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  • Care Management > Appendix A: Pre-authorization List

    EmblemHealth's Pre-authorization List
    This is a complete list of all services requiring a Prior Approval for HIP members or a Pre-Certification for GHI members* (jointly referred to as "pre-authorization") subject to their benefit plan's coverage for all places of service, including Office (POS 11). The list accounts for EmblemHealth's medical policies, medical technology database, provider manual, and special utilization management programs. Pre-authorization is not a guarantee of payment. Payment is subject to a member's eligibility for benefits on the date of service. Emergency services do not require a pre-authorization.

    *GHI PPO City of New York employees and non-Medicare eligible retirees with GHI PPO benefits will be managed by Empire BCBS for inpatient and outpatient services. To see what needs authorization, use their look-up tool: https://www.empireblue.com/wps/portal/ehpprovider.
    CPT/
    HCPCS Code
    Description
    0008M Oncology (breast), mRNA analysis of 58 genes using hybrid capture, on formalin-fixed paraffin-embedded (FFPE) tissue, prognostic algorithm reported as a risk score
    00640 Anesthesia for manipulation of the spine or for closed procedures on the cervical, thoracic or lumbar spine
    0085T Breath test for heart transplant rejection
    0100T Placement of a subconjunctival retinal prosthesis receiver and pulse generator, and implantation of intra-ocular retinal electrode array, with vitrectomy
    0195T Arthrodesis, pre-sacral interbody technique, disc space preparation, discectomy, without instrumentation, with image guidance, includes bone graft when performed; L5-S1 interspace
    0196T Arthrodesis, pre-sacral interbody technique, disc space preparation, discectomy, without instrumentation, with image guidance, includes bone graft when performed; L4-L5 interspace (List separately in addition to code for primary procedure)
    01996 Daily hospital management of epidural or subarachnoid continuous drug administration
    0232T Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed
    0249T Ligation, hemorrhoidal vascular bundle(s), including ultrasound guidance
    0345T Transcatheter mitral valve repair percutaneous approach via the coronary sinus
    0346T Ultrasound, elastography (List separately in addition to code for primary procedure)
    0387T Transcatheter insertion or replacement of permanent leadless pacemaker, ventricular
    0388T Transcatheter removal of permanent leadless pacemaker, ventricular
    0389T Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report, leadless pacemaker system
    0390T Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure or test with analysis, review and report, leadless pacemaker system
    0391T Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter, leadless pacemaker system
    0395T Insertion of Heyman capsules for clinical brachytherapy
    0402T Collagen cross-linking of cornea (including removal of the corneal epithelium and intraoperative pachymetry when performed)
    0441T Ablation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve
    0442T Ablation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other truncal nerve (e.g., brachial plexus, pudendal nerve)
    0446T Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation and patient training
    0447T Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision
    0448T Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor, including system activation
    0472T Device evaluation, interrogation, and initial programming of intraocular retinal electrode array (e.g., retinal prosthesis), in person, with iterative adjustment of the implantable device to test functionality, select optimal permanent programmed values with analysis, including visual training, with review and report by a qualified health care professional
    0473T Device evaluation and interrogation of intraocular retinal electrode array (e.g., retinal prosthesis), in person, including reprogramming and visual training, when performed, with review and report by a qualified health care professional
    10040 Acne surgery (e.g., marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)
    11200 Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions
    11201 Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (List separately in addition to code for primary procedure))
    11300 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less
    11301 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm
    11302 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 1.1 to 2.0 cm
    11303 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter over 2.0 cm
    11305 Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less
    11306 Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm
    11307 Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm
    11308 Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm
    11310 Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less
    11311 Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm
    11312 Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm
    11313 Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 2.0 cm
    11920 Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.0 sq cm or less 
    11921 Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.1 to 20.0 sq cm
    11922 Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; each additional 20.0 sq cm, or part thereof (List separately in addition to code for primary procedure)
    11950 Subcutaneous injection of filling material (e.g., collagen); 1 cc or less
    11951 Subcutaneous injection of filling material (e.g., collagen); 1.1 to 5.0 cc
    11952 Subcutaneous injection of filling material (e.g., collagen); 5.1 to 10.0 cc
    11954 Subcutaneous injection of filling material (e.g., collagen); over 10.0 cc
    11960 Insertion of tissue expander(s) for other than breast, including subsequent expansion
    11981 Insertion, non-biodegradable drug delivery implant
    11982 Removal, non-biodegradable drug delivery implant
    11983 Removal with reinsertion, non-biodegradable drug delivery implant
    15002 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of body area of infants and children
    15003 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (List separately in addition to code for primary procedure)
    15004 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of body area of infants and children
    15005 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (List separately in addition to code for primary procedure)
    15040 Harvest of skin for tissue cultured skin autograft, 100 sq cm or less
    15050 Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm diameter
    15271 Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area
    15272 Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure)
    15273 Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children
    15274 Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)
    15275 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area
    15276 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure)
    15277 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children
    15278 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)
    15730 Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)
    15733 Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid,levator scapulae).
    15734 Muscle, myocutaneous, or fasciocutaneous flap; trunk
    15756 Free muscle or myocutaneous flap with microvascular anastomosis
    15775 Punch graft for hair transplant; 1 to 15 punch grafts
    15776 Punch graft for hair transplant; more than 15 punch grafts
    15777 Implantation of biologic implant (e.g., acellular dermal matrix) for soft tissue reinforcement (e.g., breast, trunk) (List separately in addition to code for primary procedure)
    15780 Dermabrasion; total face (e.g., for acne scarring, fine wrinkling, rhytids, general keratosis)
    15781 Dermabrasion; segmental, face
    15782 Dermabrasion; regional, other than face
    15783 Dermabrasion; superficial, any site (e.g., tattoo removal)
    15786 Abrasion; single lesion (e.g., keratosis, scar)
    15787 Abrasion; each additional 4 lesions or less (List separately in addition to code for primary procedure)
    15788 Chemical peel, facial; epidermal
    15789 Chemical peel, facial; dermal
    15792 Chemical peel, nonfacial; epidermal
    15793 Chemical peel, nonfacial; dermal
    15819 Cervicoplasty
    15820 Blepharoplasty, lower eyelid
    15821 Blepharoplasty, lower eyelid; with extensive herniated fat pad
    15822 Blepharoplasty, upper eyelid
    15823 Blepharoplasty, upper eyelid; with excessive skin weighting down lid
    15824 Rhytidectomy; forehead
    15825 Rhytidectomy; neck with platysmal tightening (platysmal flap, P-flap)
    15826 Rhytidectomy; glabellar frown lines
    15828 Rhytidectomy; cheek, chin, and neck
    15829 Rhytidectomy; superficial musculoaponeurotic system (SMAS) flap
    15830 Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy
    15832 Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh
    15833 Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg
    15834 Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip
    15835 Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock
    15836 Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm
    15837 Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand
    15838 Excision, excessive skin and subcutaneous tissue (includes lipectomy); submental fat pad
    15839 Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area
    15847 Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen (e.g., abdominoplasty) (includes umbilical transposition and fascial plication) (List separately in addition to code for primary procedure)
    15876 Suction assisted lipectomy; head and neck
    15877 Suction assisted lipectomy; trunk
    15878 Suction assisted lipectomy; upper extremity
    15879 Suction assisted lipectomy; lower extremity
    16035 Escharotomy; initial incision
    16036 Escharotomy; each additional incision (List separately in addition to code for primary procedure)
    17106 Destruction of cutaneous vascular proliferative lesions (e.g., laser technique); less than 10 sq cm
    17107 Destruction of cutaneous vascular proliferative lesions (e.g., laser technique); 10.0 to 50.0 sq cm
    17108 Destruction of cutaneous vascular proliferative lesions (e.g., laser technique); over 50.0 sq cm
    17110 Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions
    17111 Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions
    17340 Cryotherapy (CO2 slush, liquid N2) for acne
    17360 Chemical exfoliation for acne (e.g., acne paste, acid) (Note: ICD-9 code 706. 1 [other acne] is considered medically necessary for this CPT code) ICD-10 codes for use on or after date of service 10/01/2015: L70.0, L70.1, L70.3, L70.4, L70.5, L70.8, L70.9 and L73.0
    17380 Electrolysis epilation, each 30 minutes
    17999 Unlisted procedure, skin, mucous membrane and subcutaneous tissue
    19081 Biopsy, breast, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including stereotactic guidance
    19082 Biopsy, breast, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including stereotactic guidance (List separately in addition to code for primary procedure)
    19083 Biopsy, breast, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including ultrasound guidance
    19084 Biopsy, breast, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including ultrasound guidance (List separately in addition to code for primary procedure)
    19085 Biopsy, breast, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including magnetic resonance guidance
    19086 Biopsy, breast, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including magnetic resonance guidance (List separately in addition to code for primary procedure)
    19281 Placement of breast localization device(s) (e.g., clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance
    19282 Placement of breast localization device(s) (e.g., clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including mammographic guidance (List separately in addition to code for primary procedure)
    19283 Placement of breast localization device(s) (e.g., clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including stereotactic guidance
    19284 Placement of breast localization device(s) (e.g., clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including stereotactic guidance (List separately in addition to code for primary procedure)
    19285 Placement of breast localization device(s) (e.g., clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance
    19286 Placement of breast localization device(s) (e.g., clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including ultrasound guidance (List separately in addition to code for primary procedure)
    19287 Placement of breast localization device(s) (e.g. clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including magnetic resonance guidance
    19288 Placement of breast localization device(s) (e.g. clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including magnetic resonance guidance (List separately in addition to code for primary procedure)
    19294 Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List separately in addition to code for primary procedure).
    19296 Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; on date separate from partial mastectomy
    19297 Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; concurrent with partial mastectomy (List separately in addition to code for primary procedure)
    19298 Placement of radiotherapy after loading brachytherapy catheters (multiple tube and button type) into the breast for interstitial radioelement application following (at the time of or subsequent to) partial mastectomy, includes imaging guidance
    19300 Mastectomy for gynecomastia
    19303 Mastectomy, simple, complete
    19304 Mastectomy, subcutaneous
    19316 Mastopexy
    19318 Reduction mammaplasty
    19324 Mammaplasty, augmentation; without prosthetic implant
    19325 Mammaplasty, augmentation; with prosthetic implant
    19328 Removal of intact mammary implant
    19330 Removal of mammary implant material
    19340 Immediate insertion of breast prosthesis following mastopexy, mastectomy or in reconstruction
    19342 Delayed insertion of breast prosthesis following mastopexy, mastectomy or in reconstruction(covered for postmastectomy reconstruction)
    19350 Nipple/areola reconstruction
    19355 Correction of inverted nipples
    19357 Breast reconstruction, immediate or delayed, with tissue expander, including subsequent expansion
    19361 Breast reconstruction with latissimus dorsi flap, without prosthetic implant
    19364 Breast reconstruction with free flap
    19366 Breast reconstruction with other technique
    19367 Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), single pedicle, including closure of donor site
    19368 Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), single pedicle, including closure of donor site; with microvascular anastomosis (supercharging)
    19369 Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), double pedicle, including closure of donor site
    19370 Open periprosthetic capsulotomy, breast
    19371 Periprosthetic capsulectomy, breast
    19380 Revision of reconstructed breast (only after a mastectomy)
    19396 Preparation of moulage for custom breast implant
    20526 Injection, therapeutic (e.g., local anesthetic, corticosteroid), carpal tunnel
    20527 Injection, enzyme (e.g., collagenase), palmar fascial cord (ie, Dupuytren's contracture)
    20550 Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar ’’fascia’’)
    20551 Injection(s); single tendon origin/insertion
    20690 Application of a Uniplane (pins or wires in one plane), unilateral, external fixation system
    20692 Application of a multiplane (pins or wires in more than one plane), unilateral, external fixation system (e.g., Ilizarov, Monticelli type)
    20693 Adjustment or revision of external fixation system requiring anesthesia (e.g., new pin(s) or wire(s) and/or new ring(s) or bar(s)
    20694 Removal, under anesthesia, of external fixation system
    20696 Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (e.g., spatial frame), including imaging; initial and subsequent alignment(s), assessment(s), and computation(s) of adjustment schedule(s).
    20697 Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (e.g., spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each.
    20816 Replantation, digit, excluding thumb (includes metacarpophalangeal joint to insertion of flexor sublimis tendon), complete amputation
    20822 Replantation, digit, excluding thumb (includes distal tip to sublimis tendon insertion), complete amputation
    20824 Replantation, thumb (includes carpometacarpal joint to MP joint), complete amputation
    20827 Replantation, thumb (includes distal tip to MP joint), complete amputation
    20900 Bone graft, any donor area; minor or small (e.g., dowel or button)
    20902 Bone graft, any donor area; major or large
    20937 Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial incision) (List separately in addition to code for primary procedure)
    20938 Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate skin or fascial incision) (List separately in addition to code for primary procedure)
    20974 Electrical stimulation to aid bone healing; noninvasive (nonoperative)
    20975 Electrical stimulation to aid bone healing; invasive (operative)
    20979 Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative)
    20982 Ablation therapy for reduction or eradication of 1 or more bone tumors (e.g., metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; radiofrequency
    20999 Unlisted procedure, musculoskeletal system, general
    21010 Arthrotomy, temporomandibular joint
    21025 Excision of bone (e.g., for osteomyelitis or bone abscess); mandible
    21030 Excision of benign tumor or cyst of maxilla or zygoma by enucleation and curettage
    21031 Excision of torus mandibularis
    21032 Excision of maxillary torus palatinus
    21034 Excision of malignant tumor of maxilla or zygoma
    21040 Excision of benign tumor or cyst of mandible, by enucleation and/or curettage 
    21044 Excision of malignant tumor of mandible;
    21045 Excision of malignant tumor of mandible; radical resection
    21046 Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (e.g., locally aggressive or destructive lesion[s])
    21047 Excision of benign tumor or cyst of mandible; requiring extra-oral osteotomy and partial mandibulectomy (e.g., locally aggressive or destructive lesion[s])
    21048 Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (e.g., locally aggressive or destructive lesion[s])
    21049 Excision of benign tumor or cyst of maxilla; requiring extra-oral osteotomy and partial maxillectomy (e.g., locally aggressive or destructive lesion[s])
    21050 Condylectomy, temporomandibular joint (separate procedure)
    21060 Meniscectomy, partial or complete, temporomandibular joint (separate procedure)
    21070 Coronoidectomy (separate procedure)
    21073 Manipulation of temporomandibular joint(s) (TMJ), therapeutic, requiring an anesthesia service (ie, general or monitored anesthesia care)
    21085 Impression and custom preparation; oral surgical splint
    21086 Impression and custom preparation; auricular prosthesis
    21087 Impression and custom preparation; nasal prosthesis
    21088 Impression and custom preparation; facial prosthesis
    21120 Genioplasty; augmentation (autograft, allograft, prosthetic material)
    21121 Genioplasty; sliding osteotomy, single piece
    21122 Genioplasty; sliding osteotomies, 2 or more osteotomies (e.g., wedge excision or bone wedge reversal for asymmetrical chin)
    21123 Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts
    21125 Augmentation, mandibular body or angle; prosthetic material
    21127 Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)
    21137 Reduction forehead; contouring only
    21141 Reconstruction midface, LeFort I; single piece, segment movement in any direction (e.g., for Long Face Syndrome), without bone graft
    21142 Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, without bone graft
    21143 Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, without bone graft
    21145 Reconstruction midface, LeFort I; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts)
    21146 Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (e.g., ungrafted unilateral alveolar cleft)
    21147 Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (e.g., ungrafted bilateral alveolar cleft or multiple osteotomies)
    21150 Reconstruction midface, LeFort II; anterior intrusion (e.g., Treacher-Collins Syndrome)
    21151 Reconstruction midface, LeFort II; any direction, requiring bone grafts (includes obtaining autografts)
    21154 Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); without LeFort I
    21155 Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); with LeFort I
    21188 Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts)
    21193 Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; without bone graft
    21194 Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; with bone graft (includes obtaining graft)
    21195 Reconstruction of mandibular rami and/or body, sagittal split; without internal rigid fixation
    21196 Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation
    21198 Osteotomy, mandible, segmental;
    21199 Osteotomy, mandible, segmental; with genioglossus advancement
    21206 Osteotomy, maxilla, segmental (e.g., Wassmund or Schuchard)
    21208 Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)
    21210 Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)
    21240 Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft)
    21242 Arthroplasty, temporomandibular joint, with allograft
    21243 Arthroplasty, temporomandibular joint, with prosthetic joint replacement
    21244 Reconstruction of mandible, extraoral, with transosteal bone plate (e.g., mandibular staple bone plate)
    21245 Reconstruction of mandible or maxilla, subperiosteal implant; partial
    21246 Reconstruction of mandible or maxilla, subperiosteal implant; complete
    21247 Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (e.g., for hemifacial microsomia)
    21248 Reconstruction of mandible or maxilla, endosteal implant (e.g., blade, cylinder); partial
    21249 Reconstruction of mandible or maxilla, endosteal implant (e.g., blade, cylinder); complete
    21255 Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts)
    21270 Malar augmentation, prosthetic material
    21275 Secondary revision of orbitocraniofacial reconstruction
    21280 Medial canthopexy (separate procedure)
    21282 Lateral canthopexy
    21295 Reduction of masseter muscle and bone (e.g., for treatment of benign masseteric hypertrophy); extraoral approach
    21296 Reduction of masseter muscle and bone (e.g., for treatment of benign masseteric hypertrophy); intraoral approach
    21299 Unlisted craniofacial and maxillofacial procedure
    21465 Open treatment of mandibular condylar fracture
    21480 Closed treatment of temporomandibular dislocation; initial or subsequent
    21485 Closed treatment of temporomandibular dislocation; complicated (e.g., recurrent requiring intermaxillary fixation or splinting), initial or subsequent
    21490 Open treatment of temporomandibular dislocation
    21497 Interdental wiring, for condition other than fracture
    21499 Unlisted musculoskeletal procedure, head
    21615 Excision first and/or cervical rib;
    21740 Reconstructive repair of pectus excavatum or carinatum; open
    21742 Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (Nuss procedure), without thoracoscopy
    21743 Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (Nuss procedure), with thoracoscopy
    21899 Unlisted procedure, neck or thorax
    22220 Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical
    22226 Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; each additional vertebral segment (List separately in addition to code for primary procedure)
    22310 Closed treatment of vertebral body fracture(s), without manipulation, requiring and including casting or bracing
    22315 Closed treatment of vertebral fracture(s) and/or dislocation(s) requiring casting or bracing, with and including casting and/or bracing by manipulation or traction
    22318 Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; without grafting
    22319 Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; with grafting
    22325 Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar
    22326 Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical
    22327 Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracic
    22328 Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; each additional fractured vertebra or dislocated segment (List separately in addition to code for primary procedure)
    22505 Manipulation of spine requiring anesthesia, any region
    22510 Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic
    22511 Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral
    22512 Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; each additional cervicothoracic or lumbosacral vertebral body (List separately in addition to code for primary procedure)
    22513 Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (e.g., kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic
    22514 Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (e.g., kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar
    22515 Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (e.g., kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure)
    22532 Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic
    22533 Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar
    22534 Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic or lumbar, each additional vertebral segment (List separately in addition to code for primary procedure)
    22548 Arthrodesis, anterior transoral or extraoral technique, clivus-C1-C2 (atlas-axis), with or without excision of odontoid process
    22551 Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2
    22552 Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2, each additional interspace (List separately in addition to code for separate procedure)
    22554 Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2
    22556 Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic
    22558 Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar
    22585 Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace
    22586 Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, L5-S1 interspace
    22590 Arthrodesis, posterior technique, craniocervical (occiput-C2)
    22595 Arthrodesis, posterior technique, atlas-axis (C1-C2)
    22600 Arthrodesis, posterior or posterolateral technique, single level; cervical below C2 segment
    22610 Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed)
    22612 Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)
    22614 Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment
    22630 Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar
    22632 Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression); each additional interspace
    22633 Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar
    22634 Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; each additional interspace and segment (List separately in addition to code for primary procedure)
    22800 Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments
    22802 Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments
    22804 Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments
    22808 Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments
    22810 Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral segments
    22812 Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments
    22818 Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); single or 2 segments
    22819 Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); 3 or more segments
    22830 Exploration of spinal fusion
    22840 Posterior non-segmental instrumentation (e.g., Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)
    22841 Internal spinal fixation by wiring of spinous processes (List separately in addition to code for primary procedure)
    22842 Posterior segmental instrumentation (e.g., pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)
    22843 Posterior segmental instrumentation (e.g., pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)
    22844 Posterior segmental instrumentation (e.g., pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (List separately in addition to code for primary procedure)
    22845 Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)
    22846 Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure)
    22847 Anterior instrumentation; 8 or more vertebral segments (List separately in addition to code for primary procedure)
    22848 Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure)
    22849 Reinsertion of spinal fixation device
    22850 Removal of posterior nonsegmental instrumentation (e.g., Harrington rod)
    22852 Removal of posterior segmental instrumentation
    22853 Unlisted procedure, spine
    22854 Insertion of intervertebral biomechanical device(s) (e.g., synthetic cage, mesh) with integral anterior instrumentation for device anchoring (e.g., screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)
    22855 Removal of anterior instrumentation
    22856 Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection), single interspace, cervical
    22857 Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), single interspace, lumbar
    22858 Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (List separately in addition to code for primary procedure)
    22859 Insertion of intervertebral biomechanical device(s) (e.g., synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)
    22861 Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical
    22862 Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar
    22864 Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical
    22865 Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar
    22867 Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level (New Code: 01/01/2017)
    22868 Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level (New Code: 01/01/2017)
    22869 Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level (New Code: 01/01/2017)
    22870 Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; second level (List separately in addition to code for primary procedure) (New Code: 01/01/2017)
    22899 Unlisted procedure, spine
    23040 Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of foreign body
    23107 Arthrotomy, glenohumeral joint, with joint exploration, with or without removal of loose or foreign body
    23130 Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release
    23180 Partial excision (craterization, saucerization, or diaphysectomy) bone (e.g., osteomyelitis), clavicle
    23333 Removal of foreign body, shoulder; deep (subfascial or intramuscular)
    23410 Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; acute
    23412 Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; chronic
    23415 Coracoacromial ligament release, with or without acromioplasty
    23420 Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty)
    23450 Capsulorrhaphy, anterior; Putti-Platt procedure or Magnuson type operation
    23455 Capsulorrhaphy, anterior; with labral repair (e.g., Bankart procedure)
    23460 Capsulorrhaphy, anterior, any type; with bone block
    23462 Capsulorrhaphy, anterior, any type; with coracoid process transfer
    23465 Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block
    23466 Capsulorrhaphy, glenohumeral joint, any type multi-directional instability
    23615 Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed;
    23616 Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed; with proximal humeral prosthetic replacement
    23630 Open treatment of greater humeral tuberosity fracture, includes internal fixation, when performed
    23660 Open treatment of acute shoulder dislocation
    23670 Open treatment of shoulder dislocation, with fracture of greater humeral tuberosity, includes internal fixation, when performed
    23680 Open treatment of shoulder dislocation, with surgical or anatomical neck fracture, includes internal fixation, when performed
    24300 Manipulation, elbow, under anesthesia
    25259 Manipulation, wrist, under anesthesia
    25405 Repair of nonunion or malunion, radius OR ulna; with autograft (includes obtaining graft)
    25420 Repair of nonunion or malunion, radius AND ulna; with autograft (includes obtaining graft)
    25440 Repair of nonunion, scaphoid carpal (navicular) bone, with or without radial styloidectomy (includes obtaining graft and necessary fixation)
    26340 Manipulation, finger joint, under anesthesia, each joint
    26341 Manipulation, palmar fascial cord (ie, Dupuytren's cord), post enzyme injection (e.g., collagenase), single cord
    27030 Arthrotomy, hip, with drainage (e.g., infection)
    27033 Arthrotomy, hip, including exploration or removal of loose or foreign body
    27036 Capsulectomy or capsulotomy, hip, with or without excision of heterotopic bone, with release of hip flexor muscles (ie, gluteus medius, gluteus minimus, tensor fascia latae, rectus femoris, sartorius, iliopsoas)
    27095 Injection procedure for hip arthrography; with anesthesia
    27096 Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed
    27097 Release or recession, hamstring, proximal
    27098 Transfer, adductor to ischium
    27100 Transfer external oblique muscle to greater trochanter including fascial or tendon extension (graft)
    27105 Transfer paraspinal muscle to hip (includes fascial or tendon extension graft)
    27110 Transfer iliopsoas; to greater trochanter of femur
    27111 Transfer iliopsoas; to femoral neck
    27120 Acetabuloplasty; (e.g., Whitman, Colonna, Haygroves, or cup type)
    27125 Hemiarthroplasty, hip partial
    27130 Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip replacement), with or without autograft or allograft
    27132 Conversation of previous hip surgery to total hip arthroplasty, both components with or without allograft or autograft
