 2.74 Excision COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 118

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Other Musculoskeletal 20205 Biopsy, muscle, deep 0.06 0.07 1.16 Excision Other Musculoskeletal Biopsy, muscle, percutaneous 20206 0.01 0.01 1.73 Excision needle Other Musculoskeletal Biopsy, bone, trocar, or 20220 0.01 0.02 1.54 Excision needle; superficial Other Musculoskeletal Biopsy, bone, trocar, or 20225 0.06 0.06 0.94 Excision needle; deep Other Musculoskeletal Biopsy, bone, open; 20240 0.07 0.06 0.85 Excision superficial Other Musculoskeletal 20245 Biopsy, bone, open; deep 0.41 0.25 0.61 Excision Other Musculoskeletal Biopsy, vertebral body, open; 20250 0.00 0.00 0.30 Excision thoracic Other Musculoskeletal Biopsy, vertebral body, open; 20251 0.00 0.00 0.59 Excision cervical or lumbar Other Musculoskeletal Injection of sinus tract; 20501 0.00 0.00 Inf Introduction or Removal therapeutic Other Musculoskeletal Biopsy, bone, open; 20520 0.12 0.03 0.26 Introduction or Removal diagnostic Removal of foreign body in Other Musculoskeletal 20525 muscle or tendon sheath; 0.17 0.03 0.19 Introduction or Removal simple Removal of foreign body in Other Musculoskeletal 20526 muscle or tendon sheath; 0.00 0.00 Inf Introduction or Removal deep or complicated Injection(s); single tendon Other Musculoskeletal 20550 sheath, or ligament, 0.01 0.02 4.04 Introduction or Removal aponeurosis Other Musculoskeletal Injection(s); single tendon 20551 0.00 0.02 6.75 Introduction or Removal origin/insertion Injection(s); single or multiple Other Musculoskeletal 20552 trigger point(s), 1 or 2 0.01 0.01 1.45 Introduction or Removal muscle(s) Arthrocentesis, aspiration Other Musculoskeletal 20600 and/or injection; small joint or 0.01 0.03 2.76 Introduction or Removal bursa Arthrocentesis, aspiration Other Musculoskeletal 20605 and/or injection; intermediate 0.12 0.17 1.39 Introduction or Removal joint or bursa Arthrocentesis, aspiration Other Musculoskeletal - 20610 and/or injection; major joint or 0.42 0.61 1.45 Intro or Removal bursa Other Musculoskeletal Aspiration and/or injection of 20612 0.01 0.00 0.70 Introduction or Removal ganglion cyst(s) any location Other Musculoskeletal Aspiration and injection for 20615 0.06 0.10 1.76 Introduction or Removal treatment of bone cyst Insertion of wire or pin with Other Musculoskeletal 20650 application of skeletal traction, 0.06 0.13 2.29 Introduction or Removal including removal 20660 Other Musculoskeletal Application of cranial tongs, 0.01 0.02 2.72 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 119

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Introduction or Removal caliper, or stereotactic frame, including removal Other Musculoskeletal Application of halo, including 20661 0.05 0.06 1.09 Introduction or Removal removal, cranial Removal of implant; Other Musculoskeletal - 20670 superficial (eg buried wire, pin 0.59 0.36 0.62 Intro or Removal or rod) Removal of implant; deep (eg Other Musculoskeletal - 20680 buried wire, pin, screw, metal 4.97 5.19 1.04 Intro or Removal band, nail, rod or plate) Application of uniplane (pins Other Musculoskeletal - 20690 or wires in 1 plane), unilateral, 0.33 0.30 0.92 Intro or Removal external fixation system Application of multiplane (pins or wires in more than 1 plane), Other Musculoskeletal - 20692 unilateral, external fixation 0.13 0.30 2.39 Intro or Removal system (eg Ilizarov, Monticelli type) Other Musculoskeletal Adjustment or revision of 20693 0.09 0.10 1.04 Introduction or Removal external fixation system Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation system with stereotactic computer-assisted adjustment Other Musculoskeletal 20696 (eg spatial frame), including 0.06 0.08 1.46 Introduction or Removal imaging; intiial and subsequent alignment(s), assessments and computations of adjusment schedule Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation system with stereotactic computer-assisted adjustment Other Musculoskeletal 20697 (eg spatial frame), including 0.01 0.03 4.08 Introduction or Removal imaging; intiial and subsequent alignment(s), assessments and computations of adjusment schedule; exchange Replantation, arm (includes Other Musculoskeletal surgical neck of humerus 20802 Reapir, Revision, or 0.00 0.00 Inf through elbow joint, complete Reconstruction amputation Replantation, forearm Other Musculoskeletal (includes radius and ulna to 20805 Reapir, Revision, or 0.00 0.00 0.07 radial carpal joint), complete Reconstruction amputation 20808 Other Musculoskeletal Replantation, hand (includes 0.00 0.00 Inf COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 120

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Reapir, Revision, or hand through Reconstruction metacarpophalangeal joints), complete Replantation, digit, excluding Other Musculoskeletal thumb (includes 20816 Reapir, Revision, or metacarophalangel joint to 0.01 0.01 0.96 Reconstruction insertion of flexor sublimis tendon), complete amputation Replantation, digit, excluding Other Musculoskeletal thumb (includes distal tip to 20822 Reapir, Revision, or 0.01 0.01 0.76 sublimis tendon insertion), Reconstruction complete amputation Other Musculoskeletal Replantation, thumb, complete 20824 Reapir, Revision, or 0.00 0.00 Inf amputation Reconstruction Other Musculoskeletal Replantation thumb (includes 20827 Reapir, Revision, or 0.00 0.00 Inf distal tip to MP joint) Reconstruction Other Musculoskeletal Bone graft, any area; minor or 20900 Repair, Revision, or 0.12 0.05 0.41 small Reconstruction Other Musculoskeletal Bone graft, any area; major or 20902 Reapir, Revision, or 0.08 0.16 2.03 large Reconstruction Other Musculoskeletal 20910 Reapir, Revision, or Cartilage graft; costochondral 0.00 0.00 Inf Reconstruction Other Musculoskeletal 20922 Reapir, Revision, or Fascia lata graft; by incision 0.00 0.00 Inf Reconstruction Other Musculoskeletal 20924 Reapir, Revision, or Tendon graft, from a distance 0.11 0.01 0.08 Reconstruction Other Musculoskeletal 20926 Reapir, Revision, or Tissue grafts, other 0.01 0.03 3.13 Reconstruction Allograft, morselized, or Other Musculoskeletal - placement of osteopromotive 20930 0.61 0.83 1.36 Intro or Removal material, for spine surgery only Other Musculoskeletal - Allograft, structural, for spine 20931 0.02 0.03 1.31 Other surgery only Autograft for spine surgery Other Musculoskeletal - 20936 only; local; obtained from 0.56 0.78 1.39 Intro or Removal same incision Autograft for spine surgery Other Musculoskeletal - 20937 only; local; obtained through 0.04 0.12 2.63 Other separate incision Other Musculoskeletal Autograft for spine surgery 20938 Reapir, Revision, or only; local; structural, 0.01 0.02 3.30 Reconstruction bicortical or tricortical COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 121

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Monitoring of interstitial fluid Other Musculoskeletal pressure in detection of 20950 0.04 0.03 0.74 Other Procedures muscle compartment syndrome Other Musculoskeletal Bone graft with microvascular 20955 0.00 0.01 5.12 Other Procedures anastomosis; fibula Other Musculoskeletal Bone graft with microvascular 20956 0.01 0.01 2.00 Other Procedures anastomosis; iliac crest Free osteocutaneous flap with Other Musculoskeletal microvascular anastomsis; 20969 0.00 0.00 Inf Other Procedures other than iliac creast, metatarsal, or great toe Free osteocutaneous flap with Other Musculoskeletal 20970 microvascular anastomsis; 0.00 0.00 Inf Other Procedures iliac crest Other Musculoskeletal Electrical stimulation to aid 20974 0.00 0.00 Inf Other Procedures bone healing; noninvasive Other Musculoskeletal Electrical stimulation to aid 20975 0.00 0.00 Inf Other Procedures bone healing; invasive Ablation, bone tumor, Other Musculoskeletal 20982 radiofrequency, percutaneous, 0.00 0.01 Inf Other Procedures including CT-guidance Computer-assisted surgical Other Musculoskeletal navigational procedure for 20985 0.01 0.00 0.12 Other Procedures musculoskeletal procedures, image-less Other Musculoskeletal 20987 0.00 0.00 Inf Other Procedures Unlisted procedure, Other Musculoskeletal 20999 musculoskeletal system, 0.01 0.04 4.75 Other Procedures general Osteotomy of spine, posterior or posterolateral approach, 22206 Spine Osteotomy three columns, one vertebral 0.02 0.01 0.50 segment (eg, pedicle/vertebral body subtraction); thoracic Osteotomy of spine, posterior or posterolateral approach, 22207 Spine Osteotomy three columns, one vertebral 0.01 0.01 0.53 segment (eg, pedicle/vertebral body subtraction); lumbar Osteotomy of spine, posterior or posterolateral approach, three columns, one vertebral 22208 Spine Osteotomy 0.01 0.00 0.41 segment (eg, pedicle/vertebral body subtraction); each additional vertebral segment Osteotomy of spine, posterior 22210 Spine Osteotomy or posterolateral approach, 1 0.00 0.01 2.15 vertebral segment; cervical 22212 Spine Osteotomy Osteotomy of spine, posterior 0.22 0.35 1.59 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 122

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate or posterolateral approach, one vertebral segment; thoracic Osteotomy of spine, posterior 22214 Spine Osteotomy or posterolateral approach, 0.03 0.16 4.75 one vertebral segment; lumbar Osteotomy of spine, posterior or posterolateral approach, 22216 Spine Osteotomy 0.19 0.64 3.48 one vertebral segment; each additional vertebral segment Osteotomy of spine, including discectomy, anterior 22220 Spine Osteotomy 0.00 0.00 Inf approach, single vertebral segment; cervical Osteotomy of spine, including discectomy, anterior 22222 Spine Osteotomy 0.00 0.02 Inf approach, single vertebral segment; thoracic Osteotomy of spine, including discectomy, anterior 22224 Spine Osteotomy 0.00 0.02 Inf approach, single vertebral segment; lumbar Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; each additional 22226 Spine Osteotomy 0.00 0.03 9.87 vertebral segment (List separately in addition to code for primary procedure) Spine Fracture and/or Closed treatment of vertebral 22305 0.00 0.03 Inf Dislocation process fracture(s) Closed treatment of vertebral Spine Fracture and/or body fracture(s), without 22310 0.00 0.06 Inf Dislocation manipulation, requiring and including casting or bracing Closed treatment of vertebral fracture(s) and/or dislocation(s) requiring casting Spine Fracture and/or 22315 or 0.01 0.03 4.82 Dislocation bracing, with and including casting and/or bracing by manipulation or traction Open treatment and/or reduction of vertebral Spine Fracture and/or fracture(s) and/or 22325 0.01 0.03 2.11 Dislocation dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar Spine Fracture and/or Open treatment and/or 22326 0.01 0.01 0.98 Dislocation reduction of vertebral COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 123

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical Open treatment and/or reduction of vertebral fracture(s) and/or Spine Fracture and/or 22327 dislocation(s), posterior 0.01 0.01 2.00 Dislocation approach, 1 fractured vertebra or dislocated segment; thoracic Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or Spine Fracture and/or 22328 dislocated segment; each 0.00 0.01 Inf Dislocation additional fractured vertebra or dislocated segment (List separately in addition to code for primary procedure) Arthrodesis, anterior transoral or extraoral technique, clivus- 22548 Spine Arthrodesis/ Anterior C1-C2 (atlas-axis), with or 0.00 0.00 Inf without excision of odontoid process Arthrodesis, anterior interbody, including disc space preparation, 22551 Spine Arthrodesis/ Anterior discectomy, osteophytectomy 0.02 0.00 0.00 and decompression of spinal cord and /or nerve roots; cervical below C2 Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord 22552 Spine Arthrodesis/ Anterior 0.01 0.00 0.00 and/or nerve roots; cervical below C2, each additional interspace (List separately in addition to code for separate procedure) Arthrodesis, anterior interbody 22554 Spine Arthrodesis/ Anterior 0.01 0.03 3.41 technique, including minimal COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 124

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate discectomy to prepare interspace (other than for decompression) cervical below C2 Arthrodesis, anterior interbody technique, including minimal 22556 Spine Arthrodesis/ Anterior discectomy to prepare 0.00 0.05 Inf interspace (other than for decompression); thoracic Arthrodesis, anterior interbody technique, including minimal 22558 Spine Arthrodesis/ Anterior discectomy to prepare 0.01 0.05 3.38 interspace (other than for decompression) lumbar Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for 22585 Spine Arthrodesis/ Anterior decompression); each 0.00 0.07 25.66 additional interspace (List separately in addition to code for primary procedure) Arthrodesis, posterior 22590 Spine Arthrodesis/ Posterior technique, craniocervical 0.01 0.01 2.41 (occiput-C2) Arthrodesis, posterior 22595 Spine Arthrodesis/ Posterior 0.00 0.01 Inf technique, Atlas-axis (C1-C2) Arthrodesis, posterior or posterolateral technique, 22600 Spine Arthrodesis/ Posterior 0.02 0.05 2.73 single level, cervical below C- 2 Arthodesis, posterior or posterolateral technique, 22610 Spine Arthrodesis/ Posterior single level : thoracic (with or 0.02 0.35 15.95 without lateral transverse technique ) Arthrodesis, Posterior or posterolateral technique, 22612 Spine Arthrodesis/ Posterior single level, lumbar (with or 0.05 0.40 8.13 without lateral trasverse technique) Arthrodesis, posterior or posterolateral technique, single level; each additional 22614 Spine Arthrodesis/ Posterior 0.04 1.01 28.01 vertebral segment (List separately in addition to code for primary procedure) Arthrodesis, posterior 22630 Spine Arthrodesis/ Posterior interbody technique, including 0.01 0.06 7.59 laminectomy and /or COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 125

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate discectomy to prepare interspace (other than for decompression), single interspace: lumbar Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other 22632 Spine Arthrodesis/ Posterior 0.00 0.13 Inf than for decompression), single interspace; each additional interspace (List separately in addition to code for primary procedure) Arthodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and /or 22633 Spine Arthrodesis/ Posterior 0.02 0.00 0.00 discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment, lumbar Arthrodesis, posterior, for Spine Arthrodesis/ spinal deformity, with or 22800 0.09 0.31 3.60 Deformity without cast; up to 6 vertebral segments (levels) Arthrodesis, posterior, for Spine Arthrodesis/ spinal deformity, with or 22802 0.54 1.50 2.76 Deformity without cast; 7 to 12 vertebral segments (levels) Arthrodesis, posterior, for Spine Arthrodesis/ spinal deformity, with or 22804 0.40 0.95 2.39 Deformity without cast; 13 or more vertebral segments (levels) Arthrodesis, anterior, for Spine Arthrodesis/ spinal deformity, with or 22808 0.00 0.04 Inf Deformity without cast; 4 to 7 vertebral segments (levels) Arthrodesis, anterior, for Spine Arthrodesis/ spinal deformity, with or 22810 0.01 0.13 9.58 Deformity without cast; 4 to 7 vertebral segments Arthrodesis, anterior, for Spine Arthrodesis/ spinal deformity, with or 22812 0.01 0.05 8.27 Deformity without cast; 8 or more vertebral segments (levels) Kyphectomy, circumferential Spine Arthrodesis/ 22818 exposure of spine and 0.00 0.01 1.85 Deformity resection of vertebral COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 126

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate segments; single or 2 segments Kyphectomy, circumferential exposure of spine and Spine Arthrodesis/ 22819 resection of vertebral 0.00 0.00 Inf Deformity segments; 3 or more segments 22830 Spine Exploration 0.01 0.18 12.94 Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across one 22840 Spine Instrumentation 0.05 0.17 3.25 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) Internal spinal fixation by 22841 Spine Instrumentation 0.00 0.01 4.60 wiring of spinous processes Posterior segmental instrumentation (eg, pedicle fixation, dual rods with 22842 Spine Instrumentation 0.10 0.41 4.27 multiple hooks and sublaminar wires); 3 to 6 vertebral segments Posterior segmental instrumentation (eg, pedicle fixation, dual rods with 22843 Spine Instrumentation 0.54 1.49 2.79 multiple hooks and sublaminar wires); 7 to 12 vertebral segments Posterior segmental instrumentation (eg, pedicle fixation, dual rods with 22844 Spine Instrumentation 0.40 0.92 2.32 multiple hooks and sublaminar wires); 13 or more vertebral segments Anterior instrumentation; 2 to 22845 Spine Instrumentation 0.02 0.04 2.19 3 vertebral segments Anterior instrumentation; 4 to 22846 Spine Instrumentation 0.00 0.06 21.81 7 vertebral segments Anterior instrumentation; 8 or 22847 Spine Instrumentation 0.00 0.02 6.60 more vertebral segments Pelvic fixation (attachment of caudal end of instrumentation 22848 Spine Instrumentation 0.08 0.23 2.75 to pelvic bony structures) other than sacrum Reinsertion of spinal fixation 22849 Spine Instrumentation 0.08 0.45 5.82 device Removal of posterior non- 22850 Spine Instrumentation 0.01 0.11 8.11 segmental instrumentation 22851 Spine Instrumentation Application of intervertebral 0.03 0.05 1.53 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 127

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate biomechanical device(s) (eg, synthetic cage[s], methylmethacrylate) to vertebral defect or interspace. Removal of posterior 22852 Spine Instrumentation 0.02 0.25 11.27 segmental instrumentation Removal of anterior 22855 Spine Instrumentation 0.00 0.00 Inf instrumentation Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation 22856 Spine Instrumentation 0.00 0.00 Inf (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical Revision including replacement of total disc arthroplasty (artificial disc), 22861 Spine Instrumentation 0.00 0.00 Inf anterior approach, single interspace; cervical Removal of total disc arthroplasty (artificial disc), 22864 Spine Instrumentation anterior approach, single 0.00 0.00 Inf interspace; cervical 22899 Spine Other Procedures 0.05 0.48 10.14 23020 Shoulder Incision Capsular contracture release 0.00 0.02 5.64 Incision and drainage, 23030 Shoulder Incision shoulder area; deep abscess 0.03 0.03 1.15 or hematoma Incision and drainage, 23031 Shoulder Incision 0.00 0.00 0.96 shoulder area; infected bursa Incision, bone cortex, shoulder 23035 Shoulder Incision 0.03 0.02 0.49 area Arthrotomy, glemohumeral joint, including exploration, 23040 Shoulder Incision 0.04 0.03 0.83 drainage, or removal of foreign body Arthorotomy, acromioclavicular, 23044 Shoulder Incision sternoclavicular joint, including 0.01 0.00 0.42 exploration, drainage, or removal of foreign body Biopsy, soft tissue of shoulder 23065 Shoulder Excision 0.00 0.00 Inf area; superficial Biopsy, soft tissue of shoulder 23066 Shoulder Excision 0.01 0.01 1.24 area; deep COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 128

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Excision, tumor, soft tissue of 23071 Shoulder Excision shoulder area, subcutaneous; 0.00 0.00 0.00 3 cm or greater Excision, tumor, soft tissue of 23073 Shoulder Excision shoulder area, subfascial; 5cm 0.01 0.00 0.00 or greater Excision, tumor, soft tissue of 23075 Shoulder Excision shoulder area, subcutaneous; 0.01 0.01 0.74 less than 3 cm Excision, tumor, soft tissue of 23076 Shoulder Excision shoulder area, subfascial; less 0.00 0.01 5.12 than 5 cm Radical resection of tumor, 23077 Shoulder Excision soft tissue of shoulder area; 0.00 0.01 Inf less than 5 cm Arthrotomy, glemohumeral 23100 Shoulder Excision 0.00 0.00 Inf joint, including biopsy Arthrotomy, acromioclavicular joint or sternoclavicular joint, 23101 Shoulder Excision 0.00 0.00 Inf including biopsu and/or excision of torn cartilage Arthrotomy; glenojumeral joint, 23105 Shoulder Excision with synovectomy, with or 0.00 0.00 Inf without biopsy Arthrotomy; sternoclavicular 23106 Shoulder Excision joint, with synovectomy, with 0.00 0.00 Inf or without biopsy Arthrotomy, glenohumeral joint, with joint exploration, 23107 Shoulder Excision 0.00 0.00 1.41 with or without removal of loose or foreign body 23120 Shoulder Excision Claviculectomy; partial 0.00 0.01 3.34 Acromioplasty or acromionectomy, partial, with 23130 Shoulder Excision 0.00 0.01 Inf or without coracoacromial ligament release Excision or curettage of bone 23140 Shoulder Excision cyst or benign tumor of 0.05 0.05 1.00 clavicle or scapula Excision or curettage of bone cyst or benign tumor of 23145 Shoulder Excision clavicle or scapula; with 0.00 0.00 Inf autograft (includes obtaining graft) Excision or curettage of bone cyst or benign tumor of 23146 Shoulder Excision 0.01 0.01 0.82 clavicle or scapula; with allograft Excision or curettage of bone 23150 Shoulder Excision cyst or benign tumor of 0.05 0.04 0.87 proximal humerus; COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 129

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Excision or curettage of bone cyst or benign tumor of 23155 Shoulder Excision proximal humerus; with 0.00 0.01 Inf autograft (includes obtaining graft) Excision or curettage of bone cyst or benign tumor of 23156 Shoulder Excision 0.02 0.04 1.98 proximal humerus; with allograft Sequestrectomy (eg, for 23170 Shoulder Excision osteomyelitis or bone 0.00 0.00 Inf abscess), clavicle Sequestrectomy (eg, for 23174 Shoulder Excision osteomyelitis or bone 0.00 0.00 Inf abscess), scapula Sequestrectomy (eg, for osteomyelitis or bone 23180 Shoulder Excision 0.00 0.01 3.19 abscess), humeral head to surgical neck Partial excision (craterization, saucerization, or 23182 Shoulder Excision 0.00 0.00 Inf diaphysectomy) bone (eg, osteomyelitis), clavicle Partial excision (craterization, saucerization, or 23184 Shoulder Excision 0.00 0.00 Inf diaphysectomy) bone (eg, osteomyelitis), scapula Partial excision (craterization, saucerization, or 23190 Shoulder Excision diaphysectomy) bone (eg, 0.00 0.00 1.56 osteomyelitis), proximal humerus Ostectomy of scapula, partial 23200 Shoulder Excision 0.00 0.00 0.59 (eg, superior medial angle) 23210 Shoulder Excision Resection, humeral head 0.01 0.01 0.96 Radical resection of tumor; 23220 Shoulder Excision 0.01 0.00 0.85 clavicle Shoulder Repair Revision Muscle transfer, any type, 23395 0.02 0.03 1.90 and/or Reconstruction shoulder or upper arn; single Shoulder Repair Revision 23397 multiple 0.01 0.04 2.98 and/or Reconstruction Shoulder Repair Revision 23400 Scapulopexy 0.00 0.01 4.15 and/or Reconstruction Shoulder Repair Revision Tenotomy, shoulder area, 23405 0.01 0.03 5.16 and/or Reconstruction single tendon Shoulder Repair Revision multiple tendons through 23406 0.00 0.02 5.56 and/or Reconstruction same incision Repair of ruptured Shoulder Repair Revision 23410 musculoteninous cuff, open; 0.01 0.01 1.05 and/or Reconstruction acute 23412 Shoulder Repair Revision chronic 0.01 0.01 1.66 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 130

