Chapter 16 / Bones, joints and connective tissue/tendon muscle

When a procedure code includes the narrative ‘including arthroscopic’, the majority of specialists do not
make additional charges for either a diagnostic or a therapeutic arthroscopy and we do not consider
these to be additional procedures (except in unusual circumstances).


We consider that decompression in the subacromial region which is frequently performed arthroscopically
is covered by the code for subacromial decompression. This includes EUA, arthroscopy, and
decompression of the subacromial region, excision of distal clavicle, reconstruction of acromioclavicular
joint, acromioplasty and repair of a small rotator cuff tear. We will not routinely reimburse this as a
multiple procedure although we will allow flexibility in individual cases. In such cases, we ask that
sufficient clinical detail is provided to allow assessment by an orthopaedic consultant.


Knee arthroscopy. At most knee procedures, in addition to the main procedure, a number of lesser
procedures are frequently performed such as excision of sinovium, drilling of cartilage, removal of loose
bodies, excision of plica lateral release etc. The code W8500 should be used in isolation for multiple
arthroscopic procedures.


EUA/MUA/Injection into joint. With all arthroscopies we consider that EUA/MUA and injection into joint
are part of the procedure. The only circumstances we would reimburse as a multiple is where the
injection is into a different joint and we ask that this is made clear on the invoice.


Application of plaster of Paris is part of any procedure where immobilisation is routine – e.g. fracture
reduction, tendon repairs and various osteotomies. As a rule we will not reimburse extra charges for this
procedure.


Where a procedure usually or frequently necessitates bone grafting, additional charges should not be
made for this as a separate service.


There is a significant number of other areas where in our opinion orthopaedic procedures have been
unreasonably disaggregated in the past. This particularly applies to shoulder procedures. Procedures on
the distal clavicle, acromioclavicular joint, glenohumeral arthroscopy, bursas and rotator cuff repair should
not be added to subacromial decompression.


Please note that all procedure codes and descriptions include the application of the first cast. For
subsequent, additional application of cast use code in Fractures section (16.3).


Please also note that all procedure codes in the fixation/arthrodesis section have been moved to
individual areas.


The following definitions are used throughout this section:


Long bones – clavicle, fibula, humerus, radius, scapula, tibia and ulna


Small bones – all bones of hand, wrist, foot, ankle and also the patella


Large joints – ankle, elbow, hip, knee, shoulder and wrist


Small joints – all other joints of the hand and foot


Child Aged 0-15


Adult Aged 16 and over


16.1 - Connective tissue/tendon muscle

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information


A8460 Static single measurement of muscle compartment pressures (Including reporting) Minor £200.00 £129.00 Show arrow
A8470 Dynamic laboratory investigation involving measurement of muscle compartment pressures with manometer Intermediate £200.00 £0.00 Show arrow
T5230 Excision plantar fibroma Intermediate £200.00 £213.00 Show arrow
T5250 Endoscopic plantar fascia release Intermediate £200.00 £213.00 Show arrow
T5900 Excision of ganglion Intermediate £300.00 £213.00 Show arrow
T6000 Repeat excision of ganglion Intermediate £250.00 £213.00 Show arrow
T6220 Excision of bursa Intermediate £200.00 £213.00 Show arrow
T6580 Tendon graft, or tendon transfer (as sole procedure, not otherwise specified) Intermediate £400.00 £213.00 Show arrow
T6800 Delayed or secondary repair of tendon (including graft, transfer and/or prosthesis) (not otherwise specified) Major £550.00 £213.00 Show arrow
T7231 Open release of constriction of sheath of tendon (e.g. trigger finger) Intermediate £300.00 £213.00 Show arrow
T7232 Percutaneous release of constriction of sheath of tendon (e.g. trigger finger) Intermediate £300.00 £213.00 Show arrow
T6910 Tenolysis, of extensor, not otherwise specified Intermediate £350.00 £213.00 Show arrow
T6980 Tenolysis, of flexor tendon (not otherwise specified) Major £450.00 £213.00 Show arrow
T7010 Percutaneous tenotomy Minor £150.00 £142.00 Show arrow
T7050 Lengthening of tendon(s), or open tenotomy Intermediate £350.00 £213.00 Show arrow
T7110 Tenosynovectomy Intermediate £300.00 £213.00 Show arrow
T8002 Minor release of muscle for pain or contracture (involving small joint) Intermediate £350.00 £285.00 Show arrow
T8003 Major release of muscle for pain or contracture (eg Quadriceps) (involving large joint) Intermediate £350.00 £285.00 Show arrow
T8100 Open biopsy of muscle or soft tissue lesion Minor £200.00 £142.00 Show arrow
W6960 Needle biopsy of synovium Minor £100.00 £129.00
W8100 Open excision of calcific deposit (eg shoulder, hip) Minor £200.00 £213.00 Show arrow

16.2 - Bone (non-specific)

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information


W0640 Total excision of sesamoid bone Intermediate £200.00 £213.00 Show arrow
W0700 Excision of ectopic bone Minor £200.00 £213.00 Show arrow
W0850 Partial excision of bone (including exostoses) Intermediate £300.00 £213.00 Show arrow
W0950 Radical clearance of sarcoma of trunk or limbs, +/- amputation or insertion of prosthesis Complex £750.00 £357.00 Show arrow
W0960 Excision of benign tumour of bone with bone grafting Xmajor £750.00 £357.00 Show arrow
W0951 Radical clearance of sarcoma of head and neck necessitating flap reconstruction Complex £1,000.00 £649.00 Show arrow
W1080 Osteotomy of long bone, with/without fixation, including graft Major £550.00 £285.00 Show arrow
W1800 Drainage/debridement of bone(s), including sequestectomy for osteomyelitis Intermediate £400.00 £213.00 Show arrow
W2700 Fixation of epiphysis, including epiphysiodesis, correction of angular deformity Intermediate £350.00 £285.00 Show arrow
W2702 Epiphysiolysis (eg Langenskiold procedure) Intermediate £350.00 £285.00 Show arrow
W3620 Open bone biopsy as sole procedure Intermediate £200.00 £213.00 Show arrow
W3622 Needle biopsy of bone as sole procedure Minor £200.00 £213.00 Show arrow
W3650 Diagnostic aspiration and trephine biopsy of bone marrow, including analysis Minor £200.00 £213.00 Show arrow
W3651 Diagnostic aspiration of bone marrow Minor £100.00 £129.00 Show arrow
W3652 Trephine biopsy of bone marrow Minor £200.00 £129.00 Show arrow
W0961 Radical clearance of benign bone tumour with reconstruction +/- insertion of prosthesis Complex £900.00 £428.00