    27134 Revision of total hip arthroplasty; both components, with or without autograft or allograft
    27137 Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft
    27138 Revision of total hip arthroplasty; femoral component only, with or without allograft
    27146 Osteotomy, iliac, acetabular or innominate bone;
    27151 Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy
    27158 Osteotomy, pelvis, bilateral (e.g., congenital malformation)
    27161 Osteotomy, femoral neck (separate procedure)
    27165 Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation and/or cast
    27226 Open treatment of posterior or anterior acetabular wall fracture, with internal fixation
    27227 Open treatment of acetabular fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across the acetabulum, with internal fixation
    27228 Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes T-fracture and both column fracture with complete articular detachment, or single column or transverse fracture with associated acetabular wall fracture, with internal fixation
    27236 Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement
    27244 Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant, with or without cerclage
    27248 Open treatment of greater trochanteric fracture, includes internal fixation, when performed
    27275 Manipulation, hip joint, requiring general anesthesia
    27279 Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixing device
    27280 Arthrodesis, open, sacroiliac joint, including obtaining bone graft, including instrumentation, when performed
    27282 Arthrodesis, symphysis pubis (including obtaining graft)
    27284 Arthrodesis, hip joint (including obtaining graft);
    27286 Arthrodesis, hip joint (including obtaining graft); with subtrochanteric osteotomy
    27299 Unlisted procedure, pelvis or hip joint
    27310 Arthrotomy, knee, with exploration, drainage, or removal of foreign body (e.g., infection)
    27412 Autologous chondrocyte implantation, knee
    27415 Osteochondral allograft, knee, open
    27416 Osteochondral autograft(s), knee, open (e.g., mosaicplasty) (includes harvesting of autograft[s])
    27448 Osteotomy, femur, shaft or supracondylar; without fixation
    27450 Osteotomy, femur, shaft or supracondylar; with fixation
    27472 Repair, nonunion or malunion, femur, distal to head and neck; with iliac or other autogenous bone graft (includes obtaining graft)
    27486 Revision of total knee arthroplasty, with or without allograft; 1 component
    27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
    27488 Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee
    27702 Arthroplasty, ankle; with implant (total ankle)
    27703 Arthroplasty, ankle; revision, total ankle
    27860 Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus)
    28250 Division of plantar fascia and muscle (e.g., Steindler stripping) (separate procedure)
    28446 Open osteochondral autograft, talus (includes obtaining graft[s])
    28899 Unlisted procedure, foot or toes
    29131 Application of finger splint; dynamic
    29260 Strapping; elbow or wrist
    29280 Strapping; hand or finger
    29800 Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure)
    29826 Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) release, when performed (List separately in addition to code for primary procedure)
    29827 Arthroscopy, shoulder, surgical; with rotator cuff repair
    29866 Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting of the autograft[s])
    29867 Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)
    29870 Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
    29871 Arthroscopy, knee, surgical; for infection, lavage and drainage
    29877 Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
    30400 Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip
    30410 Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip
    30420 Rhinoplasty, primary; including major septal repair
    30430 Rhinoplasty, secondary; minor revision (small amount of nasal tip work)
    30435 Rhinoplasty, secondary; intermediate revision (bony work with osteotomies)
    30450 Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)
    30460 Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip only
    30462 Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip, septum, osteotomies
    30520 Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft
    30620 Septal or other intranasal dermatoplasty (does not include obtaining graft)
    31256 Nasal/sinus endoscopy, surgical, with maxillary antrostomy;
    31267 Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus
    31276 Nasal/sinus endoscopy, surgical with frontal sinus exploration, with or without removal of tissue from frontal sinus
    31287 Nasal/sinus endoscopy, surgical, with sphenoidotomy
    31288 Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus
    31295 Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (e.g., balloon dilation), transnasal or via canine fossa
    31296 Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (e.g., balloon dilation)
    31297 Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (e.g., balloon dilation)
    31513 Laryngoscopy, indirect; with vocal cord injection
    31570 Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;
    31571 Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with operating microscope or telescope
    31600 Tracheostomy, planned (separate procedure);
    31626 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of fiducial markers, single or multiple
    31627 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation (List separately in addition to code for primary procedure[s])
    31634 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (e.g., fibrin glue), if performed
    31647 with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), initial lobe
    31648 with removal of bronchial valve(s), initial lobe
    31649 with removal of bronchial valve(s), each additional lobe (List separately in addition to code for primary procedure)
    31651 with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), each additional lobe (List separately in addition to code for primary procedure[s])
    32491 Removal of lung, other than pneumonectomy; with resection-plication of emphysematous lung(s) (bullous or non-bullous) for lung volume reduction, sternal split or transthoracic approach, includes any pleural procedure, when performed
    32503 Resection of apical lung tumor (e.g., Pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; without chest wall reconstruction(s)
    32504 Resection of apical lung tumor (e.g., Pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; with chest wall reconstruction
    32505 Thoracotomy; with therapeutic wedge resection (e.g., mass, nodule), initial
    32506 Thoracotomy; with therapeutic wedge resection (e.g., mass or nodule), each additional resection, ipsilateral (List separately in addition to code for primary procedure)
    32507 Thoracotomy; with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary procedure)
    32553 Placement of interstitial device(s) for radiation therapy guidance (e.g., fiducial markers, dosimeter), percutaneous, intra-thoracic, single or multiple
    32601 Thoracoscopy, diagnostic (separate procedure); lungs, pericardial sac, mediastinal or pleural space, without biopsy
    32606 Thoracoscopy, diagnostic (separate procedure); mediastinal space, with biopsy
    32607 Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (e.g., wedge, incisional), unilateral
    32608 Thoracoscopy; with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (e.g., wedge, incisional), unilateral
    32609 Thoracoscopy; with biopsy(ies) of pleura
    32650 Thoracoscopy, surgical; with pleurodesis (e.g., mechanical or chemical)
    32651 Thoracoscopy, surgical; with partial pulmonary decortication
    32652 Thoracoscopy, surgical; with total pulmonary decortication, including intrapleural pneumonolysis
    32655 Thoracoscopy, surgical; with resection-plication of bullae, includes any pleural procedure when performed
    32656 Thoracoscopy, surgical; with parietal pleurectomy
    32659 Thoracoscopy, surgical; with creation of pericardial window or partial resection of pericardial sac for drainage
    32664 Thoracoscopy, surgical; with thoracic sympathectomy
    32666 Thoracoscopy, surgical; with therapeutic wedge resection (e.g., mass, nodule), initial unilateral
    32667 Thoracoscopy, surgical; with therapeutic wedge resection (e.g., mass or nodule), each additional resection, ipsilateral (List separately in addition to code for primary procedure)
    32668 Thoracoscopy, surgical; with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary procedure)
    32850 Donor pneumonectomy(s) (including cold preservation), from cadaver donor
    32851 Lung transplant, single; without cardiopulmonary bypass
    32852 Lung transplant, single; with cardiopulmonary bypass
    32853 Lung transplant, double (bilateral sequential or en bloc); without cardiopulmonary bypass
    32854 Lung transplant, double (bilateral sequential or en bloc); with cardiopulmonary bypass
    32855 Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmonary artery, and bronchus; unilateral
    32856 Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmonary artery, and bronchus; bilateral
    32994 Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; cryoablation
    32998 Ablation therapy for reduction or eradication of one or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, radiofrequency, unilateral
    33010 Pericardiocentesis; initial
    33011 Pericardiocentesis; subsequent
    33025 Creation of pericardial window or partial resection for drainage
    33030 Pericardiectomy, subtotal or complete; without cardiopulmonary bypass
    33031 Pericardiectomy, subtotal or complete; with cardiopulmonary bypass
    33140 Transmyocardial laser revascularization, by thoracotomy; (separate procedure)
    33141 Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) (List separately in addition to code for primary procedure)
    33202 Insertion of epicardial electrode(s); open incision (e.g., thoracotomy, median sternotomy, subxiphoid approach)
    33203 Insertion of epicardial electrode(s); endoscopic approach (e.g., thoracoscopy, pericardioscopy)
    33206 Insertion or replacement of permanent pacemaker with transvenous electrode(s); atrial
    33207 Insertion or replacement of permanent pacemaker with transvenous electrode(s); ventricular
    33208 Insertion or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular
    33211 Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure)
    33212 Insertion or replacement of pacemaker pulse generator only; single chamber, atrial or ventricular
    33213 Insertion or replacement of pacemaker pulse generator only; dual chamber
    33214 Upgrade of implanted pacemaker system, conversion of single chamber system to dual chamber system (includes removal of previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse generator)
    33215 Repositioning of previously implanted transvenous pacemaker or implantable defibrillator (right atrial or right ventricular) electrode
    33216 Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator
    33217 Insertion of 2 transvenous electrodes, permanent pacemaker or implantable defibrillator
    33218 Repair of single transvenous electrode, permanent pacemaker or implantable defibrillator
    33220 Repair of 2 transvenous electrodes for permanent pacemaker or implantable defibrillator
    33221 Insertion of pacemaker pulse generator only; with existing multiple leads
    33223 Relocation of skin pocket for implantable defibrillator
    33224 Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, with attachment to previously placed pacemaker or implantable defibrillator pulse generator (including revision of pocket, removal, insertion, and/or replacement of existing generator)
    33225 Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (e.g., for upgrade to dual chamber system) (List separately in addition to code for primary procedure)
    33226 Repositioning of previously implanted cardiac venous system (left ventricular) electrode (including removal, insertion and/or replacement of existing generator)
    33230 Insertion of implantable defibrillator pulse generator only; with existing dual leads
    33231 Insertion of implantable defibrillator pulse generator only; with existing multiple leads
    33240 Insertion of implantable defibrillator pulse generator only; with existing single lead
    33241 Removal of implantable defibrillator pulse generator only
    33243 Removal of single or dual chamber implantable defibrillator electrode(s); by thoracotomy
    33244 Removal of single or dual chamber implantable defibrillator electrode(s); by transvenous extraction
    33249 Insertion or replacement of permanent implantable defibrillator system, with transvenous lead(s), single or dual chamber
    33250 Operative ablation of supraventricular arrhythmogenic focus or pathway (e.g., Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) and/or focus (foci); without cardiopulmonary bypass
    33251 Operative ablation of supraventricular arrhythmogenic focus or pathway (e.g., Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) and/or focus (foci); with cardiopulmonary bypass
    33254 Operative tissue ablation and reconstruction of atria, limited (e.g., modified maze procedure)
    33255 Operative tissue ablation and reconstruction of atria, extensive (e.g., maze procedure); without cardiopulmonary bypass
    33256 Operative tissue ablation and reconstruction of atria, extensive (e.g., maze procedure); with cardiopulmonary bypass
    33257 Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (e.g., modified maze procedure) (List separately in addition to code for primary procedure)
    33258 Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (e.g., maze procedure), without cardiopulmonary bypass (List separately in addition to code for primary procedure)
    33259 Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (e.g., maze procedure), with cardiopulmonary bypass (List separately in addition to code for primary procedure)
    33262 Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; single lead system
    33263 Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; dual lead system
    33264 Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; multiple lead system
    33265 Endoscopy, surgical; operative tissue ablation and reconstruction of atria, limited (e.g., modified maze procedure), without cardiopulmonary bypass
    33266 Endoscopy, surgical; operative tissue ablation and reconstruction of atria, extensive (e.g., maze procedure), without cardiopulmonary bypass
    33270 Insertion or replacement of permanent subcutaneous implantable defibrillator system, with subcutaneous electrode, including defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters, when performed
    33271 Insertion of subcutaneous implantable defibrillator electrode
    33272 Removal of subcutaneous implantable defibrillator electrode
    33273 Repositioning of previously implanted subcutaneous implantable defibrillator electrode
    33340 Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation
    33361 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach
    33362 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open femoral artery approach
    33363 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open axillary artery approach
    33364 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open iliac artery approach
    33365 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transaortic approach (e.g., median sternotomy, mediastinotomy)
    33366 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transapical exposure (e.g., left thoracotomy) New code effective 1/1/2014
    33367 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (e.g., femoral vessels) (List separately in addition to code for primary procedure)
    33368 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (e.g., femoral, iliac, axillary vessels) (List separately in addition to code for primary procedure)
    33369 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (e.g., aorta, right atrium, pulmonary artery) (List separately in addition to code for primary procedure)
    33405 Replacement, aortic valve, open, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve
    33406 Replacement, aortic valve, open, with cardiopulmonary bypass; with allograft valve (freehand)
    33410 Replacement, aortic valve, open, with cardiopulmonary bypass; with stentless tissue valve
    33411 Replacement, aortic valve; with aortic annulus enlargement, noncoronary sinus
    33412 Replacement, aortic valve; with transventricular aortic annulus enlargement (Konno procedure)
    33413 Replacement, aortic valve; by translocation of autologous pulmonary valve with allograft replacement of pulmonary valve (Ross procedure)
    33414 Repair of left ventricular outflow tract obstruction by patch enlargement of the outflow tract
    33415 Resection or incision of subvalvular tissue for discrete subvalvular aortic stenosis
    33416 Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic stenosis (e.g., asymmetric septal hypertrophy)
    33417 Aortoplasty (gusset) for supravalvular stenosis
    33420 Valvotomy, mitral valve; closed heart
    33422 Valvotomy, mitral valve; open heart, with cardiopulmonary bypass
    33425 Valvuloplasty, mitral valve, with cardiopulmonary bypass;
    33426 Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring
    33427 Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring
    33430 Replacement, mitral valve, with cardiopulmonary bypass
    33477 Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed
    33504 Repair of anomalous coronary artery from pulmonary artery origin; by graft, with cardiopulmonary bypass
    33507 Repair of anomalous (e.g., intramural) aortic origin of coronary artery by unroofing or translocation
    33530 Reoperation, coronary artery bypass procedure or valve procedure, more than 1 month after original operation (List separately in addition to code for primary procedure)
    33533 Coronary artery bypass, using arterial graft(s); single arterial graft
    33534 Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts
    33535 Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts
    33536 Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts
    33542 Myocardial resection (e.g., ventricular aneurysmectomy
    33545 Repair of postinfarction ventricular septal defect, with or without myocardial resection
    33548 Surgical ventricular restoration procedure, includes prosthetic patch, when performed (e.g., ventricular remodeling, SVR, SAVER, Dor procedures)
    33641 Repair atrial septal defect, secundum, with cardiopulmonary bypass, with or without patch
    33645 Direct or patch closure, sinus venosus, with or without anomalous pulmonary venous drainage
    33675 Closure of multiple ventricular septal defects;
    33676 Closure of multiple ventricular septal defects; with pulmonary valvotomy or infundibular resection (acyanotic)
    33677 Closure of multiple ventricular septal defects; with removal of pulmonary artery band, with or without gusset
    33681 Closure of single ventricular septal defect, with or without patch;
    33684 Closure of single ventricular septal defect, with or without patch; with pulmonary valvotomy or infundibular resection (acyanotic)
    33688 Closure of single ventricular septal defect, with or without patch; with removal of pulmonary artery band, with or without gusset
    33860 Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed
    33863 Ascending aorta graft, with cardiopulmonary bypass, with aortic root replacement using valved conduit and coronary reconstruction (e.g., Bentall)
    33864 Ascending aorta graft, with cardiopulmonary bypass with valve suspension, with coronary reconstruction and valve-sparing aortic root remodeling (e.g., David Procedure, Yacoub Procedure)
    33870 Transverse arch graft, with cardiopulmonary bypass
    33875 Descending thoracic aorta graft, with or without bypass
    33877 Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass
    33880 Endovascular repair of descending thoracic aorta (e.g., aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension(s), if required, to level of celiac artery origin
    33881 Endovascular repair of descending thoracic aorta (e.g., aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); not involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension(s), if required, to level of celiac artery origin
    33883 Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta (e.g., aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); initial extension
    33884 Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta (e.g., aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); each additional proximal extension (List separately in addition to code for primary procedure)
    33886 Placement of distal extension prosthesis(s) delayed after endovascular repair of descending thoracic aorta
    33927 Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy
    33928 Removal and replacement of total replacement heart system (artificial heart)
    33929 Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure)
    33930 Donor cardiectomy-pneumonectomy (including cold preservation)
    33933 Backbench standard preparation of cadaver donor heart/lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, and trachea for implantation
    33935 Heart-lung transplant with recipient cardiectomy-pneumonectomy
    33940 Donor cardiectomy (including cold preservation)
    33944 Backbench standard preparation of cadaver donor heart allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, pulmonary artery, and left atrium for implantation
    33945 Heart transplant, with or without recipient cardiectomy
    33975 Insertion of ventricular assist device; extracorporeal, single ventricle
    33976 Insertion of ventricular assist device; extracorporeal, biventricular
    33977 Removal of ventricular assist device; extracorporeal, single ventricle
    33978 Removal of ventricular assist device; extracorporeal, biventricular
    33979 Insertion of ventricular assist device, implantable intracorporeal, single ventricle
    33980 Removal of ventricular assist device, implantable intracorporeal, single ventricle
    33981 Replacement of extracorporeal ventricular assist device, single or biventricular, pump(s), single or each pump
    33982 Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, without cardiopulmonary bypass
    33983 Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, with cardiopulmonary bypass
    33999 Unlisted procedure, cardiac surgery
    34101 Embolectomy or thrombectomy, with or without catheter; axillary, brachial, innominate, subclavian artery, by arm incision
    34111 Embolectomy or thrombectomy, with or without catheter; radial or ulnar artery, by arm incision
    34151 Embolectomy or thrombectomy, with or without catheter; renal, celiac, mesentery, aortoiliac artery, by abdominal incision
    34201 Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision
    34203 Embolectomy or thrombectomy, with or without catheter; popliteal-tibio-peroneal artery, by leg incision
    34707 Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for other than rupture (e.g., for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation)
    34708 Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (e.g., for aneurysm, pseudoaneurysm, dissection, penetrating ulcer traumatic disruption)
    34812 Open femoral artery exposure for delivery of endovascular prosthesis, by groin incision, unilateral
    34820 Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy, by abdominal or retroperitoneal incision, unilateral
    35011 Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, axillary-brachial artery, by arm incision
    35013 Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, axillary-brachial artery, by arm incision
    35045 Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, radial or ulnar artery
    35121 Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, celiac, renal, or mesenteric artery
    35141 Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, common femoral artery (profunda femoris, superficial femoral)
    35142 Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, common femoral artery (profunda femoris, superficial femoral)
    35151 Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, popliteal artery
    35152 Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, popliteal artery
    35207 Repair blood vessel, direct; hand, finger
    35301 Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision
    35341 Thromboendarterectomy, including patch graft, if performed; mesenteric, celiac, or renal
    35521 Bypass graft, with vein; axillary-femoral
    35531 Bypass graft, with vein; aortoceliac or aortomesenteric
    35536 Bypass graft, with vein; splenorenal
    35537 Bypass graft, with vein; aortoiliac
    35538 Bypass graft, with vein; aortobi-iliac
    35539 Bypass graft, with vein; aortofemoral
    35540 Bypass graft, with vein; aortobifemoral
    35556 Bypass graft, with vein; femoral-popliteal
    35558 Bypass graft, with vein; femoral-femoral
    35560 Bypass graft, with vein; aortorenal
    35563 Bypass graft, with vein; ilioiliac
    35565 Bypass graft, with vein; iliofemoral
    35566 Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels
    35571 Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels
    35583 In-situ vein bypass; femoral-popliteal
    35621 Bypass graft, with other than vein; axillary-femoral
    35631 Bypass graft, with other than vein; aortoceliac, aortomesenteric, aortorenal
    35636 Bypass graft, with other than vein; splenorenal (splenic to renal arterial anastomosis)
    35637 Bypass graft, with other than vein; aortoiliac
    35638 Bypass graft, with other than vein; aortobi-iliac
    35646 Bypass graft, with other than vein; aortobifemoral
    35647 Bypass graft, with other than vein; aortofemoral
    35654 Bypass graft, with other than vein; axillary-femoral-femoral
    35656 Bypass graft, with other than vein; femoral-popliteal
    35661 Bypass graft, with other than vein; femoral-femoral
    35665 Bypass graft, with other than vein; iliofemoral
    35666 Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, or peroneal artery
    35671 Bypass graft, with other than vein; popliteal-tibial or -peroneal artery
    35860 Exploration for postoperative hemorrhage, thrombosis or infection; extremity
    35875 Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula
    35879 Revision, lower extremity arterial bypass, without thrombectomy, open; with vein patch angioplasty
    35881 Revision, lower extremity arterial bypass, without thrombectomy, open; with segmental vein interposition
    35883 Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with nonautogenous patch graft (e.g., Dacron, ePTFE, bovine pericardium)
    35884 Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with autogenous vein patch graft
    36247 Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family
    36465 Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (e.g., great saphenous vein, accessory saphenous vein)
    36466 Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (e.g., great saphenous vein, accessory saphenous vein), same leg
    36468 Single or multiple injections of sclerosing solutions, spider veins (telangiectasia); limb or trunk
    36470 Injection of sclerosing solution; single vein
    36471 Injection of sclerosing solution; multiple veins, same leg
    36473 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated (New Code 01/01/2017)
    36474 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; subsequent vein(s) treated in a single extremity, each through separate access sites (Lisa separately in addition to code for primary procedure) (New Code 01/01/2017)
    36475 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated
    36476 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure) (Revised Code 01/01/2017)
    36478 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated
    36479 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure) (Revised Code 01/01/2017)
    36482 Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (e.g., cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated
    36483 Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (e.g., cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure)
    36905 Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s); with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty
    36906 Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s); with transcatheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis circuit
    36907 Transcatheter placement of intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment (List separately in addition to code for primary procedure)
    36908 Transcatheter placement of intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment (List separately in addition to code for primary procedure)
    37184 Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel
    37215 Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection
    37216 Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; without distal embolic protection
    37217 Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angioplasty, when performed, and radiological supervision and interpretation
    37218 Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery, open or percutaneous antegrade approach, including angioplasty, when performed, and radiological supervision and interpretation
    37220 Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty
    37221 Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
    37222 Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)
    37223 Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure)
    37224 Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty
    37225 Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with atherectomy, includes angioplasty within the same vessel, when performed
    37226 Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
    37227 Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed
    37229 Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with atherectomy, includes angioplasty within the same vessel, when performed
    37230 Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
    37231 Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed
    37234 Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure)
    37235 Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure)
    37236 Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; initial artery
    37237 Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; each additional artery (List separately in addition to code for primary procedure)
    37238 Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; initial vein
    37239 Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each additional vein
    37241 Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (e.g., congenital or acquired venous malformations, venous and capillary hemangiomas, varices, varicoceles)
    37242 Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, other than hemorrhage or tumor (e.g., congenital or acquired arterial malformations, arteriovenous malformations, arteriovenous fistulas, aneurysms, pseudoaneurysms)
    37243 Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction
    37244 Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for arterial or venous hemorrhage or lymphatic extravasation
    37246 Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; initial artery
    37247 Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; each additional artery (List separately in addition to code for primary procedure)
    37248 Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein
    37249 Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; each additional vein (List separately in addition to code for primary procedure)
    37252 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List separately in addition to code for primary procedure)
    37253 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure)
    37500 Vascular endoscopy, surgical, with ligation of perforator veins, subfascial (SEPS) (Covered for Medicare members only)
    37700 Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions
    37718 Ligation, division, and stripping, short saphenous vein
    37722 Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below
    37735 Ligation and division and complete stripping of long or short saphenous veins with radical excision of ulcer and skin graft and/or interruption of communicating veins of lower leg, with excision of deep fascia
    37760 Ligation of perforator veins, subfascial, radical (Linton type), including skin graft, when performed, open,1 leg
    37761 Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg
    37765 Stab phlebectomy of varicose veins, one extremity; 10-20 stab incisions
    37766 Stab phlebectomy of varicose veins, one extremity; more than 20 incisions
    37780 Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure)
    37785 Ligation, division, and/or excision of varicose vein cluster(s), one leg
    37799 Unlisted procedure, vascular surgery (Stab phlebectomy of varicose veins, one extremity; less than 10 stab incisions)
    38100 Splenectomy; total (separate procedure)
    38101 Splenectomy; partial (separate procedure)
    38102 Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (List in addition to code for primary procedure)
    38120 Laparoscopy, surgical, splenectomy
    38129 Unlisted laparoscopy procedure, spleen
    38205 Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic
    38206 Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous
    38207 Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage
    38208 Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, without washing, per donor
    38209 Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, with washing, per donor
    38210 Transplant preparation of hematopoietic progenitor cells; specific cell depletion within harvest, T-cell depletion
    38211 Transplant preparation of hematopoietic progenitor cells; tumor cell depletion
    38212 Transplant preparation of hematopoietic progenitor cells; red blood cell removal
    38213 Transplant preparation of hematopoietic progenitor cells; platelet depletion