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate and/or Reconstruction Coracoacromial ligament Shoulder Repair Revision 23415 release, with or without 0.00 0.00 0.37 and/or Reconstruction acromioplasty Reconstruction of complete Shoulder Repair Revision shoulder (rotator) cuff 23420 0.00 0.00 Inf and/or Reconstruction avulsion, chronic (includes acromioplasty) Shoulder Repair Revision Tenodesis of long tendon of 23430 0.02 0.01 0.72 and/or Reconstruction biceps Shoulder Repair Revision Resection or transplantation of 23440 0.00 0.00 Inf and/or Reconstruction long tendon of biceps Capsulorrhaphy, anterior; Shoulder Repair Revision 23450 Putti-Platt procedure or 0.00 0.01 1.93 and/or Reconstruction Magnuson type operation Shoulder Repair Revision 23455 with labral repair 0.03 0.13 4.23 and/or Reconstruction Shoulder Repair Revision Capsulorrhaphy, anterior, any 23460 0.00 0.00 Inf and/or Reconstruction type; with bone block Shoulder Repair Revision with coracoid process 23462 0.01 0.01 0.54 and/or Reconstruction transfer] Capsulorrhaphy, Shoulder Repair Revision 23465 glenohumeral joint, posterior, 0.00 0.01 3.71 and/or Reconstruction with or without bone block Capsulorrhaphy, Shoulder Repair Revision 23466 glenohumeral joint, any type 0.01 0.02 1.23 and/or Reconstruction multi-directional instability Shoulder Repair Revision Arthroplasty, glenohumeral 23470 0.01 0.01 1.58 and/or Reconstruction joint; hemiarthroplasty Arthroplasty, glenohumeral Shoulder Repair Revision joint; total shoulder (glenoid 23472 0.01 0.02 4.34 and/or Reconstruction and proximal humeral replacement) Shoulder Repair Revision Osteotomy, clavicle, with or 23480 0.00 0.01 4.15 and/or Reconstruction without internal fixation with bone graft for Shoulder Repair Revision nonunion or malunion 23485 0.01 0.01 1.46 and/or Reconstruction (includes obtaining graft and/or necessary fixation) Prophylactic treatment Shoulder Repair Revision (nailing, pinning,plating, or 23490 0.00 0.00 Inf and/or Reconstruction wiring_ with or without methylmethacrylate; clavicle Shoulder Repair Revision 23491 Proximal humerus 0.00 0.00 Inf and/or Reconstruction Open treatment of clavicular Shoulder Fracture and/or 23515 fracture, includes internal 0.90 0.19 0.21 Dislocation fixation, when performe Open treatment of Shoulder Fracture and/or 23530 sternoclavicular dislocation, 0.02 0.03 1.31 Dislocation acute or chronic; COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 131

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Open treatment of Shoulder Fracture and/or sternoclavicular dislocation, 23532 0.01 0.00 0.37 Dislocation acute or chronic; with fascial graft (includes obtaining graft) Open treatment of Shoulder Fracture and/or 23550 acromioclavicular dislocation, 0.03 0.01 0.28 Dislocation acute or chronic; Open treatment of Shoulder Fracture and/or acromioclavicular dislocation, 23552 0.01 0.00 0.32 Dislocation acute or chronic; with fascial graft (includes obtaining graft) Open treatment of scapular Shoulder Fracture and/or fracture (body, glenoid or 23585 0.01 0.01 1.59 Dislocation acromion) includes internal fixation, when performed Open treatment of proximal humeral (surgical or anatomical neck) fracture, Shoulder Fracture and/or 23615 includes internal fixation, 0.17 0.15 0.84 Dislocation when performed, includes repair of tuberosity(s), when performed Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, Shoulder Fracture and/or 23616 when performed, includes 0.00 0.01 Inf Dislocation repair of tuberosity(s), when performed; with proximal humeral prosthetic replacement Open treatment of greater Shoulder Fracture and/or humeral tuberosity fracture, 23630 0.01 0.00 0.82 Dislocation includes internal fixation, when performed Shoulder Fracture and/or Open treatment of acute 23660 0.00 0.01 1.93 Dislocation shoulder dislocation Closed treatment of shoulder dislocation, with fracture of Shoulder Fracture and/or 23665 greater humeral tuberosity, 0.00 0.01 Inf Dislocation includes internal fixation, when performed Open treatment of shoulder dislocation, with fracture of Shoulder Fracture and/or 23670 greater humeral tuberosity, 0.00 0.00 Inf Dislocation includes internal fixation, when performed Open treatment of shoulder Shoulder Fracture and/or dislocation, with surgical or 23680 0.00 0.00 Inf Dislocation anatomical neck fracture, includes internal fixation, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 132

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate when performed 23929 Shoulder Arthroscopy unlisted procedure, shoulder 0.01 0.03 2.54 Incision and drainage, upper 23930 Humerus/Elbow Incision arm or elbow area; deep 0.07 0.07 0.87 abscess or hematoma Incision and drainage, upper 23931 Humerus/Elbow Incision 0.01 0.02 2.15 arm or elbow area; bursa Incision, deep, with opening of 23935 Humerus/Elbow Incision bone cortex, humerus or 0.05 0.04 0.74 elbow Arthrotomy, elbow, including 24000 Humerus/Elbow Incision exploration, drainage, or 0.11 0.08 0.72 removal of foreign body Arthrotomy of the elbow, with 24006 Humerus/Elbow Incision capsular excision for capsular 0.03 0.04 1.27 release Biopsy, soft tissue of upper 24065 Humerus/Elbow Excision 0.01 0.00 0.48 arm or elbow area; superficial Biopsy, soft tissue of upper 24066 Humerus/Elbow Excision arm or elbow area; deep 0.01 0.03 1.91 (subfascial or intramuscular) Excision, tumor, soft tissue of 24071 Humerus/Elbow Excision upper arm or elbow area, 0.00 0.00 Inf subcutaneous; 3 cm or greater Excision, tumor, soft tissue of upper arm or elbow area, 24073 Humerus/Elbow Excision 0.01 0.00 0.07 subfascial (eg, intramuscular); 5 cm or greater Excision, tumor, soft tissue of 24075 Humerus/Elbow Excision upper arm or elbow area, 0.02 0.01 0.66 subcutaneous; less than 3 cm Excision, tumor, soft tissue of upper arm or elbow area, 24076 Humerus/Elbow Excision 0.00 0.03 Inf subfascial (eg, intramuscular); less than 5 cm Radical resection of tumor (eg, sarcoma), soft tissue of 24077 Humerus/Elbow Excision 0.00 0.01 2.45 upper arm or elbow area; less than 5 cm Radical resection of tumor (eg, sarcoma), soft tissue of 24079 Humerus/Elbow Excision 0.00 0.00 0.00 upper arm or elbow area; 5 cm or greater Arthrotomy, elbow; with 24100 Humerus/Elbow Excision 0.00 0.00 Inf synovial biopsy only Arthrotomy, elbow; with joint exploration, with or without 24101 Humerus/Elbow Excision biopsy, with or without 0.02 0.04 1.74 removal of loose or foreign body 24102 Humerus/Elbow Excision Arthrotomy, elbow; with 0.00 0.01 2.45 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 133

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate synovectomy 24105 Humerus/Elbow Excision Excision, olecranon bursa 0.02 0.01 0.52 Excision or curettage of bone 24110 Humerus/Elbow Excision cyst or benign tumor, 0.03 0.10 3.12 humerus; Excision or curettage of bone cyst or benign tumor, 24115 Humerus/Elbow Excision 0.00 0.01 5.34 humerus; with autograft (includes obtaining graft) Excision or curettage of bone 24116 Humerus/Elbow Excision cyst or benign tumor, 0.03 0.08 2.64 humerus; with allog Excision or curettage of bone cyst or benign tumor of head 24120 Humerus/Elbow Excision 0.00 0.01 2.30 or neck of radius or olecranon process; Excision or curettage of bone cyst or benign tumor of head 24125 Humerus/Elbow Excision or neck of radius or olecranon 0.01 0.00 0.11 process; with autograft (includes obtaining graft) Excision or curettage of bone cyst or benign tumor of head 24126 Humerus/Elbow Excision 0.00 0.00 Inf or neck of radius or olecranon process; with allograft 24130 Humerus/Elbow Excision Excision, radial head 0.02 0.04 2.32 Sequestrectomy (eg, for osteomyelitis or bone 24134 Humerus/Elbow Excision 0.01 0.00 0.56 abscess), shaft or distal humerus Sequestrectomy (eg, for 24138 Humerus/Elbow Excision osteomyelitis or bone 0.00 0.00 Inf abscess), radial head or neck Sequestrectomy (eg, for 24140 Humerus/Elbow Excision osteomyelitis or bone 0.02 0.01 0.80 abscess), olecranon process Partial excision (craterization, saucerization, or 24145 Humerus/Elbow Excision 0.00 0.00 Inf diaphysectomy) bone (eg, osteomyelitis), humerus Partial excision (craterization, saucerization, or 24147 Humerus/Elbow Excision diaphysectomy) bone (eg, 0.01 0.00 0.32 osteomyelitis), radial head or neck Partial excision (craterization, saucerization, or 24149 Humerus/Elbow Excision diaphysectomy) bone (eg, 0.03 0.03 0.84 osteomyelitis), olecranon process 24150 Humerus/Elbow Excision Radical resection of capsule, 0.01 0.00 0.74 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 134

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate soft tissue, and heterotopic bone, elbow, with contracture release (separate procedure) Radical resection of tumor, 24151 Humerus/Elbow Excision 0.00 0.00 Inf shaft or distal humerus Radical resection of tumor, 24152 Humerus/Elbow Excision 0.00 0.00 Inf radial head or neck Resection of elbow joint 24155 Humerus/Elbow Excision 0.00 0.00 Inf (arthrectomy) Humerus/ Elbow 24160 Implant removal; elbow joint 0.01 0.07 8.88 Introduction or Removal Humerus/ Elbow 24164 Implant removal; radial head 0.00 0.00 Inf Introduction or Removal Removal of foreign body, Humerus/ Elbow 24200 upper arm or elbow area; 0.02 0.01 0.78 Introduction or Removal subcutaneous Removal of foreign body, Humerus/ Elbow 24201 upper arm or elbow area; 0.01 0.04 2.66 Introduction or Removal deep Humerus/ Elbow Injection procedure for elbow 24220 0.40 0.09 0.22 Introduction or Removal arthrography Humerus/ Elbow Repair, Manipulation; elbow; under 24300 Revision and/or 0.07 0.05 0.67 anesthesia Reconstruction Humerus/ Elbow Repair, Muscle or tendon transfer, any 24301 Revision and/or type, upper arm or elbow, 0.02 0.04 1.68 Reconstruction single Humerus/ Elbow Repair, Tendon lengthening, upper 24305 Revision and/or 0.04 0.09 2.33 arm or elbow, single, each Reconstruction Humerus/ Elbow Repair, Tenotomy, open elbow to 24310 Revision and/or 0.02 0.03 1.71 shoulder, single, each Reconstruction Tenoplasty, with muscle Humerus/ Elbow Repair, transfer, with or without free 24320 Revision and/or graft, elbow to shoulder, single 0.00 0.00 Inf Reconstruction (Seddon‐ Brookes type procedure) Humerus/ Elbow Repair, Flexor‐plasty, elbow, (eg, 24330 Revision and/or 0.00 0.00 1.48 Steindler type advancement) Reconstruction Humerus/ Elbow Repair, with extensor 24331 Revision and/or 0.00 0.00 Inf advancement Reconstruction Humerus/ Elbow Repair, 24332 Revision and/or Tenolysis, triceps 0.00 0.01 Inf Reconstruction Humerus/ Elbow Repair, Tenodesis of biceps tendon at 24340 Revision and/or 0.00 0.01 Inf elbow, separate procedure Reconstruction 24341 Humerus/ Elbow Repair, Repair, tendon or muscle, 0.03 0.01 0.34 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 135

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Revision and/or upper arm or elbow, each Reconstruction tendon or muscle, primary or secondary (excludes rotator cuff) Reinsertion of ruptured biceps Humerus/ Elbow Repair, tendon, distal, with or without 24342 Revision and/or 0.01 0.01 0.86 tendon graft (includes Reconstruction obtaining graft) Humerus/ Elbow Repair, Repair lateral collateral 24343 Revision and/or ligament, elbow, with local 0.02 0.02 1.00 Reconstruction tissue Humerus/ Elbow Repair, Repair lateral collateral 24344 Revision and/or ligament, elbow, with tendon 0.01 0.01 1.61 Reconstruction graft, including graft harvest Humerus/ Elbow Repair, Repair medial collateral 24345 Revision and/or ligament, elbow, with local 0.02 0.01 0.76 Reconstruction tissue Humerus/ Elbow Repair, Repair medial collateral 24346 Revision and/or ligament, elbow, with tendon 0.05 0.02 0.37 Reconstruction graft, including graft harvest Humerus/ Elbow Repair, Percutaneous medial or lateral 24350 Revision and/or 0.00 0.00 Inf epicondyle tenotomy Reconstruction Humerus/ Elbow Repair, Arthroplasty, elbow, with distal 24356 Revision and/or humeral prosthetic 0.00 0.00 Inf Reconstruction replacement Humerus/ Elbow Repair, Arthroplasty, elbow, with 24357 Revision and/or implant and fascia lata 0.00 0.00 Inf Reconstruction ligament reconstruction Arthroplasty, elbow, with distal Humerus/ Elbow Repair, humeral and proximal ulnar 24358 Revision and/or 0.01 0.01 0.79 prosthetic replacement; total Reconstruction elbow Humerus/ Elbow Repair, 24359 Revision and/or Arthroplasty, radial head 0.00 0.00 0.59 Reconstruction Humerus/ Elbow Repair, 24360 Revision and/or with implant 0.00 0.00 Inf Reconstruction Revision of total elbow Humerus/ Elbow Repair, arthroplasty, including allograft 24361 Revision and/or 0.00 0.00 Inf when performed; humeral OR Reconstruction ulnar component Humerus/ Elbow Repair, humeral AND ulnar 24362 Revision and/or 0.00 0.00 Inf component Reconstruction Humerus/ Elbow Repair, Osteotomy, humerus, with or 24363 Revision and/or 0.00 0.01 Inf without internal fixation Reconstruction Humerus/ Elbow Repair, Multiple osteotomies with 24365 0.00 0.00 0.45 Revision and/or realignment on intramedullary COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 136

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Reconstruction rod, humeral shaft (Sofield type procedure) Humerus/ Elbow Repair, 24366 Revision and/or Osteoplasty, humerus 0.00 0.00 Inf Reconstruction Humerus/ Elbow Repair, Repair of nonunion or 24400 Revision and/or malunion, humerus; without 0.04 0.12 3.09 Reconstruction graft Humerus/ Elbow Repair, with iliac or other autograft 24410 Revision and/or 0.00 0.00 Inf (includes obtaining graft) Reconstruction Humerus/ Elbow Repair, 24420 Revision and/or Hemiepiphyseal arrest 0.01 0.01 1.67 Reconstruction Humerus/ Elbow Repair, Decompression fasciotomy, 24430 Revision and/or forearm, with brachial artery 0.05 0.02 0.43 Reconstruction exploration Prophylactic treatment Humerus/ Elbow Repair, (nailing, plating, pinnig, or 24435 Revision and/or wiring), with or without 0.01 0.01 1.56 Reconstruction methylmethacrylate, humeral shaft Humerus/ Elbow Repair, Hemiepiphyseal arrest (eg, for 24470 Revision and/or cubitus varus or valgus, distal 0.00 0.01 Inf Reconstruction humerus). Humerus/ Elbow Repair, Decompression fasciotomy, 24495 Revision and/or forearm, with brachial artery 0.00 0.00 1.71 Reconstruction exploration. Prophylactic treatment Humerus/ Elbow Repair, (nailing, pinning, plating or 24498 Revision and/or 0.01 0.01 0.74 wiring), with or without Reconstruction methylmethacrylate, humerus. Open treatment of humeral Humerus/ Elbow Fracture shaft fracture with 24515 0.12 0.10 0.90 and/or Dislocation plate/screws, with or without cerclage. Open treatment of humeral shaft fracture, with insertion of Humerus/ Elbow Fracture 24516 intramedullary implant, with or 0.04 0.05 1.36 and/or Dislocation without cerclage and/or locking screws. Percutaneous skeletal fixation of supracondylar or Humerus/ Elbow Fracture 24538 transcondylar humeral 7.58 4.75 0.63 and/or Dislocation fracture, with or without intercondylar extension. Open treatment of humeral supracondylar or Humerus/ Elbow Fracture 24545 transcondylar fracture, with or 0.44 0.48 1.08 and/or Dislocation without internal or external fixation; without intercondylar COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 137

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate extension. Open treatment of humeral supracondylar or Humerus/ Elbow Fracture transcondylar fracture, with or 24546 0.16 0.28 1.78 and/or Dislocation without internal or external fixation; with intercondylar extension. Percutaneous skeletal fixation Humerus/ Elbow Fracture of humeral epicondylar 24566 0.05 0.11 2.26 and/or Dislocation fracture, medial or lateral, with manipulation. Open treatment of humeral Humerus/ Elbow Fracture epicondylar fracture, medial or 24575 0.65 0.35 0.53 and/or Dislocation lateral, with or without internal or external fixation. Open treatment of humeral Humerus/ Elbow Fracture condylar fracture, medial or 24579 1.38 0.83 0.60 and/or Dislocation lateral, with or without internal or external fixation. Percutaneous skeletal fixation Humerus/ Elbow Fracture of humeral condylar fracture, 24582 0.35 0.31 0.89 and/or Dislocation medial or lateral, with manipulation. Open treatment of periarticular fracture and/or dislocation of Humerus/ Elbow Fracture 24586 the elbow (fracture distal 0.05 0.10 2.10 and/or Dislocation humerus and proximal ulna and/ or proximal radius);. Open treatment of periarticular fracture and/or dislocation of Humerus/ Elbow Fracture the elbow (fracture distal 24587 0.00 0.01 Inf and/or Dislocation humerus and proximal ulna and/ or proximal radius); with implant arthroplasty. Treatment of closed elbow Humerus/ Elbow Fracture 24605 dislocation; requiring 0.10 0.21 2.07 and/or Dislocation anesthesia. Humerus/ Elbow Fracture Open treatment of acute or 24615 0.06 0.05 0.77 and/or Dislocation chronic elbow dislocation. Open treatment of Monteggia type of fracture dislocation at Humerus/ Elbow Fracture elbow (fracture proximal end 24635 0.20 0.14 0.72 and/or Dislocation of ulna with dislocation of radial head), with or without internal or external fixation. Open treatment of radial head Humerus/ Elbow Fracture or neck fracture, with or 24665 0.25 0.17 0.68 and/or Dislocation without internal fixation or radial head excision;. Humerus/ Elbow Fracture Open treatment of radial head 24666 0.00 0.01 Inf and/or Dislocation or neck fracture, with or COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 138

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate without internal fixation or radial head excision; with radial head prosthetic replacement. Open treatment of ulnar fracture proximal end Humerus/ Elbow Fracture 24685 (olecranon process), with or 0.37 0.24 0.64 and/or Dislocation without internal or external fixation. Tendon sheath incision; at 25000 Forearm/Wrist Incision radial styloid (eg, for 0.03 0.01 0.36 deQuervain's disease). Incision, flexor tendon sheath, 25001 Forearm/Wrist Incision 0.00 0.00 0.82 wrist ( eg, flexor carpi radialis Decompression fasciotomy, forearm and/or wrist; flexor or extensor compartment; 25020 Forearm/Wrist Incision 0.06 0.03 0.52 without debridement of nonviable muscle and/or nerve Decompression fasciotomy, forearm and/or wrist; with 25023 Forearm/Wrist Incision 0.01 0.01 1.02 debridement of nonviable muscle and/or nerve. Decompression fasciotomy, forearm and/or wrist, flexor AND extensor compartment; 25024 Forearm/Wrist Incision 0.02 0.02 0.83 without debridement of nonviable muscle and/or nerve Decompression fasciotomy, forearm and/or wrist, flexor 25025 Forearm/Wrist Incision AND extensor compartment; 0.00 0.01 4.01 with debridement of nonviable muscle and/or nerve Incision and drainage, forearm 25028 Forearm/Wrist Incision and/or wrist; deep abscess or 0.07 0.08 1.18 hematoma. Incision and drainage, forearm 25031 Forearm/Wrist Incision 0.00 0.02 Inf and/or wrist; infected bursa. Incision, deep, with opening of bone cortex (eg, for 25035 Forearm/Wrist Incision osteomyelitis or bone 0.04 0.04 0.93 abscess), forearm and/or wrist. Arthrotomy, radiocarpal or midcarpal joint, with 25040 Forearm/Wrist Incision 0.01 0.01 1.00 exploration, drainage, or removal of foreign body. Biopsy, soft tissue of forearm 25065 Forearm/Wrist Excision 0.00 0.02 Inf and/or wrist; superficial COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 139

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Biopsy, soft tissue of forearm 25066 Forearm/Wrist Excision and/or wrist; deep (subfascial 0.01 0.02 1.71 or intramuscular) Excision, tumor, soft tissue of 25071 Forearm/Wrist Excision forearm and/or wrist area, 0.00 0.00 0.07 subcutaneous; 3 cm or greater Excision, tumor, soft tissue of forearm and/or wrist area, 25073 Forearm/Wrist Excision 0.01 0.00 0.07 subfascial (eg, intramuscular); 3 cm or greater Excision, tumor, soft tissue of 25075 Forearm/Wrist Excision forearm and/or wrist area, 0.01 0.02 1.41 subcutaneous; less than 3 cm Excision, tumor, soft tissue of forearm and/or wrist area, 25076 Forearm/Wrist Excision 0.02 0.03 1.92 subfascial (eg, intramuscular); less than 3 cm Radical resection of tumor (eg, sarcoma), soft tissue of 25077 Forearm/Wrist Excision 0.01 0.01 1.00 forearm and/or wrist area; less than 3 cm Capsulotomy, wrist (eg, 25085 Forearm/Wrist Excision 0.00 0.01 3.34 contracture) Arthrotomy, wrist joint; with 25100 Forearm/Wrist Excision 0.01 0.00 0.30 biopsy Arthrotomy, wrist joint; with joint exploration, with or 25101 Forearm/Wrist Excision without biopsy, with or without 0.02 0.00 0.19 removal of loose or foreign body Arthrotomy, wrist joint; with 25105 Forearm/Wrist Excision 0.00 0.00 Inf synovectomy Arthrotomy, distal radioulnar 25107 Forearm/Wrist Excision joint including repair of 0.01 0.00 0.34 triangular cartilage, complex Excision of tendon, forearm 25109 Forearm/Wrist Excision and/or wrist, floexor or 0.01 0.00 0.00 extensor, each Excision, lesion of tendon 25110 Forearm/Wrist Excision 0.00 0.01 Inf sheath, forearm and/or wrist Excision of ganglion, wrist 25111 Forearm/Wrist Excision 0.73 0.23 0.31 (dorsal or volar); primary Excision of ganglion, wrist 25112 Forearm/Wrist Excision 0.02 0.01 0.68 (dorsal or volar); recurrent Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, 25115 Forearm/Wrist Excision 0.01 0.00 0.35 tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); flexor 25116 Forearm/Wrist Excision Radical excision of bursa, 0.00 0.00 Inf COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 140

