CMS has expanded the list of procedures ASCs can bill for, adding 168 orthopedic codes, which could significantly broaden the scope of cases centers are eligible to perform and get reimbursed for.
Here are the 168 orthopedic codes CMS added to the ASC-covered procedures list in January:
| CPT code | Description |
| 20100 | Exploration of penetrating wound – neck |
| 20101 | Exploration of penetrating wound – chest |
| 20102 | Exploration of penetrating wound – abdomen/flank/back |
| 20660 | Application of cranial tongs/caliper/stereotactic frame |
| 20661 | Application of cranial halo (with removal) |
| 20664 | Application of cranial halo – 6+ pins (thin skull/pediatric) |
| 20802 | Replantation – arm (complete amputation) |
| 20805 | Replantation – forearm (complete amputation) |
| 20808 | Replantation – hand (complete amputation) |
| 20816 | Replantation – finger (excluding thumb) |
| 20824 | Replantation – thumb (carpometacarpal to metacarpophalangeal joint) |
| 20827 | Replantation – thumb (distal tip to MP joint) |
| 20838 | Replantation – foot (complete amputation) |
| 20955 | Bone graft with microvascular anastomosis – fibula |
| 20956 | Bone graft with microvascular anastomosis – iliac crest |
| 20957 | Bone graft with microvascular anastomosis – metatarsal |
| 20962 | Bone graft with microvascular anastomosis – other |
| 20969 | Free osteocutaneous flap with microvascular anastomosis – other |
| 20970 | Free osteocutaneous flap with microvascular anastomosis – iliac crest |
| 23200 | Radical resection of tumor – clavicle |
| 23210 | Radical resection of tumor – scapula |
| 23220 | Radical resection of tumor – proximal humerus |
| 23335 | Removal of total shoulder prosthesis (humeral and glenoid) |
| 23473 | Revision of total shoulder arthroplasty – one component |
| 23474 | Revision of total shoulder arthroplasty – both components |
| 23900 | Interthoracoscapular (forequarter) amputation |
| 23920 | Disarticulation of shoulder |
| 24150 | Radical resection of tumor – shaft or distal humerus |
| 24900 | Amputation – arm through humerus, primary closure |
| 24920 | Amputation – arm through humerus, open/guillotine |
| 24930 | Amputation – arm through humerus, re-amputation |
| 24931 | Amputation – arm through humerus, with implant |
| 24935 | Stump elongation – upper extremity |
| 24940 | Cineplasty – upper extremity |
| 25170 | Radical resection of tumor – radius or ulna |
| 25900 | Amputation – forearm (radius and ulna) |
| 25905 | Amputation – forearm, open/guillotine |
| 25909 | Amputation – forearm, re-amputation |
| 25915 | Krukenberg procedure |
| 25920 | Disarticulation through wrist |
| 25924 | Disarticulation through wrist – re-amputation |
| 25927 | Transmetacarpal amputation |
| 26551 | Toe-to-hand transfer with microvascular anastomosis – great toe wrap-around |
| 26553 | Toe-to-hand transfer – single (other than great toe) |
| 26554 | Toe-to-hand transfer – double (other than great toe) |
| 26556 | Free toe joint transfer with microvascular anastomosis |
| 27005 | Tenotomy – hip flexor(s), open |
| 27025 | Fasciotomy – hip or thigh |
| 27027 | Decompression fasciotomy – pelvic/buttock compartment(s) |
| 27030 | Arthrotomy – hip, with drainage (e.g., infection) |
| 27036 | Capsulectomy/capsulotomy – hip with hip flexor release |
| 27054 | Arthrotomy with synovectomy – hip |
| 27057 | Decompression fasciotomy – pelvic/buttock with muscle debridement |
| 27070 | Partial excision – iliac wing/symphysis/greater trochanter, superficial |
| 27071 | Partial excision – iliac wing/symphysis/greater trochanter, deep |
| 27075 | Radical resection of tumor – iliac wing or single pubic/ischial ramus |
| 27076 | Radical resection of tumor – ilium including acetabulum or pubic rami |
| 27077 | Radical resection of tumor – total innominate bone |