    38214 Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion
    38215 Transplant preparation of hematopoietic progenitor cells; cell concentration in plasma, mononuclear, or buffy coat layer
    38240 Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor
    38241 Hematopoietic progenitor cell (HPC); autologous transplantation
    38242 Allogeneic lymphocyte infusions
    38243 Hematopoietic progenitor cell (HPC); HPC boost
    38500 Biopsy or excision of lymph node(s); open, superficial
    38505 Biopsy or excision of lymph node(s); by needle, superficial (e.g., cervical, inguinal, axillary)
    38510 Biopsy or excision of lymph node(s); open, deep cervical node(s)
    38520 Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad
    38525 Biopsy or excision of lymph node(s); open, deep axillary node(s
    38530 Biopsy or excision of lymph node(s); open, internal mammary node(s)
    38792 Injection procedure; radioactive tracer for identification of sentinel node
    40500 Vermilionectomy (lip shave), with mucosal advancement
    40701 Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure
    40702 Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages
    40761 Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (Abbe-Estlander type), including sectioning and inserting of pedicle
    40840 Vestibuloplasty; anterior
    40842 Vestibuloplasty; posterior, unilateral
    40843 Vestibuloplasty; posterior, bilateral
    40844 Vestibuloplasty; entire arch
    40845 Vestibuloplasty; complex (including ridge extension, muscle repositioning)
    41120 Glossectomy; less than one-half tongue
    41130 Glossectomy; hemiglossectomy
    41135 Glossectomy; partial, with unilateral radical neck dissection
    41530 Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session
    42145 Palatopharyngoplasty (e.g., uvulopalatopharyngoplasty, uvulopharyngoplasty)
    42226 Lengthening of palate, and pharyngeal flap
    42227 Lengthening of palate, with island flap
    42235 Repair of anterior palate, including vomer flap
    42280 Maxillary impression for palatal prosthesis
    42281 Insertion of pin-retained palatal prosthesis
    42410 Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection
    42415 Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve
    42420 Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve
    42425 Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve
    42426 Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection
    42440 Excision of submandibular (submaxillary) gland
    42820 Tonsillectomy and adenoidectomy; younger than age 12
    42821 Tonsillectomy and adenoidectomy; age 12 or over
    42825 Tonsillectomy, primary or secondary; younger than age 12
    42826 Tonsillectomy, primary or secondary; age 12 or over
    42830 Adenoidectomy, primary; younger than age 12
    42831 Adenoidectomy, primary; age 12 or over
    42835 Adenoidectomy, secondary; younger than age 12
    42836 Adenoidectomy, secondary; age 12 or over
    43030 Cricopharyngeal myotomy
    43107 Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (transhiatal)
    43108 Total or near total esophagectomy, without thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation and anastomosis(es)
    43112 Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty
    43113 Total or near total esophagectomy, with thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)
    43116 Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal reconstruction
    43117 Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty (Ivor Lewis)
    43118 Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)
    43121 Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without proximal gastrectomy, with thoracic esophagogastrostomy, with or without pyloroplasty
    43122 Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty
    43123 Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)
    43124 Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy
    43130 Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach
    43135 Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach
    43201 Esophagoscopy, rigid or flexible, transoral; with directed submucosal injection(s), any substance
    43204 Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal varices
    43214 Esophagoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed
    43229 Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)
    43233 Esophagogastroduodenoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed)
    43236 Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance
    43243 Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis of esophageal/gastric varices
    43246 Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube
    43270 Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)
    43280 Laparoscopy, surgical, esophagogastric fundoplasty (e.g., Nissen, Toupet procedures)
    43284 Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (ie, magnetic band), including cruroplasty when performed
    43285 Removal of esophageal sphincter augmentation device
    43300 Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of tracheoesophageal fistula
    43305 Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of tracheoesophageal fistula
    43310 Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of tracheoesophageal fistula
    43325 Esophagogastric fundoplasty, with fundic patch (Thal-Nissen procedure
    43327 Esophagogastric fundoplasty partial or complete; laparotomy
    43328 Esophagogastric fundoplasty partial or complete; thoracotomy
    43330 Esophagomyotomy (Heller type); abdominal approach
    43331 Esophagomyotomy (Heller type); thoracic approach
    43332 Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; without implantation of mesh or other prosthesis
    43333 Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthesis
    43334 Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; without implantation of mesh or other prosthesis
    43335 Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; with implantation of mesh or other prosthesis
    43337 Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; with implantation of mesh or other prosthesis
    43405 Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation
    43520 Pyloromyotomy, cutting of pyloric muscle (Fredet-Ramstedt type operation
    43620 Gastrectomy, total; with esophagoenterostomy
    43621 Gastrectomy, total; with Roux-en-Y reconstruction
    43622 Gastrectomy, total; with formation of intestinal pouch, any type
    43631 Gastrectomy, partial, distal; with gastroduodenostomy
    43632 Gastrectomy, partial, distal; with gastrojejunostomy
    43633 Gastrectomy, partial, distal; with Roux-en-Y reconstruction
    43634 Gastrectomy, partial, distal; with formation of intestinal pouch
    43640 Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective
    43641 Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell (highly selective)
    43644 Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less)
    43645 Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption
    43647 Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum
    43648 Laparoscopy, surgical; revision or removal of gastric neurostimulator electrodes, antrum
    43659 Unlisted laparoscopy procedure, stomach
    43770 Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (e.g., gastric band and subcutaneous port components)
    43771 Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only
    43772 Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only
    43773 Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only
    43774 Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components
    43775 Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy) new code effective date 01/01/2010
    43800 Pyloroplasty
    43810 Gastroduodenostomy
    43820 Gastrojejunostomy; without vagotomy
    43825 Gastrojejunostomy; with vagotomy, any type
    43842 Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty
    43843 Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty
    43845 Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal switch)
    43846 Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy
    43847 Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption
    43848 Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure)
    43881 Implantation or replacement of gastric neurostimulator electrodes, antrum, open
    43882 Revision or removal of gastric neurostimulator electrodes, antrum, open
    43886 Gastric restrictive procedure, open; revision of subcutaneous port component only
    43887 Gastric restrictive procedure, open; removal of subcutaneous port component only
    43888 Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only
    43999 Unlisted procedure, stomach
    44020 Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or foreign body removal
    44050 Reduction of volvulus, intussusception, internal hernia, by laparotomy
    44120 Enterectomy, resection of small intestine; single resection and anastomosis
    44121 Enterectomy, resection of small intestine; each additional resection and anastomosis (List separately in addition to code for primary procedure)
    44130 Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure)
    44132 Donor enterectomy (including cold preservation), open; from cadaver donor
    44133 Donor enterectomy (including cold preservation), open; partial, from living donor
    44135 Intestinal allotransplantation; from cadaver donor
    44136 Intestinal allotransplantation; from living donor
    44137 Removal of transplanted intestinal allograft, complete
    44180 Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)
    44186 Laparoscopy, surgical; jejunostomy (e.g., for decompression or feeding)
    44204 Laparoscopy, surgical; colectomy, partial, with anastomosis
    44205 Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy
    44206 Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure)
    44207 Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)
    44208 Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy
    44227 Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis
    44300 Placement, enterostomy or cecostomy, tube open (e.g., for feeding or decompression) (separate procedure)
    44320 Colostomy or skin level cecostomy;
    44322 Colostomy or skin level cecostomy; with multiple biopsies (e.g., for congenital megacolon) (separate procedure
    44372 Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube
    44373 Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube
    44620 Closure of enterostomy, large or small intestine;
    44640 Closure of intestinal cutaneous fistula
    44650 Closure of enteroenteric or enterocolic fistula
    44705 Preparation of fecal microbiota for instillation, including assessment of donor specimen
    44799 Unlisted procedure, small intestine
    44950 Appendectomy;
    44960 Appendectomy; for ruptured appendix with abscess or generalized peritonitis
    44970 Laparoscopy, surgical, appendectomy
    44979 Unlisted laparoscopy procedure, appendix
    45110 Proctectomy; complete, combined abdominoperineal, with colostomy
    45111 Proctectomy; partial resection of rectum, transabdominal approach
    45112 Proctectomy, combined abdominoperineal, pull-through procedure (e.g., colo-anal anastomosis)
    46505 Chemodenervation of internal anal sphincter
    46601 Anoscopy; diagnostic, with high-resolution magnification (HRA) (e.g., colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when performed
    46607 Anoscopy; with high-resolution magnification (HRA) (e.g., colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple
    47133 Donor hepatectomy (including cold preservation), from cadaver donor
    47135 Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age
    47140 Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments II and III)
    47141 Donor hepatectomy (including cold preservation), from living donor; total left lobectomy (segments II, III and IV)
    47142 Donor hepatectomy (including cold preservation), from living donor; total right lobectomy (segments V, VI, VII and VIII)
    47143 Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; without trisegment or lobe split
    47144 Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with trisegment split of whole liver graft into 2 partial liver grafts (ie, left lateral segment [segments II and III] and right trisegment [segments I and IV through VIII])
    47145 Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with lobe split of whole liver graft into 2 partial liver grafts (ie, left lobe [segments II, III, and IV] and right lobe [segments I and V through VIII])
    47146 Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous anastomosis, each
    47147 Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; arterial anastomosis, each
    47370 Laparoscopy, surgical, ablation of one or more liver tumor(s); radiofrequency
    47371 Laparoscopy, surgical, ablation of one or more liver tumor(s); cryosurgical
    47380 Ablation, open, of one or more liver tumor(s); radiofrequency
    47381 Ablation, open, of one or more liver tumor(s); cryosurgical
    47382 Ablation, one or more liver tumor(s), percutaneous, radiofrequency
    47383 Ablation, 1 or more liver tumor(s), percutaneous, cryoablation
    47550 Biliary endoscopy, intraoperative (choledochoscopy) (List separately in addition to code for primary procedure
    47554 Biliary endoscopy, percutaneous via T-tube or other tract; with removal of calculus/calculi
    47562 Laparoscopy, surgical; cholecystectomy
    47600 Cholecystectomy
    47720 Cholecystoenterostomy; direct
    47721 Cholecystoenterostomy; with gastroenterostomy
    47740 Cholecystoenterostomy; Roux-en-Y
    47741 Cholecystoenterostomy; Roux-en-Y with gastroenterostomy
    47760 Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract
    47765 Anastomosis, of intrahepatic ducts and gastrointestinal tract
    47780 Anastomosis, Roux-en-Y, of extrahepatic biliary ducts and gastrointestinal tract
    48140 Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy
    48145 Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy
    48146 Pancreatectomy, distal, near-total with preservation of duodenum (Child-type procedure
    48150 Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); with pancreatojejunostomy
    48152 Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); without pancreatojejunostomy
    48153 Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); with pancreatojejunostomy
    48154 Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); without pancreatojejunostomy
    48155 Pancreatectomy, total
    48160 Pancreatectomy, total or subtotal, with autologous transplantation of pancreas or pancreatic islet cells
    48510 External drainage, pseudocyst of pancreas, open
    48520 Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct
    48540 Internal anastomosis of pancreatic cyst to gastrointestinal tract; Roux-en-Y
    48548 Duodenal exclusion with gastrojejunostomy for pancreatic injury
    48550 Donor pancreatectomy (including cold preservation), with or without duodenal segment for transplantation
    48551 Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation of bile duct, ligation of mesenteric vessels, and Y-graft arterial anastomoses from iliac artery to superior mesenteric artery and to splenic artery
    48552 Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each
    48554 Transplantation of pancreatic allograft
    48556 Removal of transplanted pancreatic allograft
    49411 Placement of interstitial device(s) for radiation therapy guidance (e.g., fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or multiple
    49412 Placement of interstitial device(s) for radiation therapy guidance (e.g., fiducial markers, dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum, including image guidance, if performed, single or multiple (List separately in addition to code for primary procedure)
    49446 Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report
    49585 Repair umbilical hernia, age 5 years or older; reducible
    50130 Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy)
    50250 Ablation, open, one or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed
    50300 Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral
    50320 Donor nephrectomy (including cold preservation); open, from living donor
    50323 Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision of adrenal gland, and preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches, as necessary
    50325 Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches, as necessary
    50327 Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each
    50328 Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each
    50329 Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each
    50340 Recipient nephrectomy (separate procedure
    50360 Renal allotransplantation, implantation of graft; without recipient nephrectomy
    50365 Renal allotransplantation, implantation of graft; with recipient nephrectomy
    50370 Removal of transplanted renal allograft
    50380 Renal autotransplantation, reimplantation of kidney
    50395 Introduction of guide into renal pelvis and/or ureter with dilation to establish nephrostomy tract, percutaneous
    50542 Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring when performed
    50553 Injection(s); single or multiple trigger point(s), 3 or more muscle(s)
    50590 Lithotripsy, extracorporeal shock wave
    50592 Ablation, one or more renal tumor(s), percutaneous, unilateral, radiofrequency
    50593 Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy
    50610 Ureterolithotomy; upper one-third of ureter
    50620 Ureterolithotomy; middle one-third of ureter
    50630 Ureterolithotomy; lower one-third of ureter
    50780 Ureteroneocystostomy; anastomosis of single ureter to bladder
    51550 Cystectomy, partial; simple
    51555 Cystectomy, partial; complicated (e.g., postradiation, previous surgery, difficult location)
    51565 Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy)
    51580 Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations;
    51585 Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes
    51590 Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis
    51595 Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes
    51596 Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder
    51715 Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck
    51840 Anterior vesicourethropexy, or urethropexy (e.g., Marshall-Marchetti-Krantz, Burch); simple
    51841 Anterior vesicourethropexy, or urethropexy (e.g., Marshall-Marchetti-Krantz, Burch); complicated (e.g., secondary repair)
    51845 Abdomino-vaginal vesical neck suspension, with or without endoscopic control (e.g., Stamey, Raz, modified Pereyra
    52000 Cystourethroscopy (separate procedure)
    52287 Cystourethroscopy, with injection(s) for chemodenervation of the bladder
    52402 Cystourethroscopy with transurethral resection or incision of ejaculatory ducts
    52441 Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant
    52442 Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure)
    52647 Laser coagulation of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included if performed)
    52648 Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)
    53400 Urethroplasty; first stage, for fistula, diverticulum, or stricture (e.g., Johannsen type)
    53405 Urethroplasty; second stage (formation of urethra), including urinary diversion
    53410 Urethroplasty, 1-stage reconstruction of male anterior urethra
    53415 Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra
    53420 Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage
    53425 Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage
    53430 Urethroplasty, reconstruction of female urethra
    53431 Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (e.g., Tenago, Leadbetter procedure)
    53850 Transurethral destruction of prostate tissue; by microwave thermotherapy
    53852 Transurethral destruction of prostate tissue; by radiofrequency thermotherapy
    53860 Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence
    53899 Unlisted procedure, urinary system
    54125 Amputation of penis; complete
    54250 Nocturnal penile tumescence and/or rigidity test
    54304 Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps
    54308 Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm
    54312 Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm
    54316 Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia
    54318 Urethroplasty for third stage hypospadias repair to release penis from scrotum (e.g., third stage Cecil repair)
    54322 1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (e.g., Magpi, V-flap)
    54324 1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (e.g., flip-flap, prepucial flap)
    54326 1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra
    54328 1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap
    54332 1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap
    54344 Repair of hypospadias complications (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft
    54352 Repair of hypospadias cripple requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of local skin as grafts and island flaps and skin brought in as flaps or grafts
    54380 Plastic operation on penis for epispadias distal to external sphincter;
    54385 Plastic operation on penis for epispadias distal to external sphincter; with incontinence
    54390 Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder
    54400 Insertion of penile prosthesis; non-inflatable (semi-rigid)
    54401 Insertion of penile prosthesis; inflatable (self-contained)
    54405 Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir
    54406 Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis
    54408 Repair of component(s) of a multi-component, inflatable penile prosthesis
    54410 Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session
    54411 Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue
    54415 Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis
    54416 Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session
    54417 Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue
    54500 Biopsy of testis, needle (separate procedure)
    54505 Biopsy of testis, incisional (separate procedure)
    54520 Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach
    54660 Insertion of testicular prosthesis (separate procedure)
    54690 Laparoscopy, surgical; orchiectomy
    55040 Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure)
    55041 Excision of hydrocele; bilateral
    55060 Repair of tunica vaginalis hydrocele (Bottle type)
    55150 Resection of scrotum
    55175 Scrotoplasty; simple
    55180 Scrotoplasty; complicated
    55300 Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral
    55500 Excision of hydrocele of spermatic cord, unilateral (separate procedure)
    55530 Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure)
    55535 Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach
    55550 Laparoscopy, surgical, with ligation of spermatic veins for varicocele
    55700 Biopsy, prostate; needle or punch, single or multiple, any approach
    55860 Exposure of prostate, any approach, for insertion of radioactive substance;
    55862 Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy)
    55865 Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes
    55870 Electroejaculation
    55873 Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring)
    55875 Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy
    55876 Placement of interstitial device(s) for radiation therapy guidance (e.g., fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple
    55899 Unlisted procedure, male genital system
    55920 Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application
    55970 Intersex surgery; male to female
    55980 Intersex surgery; female to male
    56620 Vulvectomy simple; partial
    56625 Vulvectomy simple; complete
    56630 Vulvectomy, radical, partial;
    56631 Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy
    56632 Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy
    56633 Vulvectomy, radical, complete
    56634 Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy
    56637 Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy
    56640 Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy
    56800 Plastic repair of introitus
    56805 Clitoroplasty for intersex state
    57106 Vaginectomy, partial removal of vaginal wall
    57107 Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)
    57110 Vaginectomy, complete removal of vaginal wall
    57111 Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)
    57155 Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy
    57156 Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy
    57210 Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical)
    57240 Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele
    57250 Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy
    57288 Sling operation for stress incontinence (e.g., fascia or synthetic)
    57289 Pereyra procedure, including anterior colporrhaphy
    57291 Construction of artificial vagina; without graft
    57292 Construction of artificial vagina; with graft
    57295 Revision (including removal) of prosthetic vaginal graft; vaginal approach
    57296 Revision (including removal) of prosthetic vaginal graft; open abdominal approach
    57335 Vaginoplasty for intersex state
    57426 Revision (including removal) of prosthetic vaginal graft, laparoscopic approach
    57530 Trachelectomy (cervicectomy), amputation of cervix (separate procedure)
    58100 Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure)
    58150 Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);
    58152 Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (e.g., Marshall-Marchetti-Krantz, Burch
    58180 Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s)
    58200 Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s)
    58210 Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s)
    58240 Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ureteral transplantations, and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof
    58260 Vaginal hysterectomy, for uterus 250 g or less;
    58262 Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)
    58263 Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele
    58267 Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control
    58270 Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele
    58275 Vaginal hysterectomy, with total or partial vaginectomy;
    58280 Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele
    58290 Vaginal hysterectomy, for uterus greater than 250 g;
    58291 Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)
    58292 Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele
    58321 Artificial insemination; intra-cervical
    58322 Artificial insemination; intra-uterine
    58323 Sperm washing for artificial insemination
    58340 Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography
    58345 Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography
    58346 Insertion of Heyman capsules for clinical brachytherapy
    58350 Chromotubation of oviduct, including materials
    58353 Endometrial ablation, thermal, without hysteroscopic guidance
    58540 Hysteroplasty, repair of uterine anomaly (Strassman type)
    58555 Hysteroscopy, diagnostic (separate procedure)
    58558 Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C
    58559 Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)
    58560 Hysteroscopy, surgical; with division or resection of intrauterine septum (any method)
    58561 Hysteroscopy, surgical; with removal of leiomyomata
    58562 Hysteroscopy, surgical; with removal of impacted foreign body
    58563 Hysteroscopy, surgical; with endometrial ablation (e.g., endometrial resection, electrosurgical ablation, thermoablation)
    58565 Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants
    58578 Unlisted laparoscopy procedure, uterus
    58660 Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)
    58661 Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)
    58662 Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method
    58670 Laparoscopy, surgical; with fulguration of oviducts (with or without transection)
    58671 Laparoscopy, surgical; with occlusion of oviducts by device (e.g., band, clip, or Falope ring)
    58672 Laparoscopy, surgical; with fimbrioplasty
    58673 Laparoscopy, surgical; with salpingostomy (salpingoneostomy)
    58679 Unlisted laparoscopy procedure, oviduct, ovary
    58740 Lysis of adhesions (salpingolysis, ovariolysis)
    58760 Fimbrioplasty
    58770 Salpingostomy (salpingoneostomy)
    58800 Drainage of ovarian cyst(s), unilateral or bilateral, (separate procedure); vaginal approach
    58805 Drainage of ovarian cyst(s), unilateral or bilateral, (separate procedure); abdominal approach
    58825 Transposition, ovary(s)
    58920 Wedge resection or bisection of ovary, unilateral or bilateral
    58925 Ovarian cystectomy, unilateral or bilateral
    58940 Oophorectomy, partial or total, unilateral or bilateral;
    58960 Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diaphragmatic assessment with pelvic and limited para-aortic lymphadenectomy
    58970 Follicle puncture for oocyte retrieval, any method
    58974 Embryo transfer, intrauterine
    58976 Gamete, zygote, or embryo intrafallopian transfer, any method
    58999 Unlisted procedure, female genital system (nonobstetrical)
    59001 Home uterine monitor with or without associated nursing services
    59320 Cerclage of cervix, during pregnancy; vaginal
    59325 Cerclage of cervix, during pregnancy; abdominal
    60280 Excision of thyroglossal duct cyst or sinus;
    60281 Excision of thyroglossal duct cyst or sinus; recurrent
    60540 Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure);
    60650 Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal
    61050 Cisternal or lateral cervical (C1-C2) puncture; without injection (separate procedure)
    61055 Cisternal or lateral cervical (C1-C2) puncture; with injection of medication or other substance for diagnosis or treatment
    61108 Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma
    61154 Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural
    61156 Burr hole(s); with aspiration of hematoma or cyst, intracerebral
    61250 Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery
    61253 Burr hole(s) or trephine, infratentorial, unilateral or bilateral
    61537 Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery
    61548 Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic
    61566 Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy
    61624 Transcatheter permanent occlusion or embolization (e.g., for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method; central nervous system (intracranial, spinal cord)
    61630 Balloon angioplasty, intracranial (e.g., atherosclerotic stenosis), percutaneous
    61635 Transcatheter placement of intravascular stent(s), intracranial (e.g., atherosclerotic stenosis), including balloon angioplasty, if performed
    61642 Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular family (List separately in addition to code for primary procedure)
    61680 Surgery of intracranial arteriovenous malformation; supratentorial, simple
    61682 Surgery of intracranial arteriovenous malformation; supratentorial, complex
    61684 Surgery of intracranial arteriovenous malformation; infratentorial, simple
    61686 Surgery of intracranial arteriovenous malformation; infratentorial, complex
    61700 Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation
    61702 Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation
    61703 Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (Selverstone-Crutchfield type)
    61705 Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery
    61720 Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus
    61735 Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus
    61760 Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring
    61796 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion
    61797 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (List separately in addition to code for primary procedure)
    61798 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion
    61799 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (List separately in addition to code for primary procedure)
    61800 Application of stereotactic headframe for stereotactic radiosurgery (List separately in addition to code for primary procedure)
    61850 Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical
    61860 Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical
    61863 Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (e.g., thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; first array
    61864 Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (e.g., thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; each additional array (List separately in addition to primary procedure)
    61867 Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (e.g., thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; first array
    61868 Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (e.g., thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; each additional array (List separately in addition to primary procedure)
    61880 Revision or removal of intracranial neurostimulator electrodes
    61885 Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array
    61886 Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array
    61888 Revision or removal of cranial neurostimulator pulse generator or receiver
    62000 Elevation of depressed skull fracture; simple, extradural
    62005 Elevation of depressed skull fracture; compound or comminuted, extradural
    62010 Elevation of depressed skull fracture; with repair of dura and/or debridement of brain
    62100 Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea
    62180 Ventriculocisternostomy (Torkildsen type operation)
    62200 Ventriculocisternostomy, third ventricle;
    62220 Creation of shunt; ventriculo-atrial, -jugular, -auricular
    62223 Creation of shunt; ventriculo-peritoneal, -pleural, other terminus