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); extensors, with or without transposition of dorsal retinaculum Synovectomy, extensor 25118 Forearm/Wrist Excision tendon sheath, wrist, single 0.01 0.00 0.42 compartment; Excision or curettage of bone cyst or benign tumor of radius 25120 Forearm/Wrist Excision or ulna (excluding head or 0.06 0.09 1.58 neck of radius and olecranon process); Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or 25125 Forearm/Wrist Excision 0.00 0.01 Inf neck of radius and olecranon process); with autograft (includes obtaining graft) Excision or curettage of bone cyst or benign tumor of radius 25126 Forearm/Wrist Excision or ulna (excluding head or 0.01 0.02 4.12 neck of radius and olecranon process); with allograft Excision or curettage of bone 25130 Forearm/Wrist Excision cyst or benign tumor of carpal 0.02 0.01 0.41 bones; Excision or curettage of bone cyst or benign tumor of carpal 25135 Forearm/Wrist Excision 0.00 0.00 0.52 bones; with autograft (includes obtaining graft) Excision or curettage of bone 25136 Forearm/Wrist Excision cyst or benign tumor of carpal 0.00 0.00 Inf bones; with allograft Sequestrectomy (eg, for 25145 Forearm/Wrist Excision osteomyelitis or bone 0.00 0.00 0.30 abscess), forearm and/or wrist Partial excision (craterization, saucerization, or 25150 Forearm/Wrist Excision 0.01 0.01 0.72 diaphysectomy) of bone (eg, for osteomyelitis); ulna Partial excision (craterization, saucerization, or 25151 Forearm/Wrist Excision 0.01 0.01 1.82 diaphysectomy) of bone (eg, for osteomyelitis); radius Radical resection of tumor, 25170 Forearm/Wrist Excision 0.00 0.01 Inf radius or ulna 25210 Forearm/Wrist Excision Carpectomy; 1 bone 0.02 0.00 0.27 25215 Forearm/Wrist Excision Carpectomy; all bones of 0.02 0.02 1.19 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 141

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate proximal row Radial styloidectomy 25230 Forearm/Wrist Excision 0.00 0.00 0.82 (separate procedure) Excision distal ulna partial or 25240 Forearm/Wrist Excision complete (eg, Darrach type or 0.01 0.01 0.91 matched resection) Repair, tendon or muscle, Forearm/ Wrist Repair, flexor, forearm and/or wrist; 25260 Revision and/or 0.10 0.10 1.01 primary, single, each tendon Reconstruction or muscle Forearm/ Wrist Repair, secondary, single, each 25263 Revision and/or 0.00 0.01 1.85 tendon or muscle Reconstruction Forearm/ Wrist Repair, secondary, with free graft 25265 Revision and/or 0.00 0.00 Inf (includes obtaining Reconstruction Repair, tendon or muscle, Forearm/ Wrist Repair, extensor, forearm and/or wrist; 25270 Revision and/or 0.04 0.05 1.14 primary, single, each tendon Reconstruction or muscle Forearm/ Wrist Repair, secondary, single, each 25272 Revision and/or 0.01 0.01 0.67 tendon or muscle Reconstruction Forearm/ Wrist Repair, secondary, with free graft 25274 Revision and/or 0.00 0.00 Inf (includes obtaining Reconstruction Repair, tendon sheath, Forearm/ Wrist Repair, extensor, forearm and or wrist, 25275 Revision and/or 0.01 0.00 0.26 with free graft includes graft Reconstruction harvest Lengthening or shortening of Forearm/ Wrist Repair, flexor or extensor tendon, 25280 Revision and/or 0.06 0.13 2.03 forearm and/or wrist, single, Reconstruction each tendon Tenotomy, open flexor or Forearm/ Wrist Repair, extensor tendon, forearm 25290 Revision and/or 0.06 0.09 1.44 and/or wrist, single, each Reconstruction tendon Forearm/ Wrist Repair, Tenolysis, flexor or extensor 25295 Revision and/or tendon, forearm and/or wrist, 0.01 0.02 1.78 Reconstruction single, each tendon Forearm/ Wrist Repair, Tenodesis at wrist; flexors of 25300 Revision and/or 0.00 0.00 0.96 fingers Reconstruction Forearm/ Wrist Repair, 25301 Revision and/or extensors of fingers 0.00 0.01 2.08 Reconstruction Tendon transplantation or Forearm/ Wrist Repair, transfer, flexor or extensor, 25310 Revision and/or 0.05 0.17 3.21 forearm and/or wrist, single; Reconstruction each tendon COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 142

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Forearm/ Wrist Repair, with tendon graft(s) 25312 Revision and/or (includes obtaining graft), 0.00 0.02 Inf Reconstruction each tendon Flexor origin slide (eg, for Forearm/ Wrist Repair, cerebral palsy, Volkmann 25315 Revision and/or 0.00 0.00 1.71 contracture), forearm and/or Reconstruction wrist Forearm/ Wrist Repair, 25316 Revision and/or with tendon transfer 0.00 0.01 Inf Reconstruction Forearm/ Wrist Repair, Capsulorrhaphy or 25320 Revision and/or reconstruction, wrist, any 0.03 0.02 0.56 Reconstruction method open Arthroplasty, wrist, with or Forearm/ Wrist Repair, without interposition, with or 25332 Revision and/or 0.00 0.00 Inf wtihout external or internal Reconstruction fixation Forearm/ Wrist Repair, Centralization of wrist on ulna 25335 Revision and/or 0.00 0.03 9.12 eg, radial club hand) Reconstruction Reconstruction for stabilization of unstable distal Forearm/ Wrist Repair, radioulnar joint, secondary by 25337 Revision and/or 0.01 0.01 1.59 soft tissue stabilization with or Reconstruction without open reduction of distal radioulnar joint Forearm/ Wrist Repair, 25350 Revision and/or Osteotomy, radius; distal third 0.07 0.06 0.88 Reconstruction Forearm/ Wrist Repair, 25355 Revision and/or middle or proximal third 0.02 0.02 1.01 Reconstruction Forearm/ Wrist Repair, 25360 Revision and/or Osteotomy; ulna 0.05 0.08 1.55 Reconstruction Forearm/ Wrist Repair, 25365 Revision and/or radius and ulna 0.02 0.03 2.02 Reconstruction Multiple osteotomies, with Forearm/ Wrist Repair, realignment on intramedullary 25370 Revision and/or 0.00 0.00 Inf rod (Sofield type procedure); Reconstruction radius OR ulna Forearm/ Wrist Repair, 25375 Revision and/or radius AND ulna 0.00 0.00 Inf Reconstruction Forearm/ Wrist Repair, Osteoplasty, radius OR ulna; 25390 Revision and/or 0.05 0.03 0.56 shortening Reconstruction Forearm/ Wrist Repair, 25391 Revision and/or lengthening with autograft 0.00 0.02 Inf Reconstruction COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 143

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Forearm/ Wrist Repair, Osteoplasty, radius AND ulna; 25392 Revision and/or 0.00 0.00 0.74 shortening (excluding 64876) Reconstruction Forearm/ Wrist Repair, 25393 Revision and/or lengthening with autograft 0.00 0.00 Inf Reconstruction Forearm/ Wrist Repair, Osteoplasty, carpal bone, 25394 Revision and/or 0.00 0.01 Inf shortening Reconstruction Forearm/ Wrist Repair, Repair of nonunion or 25400 Revision and/or malunion, radius OR ulna; 0.11 0.03 0.28 Reconstruction without graft Forearm/ Wrist Repair, with autograft (includes 25405 Revision and/or 0.02 0.02 1.09 obtaining graft) Reconstruction Forearm/ Wrist Repair, Repair of nonunion or 25415 Revision and/or malunion, radius AND ulna; 0.02 0.01 0.74 Reconstruction without graft Forearm/ Wrist Repair, with autograft (includes 25420 Revision and/or 0.00 0.00 1.78 obtaining graft) Reconstruction Forearm/ Wrist Repair, Repair of defect with 25425 Revision and/or 0.00 0.00 0.89 autograft; radius OR ulna Reconstruction Forearm/ Wrist Repair, 25426 Revision and/or radius AND ulna 0.00 0.00 0.15 Reconstruction Forearm/ Wrist Repair, Insertion vascular pedicle into 25430 Revision and/or 0.02 0.00 0.15 carpal bone Reconstruction Repair of carpal bone Forearm/ Wrist Repair, nonunion other than scaphoid, 25431 Revision and/or 0.01 0.01 0.87 each, including graft and Reconstruction fixation,each bone Repair of nonunion, scaphoid Forearm/ Wrist Repair, navicular bone, with or without 25440 Revision and/or radial styloidectomy (includes 0.17 0.04 0.25 Reconstruction obtaining graft and necessary fixation Forearm/ Wrist Repair, 25445 Revision and/or trapezium 0.00 0.00 Inf Reconstruction Forearm/ Wrist Repair, distal radius and partial or 25446 Revision and/or 0.00 0.00 Inf entire carpus (total wrist) Reconstruction Forearm/ Wrist Repair, Interposition arthroplasty, 25447 Revision and/or intercarpal or carpometacarpal 0.00 0.01 Inf Reconstruction joints Forearm/ Wrist Repair, Revision of arthroplasty, 25449 Revision and/or including removal of implant, 0.00 0.00 Inf Reconstruction wrist joint COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 144

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Forearm/ Wrist Repair, Epiphyseal arrest by 25450 Revision and/or epiphysiodesis or stapling; 0.07 0.05 0.67 Reconstruction distal radius OR ulna Forearm/ Wrist Repair, 25455 Revision and/or distal radius AND ulna 0.02 0.01 0.35 Reconstruction Prophylactic treatment Forearm/ Wrist Repair, (nailing, pinning, plating or 25490 Revision and/or 0.00 0.00 Inf wiring) with or without methyl Reconstruction methacrylate; radius Forearm/ Wrist Repair, 25491 Revision and/or ulna 0.00 0.00 Inf Reconstruction Forearm/ Wrist Repair, 25492 Revision and/or radius AND ulna 0.00 0.00 0.59 Reconstruction Open treatment of radial shaft Forearm/ Wrist Fracture 25515 fracture, includes internal 0.42 0.19 0.45 and/or Dislocation fixation Open treatment of radial shaft Forearm/ Wrist Fracture fracture, includes internal 25525 0.09 0.04 0.48 and/or Dislocation fixation and closed treatment of dislocation of DRUJ Open treatment of radial shaft Forearm/ Wrist Fracture fracture, includes internal 25526 0.02 0.02 0.81 and/or Dislocation fixaiton and open treatment of dislocation of DRUJ Open treatment of ulnar shaft Forearm/ Wrist Fracture 25545 fracture, includes internal 0.15 0.15 1.01 and/or Dislocation fixation Open treatment of radial and Forearm/ Wrist Fracture ulnar shaft fractures with 25574 0.60 0.22 0.37 and/or Dislocation internal fixation of radius or ulna Open treatment of radial and Forearm/ Wrist Fracture ulnar shaft fractures with 25575 1.38 0.73 0.53 and/or Dislocation internal fixation of radius and ulna Percutaneous skeletal fixation Forearm/ Wrist Fracture 25606 of distal radial fracture or 1.93 0.53 0.28 and/or Dislocation epiphyseal separation Open treatment of distal radial Forearm/ Wrist Fracture extra-articular fracture or 25607 0.57 0.19 0.34 and/or Dislocation epiphyseal separation with internal fixation Open treatment of distal radial Forearm/ Wrist Fracture intra-articular fracture or 25608 0.14 0.06 0.43 and/or Dislocation epiphyseal separation with internal fixation of 2 fragments Forearm/ Wrist Fracture Open treatment of distal radial 25609 0.10 0.06 0.61 and/or Dislocation intra-articular fracture or COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 145

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate epiphyseal separation with internal fixation of 3 fragments Forearm/ Wrist Fracture 25611 0.00 0.03 Inf and/or Dislocation Forearm/ Wrist Fracture 25620 0.02 0.02 1.01 and/or Dislocation Open treatment of carpal Forearm/ Wrist Fracture 25628 scaphoid fracture, internal 0.22 0.06 0.30 and/or Dislocation fixation Forearm/ Wrist Fracture Open treatment of carpal bone 25645 0.03 0.01 0.28 and/or Dislocation fracture (excludes scaphoid) Forearm/ Wrist Fracture Percutaneous skeletal fixation 25651 0.05 0.01 0.25 and/or Dislocation of ulnar stylod fracture Forearm/ Wrist Fracture Open treatment of ulnar 25652 0.03 0.01 0.38 and/or Dislocation styloid fracture Open treatment of radiocarpal Forearm/ Wrist Fracture 25670 or intercarpal dislocation, 1 or 0.01 0.00 0.78 and/or Dislocation more bones Forearm/ Wrist Fracture Percutaneous skeletal fixation 25671 0.01 0.01 0.62 and/or Dislocation of DRUJ Forearm/ Wrist Fracture Open treatment of DRUJ 25676 0.01 0.01 0.79 and/or Dislocation dislocation Open treatment of trans- Forearm/ Wrist Fracture 25685 scaphoiperilunate type of 0.01 0.01 0.50 and/or Dislocation fracture dislocation Forearm/ Wrist Fracture Open treatment of lunate 25695 0.01 0.00 0.47 and/or Dislocation dislocation Drainage of finger abscess; 26010 Hand/Fingers Incision 0.06 0.05 0.91 simple. Drainage of finger abscess; 26011 Hand/Fingers Incision 0.15 0.08 0.57 complicated (eg, felon). Drainage of tendon sheath, 26020 Hand/Fingers Incision 0.09 0.04 0.47 one digit and/or palm. Drainage of palmar bursa; 26025 Hand/Fingers Incision 0.02 0.02 0.85 single, ulnar or radial. Drainage of palmar bursa; 26030 Hand/Fingers Incision 0.00 0.01 4.45 multiple or complicated. Incision, deep, with opening of bone cortex (eg, for 26034 Hand/Fingers Incision 0.02 0.02 1.23 osteomyelitis or bone abscess), hand or finger. Decompression fingers and/or 26035 Hand/Fingers Incision hand, injection injury (eg, 0.00 0.00 Inf grease gun). Decompressive fasciotomy, 26037 Hand/Fingers Incision 0.02 0.01 0.61 hand (excludes 26035). Fasciotomy, palmar, for 26045 Hand/Fingers Incision Dupuytren's contracture; 0.00 0.01 2.23 open, partial. Tendon sheath incision (eg, 26055 Hand/Fingers Incision 0.95 0.73 0.77 for trigger finger). COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 146

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Tenotomy, percutaneous, 26060 Hand/Fingers Incision 0.00 0.00 Inf single, each digit. Arthrotomy, with exploration, drainage, or removal of 26070 Hand/Fingers Incision 0.01 0.01 1.19 foreign body; carpometacarpal joint. Arthrotomy, with exploration, drainage, or removal of 26075 Hand/Fingers Incision 0.06 0.02 0.33 foreign body; metacarpophalangeal joint. Arthrotomy, with exploration, drainage, or removal of 26080 Hand/Fingers Incision 0.04 0.02 0.56 foreign body; interphalangeal joint, each. Arthrotomy with biopsy; 26100 Hand/Fingers Excision 0.00 0.00 Inf carpometacarpal joint, each Arthrotomy with synovial 26105 Hand/Fingers Excision biopsy; metacarpophalangeal 0.00 0.00 0.45 joint. Arthrotomy with synovial 26110 Hand/Fingers Excision biopsy; interphalangeal joint, 0.01 0.00 0.67 each. Excision, tumor or vascular malformation, soft tissue of 26111 Hand/Fingers Excision 0.02 0.00 0.02 hand or finger, subcutaneous; 1.5 cm or greater Excision, tumor, soft tissue, or vascular malformation, of 26113 Hand/Fingers Excision hand or finger, subfascial (eg, 0.02 0.00 0.01 intramuscular); 1.5 cm or greater Excision, tumor or vascular malformation, soft tissue of 26115 Hand/Fingers Excision 0.14 0.07 0.51 hand or finger, subcutaneous; less than 1.5 cm Excision, tumor, soft tissue, or vascular malformation, of 26116 Hand/Fingers Excision hand or finger, subfascial (eg, 0.06 0.07 1.04 intramuscular); less than 1.5 cm Radical resection of tumor 26117 Hand/Fingers Excision (eg, sarcoma), soft tissue of 0.00 0.01 2.23 hand or finger; less than 3 cm Radical resection of tumor 26121 Hand/Fingers Excision (eg, sarcoma), soft tissue of 0.00 0.01 4.90 hand or finger; 3 cm or greater Fasciectomy, palm only, with or without Z-plasty, other local 26123 Hand/Fingers Excision tissue rearrangement, or skin 0.00 0.03 Inf grafting (includes obtaining graft). COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 147

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or 26125 Hand/Fingers Excision 0.00 0.01 Inf without Z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft);. Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or 26130 Hand/Fingers Excision without Z-plasty, other local 0.00 0.00 Inf tissue rearrangement, or skin grafting (includes obtaining graft); each additional digit (List separately in addition. Synovectomy, 26135 Hand/Fingers Excision 0.00 0.00 Inf carpometacarpal joint. Synovectomy, proximal interphalangeal joint, including 26145 Hand/Fingers Excision 0.01 0.01 0.80 extensor reconstruction, each interphalangeal joint. Synovectomy tendon sheath, radical (tenosynovectomy), 26160 Hand/Fingers Excision 0.13 0.10 0.77 flexor, palm or finger, single, each digit. Excision of lesion of tendon sheath or capsule (eg, cyst, 26170 Hand/Fingers Excision 0.01 0.00 0.41 mucous cyst, or ganglion), hand or finger. Excision of tendon, palm, 26180 Hand/Fingers Excision flexor, single (separate 0.03 0.01 0.34 procedure), each. Excision of tendon, finger, 26185 Hand/Fingers Excision 0.00 0.00 Inf flexor (separate procedure). Sesamoidectomy, thumb or 26200 Hand/Fingers Excision 0.02 0.02 0.96 finger (separate procedure). Excision or curettage of bone 26205 Hand/Fingers Excision cyst or benign tumor of 0.01 0.01 1.26 metacarpal;. Excision or curettage of bone cyst or benign tumor of 26210 Hand/Fingers Excision 0.09 0.07 0.80 metacarpal; with autograft (includes obtaining graft). Excision or curettage of bone cyst or benign tumor of 26215 Hand/Fingers Excision 0.01 0.01 1.06 proximal, middle, or distal phalanx of finger;. Excision or curettage of bone 26230 Hand/Fingers Excision 0.00 0.00 Inf cyst or benign tumor of COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 148

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate proximal, middle, or distal phalanx of finger; with autograft (includes obtaining graft). Partial excision (craterization, saucerization, or 26235 Hand/Fingers Excision 0.00 0.01 3.04 diaphysectomy) of bone (eg, for osteomyelitis); metacarpal. Partial excision (craterization, saucerization, or 26236 Hand/Fingers Excision diaphysectomy) of bone (eg, 0.02 0.01 0.45 for osteomyelitis); proximal or middle phalanx of finger. Partial excision (craterization, saucerization, or 26250 Hand/Fingers Excision diaphysectomy) of bone (eg, 0.00 0.00 0.82 for osteomyelitis); distal phalanx of finger. Radical resection (ostectomy) 26255 Hand/Fingers Excision 0.00 0.00 Inf for tumor, metacarpal;. Radical resection (ostectomy) 26260 Hand/Fingers Excision for tumor, proximal or middle 0.00 0.01 Inf phalanx of finger;. Radical resectin of tumor, 26261 Hand/Fingers Excision 0.00 0.00 Inf distal phalanx of finger Manipulation finger joint under 26262 Hand/Fingers Excision 0.00 0.00 Inf anesthesia, each joint Hand/Fingers Reapir, Manipulation, palmar fascial 26340 Revision and/or cord, post enzyme injection, 0.03 0.02 0.64 Reconstruction single cord Hand/Fingers Reapir, secondary with free graft, 26350 Revision and/or 0.11 0.08 0.78 each tendon Reconstruction Repair or advancement, flexor Hand/Fingers Reapir, tendon, in zone 2 digital flexor 26352 Revision and/or 0.01 0.00 0.30 tendon sheath; primary Reconstruction without free graft, each tendon Hand/Fingers Reapir, secondary without free 26356 Revision and/or 0.22 0.09 0.43 graft, each tendon Reconstruction Hand/Fingers Reapir, secondary with free graft, 26357 Revision and/or 0.01 0.01 2.45 each tendon Reconstruction Repair or advancement of Hand/Fingers Reapir, profundus tendon, with intact 26358 Revision and/or 0.00 0.01 Inf superficialis tendon; primary, Reconstruction each tendon Hand/Fingers Reapir, secondary with free graft, 26370 Revision and/or 0.07 0.02 0.26 each tendon Reconstruction 26372 Hand/Fingers Reapir, secondary without free 0.01 0.00 0.47 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 149

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Revision and/or graft, each tendon Reconstruction Flexor tendon excision, Hand/Fingers Reapir, implantation of plastic tube or 26373 Revision and/or 0.01 0.00 0.07 rod for delayed tendon graft, Reconstruction hand or finger, each rod Removal of tube or rod and Hand/Fingers Reapir, insertion of flexor tendon graft 26390 Revision and/or 0.02 0.00 0.22 (includes obtaining graft), Reconstruction hand or finger Extensor tendon repair, Hand/Fingers Reapir, dorsum of hand, single, 26392 Revision and/or 0.01 0.00 0.13 primary or secondary; without Reconstruction free graft, each tendon Hand/Fingers Reapir, with free graft, (includes 26410 Revision and/or 0.15 0.05 0.32 obtaining graft), each tendon Reconstruction Extensor tendon excision, Hand/Fingers Reapir, implantation of plastic tube or 26412 Revision and/or 0.00 0.00 Inf rod for delayed tendon graft, Reconstruction hand or finger, each rod Removal of tube or rod and Hand/Fingers Reapir, insertion of extensor tendon 26415 Revision and/or 0.00 0.00 0.37 graft (includes obtaining graft), Reconstruction hand or finger Hand/Fingers Reapir, Extensor tendon repair, finger, 26416 Revision and/or primary or secondary; without 0.00 0.00 0.45 Reconstruction free graft, each tendon Hand/Fingers Reapir, with free graft, (includes 26418 Revision and/or 0.20 0.07 0.38 obtaining graft), each tendon Reconstruction Extensor tendon repair, Hand/Fingers Reapir, central slip repair, secondary 26420 Revision and/or (boutonniere deformity); using 0.01 0.00 0.47 Reconstruction local tissues, including lateral band(s), each finger Hand/Fingers Reapir, with free graft, (includes 26426 Revision and/or 0.01 0.02 1.74 obtaining graft), each finger Reconstruction Closed treatment of distal Hand/Fingers Reapir, extensor tendon insertion, 26428 Revision and/or 0.00 0.00 Inf with or without percutaneous Reconstruction pinning Hand/Fingers Reapir, Repair of extensor tendon, 26432 Revision and/or distal insetionk promary or 0.04 0.01 0.34 Reconstruction secondary; without graft Hand/Fingers Reapir, with free graft, (includes 26433 Revision and/or 0.03 0.03 0.96 obtaining graft) Reconstruction Hand/Fingers Reapir, Realignment of extensor 26434 0.00 0.00 Inf Revision and/or tendon, hand, each tendon COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 150

