cpt code for open acl reconstruction with hamstring autograft

Drill endobutton tunnel with endobutton drill. This is to make sure you can move your knee as fully as possible before your operation. Postoperative images showing quadriceps tendon autograft scar and range of motion. If the tendon is harvested from the same extremity, the harvest is included in the definition and payment for the ACL code 29888. Soft-tissue. Arthroscopic ACL Reconstruction: Hamstring Versus Quadriceps June 7, 2020. Ensure interference screw is not divergent. Am J Sports Med. Thank you! It is not intended for the general public. My appointment with Dr. Vaksha was amazing. Physician specialties with the happiest marriages, 'Like he was passing out candy': Former physician pleads guilty to fraud charges, 15 things to know about the 3 biggest ASC chains, New York physician sues employer for alleged bias. Would you like email updates of new search results? A divergence angle >30 from the bone block results in lower failure loads. Hamstring autograft versus patellar tendon autograft for : Medicine PDF Hamstring Graft Preparation Techniques for Anterior Cruciate Ligament Brand new office, same great doctors! Cpt Code For Acl Reconstruction With Allograft PDF Download May 1st, 2018 - Cpt Code For Acl Reconstruction With Allograft Acl reconstruction with allograft vs autograft aapc i would really appreciate your assistance with clarification when an acl reconstruction is performed 29888 is the Chronic Distal Biceps Repair With an Achilles Allograft eCollection 2022 Apr-Jun. It allows Mary Ann do the things that she likes to do, even on a limited basis for a while. after harvest you should note muscle fibers coming off both sides of tendon. Before The patient is a 17-year-old male, who had previously undergone anterior cruciate ligament (ACL) reconstruction. CPT Code: 29888 Anterior cruciate ligament reconstruction ( ACL reconstruction) is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after anterior cruciate ligament injury. He listens to everything and explains everything I recommend him to everyone. The staff was super friendly and down to earth. PDF Lifenet Posterior Tendon Allograft Cpt Code - ispar.hkapa.edu Outside-in technique versus inside-out semitendinosus graft harvest technique in ACLR: a randomised control trial. The semitendinosus hamstring tendon on the inner side of the knee is used in creating the hamstring tendon autograft for ACL reconstruction. ACL Reconstruction - Quadriceps Tendon Autograft Three cases required ACL reconstruction using the Semi-T hybrid autografts. There are pros and cons associated with each type of graft. The work associated with this is included in the payment for CPT 29888. ACL repair with hamstring autograft | Medical Billing and Coding - AAPC synonyms: ACL repair, ACL reconstruction, anterior cruciate reconstruction, ACL Reconstruction Pre-op Planning / Graft Considerations, ACL Bone-Patellar Tendon-Bone (BTB) Reconstruction Technique, Site Terms | Copyright Information | ContactUs | Site Registration. Scheduling my appointment was quick and easy. 2012 Oct;28(10):1481-9. doi: 10.1016/j.arthro.2012.03.019. cpt code for open acl reconstruction with hamstring autograft Reconstruction of the ACL (anterior cruciate ligament) and repair of a torn meniscus are among the most commonly performed arthroscopic surgeries. A/P view: center of the tibial attachment should be just lateral to the exact center of the tibia. Great staff. Autograft diameter in ACL reconstruction: size does matter - SICOT-J Great experience, the Doctor is nice but the staff is incredible. -, Ma C.B., Keifa E., Dunn W., Fu F.H., Harner C.D. Xie X, Liu X, Chen Z, Yu Y, Peng S, Li Q. Knee. Femoral Tunnel: should be as far posterior as possible preserving a 1-2mm cortical rim posteriorly. Allografts in patients aged 30 or less have been associated with early graft failure. (Battaglia TC, Arthroscopy. Unauthorized use of these marks is strictly prohibited. [(7#wV]4hM+VQ74^5pZYrF~4ag=r,NW 9KKgAE~A)3:G. JavaScript is disabled. Epub 2014 Dec 11. ACL reconstruction with hamstring tendon autograft and accelerated My own experience with Dr karkare has been wonderful he takes his time with you listens to what you have to say and prescribes various treatments and is very caring I would highly recommend him to anyone I would give both doctors a 10 plus rating we are very happy with them the best. The location