16.3 - Fractures

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information


Long bones

W1920 Primary open reduction of long bone with fixation Major £600.00 £357.00 Show arrow
W2100 Primary open reduction of intra-articular fracture of long bone with internal fixation, eg proximal humerus or proximal tibia (with or without arthroscopic assistance) Major £550.00 £357.00 Show arrow
W2310 Secondary open reduction of fractured long bone and intra-medullary fixation or internal fixation for non-union/mal union – including intra-articular (including bone graft) Xmajor £550.00 £285.00 Show arrow
W2380 Locked intramedullary nailing of fractured long bone Xmajor £750.00 £357.00 Show arrow
W2500 Closed reduction of fracture of long bone with external fixation (excluding fixation by cast or percutaneous K-wires) Major £500.00 £285.00 Show arrow
W2502 Closed reduction of fracture of long bone, including cast or percutaneous K-wires Intermediate £500.00 £285.00 Show arrow


Small bones

W1940 Primary open reduction of short bone with fixation (including intra-articular) Intermediate £450.00 £285.00 Show arrow
W2300 Secondary open reduction of fracture of short bone (including intra-articular fracture for delayed/non-union and including bone graft) Major £500.00 £213.00 Show arrow
W2580 Closed reduction of fracture of short bone with external fixator Intermediate £250.00 £213.00 Show arrow
W2582 Closed reduction of fracture of short bone (including cast or percutaneous K-wires) Intermediate £250.00 £213.00 Show arrow


Pelvis/acetabulum and femur

W1910 Primary reduction of fracture of neck of femur and internal fixation Xmajor £650.00 £357.00 Show arrow
W1320 Osteotomy of proximal femur Xmajor £650.00 £357.00 Show arrow
W1380 Arthroscopic femoro-acetabular surgery for hip impingement syndrome Xmajor £800.00 £571.00 Show arrow
W1390 Open femoro-acetabular surgery for hip impingement Xmajor £800.00 £571.00 Show arrow
W1642 Open reduction/internal fixation of posterior rim of acetabulum Complex £1,000.00 £357.00 Show arrow
W1643 Open reduction/internal fixation of either posterior wall/column or acetabulum or anterior column of acetabulum Complex £1,000.00 £571.00 Show arrow
W1644 Open reduction/internal fixation of both columns of acetabulum Complex £1,000.00 £714.00 Show arrow
W1645 Open reduction/internal fixation plus bone graft symphysis pubis Complex £1,000.00 £428.00 Show arrow
W1646 Open reduction/internal fixation of sacro-iliac joint Complex £1,000.00 £571.00 Show arrow
W1647 Open reduction/internal fixation of fractures of the greater trochanter, including fixation of non-union of greater trochanter after trochanteric osteotomy Xmajor £650.00 £357.00 Show arrow


Joints

W6630 Primary closed reduction of fracture or dislocation of joint, with or without fixation including cast application Intermediate £300.00 £213.00 Show arrow
W6522 Primary open reduction of dislocation of small joint Intermediate £550.00 £285.00 Show arrow
W6523 Primary open reduction of dislocation of large joint Intermediate £550.00 £285.00 Show arrow
W6702 Secondary open reduction of dislocation of small joint Intermediate £250.00 £213.00 Show arrow
W6703 Secondary open reduction of dislocation of large joint Intermediate £250.00 £213.00 Show arrow


Fixation devices

W2830 Removal of internal fixation from bone/joint, excluding K-wires +/- Image Guidance Intermediate £400.00 £213.00 Show arrow
W3020 Adjustments to Ilizarov frame/rings Major £550.00 £213.00 Show arrow
W3040 Application of Ilizarov frame for secondary non-union/mal-union including osteotomy Complex £1,600.00 £642.00 Show arrow
W3050 Adjustments to pin sites secondary for non-union/mal-union Minor Minor £350.00 £142.00
W3032 Removal of fixator/frame/pins/wires and change of plaster (as sole procedure) Intermediate £200.00 £142.00 Show arrow
W3530 Removal of percutaneous wire Minor £150.00 £142.00 Show arrow


Other (eg POP)

X4822 Change of cast under general anaesthetic (as sole procedure) Minor £150.00 £142.00 Show arrow
X4810 Change of cast without general anaesthetic (as sole procedure) £75.00 £0.00 Show arrow
T5540 Fasciotomy of limb Major £500.00 £285.00
S5730 Surgical toilet and debridement of deep wound, including traumatic or post-operative aetiology Minor £150.00 £142.00 Show arrow
W3100 Bone graft (as sole procedure) Major £450.00 £285.00 Show arrow
W7720 Minimally Invasive Sacrolliac Joint Stabilisation Surgery for Chronic Sacrolliac Pain Under Image Guidance Complex £1,000.00 £571.00 Show arrow