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Reconstruction Hand/Fingers Reapir, Tenolysis, flexor tendon; palm 26437 Revision and/or 0.01 0.02 1.90 OR finger, each tendon Reconstruction Hand/Fingers Reapir, palm AND finger, each 26440 Revision and/or 0.02 0.03 1.04 tendon Reconstruction Hand/Fingers Reapir, Tenolysis, extensor tendon, 26442 Revision and/or 0.01 0.01 1.09 hand or finger, each tendon Reconstruction Hand/Fingers Reapir, Tenolysis, complex, extensor 26445 Revision and/or tendon, finger, including 0.03 0.02 0.51 Reconstruction forearm, each tendon Hand/Fingers Reapir, Tenotomy, flexor, palm, open, 26449 Revision and/or 0.00 0.00 Inf each Reconstruction Hand/Fingers Reapir, Tenotomy, flexor finger, , 26450 Revision and/or 0.00 0.01 4.52 open, each Reconstruction Hand/Fingers Reapir, Tenotomy, extensor hand or 26455 Revision and/or 0.01 0.02 1.57 finger, single, open, each Reconstruction Hand/Fingers Reapir, Tenodesis; for proximal 26460 Revision and/or interphalangeal joint 0.00 0.01 Inf Reconstruction stabilization Hand/Fingers Reapir, 26471 Revision and/or of distal joint, each joint 0.00 0.01 2.23 Reconstruction Hand/Fingers Reapir, Tendon lengthening, extensor, 26474 Revision and/or 0.01 0.00 0.82 hand or finger, single, each Reconstruction Hand/Fingers Reapir, Tendon shortening, extensor, 26476 Revision and/or 0.00 0.01 Inf hand or finger, single, each Reconstruction Hand/Fingers Reapir, Tendon lengthening, flexor, 26477 Revision and/or 0.00 0.00 1.71 hand or finger, single, each Reconstruction Hand/Fingers Reapir, Tendon shortening, flexor, 26478 Revision and/or 0.02 0.07 3.56 hand or finger, single, each Reconstruction Tendon transfer or transplant, Hand/Fingers Reapir, carpometacarpal area or 26479 Revision and/or 0.00 0.00 Inf dorsum of hand, single; Reconstruction without free graft, each Hand/Fingers Reapir, with free tendon graft 26480 Revision and/or (includes obtaining graft), 0.03 0.04 1.34 Reconstruction each tendon Hand/Fingers Reapir, Tendon transfer or transplant, 26483 Revision and/or palmar, single, each tendon; 0.00 0.00 Inf Reconstruction without free tendon graft 26485 Hand/Fingers Reapir, with free tendon graft 0.02 0.02 1.45 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 151

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Revision and/or (includes obtaining graft), Reconstruction each tendon Hand/Fingers Reapir, Opopnensplasty, superficialis 26489 Revision and/or tendon transfer type, each 0.00 0.00 Inf Reconstruction tendon Hand/Fingers Reapir, tendon transfer with graft 26490 Revision and/or (includes obtaining graft), 0.01 0.01 1.34 Reconstruction each tendon Hand/Fingers Reapir, hypothenar muscle 26492 Revision and/or 0.00 0.00 1.78 transfer Reconstruction Hand/Fingers Reapir, 26494 Revision and/or other methods 0.00 0.02 6.01 Reconstruction Hand/Fingers Reapir, Transfer of tendon to restore 26496 Revision and/or intrinsic function; ring and 0.00 0.00 Inf Reconstruction small finger Hand/Fingers Reapir, 26497 Revision and/or all 4 fingers 0.00 0.00 Inf Reconstruction Hand/Fingers Reapir, Correction claw finger, other 26498 Revision and/or 0.00 0.00 Inf methods Reconstruction Hand/Fingers Reapir, Tendon pulley reconstruction, 26499 Revision and/or with local tissues separate 0.00 0.01 Inf Reconstruction procedure Hand/Fingers Reapir, with tendon or fascial graft 26500 Revision and/or (includes obtaining graft) 0.02 0.01 0.50 Reconstruction separate procedure Hand/Fingers Reapir, Tendon pulley reconstruction; 26502 Revision and/or with tendon prosthesis 0.00 0.00 1.41 Reconstruction (separate procedure). Hand/Fingers Reapir, Thenar muscle release for 26508 Revision and/or 0.04 0.04 1.04 thumb contracture Reconstruction Hand/Fingers Reapir, Cross intrinsic transfer, each 26510 Revision and/or 0.00 0.00 Inf tendon Reconstruction Hand/Fingers Reapir, Capsulodesis M‐P joint; single 26516 Revision and/or 0.01 0.01 1.06 digit Reconstruction Hand/Fingers Reapir, 26517 Revision and/or 2 digits 0.00 0.00 Inf Reconstruction Hand/Fingers Reapir, 26518 Revision and/or 3 or 4 digits 0.00 0.00 Inf Reconstruction Capsulectomy or Hand/Fingers Reapir, capsulotomy; 26520 Revision and/or 0.01 0.01 1.73 metacarpophalangeal joint, Reconstruction single, each COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 152

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Hand/Fingers Reapir, interphalangeal joint, 26525 Revision and/or 0.04 0.03 0.71 single each Reconstruction Hand/Fingers Reapir, Arthroplasty, 26530 Revision and/or metacarpophalangeal joint; 0.00 0.00 1.04 Reconstruction single, each Hand/Fingers Reapir, with prosthetic implant, 26531 Revision and/or 0.00 0.00 Inf single, each Reconstruction Hand/Fingers Reapir, Arthroplasty, interphalangeal 26535 Revision and/or 0.00 0.00 Inf joint; single, each Reconstruction Hand/Fingers Reapir, with prosthetic implant, 26536 Revision and/or 0.00 0.00 Inf single, each Reconstruction Hand/Fingers Reapir, Repair of collateral ligament, 26540 Revision and/or metacarpophalangeal or 0.22 0.03 0.15 Reconstruction interphalangeal joint Reconstruction, collateral Hand/Fingers Reapir, ligament, 26541 Revision and/or metacarpophalangeal joint, 0.02 0.01 0.64 Reconstruction singel; with tendon or fascial graft (includes obtaining graft) Hand/Fingers Reapir, 26542 Revision and/or with local tissue 0.00 0.02 8.38 Reconstruction Reconstruction, collateral Hand/Fingers Reapir, ligament, interphalangeal joint, 26545 Revision and/or 0.02 0.02 0.95 single, including graft, each Reconstruction joint Repair nonunion, metacarpal Hand/Fingers Reapir, or phalanx, including bone 26546 Revision and/or 0.04 0.01 0.23 graft with or without internal or Reconstruction external fixation Hand/Fingers Reapir, Repair and reconstruction, 26548 Revision and/or finger volar plate, 0.01 0.02 3.63 Reconstruction interphalangeal joint Hand/Fingers Reapir, 26550 Revision and/or Pollicization of a digit 0.01 0.05 3.68 Reconstruction Transfer, toe-to-hand with Hand/Fingers Reapir, microvascular anastomosis; 26551 Revision and/or 0.00 0.00 0.22 great toe wrap-around with Reconstruction bone graft Hand/Fingers Reapir, 26553 Revision and/or other than great toe, single 0.00 0.00 Inf Reconstruction Hand/Fingers Reapir, other than great toe, 26554 Revision and/or 0.00 0.00 Inf double Reconstruction 26555 Hand/Fingers Reapir, Transfer, finger to another 0.00 0.00 Inf COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 153

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Revision and/or position without microvascualr Reconstruction anastomosis Hand/Fingers Reapir, Transfer, free toe joint with 26556 Revision and/or 0.00 0.00 Inf microvascular anastomosis Reconstruction Hand/Fingers Reapir, Repair of syndactyly web 26560 Revision and/or finger each web space; with 0.06 0.16 2.56 Reconstruction skin flaps Hand/Fingers Reapir, 26561 Revision and/or with skin flaps and grafts 0.14 0.29 2.14 Reconstruction Hand/Fingers Reapir, complex, involving bone, 26562 Revision and/or 0.01 0.10 6.90 nails, etc Reconstruction Hand/Fingers Reapir, 26565 Revision and/or Osteotomy; metacarpal, each 0.03 0.03 1.04 Reconstruction Hand/Fingers Reapir, 26567 Revision and/or phalanx of finger, each 0.08 0.09 1.12 Reconstruction Hand/Fingers Reapir, 26568 Revision and/or Osteotomy; metacarpal, each 0.01 0.01 2.15 Reconstruction Hand/Fingers Reapir, 26580 Revision and/or Repair cleft hand 0.00 0.01 Inf Reconstruction Hand/Fingers Reapir, Reconstruction of 26587 Revision and/or polydactylous digit, soft tissue 0.29 0.29 0.98 Reconstruction and bone Hand/Fingers Reapir, Repair macrodacylia, each 26590 Revision and/or 0.00 0.01 4.08 digit Reconstruction Hand/Fingers Reapir, Repair, intrinsic muscles of 26591 Revision and/or 0.01 0.00 0.26 hand, each muscle Reconstruction Hand/Fingers Reapir, Release, intrinsic muscles of 26593 Revision and/or 0.01 0.02 1.45 hand Reconstruction Hand/Fingers Reapir, Excision of constricting ring of 26596 Revision and/or 0.01 0.04 7.27 finger, with multiple Z‐plasties Reconstruction Closed treatment of Hand/Fingers Fracture metacarpal fracture, with 26607 0.03 0.04 1.16 and/or Dislocation manipulation, with internal or external fixation, each bone. Percutaneous skeletal fixation Hand/Fingers Fracture 26608 of metacarpal fracture, each 0.56 0.16 0.28 and/or Dislocation bone. Open treatment of metacarpal Hand/Fingers Fracture 26615 fracture, single, with or without 0.61 0.17 0.28 and/or Dislocation internal or external fixation, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 154

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate each bone. Percutaneous skeletal fixation of carpometacarpal fracture Hand/Fingers Fracture dislocation, thumb (Bennett 26650 0.07 0.02 0.30 and/or Dislocation fracture), with manipulation, with or without external fixation. Open treatment of carpometacarpal fracture Hand/Fingers Fracture 26665 dislocation, thumb (Bennett 0.04 0.02 0.43 and/or Dislocation fracture), with or without internal or external fixation. Closed treatment of carpometacarpal dislocation, Hand/Fingers Fracture other than thumb (Bennett 26675 0.00 0.01 Inf and/or Dislocation fracture), single, with manipulation; requiring anesthesia. Percutaneous skeletal fixation of carpometacarpal Hand/Fingers Fracture 26676 dislocation, other than thumb 0.06 0.02 0.29 and/or Dislocation (Bennett fracture), single, with manipulation. Open treatment of carpometacarpal dislocation, Hand/Fingers Fracture other than thumb (Bennett 26685 0.02 0.01 0.41 and/or Dislocation fracture); single, with or without internal or external fixation. Open treatment of carpometacarpal dislocation, Hand/Fingers Fracture 26686 other than thumb (Bennett 0.01 0.00 0.52 and/or Dislocation fracture); complex, multiple or delayed reduction. Percutaneous skeletal fixation Hand/Fingers Fracture of metacarpophalangeal 26706 0.01 0.01 1.21 and/or Dislocation dislocation, single, with manipulation. Open treatment of metacarpophalangeal Hand/Fingers Fracture 26715 dislocation, single, with or 0.05 0.02 0.40 and/or Dislocation without internal or external fixation. Percutaneous skeletal fixation of unstable phalangeal shaft Hand/Fingers Fracture 26727 fracture, proximal or middle 1.31 0.25 0.19 and/or Dislocation phalanx, finger or thumb, with manipulation, each. Open treatment of phalangeal Hand/Fingers Fracture 26735 shaft fracture, proximal or 0.56 0.15 0.27 and/or Dislocation middle phalanx, finger or COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 155

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate thumb, with or without internal or external fixation, each. Open treatment of articular fracture, involving Hand/Fingers Fracture metacarpophalangeal or 26746 0.49 0.07 0.13 and/or Dislocation interphalangeal joint, with or without internal or external fixation, each. Percutaneous skeletal fixation Hand/Fingers Fracture 26756 of distal phalangeal fracture, 0.14 0.06 0.39 and/or Dislocation finger or thumb, each. Open treatment of distal Hand/Fingers Fracture phalangeal fracture, finger or 26765 0.29 0.08 0.28 and/or Dislocation thumb, with or without internal or external fixation, each. Closed treatment of interphalangeal joint Hand/Fingers Fracture 26770 dislocation, single, with 0.00 0.03 9.87 and/or Dislocation manipulation; without anesthesia Closed treatment of interphalangeal joint Hand/Fingers Fracture 26775 dislocation, single, with 0.01 0.02 1.80 and/or Dislocation manipulation; requiring anesthesia Percutaneous skeletal fixation Hand/Fingers Fracture of interphalangeal joint 26776 0.04 0.02 0.57 and/or Dislocation dislocation, single, with manipulation. Open treatment of interphalangeal joint Hand/Fingers Fracture 26785 dislocation, with or without 0.04 0.02 0.47 and/or Dislocation internal or external fixation, single. Amputation, metacarpal, with finger or thumb (ray 26910 Hand/Fingers Amputation 0.02 0.03 1.60 amputation), single, with or without interosseous transfer. Amputation, finger or thumb, primary or secondary, any 26951 Hand/Fingers Amputation joint or phalanx, single, 0.21 0.28 1.31 including neurectomies; with direct closure. Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, 26952 Hand/Fingers Amputation 0.06 0.05 0.88 including neurectomies; with local advancement flaps (V-Y, hood). Hand/Fingers Other Unlisted procedure, hand or 26989 0.02 0.13 7.80 Procedures fingers COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 156

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Incision and drainage, pelvis 26990 Pelvis/ Hip Incision or hip joint area; deep 0.07 0.14 2.01 abscess or hematoma. Incision and drainage, pelvis 26991 Pelvis/ Hip Incision or hip joint area; infected 0.00 0.01 4.45 bursa. Incision, deep, with opening of bone cortex (eg, for 26992 Pelvis/ Hip Incision osteomyelitis or bone 0.05 0.04 0.94 abscess), pelvis and/or hip joint. Tenotomy, adductor of hip, 27000 Pelvis/ Hip Incision subcutaneous, closed 0.09 0.39 4.37 (separate procedure). Tenotomy, adductor of hip, 27001 Pelvis/ Hip Incision 0.45 1.07 2.37 subcutaneous, open. Tenotomy, adductor, 27003 Pelvis/ Hip Incision subcutaneous, open, with 0.02 0.08 4.34 obturator neurectomy. Tenotomy, iliopsoas, open 27005 Pelvis/ Hip Incision 0.12 0.39 3.35 (separate procedure). Tenotomy, abductors of hip, 27006 Pelvis/ Hip Incision 0.02 0.09 3.43 open (separate procedure). Fasciotomy, hip or thigh, any 27025 Pelvis/ Hip Incision 0.01 0.02 1.83 type. Decompression 27027 Pelvis/ Hip Incision fasciotomy(ies), pelvic 0.00 0.00 Inf (buttock) compartment(s) Arthrotomy, hip, for infection, 27030 Pelvis/ Hip Incision 0.25 0.29 1.20 with drainage. Arthrotomy, hip, with 27033 Pelvis/ Hip Incision exploration or removal of 0.03 0.05 1.79 loose or foreign body. Hip joint denervation, intrapelvic or extrapelvic intra- 27035 Pelvis/ Hip Incision 0.00 0.01 Inf articular branches of sciatic, femoral, or obturator nerves. Capsulectomy or capsulotomy of hip, with or without excision of heterotopic bone, with release of hip flexor muscles 27036 Pelvis/ Hip Incision 0.04 0.09 2.09 (ie, gluteus medius, gluteus minimus, tensor fascia latae, rectus femoris, sartorius, iliopsoas). Biopsy, soft tissue of pelvis 27040 Pelvis/ Hip Excision 0.00 0.00 Inf and hip area; superficial. Biopsy, soft tissue of pelvis 27041 Pelvis/ Hip Excision 0.01 0.03 1.97 and hip area; deep. Excision, tumor, pelvis and hip 27045 Pelvis/ Hip Excision 0.00 0.00 0.00 area; subcutaneous, 3 cm or COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 157

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate greater. Excision, tumor, pelvis and hip 27047 Pelvis/ Hip Excision area; deep, subfascial, 0.00 0.00 Inf intramuscular, 5 cm or greater Excision, tumor, pelvis and hip 27048 Pelvis/ Hip Excision area; subcutaneous, less than 0.00 0.02 8.68 3 cm Excision, tumor, pelvis and hip 27049 Pelvis/ Hip Excision area; deep, subfascial, 0.00 0.01 Inf intramuscular, less than 5 cm Radical resection of tumor (eg, malignant neoplasm), soft 27050 Pelvis/ Hip Excision 0.00 0.00 Inf tissue of pelvis and hip area, less than 5 cm. Arthrotomy, with biopsy; 27052 Pelvis/ Hip Excision 0.01 0.01 2.45 sacroiliac joint. Arthrotomy, with biopsy; hip 27054 Pelvis/ Hip Excision 0.00 0.02 6.75 joint. Arthrotomy with synovectomy, 27057 Pelvis/ Hip Excision 0.00 0.00 Inf hip joint. Radical resection of tumor (eg, malignant neoplasm), soft 27060 Pelvis/ Hip Excision 0.00 0.00 0.37 tissue of pelvis and hip area 5 cm or greater. 27062 Pelvis/ Hip Excision Excision; ischial bursa. 0.00 0.01 2.00 Excision; trochanteric bursa or 27065 Pelvis/ Hip Excision 0.01 0.04 3.20 calcification. Excision of bone cyst or benign tumor; superficial (wing 27066 Pelvis/ Hip Excision of ilium, symphysis pubis, or 0.03 0.13 4.31 greater trochanter of femur) with or without autograft. Excision of bone cyst or 27067 Pelvis/ Hip Excision benign tumor; deep, with or 0.00 0.01 Inf without autograft. Excision of bone cyst or 27070 Pelvis/ Hip Excision benign tumor; with autograft 0.00 0.01 Inf requiring separate incision. Partial excision (craterization, saucerization) (eg, for osteomyelitis); superficial (eg, 27071 Pelvis/ Hip Excision 0.02 0.02 1.24 wing of ilium, symphysis pubis or greater trochanter of femur). Partial excision (craterization, 27075 Pelvis/ Hip Excision saucerization) (eg, for 0.01 0.01 1.01 osteomyelitis); deep. Radical resection of tumor or infection; wing of ilium, one 27076 Pelvis/ Hip Excision 0.00 0.01 2.45 pubic or ischial ramus or symphysis pubis. COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 158

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Radical resection of tumor or infection; ilium, including 27077 Pelvis/ Hip Excision 0.00 0.00 Inf acetabulum, both pubic rami, or ischium and acetabulum. Radical resection of tumor or 27078 Pelvis/ Hip Excision infection; innominate bone, 0.00 0.00 Inf total. Radical resection of tumor or infection; ischial tuberosity 27079 Pelvis/ Hip Excision 0.00 0.00 Inf and greater trochanter of femur. Radical resection of tumor or infection; ischial tuberosity 27080 Pelvis/ Hip Excision 0.00 0.01 4.01 and greater trochanter of femur, with skin flaps. Pelvis/ Hip Introduction or 27086 Coccygectomy, primary. 0.00 0.01 Inf Removal Removal of foreign body, Pelvis/ Hip Introduction or 27087 pelvis or hip; subcutaneous 0.01 0.09 10.26 Removal tissue. Pelvis/ Hip Introduction or Removal of foreign body, 27090 0.00 0.08 Inf Removal pelvis or hip; deep. Pelvis/ Hip Introduction or Removal of hip prosthesis; 27091 0.00 0.01 2.97 Removal (separate procedure). Removal of hip prosthesis; Pelvis/ Hip Introduction or complicated, including "total 27093 0.03 0.02 0.80 Removal hip" and methylmethacrylate, when applicable. Injection procedure for hip Pelvis/ Hip Introduction or 27095 arthrography; without 0.76 0.87 1.15 Removal anesthesia. Pelvis/ Hip Introduction or Injection procedure for hip 27096 0.00 0.01 2.23 Removal arthrography; with anesthesia. Injection procedure for sacroiliac joint, Pelvis/ Hip Repair, Revision 27097 anesthetic/steroid, with image 0.01 0.06 7.59 and/or Reconstruction guidance including arthrography when performed Pelvis/ Hip Repair, Revision Release or recession, 27098 0.00 0.00 Inf and/or Reconstruction hamstring, proximal Pelvis/ Hip Repair, Revision 27100 Transfer, adductor to ischium 0.00 0.01 Inf and/or Reconstruction Transfer external oblique Pelvis/ Hip Repair, Revision muscle to greater trochanter 27110 0.00 0.00 0.96 and/or Reconstruction including fascial or tendon extension (graft) Pelvis/ Hip Repair, Revision Transfer iliopsoas; to greater 27111 0.00 0.00 Inf and/or Reconstruction trochanter of femur Pelvis/ Hip Repair, Revision 27120 to femoral neck 0.02 0.07 3.24 and/or Reconstruction 27122 Pelvis/ Hip Repair, Revision Acetabuloplasty; (eg, 0.02 0.07 3.86 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 159

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate and/or Reconstruction Whitman, Colonna, Haygroves, or cup type) Pelvis/ Hip Repair, Revision resection, femoral head 27125 0.02 0.05 2.72 and/or Reconstruction (eg, Girdlestone procedure) Hemiarthroplasty, hip, partial Pelvis/ Hip Repair, Revision 27130 (eg, femoral stem prosthesis, 0.04 0.16 3.94 and/or Reconstruction bipolar arthroplasty) Arthroplasty, acetabular and proximal femoral prosthetic Pelvis/ Hip Repair, Revision 27132 replacement (total hip 0.00 0.01 2.15 and/or Reconstruction arthroplasty), with or without autograft or allograft Conversion of previous hip Pelvis/ Hip Repair, Revision surgery to total hip 27134 0.00 0.01 4.67 and/or Reconstruction arthroplasty, with or without autograft or allograft Revision of total hip Pelvis/ Hip Repair, Revision arthroplasty; both 27137 0.00 0.00 Inf and/or Reconstruction components, with or without autograft or allograft acetabular component Pelvis/ Hip Repair, Revision 27138 only, with or without autograft 0.00 0.00 Inf and/or Reconstruction or allograft Pelvis/ Hip Repair, Revision femoral component only, 27140 0.04 0.08 2.06 and/or Reconstruction with or without allograft Osteotomy and transfer of Pelvis/ Hip Repair, Revision 27146 greater trochanter of femur 0.09 0.40 4.27 and/or Reconstruction (separate procedure) Pelvis/ Hip Repair, Revision Osteotomy, iliac, acetabular or 27147 0.04 0.10 2.31 and/or Reconstruction innominate bone; Pelvis/ Hip Repair, Revision 27151 with open reduction of hip 0.13 0.27 2.10 and/or Reconstruction Pelvis/ Hip Repair, Revision 27156 with femoral osteotomy 0.13 0.30 2.38 and/or Reconstruction Pelvis/ Hip Repair, Revision with femoral osteotomy 27158 0.00 0.04 14.61 and/or Reconstruction and with open reduction of hip Pelvis/ Hip Repair, Revision Osteotomy, pelvis, bilateral 27161 0.03 0.11 3.88 and/or Reconstruction (eg, congenital malformation) Pelvis/ Hip Repair, Revision Osteotomy, femoral neck 27165 0.38 1.05 2.74 and/or Reconstruction (separate procedure) Osteotomy, intertrochanteric Pelvis/ Hip Repair, Revision or subtrochanteric including 27170 0.02 0.04 1.56 and/or Reconstruction internal or external fixation and/or cast Bone graft, femoral head, Pelvis/ Hip Repair, Revision neck, intertrochanteric or 27175 0.00 0.01 Inf and/or Reconstruction subtrochanteric area (includes obtaining bone graft) Treatment of slipped femoral Pelvis/ Hip Repair, Revision 27176 epiphysis; by traction, without 0.85 0.94 1.11 and/or Reconstruction reduction COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 160