of the graft site may not help and cause morbidity. A surgeon performs an anterior cruciate ligament (ACL) repair (29888), a lateral meniscectomy (29881), and a synovectomy (29876) in the patella and medial compartments. ]}yk +dG@M._Gu- '3{YtbJ*"~\F{,5"TF[ Ux*j*V]bXD) n_EX*,6=v We set up a consultation and my wife and I left his office feeling totally confident and comfortable with moving ahead with the surgery. Thank you very much to everyone who replied. The https:// ensures that you are connecting to the JCM | Free Full-Text | Clinical Research Progress of Internal Brace Olivos-Meza A, Suarez-Ahedo C, Jimnez-Aroche CA, Pantanali N, Valdez-Chvez MV, Prez-Jimnez FJ, Olivos-Daz B, Olivos-Grces NA, Gonzlez-Hernndez A, Ibarra C. Arthrosc Tech. April 28th, 2018 - Tibialis Anterior or Posterior Allograft Anterior Cruciate Ligament Reconstruction Versus Hamstring Autograft procedure code OR times in this study were de?ned as . 2015 Mar;22(2):100-10. doi: 10.1016/j.knee.2014.11.014. doi: 10.2106/JBJS.ST.20.00053. Home Knee Anterior Cruciate Ligament ACL Surgery Allograft vs Autograft. The allograft is readily available and comes in different sizes. Currently, CPT code 29876 bundles with 29888. For example, you may not be able to completely straighten or bend your leg as far as the other leg. Over the past decade, use of allografts has risen as processing of grafts has improved its safety profile. He takes time to listen and offer suggestions to help you get better. I he was amazing he made me feel very comfortable and explained everything that was going to happen from surgery all the way through my physical therapy highly recommend Dr. Vaksha. usually has 180 twist in graft after screw placement, WB in extension for 6wks to protect donor sight, Pre-operative antibiotics, +/- regional block. The torn ligament is removed from the knee before the graft is inserted . Epub 2019 May 16. Dr.VAksha is the best, I love the way he treats me as his patient, he is caring,understanding and very attentive to my needs. My orthopedic doctor kept recommending knee replacement . The surgeon drills small holes into the upper and lower leg bones where these bones come close together at the knee joint. PMC Copyright - St. George Surgical Center -, ChondroplastyCartilage Debridement (Arthroscopic). Total knee replacement was the only viable option. Accessibility Combined hamstrings and peroneus longus tendon for undersized graft in anterior cruciate ligament reconstruction: A report of two adolescence female patients. Knee brace may be removed when non-weight bearing. Author links open overlay panel Derek N. Pamukoff a, Melissa M. Montgomery a, Skylar C. Holmes a, Tyler J. Moffit a, Steven A. Garcia a, Michael N. Vakula b. After 1wk may begin low-resistance stationalry bike out of brace, quad sets, straight leg raises, early hamstring resistance exercises, closed-chain exercises with elastic cord. Recovery To care for your incision while it heals, you need to keep it clean and dry and watch for signs of infection. Bone grafting is commonly reported using iliac crest autograft and allograft bone chips and dowels, while hamstring autograft and BPTB autograft were the most utilized grafts during the second-stage definitive reconstruction. 2020 Jan 23;9(1):e191-e198. Arthroscopy. Ql#Q1ED[ Sterile saline (salt) solution is pumped into the knee through one incision to expand it and to wash blood from the area. It was the afternoon of Friday Sept. 24. Tibial Tunnel: Center should be along a line from the (1)posterior edge of anterior horn of the lateral meniscus, (2)just breach the lateral portion of the medial tibial spine, (3)7mm anterior to PCL(which gives 1-2mm wall after 10mm tunnel is reamed), (4)posterior aspect of tibial stump footprint. The quadriceps tendon is a thick tissue located above the patella or kneecap. All rights reserved. Although the irradiation kills any infectious agent, there might still be a possibility of transmission of a disease agent. ACL reconstruction usually would be considered medically necessary and covered by health insurance. I completed my MBBS (Bachelor of Medicine & Bachelor of Surgery) at Govt. 3-4mm offset femoral tunnel guide used to place guide wire in the 11oclock position for right knee. check alignment, joint space and patella alignment. ACL surgery is defined by CPT 29888 (Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction). There is no better Orthopedic doctor you will find. T84.490S is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. triangular tibial plug 9mmx20mm for femoral tunnel, trapezoidal patellar plug 10mmx25mm for tibial tunnel, 230 oscillating sawblade start distally to avoid blood in field, 7mm anterior to PCL, posterior edge anterior horn LM, posterior to notch in extension, ellipiticises anterolatcially to ease graft placement. graft should be 9-10mm wide or 1/3 of tendon width. 