    62263 Percutaneous lysis of epidural adhesions using solution injection (e.g., hypertonic saline, enzyme) or mechanical means (e.g., catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 2 or more days
    62264 Percutaneous lysis of epidural adhesions using solution injection (e.g., hypertonic saline, enzyme) or mechanical means (e.g., catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 1 day
    62290 Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy
    62320 Injection(s), of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance (New Code 01/01/2017)
    62321 Injection(s), of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or CT) (New Code 01/01/2017)
    62322 Injection(s), of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance (New Code: 01/01/2017)
    62323 Injection(s), of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT) (New Code: 01/01/2017)
    62324 Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance (New Code: 01/01/2017)
    62325 Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or CT) (New Code: 01/01/2017)
    62326 Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance (New Code: 01/01/2017)
    62327 Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT) (New Code: 01/01/2017)
    62350 Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy
    62351 Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminectomy
    62355 Removal of previously implanted intrathecal or epidural catheter
    62360 Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir
    62361 Implantation or replacement of device for intrathecal or epidural drug infusion; non programmable pump
    62362 Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming
    62365 Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion
    62367 Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming
    62368 Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming
    62369 Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill
    62370 Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill (requiring skill of a physician or other qualified health care professional)
    63001 Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (e.g., spinal stenosis), 1 or 2 vertebral segments; cervical
    63003 Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (e.g., spinal stenosis), 1 or 2 vertebral segments; thoracic
    63005 Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (e.g., spinal stenosis), 1 or 2 vertebral segments; lumbar, except for spondylolisthesis
    63011 Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (e.g., spinal stenosis), 1 or 2 vertebral segments; sacral
    63012 Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure)
    63015 Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (e.g., spinal stenosis), more than 2 vertebral segments; cervical
    63016 Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (e.g., spinal stenosis), more than 2 vertebral segments; thoracic
    63017 Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (e.g., spinal stenosis), more than 2 vertebral segments; lumbar
    63020 Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical
    63030 Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar
    63035 Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or lumbar (List separately in addition to code for primary procedure)
    63040 Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervical
    63042 Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar
    63043 Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each additional cervical interspace (List separately in addition to code for primary procedure)
    63044 Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each additional lumbar interspace (List separately in addition to code for primary procedure)
    63045 Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical
    63046 Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; thoracic
    63047 Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar
    63048 Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure)
    63050 Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments;
    63051 Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed)
    63055 Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (e.g., herniated intervertebral disc), single segment; thoracic
    63056 Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (e.g., herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal approach) (e.g., far lateral herniated intervertebral disc)
    63057 Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (e.g., herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (List separately in addition to code for primary procedure)
    63064 Costovertebral approach with decompression of spinal cord or nerve root(s) (e.g., herniated intervertebral disc), thoracic; single segment
    63066 Costovertebral approach with decompression of spinal cord or nerve root(s) (e.g., herniated intervertebral disc), thoracic; each additional segment (List separately in addition to code for primary procedure)
    63075 Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace
    63076 Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace (List separately in addition to code for primary procedure)
    63077 Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace
    63078 Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additional interspace (List separately in addition to code for primary procedure)
    63081 Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment
    63082 Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (List separately in addition to code for primary procedure)
    63085 Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment
    63086 Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (List separately in addition to code for primary procedure)
    63087 Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single segment
    63088 Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each additional segment (List separately in addition to code for primary procedure)
    63090 Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; single segment
    63091 Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; each additional segment (List separately in addition to code for primary procedure)
    63101 Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (e.g., for tumor or retropulsed bone fragments); thoracic, single segment
    63102 Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (e.g., for tumor or retropulsed bone fragments); lumbar, single segment
    63103 Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (e.g., for tumor or retropulsed bone fragments); thoracic or lumbar, each additional segment (List separately in addition to code for primary procedure)
    63170 Laminectomy with myelotomy (e.g., Bischof or DREZ type), cervical, thoracic, or thoracolumbar
    63172 Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space
    63173 Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space
    63180 Laminectomy and section of dentate ligaments, with or without dural graft, cervical; 1 or 2 segments
    63182 Laminectomy and section of dentate ligaments, with or without dural graft, cervical; more than 2 segments
    63185 Laminectomy with rhizotomy; one or two segments
    63190 Laminectomy with rhizotomy; more than 2 segments
    63191 Laminectomy with section of spinal accessory nerve
    63194 Laminectomy with cordotomy, with section of 1 spinothalamic tract, 1 stage; cervical
    63195 Laminectomy with cordotomy, with section of 1 spinothalamic tract, 1 stage; thoracic
    63196 Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage; cervical
    63197 Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage; thoracic
    63198 Laminectomy with cordotomy with section of both spinothalamic tracts, 2 stages within 14 days; cervical
    63199 Laminectomy with cordotomy with section of both spinothalamic tracts, 2 stages within 14 days; thoracic
    63200 Laminectomy, with release of tethered spinal cord, lumbar
    63250 Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical
    63251 Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic
    63252 Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar
    63265 Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical
    63266 Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic
    63267 Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar
    63268 Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral
    63270 Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical
    63271 Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic
    63272 Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar
    63273 Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral
    63275 Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical
    63276 Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic
    63277 Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar
    63278 Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral
    63280 Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical
    63281 Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic
    63282 Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar
    63283 Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral
    63285 Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical
    63286 Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic
    63287 Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar
    63290 Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level
    63295 Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for primary procedure)
    63300 Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical
    63301 Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach
    63302 Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach
    63303 Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach
    63304 Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical
    63305 Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach
    63306 Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach
    63307 Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach
    63308 Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (List separately in addition to codes for single segment)
    63620 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion
    63621 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (List separately in addition to code for primary procedure)
    63650 Percutaneous implantation of neurostimulator electrode array, epidural
    63655 Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural
    63661 Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed
    63662 Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed
    63663 Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed
    63664 Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed
    63685 Incision and subcutaneous placement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling
    63688 Revision or removal of implanted spinal neurostimulator pulse generator or receiver
    63700 Repair of meningocele; less than 5 cm diameter
    63702 Repair of meningocele; larger than 5 cm diameter
    63704 Repair of myelomeningocele; less than 5 cm diameter
    63706 Repair of myelomeningocele; larger than 5 cm diameter
    63740 Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy
    63741 Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy
    64400 Injection, anesthetic agent; trigeminal nerve, any division or branch
    64402 Injection, anesthetic agent; facial nerve
    64405 Injection, anesthetic agent; greater occipital nerve
    64413 Injection, anesthetic agent; cervical plexus
    64415 Injection, anesthetic agent; brachial plexus, single
    64416 Injection, anesthetic agent; brachial plexus, continuous infusion by catheter (including catheter placement)
    64417 Injection, anesthetic agent; axillary nerve
    64418 Injection, anesthetic agent; suprascapular nerve
    64420 Injection, anesthetic agent; intercostal nerve, single
    64421 Injection, anesthetic agent; intercostal nerves, multiple, regional block
    64425 Injection, anesthetic agent; ilioinguinal, iliohypogastric nerves
    64430 Injection, anesthetic agent; pudendal nerve
    64445 Injection, anesthetic agent; sciatic nerve, single
    64446 Injection, anesthetic agent; sciatic nerve, continuous infusion by catheter (including catheter placement)
    64447 Injection, anesthetic agent; femoral nerve, single
    64448 Injection, anesthetic agent; femoral nerve, continuous infusion by catheter (including catheter placement)
    64449 Injection, anesthetic agent; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement)
    64450 Injection, anesthetic agent; other peripheral nerve or branch
    64455 Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (e.g., Morton's neuroma)
    64479 Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thoracic, single level
    64480 Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thoracic each additional level (list separately in addition to code for primary procedure)
    64483 Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, single level
    64484 4 Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional level (List separately in addition to code for primary procedure)
    64490 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level
    64491 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; second level (list separately in addition to code for primary procedure)
    64492 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; third and any additional level(s) (list separately in addition to code for primary procedure)
    64493 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level
    64494 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; second level (list separately in addition to code for primary procedure)
    64495 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; third and any additional level(s) (list separately in addition to code for primary procedure)
    64550 Application of surface (transcutaneous) neurostimulator
    64553 Percutaneous implantation of neurostimulator electrode array; cranial nerve
    64561 Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed
    64566 Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming
    64568 Incision for implantation of cranial nerve (e.g., vagus nerve) neurostimulator electrode array and pulse generator
    64569 Revision or replacement of cranial nerve (e.g., vagus nerve) neurostimulator electrode array, including connection to existing pulse generator
    64570 Removal of cranial nerve (e.g., vagus nerve) neurostimulator electrode array and pulse generator
    64575 Incision for implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)
    64580 Incision for implantation of neurostimulator electrode array; neuromuscular
    64581 Incision for implantation of neurostimulator electrodes; sacral nerve (transforaminal placement)
    64585 Revision or removal of peripheral neurostimulator electrode array
    64590 Insertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver, direct or inductive coupling
    64595 Revision or removal of peripheral or gastric neurostimulator pulse generator or receiver
    64600 Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch
    64605 Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale
    64610 Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring
    64611 Chemodenervation of parotid and submandibular salivary glands, bilateral
    64612 Chemodenervation of muscle(s); muscle(s) innervated by facial nerve (e.g., for blepharospasm, hemifacial spasm)
    64615 Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (e.g., for chronic migraine)
    64616 Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (e.g., for cervical dystonia, spasmodic torticollis)
    64617 Chemodenervation of muscle(s); larynx, unilateral, percutaneous (e.g., for spasmodic dysphonia), includes guidance by needle electromyography, when performed
    64633 Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint
    64634 Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (List separately in addition to code for primary procedure)
    64635 Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint
    64636 Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure
    64642 Chemodenervation of one extremity; 1-4 muscle(s)
    64643 Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (list separately in addition to code for primary procedure)
    64644 Chemodenervation of one extremity; 5 or more muscles
    64645 Chemodenervation of one extremity; each additional extremity, 5 or more muscles (list separately in addition to code for primary procedure)
    64646 Chemodenervation of trunk muscle(s); 1-5 muscle(s)
    64647 Chemodenervation of trunk muscle(s); 6 or more muscle(s)
    64650 Chemodenervation of eccrine glands; both axillae
    64653 Chemodenervation of eccrine glands; other area(s) (e.g., scalp, face, neck), per day
    64912 Nerve repair; with nerve allograft, each nerve, first strand (cable)
    64913 Nerve repair; with nerve allograft, , each additional strand (List separately in addition to code for primary procedure)
    64999 Unlisted procedure, nervous system
    65710 Keratoplasty (corneal transplant); anterior lamellar
    65730 Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia) Revised
    65750 Keratoplasty (corneal transplant); penetrating (in aphakia)
    65755 Keratoplasty (corneal transplant); penetrating (in pseudophakia)
    65756 Keratoplasty (corneal transplant); endothelial.
    65757 Backbench preparation of corneal endothelial allograft prior to transplantation (List separately in addition to code for primary procedure).
    65760 Keratomileusis
    65765 Keratophakia
    65767 Epikeratoplasty
    65770 Keratoprosthesis
    65771 Radial keratotomy
    65778 Placement of amniotic membrane on the ocular surface; without sutures
    65779 Placement of amniotic membrane on the ocular surface; single layer, sutured
    65780 Ocular surface reconstruction; amniotic membrane transplantation, multiple layers
    65781 Ocular surface reconstruction; limbal stem cell allograft (e.g., cadaveric or living donor)
    65782 Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft)
    65785 Implantation of intrastromal corneal ring segments
    65820 Goniotomy
    65855 Trabeculoplasty by laser surgery
    66150 Fistulization of sclera for glaucoma; trephination with iridectomy
    66155 Fistulization of sclera for glaucoma; thermocauterization with iridectomy
    66160 Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy
    66170 Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae
    66172 Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents)
    66174 Transluminal dilation of aqueous outflow canal; without retention of device or stent
    66175 Transluminal dilation of aqueous outflow canal; with retention of device or stent
    66179 Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft
    66180 Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft
    66183 Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach
    66184 Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft
    66185 Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft
    66710 Ciliary body destruction; cyclophotocoagulation, transscleral
    66720 Ciliary body destruction; cryotherapy
    66761 Iridotomy/iridectomy by laser surgery (e.g., for glaucoma) (per session)
    67027 Implantation of intravitreal drug delivery system (e.g., ganciclovir implant), includes concomitant removal of vitreous
    67028 Intravitreal injection of a pharmacologic agent (separate procedure)
    67221 Destruction of localized lesion of choroid (e.g., choroidal neovascularization); photodynamic therapy (includes intravenous infusion)
    67225 Destruction of localized lesion of choroid (e.g., choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment)
    67255 Scleral reinforcement (separate procedure); with graft
    67299 Unlisted procedure, posterior segment
    67311 Strabismus surgery, recession or resection procedure; 1 horizontal muscle
    67312 Strabismus surgery, recession or resection procedure; 2 horizontal muscles
    67314 Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique)
    67316 Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique)
    67318 Strabismus surgery, any procedure, superior oblique muscle
    67320 Transposition procedure (e.g., for paretic extraocular muscle), any extraocular muscle (specify) (List separately in addition to code for primary procedure)
    67331 Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (List separately in addition to code for primary procedure)
    67332 Strabismus surgery on patient with scarring of extraocular muscles (e.g., prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (e.g., dysthyroid ophthalmopathy) (List separately in addition to code for primary procedure)
    67334 Strabismus surgery by posterior fixation suture technique, with or without muscle recession (List separately in addition to code for primary procedure)
    67335 Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (List separately in addition to code for specific strabismus surgery)
    67340 Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (List separately in addition to code for primary procedure)
    67343 Release of extensive scar tissue without detaching extraocular muscle (separate procedure)
    67345 Chemodenervation of extraocular muscle
    67400 Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy
    67405 Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only
    67412 Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion
    67413 Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body
    67414 Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression
    67420 Orbitotomy with bone flap or window, lateral approach (e.g., Kroenlein); with removal of lesion
    67430 Orbitotomy with bone flap or window, lateral approach (e.g., Kroenlein); with removal of foreign body
    67440 Orbitotomy with bone flap or window, lateral approach (e.g., Kroenlein); with drainage
    67445 Orbitotomy with bone flap or window, lateral approach (e.g., Kroenlein); with removal of bone for decompression
    67450 Orbitotomy with bone flap or window, lateral approach (e.g., Kroenlein); for exploration, with or without biopsy
    67900 Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)
    67901 Repair of blepharoptosis; frontalis muscle technique with suture or other material (e.g., banked fascia)
    67902 Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia)
    67903 Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach
    67904 Repair of blepharoptosis; (tarso) levator resection or advancement, external approach
    67906 Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia)
    67908 Repair of blepharoptosis; conjunctive-tarso-Müller's muscle-levator resection (e.g., Fasanella-Servet type)
    67909 Reduction of overcorrection of ptosis
    67911 Repair of ectropion; extensive (e.g., tarsal strip operations)
    67914 Repair of ectropion; extensive (e.g., tarsal strip operations)
    67915 Repair of ectropion; extensive (e.g., tarsal strip operations)
    67916 Repair of ectropion; extensive (e.g., tarsal strip operations)
    67917 Repair of ectropion; extensive (e.g., tarsal strip operations)
    67921 Repair of entropion; suture
    67922 Repair of entropion; thermocauterization
    67923 Repair of entropion; excision tarsal wedge
    67924 Repair of entropion; extensive (e.g., tarsal strip or capsulopalpebral fascia repairs operation)
    68816 Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation
    69090 Ear piercing
    69300 Otoplasty, protruding ear, with or without size reduction
    69501 Transmastoid antrotomy (simple mastoidectomy)
    69502 Mastoidectomy; complete
    69511 Mastoidectomy; radical
    69601 Revision mastoidectomy; resulting in complete mastoidectomy
    69602 Revision mastoidectomy; resulting in modified radical mastoidectomy
    69603 Revision mastoidectomy; resulting in radical mastoidectomy
    69604 Revision mastoidectomy; resulting in tympanoplasty
    69620 Myringoplasty (surgery confined to drumhead and donor area)
    69631 Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction
    69632 Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (e.g., postfenestration)
    69633 Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (e.g., partial ossicular replacement prosthesis [PORP], total ossicular replacement prosthesis [TORP])
    69635 Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction
    69636 Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction
    69637 Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (e.g., partial ossicular replacement prosthesis [PORP], total ossicular replacement prosthesis [TORP])
    69641 Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction
    69642 Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction
    69643 Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction
    69644 Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction
    69645 Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction
    69646 Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction
    69650 Stapes mobilization
    69660 Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material;
    69661 Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out
    69710 Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone
    69711 Removal or repair of electromagnetic bone conduction hearing device in temporal bone
    69714 Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; without mastoidectomy
    69715 Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; with mastoidectomy
    69717 Replacement (including removal of existing device), osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; without mastoidectomy
    69718 Replacement (including removal of existing device), osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; with mastoidectomy
    69930 Cochlear device implantation, with or without mastoidectomy
    70336 Magnetic resonance (e.g., proton) imaging, temporomandibular joint(s)
    70450 Computed tomography, head or brain; without contrast material
    70460 Computed tomography, head or brain; with contrast material(s)
    70470 Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections
    70480 Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material
    70481 Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)
    70482 Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections
    70486 Computed tomography, maxillofacial area; without contrast material
    70487 Computed tomography, maxillofacial area; with contrast material(s)
    70488 Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections
    70490 Computed tomography, soft tissue neck; without contrast material
    70491 Computed tomography, soft tissue neck; with contrast material(s)
    70492 Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections
    70496 Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing
    70498 Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing
    70540 Magnetic resonance (e.g., proton) imaging, orbit, face, and/or neck; without contrast material(s)
    70542 Magnetic resonance (e.g., proton) imaging, orbit, face, and/or neck; with contrast material(s)
    70543 Magnetic resonance (e.g., proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences
    70544 Magnetic resonance angiography, head; without contrast material(s)
    70545 Magnetic resonance angiography, head; with contrast material(s)
    70546 Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences
    70547 Magnetic resonance angiography, neck; without contrast material(s)
    70548 Magnetic resonance angiography, neck; with contrast material(s)
    70549 Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences
    70551 Magnetic resonance (e.g., proton) imaging, brain (including brain stem); without contrast material
    70552 Magnetic resonance (e.g., proton) imaging, brain (including brain stem); with contrast material(s)
    70553 Magnetic resonance (e.g., proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences
    70554 Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration
    70555 Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional testing
    71250 Computed tomography, thorax; without contrast material
    71260 Computed tomography, thorax; with contrast material(s)
    71270 Computed tomography, thorax; without contrast material, followed by contrast material(s) and further sections
    71275 Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing
    71550 Magnetic resonance (e.g., proton) imaging, chest (e.g., for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)
    71551 Magnetic resonance (e.g., proton) imaging, chest (e.g., for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)
    71552 Magnetic resonance (e.g., proton) imaging, chest (e.g., for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences
    71555 Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)
    72125 Computed tomography, cervical spine; without contrast material
    72126 Computed tomography, cervical spine; with contrast material
    72127 Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections
    72128 Computed tomography, thoracic spine; without contrast material
    72129 Computed tomography, thoracic spine; with contrast material
    72130 Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections
    72131 Computed tomography, lumbar spine; without contrast material
    72132 Computed tomography, lumbar spine; with contrast material
    72133 Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections
    72141 Magnetic resonance (e.g., proton) imaging, spinal canal and contents, cervical; without contrast material
    72142 Magnetic resonance (e.g., proton) imaging, spinal canal and contents, cervical; with contrast material(s)
    72146 Magnetic resonance (e.g., proton) imaging, spinal canal and contents, thoracic; without contrast material
    72147 Magnetic resonance (e.g., proton) imaging, spinal canal and contents, thoracic; with contrast material(s)
    72148 Magnetic resonance (e.g., proton) imaging, spinal canal and contents, lumbar; without contrast material
    72149 Magnetic resonance (e.g., proton) imaging, spinal canal and contents, lumbar; with contrast material(s)
    72156 Magnetic resonance (e.g., proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical
    72157 Magnetic resonance (e.g., proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic
    72158 Magnetic resonance (e.g., proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar
    72159 Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)
    72191 Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing
    72192 Computed tomography, pelvis; without contrast material
    72193 Computed tomography, pelvis; with contrast material(s)
    72194 Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections
    72195 Magnetic resonance (e.g., proton) imaging, pelvis; without contrast material(s)
    72196 Magnetic resonance (e.g., proton) imaging, pelvis; with contrast material(s)
    72197 Magnetic resonance (e.g., proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences
    72198 Magnetic resonance angiography, pelvis, with or without contrast material(s)
    72295 Discography, lumbar, radiological supervision and interpretation
    73200 Computed tomography, upper extremity; without contrast material
    73201 Computed tomography, upper extremity; with contrast material(s)
    73202 Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections
    73206 Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing
    73218 Magnetic resonance (e.g., proton) imaging, upper extremity, other than joint; without contrast material(s)
    73219 Magnetic resonance (e.g., proton) imaging, upper extremity, other than joint; with contrast material(s)
    73220 Magnetic resonance (e.g., proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences
    73221 Magnetic resonance (e.g., proton) imaging, any joint of upper extremity; without contrast material(s)
    73222 Magnetic resonance (e.g., proton) imaging, any joint of upper extremity; with contrast material(s)
    73223 Magnetic resonance (e.g., proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences
    73225 Magnetic resonance angiography, upper extremity, with or without contrast material(s)
    73700 Computed tomography, lower extremity; without contrast material
    73701 Computed tomography, lower extremity; with contrast material(s)
    73702 Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections
    73706 Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing
    73718 Magnetic resonance (e.g., proton) imaging, lower extremity other than joint; without contrast material(s)
    73719 Magnetic resonance (e.g., proton) imaging, lower extremity other than joint; with contrast material(s)
    73720 Magnetic resonance (e.g., proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences
    73721 Magnetic resonance (e.g., proton) imaging, any joint of lower extremity; without contrast material
    73722 Magnetic resonance (e.g., proton) imaging, any joint of lower extremity; with contrast material(s)
    73723 Magnetic resonance (e.g., proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences
    73725 Magnetic resonance angiography, lower extremity, with or without contrast material(s)
    74150 Computed tomography, abdomen; without contrast material
    74160 Computed tomography, abdomen; with contrast material(s)
    74170 Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections
    74174 Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing
    74175 Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing
    74176 Computed tomography, abdomen and pelvis; without contrast material
    74177 Computed tomography, abdomen and pelvis; with contrast material(s)
    74178 Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions
    74181 Magnetic resonance (e.g., proton) imaging, abdomen; without contrast material(s)
    74182 Magnetic resonance (e.g., proton) imaging, abdomen; with contrast material(s)
    74183 Magnetic resonance (e.g., proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences
    74185 Magnetic resonance angiography, abdomen, with or without contrast material(s)
    74261 Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material
    74262 Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed.
