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 1 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. 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 4 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.