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Pelvis/ Hip Repair, Revision by single or multiple 27177 0.03 0.09 2.70 and/or Reconstruction pinning, in situ Open treatment of slipped Pelvis/ Hip Repair, Revision femoral epiphysis; single or 27178 0.03 0.30 9.02 and/or Reconstruction multiple pinning or bone graft (includes obtaining graft) Pelvis/ Hip Repair, Revision closed manipulation with 27179 0.02 0.05 2.46 and/or Reconstruction single or multiple pinning osteoplasty of femoral Pelvis/ Hip Repair, Revision 27181 neck (Heyman type 0.02 0.04 2.03 and/or Reconstruction procedure) Pelvis/ Hip Repair, Revision osteotomy and internal 27185 0.02 0.05 2.06 and/or Reconstruction fixation Epiphyseal arrest by Pelvis/ Hip Repair, Revision 27187 epiphysiodesis or stapling, 0.03 0.04 1.17 and/or Reconstruction greater trochanter of femur Prophylactic treatment (nailing, pinning, plating or Pelvis/ Hip Trauma - 27194 wiring) with or without 0.04 0.02 0.42 Fracture and/or Dislocation methylmethacrylate, femoral neck and proximal femur Closed treatment of pelvic ring fracture, dislocation, diastasis Pelvis/ Hip Trauma - 27202 or subluxation; with 0.00 0.00 Inf Fracture and/or Dislocation manipulation, requiring more than local anesthesia. Pelvis/ Hip Trauma - Open treatment of coccygeal 27215 0.02 0.01 0.54 Fracture and/or Dislocation fracture. Open treatment of iliac spine(s), tuberosity avulsion, Pelvis/ Hip Trauma - or iliac wing fracture(s) (eg, 27216 0.11 0.04 0.39 Fracture and/or Dislocation pelvic fracture(s) which do not disrupt the pelvic ring), with internal fixation. Percutaneous skeletal fixation of posterior pelvic ring fracture Pelvis/ Hip Trauma - 27217 and/or dislocation (includes 0.05 0.04 0.68 Fracture and/or Dislocation ilium, sacroiliac joint and/or sacrum). Open treatment of anterior Pelvis/ Hip Trauma - ring fracture and/or dislocation 27218 0.04 0.03 0.77 Fracture and/or Dislocation with internal fixation (includes pubic symphysis and/or rami). Open treatment of posterior ring fracture and/or dislocation Pelvis/ Hip Trauma - 27226 with internal fixation (includes 0.02 0.01 0.68 Fracture and/or Dislocation ilium, sacroiliac joint and/ or sacrum). Open treatment of posterior or Pelvis/ Hip Trauma - 27227 anterior acetabular wall 0.02 0.03 1.45 Fracture and/or Dislocation fracture, with internal fixation. COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 161

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Open treatment of acetabular fracture(s) involving anterior or Pelvis/ Hip Trauma - posterior (one) column, or a 27228 0.02 0.02 1.01 Fracture and/or Dislocation fracture running transversely across the acetabulum, with internal fixation. Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes T-fracture and both Pelvis/ Hip Trauma - 27235 column fracture with complete 0.12 0.21 1.78 Fracture and/or Dislocation articular detachment, or single column or transverse fracture with associated acetabular wall fracture, wit. Percutaneous skeletal fixation of femoral fracture, proximal Pelvis/ Hip Trauma - 27236 end, neck, undisplaced, mildly 0.09 0.20 2.36 Fracture and/or Dislocation displaced, or impacted fracture. Open treatment of femoral fracture, proximal end, neck, Pelvis/ Hip Trauma - 27244 internal fixation or prosthetic 0.09 0.12 1.38 Fracture and/or Dislocation replacement (direct fracture exposure). Open treatment of intertrochanteric, pertrochanteric, or Pelvis/ Hip Trauma - 27245 subtrochanteric femoral 0.12 0.15 1.27 Fracture and/or Dislocation fracture; with plate/screw type implant, with or without cerclage. Open treatment of intertrochanteric, pertrochanteric, or Pelvis/ Hip Trauma - subtrochanteric femoral 27248 0.00 0.01 3.93 Fracture and/or Dislocation fracture; with intramedullary implant, with or without interlocking screws and/or cerclage. Open treatment of greater Pelvis/ Hip Trauma - trochanteric fracture, with or 27253 0.01 0.01 1.30 Fracture and/or Dislocation without internal or external fixation. Open treatment of hip Pelvis/ Hip Trauma - 27254 dislocation, traumatic, without 0.02 0.01 0.66 Fracture and/or Dislocation internal fixation. Open treatment of hip Pelvis/ Hip Trauma - dislocation, traumatic, with 27256 0.01 0.06 5.49 Fracture and/or Dislocation acetabular wall and femoral head fracture, with or without COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 162

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate internal or external fixation. Treatment of spontaneous hip dislocation (developmental, including congenital or Pelvis/ Hip Trauma - 27257 pathological), by abduction, 0.22 0.26 1.18 Fracture and/or Dislocation splint or traction; without anesthesia, without manipulation. Treatment of spontaneous hip dislocation (developmental, including congenital or Pelvis/ Hip Trauma - 27258 pathological), by abduction, 0.08 0.21 2.55 Fracture and/or Dislocation splint or traction; with manipulation, requiring anesthesia. Open treatment of spontaneous hip dislocation (developmental, including Pelvis/ Hip Trauma - 27259 congenital or pathological), 0.02 0.09 4.54 Fracture and/or Dislocation replacement of femoral head in acetabulum (including tenotomy, etc);. Open treatment of spontaneous hip dislocation (developmental, including Pelvis/ Hip Trauma - congenital or pathological), 27265 0.00 0.00 Inf Fracture and/or Dislocation replacement of femoral head in acetabulum (including tenotomy, etc); with femoral shaft shortening. Closed treatment of post hip Pelvis/ Hip Trauma - 27266 arthroplasty dislocation; 0.00 0.01 3.49 Fracture and/or Dislocation requiring anesthesia Closed treatment of femoral Pelvis/ Hip Trauma - 27267 fracture, proximal end, head; 0.00 0.00 Inf Fracture and/or Dislocation without manipulation Closed treatment of femoral Pelvis/ Hip Trauma - 27268 fracture, proximal end, head; 0.00 0.00 Inf Fracture and/or Dislocation with manipulation Open treatment of femoral Pelvis/ Hip Trauma - fracture, proximal end, head, 27269 0.02 0.00 0.25 Fracture and/or Dislocation includes internal fixation, when performed Pelvis/ Hip Trauma - 27275 0.01 0.11 7.74 manipulation Pelvis/ Hip Other Unlisted procedure, pelvis or 27299 0.12 0.29 2.47 Procedures hip joint Incision and drainage of deep abscess, infected bursa, or 27301 Femur/ Knee Incision 0.28 0.22 0.80 hematoma, thigh or knee region. COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 163

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Incision, deep, with opening of bone cortex (eg, for 27303 Femur/ Knee Incision 0.17 0.14 0.82 osteomyelitis or bone abscess), femur or knee. Fasciotomy, iliotibial 27305 Femur/ Knee Incision 0.03 0.03 1.00 (tenotomy), open. Tenotomy, subcutaneous, 27306 Femur/ Knee Incision closed, adductor or hamstring, 0.01 0.10 8.64 (separate procedure); single. Tenotomy, subcutaneous, closed, adductor or hamstring, 27307 Femur/ Knee Incision 0.02 0.28 14.45 (separate procedure); multiple. Arthrotomy, knee, for infection, with exploration, 27310 Femur/ Knee Incision 0.36 0.29 0.80 drainage or removal of foreign body. Biopsy, soft tissue of thigh or 27323 Femur/ Knee Excision 0.00 0.01 3.93 knee area; superficial. Biopsy, soft tissue of thigh or 27324 Femur/ Knee Excision 0.03 0.09 3.14 knee area; deep. Neurectomy, hamstring 27325 Femur/ Knee Excision 0.00 0.00 Inf muscle Neurectomy, popliteal 27326 Femur/ Knee Excision 0.00 0.00 Inf (gastrocnemius) Excision, tumor, thigh or knee 27327 Femur/ Knee Excision area; subcutaneous less than 0.02 0.03 1.78 3 cm Excision, tumor, thigh or knee 27328 Femur/ Knee Excision area; deep, subfascial, or 0.02 0.11 4.56 intramuscular less than 5 cm Radical resection of tumor (eg, malignant neoplasm), soft 27329 Femur/ Knee Excision 0.01 0.03 4.75 tissue of thigh or knee area less than 5 cm Arthrotomy, knee; with 27330 Femur/ Knee Excision 0.01 0.01 1.11 synovial biopsy only. Arthrotomy, knee; with joint exploration, with or without 27331 Femur/ Knee Excision biopsy, with or without 0.09 0.06 0.70 removal of loose or foreign bodies. Arthrotomy, knee, with excision of semilunar cartilage 27332 Femur/ Knee Excision 0.00 0.00 Inf (meniscectomy); medial OR lateral. Arthrotomy, knee, with excision of semilunar cartilage 27333 Femur/ Knee Excision 0.00 0.00 Inf (meniscectomy); medial AND lateral. 27334 Femur/ Knee Excision Arthrotomy, knee, with 0.02 0.02 1.09 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 164

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate synovectomy; anterior OR posterior. Arthrotomy, knee, with synovectomy; anterior AND 27335 Femur/ Knee Excision 0.01 0.01 0.65 posterior including popliteal area. Excision, tumor, thigh or knee 27337 Femur/ Knee Excision area; subcutaneous 3 cm or 0.03 0.00 0.01 greater Excision, tumor, thigh or knee 27339 Femur/ Knee Excision area; deep, subfascial, or 0.01 0.00 0.01 intramuscular5 cm or greater 27340 Femur/ Knee Excision Excision, prepatellar bursa. 0.03 0.01 0.41 Excision of synovial cyst of 27345 Femur/ Knee Excision 0.01 0.02 1.65 popliteal space (Baker's cyst). Excision of lesion of meniscus 27347 Femur/ Knee Excision 0.01 0.01 1.38 or capsule, knee Patellectomy or 27350 Femur/ Knee Excision 0.03 0.01 0.50 hemipatellectomy. Excision or curettage of bone 27355 Femur/ Knee Excision 0.33 0.36 1.11 cyst or benign tumor of femur;. Excision or curettage of bone 27356 Femur/ Knee Excision cyst or benign tumor of femur; 0.12 0.13 1.12 with allograft. Excision or curettage of bone cyst or benign tumor of femur; 27357 Femur/ Knee Excision 0.01 0.02 1.67 with autograft (includes obtaining graft). Excision or curettage of bone cyst or benign tumor of femur; 27358 Femur/ Knee Excision with internal fixation (list in 0.04 0.03 0.97 addition to 27355, 27356, or 27357). Partial excision (craterization, saucerization, or 27360 Femur/ Knee Excision diaphysectomy) of bone (eg, 0.06 0.05 0.83 for osteomyelitis), femur, proximal tibia and/ or fibula. Radical resection of tumor (eg, malignant neoplasm), soft 27364 Femur/ Knee Excision 0.00 0.00 0.00 tissue of thigh or knee area 5 cm or greater Radical resection of tumor, 27365 Femur/ Knee Excision 0.05 0.09 1.69 bone, femur or knee. Femur/ Knee Introduction or 27372 0.07 0.20 2.94 Removal Femur/ Knee repair, Removal of foreign body, 27380 Revision and/or deep, thigh region or knee 0.10 0.08 0.74 Reconstruction area. Femur/ Knee repair, Suture of infrapatellar tendon; 27381 0.00 0.02 5.49 Revision and/or primary COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 165

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Reconstruction Femur/ Knee repair, secondary reconstruction, 27385 Revision and/or including fascial or tendon 0.07 0.03 0.34 Reconstruction graft Femur/ Knee repair, Suture of quadriceps or 27386 Revision and/or hamstring muscle rupture; 0.01 0.00 0.63 Reconstruction primary Femur/ Knee repair, secondary reconstruction, 27390 Revision and/or including fascial or tendon 0.01 0.03 2.47 Reconstruction graft Femur/ Knee repair, Tenotomy, open, hamstring, 27391 Revision and/or 0.01 0.10 8.73 knee to hip; single tendon Reconstruction Femur/ Knee repair, 27392 Revision and/or multiple tendons, one leg 0.02 0.26 11.90 Reconstruction Femur/ Knee repair, 27393 Revision and/or multiple tendons, bilateral 0.01 0.06 5.08 Reconstruction Femur/ Knee repair, Lengthening of hamstring 27394 Revision and/or 0.06 0.17 2.93 tendon; single tendon Reconstruction Femur/ Knee repair, 27395 Revision and/or multiple tendons, one leg 0.12 0.56 4.71 Reconstruction Femur/ Knee repair, 27396 Revision and/or multiple tendons, bilateral 0.02 0.05 2.72 Reconstruction Femur/ Knee repair, Transplant or transfer (with 27397 Revision and/or muscle redirection or 0.00 0.01 3.19 Reconstruction rerouting), thigh; single tendon Femur/ Knee repair, 27400 Revision and/or multiple tendons 0.01 0.07 8.80 Reconstruction Femur/ Knee repair, Transfer, tendon or muscle, 27403 Revision and/or 0.03 0.02 0.63 hamstrings to femur Reconstruction Femur/ Knee repair, Arthrotomy with meniscus 27405 Revision and/or 0.16 0.05 0.31 repair, knee Reconstruction Femur/ Knee repair, Repair, primary, torn ligament 27407 Revision and/or and/or capsule, knee; 0.01 0.02 3.00 Reconstruction collateral Femur/ Knee repair, 27409 Revision and/or cruciate 0.01 0.01 1.67 Reconstruction Femur/ Knee repair, collateral and cruciate 27412 Revision and/or 0.02 0.01 0.58 ligaments Reconstruction Femur/ Knee repair, Autologous chondrocyte 27415 0.02 0.02 0.97 Revision and/or implantation, knee COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 166

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Reconstruction Femur/ Knee repair, Osteohondral allograft, knee, 27416 Revision and/or 0.02 0.01 0.48 open Reconstruction Femur/ Knee repair, Osteochondral, knee, open 27418 Revision and/or (includes harvesting of 0.12 0.13 1.04 Reconstruction autografts) Femur/ Knee repair, 27420 Revision and/or Anterior tibial tubercleplasty 0.18 0.12 0.68 Reconstruction Femur/ Knee repair, Reconstruction of dislocating 27422 Revision and/or 0.35 0.28 0.80 patella Reconstruction Femur/ Knee repair, with extensor realignment 27424 Revision and/or and/or muscle advancement 0.00 0.00 0.82 Reconstruction or release Femur/ Knee repair, 27425 Revision and/or with patellectomy 0.07 0.13 1.94 Reconstruction Femur/ Knee repair, Lateral retinacular release, 27427 Revision and/or 0.39 0.12 0.31 open Reconstruction Femur/ Knee repair, Ligamentous reconstruction 27428 Revision and/or (augmentation), knee; extra- 0.02 0.02 1.26 Reconstruction articular Femur/ Knee repair, 27429 Revision and/or intra-articular (open) 0.01 0.02 1.95 Reconstruction Femur/ Knee repair, intra-articular (open) and 27430 Revision and/or 0.04 0.08 2.22 extra-articular Reconstruction Femur/ Knee repair, Quadricepsplasty (eg, Bennett 27435 Revision and/or 0.01 0.05 8.49 or Thompson type) Reconstruction Femur/ Knee repair, Capsulotomy, posterior 27437 Revision and/or 0.00 0.00 0.67 capsular release, knee Reconstruction Femur/ Knee repair, Arthroplasty, patella; without 27438 Revision and/or 0.00 0.00 Inf prosthesis Reconstruction Femur/ Knee repair, 27440 Revision and/or with prosthesis 0.00 0.00 Inf Reconstruction Femur/ Knee repair, Arthoroplasty, knee, tibial 27441 Revision and/or 0.00 0.00 Inf plateau Reconstruction Femur/ Knee repair, with debridement and 27442 Revision and/or 0.01 0.01 0.72 partial synovectomy Reconstruction Femur/ Knee repair, Arthroplasty, femoral condyles 27443 0.00 0.00 Inf Revision and/or or tibial plateay(s), knee COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 167

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Reconstruction Femur/ Knee repair, with debridement and 27445 Revision and/or 0.01 0.04 3.25 partial synovectomy Reconstruction Femur/ Knee repair, Arthroplasty, knee, hinge 27446 Revision and/or 0.00 0.01 Inf prosthesis Reconstruction Femur/ Knee repair, Arthroplasty, knee, condyle 27447 Revision and/or and plateau; medial OR lateral 0.04 0.19 4.78 Reconstruction compartment medial AND lateral Femur/ Knee repair, compartments with or without 27448 Revision and/or 0.01 0.04 4.94 parella resurfacing (total knee Reconstruction arthroplasty) Femur/ Knee repair, Osteotomy, femur, shaft or 27450 Revision and/or 0.19 0.82 4.34 supracondylar; without fixation Reconstruction Femur/ Knee repair, 27454 Revision and/or with fixation 0.03 0.10 3.44 Reconstruction Femur/ Knee repair, Osteotomy, multiple, with 27455 Revision and/or realignment on intramedullary 0.04 0.13 3.32 Reconstruction rod, femoral shaft Osteotomy, proximal tibia, including fibular excision or Femur/ Knee repair, osteotomy (includes correction 27457 Revision and/or 0.01 0.08 5.56 of genu varus [bowleg] or Reconstruction genu valgus [knock knee]); before epiphyseal closure Femur/ Knee repair, 27465 Revision and/or after epiphyseal closure 0.01 0.06 6.90 Reconstruction Femur/ Knee repair, 27466 Revision and/or Osteoplasty, femyr;shortening 0.03 0.09 2.57 Reconstruction Femur/ Knee repair, 27468 Revision and/or lengthening 0.00 0.01 3.78 Reconstruction Femur/ Knee repair, combined, lengthing and 27470 Revision and/or shortening with femoral 0.02 0.02 0.76 Reconstruction segment transfer Femur/ Knee repair, Repair, nonunion or malunion, 27472 Revision and/or femyr, distal to head and 0.01 0.02 1.50 Reconstruction neck: without graft Femur/ Knee repair, with iliac or other 27475 Revision and/or autogenous bone graft 0.12 0.55 4.75 Reconstruction (includes obtaining graft) Femur/ Knee repair, Arrest, epiphyseal, any 27477 Revision and/or 0.04 0.29 6.94 method; distal femur Reconstruction 27479 Femur/ Knee repair, tibial and fibula, proximal 0.12 0.32 2.76 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 168

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Revision and/or Reconstruction Femur/ Knee repair, combined distal femur, 27485 Revision and/or 0.43 0.73 1.68 proximal tibial or fibula Reconstruction Femur/ Knee repair, Arrest, hemiepiphyseal, distal 27486 Revision and/or femur or proximal tibia or 0.01 0.02 3.12 Reconstruction fibula Femur/ Knee repair, Revison of total knee 27487 Revision and/or arthroplasty, with or without 0.00 0.02 Inf Reconstruction allograft; 1 component Femur/ Knee repair, femoral and entire tibial 27488 Revision and/or 0.00 0.04 Inf component Reconstruction Removal of prosthesis, including total knee Femur/ Knee repair, prosthesis, 27495 Revision and/or 0.02 0.04 1.74 methylmethacrylate with or Reconstruction without insertion of spacer, knee Prophylactic treatment Femur/ Knee repair, (nailing, pinning, plating,or 27496 Revision and/or 0.00 0.01 Inf wiring) with or without Reconstruction methylmethacrylate, femur Decompression fasciotomy, Femur/ Knee repair, thigh and/or knee, one 27497 Revision and/or 0.01 0.00 0.17 compartment (flexor or Reconstruction extensor or adductor); Femur/ Knee repair, with debridement of 27498 Revision and/or nonviable muscle and/or 0.01 0.01 1.26 Reconstruction nerve Femur/ Knee repair, Decompression fasciotomy, 27499 Revision and/or thigh and/or knee, multiple 0.01 0.00 0.41 Reconstruction compartments; with debridement of Femur/Knee Trauma - 27506 nonviable muscle and/or 1.13 1.62 1.43 Fracture and/ or Dislocation nerve Open treatment of femoral shaft fracture, with or without Femur/Knee Trauma - external fixation, with insertion 27507 0.28 0.33 1.16 Fracture and/ or Dislocation of intramedullary implant, with or without cerclage and/or locking screws. Open treatment of femoral Femur/Knee Trauma - shaft fracture with 27509 0.17 0.23 1.33 Fracture and/ or Dislocation plate/screws, with or without cerclage. Percutaneous skeletal fixation Femur/Knee Trauma - of femoral fracture, distal end, 27511 0.11 0.10 0.90 Fracture and/ or Dislocation medial or lateral condyle, or supracondylar or COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 169

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate transcondylar, with or without intercondylar extension, or distal femoral epiphyseal separation. Open treatment of femoral supracondylar or Femur/Knee Trauma - transcondylar fracture without 27513 0.04 0.07 1.74 Fracture and/ or Dislocation intercondylar extension, with or without internal or external fixation. Open treatment of femoral supracondylar or Femur/Knee Trauma - transcondylar fracture with 27514 0.12 0.09 0.71 Fracture and/ or Dislocation intercondylar extension, with or without internal or external fixation. Open treatment of femoral Femur/Knee Trauma - fracture, distal end, medial or 27519 0.08 0.07 0.80 Fracture and/ or Dislocation lateral condyle, with or without internal or external fixation. Open treatment of distal Femur/Knee Trauma - femoral epiphyseal 27524 0.17 0.12 0.74 Fracture and/ or Dislocation separation, with or without internal or external fixation. Open treatment of patellar fracture, with internal fixation Femur/Knee Trauma - 27535 and/or partial or complete 0.17 0.13 0.74 Fracture and/ or Dislocation patellectomy and soft tissue repair. Open treatment of tibial Femur/Knee Trauma - fracture, proximal (plateau); 27536 0.03 0.06 2.24 Fracture and/ or Dislocation unicondylar, with or without internal or external fixation. Open treatment of tibial Femur/Knee Trauma - fracture, proximal (plateau); 27540 0.40 0.16 0.39 Fracture and/ or Dislocation bicondylar, with or without internal fixation. Open treatment of intercondylar spine(s) and/or Femur/Knee Trauma - 27552 tuberosity fracture(s) of the 0.01 0.01 0.80 Fracture and/ or Dislocation knee, with or without internal or external fixation. Closed treatment of knee Femur/Knee Trauma - 27556 dislocation; requiring 0.01 0.01 0.77 Fracture and/ or Dislocation anesthesia. Open treatment of knee dislocation, with or without Femur/Knee Trauma - internal or external fixation; 27557 0.00 0.01 2.08 Fracture and/ or Dislocation without primary ligamentous repair or augmentation/reconstruction. COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 170