16.4 - Nerves

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information


A6030 Transection of peripheral nerve for neuroma Intermediate £250.00 £213.00 Show arrow
A6080 Neurectomy (major nerve) Intermediate £400.00 £213.00 Show arrow
A6110 Excision of lesion of peripheral nerve (eg neurilemoma) Intermediate £300.00 £213.00 Show arrow
A6180 Excision of lesion of major nerve Intermediate £400.00 £213.00 Show arrow
A6300 Graft to peripheral nerve Xmajor £650.00 £357.00 Show arrow
A6302 Graft to major nerve Xmajor £650.00 £357.00 Show arrow
A6400 Repair of peripheral nerve Intermediate £250.00 £213.00 Show arrow
A6402 Repair of major nerve Major £300.00 £213.00 Show arrow
A6510 Carpal tunnel release (open) Intermediate £250.00 £213.00 Show arrow
A6580 Carpal tunnel release (open) - bilateral Intermediate £450.00 £357.00 Show arrow
A6600 Release of entrapment of deeply placed peripheral nerve Intermediate £250.00 £213.00 Show arrow
A6700 Release of entrapment of peripheral nerve Intermediate £250.00 £213.00 Show arrow
A6710 Cubital tunnel release (open) (without transposition) Intermediate £250.00 £213.00 Show arrow
A6711 Cubital tunnel release (open) bilateral (without transposition) Intermediate £450.00 £357.00 Show arrow
A6810 Neurolysis and transposition of peripheral nerve (excludes carpal tunnel release) Intermediate £300.00 £213.00 Show arrow
A6900 Revision of release of peripheral nerve Major £450.00 £213.00 Show arrow
A7010 Implantation of neurostimulator to peripheral nerve Major £550.00 £142.00 Show arrow
A7011 Trial of neurostimulator to peripheral nerve (as sole procedure) not at time of permanent implant Intermediate £450.00 £142.00 Show arrow
A6530 Carpal tunnel release (endoscopic) Intermediate £250.00 £213.00 Show arrow
A6570 Carpal tunnel release (endoscopic) - Bilateral Intermediate £450.00 £357.00 Show arrow
A6740 Cubital tunnel release (endoscopic) (without transposition) Intermediate £250.00 £213.00 Show arrow
A6750 Cubital tunnel release (endoscopic) Bilateral (without transposition) Intermediate £450.00 £357.00 Show arrow
A7310 Biopsy of peripheral nerve Intermediate £250.00 £213.00 Show arrow
A7340 Exploration and grafting of brachial plexus Complex £1,000.00 £857.00 Show arrow
T7483 Ultrasound guided barbotage of calcific deposits of joint (as sole procedure) Minor £100.00 £0.00

16.5 - Joints, including replacement/reconstruction (not listed elsewhere)

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information


W5540 Debridement of infected total joint replacement Major £550.00 £357.00 Show arrow
W5722 Excision reconstruction of small joint Major £500.00 £285.00 Show arrow
W5723 Excision reconstruction of large joint Major £500.00 £285.00 Show arrow
W6912 Total synovectomy of small joint Major £500.00 £285.00 Show arrow
W9050 Shoulder hydrodistension +/- image guidance Minor £150.00 £0.00 Show arrow
W6913 Total synovectomy of large joint Major £500.00 £285.00 Show arrow
W7400 Reconstruction of one or two ligaments not elsewhere specified Major £450.00 £213.00 Show arrow
W7500 Prosthetic open repair of ligament Major £450.00 £213.00 Show arrow
W7881 Release of contracture of interphalangeal joint of finger (excluding trigger finger or Dupuytren's disease) Intermediate £250.00 £285.00 Show arrow
W8150 Arthrotomy of large joint, including removal of loose body from joint Intermediate £350.00 £213.00 Show arrow
W8180 Arthrotomy of small joint, including removal of loose body from joint Minor £100.00 £129.00 Show arrow
W8300 Therapeutic arthroscopy operation on articular cartilage (other than W8200 and W8230) (as sole procedure) Intermediate £350.00 £357.00 Show arrow
W8380 Therapeutic arthroscopy operation on articular cartilage (other than W8200) - bilateral (as sole procedure) Major £550.00 £499.00 Show arrow
W8600 Therapeutic arthroscopy operation on cavity of joint (not otherwise specified) (as sole procedure) Major £550.00 £357.00 Show arrow
W8680 Therapeutic arthroscopy operation on cavity of joint - bilateral (not otherwise specified) (as sole procedure) Complex £800.00 £499.00 Show arrow
W8700 Diagnostic arthroscopic examination of joint, with or without biopsy (not otherwise specified) (as sole procedure) Intermediate £250.00 £285.00 Show arrow
W8780 Diagnostic arthroscopic examination of joint, with or without biopsy - bilateral (not otherwise specified) (as sole procedure) Intermediate £400.00 £357.00 Show arrow
W8782 Flexible arthroscopy, +/- biopsy (as sole procedure) Intermediate £200.00 £213.00 Show arrow
W9017 Yttrium joint injection (with radioactive precautions) Minor £100.00 £0.00 Show arrow
W9020 Dynamic arthrogram of joint Intermediate £100.00 £129.00 Show arrow
W9030 Injection(s) +/- aspiration, into joint, cyst, bursa with image guidance Minor £115.00 £142.00 Show arrow
W9240 Examination/ manipulation of joint under general anaesthetic +/- injection +/- arthrogram (as sole procedure) Minor £150.00 £142.00 Show arrow
W9032 Injection of viscosupplement into joint with image guidance Minor £115.00 £0.00 Show arrow
W9033 Injection of viscosupplement into joint with image guidance - bilateral Minor £135.00 £0.00
W9035 Injection(s) +/- aspiration, into two or more joints, cysts, bursae with image guidance - bilateral Minor £135.00 £0.00 Show arrow
W9042 Injection of viscosupplement into joint Minor £50.00 £0.00
W9043 Injections of viscosupplement into joints - bilateral Minor £75.00 £0.00
W9045 Injection(s) +/- aspiration, into two or more joints, cysts, bursae - bilateral Minor £115.00 £0.00
W9170 Manipulation of foot/ankle joint under local anaesthetic +/- injection (as a sole procedure) Minor £110.00 £0.00

