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December 2016 Texas Medicaid Provider Procedures Manual

Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook : 9 Physician : 9.2 Services, Benefits, Limitations, and Prior Authorization : 9.2.69 Surgery Billing Guidelines : 9.2.69.9 Orthopedic Hardware

9.2.69.9
Reimbursement for the orthopedic hardware (e.g., buried wire, pin, screw, metal band, nail, rod, or plate) is part of the surgeon’s global fee or the facility’s payment group. The hardware is not reimbursed separately to either the surgeon or the facility.
The removal of orthopedic hardware is not payable to the same provider who inserted it, if removed within the global operative care period of the original insertion.
Services for removal of orthopedic hardware may be reimbursed separately after the global post operative care period.

Texas Medicaid & Healthcare Partnership
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