    74263 Computed tomographic (CT) colonography, screening, including image postprocessing
    74328 Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation
    74712 Magnetic resonance (e.g., proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation
    74713 Magnetic resonance (e.g., proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure)
    75557 Cardiac magnetic resonance imaging for morphology and function without contrast material;
    75559 Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging
    75561 Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences;
    75563 Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging
    75571 Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium
    75572 Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)
    75573 Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of LV cardiac function, RV structure and function and evaluation of venous structures, if performed)
    75574 Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)
    75635 Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing
    75894 Transcatheter therapy, embolization, any method, radiological supervision and interpretation
    75956 Endovascular repair of descending thoracic aorta (e.g., aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension(s), if required, to level of celiac artery origin, radiological supervision and interpretation
    75957 Endovascular repair of descending thoracic aorta (e.g., aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); not involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension(s), if required, to level of celiac artery origin, radiological supervision and interpretation
    75958 Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta (e.g., aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption), radiological supervision and interpretation
    75959 Placement of distal extension prosthesis(s) (delayed) after endovascular repair of descending thoracic aorta, as needed, to level of celiac origin, radiological supervision and interpretation
    76376 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation
    76377 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation
    76380 Computed tomography, limited or localized follow-up study
    76390 Magnetic resonance spectroscopy
    76499 Unlisted diagnostic radiographic procedure
    76801 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation
    76802 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately in addition to code for primary procedure)
    76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation
    76810 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List separately in addition to code for primary procedure)
    76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation
    76812 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separately in addition to code for primary procedure)
    76813 Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation
    76814 Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separately in addition to code for primary procedure)
    76815 Ultrasound, pregnant uterus, real time with image documentation, limited (e.g., fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses
    76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up (e.g., re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetus
    76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal
    76818 Fetal biophysical profile; with non-stress testing
    76819 Fetal biophysical profile; without non-stress testing
    76820 Doppler velocimetry, fetal; umbilical artery
    76821 Doppler velocimetry, fetal; middle cerebral artery
    76825 Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording;
    76826 Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study
    76827 Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete
    76828 Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study
    76873 Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)
    76940 Ultrasound guidance for, and monitoring of, parenchymal tissue ablation
    76942 Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation
    76948 Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation
    76965 Ultrasonic guidance for interstitial radioelement application
    76975 Gastrointestinal endoscopic ultrasound, supervision and interpretation
    76998 Ultrasonic guidance, intraoperative
    77003 Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid)(List separately in addition to code for primary procedure) (Revised 01/01/2017)
    77011 Computed tomography guidance for stereotactic localization
    77012 Computed tomography guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), radiological supervision and interpretation
    77013 Computed tomography guidance for, and monitoring of, parenchymal tissue ablation
    77014 Computed tomography guidance for placement of radiation therapy fields
    77021 Magnetic resonance guidance for needle placement (e.g., for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation
    77022 Magnetic resonance guidance for, and monitoring of, parenchymal tissue ablation
    77058 Magnetic resonance imaging, breast, without and/or with contrast material(s); unilateral
    77059 Magnetic resonance imaging, breast, without and/or with contrast material(s); bilateral
    77061 Digital breast tomosynthesis; unilateral
    77062 Digital breast tomosynthesis; bilateral
    77078 Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (e.g., hips, pelvis, spine)
    77084 Magnetic resonance (e.g., proton) imaging, bone marrow blood supply
    77261 Therapeutic radiology treatment planning; simple
    77262 Therapeutic radiology treatment planning; intermediate
    77263 Therapeutic radiology treatment planning; complex
    77280 Therapeutic radiology simulation-aided field setting; simple
    77285 Therapeutic radiology simulation-aided field setting; intermediate
    77290 Therapeutic radiology simulation-aided field setting; complex
    77293 Respiratory motion management simulation (List separately in addition to code for primary procedure)
    77295 3-dimensional radiotherapy plan, including dose-volume histograms
    77299 Unlisted procedure, therapeutic radiology clinical treatment planning
    77300 Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician
    77301 Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications
    77305 Teletherapy, isodose plan (whether hand or computer calculated); simple (1 or 2 parallel opposed unmodified ports directed to a single area of interest)
    77306 Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)
    77307 Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)
    77316 Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)
    77317 Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)
    77318 Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)
    77321 Special teletherapy port plan, particles, hemibody, total body
    77331 Special dosimetry (e.g., TLD, microdosimetry) (specify), only when prescribed by the treating physician
    77332 Treatment devices, design and construction; simple (simple block, simple bolus)
    77333 Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)
    77334 Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)
    77336 Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation oncologist, reported per week of therapy
    77338 Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per IMRT plan
    77370 Special medical radiation physics consultation
    77371 Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-source Cobalt 60 based
    77372 Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; linear accelerator based
    77373 Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions
    77385 Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; simple
    77386 Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex
    77387 Guidance for localization of target volume for delivery of radiation treatment delivery, includes intrafraction tracking, when performed
    77399 Unlisted procedure, medical radiation physics, dosimetry and treatment devices, and special services
    77401 Radiation treatment delivery, superficial and/or ortho voltage, per day
    77402 Radiation treatment delivery, =>1 MeV; simple
    77407 Radiation treatment delivery, =>1 MeV; intermediate
    77412 Radiation treatment delivery, => 1 MeV; complex
    77417 Therapeutic radiology port image(s)
    77422 High energy neutron radiation treatment delivery; single treatment area using a single port or parallel-opposed ports with no blocks or simple blocking
    77423 High energy neutron radiation treatment delivery; 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge, and/or compensator(s)
    77424 Intraoperative radiation treatment delivery, x-ray, single treatment session
    77425 Intraoperative radiation treatment delivery, electrons, single treatment session
    77427 Radiation treatment management, 5 treatments
    77431 Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only
    77432 Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of one session)
    77435 Stereotactic body radiation therapy, treatment management, per treatment course, to one or more lesions, including image guidance, entire course not to exceed 5 fractions
    77469 Intraoperative radiation treatment management
    77470 Special treatment procedure (e.g., total body irradiation, hemibody radiation, per oral or endocavitary irradiation)
    77499 Unlisted procedure, therapeutic radiology treatment management
    77520 Proton treatment delivery; simple, without compensation
    77522 Proton treatment delivery; simple, with compensation
    77523 Proton treatment delivery; intermediate
    77525 Proton treatment delivery; complex
    77600 Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)
    77605 Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)
    77610 Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators
    77615 Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators
    77620 Hyperthermia generated by intracavitary probe(s)
    77750 Infusion or instillation of radioelement solution (includes 3-month follow-up care)
    77761 Intracavitary radiation source application; simple
    77762 Intracavitary radiation source application; intermediate
    77763 Intracavitary radiation source application; complex
    77767 Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel
    77768 Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions
    77770 Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel
    77771 Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels
    77772 Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels
    77778 Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed
    77789 Surface application of low dose rate radionuclide source
    77790 Supervision, handling, loading of radiation source
    77799 Unlisted procedure, clinical brachytherapy
    78012 Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)
    78013 Thyroid imaging (including vascular flow, when performed);
    78014 Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)
    78015 Thyroid carcinoma metastases imaging; limited area (e.g., neck and chest only)
    78016 Thyroid carcinoma metastases imaging; with additional studies (e.g., urinary recovery)
    78018 Thyroid carcinoma metastases imaging; whole body
    78020 Thyroid carcinoma metastases uptake (List separately in addition to code for primary procedure)
    78070 Parathyroid planar imaging (including subtraction, when performed);
    78071 Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT)
    78072 Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT), and concurrently acquired computed tomography (CT) for anatomical localization
    78075 Adrenal imaging, cortex and/or medulla
    78102 Bone marrow imaging; limited area
    78103 Bone marrow imaging; multiple areas
    78104 Bone marrow imaging; whole body
    78185 Spleen imaging only, with or without vascular flow
    78195 Lymphatics and lymph nodes imaging
    78201 Liver imaging; static only
    78202 Liver imaging; with vascular flow
    78205 Liver imaging (SPECT);
    78206 Liver imaging (SPECT); with vascular flow
    78215 Liver and spleen imaging; static only
    78216 Liver and spleen imaging; with vascular flow
    78226 Hepatobiliary system imaging, including gallbladder when present;
    78227 Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed
    78230 Salivary gland imaging;
    78231 Salivary gland imaging; with serial images
    78232 Salivary gland function study
    78258 Esophageal motility
    78261 Gastric mucosa imaging
    78262 Gastroesophageal reflux study
    78264 Gastric emptying imaging study (e.g., solid, liquid, or both);
    78265 Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump
    78266 Gastric emptying imaging study (e.g., solid, liquid, or both); with small bowel and colon transit, multiple days
    78278 Acute gastrointestinal blood loss imaging
    78282 Gastrointestinal protein loss
    78290 Intestine imaging (e.g., ectopic gastric mucosa, Meckel's localization, volvulus)
    78291 Peritoneal-venous shunt patency test (e.g., for LeVeen, Denver shunt)
    78300 Bone and/or joint imaging; limited area
    78305 Bone and/or joint imaging; multiple areas
    78306 Bone and/or joint imaging; whole body
    78315 Bone and/or joint imaging; 3 phase study
    78320 Bone and/or joint imaging; tomographic (SPECT)
    78414 Determination of central c-v hemodynamics (non-imaging) (e.g., ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations
    78428 Cardiac shunt detection
    78445 Non-cardiac vascular flow imaging (ie, angiography, venography)
    78451 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)
    78452 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection
    78453 Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)
    78454 Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection
    78456 Acute venous thrombosis imaging, peptide
    78457 Venous thrombosis imaging, venogram; unilateral
    78458 Venous thrombosis imaging, venogram; bilateral
    78459 Myocardial imaging, positron emission tomography (PET), metabolic evaluation
    78466 Myocardial imaging, infarct avid, planar; qualitative or quantitative
    78468 Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique
    78469 Myocardial imaging, infarct avid, planar; tomographic SPECT with or without quantification
    78472 Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing
    78473 Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification
    78481 Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification
    78483 Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification
    78491 Myocardial imaging, positron emission tomography (PET), perfusion; single study at rest or stress
    78492 Myocardial imaging, positron emission tomography (PET), perfusion; multiple studies at rest and/or stress
    78494 Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing
    78496 Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (List separately in addition to code for primary procedure)
    78579 Pulmonary ventilation imaging (e.g., aerosol or gas)
    78580 Pulmonary perfusion imaging (e.g., particulate)
    78582 Pulmonary ventilation (e.g., aerosol or gas) and perfusion imaging
    78597 Quantitative differential pulmonary perfusion, including imaging when performed
    78598 Quantitative differential pulmonary perfusion and ventilation (e.g., aerosol or gas), including imaging when performed
    78600 Brain imaging, less than 4 static views;
    78601 Brain imaging, less than 4 static views; with vascular flow
    78605 Brain imaging, minimum 4 static views;
    78606 Brain imaging, minimum 4 static views; with vascular flow
    78607 Brain imaging, tomographic (SPECT)
    78608 Brain imaging, positron emission tomography (PET); metabolic evaluation
    78609 Brain imaging, positron emission tomography (PET); perfusion evaluation
    78610 Brain imaging, vascular flow only
    78630 Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography
    78635 Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography
    78645 Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation
    78647 Cerebrospinal fluid flow, imaging (not including introduction of material); tomographic (SPECT)
    78650 Cerebrospinal fluid leakage detection and localization
    78660 Radiopharmaceutical dacryocystography
    78700 Kidney imaging morphology;
    78701 Kidney imaging morphology; with vascular flow
    78707 Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention
    78708 Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (e.g., angiotensin converting enzyme inhibitor and/or diuretic)
    78709 Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (e.g., angiotensin converting enzyme inhibitor and/or diuretic)
    78710 Kidney imaging morphology; tomographic (SPECT)
    78725 Kidney function study, non-imaging radioisotopic study
    78730 Urinary bladder residual study (List separately in addition to code for primary procedure)
    78740 Ureteral reflux study (radiopharmaceutical voiding cystogram)
    78761 Testicular imaging with vascular flow
    78800 Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); limited area
    78801 Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); multiple areas
    78802 Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); whole body, single day imaging
    78803 Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); tomographic (SPECT)
    78804 Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); whole body, requiring 2 or more days imaging
    78805 Radiopharmaceutical localization of inflammatory process; limited area
    78806 Radiopharmaceutical localization of inflammatory process; whole body
    78807 Radiopharmaceutical localization of inflammatory process; tomographic (SPECT)
    78811 Positron emission tomography (PET) imaging; limited area (e.g., chest, head/neck)
    78812 Positron emission tomography (PET) imaging; skull base to mid-thigh
    78813 Positron emission tomography (PET) imaging; whole body
    78814 Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (e.g., chest, head/neck)
    78815 Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh
    78816 Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body
    79101 Radiopharmaceutical therapy, by intravenous administration
    79445 5 Radiopharmaceutical therapy, by intra-arterial particulate administration
    81105 Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa], antigen CD61 [GPIIIa]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-1a/b (L33P)
    81106 Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib [platelet], alpha polypeptide [GPIba]) (e.g., neonatal alloimmune thrombocytopenia [NAIT],  post- transfusion purpura), gene analysis, common variant, HPA-2a/b (T145M)
    81107 Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex], antigen CD41 [GPIIb]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-3a/b (I843S)
    81108 Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa], antigen CD61 [GPIIIa]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-4a/b (R14)
    81109 Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 [CD49B, alpha 2 subunit of VLA-2 receptor] [GPIa]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant (e.g., HPA-5a/b (K505E)
    81110 Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa, antigen CD61] [GPIIIa])(e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-6a/b (R489Q)
    81111 Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex, antigen CD41] [GPIIb]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-9a/b (V837M)
    81112 Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y)
    81120 IDH1 (isocitrate dehydrogenase 1 [NADP+], soluble) (e.g., glioma), common variants (e.g., R132H, R132C)
    81121 IDH2 (isocitrate dehydrogenase 2 [NADP+], mitochondrial) (e.g., glioma), common variants (e.g., R140W, R172M)
    81162 BRCA1, BRCA2 (breast cancer 1 and 2) (e.g., hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis
    81170 ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (e.g., acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain (New code effective 01/01/2016)
    81200 ASPA (aspartoacylase) (e.g., Canavan disease) gene analysis, common variants (e.g., E285A, Y231X)
    81201 APC (adenomatous polyposis coli) (e.g., familial adenomatosis polyposis [FAP], attenuated FAP) gene analysis; full gene sequence
    81202 APC (adenomatous polyposis coli) (e.g., familial adenomatosis polyposis [FAP], attenuated FAP) gene analysis; known familial variants
    81203 APC (adenomatous polyposis coli) (e.g., familial adenomatosis polyposis [FAP], attenuated FAP) gene analysis; duplication/deletion variants
    81205 BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (e.g., maple syrup urine disease) gene analysis, common variants (e.g., R183P, G278S, E422X)
    81206 BCR/ABL1 (t(9;22)) (e.g., chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative
    81207 BCR/ABL1 (t(9;22)) (e.g., chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative
    81208 BCR/ABL1 (t(9;22)) (e.g., chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative
    81209 BLM (Bloom syndrome, RecQ helicase-like) (e.g., Bloom syndrome) gene analysis, 2281del6ins7 variant
    81210 BRAF (B-Raf proto-oncogene, serine/threonine kinase) (e.g., colon cancer, melanoma), gene analysis, V600 variant(s)
    81211 BRCA1, BRCA2 (breast cancer 1 and 2) (e.g., hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants in BRCA1 (ie, exon 13 del 3.835kb, exon 13 dup 6kb, exon 14-20 del 26kb, exon 22 del 510 bp, exon 8-9 del 7.1kb)
    81212 BRCA1, BRCA2 (breast cancer 1 and 2) (e.g., hereditary breast and ovarian cancer) gene analysis; 185 delAG, 5385insC, 6174delT variants
    81213 BRCA1, BRCA2 (breast cancer 1 and 2) (e.g., hereditary breast and ovarian cancer) gene analysis; uncommon duplication/deletion variants
    81214 BRCA1 (breast cancer 1) (e.g., hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants (ie, exon 13 del 3.835kb, exon 13 dup 6kb, exon 14-20 del 26kb, exon 22 del 510 bp, exon 8-9 del 7.1kb)
    81215 BRCA1 (breast cancer 1) (e.g., hereditary breast and ovarian cancer) gene analysis; known familial variant
    81216 BRCA2 (breast cancer 2) (e.g., hereditary breast and ovarian cancer) gene analysis; full sequence analysis
    81217 BRCA2 (breast cancer 2) (e.g., hereditary breast and ovarian cancer) gene analysis; known familial variant
    81218 Oophorectomy, partial or total, unilateral or bilateral;
    81219 CALR (calreticulin) (e.g., myeloproliferative disorders), gene analysis, common variants in exon 9
    81220 CFTR (cystic fibrosis transmembrane conductance regulator) (e.g., cystic fibrosis) gene analysis; common variants (e.g., ACMG/ACOG guidelines)
    81221 CFTR (cystic fibrosis transmembrane conductance regulator) (e.g., cystic fibrosis) gene analysis; known familial variants
    81222 CFTR (cystic fibrosis transmembrane conductance regulator) (e.g., cystic fibrosis) gene analysis; duplication/deletion variants
    81223 CFTR (cystic fibrosis transmembrane conductance regulator) (e.g., cystic fibrosis) gene analysis; full gene sequence
    81224 CFTR (cystic fibrosis transmembrane conductance regulator) (e.g., cystic fibrosis) gene analysis; intron 8 poly-T analysis (e.g., male infertility)
    81228 Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number variants (e.g., bacterial artificial chromosome [BAC] or oligo-based comparative genomic hybridization [CGH] microarray analysis)
    81229 Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants for chromosomal abnormalities
    81235 EGFR (epidermal growth factor receptor) (e.g., non-small cell lung cancer) gene analysis, common variants (e.g., exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q)
    81238 F9 (coagulation factor IX) (e.g., hemophilia B), full gene sequence
    81241 F5 (coagulation factor V) (e.g., hereditary hypercoagulability) gene analysis, Leiden variant
    81242 FANCC (Fanconi anemia, complementation group C) (e.g., Fanconi anemia, type C) gene analysis, common variant (e.g., IVS4+4A>T)
    81243 FMR1 (fragile X mental retardation 1) (e.g., fragile X mental retardation) gene analysis; evaluation to detect abnormal (e.g., expanded) alleles
    81244 FMR1 (Fragile X mental retardation 1) (e.g., fragile X mental retardation) gene analysis; characterization of alleles (e.g., expanded size and methylation status)
    81245 FLT3 (fms-related tyrosine kinase 3) (e.g., acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15)
    81246 FLT3 (fms-related tyrosine kinase 3) (e.g., acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (e.g., D835, I836)
    81247 G6PD (glucose-6-phosphate dehydrogenase) (e.g., hemolytic anemia, jaundice), gene analysis; common variant(s) (e.g., A, A-)
    81248 G6PD (glucose-6-phosphate dehydrogenase) (e.g., hemolytic anemia, jaundice), gene analysis; known familial variant(s)
    81249 G6PD (glucose-6-phosphate dehydrogenase) (e.g., hemolytic anemia, jaundice), gene analysis; full gene sequence
    81250 G6PC (glucose-6-phosphatase, catalytic subunit) (e.g., Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (e.g., R83C, Q347X)
    81251 GBA (glucosidase, beta, acid) (e.g., Gaucher disease) gene analysis, common variants (e.g., N370S, 84GG, L444P, IVS2+1G>A)
    81255 HEXA (hexosaminidase A [alpha polypeptide]) (e.g., Tay-Sachs disease) gene analysis, common variants (e.g., 1278insTATC, 1421+1G>C, G269S)
    81256 HFE (hemochromatosis) (e.g., hereditary hemochromatosis) gene analysis, common variants (e.g., C282Y, H63D)
    81257 HBA1/HBA2 (alpha globin 1 and alpha globin 2) (e.g., alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis, for common deletions or variant (e.g., Southeast Asian, Thai, Filipino, Mediterranean, alpha3.7, alpha4.2, alpha20.5, and Constant Spring)
    81258 HBA1/HBA2 (alpha globin 1 and alpha globin 2)(e.g., alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant
    81259 HBA1/HBA2 (alpha globin 1 and alpha globin 2)(e.g., alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence
    81260 HBA1/HBA2 (alpha globin 1 and alpha globin 2)(e.g., alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence
    81262 IGH@ (Immunoglobulin heavy chain locus) (e.g., leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (e.g., Southern blot)
    81269 HBA1/HBA2 (alpha globin 1 and alpha globin 2)(e.g., alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants
    81270 JAK2 (Janus kinase 2) (e.g., myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant
    81272 KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (e.g., gastrointestinal stromal tumor [GIST], acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (e.g., exons 8, 11, 13, 17, 18)
    81273 KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (e.g., mastocytosis), gene analysis, D816 variant(s)
    81275 KRAS (Kirsten rat sarcoma viral oncogene homolog) (e.g., carcinoma) gene analysis; variants in exon 2 (e.g., codons 12 and 13)
    81276 KRAS (Kirsten rat sarcoma viral oncogene homolog) (e.g., carcinoma) gene analysis; additional variant(s) (e.g., codon 61, codon 146)
    81287 MGMT (O-6-methylguanine-DNA methyltransferase) (e.g., glioblastoma multiforme), methylation analysis
    81288 MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis
    81290 MCOLN1 (mucolipin 1) (e.g., Mucolipidosis, type IV) gene analysis, common variants (e.g., IVS3-2A>G, del6.4kb)
    81292 MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis
    81293 MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants
    81294 MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants
    81295 MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis
    81296 MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants
    81297 MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants
    81298 MSH6 (mutS homolog 6 [E. coli]) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis
    81299 MSH6 (mutS homolog 6 [E. coli]) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants
    81300 MSH6 (mutS homolog 6 [E. coli]) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants
    81301 Microsatellite instability analysis (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (e.g., BAT25, BAT26), includes comparison of neoplastic and normal tissue, if performed
    81311 NRAS (neuroblastoma RAS viral [v-ras] oncogene homolog) (e.g., colorectal carcinoma), gene analysis, variants in exon 2 (e.g., codons 12 and 13) and exon 3 (e.g., codon 61)
    81314 PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (e.g., gastrointestinal stromal tumor [GIST]), gene analysis, targeted sequence analysis (e.g., exons 12, 18)
    81317 PMS2 (postmeiotic segregation increased 2 [S. cerevisiae]) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis
    81318 PMS2 (postmeiotic segregation increased 2 [S. cerevisiae]) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants
    81319 PMS2 (postmeiotic segregation increased 2 [S. cerevisiae]) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants
    81321 PTEN (phosphatase and tensin homolog) (e.g., Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis
    81322 PTEN (phosphatase and tensin homolog) (e.g., Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant
    81323 PTEN (phosphatase and tensin homolog) (e.g., Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant
    81324 PMP22 (peripheral myelin protein 22) (e.g., Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis
    81325 PMP22 (peripheral myelin protein 22) (e.g., Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis
    81326 PMP22 (peripheral myelin protein 22) (e.g., Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant
    81330 SMPD1(sphingomyelin phosphodiesterase 1, acid lysosomal) (e.g., Niemann-Pick disease, Type A) gene analysis, common variants (e.g., R496L, L302P, fsP330)
    81335 TPMT(thiopurine S-methyltransferase) (e.g., drug metabolism),  gene analysis, common variants (e.g., *2, *3)
    81346 TYMS (thymidylate synthetase) (e.g., 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (e.g., tandem repeat variant)
    81350 UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (e.g., irinotecan metabolism), gene analysis, common variants (e.g., *28, *36, *37)
    81355 VKORC1 (vitamin K epoxide reductase complex, subunit 1) (e.g., warfarin metabolism), gene analysis, common variant(s) (e.g., -1639G>A, c.173+1000C>T)
    81381 HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (e.g., B*57:01P), each
    81400 Molecular pathology procedure, Level 1(e.g., identification of single germline variant [eg, SNP] by techniques such as restriction enzyme digestion or melt curve analysis)
    81401 Molecular pathology procedure, Level 2 (e.g., 2-10 SNPs, 1 methylated variant, or 1 somatic variant [typically using nonsequencing target variant analysis], or detection of a dynamic mutation disorder/triplet repeat)
    81402 Molecular pathology procedure, Level 3 (e.g., >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants [typically using non-sequencing target variant analysis], immunoglobulin and T-cell receptor gene rearrangements, duplication/deletion variants of 1 exon, loss of heterozygosity [LOH], uniparental disomy [UPD])
    81403 Molecular pathology procedure, Level 4 (e.g., analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or duplication/deletion variants of 2-5 exons)
    81404 Molecular pathology procedure, Level 5 (e.g., analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation disorder/triplet repeat by Southern blot analysis)
    81405 Molecular pathology procedure, Level 6 (e.g., analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array analysis)
    81406 Molecular pathology procedure, Level 7 (e.g., analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons, cytogenomic array analysis for neoplasia)
    81407 Molecular pathology procedure, Level 8 (e.g., analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on one platform)
    81408 Molecular pathology procedure, Level 9 (e.g., analysis of >50 exons in a single gene by DNA sequence analysis)
    81412 Ashkenazi Jewish associated disorders (e.g., Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analysis panel, must include sequencing of at least 9 genes, including ASPA, BLM, CFTR, FANCC, GBA, HEXA, IKBKAP, MCOLN1, AND SMPD1
    81420 Fetal chromosomal aneuploidy (e.g., trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21
    81435 Hereditary colon cancer disorders (e.g., Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis); genomic sequence analysis panel, must include sequencing of at least 10 genes, including APC, BMPR1A, CDH1, MLH1, MSH2, MSH6, MUTYH, PTEN, SMAD4, and STK11
    81436 Hereditary colon cancer disorders (e.g., Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis); duplication/deletion analysis panel, must include analysis of at least 5 genes, including MLH1, MSH2, EPCAM, SMAD4, and STK11
    81479 Unlisted molecular pathology procedure [when specified as gene analysis of V600K variant]
    81490 Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score
    81493 Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score
    81507 Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy
    81519 Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as recurrence score
    81520 Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin- embedded tissue, algorithm reported as a recurrence risk score