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Open treatment of knee dislocation, with or without Femur/Knee Trauma - 27558 internal or external fixation; 0.00 0.01 Inf Fracture and/ or Dislocation with primary ligamentous repair. Open treatment of knee dislocation, with or without Femur/Knee Trauma - internal or external fixation; 27562 0.00 0.01 Inf Fracture and/ or Dislocation with primary ligamentous repair, with augmentation/reconstruction. Closed treatment of patellar Femur/Knee Trauma - 27566 dislocation; requiring 0.02 0.02 1.07 Fracture and/ or Dislocation anesthesia. Open treatment of patellar Femur/ Knee Trauma - 27570 dislocation, with or without 0.17 0.13 0.77 Manipulation partial or total patellectomy. Femur/ Knee Other 27599 Disarticulation at knee. 0.06 0.28 4.42 Procedures Decompression fasciotomy, 27600 Leg/Ankle Incision leg; anterior and/or lateral 0.09 0.11 1.20 compartments only. Decompression fasciotomy, 27601 Leg/Ankle Incision leg; posterior compartment(s) 0.01 0.01 0.80 only. Decompression fasciotomy, 27602 Leg/Ankle Incision leg; anterior and/or lateral, 0.15 0.12 0.78 and posterior compartment(s). Incision and drainage, leg or 27603 Leg/Ankle Incision ankle; deep abscess or 0.20 0.22 1.09 hematoma. Incision and drainage, leg or 27604 Leg/Ankle Incision 0.01 0.02 2.27 ankle; infected bursa. Tenotomy, Achilles tendon, 27605 Leg/Ankle Incision subcutaneous (separate 0.13 0.15 1.13 procedure); local anesthesia. Tenotomy, Achilles tendon, subcutaneous (separate 27606 Leg/Ankle Incision 0.69 2.05 2.95 procedure); general anesthesia. Incision, deep, with opening of bone cortex (eg, for 27607 Leg/Ankle Incision 0.23 0.15 0.66 osteomyelitis or bone abscess), leg or ankle. Arthrotomy, ankle, for infection, with exploration, 27610 Leg/Ankle Incision 0.13 0.08 0.63 drainage, or removal of foreign body. Arthrotomy, ankle, posterior 27612 Leg/Ankle Incision capsular release, with or 0.07 0.28 4.01 without Achilles tendon COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 171

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate lengthening. Biopsy, soft tissue of leg or 27613 Leg/Ankle Excision 0.02 0.01 0.59 ankle area; superficial. Biopsy, soft tissue of leg or 27614 Leg/Ankle Excision 0.03 0.05 1.93 ankle area; deep. Radical resection of tumor (eg, malignant neoplasm), soft 27615 Leg/Ankle Excision 0.01 0.01 2.48 tissue of leg or ankle area less than 5 cm Radical resection of tumor (eg, malignant neoplasm), soft 27616 Leg/Ankle Excision 0.00 0.00 0.00 tissue of leg or ankle area 5 cm or greater Excision, tumor, leg or ankle 27618 Leg/Ankle Excision area; subcutaneous; less than 0.01 0.02 4.12 3 cm Excision, tumor, leg or ankle 27619 Leg/Ankle Excision area; deep, subfascial or 0.02 0.07 2.80 intramuscular; less than 5 cm Arthrotomy, ankle, with joint exploration, with or without 27620 Leg/Ankle Excision biopsy, with or without 0.04 0.03 0.75 removal of loose or foreign body. Arthrotomy, ankle, with 27625 Leg/Ankle Excision 0.02 0.01 0.35 synovectomy;. Arthrotomy, ankle, with 27626 Leg/Ankle Excision synovectomy; including 0.01 0.00 0.48 tenosynovectomy. Excision of lesion of tendon 27630 Leg/Ankle Excision sheath or capsule (eg, cyst or 0.02 0.03 1.10 ganglion), leg and/or ankle. Excision, tumor, leg or ankle 27632 Leg/Ankle Excision area; subcutaneous; 3 cm or 0.01 0.00 0.00 greater Excision, tumor, leg or ankle 27634 Leg/Ankle Excision area; deep, subfascial or 0.00 0.00 0.07 intramuscular; 5 cm or greater Excision or curettage of bone 27635 Leg/Ankle Excision cyst or benign tumor, tibia or 0.31 0.34 1.09 fibula;. Excision or curettage of bone cyst or benign tumor, tibia or 27637 Leg/Ankle Excision 0.01 0.03 2.26 fibula; with autograft (includes obtaining graft). Excision or curettage of bone 27638 Leg/Ankle Excision cyst or benign tumor, tibia or 0.08 0.15 1.93 fibula; with allograft. Partial excision (craterization, 27640 Leg/Ankle Excision saucerization, or 0.10 0.10 0.99 diaphysectomy) of bone (eg, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 172

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate for osteomyelitis or exostosis); tibia. Partial excision (craterization, saucerization, or 27641 Leg/Ankle Excision diaphysectomy) of bone (eg, 0.01 0.03 1.94 for osteomyelitis or exostosis); fibula. Radical resection of tumor, 27645 Leg/Ankle Excision 0.02 0.04 1.83 bone; tibia. Radical resection of tumor, 27646 Leg/Ankle Excision 0.01 0.01 1.24 bone; fibula. Radical resection of tumor, 27647 Leg/Ankle Excision 0.00 0.00 Inf bone; talus or calcaneus. Leg/ Ankle Repair, Repair, primary, open or 27650 Revision, and/or percutaneous, ruptured 0.08 0.06 0.72 Reconstruction Achilles tendon; Leg/ Ankle Repair, with graft (includes 27652 Revision, and/or 0.00 0.01 Inf obtaining graft) Reconstruction Leg/ Ankle Repair, Repair, secondary, Achilles 27654 Revision, and/or 0.00 0.01 3.78 tendon, with or without graft Reconstruction Leg/ Ankle Repair, 27656 Revision, and/or Repair, fascial defect of leg 0.00 0.00 1.78 Reconstruction Leg/ Ankle Repair, Repair, flexor tendon, leg; 27658 Revision, and/or primary, without graft, each 0.04 0.02 0.51 Reconstruction tendon Leg/ Ankle Repair, secondary, with or without 27659 Revision, and/or 0.01 0.00 0.15 graft, each tendon Reconstruction Leg/ Ankle Repair, Repair, extensor tendon, leg; 27664 Revision, and/or primary, without graft, each 0.02 0.02 0.85 Reconstruction tendon Leg/ Ankle Repair, secondary, with or without 27665 Revision, and/or 0.00 0.00 1.19 graft, each tendon Reconstruction Leg/ Ankle Repair, Repair, dislocating peroneal 27675 Revision, and/or tendons; without fibular 0.01 0.01 0.96 Reconstruction osteotomy Leg/ Ankle Repair, 27676 Revision, and/or with fibular osteotomy 0.02 0.01 0.38 Reconstruction Leg/ Ankle Repair, Tenolysis, flexor or extensor 27680 Revision, and/or tendon, leg and/or ankle; 0.05 0.07 1.27 Reconstruction single, each tendon Leg/ Ankle Repair, multiple tendons (through 27681 Revision, and/or 0.01 0.03 3.68 separate incision[s]) Reconstruction Leg/ Ankle Repair, Lengthening or shortening of 27685 0.36 1.39 3.86 Revision, and/or tendon, leg or ankle; single COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 173

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Reconstruction tendon Leg/ Ankle Repair, multiple tendons (through 27686 Revision, and/or 0.10 0.51 5.08 same incision[s]) Reconstruction Leg/ Ankle Repair, 27687 Revision, and/or Gastrocnemius recession 0.40 0.87 2.18 Reconstruction Transfer or transplant of single Leg/ Ankle Repair, tendon (with muscle 27690 Revision, and/or 0.13 0.44 3.38 redirection or rerouting); Reconstruction superficial Leg/ Ankle Repair, 27691 Revision, and/or deep 0.14 0.55 3.88 Reconstruction Leg/ Ankle Repair, 27692 Revision, and/or each additional tendon 0.00 0.09 Inf Reconstruction Leg/ Ankle Repair, Repair, primary, disrupted 27695 Revision, and/or 0.08 0.04 0.52 ligament, ankle; collateral Reconstruction Leg/ Ankle Repair, 27696 Revision, and/or both collateral ligaments 0.04 0.01 0.22 Reconstruction Leg/ Ankle Repair, Repair, secondary, disrupted 27698 Revision, and/or ligament, ankle, collateral (eg, 0.10 0.03 0.28 Reconstruction Watson-Jones procedure) Leg/ Ankle Repair, 27700 Revision, and/or Arthroplasty, ankle 0.00 0.00 Inf Reconstruction Leg/ Ankle Repair, 27702 Revision, and/or with implant (total ankle) 0.00 0.00 Inf Reconstruction Leg/ Ankle Repair, 27703 Revision, and/or revision, total ankle 0.00 0.00 Inf Reconstruction Leg/ Ankle Repair, 27704 Revision, and/or Removla of ankle implant 0.02 0.12 7.38 Reconstruction Leg/ Ankle Repair, 27705 Revision, and/or Osteotomy; tibial 0.15 0.55 3.53 Reconstruction Leg/ Ankle Repair, 27707 Revision, and/or fibula 0.02 0.05 3.13 Reconstruction Leg/ Ankle Repair, 27709 Revision, and/or tibia and fibula 0.15 0.58 3.88 Reconstruction Leg/ Ankle Repair, multiple, with realignment 27712 Revision, and/or 0.01 0.08 15.02 on intramedullary rod Reconstruction 27715 Leg/ Ankle Repair, Osteoplasty, tibia and fibula, 0.05 0.08 1.60 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 174

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Revision, and/or lengthening or shortening Reconstruction Leg/ Ankle Repair, Repair of nonunion or 27720 Revision, and/or 0.04 0.03 0.71 malunion, tibia: without graft Reconstruction Leg/ Ankle Repair, 27722 Revision, and/or with sliding graft 0.00 0.00 Inf Reconstruction Leg/ Ankle Repair, with iliac or other autograft 27724 Revision, and/or 0.02 0.04 2.24 (includes obtaining graft) Reconstruction Leg/ Ankle Repair, by synostosis, with fibula, 27725 Revision, and/or 0.01 0.01 1.08 any method Reconstruction Leg/ Ankle Repair, Repair of fibula nonunion 27726 Revision, and/or and/or malunion with internal 0.01 0.01 0.84 Reconstruction fixation Leg/ Ankle Repair, Repair of congenital 27727 Revision, and/or 0.01 0.02 1.95 pseudarthrosis, tibia Reconstruction Leg/ Ankle Repair, Arrest, epiphyseal 27730 Revision, and/or (epiphysiodesis), open; distal 0.07 0.19 2.55 Reconstruction tibia Leg/ Ankle Repair, 27732 Revision, and/or distal fibula 0.02 0.05 2.77 Reconstruction Leg/ Ankle Repair, 27734 Revision, and/or distal tibia and fibula 0.02 0.06 2.79 Reconstruction Arrest, epiphyseal Leg/ Ankle Repair, (epiphysiodesis), any method, 27740 Revision, and/or 0.00 0.07 24.18 combined, proximal and distal Reconstruction tibia and fibula Leg/ Ankle Repair, 27742 Revision, and/or and distal femur 0.00 0.05 19.58 Reconstruction Prophylactic treatment Leg/ Ankle Repair, (nailing, pinning, plating or 27745 Revision, and/or 0.01 0.02 4.49 wiring) with or without Reconstruction methylmethacrylate, tibia Percutaneous skeletal fixation Leg/ Ankle Trauma - of tibial shaft fracture (with or 27756 0.18 0.21 1.14 Fracture and/or Dislocation without fibular fracture) (eg, pins or screws). Open treatment of tibial shaft fracture, (with or without Leg/ Ankle Trauma - 27758 fibular fracture) with 0.30 0.26 0.87 Fracture and/or Dislocation plate/screws, with or without cerclage. Leg/ Ankle Trauma - Open treatment of tibial shaft 27759 0.64 0.53 0.83 Fracture and/or Dislocation fracture (with or without fibular COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 175

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate fracture) by intramedullary implant, with or without interlocking screws and/or cerclage. Open treatment of medial Leg/ Ankle Trauma - malleolus fracture, with or 27766 0.56 0.26 0.46 Fracture and/or Dislocation without internal or external fixation. Open treatment of posterior Leg/ Ankle Trauma - malleous fracture,includes 27769 0.03 0.00 0.07 Fracture and/or Dislocation internal fixation, when performed Open treatment of proximal Leg/ Ankle Trauma - fibula or shaft fracture, with or 27784 0.06 0.02 0.42 Fracture and/or Dislocation without internal or external fixation. Open treatment of distal Leg/ Ankle Trauma - fibular fracture (lateral 27792 0.81 0.27 0.34 Fracture and/or Dislocation malleolus), with or without internal or external fixation. Open treatment of bimalleolar Leg/ Ankle Trauma - 27814 ankle fracture, with or without 0.54 0.40 0.75 Fracture and/or Dislocation internal or external fixation. Open treatment of trimalleolar ankle fracture, with or without Leg/ Ankle Trauma - internal or external fixation, 27822 0.14 0.06 0.47 Fracture and/or Dislocation medial and/or lateral malleolus; without fixation of posterior lip. Open treatment of trimalleolar ankle fracture, with or without Leg/ Ankle Trauma - internal or external fixation, 27823 0.04 0.05 1.18 Fracture and/or Dislocation medial and/or lateral malleolus; with fixation of posterior lip. Open treatment of fracture of weight bearing articular Leg/ Ankle Trauma - surface/ portion of distal tibia 27826 0.06 0.02 0.36 Fracture and/or Dislocation (eg, pilon or tibial plafond), with internal or external fixation; of fibula only. Open treatment of fracture of weight bearing articular Leg/ Ankle Trauma - surface/ portion of distal tibia 27827 0.76 0.39 0.52 Fracture and/or Dislocation (eg, pilon or tibial plafond), with internal or external fixation; of tibia only. Open treatment of fracture of Leg/ Ankle Trauma - weight bearing articular 27828 0.14 0.10 0.67 Fracture and/or Dislocation surface/ portion of distal tibia (eg, pilon or tibial plafond), COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 176

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate with internal or external fixation; of both tibia and fibula. Open treatment of distal Leg/ Ankle Trauma - tibiofibular joint (syndesmosis) 27829 0.60 0.17 0.29 Fracture and/or Dislocation disruption, with or without internal or external fixation. Closed treatment of proximal Leg/ Ankle Trauma - 27831 tibiofibular joint dislocation; 0.00 0.00 Inf Fracture and/or Dislocation requiring anesthesia. Open treatment of proximal tibiofibular joint dislocation, Leg/ Ankle Trauma - 27832 with or without internal or 0.01 0.00 0.25 Fracture and/or Dislocation external fixation, or with excision of proximal fibula. Closed treatment of ankle Leg/ Ankle Trauma - dislocation; requiring 27842 0.00 0.05 18.91 Fracture and/or Dislocation anesthesia, with or without percutaneous skeletal fixation. Open treatment of ankle dislocation, with or without Leg/ Ankle Trauma - 27846 percutaneous skeletal fixation; 0.00 0.01 Inf Fracture and/or Dislocation without repair or internal fixation. Open treatment of ankle dislocation, with or without Leg/ Ankle Trauma - 27848 percutaneous skeletal fixation; 0.01 0.03 3.13 Fracture and/or Dislocation with repair or internal or external fixation. Amputation, leg, through tibia 27880 Leg/ Ankle Amputation 0.02 0.05 2.76 and fibula;. Amputation, leg, through tibia and fibula; with immediate 27881 Leg/ Ankle Amputation 0.00 0.00 Inf fitting technique including application of first cast. Amputation, leg, through tibia 27882 Leg/ Ankle Amputation and fibula; open, circular 0.00 0.01 2.52 (guillotine). Amputation, leg, through tibia 27884 Leg/ Ankle Amputation and fibula; secondary closure 0.00 0.02 Inf or scar revision. Amputation, leg, through tibia 27886 Leg/ Ankle Amputation 0.03 0.06 1.92 and fibula; re-amputation. Amputation, ankle, through malleoli of tibia and fibula (Syme, Pirogoff type 27888 Leg/ Ankle Amputation 0.05 0.06 1.27 procedures), with plastic closure and resection of nerves. 27889 Leg/ Ankle Amputation Ankle disarticulation. 0.00 0.01 2.60 27892 Leg/ Ankle Other Decompression fasciotomy, 0.01 0.01 0.79 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 177

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Procedures leg; anterior and/or lateral compartments only, with debridement of nonviable muscle and/or nerve Decompression fasciotomy, leg; posterior compartments Leg/ Ankle Other 27893 only, with debridement of 0.00 0.00 0.59 Procedures nonviable muscle and/or nerve Decompression fasciotomy, leg; anterior and/or lateral Leg/ Ankle Other 27894 compartments only, with 0.02 0.04 1.52 Procedures debridement of nonviable muscle and/or nerve Leg/ Ankle Other Unlisted procedure, leg or 27899 0.04 0.20 5.19 Procedures ankle Incision and drainage, infected 28001 Foot/ Toes Incision 0.01 0.03 4.52 bursa, foot. Deep dissection below fascia, for deep infection of foot, with 28002 Foot/ Toes Incision or without tendon sheath 0.04 0.05 1.16 involvement; single bursal space, specify. Deep dissection below fascia, for deep infection of foot, with 28003 Foot/ Toes Incision 0.04 0.06 1.80 or without tendon sheath involvement; multiple areas. Incision, deep, with opening of bone cortex (eg, for 28005 Foot/ Toes Incision 0.06 0.07 1.03 osteomyelitis or bone abscess), foot. 28008 Foot/ Toes Incision Fasciotomy, foot and/or toe. 0.03 0.06 1.94 Tenotomy, subcutaneous, toe; 28010 Foot/ Toes Incision 0.02 0.06 3.57 single. Tenotomy, subcutaneous, toe; 28011 Foot/ Toes Incision 0.02 0.10 5.76 multiple. Arthrotomy, with exploration, drainage, or removal of loose 28020 Foot/ Toes Incision 0.02 0.01 0.43 or foreign body; intertarsal or tarsometatarsal joint. Arthrotomy, with exploration, drainage, or removal of loose 28022 Foot/ Toes Incision 0.02 0.01 0.47 or foreign body; metatarsophalangeal joint. Arthrotomy, with exploration, drainage, or removal of loose 28024 Foot/ Toes Incision 0.02 0.01 0.58 or foreign body; interphalangeal joint. Neurectomy of intrinsic 28035 Foot/ Toes Incision 0.01 0.01 0.73 musculature of foot. 28039 Foot/ Toes Excision Tarsal tunnel release 0.01 0.00 0.06 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 178

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate (posterior tibial nerve decompression). Excision, tumor, foot; 28041 Foot/ Toes Excision subcutaneous; 1.5 cm or 0.02 0.00 0.01 greater Excision, tumor, foot; deep, 28043 Foot/ Toes Excision subfascial, intramuscular; 1.5 0.02 0.05 2.94 cm or greater Excision, tumor, foot; 28045 Foot/ Toes Excision subcutaneous; less than1.5 0.02 0.05 1.93 cm Excision, tumor, foot; deep, 28046 Foot/ Toes Excision subfascial, intramuscular; less 0.00 0.01 Inf than 1.5 cm Radical resection of tumor 28050 Foot/ Toes Excision (eg, malignant neoplasm), soft 0.00 0.00 Inf tissue of foot; 3 cm or greater Arthrotomy for synovial 28052 Foot/ Toes Excision biopsy; intertarsal or 0.00 0.00 Inf tarsometatarsal joint. Arthrotomy for synovial 28054 Foot/ Toes Excision biopsy; metatarsophalangeal 0.00 0.00 Inf joint. Arthrotomy for synovial 28055 Foot/ Toes Excision 0.00 0.00 Inf biopsy; interphalangeal joint. Neurectomy, intrinsic 28060 Foot/ Toes Excision 0.01 0.09 15.39 musculature of foot Fasciectomy, excision of 28062 Foot/ Toes Excision plantar fascia; partial 0.01 0.05 8.72 (separate procedure). Fasciectomy, excision of 28070 Foot/ Toes Excision plantar fascia; radical 0.00 0.00 0.89 (separate procedure). Synovectomy; intertarsal or 28072 Foot/ Toes Excision 0.00 0.00 0.45 tarsometatarsal joint, each. Synovectomy; 28080 Foot/ Toes Excision metatarsophalangeal joint, 0.00 0.00 Inf each. Excision of interdigital 28086 Foot/ Toes Excision (Morton) neuroma, single, 0.01 0.00 0.45 each. Synovectomy, tendon sheath, 28088 Foot/ Toes Excision 0.00 0.00 Inf foot; flexor. Synovectomy, tendon sheath, 28090 Foot/ Toes Excision 0.03 0.05 1.46 foot; extensor. Excision of lesion of tendon or fibrous sheath or capsule 28092 Foot/ Toes Excision 0.01 0.01 2.56 (including synovectomy) (cyst or ganglion); foot. Excision of lesion of tendon or 28100 Foot/ Toes Excision 0.02 0.04 1.48 fibrous sheath or capsule COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 179

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate (including synovectomy) (cyst or ganglion); toes. Excision or curettage of bone 28102 Foot/ Toes Excision cyst or benign tumor, talus or 0.00 0.01 Inf calcaneus;. Excision or curettage of bone cyst or benign tumor, talus or 28103 Foot/ Toes Excision calcaneus; with iliac or other 0.02 0.03 1.25 autograft (includes obtaining graft). Excision or curettage of bone 28104 Foot/ Toes Excision cyst or benign tumor, talus or 0.03 0.03 0.92 calcaneus; with allograft. Excision or curettage of bone cyst or benign tumor, tarsal or 28106 Foot/ Toes Excision 0.00 0.00 Inf metatarsal bones, except talus or calcaneus;. Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal bones, except talus 28107 Foot/ Toes Excision 0.01 0.01 0.93 or calcaneus; with iliac or other autograft (includes obtaining graft). Excision or curettage of bone cyst or benign tumor, tarsal or 28108 Foot/ Toes Excision 0.05 0.05 1.15 metatarsal bones, except talus or calcaneus; with allograft. Excision or curettage of bone 28110 Foot/ Toes Excision cyst or benign tumor, 0.01 0.01 0.61 phalanges of foot. Ostectomy, partial excision, fifth metatarsal head 28111 Foot/ Toes Excision 0.00 0.00 Inf (bunionette) (separate procedure). Ostectomy, complete excision; 28112 Foot/ Toes Excision 0.00 0.00 Inf first metatarsal head. Ostectomy, complete excision; 28113 Foot/ Toes Excision other metatarsal head 0.00 0.00 Inf (second, third or fourth). Ostectomy, complete excision; 28114 Foot/ Toes Excision 0.00 0.00 Inf fifth metatarsal head. Ostectomy, complete excision; all metatarsal heads, with partial proximal 28116 Foot/ Toes Excision 0.16 0.32 1.94 phalangectomy, excluding first metatarsal (Clayton type procedure). Ostectomy, excision of tarsal 28118 Foot/ Toes Excision 0.02 0.06 3.19 coalition. 28119 Foot/ Toes Excision Ostectomy, calcaneus;. 0.01 0.01 1.37 28120 Foot/ Toes Excision Ostectomy, calcaneus; for 0.08 0.04 0.48 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 180