8months=if 90% of hamstring and quadriceps strength have been regained and patient has full unrestricted ROM they may return to full, unrestricted sport with functional knee brace. It may not display this or other websites correctly. PDF Acl Reconstruction With Allograft Cpt Code - annualreport.psg.fr JCM | Free Full-Text | Femoral Tunnel Position Affects Postoperative Allograft may be from a cadaveric achilles tendon, tibialis anterior/posterior tendon, hamstrings or patellar tendon. Both autograft and allograft are safe options for ACL reconstruction but the ultimate decision for the graft type may depend upon the patients needs and anatomy. This allows the doctor to see the knee structures more clearly. This involves harvesting a piece of bone from the patella (kneecap), the central 1cm of the patellar tendon, and a piece of bone from the tibia to create the new ACL. Price: $7,931 CPT Code: 29888 Anterior cruciate ligament reconstruction ( ACL reconstruction) is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after anterior cruciate ligament injury. Association between gait mechanics and ultrasonographic measures of femoral cartilage thickness in individuals with ACL reconstruction. 16. ACL Hamstring Tendon Autograft Reconstruction Protocol . I appreciate the guidance and knowledge you have shared. For patients not covered by health insurance, the cost of ACL reconstruction, including the surgeon's fee, facility fee, anesthesia and graft, if needed, ranges from just under $20,000 to $50,000. ACL reconstruction - Mayo Clinic After a thorough examination and given exercises to do at home , I am feeling much better , and I ended up avoiding surgery . This site needs JavaScript to work properly. Anterior cruciate ligament (ACL) reconstruction is one of the most common orthopedic surgeries. If your child or adolescent has open growth plates and an ACL tear, talk to the surgeon about the risks and benefits of surgery, as the growth plates can be avoided with certain surgical techniques. Arthrosc Tech 2012;1:e165-e168. Caracciolo G, Yez R, Silvestre R, De la Fuente C, Zamorano H, Ossio A, Strmbck L, Abusleme S, P Carpes F. J Exp Orthop. Very friendly office and I'm glad to be a patient here. (for hamstring tendon autograft procedure only) Hamstring curls - add weight as tolerated (for patellar tendon autograft procedure only) Heel slides (to 90 only for hamstring tendon autograft procedure) Quad sets (consider NMES for poor quad sets) Gastroc/Soleus stretching Complete Ortho should be complimented for having such a person on their staff.I highly recommend this place!!! 2011;60:499-521, Driscoll MD, Isabell GP Jr, Conditt MA, Ismaily SK, Jupiter DC, Noble PC, Lowe WR. While a robust tendon a good source for an ACL autograft the quadriceps tendon hasn't been used or researched as much as other graft sources. Dr. Karkare is very knowledgeable, helpful, and caring. Daniel J. Prohaska, M.D. Surgical instruments are inserted through other small incisions. (Kenna B Arthroscopy 1993;9:228-230), tibial tunnel length = tendon length + tibial bone plug length intraarticular distance(usually 23-30mm) (Fineberg Arthroscopy 2000;16:715-724): Indirect method of measurement = add 7 degrees to the length of tendinous portion of the graft and use this number for the tibial guide angle (Miller MD, Arthroscopy 1996;12:124-126). Dr. Vaksha was very thorough and kind. Board Certified Surgeon & Anesthesia Providers, Extremely low infection rate, 0.037%(Natl Avg 2.6%), 11,000 sq ft with 4 state-of-the-art surgery suites, 23-hour Overnight/Extended Stay facility (the only ASC in Southern Utah with overnight capabilities). ACL Reconstruction with Allograft or Hamstring Autograft: Post-op Protocol 2019-10-21T16:09:31-04:00. . He developed a complication of torn ACL graft and underwent further arthroscopic ACL revision with hamstring autograft and anterolateral ligament reconstruction. Show more. The soft tissue tendon grafts are usually secured in the