| 27078 | Radical resection of tumor – ischial tuberosity and greater trochanter |
| 27090 | Removal of hip prosthesis |
| 27091 | Removal of total hip prosthesis (complicated) |
| 27120 | Acetabuloplasty |
| 27122 | Acetabuloplasty – resection of femoral head (Girdlestone) |
| 27125 | Partial hip arthroplasty (hemiarthroplasty) |
| 27132 | Conversion of prior hip surgery to total hip arthroplasty |
| 27134 | Revision of total hip arthroplasty – both components |
| 27137 | Revision of total hip arthroplasty – acetabular component only |
| 27138 | Revision of total hip arthroplasty – femoral component only |
| 27140 | Osteotomy and transfer of greater trochanter of femur |
| 27146 | Iliac/acetabular/innominate osteotomy |
| 27147 | Iliac osteotomy with open hip reduction |
| 27151 | Iliac osteotomy with femoral osteotomy |
| 27156 | Iliac osteotomy with femoral osteotomy and open hip reduction |
| 27158 | Bilateral pelvic osteotomy (e.g., congenital malformation) |
| 27161 | Femoral neck osteotomy |
| 27165 | Intertrochanteric/subtrochanteric osteotomy with fixation |
| 27170 | Bone graft – femoral head/neck/trochanteric area |
| 27175 | Treatment of slipped femoral epiphysis by traction (no reduction) |
| 27176 | Treatment of slipped femoral epiphysis – pinning in situ |
| 27177 | Open treatment of slipped femoral epiphysis – pinning or bone graft |
| 27178 | Open treatment of slipped femoral epiphysis – closed manipulation with pinning |
| 27179 | Open treatment of slipped femoral epiphysis – osteoplasty of femoral neck |
| 27181 | Open treatment of slipped femoral epiphysis – osteotomy with fixation |
| 27185 | Epiphyseal arrest – greater trochanter |
| 27187 | Prophylactic treatment – femoral neck and proximal femur |
| 27222 | Closed treatment of acetabular fracture with manipulation |
| 27226 | Open treatment of acetabular wall fracture with internal fixation |
| 27227 | Open treatment of acetabular fracture – anterior or posterior column |
| 27228 | Open treatment of acetabular fracture – anterior and posterior columns |
| 27232 | Closed treatment of femoral neck fracture with manipulation |
| 27235 | Percutaneous fixation of femoral neck fracture |
| 27236 | Open treatment of femoral neck fracture with internal fixation or prosthetic replacement |
| 27240 | Closed treatment of intertrochanteric/subtrochanteric fracture with manipulation |
| 27244 | Treatment of intertrochanteric/subtrochanteric fracture – plate/screw implant |
| 27245 | Treatment of intertrochanteric/subtrochanteric fracture – intramedullary implant |
| 27248 | Open treatment of greater trochanteric fracture with internal fixation |
| 27253 | Open treatment of traumatic hip dislocation (no internal fixation) |
| 27254 | Open treatment of traumatic hip dislocation with acetabular/femoral head fracture |
| 27258 | Open treatment of spontaneous hip dislocation – femoral head replacement |
| 27259 | Open treatment of spontaneous hip dislocation with femoral shortening |
| 27268 | Closed treatment of femoral head fracture with manipulation |
| 27269 | Open treatment of femoral head fracture with internal fixation |
| 27280 | Arthrodesis – sacroiliac joint, open |
| 27282 | Arthrodesis – symphysis pubis |
| 27284 | Arthrodesis – hip joint |
| 27286 | Arthrodesis – hip joint with subtrochanteric osteotomy |
| 27290 | Hindquarter (interpelviabdominal) amputation |
| 27295 | Disarticulation of hip |
| 27303 | Deep incision with bone cortex opening – femur or knee (e.g., osteomyelitis) |
| 27365 | Radical resection of tumor – femur or knee |
| 27448 | Femoral shaft/supracondylar osteotomy without fixation |
| 27450 | Femoral shaft/supracondylar osteotomy with fixation |
| 27454 | Multiple femoral osteotomies with intramedullary rod realignment (Sofield-type) |