    81521 Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin- embedded tissue, algorithm reported as index related to risk of distant metastasis
    81525 Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence score
    81538 Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival
    81541 Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin- embedded tissue, algorithm reported as a disease- specific mortality risk score
    81545 Oncology (thyroid), gene expression analysis of 142 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (e.g., benign or suspicious)
    81551 Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate cancer detection on repeat biopsy
    81595 Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported as a rejection risk score
    81599 Unlisted multianalyte assay with algorithmic analysis
    82542 Column chromatography, includes mass spectrometry, if performed (e.g., HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen
    82657 Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen
    82731 Fetal fibronectin, cervicovaginal secretions, semi-quantitative
    84999 Unlisted chemistry procedure
    85415 Fibrinolytic factors and inhibitors; plasminogen activator
    86790 Antibody; virus, not elsewhere specified
    86849 Unlisted immunology procedure
    87483 Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (e.g., Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus agalactiae, enterovirus, human parechovirus, herpes simplex virus type 1 and 2, human herpesvirus 6, cytomegalovirus, varicella zoster virus, Cryptococcus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 12-25 targets
    87623 Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (e.g., 6, 11, 42, 43, 44)
    87900 Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics
    87901 Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions
    87902 Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus
    87903 Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested
    87904 Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary procedure)
    87906 Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (e.g., integrase, fusion)
    88230 Tissue culture for non-neoplastic disorders; lymphocyte
    88272 Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (e.g., for derivatives and markers)
    88273 Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (e.g., for microdeletions)
    88274 Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells
    88291 Cytogenetics and molecular cytogenetics, interpretation and report
    88341 Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)
    88342 Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure
    88356 Morphometric analysis; nerve
    88360 Morphometric analysis, tumor immunohistochemistry (e.g., Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual
    88361 Morphometric analysis, tumor immunohistochemistry (e.g., Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology
    88363 Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (e.g., KRAS mutational analysis) [when specified in relation to BRAF testing]
    88368 Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure
    89250 Culture of oocyte(s)/embryo(s), less than 4 days;
    89251 Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos
    89253 Assisted embryo hatching, microtechniques (any method)
    89254 Oocyte identification from follicular fluid
    89255 Preparation of embryo for transfer (any method)
    89257 Sperm identification from aspiration (other than seminal fluid)
    89258 Cryopreservation; embryo(s)
    89260 Sperm isolation; simple prep (e.g., sperm wash and swim-up) for insemination or diagnosis with semen analysis
    89261 Sperm isolation; complex prep (e.g., Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis
    89264 Sperm identification from testis tissue, fresh or cryopreserved
    89268 Insemination of oocytes
    89272 Extended culture of oocyte(s)/embryo(s), 4-7 days
    89280 Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes
    89281 Assisted oocyte fertilization, microtechnique; greater than 10 oocytes
    89290 Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos
    89291 Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos
    89300 Semen analysis; presence and/or motility of sperm including Huhner test (post coital)
    89310 Semen analysis; motility and count (not including Huhner test)
    89320 Semen analysis; volume, count, motility, and differential
    89321 Semen analysis; sperm presence and motility of sperm, if performed
    90867 Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management
    90868 Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session
    90869 Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management
    91035 Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, recording, analysis and interpretation
    91110 Gastrointestinal tract imaging, intraluminal (e.g., capsule endoscopy), esophagus through ileum, with physician interpretation and report
    91111 Gastrointestinal tract imaging, intraluminal (e.g., capsule endoscopy), esophagus with physician interpretation and report
    91200 Liver elastography, mechanically induced shear wave (e.g., vibration), without imaging, with interpretation and report
    92025 Computerized corneal topography, unilateral or bilateral, with interpretation and report
    92275 Electroretinography with interpretation and report
    92287 Anterior segment imaging with interpretation and report; with fluorescein angiography
    92499 Unlisted ophthalmological service or procedure
    92508 Treatment of speech, language, voice, communication, and/or auditory processing disorder; group, 2 or more individuals
    92521 Evaluation of speech fluency (e.g., stuttering, cluttering) (New code 1-1-2014)
    92522 Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria); (New code 1-1-2014)
    92523 Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (e.g., receptive and expressive language) (New code 1-1-2014)
    92524 Behavioral and qualitative analysis of voice and resonance (New code 1-1-2014)
    92558 Evoked otoacoustic emissions, screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis
    92587 Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report
    92588 Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report
    92597 Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech
    92601 Diagnostic analysis of cochlear implant, patient younger than 7 years of age; with programming
    92602 Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming
    92603 Diagnostic analysis of cochlear implant, age 7 years or older; with programming
    92604 Diagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming
    92928 Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch
    92929 Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure)
    92933 Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch
    92934 Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure)
    92937 Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel
    92938 Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (List separately in addition to code for primary procedure)
    92941 Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel
    92943 Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; single vessel
    92944 Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft (List separately in addition to code for primary procedure)
    92971 CardiAssist-method of circulatory assist; external
    92974 Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure)
    92997 Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel
    92998 Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure)
    93015 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with supervision, interpretation and report
    93025 Microvolt T-wave alternans for assessment of ventricular arrhythmias
    93224 External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional
    93225 External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes connection, recording, and disconnection)
    93226 External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; scanning analysis with report
    93227 External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional
    93228 External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ECG data storage (retrievable with query) with ECG triggered and patient selected events transmitted to a remote attended surveillance center for up to 30 days; review and interpretation with report by a physician or other qualified health care professional
    93229 External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ECG data storage (retrievable with query) with ECG triggered and patient selected events transmitted to a remote attended surveillance center for up to 30 days; technical support for connection and patient instructions for use, attended surveillance, analysis and transmission of daily and emergent data reports as prescribed by a physician or other qualified health care professional
    93260 Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead defibrillator system
    93261 Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system
    93268 External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; includes transmission, review and interpretation by a physician or other qualified health care professional
    93270 External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; recording (includes connection, recording, and disconnection)
    93271 External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; transmission and analysis
    93272 External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; review and interpretation by a physician or other qualified health care professional
    93282 Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead transvenous implantable defibrillator system
    93283 Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead transvenous implantable defibrillator system
    93289 Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including analysis of heart rhythm derived data elements
    93292 nterrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system
    93295 Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead implantable defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional
    93303 Transthoracic echocardiography for congenital cardiac anomalies; complete
    93304 Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study
    93306 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography
    93307 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography
    93308 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study
    93350 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;
    93351 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with supervision by a physician or other qualified health care professional
    93452 Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed
    93453 Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed
    93454 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;
    93455 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography
    93456 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization
    93457 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization
    93458 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed
    93459 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography
    93460 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed
    93461 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography
    93462 Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure)
    93580 Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant
    93581 Percutaneous transcatheter closure of a congenital ventricular septal defect with implant
    93583 Percutaneous transcatheter septal reduction therapy (e.g., alcohol septal ablation) including temporary pacemaker insertion when performed
    93590 Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve
    93592 Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure)
    93600 Bundle of His recording
    93602 Intra-atrial recording
    93603 Right ventricular recording
    93609 Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (List separately in addition to code for primary procedure)
    93610 Intra-atrial pacing
    93612 Intraventricular pacing
    93613 Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure)
    93618 Induction of arrhythmia by electrical pacing
    93619 Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia
    93620 Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording
    93621 Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (List separately in addition to code for primary procedure)
    93622 Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (List separately in addition to code for primary procedure)
    93623 Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure)
    93624 Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia
    93644 Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)
    93650 Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement
    93656 Comprehensive electrophysiologic evaluation including transseptal catheterizations, insertion and repositioning of multiple electrode catheters with induction or attempted induction of an arrhythmia including left or right atrial pacing/recording when necessary, right ventricular pacing/recording when necessary, and His bundle recording when necessary with intracardiac catheter ablation of atrial fibrillation by pulmonary vein isolation
    93657 Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in addition to code for primary procedure)
    93668 Peripheral arterial disease (PAD) rehabilitation, per session
    93745 Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electronic ECG, transmission of data to data repository, patient instruction in wearing system and patient reporting of problems or events
    93797 Physician or other qualified health care professional services for outpatient cardiac rehabilitation; without continuous ECG monitoring (per session)
    93798 Physician services for outpatient cardiac rehabilitation; with continuous ECG monitoring (per session)
    93799 Unlisted cardiovascular service or procedure
    93886 Transcranial Doppler study of the intracranial arteries; complete study
    93971 Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study
    94014 Patient-initiated spirometric recording per 30-day period of time; includes reinforced education, transmission of spirometric tracing, data capture, analysis of transmitted data, periodic recalibration and review and interpretation by a physician or other qualified health care professional
    94015 Patient-initiated spirometric recording per 30-day period of time; recording (includes hook-up, reinforced education, data transmission, data capture, trend analysis, and periodic recalibration)
    94016 Patient-initiated spirometric recording per 30-day period of time; review and interpretation only by a physician or other qualified health care professional
    94660 Continuous positive airway pressure ventilation (CPAP), initiation and management
    94669 Mechanical chest wall oscillation to facilitate lung function, per session
    94726 Plethysmography for determination of lung volumes and, when performed, airway resistance
    94728 Airway resistance by impulse oscillometry
    94750 Pulmonary compliance study (e.g., plethysmography, volume and pressure measurements)
    94760 Noninvasive ear or pulse oximetry for oxygen saturation; single determination
    94761 Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (e.g., during exercise)
    94762 Noninvasive ear or pulse oximetry for oxygen saturation; by continuous overnight monitoring (separate procedure)
    95249 Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment, sensor placement, hook- up, calibration of monitor, patient training, and printout of recording
    95250 Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; sensor placement, hook-up, calibration of monitor, patient training, removal of sensor, and printout of recording
    95251 Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; interpretation and report
    95782 Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
    95783 Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist
    95800 Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
    95801 Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
    95803 Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
    95805 Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
    95806 Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoracoabdominal movement)
    95807 Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
    95808 Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist
    95810 Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
    95811 Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist
    95905 Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes F-wave study when performed, with interpretation and report
    95907 Nerve conduction studies; 1-2 studies
    95908 Nerve conduction studies; 3-4 studies
    95909 Nerve conduction studies; 5-6 studies
    95910 Nerve conduction studies; 7-8 studies
    95911 Nerve conduction studies; 9-10 studies
    95912 Nerve conduction studies; 11-12 studies
    95913 Nerve conduction studies; 13 or more studies
    95925 Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs
    95926 Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs
    95927 Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head
    95930 Visual evoked potential (VEP) testing central nervous system, checkerboard or flash
    95940 Continuous intraoperative neurophysiology monitoring in the operating room, one on one monitoring requiring personal attendance, each 15 minutes (List separately in addition to code for primary procedure)
    95941 Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby) or for monitoring of more than one case while in the operating room, per hour (List separately in addition to code for primary procedure)
    95961 Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional
    95962 Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (List separately in addition to code for primary procedure)
    95965 Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (e.g., epileptic cerebral cortex localization)
    95966 Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (e.g., sensory, motor, language, or visual cortex localization)
    95967 Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (e.g., sensory, motor, language, or visual cortex localization) (List separately in addition to code for primary procedure)
    95970 Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); simple or complex brain, spinal cord, or peripheral (ie, cranial nerve, peripheral nerve, autonomic nerve, neuromuscular) neurostimulator pulse generator/transmitter, without reprogramming
    95971 Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); simple spinal cord, or peripheral (ie, peripheral nerve, sacral nerve, neuromuscular) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming
    95972 Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex spinal cord, or peripheral (ie, peripheral nerve, sacral nerve, neuromuscular) (except cranial nerve) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming, first hour
    95974 Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex cranial nerve neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming, with or without nerve interface testing, first hour
    95975 Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex cranial nerve neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming, each additional 30 minutes after first hour (List separately in addition to code for primary procedure)
    95978 Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude and duration, battery status, electrode selectability and polarity, impedance and patient compliance measurements), complex deep brain neurostimulator pulse generator/transmitter, with initial or subsequent programming; first hour
    95979 Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude and duration, battery status, electrode selectability and polarity, impedance and patient compliance measurements), complex deep brain neurostimulator pulse generator/transmitter, with initial or subsequent programming; each additional 30 minutes after first hour (List separately in addition to code for primary procedure)
    95980 Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; intraoperative, with programming
    95990 Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed
    95991 Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; requiring skill of a physician or other qualified health care professional Revised code
    95999 Unlisted neurological or neuromuscular diagnostic procedure
    96000 Comprehensive computer-based motion analysis by video-taping and 3D kinematics;
    96001 Comprehensive computer-based motion analysis by video-taping and 3D kinematics; with dynamic plantar pressure measurements during walking
    96002 Dynamic surface electromyography, during walking or other functional activities, 1-12 muscles
    96003 Dynamic fine wire electromyography, during walking or other functional activities, 1 muscle
    96040 Medical genetics and genetic counseling services, each 30 minutes face-to-face with patient/family
    96105 Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, eg, by Boston Diagnostic Aphasia Examination) with interpretation and report, per hour
    96116 Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities), per hour of the psychologist's or physician's time, both face-to-face time with the patient and time interpreting test results and preparing the report
    96118 Neuropsychological testing (e.g., Halstead-Reitan Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting Test), per hour of the psychologist's or physician's time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report
    96119 Neuropsychological testing (e.g., Halstead-Reitan Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting Test), with qualified health care professional interpretation and report, administered by technician, per hour of technician time, face-to-face
    96120 Neuropsychological testing (e.g., Wisconsin Card Sorting Test), administered by a computer, with qualified health care professional interpretation and report
    96125 Standardized cognitive performance testing (e.g., Ross Information Processing Assessment) per hour of a qualified health care professional's time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report
    96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
    96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)
    96368 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (List separately in addition to code for primary procedure)
    96369 Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); initial, up to 1 hour, including pump set-up and establishment of subcutaneous infusion site(s)
    96370 Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)
    96371 Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); additional pump set-up with establishment of new subcutaneous infusion site(s) (List separately in addition to code for primary procedure)
    96377 Application of on-body injector (includes cannula insertion) for timed subcutaneous injection
    96379 Unlisted therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injection or infusion
    96523 Irrigation of implanted venous access device for drug delivery systems
    96567 Photodynamic therapy by external application of light to destroy premalignant and/or malignant lesions of the skin and adjacent mucosa (e.g., lip) by activation of photosensitive drug(s), each phototherapy exposure session
    96573 Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day
    96574 Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day
    96902 Microscopic examination of hairs plucked or clipped by the examiner (excluding hair collected by the patient) to determine telogen and anagen counts, or structural hair shaft abnormality
    96910 Photochemotherapy; tar and ultraviolet B (Goeckerman treatment) or petrolatum and ultraviolet B
    96912 Photochemotherapy; psoralens and ultraviolet A (PUVA)
    96913 Photochemotherapy (Goeckerman and/or PUVA) for severe photoresponsive dermatoses requiring at least four to eight hours of care under direct supervision of the physician (includes application of medication and dressings)
    96920 Laser treatment for inflammatory skin disease (psoriasis); total area less than 250 sq cm
    96921 Laser treatment for inflammatory skin disease (psoriasis); 250 sq cm to 500 sq cm
    96922 Laser treatment for inflammatory skin disease (psoriasis); over 500 sq cm
    96999 Unlisted special dermatological service or procedure
    97010 Application of a modality to 1 or more areas; hot or cold packs
    97012 Application of a modality to 1 or more areas; traction, mechanical
    97014 Application of a modality to 1 or more areas; electrical stimulation (unattended)
    97016 Application of a modality to one or more areas; vasopneumatic devices
    97018 Application of a modality to 1 or more areas; paraffin bath
    97022 Application of a modality to 1 or more areas; whirlpool
    97024 Application of a modality to 1 or more areas; diathermy (e.g., microwave)
    97026 Application of a modality to 1 or more areas; infrared
    97028 Application of a modality to 1 or more areas; ultraviolet
    97032 Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes
    97033 Application of a modality to 1 or more areas; iontophoresis, each 15 minutes
    97034 Application of a modality to 1 or more areas; contrast baths, each 15 minutes
    97035 Application of a modality to 1 or more areas; ultrasound, each 15 minutes
    97036 Application of a modality to 1 or more areas; Hubbard tank, each 15 minutes
    97039 Unlisted modality (specify type and time if constant attendance)
    97110 Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility
    97112 Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities
    97113 Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises
    97116 Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)
    97124 Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)
    97127 Therapeutic interventions that focus on cognitive function (e.g., attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (e.g., managing time or schedules, initiating, organizing and sequencing tasks), direct (one-on-one) patient contact
    97139 Unlisted therapeutic procedure (specify)
    97140 Manual therapy techniques (e.g., mobilization/ manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes
    97150 Therapeutic procedure(s), group (2 or more individuals)
    97161 Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with stable and/or uncomplicated characteristics; and Clinical decision making of low complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 20 minutes are spent face-to-face with the patient and/or family.
    97162 Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures in addressing a total of 3 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; An evolving clinical presentation with changing characteristics; and Clinical decision making of moderate complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 30 minutes are spent face-to-face with the patient and/or family.
    97163 Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures addressing a total of 4 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with unstable and unpredictable characteristics; and Clinical decision making of high complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 45 minutes are spent face-to-face with the patient and/or family.
    97164 Re-evaluation of physical therapy established plan of care, requiring these components: An examination including a review of history and use of standardized tests and measures is required; and Revised plan of care using a standardized patient assessment instrument and/or measurable assessment of functional outcome Typically, 20 minutes are spent face-to-face with the patient and/or family.
    97165 Occupational therapy evaluation, low complexity, requiring these components: An occupational profile and medical and therapy history, which includes a brief history including review of medical and/or therapy records relating to the presenting problem; An assessment(s) that identifies 1-3 performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of low complexity, which includes an analysis of the occupational profile, analysis of data from problem-focused assessment(s), and consideration of a limited number of treatment options. Patient presents with no comorbidities that affect occupational performance. Modification of tasks or assistance (e.g., physical or verbal) with assessment(s) is not necessary to enable completion of evaluation component. Typically, 30 minutes are spent face-to-face with the patient and/or family.
    97166 Occupational therapy evaluation, moderate complexity, requiring these components: An occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy records and additional review of physical, cognitive, or psychosocial history related to current functional performance; An assessment(s) that identifies 3-5 performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of moderate analytic complexity, which includes an analysis of the occupational profile, analysis of data from detailed assessment(s), and consideration of several treatment options. Patient may present with comorbidities that affect occupational performance. Minimal to moderate modification of tasks or assistance (e.g., physical or verbal) with assessment(s) is necessary to enable patient to complete evaluation component. Typically, 45 minutes are spent face-to-face with the patient and/or family.
    97167 Occupational therapy evaluation, high complexity, requiring these components: An occupational profile and medical and therapy history, which includes review of medical and/or therapy records and extensive additional review of physical, cognitive, or psychosocial history related to current functional performance; An assessment(s) that identifies 5 or more performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of high analytic complexity, which includes an analysis of the patient profile, analysis of data from comprehensive assessment(s), and consideration of multiple treatment options. Patient presents with comorbidities that affect occupational performance. Significant modification of tasks or assistance (e.g., physical or verbal) with assessment(s) is necessary to enable patient to complete evaluation component. Typically, 60 minutes are spent face-to-face with the patient and/or family.
    97168 Re-evaluation of occupational therapy established plan of care, requiring these components: An assessment of changes in patient functional or medical status with revised plan of care; An update to the initial occupational profile to reflect changes in condition or environment that affect future interventions and/or goals; and A revised plan of care. A formal reevaluation is performed when there is a documented change in functional status or a significant change to the plan of care is required. Typically, 30 minutes are spent face-to-face with the patient and/or family.
    97530 Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes
    97532 Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes
    97533 Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes
    97535 Self-care/home management training (e.g., activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes
    97542 Wheelchair management (e.g., assessment, fitting, training), each 15 minutes
    97545 Work hardening/conditioning; initial 2 hours
    97546 Work hardening/conditioning; each additional hour (List separately in addition to code for primary procedure)
    97605 Negative pressure wound therapy (e.g., vacuum assisted drainage collection), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters
    97606 Negative pressure wound therapy (e.g., vacuum assisted drainage collection), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters
    97607 Negative pressure wound therapy, (e.g., vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters
    97608 Negative pressure wound therapy, (e.g., vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters
    97750 Physical performance test or measurement (e.g., musculoskeletal, functional capacity), with written report, each 15 minutes
    97760 Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(s), lower extremity(s) and/or trunk, each 15 minutes
    97763 Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes
    99183 Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session
    99184 Initiation of selective head or total body hypothermia in the critically ill neonate, includes appropriate patient selection by review of clinical, imaging and laboratory data, confirmation of esophageal temperature probe location, evaluation of amplitude EEG, supervision of controlled hypothermia, and assessment of patient tolerance of cooling
    99199 Unlisted special service, procedure or report
    99341 Home visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low severity. Typically, 20 minutes are spent face-to-face with the patient and/or family.