tunnel for ACL using undo buttons, screws, etc. Medical College, Patiala, India. When ACL reconstruction does not help: risk factors associated with not Segond fracture (avulsion fracture of the proximal lateral tibia) is pathognomonic for an ACL tear, physical therapy & lifestyle modifications, low demand patients with decreased laxity, increased meniscal/cartilage damage linked to, level I and II activity (e.g. ), Anterior knee pain / kneeling pain: 17.4%/100% BTB, 11.5% Hamstring. Although there are a variety of autograft and allograft options available for ACL reconstruction, advantages of hamstring tendon autografts include decreased postoperative knee pain and an overall easier surgical recovery compared with bone patellar tendon bone autograft. Copyright 2023 Lineage Medical, Inc. All rights reserved. Am J Sports Med. Autogenous tissue has been compromised (e.g., by previous surgery, previous injury), Multi-ligament reconstruction is being performed, Pathology such as chronic patellar tendonitis and hamstring injury exists, M22.2X1-M22.3X9 Patellofemoral disorders and other derangements of patella, (including lateral, medial, anterior and posterior ligaments), M22.8X1-M22.8X9 Other disorders of patella (including lateral, medial, anterior and posterior ligaments), M23.50-M23.52 Chronic instability of knee (including lateral, medial, anterior and posterior ligaments), M23.601-M23.8X9 Other spontaneous disruption of ligament(s) of knee and other internal derangements of knee (including lateral, medial, anterior and posterior ligaments), 0SUC0KZ-0SUD4KZ Supplement knee joint with nonautologous tissue substitute, 27427 Ligamentous reconstruction, knee; extra-articular, 27428 Ligamentous reconstruction, knee; intra-articular (open), 27429 Ligamentous reconstruction, knee; intra-articular and extra-articular, 29888 Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction, 29889 Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction. I would highly recommend this office. Metso L, Bister V, Sandelin J, Harilainen A. BMC Surg. The site is secure. In addition, 4-stranded (quadruple) hamstring grafts are among the strongest grafts biomechanically (at time equals zero). During the past decades, hamstring tendon (HT) and bone- patellar tendon (middle 1/3)-bone (BPTB) autografts are the most used grafts for ACL reconstruction. use a right angle clamp to bluntly release the tendons from the deep portion of the sartorial fascia, release adhesions until the tendons have good recoil when tension is applied, use the tendon stripper to harvest the tendons, keep the knee flexed when harvesting to protect the saphenous nerve, remove the remaining muscle fibers from the tendons with a metal ruler or large curette, double both tendons over a central suture or around the device for fixation, an 11 blade is used to create the portal at a 45 degree angle into the joint just lateral to the patella tendon and just inferior to the distal pole of the patella, insert the blunt trocar at the same angle as incision, often created under direct visualization once the medial compartment is entered, place knee in approximately 30 degrees of flexion with valgus moment applied, use a spinal needle to assess direction and appropriate superior/inferior direction visualizing the entrance from the lateral viewing portal, the medial portal should be located just superior to the medial meniscus and able to provide access to the anatomic ACL footprint on the femur as well and the medial meniscal root if needed, visualize the medial femoral condyle and follow it while bringing the knee into slight flexion and applying a valgus stress to the knee as you go into the medial compartment, the foot will be positioned on your opposite hip for control, medial meniscus, medial femoral condyle, and medial tibial plateau, once the anteriomedial portal is created, a probe is used to assess the medial meniscus and cartilage, the surgeon can bring the leg into a figure-4 position or place the operative limb on the surgeon's hip to create a varus stress and flexion to the knee to enter the lateral compartment, lateral meniscus, lateral femoral condyle, and lateral tibial plateau, a probe is used to assess the lateral meniscus and cartilage. TECHNIQUE VIDEO. HHS Vulnerability Disclosure, Help Autograft harvesting also increases the operative time of the surgery. Anterior cruciate ligament reconstruction ( ACL reconstruction) is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after anterior cruciate ligament injury. MCL Repair Indications Chronic MCL laxity / instability Acute MCL tear in a multi-ligament knee injury / Knee Dislocation. Quad Tendon Graft vs. Hamstring Graft | Best Way to Fix ACL | ACL Surgeon These tendons are then doubled over, resulting in a 4 stranded graft. The information on this website may not be complete or accurate. This allows any swelling to go down. (Fineberg Arthroscopy 2000;16:715), Tunnel position is the most common cause for technical failure. An official website of the United States government. Problems related to the surgery itself. 