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate spur, with or without plantar fascial release. Partial excision (craterization, saucerization, sequestrectomy, or 28122 Foot/ Toes Excision 0.06 0.06 0.99 diaphysectomy) of bone (eg, for osteomyelitis or talar bossing), talus or calcaneus. Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, 28124 Foot/ Toes Excision for osteomyelitis or tarsal 0.03 0.02 0.53 bossing), tarsal or metatarsal bone, except talus or calcaneus. Partial excision (craterization, saucerization, or 28126 Foot/ Toes Excision diaphysectomy) of bone (eg, 0.00 0.01 Inf for osteomyelitis or dorsal bossing), phalanx of toe. Resection, partial or complete, 28130 Foot/ Toes Excision phalangeal base, single toe, 0.01 0.04 4.77 each. 28140 Foot/ Toes Excision Talectomy (astragalectomy). 0.00 0.01 Inf 28150 Foot/ Toes Excision Metatarsectomy. 0.00 0.04 Inf Phalangectomy of toe, single, 28153 Foot/ Toes Excision 0.00 0.00 Inf each. Resection, head of phalanx, 28160 Foot/ Toes Excision 0.00 0.01 Inf toe. Hemiphalangectomy or 28171 Foot/ Toes Excision interphalangeal joint excision, 0.00 0.00 Inf toe, single, each. Radical resection of tumor, 28173 Foot/ Toes Excision bone; tarsal (except talus or 0.00 0.00 Inf calcaneus). Radical resection of tumor, 28175 Foot/ Toes Excision 0.00 0.00 Inf bone; metatarsal. Foot/ Toes Introduction or Removal of foreign body, foot; 28190 0.07 0.05 0.67 Removal subcutaneous Foot/ Toes Introduction or Removal of foreign body, foot; 28192 0.17 0.11 0.66 Removal deep Foot/ Toes Introduction or Removal of foreign body, foot; 28193 0.02 0.02 0.68 Removal complicated Foot/ Toes Repair, Revision Radical resection of tumor, 28200 0.04 0.02 0.68 and/or Reconstruction bone; phalanx of toe. Repair, tendon, flexor, foot; Foot/ Toes Repair, Revision 28202 primary or secondary, without 0.00 0.00 0.67 and/or Reconstruction free graft, each tendon Repair, tendon, flexor, foot; Foot/ Toes Repair, Revision 28208 secondary with free graft, 0.07 0.07 0.91 and/or Reconstruction each tendon (includes COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 181

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate obtaining graft) Repair, tendon, extensor, foot; Foot/ Toes Repair, Revision 28210 primary or secondary, each 0.00 0.00 Inf and/or Reconstruction tendon Repair, tendon, extensor, foot; Foot/ Toes Repair, Revision secondary with free graft, 28220 0.00 0.03 10.90 and/or Reconstruction each tendon (includes obtaining graft) Foot/ Toes Repair, Revision Tenolysis, flexor, foot; single 28222 0.00 0.04 Inf and/or Reconstruction tendon Foot/ Toes Repair, Revision Tenolysis, flexor, foot; multiple 28225 0.01 0.02 2.82 and/or Reconstruction tendons Foot/ Toes Repair, Revision Tenolysis, extensor, foot; 28226 0.00 0.01 Inf and/or Reconstruction single tendon Foot/ Toes Repair, Revision Tenolysis, extensor, foot; 28230 0.05 0.27 5.24 and/or Reconstruction multiple tendons Tenotomy, open, tendon Foot/ Toes Repair, Revision 28232 flexor; foot, single or multiple 0.13 0.31 2.45 and/or Reconstruction tendon(s) Foot/ Toes Repair, Revision Tenotomy, open, tendon 28234 0.02 0.15 6.16 and/or Reconstruction flexor; toe single tendon Foot/ Toes Repair, Revision Tenotomy, open, extensor, 28238 0.16 0.19 1.16 and/or Reconstruction foot or toe, each tendon Reconstruction (advancement), posterior tibial Foot/ Toes Repair, Revision 28240 tendon with excision of 0.02 0.08 3.37 and/or Reconstruction accessory tarsal navicular bone Tenotomy, lengthening, or Foot/ Toes Repair, Revision 28250 release, abductor hallucis 0.08 0.21 2.65 and/or Reconstruction muscle Division of plantar fascia and Foot/ Toes Repair, Revision 28260 muscle (eg, Steindler 0.04 0.09 2.22 and/or Reconstruction stripping) Foot/ Toes Repair, Revision Capsulotomy, midfoot; medial 28261 0.01 0.08 13.61 and/or Reconstruction release only Foot/ Toes Repair, Revision Capsulotomy, midfoot; with 28262 0.08 0.70 8.73 and/or Reconstruction tendon lengthening Capsulotomy, midfoot; Foot/ Toes Repair, Revision extensive, including posterior 28264 0.01 0.02 2.94 and/or Reconstruction talotibial capsulotomy and tendon(s) lengthening Foot/ Toes Repair, Revision Capsulotomy, midtarsal (eg, 28270 0.02 0.04 1.80 and/or Reconstruction Heyman type procedure) Capsulotomy; Foot/ Toes Repair, Revision metatarsophalangeal joint, 28272 0.01 0.02 3.78 and/or Reconstruction with or without tenorrhaphy, each joint Foot/ Toes Repair, Revision Capsulotomy; interphalangeal 28280 0.00 0.01 Inf and/or Reconstruction joint, each joint 28285 Foot/ Toes Repair, Revision Syndactylization, toes (eg, 0.04 0.11 2.45 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 182

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate and/or Reconstruction webbing or Kelikian type procedure) Correction, hammertoe (eg, Foot/ Toes Repair, Revision 28286 interphalangeal fusion, partial 0.00 0.01 4.23 and/or Reconstruction or total phalangectomy) Correction, cock-up fifth toe, Foot/ Toes Repair, Revision 28288 with plastic skin closure (eg, 0.00 0.01 4.82 and/or Reconstruction Ruiz-Mora type procedure) Ostectomy, partial, Foot/ Toes Repair, Revision exostectomy or condylectomy, 28289 0.00 0.01 Inf and/or Reconstruction metatarsal head, each metatarsal head Hallux rigidus correction with Foot/ Toes Repair, Revision cheilectomy, debridement and 28290 0.01 0.02 3.08 and/or Reconstruction capsular release of the first metatarsophalangeal joint Hallux rigidus correction with cheilectomy, debridement and Foot/ Toes Repair, Revision 28292 capsular release of the first 0.03 0.03 0.96 and/or Reconstruction metatarsophalangeal joint, with implant Correction, hallux valgus, with sesamoidectomy, when Foot/ Toes Repair, Revision 28293 performed; with resection of 0.00 0.00 Inf and/or Reconstruction proximal phalanx base, when performed, any method Correction, hallux valgus, with sesamoidectomy, when Foot/ Toes Repair, Revision 28294 performed; with proximal 0.00 0.00 Inf and/or Reconstruction metatarsal osteotomy, any method Correction, hallux valgus, with sesamoidectomy, when Foot/ Toes Repair, Revision 28296 performed; with distal 0.04 0.11 2.89 and/or Reconstruction metatarsal osteotomy, any method Correction, hallux valgus, with sesamoidectomy, when Foot/ Toes Repair, Revision performed; with first 28297 0.00 0.01 4.01 and/or Reconstruction metatarsal and medial cuneiform joint arthrodesis, any method Correction, hallux valgus, with Foot/ Toes Repair, Revision sesamoidectomy, when 28298 0.02 0.03 1.63 and/or Reconstruction performed; with phalanx osteotomy, any method Correction, hallux valgus, with Foot/ Toes Repair, Revision sesamoidectomy, when 28299 0.04 0.04 1.09 and/or Reconstruction performed; with double osteotomy, any method 28300 Foot/ Toes Repair, Revision Osteotomy; calcaneus (eg, 0.35 0.86 2.50 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 183

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate and/or Reconstruction Dwyer or Chambers type procedure), with or without internal fixation Foot/ Toes Repair, Revision 28302 Osteotomy; talus 0.00 0.02 6.68 and/or Reconstruction Foot/ Toes Repair, Revision Osteotomy, tarsal bones, 28304 0.18 0.51 2.86 and/or Reconstruction other than calcaneus or talus Osteotomy, tarsal bones, Foot/ Toes Repair, Revision 28305 other than calcaneus or talus; 0.03 0.10 3.03 and/or Reconstruction with autograft Osteotomy, with or without Foot/ Toes Repair, Revision lengthening, shortening or 28306 0.06 0.18 3.28 and/or Reconstruction angular correction, metatarsal; first metatarsal Osteotomy, with or without lengthening, shortening or Foot/ Toes Repair, Revision 28307 angular correction, metatarsal; 0.01 0.02 4.01 and/or Reconstruction first metatarsal with autograft (other than first toe) Osteotomy, with or without lengthening, shortening or Foot/ Toes Repair, Revision 28308 angular correction, metatarsal; 0.06 0.09 1.55 and/or Reconstruction first metatarsal with autograft (other than first toe) Osteotomy, with or without Foot/ Toes Repair, Revision lengthening, shortening or 28309 0.02 0.04 1.63 and/or Reconstruction angular correction, metatarsal; multiple Osteotomy, shortening, Foot/ Toes Repair, Revision angular or rotational 28310 0.02 0.04 2.41 and/or Reconstruction correction; proximal phalanx, first toe Osteotomy, shortening, Foot/ Toes Repair, Revision angular or rotational 28312 0.01 0.04 2.67 and/or Reconstruction correction; other phalanges, any toe Reconstruction, angular Foot/ Toes Repair, Revision 28313 deformity of toe, soft tissue 0.02 0.11 4.62 and/or Reconstruction procedures only Foot/ Toes Repair, Revision Sesamoidectomy, first toe 28315 0.02 0.00 0.23 and/or Reconstruction (separate procedure) Foot/ Toes Repair, Revision Repair, nonunion or malunion; 28320 0.00 0.00 Inf and/or Reconstruction tarsal bones Repair, nonunion or malunion; Foot/ Toes Repair, Revision 28322 metatarsal, with or without 0.01 0.01 0.96 and/or Reconstruction bone graft Reconstruction, toe, Foot/ Toes Repair, Revision 28340 macrodactyly; soft tissue 0.00 0.01 Inf and/or Reconstruction resection Foot/ Toes Repair, Revision Reconstruction, toe, 28341 0.01 0.02 3.30 and/or Reconstruction macrodactyly; requiring bone COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 184

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate resection Foot/ Toes Repair, Revision Reconstruction, toe(s); 28344 0.20 0.34 1.72 and/or Reconstruction polydactyly Reconstruction, toe(s); Foot/ Toes Repair, Revision 28345 syndactyly, with or without 0.03 0.10 3.55 and/or Reconstruction skin graft(s), each web Foot/ Toes Repair, Revision 28360 Reconstruction, cleft foot 0.00 0.02 7.34 and/or Reconstruction Percutaneous skeletal fixation Foot/ Toes Trauma - 28406 of calcaneal fracture, with 0.01 0.01 1.26 Fracture and/ or Dislocation manipulation Open treatment of calcaneal Foot/ Toes Trauma - 28415 fracture, includes internal 0.04 0.03 0.70 Fracture and/ or Dislocation fixation, when performed Open treatment of calcaneal fracture, includes internal Foot/ Toes Trauma - 28420 fixation, when performed; with 0.00 0.00 1.34 Fracture and/ or Dislocation primary iliac or other autogenous bone graft Percutaneous skeletal fixation Foot/ Toes Trauma - 28436 of talus fracture, with 0.00 0.01 Inf Fracture and/ or Dislocation manipulation Open treatment of talus fracture, includes internal Foot/ Toes Trauma - 28445 fixation, when performed; with 0.07 0.05 0.63 Fracture and/ or Dislocation primary iliac or other autogenous bone graft Foot/ Toes Trauma - Open osteochondral allograft, 28446 0.00 0.00 1.48 Fracture and/ or Dislocation talus (includes obtaining graft) Treatment of tarsal bone Foot/ Toes Trauma - fracture (except talus and 28450 0.02 0.02 0.79 Fracture and/ or Dislocation calcaneus); without manipulation, each Treatment of tarsal bone Foot/ Toes Trauma - fracture (except talus and 28455 0.01 0.00 0.56 Fracture and/ or Dislocation calcaneus); with manipulation, each Percutaneous skeletal fixation Foot/ Toes Trauma - of tarsal bone fracture (except 28456 0.01 0.00 0.85 Fracture and/ or Dislocation talus and calcaneus), with manipulation, each Open treatment of tarsal bone Foot/ Toes Trauma - fracture (except talus and 28465 0.05 0.03 0.56 Fracture and/ or Dislocation calcaneus), includes internal fixation, when performed Percutaneous skeletal fixation Foot/ Toes Trauma - 28476 of metatarsal fracture, with 0.10 0.07 0.65 Fracture and/ or Dislocation manipulation Open treatment of metatarsal Foot/ Toes Trauma - 28485 fracture, includes internal 0.20 0.11 0.58 Fracture and/ or Dislocation fixation, when performed COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 185

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Percutaneous skeletal fixation Foot/ Toes Trauma - of fracture of great toe, 28496 0.07 0.04 0.52 Fracture and/ or Dislocation phalanx or phalanges, with manipulation Open treatment of fracture, Foot/ Toes Trauma - great toe, phalanx or 28505 0.16 0.05 0.34 Fracture and/ or Dislocation phalanges, includes internal fixation, when performed Open treatment of fracture, phalanx or phalanges, other Foot/ Toes Trauma - 28525 than great toe, includes 0.06 0.03 0.52 Fracture and/ or Dislocation internal fixation, when performed, each Open treatment of sesamoid Foot/ Toes Trauma - 28531 fracture, with or without 0.00 0.00 Inf Fracture and/ or Dislocation internal fixation Percutaneous skeletal fixation Foot/ Toes Trauma - of tarsal bone dislocation, 28546 0.00 0.00 Inf Fracture and/ or Dislocation other than talotarsal, with manipulation Open treatment of tarsal bone Foot/ Toes Trauma - 28555 dislocation, includes internal 0.02 0.02 0.99 Fracture and/ or Dislocation fixation, when performed Percutaneous skeletal fixation Foot/ Toes Trauma - 28576 of talotarsal joint dislocation, 0.02 0.02 1.05 Fracture and/ or Dislocation with manipulation. Open treatment of talotarsal Foot/ Toes Trauma - joint dislocation, with or 28585 0.01 0.02 1.39 Fracture and/ or Dislocation without internal or external fixation. Percutaneous skeletal fixation Foot/ Toes Trauma - 28606 of tarsometatarsal joint 0.02 0.01 0.79 Fracture and/ or Dislocation dislocation, with manipulation. Open treatment of Foot/ Toes Trauma - tarsometatarsal joint 28615 0.11 0.04 0.34 Fracture and/ or Dislocation dislocation, with or without internal or external fixation. Percutaneous skeletal fixation Foot/ Toes Trauma - 28636 of metatarsophalangeal joint 0.01 0.01 1.34 Fracture and/ or Dislocation dislocation, with manipulation. Open treatment of Foot/ Toes Trauma - metatarsophalangeal joint 28645 0.01 0.01 0.70 Fracture and/ or Dislocation dislocation, with or without internal or external fixation. Percutaneous skeletal fixation Foot/ Toes Trauma - 28666 of interphalangeal joint 0.02 0.01 0.64 Fracture and/ or Dislocation dislocation, with manipulation. Open treatment of Foot/ Toes Trauma - interphalangeal joint 28675 0.04 0.01 0.28 Fracture and/ or Dislocation dislocation, with or without internal or external fixation. COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 186

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate 28705 Foot/ Toes Arthrodesis Pantalar arthrodesis. 0.00 0.00 Inf 28715 Foot/ Toes Arthrodesis Triple arthrodesis. 0.02 0.13 6.10 28725 Foot/ Toes Arthrodesis Subtalar arthrodesis. 0.02 0.11 4.40 Arthrodesis, midtarsal or 28730 Foot/ Toes Arthrodesis tarsometatarsal, multiple or 0.01 0.03 1.97 transverse;. Arthrodesis, midtarsal or tarsometatarsal, multiple or 28735 Foot/ Toes Arthrodesis 0.04 0.05 1.21 transverse; with osteotomy as for flatfoot correction. Arthrodesis, midtarsal navicular-cuneiform, with 28737 Foot/ Toes Arthrodesis tendon lengthening and 0.00 0.01 5.19 advancement (Miller type procedure). Arthrodesis, midtarsal or 28740 Foot/ Toes Arthrodesis 0.04 0.05 1.42 tarsometatarsal, single joint. Arthrodesis, great toe; 28750 Foot/ Toes Arthrodesis 0.02 0.11 5.03 metatarsophalangeal joint. Arthrodesis, great toe; 28755 Foot/ Toes Arthrodesis 0.02 0.07 2.67 interphalangeal joint. Arthrodesis, great toe, interphalangeal joint, with 28760 Foot/ Toes Arthrodesis extensor hallucis longus 0.01 0.05 8.75 transfer to first metatarsal neck (Jones type procedure). Amputation, foot; midtarsal 28800 Foot/ Toes Amputation 0.01 0.02 2.00 (Chopart type procedure). Amputation, foot; 28805 Foot/ Toes Amputation 0.01 0.01 0.99 transmetatarsal. Amputation, metatarsal, with 28810 Foot/ Toes Amputation 0.02 0.05 1.99 toe, single. Amputation, toe; 28820 Foot/ Toes Amputation 0.03 0.13 4.33 metatarsophalangeal joint. Amputation, toe; 28825 Foot/ Toes Amputation 0.05 0.06 1.13 interphalangeal joint. Foot/ Toes Other 28899 0.04 0.20 4.76 Procedures Arthroscopy, shoulder, 29805 Shoulder Other Procedures diagnostic, with or without 0.04 0.11 2.92 synovial biopsy Arthroscopy, shoulder, 29806 Shoulder Arthroscopy 1.04 0.18 0.17 surgical;capsulorrhaphy 29807 Shoulder Arthroscopy with repair of SLAP lesion 0.31 0.17 0.56 with removal of loose or 29819 Shoulder Arthroscopy 0.06 0.02 0.26 foreign body 29820 Shoulder Arthroscopy with synovectomy, partial 0.01 0.01 0.99 with synovectomy, 29821 Shoulder Arthroscopy 0.01 0.00 0.45 complete 29822 Shoulder Arthroscopy with debridement, limited 0.14 0.09 0.62 29823 Shoulder Arthroscopy with debridement, 0.08 0.04 0.50 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 187

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate extensive with distal claviculectomy 29824 Shoulder Arthroscopy including distal articular 0.01 0.03 2.41 surface (Mumford procedure) with lysis and resection of 29825 Shoulder Arthroscopy adhesions, with or without 0.02 0.02 0.99 manipulation with decompression of subacromial space with partial 29826 Shoulder Arthroscopy acromioplasty, with 0.04 0.10 2.23 coracoacromial ligament release, whem performed 29827 Shoulder Arthroscopy with rotator cuff repair 0.03 0.07 2.14 29828 Shoulder Arthroscopy with biceps tenodesis 0.01 0.01 1.45 Arthroscopy, elbow, Humerus/ Elbow 29830 diagnostic,with or without 0.03 0.03 0.94 Arthroscopy synovial biopsy Arthroscopy, elbow, surgical; Humerus/ Elbow 29834 with removal of loose or 0.09 0.07 0.76 Arthroscopy foreign body Humerus/ Elbow 29835 with synovectomy, partial 0.03 0.02 0.64 Arthroscopy Humerus/ Elbow with synovectomy, 29836 0.00 0.01 2.23 Arthroscopy complete Humerus/ Elbow 29837 with debridement, limited 0.06 0.04 0.67 Arthroscopy Humerus/ Elbow with debridement, 29838 0.05 0.04 0.74 Arthroscopy extensive Arthroscopy, wrist, diagnostic, 29840 Forearm/ Wrist Arthroscopy 0.02 0.02 0.95 with or without synovial biopsy Arthroscopy, wrist, surgical; 29843 Forearm/ Wrist Arthroscopy for infection, lavage and 0.00 0.00 Inf drainage 29844 Forearm/ Wrist Arthroscopy with synovectomy, partial 0.02 0.01 0.69 with synovectomy, 29845 Forearm/ Wrist Arthroscopy 0.00 0.00 0.67 complete with excision and/or repair 29846 Forearm/ Wrist Arthroscopy of triangular fibrocartilage 0.14 0.05 0.37 and/or joint debridement with internternal fixation 29847 Forearm/ Wrist Arthroscopy 0.01 0.00 0.56 for fracture or instability Endoscopy, wrist, surgical, 29848 Forearm/ Wrist Arthroscopy with release of transverse 0.01 0.01 1.05 carpal ligament Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity 29850 Femur/ Knee Arthroscopy 0.03 0.01 0.48 fracture(s) of the knee, with or without manipulation; without internal or external fixation 29851 Femur/ Knee Arthroscopy with internal or external 0.17 0.06 0.38 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 188

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate fixation Arthroscopically aided treatment of tibial fracture, 29855 Femur/ Knee Arthroscopy proximal (plateau); 0.02 0.01 0.35 unicondylar, includes internal fixation, when perforned bicondylar, in cludes 29856 Femur/ Knee Arthroscopy internal fixation, when 0.00 0.00 0.89 performed Arthroscopy,hip, 29860 Pelvis/ Hip Arthroscopy diagnostic,with or without 0.01 0.01 1.61 synovial biopsy Arthroscopy, hip, surgical; with 29861 Pelvis/ Hip Arthroscopy removal of loose or foreign 0.03 0.01 0.28 body with debridement/shaving of articular cartilage 29862 Pelvis/ Hip Arthroscopy (chondroplasty), abrasion 0.05 0.11 2.14 arthroplasty, and/or resection of labrum 29863 Pelvis/ Hip Arthroscopy with synovectomy 0.02 0.02 0.76 Arthroscopy, knee, surgical; osteochondral autograft(s) 29866 Femur/ Knee Arthroscopy 0.02 0.01 0.87 (includes harvesting of the autograft[s]) 29867 Femur/ Knee Arthroscopy osteochodral allograft 0.01 0.01 0.64 meniscal translplantation, 29868 Femur/ Knee Arthroscopy 0.01 0.00 0.85 medial or lateral Arthroscopy, knee, diagnostic, 29870 Femur/ Knee Arthroscopy 0.43 0.61 1.43 with or without synovial biopsy Arthroscopy, knee, surgical; 29871 Femur/ Knee Arthroscopy for infection, lavage and 0.20 0.10 0.51 drainage 29873 Femur/ Knee Arthroscopy with lateral release 0.37 0.24 0.65 for removal of loose or 29874 Femur/ Knee Arthroscopy 0.59 0.23 0.40 foreign body 29875 Femur/ Knee Arthroscopy with synovectomy, limited 0.68 0.31 0.46 with synovectomy, major, 29876 Femur/ Knee Arthroscopy 0.19 0.09 0.50 2 or more compartments debridement/shaving of 29877 Femur/ Knee Arthroscopy 0.69 0.38 0.55 articular cartilage abrasion arthoplasty (includes chondroplsty where 29879 Femur/ Knee Arthroscopy 0.42 0.18 0.43 necessary) or multiple drilling or microfracture with meniscectomy (medial AND lateral, including any meniscal shaving) 29880 Femur/ Knee Arthroscopy 0.17 0.13 0.76 including debridement/ shaving of articular cartilage, same or separate COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 189