    99342 Home visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
    99343 Home visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
    99344 Home visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
    99345 Home visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant new problem requiring immediate physician attention. Typically, 75 minutes are spent face-to-face with the patient and/or family.
    99347 Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family.
    99348 Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
    99349 Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
    99350 Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive interval history; A comprehensive examination; Medical decision making of moderate to high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Typically, 60 minutes are spent face-to-face with the patient and/or family.
    99500 Home visit for prenatal monitoring and assessment to include fetal heart rate, non-stress test, uterine monitoring, and gestational diabetes monitoring
    99601 Home infusion/specialty drug administration, per visit (up to 2 hours);
    99602 Home infusion/specialty drug administration, per visit (up to 2 hours); each additional hour (List separately in addition to code for primary procedure)
    A0021 Ambulance service, outside state per mile, transport (Medicaid only)
    A0130 Nonemergency transportation: wheelchair van
    A0140 Nonemergency transportation and air travel (private or commercial) intra- or interstate
    A0426 Ambulance service, advanced life support, nonemergency transport, level 1 (ALS 1)
    A0428 Ambulance service, basic life support, nonemergency transport, (BLS)
    A0430 Ambulance service, conventional air services, transport, one way (fixed wing)
    A0431 Ambulance service, conventional air services, transport, one way (rotary wing)
    A0434 Specialty care transport (SCT)
    A0435 Fixed wing air mileage, per statute mile
    A0436 Rotary wing air mileage, per statute mile
    A0999 Unlisted ambulance service
    A4221 Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)
    A4224 Supplies for maintenance of insulin infusion catheter, per week
    A4225 Supplies for external insulin infusion pump, syringe type cartridge, sterile, each
    A4290 Sacral nerve stimulation test lead, each
    A4335 Incontinence supply; miscellaneous
    A4575 Conductive gel or paste, for use with electrical device (e.g., TENS, NMES), per oz
    A4604 Authorization required on or after 12/1/18: Tubing with integrated heating element for use with positive airway pressure device
    A4606 Oxygen probe for use with oximeter device, replacement
    A4649 Surgical supply; miscellaneous
    A4650 Implantable radiation dosimeter, each
    A5500 For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe
    A5501 For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe
    A5503 For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe with roller or rigid rocker bottom, per shoe
    A5504 For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe with wedge(s), per shoe
    A5505 For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe with metatarsal bar, per shoe
    A5506 For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe with off-set heel(s), per shoe
    A5507 For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe, per shoe
    A5508 For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom molded shoe, per shoe
    A5510 For diabetics only, direct formed, compression molded to patient's foot without external heat source, multiple-density insert(s) prefabricated, per shoe
    A5512 For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees Fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each
    A5513 For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer or higher, includes arch filler and other shaping material, custom fabricated, each
    A6261 Wound filler, gel/paste, per fluid ounce, not otherwise specified
    A6262 Wound filler, dry form, per gram, not otherwise specified
    A6549 Gradient compression stocking/sleeve, not otherwise specified
    A6550 Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories
    A7025 High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each
    A7026 High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each
    A7027 Combination oral/nasal mask, used with continuous positive airway pressure device, each
    A7028 Oral cushion for combination oral/nasal mask, replacement only, each
    A7029 Nasal pillows for combination oral/nasal mask, replacement only, pair
    A7030 Full face mask used with positive airway pressure device, each
    A7031 Face mask interface, replacement for full face mask, each
    A7032 Authorization required on or after 12/1/18: Cushion for use on nasal mask interface, replacement only, each
    A7033 Pillow for use on nasal cannula type interface, replacement only, pair
    A7034 Authorization required on or after 12/1/18: Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap
    A7035 Authorization required on or after 12/1/18: Headgear used with positive airway pressure device
    A7036 Authorization required on or after 12/1/18: Chinstrap used with positive airway pressure device
    A7037 Authorization required on or after 12/1/18: Tubing used with positive airway pressure device
    A7038 Authorization required on or after 12/1/18: Filter, disposable, used with positive airway pressure device
    A7039 Authorization required on or after 12/1/18: Filter, non disposable, used with positive airway pressure device
    A7044 Oral interface used with positive airway pressure device, each
    A7045 Exhalation port with or without swivel used with accessories for positive airway devices, replacement only
    A7046 Authorization required on or after 12/1/18: Water chamber for humidifier, used with positive airway pressure device, replacement, each
    A9282 Wig, any type, each
    A9586 Florbetapir F18, diagnostic, per study dose, up to 10 millicuries
    A9606 Radium RA-223 dichloride, therapeutic, per microcurie
    A9900 Miscellaneous dme supply, accessory, and/or service component of another hcpcs code
    A9999 Miscellaneous dme supply or accessory, not otherwise specified
    C1715 Brachytherapy needle
    C1716 Brachytherapy source, nonstranded, gold-198, per source
    C1717 Brachytherapy source, nonstranded, high dose rate iridium-192, per source
    C1719 Brachytherapy source, nonstranded, nonhigh dose rate iridium-192, per source
    C1721 Cardioverter-defibrillator, dual chamber (implantable)
    C1722 Cardioverter-defibrillator, single chamber (implantable)
    C1725 Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability)
    C1728 Catheter, brachytherapy seed administration
    C1767 Generator, neurostimulator (implantable), nonrechargeable
    C1777 Lead, cardioverter-defibrillator, endocardial single coil (implantable)
    C1778 Lead, neurostimulator (implantable)
    C1779 Lead, pacemaker, transvenous VDD single pass
    C1785 Pacemaker, dual chamber, rate-responsive (implantable)
    C1786 Pacemaker, single chamber, rate-responsive (implantable)
    C1789 Prosthesis, breast (implantable)
    C1816 Receiver and/or transmitter, neurostimulator (implantable)
    C1820 Generator, neurostimulator (implantable), with rechargeable battery and charging system
    C1882 Cardioverter-defibrillator, other than single or dual chamber (implantable)
    C1883 Adaptor/extension, pacing lead or neurostimulator lead (implantable)
    C1885 Catheter, transluminal angioplasty, laser
    C1889 Implantable/insertable device for device intensive procedure, not otherwise classified
    C1895 Lead, cardioverter-defibrillator, endocardial dual coil (implantable)
    C1896 Lead, cardioverter-defibrillator, other than endocardial single or dual coil (implantable)
    C1898 Lead, pacemaker, other than transvenous VDD single pass
    C1899 Lead, pacemaker/cardioverter-defibrillator combination (implantable)
    C1900 Lead, left ventricular coronary venous system
    C2619 Pacemaker, dual chamber, nonrate-responsive (implantable)
    C2620 Pacemaker, single chamber, nonrate-responsive (implantable)
    C2621 Pacemaker, other than single or dual chamber (implantable)
    C2634 Brachytherapy source, nonstranded, high activity, iodine-125, greater than 1.01 mCi (NIST), per source
    C2635 Brachytherapy source, nonstranded, high activity, palladium-103, greater than 2.2 mCi (NIST), per source
    C2636 Brachytherapy linear source, nonstranded, palladium-103, per 1 mm
    C2637 Brachytherapy source, nonstranded, ytterbium-169, per source
    C2638 Brachytherapy source, stranded, iodine-125, per source
    C2639 Brachytherapy source, nonstranded, iodine-125, per source
    C2640 Brachytherapy source, stranded, palladium-103, per source
    C2641 Brachytherapy source, nonstranded, palladium-103, per source
    C2642 Brachytherapy source, stranded, cesium-131, per source
    C2643 Brachytherapy source, nonstranded, cesium-131, per source
    C2698 Brachytherapy source, stranded, not otherwise specified, per source
    C2699 Brachytherapy source, nonstranded, not otherwise specified, per source
    C8900 Magnetic resonance angiography with contrast, abdomen
    C8901 Magnetic resonance angiography without contrast, abdomen
    C8902 Magnetic resonance angiography without contrast followed by with contrast, abdomen
    C8903 Magnetic resonance imaging with contrast, breast; unilateral
    C8904 Magnetic resonance imaging without contrast, breast; unilateral
    C8905 Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral
    C8906 Magnetic resonance imaging with contrast, breast; bilateral
    C8907 Magnetic resonance imaging without contrast, breast; bilateral
    C8908 Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral
    C8909 Magnetic resonance angiography with contrast, chest (excluding myocardium)
    C8910 Magnetic resonance angiography without contrast, chest (excluding myocardium)
    C8911 Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)
    C8912 Magnetic resonance angiography with contrast, lower extremity
    C8913 Magnetic resonance angiography without contrast, lower extremity
    C8914 Magnetic resonance angiography without contrast followed by with contrast, lower extremity
    C8918 Magnetic resonance angiography with contrast, pelvis
    C8919 Magnetic resonance angiography without contrast, pelvis
    C8920 Magnetic resonance angiography without contrast followed by with contrast, pelvis
    C8921 Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete
    C8922 Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited study
    C8923 Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color doppler echocardiography
    C8924 Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2D), includes M-mode recording when performed, follow-up or limited study
    C8928 Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report
    C8929 Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography
    C8930 Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision
    C8931 Magnetic resonance angiography with contrast, spinal canal and contents
    C8932 Magnetic resonance angiography without contrast, spinal canal and contents
    C8933 Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents
    C8934 Magnetic resonance angiography with contrast, upper extremity
    C8935 Magnetic resonance angiography without contrast, upper extremity
    C8936 Magnetic resonance angiography without contrast followed by with contrast, upper extremity
    C9030 Injection, copanlisib, 1 mg
    C9031 Lutetium Lu 177, dotatate, therapeutic, 1 mCi
    C9032 Injection, voretigene neparvovec-rzyl, 1 billion vector genome
    C9033 Injection, fosnetupitant 235 mg and palonosetron 0.25 mg
    C9034 Injection, dexamethasone 9%, intraocular, 1 mcg
    C9140 Injection, factor VIII (antihemophilic factor, recombinant) (Afstyla), 1 IU
    C9399 Unclassified drugs or biologicals
    C9462 Injection, delafloxacin, 1 mg
    C9463 Injection, aprepitant, 1 mg
    C9464 Injection, rolapitant, 0.5 mg
    C9465 Hyaluronan or derivative, Durolane, for intra-articular injection, per dose
    C9466 Injection, benralizumab, 1 mg
    C9467 Injection, rituximab and hyaluronidase, 10 mg
    C9468 Injection, Factor IX (antihemophilic factor, recombinant), glycopegylated, Rebinyn, 1 IU
    C9600 Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch
    C9601 Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)
    C9602 Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch
    C9603 Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)
    C9604 Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel
    C9605 Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (list separately in addition to code for primary procedure)
    C9606 Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel
    C9607 Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; single vessel
    C9608 Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft (list separately in addition to code for primary procedure)
    C9725 Placement of endorectal intracavitary applicator for high intensity brachytherapy
    C9726 Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure
    C9728 Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperitoneum, thorax, single or multiple
    C9739 Cystourethroscpy, with insertion of transprostatic implant; 1 to 3
    C9740 Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants
    E0157 Crutch attachment, walker, each
    E0159 Brake attachment for wheeled walker, replacement, each
    E0160 Sitz type bath or equipment, portable, used with or without commode
    E0170 Commode chair with integrated seat lift mechanism, electric, any type
    E0171 Commode chair with integrated seat lift mechanism, non-electric, any type
    E0172 Seat lift mechanism placed over or on top of toilet, any type
    E0175 Foot rest, for use with commode chair, each
    E0181 Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty
    E0182 Pump for alternating pressure pad, for replacement only
    E0184 Dry pressure mattress
    E0185 Gel or gel-like pressure pad for mattress, standard mattress length and width
    E0186 Air pressure mattress
    E0187 Water pressure mattress
    E0189 Lambswool sheepskin pad, any size
    E0190 Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories
    E0193 Powered air flotation bed (low air loss therapy)
    E0194 Air fluidized bed
    E0196 Gel pressure mattress
    E0197 Air pressure pad for mattress, standard mattress length and width
    E0198 Water pressure pad for mattress, standard mattress length and width
    E0200 Heat lamp, without stand (table model), includes bulb, or infrared element
    E0203 Therapeutic lightbox, minimum 10,000 lux, table top model
    E0205 Heat lamp, with stand, includes bulb, or infrared element
    E0210 Electric heat pad, standard
    E0217 Water circulating heat pad with pump
    E0218 Water circulating cold pad with pump
    E0221 Infrared heating pad system
    E0225 Hydrocollator unit, includes pads
    E0235 Paraffin bath unit, portable (see medical supply code a4265 for paraffin)
    E0236 Pump for water circulating pad
    E0239 Hydrocollator unit, portable
    E0246 Transfer tub rail attachment
    E0247 Transfer bench for tub or toilet with or without commode opening
    E0248 Transfer bench, heavy duty, for tub or toilet with or without commode opening
    E0250 Hospital bed, fixed height, with any type side rails, with mattress
    E0251 Hospital bed, fixed height, with any type side rails, without mattress
    E0255 Hospital bed, variable height, hi-lo, with any type side rails, with mattress
    E0256 Hospital bed, variable height, hi-lo, with any type side rails, without mattress
    E0260 Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
    E0261 Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress
    E0265 Hospital bed, total electric (head, foot, and height adjustments), with any type side rails, with mattress
    E0266 Hospital bed, total electric (head, foot, and height adjustments), with any type side rails, without mattress
    E0270 Hospital bed, institutional type includes: oscillating, circulating and stryker frame, with mattress
    E0271 Mattress, innerspring
    E0272 Mattress, foam rubber
    E0273 Bed board
    E0274 Over-bed table
    E0277 Powered pressure-reducing air mattress
    E0280 Bed cradle, any type
    E0290 Hospital bed, fixed height, without side rails, with mattress
    E0291 Hospital bed, fixed height, without side rails, without mattress
    E0292 Hospital bed, variable height, hi-lo, without side rails, with mattress
    E0293 Hospital bed, variable height, hi-lo, without side rails, without mattress
    E0294 Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress
    E0295 Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress
    E0296 Hospital bed, total electric (head, foot, and height adjustments), without side rails, with mattress
    E0297 Hospital bed, total electric (head, foot, and height adjustments), without side rails, without mattress
    E0300 Pediatric crib, hospital grade, fully enclosed, with or without top enclosure
    E0301 Hospital bed, heavy-duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress
    E0302 Hospital bed, extra heavy-duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress
    E0303 Hospital bed, heavy-duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress
    E0304 Hospital bed, extra heavy-duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress
    E0305 Bed side rails, half length
    E0310 Bed side rails, full length
    E0315 Bed accessory: board, table, or support device, any type
    E0316 Safety enclosure frame/canopy for use with hospital bed, any type
    E0328 Hospital bed, pediatric, manual, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress
    E0329 Hospital bed, pediatric, electric or semi-electric, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress
    E0350 Control unit for electronic bowel irrigation/evacuation system
    E0352 Disposable pack (water reservoir bag, speculum, valving mechanism and collection bag/box) for use with the electronic bowel irrigation/evacuation system
    E0371 Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width
    E0372 Powered air overlay for mattress, standard mattress length and width
    E0373 Nonpowered advanced pressure reducing mattress
    E0424 Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing
    E0425 Stationary compressed gas system, purchase; includes regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing
    E0430 Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing
    E0431 Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing
    E0433 Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge
    E0434 Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing
    E0435 Portable liquid oxygen system, purchase; includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor
    E0439 Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing
    E0440 Stationary liquid oxygen system, purchase; includes use of reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing
    E0441 Stationary oxygen contents, gaseous, 1 month's supply = 1 unit
    E0442 Stationary oxygen contents, liquid, 1 month's supply = 1 unit
    E0443 Portable oxygen contents, gaseous, 1 month's supply = 1 unit
    E0444 Portable oxygen contents, liquid, 1 month's supply = 1 unit
    E0445 Oximeter device for measuring blood oxygen levels noninvasively
    E0446 Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories
    E0455 Oxygen tent, excluding croup or pediatric tents
    E0457 Chest shell (cuirass)
    E0459 Chest wrap
    E0462 Rocking bed with or without side rails
    E0465 Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)
    E0466 Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)
    E0470 Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)
    E0471 Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)
    E0472 Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)
    E0480 Percussor, electric or pneumatic, home model
    E0481 Intrapulmonary percussive ventilation system and related accessories
    E0482 Cough stimulating device, alternating positive and negative airway pressure
    E0483 High frequency chest wall oscillation air-pulse generator system, (includes hoses and vest), each
    E0484 Oscillatory positive expiratory pressure device, non-electric, any type, each
    E0485 Oral device/appliance used to reduce upper airway collapsibility, adjustable or nonadjustable, prefabricated, includes fitting and adjustment
    E0486 Oral device/appliance used to reduce upper airway collapsibility, adjustable or nonadjustable, custom fabricated, includes fitting and adjustment
    E0487 Spirometer, electronic, includes all accessories
    E0550 Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery
    E0555 Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter
    E0561 Humidifier, non heated, used with positive airway pressure device
    E0562 Humidifier, heated, used with positive airway pressure device
    E0570 Nebulizer, with compressor
    E0572 Aerosol compressor, adjustable pressure, light duty for intermittent use
    E0574 Ultrasonic/electronic aerosol generator with small volume nebulizer
    E0575 Nebulizer, ultrasonic, large volume
    E0580 Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter
    E0585 Nebulizer, with compressor and heater
    E0601 Continuous positive airway pressure (CPAP) device
    E0605 Vaporizer, room type
    E0610 Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)
    E0615 Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems
    E0617 External defibrillator with integrated electrocardiogram analysis
    E0618 Apnea monitor, without recording feature
    E0619 Apnea monitor, with recording feature
    E0620 Skin piercing device for collection of capillary blood, laser, each
    E0625 Patient lift, bathroom or toilet, not otherwise classified
    E0627 Seat lift mechanism, electric, any type
    E0629 Seat lift mechanism, non-electric, any type
    E0630 Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)
    E0635 Patient lift, electric, with seat or sling
    E0636 Multipositional patient support system, with integrated lift, patient accessible controls
    E0637 Combination sit to stand frame/table system, any size including pediatric, with seat lift feature, with or without wheels
    E0638 Standing frame/table system, one position (e.g., upright, supine or prone stander), any size including pediatric, with or without wheels
    E0639 Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories
    E0640 Patient lift, fixed system, includes all components/accessories
    E0641 Standing frame/table system, multi-position (e.g., three-way stander), any size including pediatric, with or without wheels
    E0642 Standing frame/table system, mobile (dynamic stander), any size including pediatric
    E0650 Pneumatic compressor, nonsegmental home model
    E0651 Pneumatic compressor, segmental home model without calibrated gradient pressure
    E0652 Pneumatic compressor, segmental home model with calibrated gradient pressure
    E0655 Nonsegmental pneumatic appliance for use with pneumatic compressor, half arm
    E0656 Segmental pneumatic appliance for use with pneumatic compressor, trunk
    E0657 Segmental pneumatic appliance for use with pneumatic compressor, chest
    E0660 Nonsegmental pneumatic appliance for use with pneumatic compressor, full leg
    E0665 Nonsegmental pneumatic appliance for use with pneumatic compressor, full arm
    E0666 Nonsegmental pneumatic appliance for use with pneumatic compressor, half leg
    E0667 Segmental pneumatic appliance for use with pneumatic compressor, full leg
    E0668 Segmental pneumatic appliance for use with pneumatic compressor, full arm
    E0669 Segmental pneumatic appliance for use with pneumatic compressor, half leg
    E0670 Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk
    E0671 Segmental gradient pressure pneumatic appliance, full leg
    E0672 Segmental gradient pressure pneumatic appliance, full arm
    E0673 Segmental gradient pressure pneumatic appliance, half leg
    E0675 Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)
    E0676 Intermittent limb compression device (includes all accessories), not otherwise specified
    E0691 Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 sq ft or less
    E0692 Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 ft panel
    E0693 Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 ft panel
    E0700 Safety equipment, device or accessory, any type
    E0710 Restraints, any type (body, chest, wrist or ankle)
    E0720 Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation
    E0730 Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation
    E0740 Non-implanted pelvic floor electrical stimulator, complete system
    E0744 Neuromuscular stimulator for scoliosis
    E0745 Neuromuscular stimulator, electronic shock unit
    E0746 Electromyography (emg), biofeedback device
    E0747 Osteogenesis stimulator, electrical, noninvasive, other than spinal applications
    E0748 Osteogenesis stimulator, electrical, noninvasive, spinal applications
    E0749 Osteogenesis stimulator, electrical, surgically implanted
    E0755 Electronic salivary reflex stimulator (intra-oral/non-invasive)
    E0760 Osteogenesis stimulator, low intensity ultrasound, noninvasive
    E0761 Nonthermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device
    E0762 Transcutaneous electrical joint stimulation device system, includes all accessories
    E0764 Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program
    E0765 FDA approved nerve stimulator, with replaceable batteries, for treatment of nausea and vomiting
    E0766 Electrical stimulation device used for cancer treatment, includes all accessories, any type
    E0769 Electrical stimulation or electromagnetic wound treatment device, not otherwise classified
    E0770 Functional electrical stimulator, transcutaneous stimulation of nerve and/or muscle groups, any type, complete system, not otherwise specified
    E0776 Iv pole
    E0779 Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater
    E0780 Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours
    E0781 Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient
    E0784 External ambulatory infusion pump, insulin
    E0786 Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)
    E0791 Parenteral infusion pump, stationary, single or multi-channel
    E0830 Ambulatory traction device, all types, each
    E0840 Traction frame, attached to headboard, cervical traction
    E0849 Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible
    E0850 Traction stand, freestanding, cervical traction
    E0920 Fracture frame, attached to bed, includes weights
    E0930 Fracture frame, free standing, includes weights
    E0935 Continuous passive motion exercise device for use on knee only
    E0936 Continuous passive motion exercise device for use other than knee
    E0940 Trapeze bar, free standing, complete with grab bar
    E0941 Gravity assisted traction device, any type
    E0946 Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)
    E0947 Fracture frame, attachments for complex pelvic traction
    E0948 Fracture frame, attachments for complex cervical traction
    E0951 Heel loop/holder, any type, with or without ankle strap, each
    E0952 Toe loop/holder, any type, each
    E0955 Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each
    E0956 Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each
    E0957 Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each
    E0959 Manual wheelchair accessory, adapter for amputee, each
    E0960 Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware
    E0961 Manual wheelchair accessory, wheel lock brake extension (handle), each
    E0967 Manual wheelchair accessory, hand rim with projections, any type, replacement only, each
    E0969 Narrowing device, wheelchair
    E0973 Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each
    E0974 Manual wheelchair accessory, anti-rollback device, each
    E0980 Safety vest, wheelchair
    E0981 Wheelchair accessory, seat upholstery, replacement only, each
    E0982 Wheelchair accessory, back upholstery, replacement only, each
    E0983 Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control
    E0984 Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control
    E0985 Wheelchair accessory, seat lift mechanism
    E0986 Manual wheelchair accessory, push-rim activated power assist system
    E0988 Manual wheelchair accessory, lever-activated, wheel drive, pair
    E0992 Manual wheelchair accessory, solid seat insert
    E0994 Arm rest, each
    E0995 Wheelchair accessory, calf rest/pad, replacement only, each
    E1002 Wheelchair accessory, power seating system, tilt only
    E1003 Wheelchair accessory, power seating system, recline only, without shear reduction
    E1004 Wheelchair accessory, power seating system, recline only, with mechanical shear reduction
    E1005 Wheelchair accessory, power seating system, recline only, with power shear reduction
    E1006 Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction
    E1007 Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction
    E1008 Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction
    E1009 Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each
    E1010 Wheelchair accessory, addition to power seating system, power leg elevation system, including legrest, pair
    E1011 Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)
    E1012 Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each
    E1014 Reclining back, addition to pediatric size wheelchair
    E1015 Shock absorber for manual wheelchair, each
    E1016 Shock absorber for power wheelchair, each
    E1017 Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each