16.6 - Hand

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information


Incision/excision

T5202 Dupuytren’s fasciectomy palm only Intermediate £350.00 £213.00 Show arrow
T5203 Dupuytren’s fasciectomy single digit with proximal interphalangeal joint Intermediate £350.00 £213.00 Show arrow
T5210 Dupuytren’s fasciectomy multiple digits with proximal interphalangeal joints Major £600.00 £357.00 Show arrow
T5222 Dupuytren’s dermofasciectomy and graft, or for recurrent disease – single digit Major £650.00 £357.00 Show arrow
T5223 Dupuytren’s dermofasciectomy and graft, or for recurrent disease – multiple digits Major £650.00 £357.00 Show arrow
T5410 Dupuytren’s subcutaneous fasciotomy Minor Minor £200.00 £142.00 Show arrow
W0282 Total excision of trapezium Xmajor £700.00 £357.00 Show arrow
W0283 Total excision of trapezium with spacer Xmajor £700.00 £357.00 Show arrow
W0284 Total excision of trapezium and ligament reconstruction Xmajor £700.00 £357.00 Show arrow
W0285 Trapezio-metacarpal joint surface replacement Major £700.00 £357.00 Show arrow


Repair/reconstruction

W1641 Osteotomy of short bone of hand (including fixation and bone grafting) Intermediate £350.00 £213.00 Show arrow
T6710 Primary repair of extensor of hand Intermediate £250.00 £213.00 Show arrow
T6820 Secondary repair or reconstruction of extensor of hand/forearm Major £500.00 £213.00 Show arrow
T6914 Tenolysis of extensor tendon of hand Intermediate £350.00 £213.00 Show arrow
T6750 Primary repair of flexor of hand (excluding Zone II) Intermediate £500.00 £213.00 Show arrow
T6752 Primary repair of flexor of hand in Zone II Major £500.00 £213.00 Show arrow
T6830 Secondary or second repair of 1st stage reconstruction of flexor of hand Major £550.00 £285.00 Show arrow
T6832 Second stage reconstruction of flexor of hand Major £550.00 £285.00 Show arrow
T6982 Tenolysis of flexor tendon of hand Intermediate £450.00 £213.00 Show arrow
T6402 Tendon transfer of hand – single Major £300.00 £213.00 Show arrow
T6410 Tendon transfer of hand – multiple (eg for radial nerve injury) Major £600.00 £285.00 Show arrow
W0120 Pollicisation of finger for thumb reconstruction Complex £1,000.00 £213.00
W0512 Interpositional silastic arthroplasty of MCP/PIP joints – single Major £600.00 £213.00 Show arrow
W0513 Interpositional silastic arthroplasty of MCP/PIP joints - multiple Major £600.00 £213.00 Show arrow
W0514 Prosthetic surface arthroplasty of interphalanageal/metacarpo-phalangeal joint – single joint (both cemented and uncemented) Major £600.00 £213.00 Show arrow
W5310 Total prosthetic replacement of wrist joint Xmajor £700.00 £357.00 Show arrow
W8830 Diagnostic arthroscopic examination of wrist joint, with or without biopsy (as sole procedure) Intermediate £250.00 £285.00 Show arrow
W8602 Therapeutic arthroscopy of wrist joint (sole procedure) Major £550.00 £213.00 Show arrow
W7482 Scaphoid lunate ligament reconstruction Major £700.00 £285.00 Show arrow
W7483 Triquetrolunate ligament reconstruction Major £700.00 £285.00 Show arrow
W7484 Multiple ligament reconstruction Xmajor £700.00 £285.00 Show arrow
W7485 Small joint (eg interphalangeal/metacarpo-phalangeal joint) ligament reconstruction Major £550.00 £285.00 Show arrow
W7486 Carpo-metacarpal joint ligament reconstruction Major £550.00 £285.00 Show arrow
W6230 Vascular implantation to carpal bone Xmajor £700.00 £499.00 Show arrow
W0110 Toe to hand transfer (as sole procedure) including closure of secondary defect Complex £1,000.00 £213.00


Fixation/arthrodesis

W3200 Open reduction and internal fixation of cancellous bone graft scaphoid non-union Major £550.00 £285.00 Show arrow
W3202 Open reduction and internal fixation wedge reconstruction bone graft scaphoid non-union Major £550.00 £285.00 Show arrow
W3203 Early open reduction and internal fixation of scaphoid fracture ie within 6 weeks of fracture Major £550.00 £285.00 Show arrow
W6202 Partial fusion of wrist Intermediate £550.00 £357.00 Show arrow
W6200 Total fusion of all joints of wrist with or without graft and with or without internal fixation Major £550.00 £357.00 Show arrow
W5930 Fusion of digit joint(s) of hand with or without graft and with or without internal fixation Intermediate £300.00 £285.00 Show arrow


Other (eg amputation)

X0710 Forequarter amputation Complex £1,000.00 £499.00 Show arrow
X0720 Disarticulation of shoulder Xmajor £800.00 £571.00
X0750 Amputation of arm Major £400.00 £285.00 Show arrow
X0820 Partial amputation of digit Intermediate £300.00 £213.00 Show arrow
X0822 Amputation of whole ray Major £300.00 £213.00 Show arrow
X0880 Amputation through mid-carpal/transmetacarpal Intermediate £300.00 £213.00 Show arrow
X0910 Hindquarter amputation Complex £1,000.00 £571.00 Show arrow

16.7 - Shoulder

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information


Incision/excision

W0610 Total excision of cervical rib Major £600.00 £357.00 Show arrow
W0890 Excision distal clavicle, as sole procedure Major £450.00 £285.00 Show arrow