3. Intrafix tibial fastener: make sutures 5 form tibial tunnel and knot corresponding limbs together. Typically the surgeon does this in preparation of the graft. [14-16] Reconstructed ACL graft rupture more commonly occurred in the hamstring autograft than in the patellar tendon autograft. Both types of graft are highly successful and have been in use for the past many years. Office very clean. FOIA Helpful Codes For Cruciate Reconstruction With Allograft The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care". Proximal attachment is circumferential, i.e. I don't code an allograft for ACL repair. Anatomic Considerations in Hamstring Tendon Harvesting for Ligament Reconstruction. Consistent Indications and Good Outcomes Despite High Variability in Repair with internal bracing of the ACL provides an unobtrusive support which allows accelerated recovery. For revision ACL reconstruction consider freeze-dried allograft bone dowels to fill bony defects. Thank you Dr. Karkare.SincerelyVito Congro. I was taught that if it's a separate incision, you can use 20924. ACL Surgery - Allograft vs Autograft - Complete Orthopedics Similarly, hamstring autograft may cause inhibition of the hamstrings. He is very compassionate. 2019 Jun;47(7):1576-1582. doi: 10.1177/0363546519849607. Bethesda, MD 20894, Web Policies While the autograft offers the advantage of being a part of the patients own body, it may have a few associated cons. JFMK | Free Full-Text | Patient-Reported Measures Associated with the ACL Patella Tendon Autograft Reconstruction Protocol ACL Patella Tendon Autograft Reconstruction Protocol The intent of this protocol is to provide the clinician with a guideline for the post-operative . - Find-A-Code Medical Coding and Billing Articles Here are some key documentation issues to consider when reporting an ACL reconstruction. 2. 11 oclock position for right knee. In studies comparing outcomes of patellar tendon and hamstring autograft ACL reconstruction, the rate of graft failure was lower in the . Example: 29888 - ACL Repair G0289 - Arthroscopy, knee, surgical, for removal of loose body, ACL Reconstruction CPT 29888 See all Cruciate Ligament CPT codes Revision ACL recon= 29999 (unlisted) or 29888-22 ACL Reconstruction Indications Complete tear with MCL or LCL injury Complete tear, IKDC Level 1 or 2 activity ACL Reconstruction Contraindications Partial tear with >50% of ACL intact and no functional instability I was recommended here by a friend Dr. Vashka helped me from day 1 and still continues to check in on me and my healing ankle. They are an excellent practice. PDF ACL Patellar Tendon Autograft Reconstruction Protocol Graft excursion <2.5mm from full flexion to full extension. Patellar tendon grafts have been associated with pain located in front of the knee. The graft is commonly taken from the patellar tendon along with bone blocks from the patella and the tibia (Bone-Patellar-Tendon-Bone). The allograft ACL reconstruction is also considered to be less strong than the autograft reconstruction. CPT Code: 29888. There are three main sources of autograft: bone-tendon-bone (BTB) graft of the patellar tendon or a tendon graft from hamstring or quadricep tendon. Loss of stability / Graft failure: @10% (more common in patients younger than 20)(Webster KE, Feller JA, Leigh WB, Richmond AK. Peroneus Longus Tendon Harvesting for Anterior Cruciate Ligament Reconstruction. 