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate compartment(s), when performed with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/ 29881 Femur/ Knee Arthroscopy 2.84 1.02 0.36 shaving of articular cartilage, same or separate compartment(s), when performed with meniscus repair 29882 Femur/ Knee Arthroscopy 2.25 0.58 0.26 (medial OR lateral) with meniscus repair 29883 Femur/ Knee Arthroscopy 0.25 0.06 0.24 (medial AND lateral) with lysis of adhesions, 29884 Femur/ Knee Arthroscopy 0.12 0.05 0.41 with or with out manipulation driling for ostiochondritis dissecans with bone grafting, 29885 Femur/ Knee Arthroscopy withour without internal 0.07 0.06 0.81 fixation (including debridement of base of lesion) drilling for intact 29886 Femur/ Knee Arthroscopy ostiochondritis dissecans 0.09 0.13 1.33 lesion drilling for intact 29887 Femur/ Knee Arthroscopy ostiochondritis dissecans 0.12 0.07 0.60 lesion with internal fixation Arthroscopically aided anterior cruciate ligament repair/ 29888 Femur/ Knee Arthroscopy 4.08 1.49 0.36 augmentation or reconstruction Arthroscopically aided posterior cruciate ligament 29889 Femur/ Knee Arthroscopy 0.06 0.03 0.52 repair/ augmentation or reconstruction Arthroscopy, ankle, surgical, excision of osteochondral 29891 Leg/ Ankle Arthroscopy 0.18 0.04 0.24 defect of talus and/or tibia, including drilling of the defect Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome 29892 Leg/ Ankle Arthroscopy 0.03 0.01 0.45 fracture, or tibial plafond fracture, with or without internal fixation 29893 Leg/ Ankle Arthroscopy Endoscopic plantar fasciotomy 0.00 0.00 Inf Arthroscopy, ankle, surgical; 29894 Leg/ Ankle Arthroscopy with removal of loose or 0.05 0.03 0.62 foreign body 29895 Leg/ Ankle Arthroscopy with synovectomy, partial 0.06 0.03 0.55 29897 Leg/ Ankle Arthroscopy with debridement, limited 0.10 0.08 0.71 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 190

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate with debridement, 29898 Leg/ Ankle Arthroscopy 0.12 0.05 0.45 extensive 29899 Leg/ Ankle Arthroscopy with ankle arthrodesis 0.00 0.00 Inf Arthroscopy, metatarsophalangeal joint, 29900 Foot/ Toes Arthroscopy 0.00 0.00 Inf diagnostic, includes synovial biopsy Arthroscopy, 29901 Foot/ Toes Arthroscopy metatarsophalangeal joint, 0.00 0.00 Inf surgical; with debridement with reduction of displaced 29902 Foot/ Toes Arthroscopy 0.00 0.00 Inf ulnar collateral ligament Arthroscopy, subtalar joint, 29904 Foot/ Toes Arthroscopy surgical; with removal of loose 0.01 0.00 0.00 or foreign body 29905 Foot/ Toes Arthroscopy with synovectomy 0.01 0.00 0.00 29906 Foot/ Toes Arthroscopy with debridement 0.01 0.00 0.06 29907 Foot/ Toes Arthroscopy with subtalar arthrodesis 0.00 0.00 Inf 29914 Pelvis/ Hip Arthroscopy with femoroplasty 0.27 0.00 0.00 29915 Pelvis/ Hip Arthroscopy with acetabuloplasty 0.13 0.00 0.00 29916 Pelvis/ Hip Arthroscopy with labral repair 0.35 0.00 0.00 unlisted procedure, 29999 Foot/ Toes Arthroscopy 0.17 0.05 0.28 arthroscopy Nervous System Spine & Laminectomy with exploration Spinal Cord Posterior and /or decompression of Extradural Laminotomy or spinal cord and/or cauda Laminectomy for 63001 equina, without facetectomy, 0.00 0.01 Inf Exploration/Decompression foraminotomy or discectomy of Neural Elements or (e.g., spinal stenosis), 1 or 2 Excision of Herniated vertebral segments, cervical Intervertebral Disc Nervous System Spine & Laminectomy with exploration Spinal Cord Posterior and /or decompression of Extradural Laminotomy or spinal cord and/or cauda Laminectomy for 63003 equina, without facetectomy, 0.00 0.01 Inf Exploration/Decompression foraminotomy or discectomy of Neural Elements or (e.g., spinal stenosis), 1 or 2 Excision of Herniated vertebral segments, thoracic Intervertebral Disc Nervous System Spine & Laminectomy with exploration Spinal Cord Posterior and /or decompression of Extradural Laminotomy or spinal cord and/or cauda Laminectomy for equina, without facetectomy, 63005 0.00 0.03 Inf Exploration/Decompression foraminotomy or discectomy of Neural Elements or (e.g., spinal stenosis), 1 or 2 Excision of Herniated vertebral segments, lumbar, Intervertebral Disc except for spondylolistheseis Nervous System Spine & Laminectomy with exploration Spinal Cord Posterior and/or decompression of 63011 0.00 0.00 Inf Extradural Laminotomy or spinal cord and/or cauda Laminectomy for equina, without facetectomy, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 191

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Exploration/Decompression foraminotomy or discectomy of Neural Elements or (eg, spinal stenosis), 1 or 2 Excision of Herniated vertebral segments; sacral Intervertebral Disc Nervous System Spine & Laminectomy with removal of Spinal Cord Posterior abnormal facets and/or pars Extradural Laminotomy or inter-articularis with Laminectomy for 63012 decompression of cauda 0.02 0.02 0.76 Exploration/Decompression equina and nerve roots for of Neural Elements or spondylolisthesis, lumbar (Gill Excision of Herniated type procedure) Intervertebral Disc Nervous System Spine & Laminectomy with exploration Spinal Cord Posterior and /or decompression of Extradural Laminotomy or spinal cord and /or cauda Laminectomy for equina, without facetectomy, 63015 0.00 0.00 Inf Exploration/Decompression foraminotomy or discectomy of Neural Elements or (e.g., spinal stenosis), more Excision of Herniated than 2 vertebral segments, Intervertebral Disc cervical Nervous System Spine & Laminectomy with exploration Spinal Cord Posterior and /or decompression of Extradural Laminotomy or spinal cord and /or cauda Laminectomy for equina, without facetectomy, 63016 0.00 0.01 2.23 Exploration/Decompression foraminotomy or discectomy of Neural Elements or (e.g., spinal stenosis), more Excision of Herniated than 2 vertebral segments, Intervertebral Disc thoracic Nervous System Spine & Laminectomy with exploration Spinal Cord Posterior and /or decompression of Extradural Laminotomy or spinal cord and /or cauda Laminectomy for equina, without facetectomy, 63017 0.00 0.03 Inf Exploration/Decompression foraminotomy or discectomy of Neural Elements or (e.g., spinal stenosis), more Excision of Herniated than 2 vertebral segments, Intervertebral Disc lumbar Laminotomy Nervous System Spine & (hemilaminectomy). with Spinal Cord Posterior decompression of nerve Extradural Laminotomy or root(s), including partial Laminectomy for facetectomy, foraminotomy 63020 0.00 0.00 1.48 Exploration/Decompression and/or excision of herniated of Neural Elements or intervertebral disc, including Excision of Herniated open and edoscopically Intervertebral Disc assisted approaches, 1 interspace, cervical Nervous System Spine & Laminotomy Spinal Cord Posterior (hemilaminectomy). with 63030 Extradural Laminotomy or decompression of nerve 0.07 0.04 0.57 Laminectomy for root(s), including partial Exploration/Decompression facetectomy, foraminotomy COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 192

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate of Neural Elements or and/or excision of herniated Excision of Herniated intervertebral disc, including Intervertebral Disc open and edoscopically assisted approaches, 1 interspace, lumbar Laminotomy (hemilaminectomy), with decompression of nerve Nervous System Spine & root(s), including Spinal Cord Posterior partial facetectomy, Extradural Laminotomy or foraminotomy and/or excision Laminectomy for 63035 of herniated intervertebral 0.01 0.01 0.93 Exploration/Decompression disc; of Neural Elements or each additional interspace, Excision of Herniated cervical or lumbar (List Intervertebral Disc separately in addition to code for primary procedure) Laminotomy Nervous System Spine & (hemilaminectomy), with Spinal Cord Posterior decompression of nerve Extradural Laminotomy or root(s), including Laminectomy for partial facetectomy, 63040 0.00 0.00 Inf Exploration/Decompression foraminotomy and/or excision of Neural Elements or of herniated intervertebral Excision of Herniated disc, Intervertebral Disc reexploration, single interspace; cervical Laminotomy Nervous System Spine & (hemilaminectomy), with Spinal Cord Posterior decompression of nerve Extradural Laminotomy or root(s), including Laminectomy for partial facetectomy, 63042 0.00 0.01 Inf Exploration/Decompression foraminotomy and/or excision of Neural Elements or of herniated intervertebral Excision of Herniated disc, Intervertebral Disc reexploration, single interspace; lumbar Laminotomy (hemilaminectomy), with decompression of nerve Nervous System Spine & root(s), including Spinal Cord Posterior partial facetectomy, Extradural Laminotomy or foraminotomy and/or excision Laminectomy for 63043 of herniated intervertebral 0.00 0.00 Inf Exploration/Decompression disc, of Neural Elements or reexploration, single Excision of Herniated interspace; each additional Intervertebral Disc cervical interspace (List separately in addition to code for primary COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 193

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate procedure) Laminotomy (hemilaminectomy), with decompression of nerve Nervous System Spine & root(s), including Spinal Cord Posterior partial facetectomy, Extradural Laminotomy or foraminotomy and/or excision Laminectomy for of herniated intervertebral 63044 0.00 0.01 Inf Exploration/Decompression disc, of Neural Elements or reexploration, single Excision of Herniated interspace; each additional Intervertebral Disc lumbar interspace (List separately in addition to code for primary procedure) Nervous System Spine & Laminectomy, facetectomy Spinal Cord Posterior and foraminotomy (unilateral Extradural Laminotomy or or bilateral with Laminectomy for decompression of spinal cord, 63045 0.00 0.00 Inf Exploration/Decompression cauda equina and /or nerve of Neural Elements or root(s), (e.g., spinal or lateral Excision of Herniated recess stenosis), single Intervertebral Disc vertebral segment, cervical Nervous System Spine & Laminectomy, facetectomy Spinal Cord Posterior and foraminotomy (unilateral Extradural Laminotomy or or bilateral with Laminectomy for decompression of spinal cord, 63046 0.00 0.01 Inf Exploration/Decompression cauda equina and/or nerve of Neural Elements or root[s], [eg, spinal or lateral Excision of Herniated recess stenosis]), single Intervertebral Disc vertebral segment; thoracic Nervous System Spine & Laminectomy, facetectomy Spinal Cord Posterior and foraminotomy (unilateral Extradural Laminotomy or or bilateral with Laminectomy for decompression of spinal cord, 63047 0.03 0.05 1.74 Exploration/Decompression cauda equina and /or nerve of Neural Elements or root(s), (e.g., spinal or lateral Excision of Herniated recess stenosis), single Intervertebral Disc vertebral segment, lumbar Laminectomy, facetectomy and foraminotomy (unilateral Nervous System Spine & or bilateral with Spinal Cord Posterior decompression of spinal cord, Extradural Laminotomy or cauda equina and/or nerve Laminectomy for root[s], [eg, spinal or lateral 63048 0.01 0.04 4.55 Exploration/Decompression recess stenosis]), single of Neural Elements or vertebral segment; each Excision of Herniated additional segment, cervical, Intervertebral Disc thoracic, or lumbar (List separately in addition to code for primary procedure) COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 194

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Nervous System Spine & Spinal Cord Posterior Extradural Laminotomy or Laminoplasty, cervical, with Laminectomy for decompression of the spinal 63050 0.00 0.00 Inf Exploration/Decompression cord, 2 or more vertebral of Neural Elements or segments; Excision of Herniated Intervertebral Disc Laminoplasty, cervical, with decompression of the spinal Nervous System Spine & cord, 2 or more vertebral Spinal Cord Posterior segments; with reconstruction Extradural Laminotomy or of the posterior bony elements Laminectomy for 63051 (including the 0.00 0.00 Inf Exploration/Decompression application of bridging bone of Neural Elements or graft and non-segmental Excision of Herniated fixation devices [eg, wire, Intervertebral Disc suture, mini-plates], when performed) Nervous System Spine & Discectomy, anterior, with Spinal Cord Anterior or decompression of spinal cord 63075 Anterolateral Approach for and/or nerve root(s), 0.00 0.01 Inf Extradural including osteophytectomy; Exploration/Decompression cervical, single interspace Discectomy, anterior, with decompression of spinal cord Nervous System Spine & and/or nerve root(s), Spinal Cord Anterior or including osteophytectomy; 63076 Anterolateral Approach for 0.00 0.01 Inf cervical, each additional Extradural interspace (List separately in Exploration/Decompression addition to code for primary procedure) Nervous System Spine & Discectomy, anterior, with Spinal Cord Anterior or decompression of spinal cord 63077 Anterolateral Approach for and/or nerve root(s), 0.00 0.01 Inf Extradural including osteophytectomy; Exploration/Decompression thoracic, single interspace Discectomy, anterior, with decompression of spinal cord Nervous System Spine & and/or nerve root(s), Spinal Cord Anterior or including osteophytectomy; 63078 Anterolateral Approach for 0.00 0.03 Inf thoracic, each additional Extradural interspace (List separately in Exploration/Decompression addition to code for primary procedure) Vertebral corpectomy Nervous System Spine & (vertebral body resection), Spinal Cord Anterior or partial or complete, anterior 63081 Anterolateral Approach for 0.00 0.01 2.45 approach with decompression Extradural of spinal cord and/or nerve Exploration/Decompression root(s); cervical, single COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 195

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate segment Vertebral corpectomy (vertebral body resection), Nervous System Spine & partial or complete, anterior Spinal Cord Anterior or approach with decompression 63082 Anterolateral Approach for of spinal cord and/or nerve 0.00 0.00 Inf Extradural root(s); cervical, each Exploration/Decompression additional segment (List separately in addition to code for primary procedure) Vertebral corpectomy Nervous System Spine & (vertebral body resection), Spinal Cord Anterior or partial or complete, 63085 Anterolateral Approach for transthoracic approach with 0.00 0.01 2.30 Extradural decompression of spinal cord Exploration/Decompression and/or nerve root(s); thoracic, single segment Vertebral corpectomy Nervous System Spine & (vertebral body resection), Spinal Cord Anterior or partial or complete, 63086 Anterolateral Approach for transthoracic approach with 0.00 0.01 Inf Extradural decompression of spinal cord Exploration/Decompression and/or nerve root(s); thoracic, each additional segment Vertebral corpectomy (vertebral body resection), Nervous System Spine & partial or complete, combined Spinal Cord Anterior or thoracolumbar approach with 63087 Anterolateral Approach for 0.00 0.02 Inf decompression of spinal cord, Extradural cauda equina or nerve Exploration/Decompression root(s), lower thoracic or lumbar; single segment Vertebral corpectomy (vertebral body resection), partial or complete, combined Nervous System Spine & thoracolumbar approach with Spinal Cord Anterior or decompression of spinal cord, 63088 Anterolateral Approach for cauda equina or nerve 0.00 0.01 Inf Extradural root(s), lower thoracic or Exploration/Decompression lumbar; each additional segment (List separately in addition to code for primary procedure) Vertebral corpectomy (vertebral body resection), Nervous System Spine & partial or complete, Spinal Cord Anterior or transperitoneal 63090 Anterolateral Approach for 0.00 0.01 Inf or retroperitoneal approach Extradural with decompression of spinal Exploration/Decompression cord, cauda equina or nerve root(s), lower thoracic, lumbar, COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 196

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate or sacral; single segment Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal Nervous System Spine & or retroperitoneal approach Spinal Cord Anterior or with decompression of spinal 63091 Anterolateral Approach for 0.00 0.00 Inf cord, cauda equina or nerve Extradural root(s), lower thoracic, lumbar, Exploration/Decompression or sacral; each additional segment (List separately in addition to code for primary procedure) Nervous System Spine & Neuroplasty; digital, 1 or both, 64702 0.04 0.01 0.33 Spinal Cord Neuroplasty same digit Nervous System Spine & Neuroplasty; nerve of hand or 64704 0.00 0.01 Inf Spinal Cord Neuroplasty foot Neuroplasty, major peripheral Nervous System Spine & 64708 nerve, arm or leg, open; other 0.13 0.06 0.44 Spinal Cord Neuroplasty than specified Neuroplasty, major peripheral Nervous System Spine & 64712 nerve, arm or leg, open; 0.01 0.01 1.13 Spinal Cord Neuroplasty sciatic nerve Neuroplasty, major peripheral Nervous System Spine & 64713 nerve, arm or leg, open; 0.02 0.03 1.27 Spinal Cord Neuroplasty brachial plexus Neuroplasty, major peripheral Nervous System Spine & 64714 nerve, arm or leg, open; 0.00 0.00 0.74 Spinal Cord Neuroplasty lumbar plexus Neuroplasty and/or Nervous System Spine & 64718 transposition; ulnar nerve at 0.20 0.10 0.49 Spinal Cord Neuroplasty elbow Neuroplasty and/or Nervous System Spine & 64719 transposition; ulnar nerve at 0.01 0.01 0.62 Spinal Cord Neuroplasty wrist Neuroplasty and/or Nervous System Spine & 64721 transposition; median nerve at 0.13 0.13 0.99 Spinal Cord Neuroplasty carpal tunnel Nervous System Spine & Decompression; unspecified 64722 0.01 0.02 1.56 Spinal Cord Neuroplasty nerve(s) (specify) Nervous System Spine & Decompression; plantar digital 64726 0.00 0.00 Inf Spinal Cord Neuroplasty nerve Internal neurolysis, requiring use of operating microscope Nervous System Spine & (List separately in addition 64727 0.01 0.01 0.95 Spinal Cord Neuroplasty to code for neuroplasty) (Neuroplasty includes external neurolysis) Nervous System Spine & Suture of digital nerve, hand 64831 0.25 0.06 0.23 Spinal Cord Neurorrhaphy or foot; 1 nerve 64832 Nervous System Spine & Suture of digital nerve, hand 0.02 0.02 0.80 COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 197

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate Spinal Cord Neurorrhaphy or foot; each additional digital nerve (List separately in addition to code for primary procedure) Nervous System Spine & Suture of 1 nerve; hand or 64834 0.02 0.01 0.45 Spinal Cord Neurorrhaphy foot, common sensory nerve Nervous System Spine & Suture of 1 nerve; median 64835 0.01 0.00 0.63 Spinal Cord Neurorrhaphy motor thenar Nervous System Spine & 64836 Suture of 1 nerve; ulnar motor 0.01 0.01 1.74 Spinal Cord Neurorrhaphy Suture of each additional nerve, hand or foot (List Nervous System Spine & 64837 separately in addition to code 0.00 0.01 Inf Spinal Cord Neurorrhaphy for primary procedure) Nervous System Spine & 64840 Suture of posterior tibial nerve 0.00 0.00 0.37 Spinal Cord Neurorrhaphy Suture of major peripheral Nervous System Spine & 64856 nerve, arm or leg, except 0.04 0.01 0.26 Spinal Cord Neurorrhaphy sciatic; including transposition Suture of major peripheral Nervous System Spine & 64857 nerve, arm or leg, except 0.09 0.03 0.32 Spinal Cord Neurorrhaphy sciatic; without transposition Suture of each additional Nervous System Spine & major peripheral nerve (List 64859 0.01 0.00 0.18 Spinal Cord Neurorrhaphy separately in addition to code for primary procedure) Suture of nerve; requiring extensive mobilization, or Nervous System Spine & 64861 transposition of nerve (List 0.01 0.01 1.89 Spinal Cord Neurorrhaphy separately in addition to code for nerve suture) Suture of nerve; requiring extensive mobilization, or Nervous System Spine & 64874 transposition of nerve (List 0.00 0.00 Inf Spinal Cord Neurorrhaphy separately in addition to code for nerve suture) Nervous System Spine & Spinal Cord Neurorrhaphy Nerve graft, head or neck; up 64885 0.01 0.00 0.24 with Nerve Graft, Vein Graft to 4 cm in length or Conduit Nervous System Spine & Nerve graft, single strand, Spinal Cord Neurorrhaphy 64890 hand or foot; up to 4 cm in 0.00 0.00 0.89 with Nerve Graft, Vein Graft length or Conduit Nervous System Spine & Nerve graft, single strand, Spinal Cord Neurorrhaphy 64891 hand or foot; more than 4 cm 0.00 0.00 Inf with Nerve Graft, Vein Graft in length or Conduit Nervous System Spine & Nerve graft, single strand, arm 64892 0.00 0.01 Inf Spinal Cord Neurorrhaphy or leg; up to 4 cm in length COPYRIGHT © BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED KOHRING ET AL. OPERATIVE EXPERIENCE DURING ORTHOPAEDIC RESIDENCY COMPARED WITH EARLY PRACTICE IN THE U.S. http://dx.doi.org/10.2106/JBJS.17.01115 Page 198

CPT Relative CPT Code Category CPT Code Description Practitioner % Resident % Codea Rate with Nerve Graft, Vein Graft or Conduit Nervous System Spine & Nerve graft, single strand, arm Spinal Cord Neurorrhaphy 64893 or leg; more than 4 cm in 0.01 0.00 0.70 with Nerve Graft, Vein Graft length or Conduit Nervous System Spine & Nerve graft, multiple strands, Spinal Cord Neurorrhaphy 64895 hand or foot; up to 4 cm in 0.00 0.00 0.30 with Nerve Graft, Vein Graft length or Conduit Nervous System Spine & Nerve graft, multiple strands, Spinal Cord Neurorrhaphy 64896 hand or foot; more than 4 cm 0.00 0.00 0.89 with Nerve Graft, Vein Graft in length or Conduit Nervous System Spine & Nerve graft, multiple strands, Spinal Cord Neurorrhaphy 64897 arm or leg; up to 4 cm in 0.00 0.00 1.63 with Nerve Graft, Vein Graft length or Conduit Nervous System Spine & Nerve graft, multiple strands, Spinal Cord Neurorrhaphy 64898 arm or leg; more than 4 cm in 0.01 0.01 0.56 with Nerve Graft, Vein Graft length or Conduit Nervous System Spine & Spinal Cord Neurorrhaphy Nerve graft, additional nerve; 64901 0.00 0.00 Inf with Nerve Graft, Vein Graft single strand or Conduit Nervous System Spine & Spinal Cord Neurorrhaphy Nerve graft, additional nerve; 64902 0.02 0.01 0.28 with Nerve Graft, Vein Graft multiple strands or Conduit Nervous System Spine & Spinal Cord Neurorrhaphy Nerve pedicle transfer; first 64905 0.04 0.00 0.11 with Nerve Graft, Vein Graft stage or Conduit Nervous System Spine & Spinal Cord Neurorrhaphy Nerve pedicle transfer; second 64907 0.00 0.00 Inf with Nerve Graft, Vein Graft stage or Conduit Nervous System Spine & Nerve repair; with synthetic Spinal Cord Neurorrhaphy 64910 conduit or vein allograft, each 0.06 0.02 0.28 with Nerve Graft, Vein Graft nerve or Conduit Nervous System Spine & Nerve repair; with synthetic Spinal Cord Neurorrhaphy 64911 conduit or vein autogenous, 0.00 0.00 Inf with Nerve Graft, Vein Graft each nerve or Conduit a Sorted by this column.