Repair/reconstruction

A7340 Exploration and grafting of brachial plexus Complex £1,000.00 £857.00 Show arrow
W4900 Shoulder hemiarthroplasty, as sole procedure Xmajor £650.00 £285.00 Show arrow
W4930 Revisional shoulder hemiarthroplasty Xmajor £700.00 £285.00 Show arrow
W5050 Reverse polarity arthroplasty of shoulder Xmajor £900.00 £428.00 Show arrow
W4902 Shoulder hemiarthroplasty with reconstruction for fracture Xmajor £700.00 £357.00 Show arrow
W5000 Primary total shoulder replacement Xmajor £800.00 £357.00 Show arrow
W5030 Revision total shoulder replacement Complex £1,000.00 £642.00 Show arrow
W4920 Conversion of hemiarthroplasty to total shoulder replacement Complex £800.00 £285.00 Show arrow
W5600 Primary repair of rupture of acromioclavicular or sternoclavicular joint +/- internal fixation Xmajor £750.00 £285.00 Show arrow
W5630 Secondary repair of acromioclavicular or sternoclavicular joint +/– internal fixation Xmajor £750.00 £285.00 Show arrow
W7713 Primary stabilisation of multi-directional instability of shoulder joint +/- tendon repair Major £550.00 £285.00 Show arrow
W7714 Primary open or arthroscopic shoulder stabilisation pocedure (including labral/SLAP/tendon repair) Major £600.00 £285.00 Show arrow
W7715 Corocoid bone block transfer for recurrent instability of shoulder (Bristow-Latarjet Procedure) Major £550.00 £285.00 Show arrow
W7780 Revision stabilisation of shoulder joint Xmajor £650.00 £357.00 Show arrow
W7810 Open arthrolysis of shoulder contracture +/- manipulation/injection Major £600.00 £285.00 Show arrow
W7872 Arthroscopic arthrolysis of shoulder contracture +/- manipulation/injection Major £600.00 £213.00 Show arrow
T7910 Open sub acromial decompression and rotator cuff repair +/- excision of distal clavicle Major £650.00 £428.00 Show arrow
T7915 Arthroscopic rotator cuff repair greater than 2cm Xmajor £750.00 £428.00 Show arrow
T7981 Extensive, greater than 2cm tear repair of large muscle including arthroscopic (excluding rotator cuff) Major £650.00 £428.00 Show arrow
T7982 Arthroscopic sub acromial decompression and rotator cuff repair (including arthroscopic procedures in glenohumeral joint) Major £550.00 £285.00 Show arrow
T7990 Revision of open or arthroscopic rotator cuff repair +/- decompression Major £600.00 £285.00 Show arrow
W8193 Arthroscopic subacromial decompression Major £550.00 £285.00 Show arrow
W8194 Arthroscopic sub-acromial decompression and excision of distal clavicle (including arthroscopic procedures in glenohumeral joint) Major £550.00 £285.00 Show arrow
W8603 Therapeutic arthroscopy of shoulder (as sole procedure) Major £550.00 £285.00 Show arrow
W8820 Diagnostic arthroscopic examination of shoulder joint, with or without biopsy (as sole procedure) Intermediate £250.00 £285.00 Show arrow
T6450 Tenodesis of biceps tendon (as sole procedure) Major £300.00 £213.00 Show arrow


Fixation/arthrodesis

W6012 Primary arthrodesis of joint with or without graft and with or without internal fixation – shoulder Major £700.00 £357.00 Show arrow
W6030 Revision or conversion to arthrodesis of shoulder Xmajor £600.00 £285.00 Show arrow
W2810 Repair of non-union of clavicle Major £550.00 £285.00 Show arrow
W4940 Scapulo-thoracic fusion Xmajor £650.00 £357.00 Show arrow
W9111 Manipulation of joint (including intra-articular injection) for “Frozen Shoulder” (as sole procedure) – bilateral Intermediate £200.00 £259.00 Show arrow
W9112 Manipulation of joint (including intra-articular injection) for “Frozen Shoulder” (as sole procedure) Minor £150.00 £194.00 Show arrow
W5031 2 Stage Revision of Total Shoulder Replacement For Infection - First Stage Complex £1,000.00 £642.00
W5032 2 stage revision of total shoulder replacement for infection - second stage Complex £1,000.00 £642.00

16.8 - Elbow

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information


Incision/excision

W5550 Excision of radial head (as sole procedure) Major £650.00 £357.00 Show arrow


Repair/reconstruction

W5510 Total prosthetic replacement of elbow Xmajor £800.00 £642.00 Show arrow
W5520 Revisional prosthetic replacement of elbow Complex £1,600.00 £714.00 Show arrow
T8050 Surgical release of humeral epicondylitis (lateral or medial) (eg “Tennis Elbow”) Intermediate £350.00 £285.00 Show arrow
W5560 OK (Outerbridge and Kashiwagi) procedure Major £550.00 £357.00 Show arrow
W5512 Prosthetic replacement of radial head Xmajor £800.00 £642.00 Show arrow
T6782 Repair of distal biceps tendon Major £400.00 £213.00 Show arrow
W7850 Open arthrolysis of elbow Major £350.00 £213.00 Show arrow
W7860 Arthroscopic arthrolysis of elbow (as sole procedure) Major £550.00 £285.00 Show arrow
W5502 Interposition arthroplasty of elbow Xmajor £650.00 £357.00 Show arrow
W5040 Replacement of elbow and shoulder (single operation) Complex £1,600.00 £883.00 Show arrow
W8880 Arthroscopy of elbow (as sole procedure) Major £550.00 £285.00 Show arrow

16.9 - Hip, leg and pelvis

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information


Incision/excision

W0702 Excision of ectopic bone around a total hip replacement Intermediate £200.00 £213.00 Show arrow
W7761 Repair of hip labral tear Major £550.00 £357.00 Show arrow