| 27455 | Proximal tibial osteotomy (genu varus/valgus correction) – before epiphyseal closure |
| 27457 | Proximal tibial osteotomy – after epiphyseal closure |
| 27458 | Femoral osteotomy(ies) with externally controlled intramedullary lengthening device |
| 27465 | Osteoplasty of femur – shortening |
| 27466 | Osteoplasty of femur – lengthening |
| 27470 | Repair of femoral nonunion or malunion without graft |
| 27472 | Repair of femoral nonunion or malunion with bone graft |
| 27477 | Epiphyseal arrest – proximal tibia and fibula |
| 27485 | Hemi-epiphyseal arrest – distal femur or proximal tibia/fibula |
| 27486 | Revision of total knee arthroplasty – 1 component |
| 27487 | Revision of total knee arthroplasty – femoral and full tibial components |
| 27488 | Removal of total knee prosthesis (with or without spacer insertion) |
| 27495 | Prophylactic treatment – femur (nailing, pinning, plating) |
| 27506 | Open treatment of femoral shaft fracture with intramedullary implant |
| 27507 | Open treatment of femoral shaft fracture with plate/screws |
| 27511 | Open treatment of supracondylar/transcondylar femoral fracture (no intercondylar extension) |
| 27513 | Open treatment of supracondylar/transcondylar femoral fracture with intercondylar extension |
| 27514 | Open treatment of distal femoral condyle fracture |
| 27519 | Open treatment of distal femoral epiphyseal separation |
| 27535 | Open treatment of tibial plateau fracture – unicondylar |
| 27536 | Open treatment of tibial plateau fracture – bicondylar |
| 27540 | Open treatment of tibial intercondylar spine/tuberosity fracture |
| 27556 | Open treatment of knee dislocation without ligament repair |
| 27557 | Open treatment of knee dislocation with ligament repair |
| 27558 | Open treatment of knee dislocation with ligament repair and reconstruction |
| 27580 | Arthrodesis – knee |
| 27590 | Amputation – thigh through femur |
| 27591 | Amputation – thigh, immediate fitting technique with first cast |
| 27592 | Amputation – thigh, open/guillotine |
| 27596 | Amputation – thigh, re-amputation |
| 27598 | Disarticulation at knee |
| 27645 | Radical resection of tumor – tibia |
| 27646 | Radical resection of tumor – fibula |
| 27703 | Revision of total ankle arthroplasty |
| 27712 | Multiple tibial osteotomies with intramedullary rod realignment (Sofield-type) |
| 27713 | Tibial (and fibular) osteotomy(ies) with externally controlled intramedullary lengthening device |
| 27715 | Osteoplasty – tibia and fibula lengthening or shortening |
| 27722 | Repair of tibial nonunion or malunion – sliding graft |
| 27724 | Repair of tibial nonunion or malunion – iliac or other autograft |
| 27725 | Repair of tibial nonunion or malunion – synostosis with fibula |
| 27727 | Repair of congenital pseudarthrosis – tibia |
| 27880 | Amputation – leg through tibia and fibula |
| 27881 | Amputation – leg, immediate fitting with first cast |
| 27882 | Amputation – leg, open/guillotine |
| 27886 | Amputation – leg, re-amputation |
| 27888 | Ankle amputation through malleoli (Syme/Pirogoff-type) |
| 28360 | Reconstruction of cleft foot |
| 28800 | Midtarsal foot amputation (Chopart-type) |
| 28805 | Transmetatarsal foot amputation |
| 1003T | Arthroplasty – first carpometacarpal joint total replacement |
| 0202T | Posterior vertebral joint(s) arthroplasty – lumbar (facet replacement) |
| G0412 | Open treatment of iliac spine/wing fracture (no pelvic ring disruption) |
| G0413 | Percutaneous fixation of posterior pelvic fracture/dislocation (pelvic ring disruption) |
| G0414 | Open treatment of anterior pelvic fracture/dislocation (pelvic ring disruption) |
| G0415 | Open treatment of posterior pelvic fracture/dislocation (pelvic ring disruption) |
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