2005 Jun;21(6):767). Helpful Codes For Osteochondral Allograft Procedures In The Talus And Ankle, Helpful Codes For Osteochondral Allograft Procedures In The Shoulder, Helpful Codes For Allograft Meniscus Reconstruction, Helpful Codes For Osteochondral Allograft Procedures In The Distal Femur. Patellar fracture / patellar tendon rupture: <1% (BTB grafts), Arthritis: incidence after reconstruction is unkown, Hinged knee brace locked at 15 degrees for 6 days, WBAT with crutches, discontinue crutches when comfortable, usually @ 2 weeks, 1wk post-op: brace opened to 15 degrees to unlimited flexion. The autograft ACL reconstruction may also prolong the rehabilitation period. The staff is very professional and helpful. (Beynnon BD, Am J Sports Med. Anterior Cruciate Ligament (ACL) Reconstruction with Allograft reconstruction is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after Anterior Cruciate Ligament injury. ACL reconstruction is surgery to replace a torn anterior cruciate (KROO-she-ate) ligament (ACL) a major ligament in your knee. Generally 2-6wks. Dr. Karkare put my fears to rest . Here are some key documentation issues to consider when reporting an ACL reconstruction. ACL Reconstruction Richmond VA | Hamstring Tendon Graft | Knee Injuries PDF ACL Hamstring Tendon Autograft Reconstruction Protocol Genetic compatibility ensures that the graft is not rejected by the bodys immune system. The graft is a part of the patients body that has the same cellular and tissue makeup. Your knee will be swollen, and you may have numbness around the incision on your knee. Dr. V had a great personality and was no BS, straight forward diagnosis and a play on next steps. It is no means intended to be a substitute for one's clinical decision making I worked with Linda, who was profession and assisted me beyond what any person has done at other practices. Other autografts that may be used for ACL reconstruction include the quadriceps tendon and the peroneal tendon. I thought for ACL repair you could only report the graft if it was harvested from the other leg. Documentation of the additional physician's work must be very specific significantly above and beyond the work associated with a primary ACL reconstruction. I came back in for my follow up and had the same great experience. If only on one side you may have harvested semitendinosis. I have seen Dr. Kuo two times already and he's awesome along with his staff. The grafts of choice are the hamstring and quadriceps tendon autograft. The OATS procedure focuses on chondral defects that are associated with chronic tears of the anterior cruciate ligament (ACL), using an arthroscopic approach that can provide access to both the ACL for reconstruction and performance of the autograft. This creates a two- or four-strand tendon graft. Tunnel angled @45 degrees drill/dilate to size. (Jackson DW Arthroscopy 1994;10:124-131). The screws that attach the graft to the leg bones may cause problems and require removal. Rehab attempts to restore a range of motion between zero degrees (straight) and 130 degrees (bent). It is not uncommon in these cases to have an assistant surgeon or assistant at surgery, such as a PA. Cookie Policy. [17-19] However, whether the risk of CACL tear is . Bone tunnel plug used in ACL reconstruction. So the spine surgeon would report CPT 22558-62, 22845 and 22851. Hn1E^jlgKQ"Ruh6,*kc3_guq1,QWf;2vz*Oen6FY5|a=7FQ"cL{=Y9qU/8wwY=~:#wvIemCB!W)7\Fto*vh. ACL surgery is defined by CPT 29888 (Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction). 2005;21:791803. Delay indicated to decrease risk of arthrofibrosis. In an L4-5 anterior lumbar interbody fusion, both surgeons report CPT 22558-62 for the fusion part of the procedure. The bodys immune system may reject the graft and the resulting inflammation may lead to graft failure. Medicare has a CCI edit in place with the transforaminal epidural injections and trigger point injections. I went home two days after the surgery, and yes walked my daughter down the aisle at her wedding only one week after the surgery without even a cane! Short description: Mech compl of muscle and tendon graft, sequela The 2023 edition of ICD-10-CM T84.490S became effective on October 1, 2022. I had an issue with paperwork and she cleared it right up. MCL Repair Contraindications (Mather RC, JBJS 2013;95A:1751), at 11.5 year follow up: 7.0% graft failure forBPTB and HT autograft;Kellgren-Lawrence grade 2 arthritis found in 52.0% ofBPTB and 51.0% HT autograft patients (Belk, JW, Arthroscopy. Hamstring Tendon Graft Reconstruction of the ACL - Orthogate Intraoperative photograph (left leg) showing dissection of the gracilis from the sartorial fascia and from the semitendinosus, prior to harvesting.

cpt code for open acl reconstruction with hamstring autograft 2023