Repair, reconstruction and replacement

W1911 Core decompression of hip Major £700.00 £357.00 Show arrow
W3712 Primary total hip replacement with or without cement Xmajor £800.00 £499.00 Show arrow
W3713 Complex primary total hip replacement including bone grafting or femoral osteotomy Xmajor £800.00 £499.00 Show arrow
W3714 Total hip replacement, with or without cement, after excision arthroplasty or arthrodesis, including conversion of hemiarthroplasty or revision of other previous hip surgery which involved internal fixation Xmajor £800.00 £499.00 Show arrow
W3715 Hip resurfacing arthroplasty Xmajor £800.00 £499.00 Show arrow
W3716 Minimally invasive hip replacement (2 incisions) Xmajor £800.00 £499.00 Show arrow
W3717 Minimally invasive hip replacement (one incision) Xmajor £800.00 £499.00 Show arrow
W3719 Hip Resurfacing Arthroplasty - Bilateral Complex £1,200.00 £714.00 Show arrow
W3732 Revision of uncemented or cemented total hip replacement without adjunctive procedures Complex £1,600.00 £857.00 Show arrow
W3733 Revision of total hip replacement including insertion of reconstruction rings, plates, screws, etc., and/or impaction bone grafting to acetabulum and/or femur Complex £1,600.00 £857.00 Show arrow
W3740 Second, third or further revision total hip replacement (excluding acetabular liner and head changes) Complex £1,600.00 £857.00 Show arrow
W3741 Proximal Femoral Replacement Complex £1,600.00 £857.00 Show arrow
W3942 Removal of total hip replacement and creating a pseudarthrosis Xmajor £750.00 £571.00 Show arrow
W3943 Removal of total hip replacement and complete clearance of cement Complex £1,600.00 £857.00 Show arrow
W3944 Acetabular liner and head changes Complex £1,600.00 £857.00 Show arrow
W3780 Total prosthetic replacement of the hip, with or without cement, bilateral Complex £1,600.00 £714.00 Show arrow
W4600 Prosthetic replacement of head of femur Major £600.00 £357.00 Show arrow
W1700 Shelf augmentation of acetabulum, eg Wainwright or Trillat Xmajor £700.00 £1,071.00 Show arrow
T7930 Repair of abductor mechanism of hip Major £200.00 £259.00 Show arrow
W1648 Osteotomy/transfer of greater trochanter in isolation Xmajor £1,000.00 £357.00 Show arrow
W6600 Closed reduction of dislocated hip prosthesis Intermediate £300.00 £213.00 Show arrow
W6540 Open reduction of dislocated hip prosthesis Major £550.00 £285.00 Show arrow
W8800 Diagnostic arthroscopic examination of hip joint including wash-out, with or without biopsy (as sole procedure) Intermediate £500.00 £357.00 Show arrow
W8620 Therapeutic arthroscopy examination of hip joint, +/- biopsy Xmajor £700.00 £357.00 Show arrow


Fixation/arthrodesis

W6013 Primary arthrodesis of hip joint with or without graft and with or without internal fixation – hip Major £700.00 £357.00 Show arrow
W1640 Simple pelvic osteotomy and fixation eg Salter or Chiari osteotomies Major £1,000.00 £357.00 Show arrow
W1649 Complex pelvic osteotomies and fixation, eg triple osteotomy, peri-acetabular osteotomy Complex £1,000.00 £357.00 Show arrow
W1912 Pinning of head of femur – open or percutaneous (eg slipped femoral epiphysis, undisplaced neck fracture) Major £650.00 £357.00 Show arrow
W1913 Pinning for bilateral slipped upper femoral epiphysis Xmajor £700.00 £499.00 Show arrow
W3945 Open reduction and internal fixation for periprosthetic fracture around hip Xmajor £650.00 £357.00 Show arrow
W4542 Open reduction, internal fixation and revision of femoral component for peri-prosthetic fracture Complex £750.00 £285.00 Show arrow
W4543 Open reduction, internal fixation and complete revision for peri-prosthetic fracture Complex £800.00 £285.00 Show arrow


Other

X0930 Amputation of leg/foot (including Symes Lisfranc and Chopart) Major £550.00 £285.00 Show arrow
X2280 Manipulation of hip and casting (as sole procedure) Minor £400.00 £213.00 Show arrow
T6213 Soft tissue operations in the region of the greater trochanter (trochanteric bursitis, snapping hip) Major £200.00 £213.00 Show arrow
W9018 Percutaneous biopsy/ arthrography/ aspiration in assessment of total hip replacement Minor £100.00 £129.00 Show arrow
X2200 Closed reduction and Frog POP for congenital dislocation of hip (including dynamic arthrogram, traction and soft tissue release) Major £650.00 £428.00 Show arrow
X2260 Open reduction and Frog POP for congenital dislocation of hip (including traction and innominate/femoral osteotomy) Complex £1,000.00 £714.00 Show arrow
X2262 Complex open reduction for congenital dislocation of hip (i.e. pelvic and femoral or Pemberton osteotomy or revision of open reduction) Complex £1,300.00 £1,071.00 Show arrow
W3751 Customised unilateral hip replacement Extra Major £800.00 £499.00 Show arrow Show arrow
W3742 2 Stage Revision Of Total Hip Replacement For Infection - First Stage Complex £1,600.00 £857.00
W3743 2 Stage Revision Of Total Hip Replacement For Infection - Second Stage Complex £1,600.00 £857.00

16.10 - Knee

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information


Incision/excision

W5210 Revision of unicompartmental knee replacement Complex £850.00 £454.00 Show arrow
W5800 Conversion of a unicompartmental knee replacement to a total replacement of knee joint Complex £1,100.00 £519.00 Show arrow
W1660 Tibial osteotomy Major £550.00 £285.00 Show arrow


Repair/reconstruction

W3090 Core decompression of knee Major £700.00 £357.00 Show arrow
W3122 Harvesting for autologous chondrocyte transplantation into knee including arthroscopy Major £500.00 £285.00 Show arrow
W0633 Prosthetic replacement of Patellofemoral joint - bilateral (as sole procedure) Xmajor £1,100.00 £454.00 Show arrow
W7430 Reconstruction of lateral collateral ligament complex Major £650.00 £285.00 Show arrow
W7440 Allograft anterior cruciate ligament reconstruction Xmajor £750.00 £499.00 Show arrow
W7530 Repair of lateral collateral ligament complex Major £550.00 £285.00 Show arrow
W4210 Total prosthetic replacement of knee joint, with or without cement, +/– patella Xmajor £800.00 £499.00 Show arrow
W4244 Tibial liner exchange in total knee replacement Complex £1,200.00 £584.00 Show arrow
W4212 Minimally invasive knee replacement Complex £800.00 £499.00 Show arrow
W5200 Unicompartmental knee replacement Xmajor £750.00 £357.00 Show arrow
W5201 Unicompartmental knee replacement - bilateral Complex £1,150.00 £519.00 Show arrow
W4280 Total prosthetic replacement of knee joint – bilateral Complex £1,600.00 £714.00 Show arrow
W4230 Revision of total replacement of knee joint Complex £1,600.00 £714.00 Show arrow
W4200 Complex primary total knee replacement (ie including bone graft, augmentation or osteotomy) Complex £800.00 £499.00 Show arrow
W4240 2 stage revision of total knee replacement for infection – first stage Xmajor £1,600.00 £714.00 Show arrow
W4242 2 stage revision of total knee replacement for infection – second stage Xmajor £1,600.00 £714.00 Show arrow
W7580 Open surgical stabilisation of patella, including soft tissue/tendon transfer or release, +/- application of cast (adult) Xmajor £700.00 £357.00 Show arrow
W7582 Open surgical stabilisation of patella, including soft tissue/tendon transfer or release, +/- application of cast (child) Xmajor £700.00 £357.00 Show arrow
W7451 2 stage revision anterior cruciate ligament reconstruction - first stage Major £550.00 £357.00 Show arrow
W7452 2 stage revision anterior cruciate ligament reconstruction - second stage Major £750.00 £454.00 Show arrow
W0632 Prosthetic patello-femoral replacement (as sole procedure) Major £750.00 £357.00 Show arrow
W7583 Repair of patellar/quadricep tendon Major £450.00 £285.00 Show arrow
W8520 Arthroscopy of knee (including examination under anaesthetic, washout and biopsy) (as sole procedure) Intermediate £550.00 £357.00 Show arrow
W8200 Arthroscopic meniscectomy (including debridement) Major £550.00 £357.00 Show arrow
W8280 Arthroscopic meniscectomy (including debridement) – bilateral Complex £800.00 £499.00 Show arrow
W8500 Multiple arthroscopic operation on knee (including meniscectomy, chondroplasty, drilling or microfracture) Major £550.00 £357.00 Show arrow
W8580 Multiple arthroscopic operation on knee (including meniscectomy, chondroplasty, drilling or microfracture) ? bilateral Complex £800.00 £499.00 Show arrow
W8230 Arthroscopic meniscal repair Major £650.00 £357.00 Show arrow
W7492 Open/arthroscopic lateral release Intermediate £450.00 £285.00 Show arrow
W0630 Patellectomy Major £450.00 £213.00 Show arrow
W8400 Repair of knee ligaments (open or arthroscopic) Major £550.00 £285.00 Show arrow
W7420 Autograft anterior cruciate ligament reconstruction (including arthroscopic and meniscectomy) Xmajor £750.00 £499.00 Show arrow
W8240 Meniscal allograft transplantation Xmajor £800.00 £389.00 Show arrow
W7490 Reconstruction of posterior lateral corner of knee Major £450.00 £285.00 Show arrow
W7410 Multiple ligament reconstruction of knee including posterior cruciate ligament Complex £1,000.00 £499.00 Show arrow
W7470 Revision of anterior cruciate ligament reconstruction including autograft/allograft Xmajor £800.00 £499.00 Show arrow
W7480 Posterior cruciate ligament reconstruction including arthroscopic Xmajor £700.00 £499.00 Show arrow


Fixation/arthrodesis

W6014 Primary arthrodesis of knee joint with or without graft and with or without internal fixation Major £700.00 £357.00 Show arrow
W5810 Patella resurfacing (as sole procedure) Major £350.00 £259.00
W7430 Reconstruction of lateral collateral ligament complex Major £650.00 £285.00 Show arrow

16.11 - Foot

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information




Ankle

W5790 Repair to plantar plate Major £550.00 £259.00 Show arrow
T6720 Tendo Achilles lengthening percutaneous Intermediate £350.00 £213.00 Show arrow
T6722 Tendo Achilles lengthening primary open Major £350.00 £213.00 Show arrow
T6723 Tendo Achilles lengthening repeat procedure Major £350.00 £213.00 Show arrow
T6780 Primary repair of Achilles tendon Intermediate £400.00 £213.00 Show arrow
T6810 Delayed or Secondary Repair Of Achilles Tendon Without Tendon Or Fascial Graft Major £550.00 £194.00 Show arrow
T6822 Delayed or secondary repair of Achilles tendon with tendon or fascial graft Xmajor £650.00 £213.00 Show arrow
W8840 Diagnostic arthroscopic examination of ankle including anterior synovectomy to gain vision (as sole procedure) Intermediate £250.00 £285.00 Show arrow
W7880 Open or arthroscopic release of ankle joint contracture (excluding Achilles tendon lengthening) Major £550.00 £357.00 Show arrow
W4410 Total prosthetic replacement of ankle joint Xmajor £750.00 £357.00 Show arrow
W4420 Complex total replacement of ankle (ie including custom prosthesis, wedges, internal fixation of fractures) Complex £750.00 £357.00 Show arrow
W4430 Revision of total prosthetic replacement of ankle joint Complex £1,000.00 £642.00 Show arrow
T6770 Peroneal sling/groove reconstruction and replacement of dislocated peroneal tendons Major £400.00 £213.00 Show arrow
W7530 Repair of lateral collateral ligament complex Major £550.00 £285.00 Show arrow
W7430 Reconstruction of lateral collateral ligament complex Major £650.00 £285.00 Show arrow
W6015 Ankle arthrodesis – open Intermediate £650.00 £285.00 Show arrow
W6016 Ankle arthrodesis with autogenous graft Intermediate £600.00 £285.00 Show arrow
W6017 Ankle arthrodesis with internal fixation (arthroscopic) Intermediate £750.00 £285.00 Show arrow
W6018 Ankle arthrodesis – revision, including converstion from total ankle replacement Intermediate £600.00 £285.00 Show arrow
W6019 Ankle syndesmosis reconstruction Complex £1,000.00 £714.00 Show arrow


Hind foot and mid foot

W8850 Diagnostic subtalar arthroscopy including synovectomy to gain vision (as sole procedure) Intermediate £300.00 £213.00 Show arrow
W8650 Therapeutic sub-talar arthroscopy additional to synovectomy to gain vision Major £550.00 £285.00 Show arrow
W0432 Isolated sub talar fusion or mid foot fusion with autogenous graft (adult) Major £650.00 £285.00 Show arrow
W0434 Isolated sub talar fusion or mid foot fusion without autogenous graft (adult) Major £650.00 £285.00 Show arrow
W0420 Triple fusion of joints of hindfoot without autogenous graft Major £650.00 £285.00 Show arrow
W0422 Triple fusion of joints of hindfoot with autogenous graft Major £700.00 £285.00 Show arrow
W0460 Complex procedure to mid foot or hind foot without autogenous bone graft (osteotomy/fusion +/? tendon transfers) Xmajor £750.00 £357.00 Show arrow
W0462 Complex procedure to mid foot or hind foot with autogenous bone graft (osteotomy/fusion +/- tendon transfers/fixation) Xmajor £800.00 £357.00 Show arrow
W0463 Complex procedure to mid foot and hind foot without autogenous graft (osteotomy/fusion +/? tendon transfers/fixation) Complex £800.00 £357.00 Show arrow
W0464 Complex procedure to mid foot and hind foot with autogenous graft (including osteotomy, fusion +/? tendon transfers, fixation) Complex £1,000.00 £499.00 Show arrow


Forefoot

W0300 Multiple procedures on forefoot, distal to and including the tarsometatarsal joints, which involves at least two distinct procedures not intrinsic to each other Xmajor £650.00 £357.00 Show arrow
W0310 Multiple procedures on forefoot, distal to and including the tarsometatarsal joints, which involves at least two distinct procedures not intrinsic to each other - bilateral Complex £1,000.00 £499.00 Show arrow
W1590 Correction of retracted/dislocated metatarso-phalangeal joint including tendon transfer, division/realignment of bone and internal fixation Major £550.00 £357.00 Show arrow
W1040 Osteotomy of short bone of foot (excluding hallux valgus and including internal fixation) Intermediate £500.00 £285.00 Show arrow


Hallux

W0860 Metatarso-phalangeal cheilectomy - unilateral, as sole procedure Major £450.00 £213.00 Show arrow
W0861 Metatarso-phalangeal cheilectomy - bilateral, as sole procedure Xmajor £700.00 £357.00 Show arrow
W7910 Metatarsal osteotomy (e.g. scarf) for Hallux valgus, +/- internal fixation and soft tissue correction Major £550.00 £357.00 Show arrow
W7980 Metatarsal osteotomy (e.g. scarf) for Hallux valgus, +/- internal fixation and soft tissue correction - bilateral Xmajor £650.00 £428.00 Show arrow
W5700 Excision arthroplasty of first metatarso-phalangeal joint with prosthetic implantation or interposition arthroplasty Major £500.00 £285.00 Show arrow
W5701 Excision arthroplasty of first metatarso-phalangeal joint with prosthetic implantation or interposition arthroplasty – bilateral Xmajor £800.00 £428.00 Show arrow
W5710 Excision arthroplasty of first metatarso-phalangeal joint, (e.g. Keller, Bonney-Kessel procedures) including cheilectomy Intermediate £350.00 £213.00 Show arrow
W5780 Excision arthroplasty of first metatarso-phalangeal joint, (e.g. Keller, Bonney-Kessel procedures) including cheilectomy - bilateral Major £550.00 £357.00 Show arrow
W0321 Osteotomy/ies (eg Scarf and Akin) for Hallux Valgus correction with or without internal fixation and soft tissue correction Major £600.00 £357.00 Show arrow
W0322 Osteotomy/ies (eg Scarf and Akin) for Hallux Valgus correction with or without internal fixation and soft tissue correction - bilateral Xmajor £800.00 £454.00 Show arrow
W0330 Fusion of first metatarso-phalangeal joint Intermediate £450.00 £213.00 Show arrow
W0380 Fusion of first metatarso-phalangeal joint – bilateral Major £650.00 £357.00 Show arrow
W5920 Fusion of first metatarso-phalangeal joint with bone grafting +/- internal fixation (as sole procedure) Intermediate £450.00 £213.00 Show arrow


Toes

T6460 Tendon transfer of toe – unilateral Intermediate £300.00 £213.00 Show arrow
T6461 Tendon transfer of toe – bilateral Major £450.00 £285.00 Show arrow
W5940 Fusion of interphalangeal joint(s) of toe (including internal fixation) Intermediate £300.00 £213.00 Show arrow
W5980 Fusion of interphalangeal joint(s) of toe (including internal fixation) – bilateral Major £500.00 £357.00 Show arrow
W0881 Excision of joint of toe with release of contracture and soft tissue correction Major £550.00 £357.00 Show arrow
T6462 Excision or partial excision of IP joint of lesser toe with tendon transfer Intermediate £450.00 £213.00 Show arrow


General foot

T6762 Repair of tendon of foot - flexor Minor £150.00 £194.00 Show arrow
W7900 Excision of medial eminence 1st or 5th MT head with soft tissue repair (bunionectomy) Intermediate £200.00 £213.00 Show arrow
T6763 Repair of tendon of foot – extensor Minor Minor £150.00 £194.00 Show arrow
X1110 Amputation of toe Intermediate £300.00 £213.00 Show arrow
X0822 Amputation of whole ray Major £300.00 £213.00 Show arrow
X0930 Amputation of leg/foot (including Symes Lisfranc and Chopart) Major £550.00 £285.00 Show arrow
W8645 Multiple arthroscopic operations on ankle (including soft tissue, bony and/or joint surface procedures with ligament reconstruction). Major £550.00 £285.00 Show arrow
W8646 Multiple arthroscopic operations on ankle (including soft tissue, bony and/or joint surface procedures without ligament reconstruction) Major £500.00 £259.00 Show arrow

16.12 - External fixation/traction

Code Description Complexity Procedure fees Fee for general anaesthesia
Unacceptable Combinations
Additional Information


W2910 Application of skeletal traction to bone Minor £200.00 £213.00 Show arrow
W2930 Removal of skeletal traction from bone Minor £150.00 £142.00 Show arrow
W3010 Application of external fixation to bone Major £500.00 £213.00 Show arrow
W3030 Removal of external fixation from bone Minor £200.00 £142.00 Show arrow



Back to chapter list