    E1018 Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each
    E1028 Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory
    E1029 Wheelchair accessory, ventilator tray, fixed
    E1030 Wheelchair accessory, ventilator tray, gimbaled
    E1036 Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs
    E1050 Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests
    E1060 Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests
    E1070 Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest
    E1161 Manual adult size wheelchair, includes tilt in space
    E1220 Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification
    E1225 Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each
    E1226 Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each
    E1229 Wheelchair, pediatric size, not otherwise specified
    E1230 Power operated vehicle (3- or 4-wheel nonhighway), specify brand name and model number
    E1231 Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system
    E1232 Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system
    E1233 Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system
    E1234 Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system
    E1235 Wheelchair, pediatric size, rigid, adjustable, with seating system
    E1236 Wheelchair, pediatric size, folding, adjustable, with seating system
    E1237 Wheelchair, pediatric size, rigid, adjustable, without seating system
    E1238 Wheelchair, pediatric size, folding, adjustable, without seating system
    E1239 Power wheelchair, pediatric size, not otherwise specified
    E1240 Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest
    E1250 Lightweight wheelchair, fixed full length arms, swing away detachable footrest
    E1260 Lightweight wheelchair, detachable arms (desk or full length) swing away detachable footrest
    E1270 Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests
    E1280 Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests
    E1285 Heavy duty wheelchair, fixed full length arms, swing away detachable footrest
    E1290 Heavy duty wheelchair, detachable arms (desk or full length) swing away detachable footrest
    E1295 Heavy-duty wheelchair, fixed full-length arms, elevating legrest
    E1296 Special wheelchair seat height from floor
    E1297 Special wheelchair seat depth, by upholstery
    E1298 Special wheelchair seat depth and/or width, by construction
    E1352 Oxygen accessory, flow regulator capable of positive inspiratory pressure
    E1355 Stand/rack
    E1356 Oxygen accessory, battery pack/cartridge for portable concentrator, any type, replacement only, each
    E1357 Oxygen accessory, battery charger for portable concentrator, any type, replacement only, each
    E1358 Oxygen accessory, dc power adapter for portable concentrator, any type, replacement only, each
    E1372 Immersion external heater for nebulizer
    E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate
    E1391 Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each
    E1392 Portable oxygen concentrator, rental
    E1399 Durable medical equipment, miscellaneous
    E1405 Oxygen and water vapor enriching system with heated delivery
    E1406 Oxygen and water vapor enriching system without heated delivery
    E1800 Dynamic adjustable elbow extension/flexion device, includes soft interface material
    E1801 Static progressive stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories
    E1802 Dynamic adjustable forearm pronation/supination device, includes soft interface material
    E1805 Dynamic adjustable wrist extension/flexion device, includes soft interface material
    E1806 Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories
    E1825 Dynamic adjustable finger extension/flexion device, includes soft interface material
    E1840 Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material
    E1841 Static progressive stretch shoulder device, with or without range of motion adjustment, includes all components and accessories
    E2000 Gastric suction pump, home model, portable or stationary, electric
    E2100 Blood glucose monitor with integrated voice synthesizer
    E2101 Blood glucose monitor with integrated lancing/blood sample
    E2201 Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches
    E2202 Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches
    E2203 Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches
    E2204 Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches
    E2205 Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each
    E2206 Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each
    E2207 Wheelchair accessory, crutch and cane holder, each
    E2208 Wheelchair accessory, cylinder tank carrier, each
    E2209 Accessory, arm trough, with or without hand support, each
    E2210 Wheelchair accessory, bearings, any type, replacement only, each
    E2211 Manual wheelchair accessory, pneumatic propulsion tire, any size, each
    E2212 Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each
    E2213 Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each
    E2214 Manual wheelchair accessory, pneumatic caster tire, any size, each
    E2215 Manual wheelchair accessory, tube for pneumatic caster tire, any size, each
    E2216 Manual wheelchair accessory, foam filled propulsion tire, any size, each
    E2217 Manual wheelchair accessory, foam filled caster tire, any size, each
    E2218 Manual wheelchair accessory, foam propulsion tire, any size, each
    E2219 Manual wheelchair accessory, foam caster tire, any size, each
    E2220 Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each
    E2221 Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each
    E2222 Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each
    E2224 Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each
    E2225 Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each
    E2226 Manual wheelchair accessory, caster fork, any size, replacement only, each
    E2227 Manual wheelchair accessory, gear reduction drive wheel, each
    E2228 Manual wheelchair accessory, wheel braking system and lock, complete, each
    E2230 Manual wheelchair accessory, manual standing system
    E2231 Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware
    E2291 Back, planar, for pediatric size wheelchair including fixed attaching hardware
    E2292 Seat, planar, for pediatric size wheelchair including fixed attaching hardware
    E2293 Back, contoured, for pediatric size wheelchair including fixed attaching hardware
    E2294 Seat, contoured, for pediatric size wheelchair including fixed attaching hardware
    E2295 Manual wheelchair accessory, for pediatric size wheelchair, dynamic seating frame, allows coordinated movement of multiple positioning features
    E2300 Wheelchair accessory, power seat elevation system, any type
    E2301 Wheelchair accessory, power standing system, any type
    E2310 Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware
    E2311 Power wheelchair accessory, electronic connection between wheelchair controller and 2 or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware
    E2312 Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware
    E2313 Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each
    E2321 Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware
    E2322 Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware
    E2323 Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated
    E2324 Power wheelchair accessory, chin cup for chin control interface
    E2325 Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware
    E2326 Power wheelchair accessory, breath tube kit for sip and puff interface
    E2327 Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware
    E2328 Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware
    E2329 Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware
    E2330 Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware
    E2331 Power wheelchair accessory, attendant control, proportional, including all related electronics and fixed mounting hardware
    E2351 Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface
    E2358 Power wheelchair accessory, group 34 non-sealed lead acid battery, each
    E2359 Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)
    E2360 Power wheelchair accessory, 22nf non-sealed lead acid battery, each
    E2361 Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)
    E2362 Power wheelchair accessory, group 24 non-sealed lead acid battery, each
    E2363 Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)
    E2364 Power wheelchair accessory, u-1 non-sealed lead acid battery, each
    E2365 Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)
    E2366 Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each
    E2367 Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each
    E2368 Power wheelchair component, drive wheel motor, replacement only
    E2369 Power wheelchair component, drive wheel gear box, replacement only
    E2370 Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only
    E2371 Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each
    E2372 Power wheelchair accessory, group 27 non-sealed lead acid battery, each
    E2373 Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware
    E2374 Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only
    E2375 Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only
    E2376 Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only
    E2377 Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue
    E2378 Power wheelchair component, actuator, replacement only
    E2381 Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each
    E2382 Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each
    E2383 Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each
    E2384 Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each
    E2385 Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each
    E2386 Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each
    E2387 Power wheelchair accessory, foam filled caster tire, any size, replacement only, each
    E2388 Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each
    E2389 Power wheelchair accessory, foam caster tire, any size, replacement only, each
    E2390 Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each
    E2391 Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each
    E2392 Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each
    E2394 Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each
    E2395 Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each
    E2396 Power wheelchair accessory, caster fork, any size, replacement only, each
    E2397 Power wheelchair accessory, lithium-based battery, each
    E2402 Negative pressure wound therapy electrical pump, stationary or portable 
    E2500 Speech generating device, digitized speech, using prerecorded messages, less than or equal to 8 minutes recording time
    E2502 Speech generating device, digitized speech, using prerecorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time
    E2504 Speech generating device, digitized speech, using prerecorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time
    E2506 Speech generating device, digitized speech, using prerecorded messages, greater than 40 minutes recording time
    E2508 Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device
    E2510 Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access
    E2511 Speech generating software program, for personal computer or personal digital assistant
    E2512 Accessory for speech generating device, mounting system
    E2599 Accessory for speech generating device, not otherwise classified
    E2609 Custom fabricated wheelchair seat cushion, any size
    E2610 Wheelchair seat cushion, powered
    E2611 General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware
    E2612 General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware
    E2613 Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware
    E2614 Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware
    E2615 Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware
    E2616 Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware
    E2617 Custom fabricated wheelchair back cushion, any size, including any type mounting hardware
    E2619 Replacement cover for wheelchair seat cushion or back cushion, each
    E2620 Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware
    E2621 Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware
    E2622 Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth
    E2623 Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth
    E2624 Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth
    E2625 Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth
    E2626 Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable
    E2627 Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type
    E2628 Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining
    E2629 Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)
    E2630 Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support
    E2631 Wheelchair accessory, addition to mobile arm support, elevating proximal arm
    E2632 Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control
    E2633 Wheelchair accessory, addition to mobile arm support, supinator
    E8000 Gait trainer, pediatric size, posterior support, includes all accessories and components
    E8001 Gait trainer, pediatric size, upright support, includes all accessories and components
    E8002 Gait trainer, pediatric size, anterior support, includes all accessories and components
    G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision
    G0124 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician
    G0129 Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization treatment program, per session (45 minutes or more)
    G0130 Single energy x-ray absorptiometry (SEXA) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)
    G0151 Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes
    G0152 Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes
    G0153 Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes
    G0155 Services of clinical social worker in home health or hospice settings, each 15 minutes
    G0156 Services of home health/hospice aide in home health or hospice settings, each 15 minutes
    G0157 Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes
    G0158 Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes
    G0159 Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes
    G0160 Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes
    G0161 Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes
    G0166 External counterpulsation, per treatment session
    G0206 Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral
    G0219 PET imaging whole body; melanoma for noncovered indications
    G0235 PET imaging, any site, not otherwise specified
    G0248 Demonstration, prior to initiation of home INR monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the INR monitor, obtaining at least one blood sample, provision of instructions for reporting home INR test results, and documentation of patient's ability to perform testing and report results
    G0249 Provision of test materials and equipment for home INR monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests
    G0250 Physician review, interpretation, and patient management of home INR testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests
    G0252 PET imaging, full and partial-ring PET scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes)
    G0260 Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography
    G0276 Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (PILD) or placebo-control, performed in an approved coverage with evidence development (CED) clinical trial
    G0277 Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval
    G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (List separately in addition to G0204 or G0206)
    G0281 Electrical stimulation, (unattended), to one or more areas, for chronic Stage III and Stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care
    G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee
    G0295 Electromagnetic therapy, to one or more areas, for wound care other than described in G0329 or for other uses
    G0297 Low dose CT scan (LDCT) for lung cancer screening
    G0302 Preoperative pulmonary surgery services for preparation for LVRS, complete course of services, to include a minimum of 16 days of services
    G0303 Preoperative pulmonary surgery services for preparation for LVRS, 10 to 15 days of services
    G0304 Preoperative pulmonary surgery services for preparation for LVRS, 1 to 9 days of services
    G0305 Postdischarge pulmonary surgery services after LVRS, minimum of 6 days of services
    G0329 Electromagnetic therapy, to one or more areas for chronic Stage III and Stage IV pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care
    G0339 Electromagnetic therapy, to one or more areas for chronic Stage III and Stage IV pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care
    G0340 Image guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment
    G0341 Percutaneous islet cell transplant, includes portal vein catheterization and infusion
    G0398 Home sleep study test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
    G0399 Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
    G0400 Home sleep test (HST) with type IV portable monitor, unattended; minimum of 3 channels
    G0422 Intensive cardiac rehabilitation; with or without continuous ECG monitoring with exercise, per session
    G0423 Intensive cardiac rehabilitation; with or without continuous ECG monitoring; without exercise, per session
    G0452 Molecular pathology procedure; physician interpretation and report
    G0460 Autologous platelet rich plasma for chronic wounds/ulcers, including phlebotomy, centrifugation, and all other preparatory procedures, administration and dressings, per treatment
    G0472 Hepatitis C antibody screening for individual at high risk and other covered indication(s)
    G0493 Skilled services of a registered nurse (RN) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)
    G0494 Skilled services of a licensed practical nurse (LPN) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)
    G0495 Skilled services of a registered nurse (RN), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes
    G0496 Skilled services of a licensed practical nurse (LPN), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes
    G0505 Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment, history obtained from patient and/or caregiver, in office or other outpatient setting or home or domiciliary or rest home
    G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)
    G6001 Ultrasonic guidance for placement of radiation therapy fields
    G6002 Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy
    G6003 Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: up to 5 mev
    G6004 Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: 6-10 mev
    G6005 Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: 11-19 mev
    G6006 Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: 20 mev or greater
    G6007 Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: up to 5 mev
    G6008 Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 6-10 mev
    G6009 Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 11-19 mev
    G6010 Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 20 mev or greater
    G6011 Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; up to 5 mev
    G6012 Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 6-10 mev
    G6013 Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 11-19 mev
    G6014 Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 20 mev or greater
    G6015 Intensity modulated treatment delivery, single or multiple fields/arcs, via narrow spatially and temporally modulated beams, binary, dynamic MLC, per treatment session
    G6016 Compensator-based beam modulation treatment delivery of inverse planned treatment using 3 or more high resolution (milled or cast) compensator, convergent beam modulated fields, per treatment session
    G6017 Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (e.g., 3D positional tracking, gating, 3D surface tracking), each fraction of treatment
    G9143 Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s)
    J0129 Injection, abatacept, 10 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)
    J0178 Injection, aflibercept, 1 mg
    J0180 Injection, agalsidase beta, 1 mg
    J0202 Injection, alemtuzumab, 1 mg
    J0221 Injection, alglucosidase alfa, (Lumizyme), 10 mg
    J0256 Injection, alpha 1-proteinase inhibitor (human), not otherwise specified, 10 mg
    J0257 Injection, alpha 1 proteinase inhibitor (human), (GLASSIA), 10 mg
    J0475 Injection, baclofen, 10 mg
    J0476 Injection, baclofen, 50 mcg for intrathecal trial
    J0490 Injection, belimumab, 10 mg
    J0585 Injection, onabotulinumtoxinA, 1 unit
    J0586 Injection, abobotulinumtoxinA, 5 units
    J0587 Injection, rimabotulinumtoxinB, 100 units
    J0588 Injection, incobotulinumtoxinA, 1 unit
    J0597 Injection, C-1 esterase inhibitor (human), Berinert, 10 units
    J0598 Injection, C-1 esterase inhibitor (human), Cinryze, 10 units
    J0641 Injection, levoleucovorin calcium, 0.5 mg
    J0717 Injection, certolizumab pegol, 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
    J0735 Injection, clonidine hydrochloride, 1 mg
    J0775 Injection, collagenase, clostridium histolyticum, 0.01 mg
    J0800 Injection, corticotropin, up to 40 units
    J0881 Injection, darbepoetin alfa, 1 mcg (non-ESRD use)
    J0885 Injection, epoetin alfa, (for non-ESRD use), 1000 units
    J0897 Injection, denosumab, 1 mg
    J1170 Injection, hydromorphone, up to 4 mg
    J1300 Injection, eculizumab, 10 mg
    J1428 Injection, eteplirsen, 10 mg
    J1442 Injection, filgrastim (G-CSF), excludes biosimilars, 1 microgram
    J1458 Injection, galsulfase, 1 mg 
    J1459 Injection, immune globulin (Privigen), intravenous, nonlyophilized (e.g., liquid), 500 mg
    J1555 Injection, immune globulin (cuvitru), 100 mg
    J1556 Injection, immune globulin (Bivigam), 500 mg
    J1557 Injection, immune globulin, (Gammaplex), intravenous, nonlyophilized (e.g., liquid), 500 mg
    J1559 Injection, immune globulin (Hizentra), 100 mg
    J1561 Injection, immune globulin, (Gamunex/Gamunex-C/Gammaked), nonlyophilized (e.g., liquid), 500 mg
    J1566 Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg
    J1568 Injection, immune globulin, (Octagam), intravenous, nonlyophilized (e.g., liquid), 500 mg
    J1569 Injection, immune globulin, (Gammagard liquid), nonlyophilized, (e.g., liquid), 500 mg
    J1572 Injection, immune globulin, (Flebogamma/Flebogamma Dif), intravenous, nonlyophilized (e.g., liquid), 500 mg
    J1575 Injection, immune globulin/hyaluronidase, 100 mg immuneglobulin
    J1602 Injection, golimumab, 1 mg, for intravenous use
    J1726 Injection, hydroxyprogesterone caproate, (makena), 10 mg
    J1729 Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg
    J1743 Injection, idursulfase, 1 mg
    J1745 Injection, infliximab, excludes biosimilar, 10 mg
    J1786 Injection, imiglucerase, 10 units
    J1833 Injection, isavuconazonium, 1 mg
    J1931 Injection, laronidase, 0.1 mg
    J2182 Injection, mepolizumab, 1 mg
    J2278 Injection, ziconotide, 1 microgram
    J2323 Injection, natalizumab, 1 mg
    J2326 Injection, nusinersen, 0.1 mg
    J2350 Injection, ocrelizumab, 1 mg
    J2353 Injection, octreotide, depot form for intramuscular injection, 1 mg
    J2469 Injection, palonosetron HCl, 25 mcg
    J2505 Injection, pegfilgrastim, 6 mg
    J2778 Injection, ranibizumab, 0.1 mg 
    J2796 Injection, romiplostim, 10 mcg
    J2820 Injection, sargramostim (GM-CSF), 50 mcg
    J2940 Injection, somatrem, 1 mg
    J2941 Injection, somatropin, 1 mg
    J3010 Injection, fentanyl citrate, 0.1 mg
    J3060 Injection, taliglucerase alfa, 10 units
    J3262 Injection, tocilizumab, 1 mg
    J3357 Ustekinumab, for subcutaneous injection, 1 mg
    J3358 Ustekinumab, for intravenous injection, 1 mg
    J3380 Injection, vedolizumab, 1 mg
    J3385 Injection, velaglucerase alfa, 100 units
    J3396 Injection, verteporfin, 0.1 mg
    J3489 Injection, zoledronic acid, 1 mg
    J3490 Injection, zoledronic acid, 1 mg
    J3590 Unclassified biologics
    J7175 Injection, factor x, (human), 1 i.u. (New Code: 01/01/2017)
    J7179 Injection, von willebrand factor (recombinant), (vonvendi), 1 i.u. vwf:rco (New Code: 01/01/2017)
    J7180 Injection, factor XIII (antihemophilic factor, human), 1 IU
    J7181 Injection, factor XIII A-subunit, (recombinant), per IU
    J7182 Injection, factor VIII, (antihemophilic factor, recombinant), (NovoEight), per IU
    J7183 Injection, von Willebrand factor complex (human), Wilate, 1 IU vWF:RCo
    J7185 Injection, factor VIII (antihemophilic factor, recombinant) (XYNTHA), per IU
    J7186 Injection, antihemophilic factor VIII/von Willebrand factor complex (human), per factor VIII i.u.
    J7187 Injection, von Willebrand factor complex (Humate-P), per IU VWF:RCO
    J7188 Injection, factor VIII (antihemophilic factor, recombinant), per IU
    J7189 Factor VIIa (antihemophilic factor, recombinant), per 1 mcg
    J7190 Factor VIII (antihemophilic factor, human) per IU
    J7192 Factor VIII (antihemophilic factor, recombinant) per IU, not otherwise specified
    J7193 Factor IX (antihemophilic factor, purified, nonrecombinant) per IU
    J7194 Factor IX complex, per IU
    J7195 Injection, factor IX (antihemophilic factor, recombinant) per IU, not otherwise specified
    J7198 Antiinhibitor, per IU
    J7199 Hemophilia clotting factor, not otherwise classified
    J7200 Injection, factor IX, (antihemophilic factor, recombinant), Rixubis, per IU
    J7201 Injection, factor ix, fc fusion protein, (recombinant), alprolix, 1 i.u. (Revised Code: 01/01/2017)
    J7202 Injection, factor ix, albumin fusion protein, (recombinant), idelvion, 1 i.u. (New Code: 01/01/2017)
    J7205 Injection, factor VIII Fc fusion protein (recombinant), per IU
    J7207 Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u. (New Code: 01/01/2017)
    J7209 Injection, factor viii, (antihemophilic factor, recombinant), (nuwiq), 1 i.u. (New Code: 01/01/2017)
    J7210 Injection, factor viii, (antihemophilic factor, recombinant), (afstyla), 1 i.u.
    J7211 Injection, factor viii, (antihemophilic factor, recombinant), (kovaltry), 1 i.u.
    J7308 Aminolevulinic acid HCl for topical administration, 20%, single unit dosage form (354 mg)
    J7320 Hyaluronan or derivative, GenVisc 850, for intra-articular injection, 1 mg
    J7321 Hyaluronan or derivative, Hyalgan or Supartz, for intra-articular injection, per dose
    J7322 Hyaluronan or derivative, Hymovis, for intra-articular injection, 1 mg
    J7323 Hyaluronan or derivative, Euflexxa, for intra-articular injection, per dose
    J7324 Hyaluronan or derivative, Orthovisc, for intra-articular injection, per dose
    J7325 Hyaluronan or derivative, Synvisc or Synvisc-One, for intra-articular injection, 1 mg
    J7326 Hyaluronan or derivative, Gel-One, for intra-articular injection, per dose
    J7327 Hyaluronan or derivative, Monovisc, for intra-articular injection, per dose
    J7328 Hyaluronan or derivative, Gel-Syn, for intra-articular injection, 0.1 mg
    J7330 Autologous cultured chondrocytes, implant
    J9023 Injection, avelumab, 10 mg
    J9035 Injection, bevacizumab, 10 mg " to "Injection, bevacizumab, (Avastin) 10 mg (Cancer indications only; ophthalmologic injections do not require PA.  Submit under J3490 with NDC
    J9043 Injection, cabazitaxel, 1 mg
    J9055 Injection, cetuximab, 10 mg
    J9179 Injection, eribulin mesylate, 0.1 mg
    J9219 Leuprolide acetate implant, 65 mg
    J9225 Histrelin implant (Vantas), 50 mg
    J9228 Injection, ipilimumab, 1 mg
    J9264 Injection, paclitaxel protein-bound particles, 1 mg
    J9271 Injection, pembrolizumab, 1 mg
    J9299 Injection, nivolumab, 1 mg
    J9303 Injection, panitumumab, 10 mg
    J9305 Injection, pemetrexed, 10 mg
    J9306 Injection, pertuzumab, 1 mg
    J9310 Injection, rituximab, 100 mg
    J9354 Injection, ado-trastuzumab emtansine, 1 mg
    J9355 Injection, trastuzumab, 10 mg
    K0001 Standard wheelchair
    K0002 Standard hemi (low seat) wheelchair
    K0003 Lightweight wheelchair
    K0004 High strength, lightweight wheelchair
    K0005 Ultralightweight wheelchair
    K0006 Heavy duty wheelchair
    K0007 Extra heavy duty wheelchair
    K0008 Custom manual wheelchair/base
    K0009 Other manual wheelchair/base
    K0010 Standard - weight frame motorized/power wheelchair
    K0011 Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking
    K0012 Lightweight portable motorized/power wheelchair
    K0013 Custom motorized/power wheelchair base
    K0014 Other motorized/power wheelchair base
    K0015 Detachable, non-adjustable height armrest, replacement only, each
    K0017 Detachable, adjustable height armrest, base, replacement only, each
    K0018 Detachable, adjustable height armrest, upper portion, replacement only, each
    K0019 Arm pad, replacement only, each
    K0020 Fixed, adjustable height armrest, pair
    K0037 High mount flip-up footrest, replacement only, each
    K0038 Leg strap, each
    K0039 Leg strap, h style, each
    K0040 Adjustable angle footplate, each
    K0041 Large size footplate, each
    K0042 Standard size footplate, replacement only, each
    K0043 Footrest, lower extension tube, replacement only, each
    K0044 Footrest, upper hanger bracket, replacement only, each
    K0045 Footrest, complete assembly, replacement only, each
    K0046 Elevating legrest, lower extension tube, replacement only, each
    K0047 Elevating legrest, upper hanger bracket, replacement only, each
    K0050 Ratchet assembly, replacement only
    K0051 Cam release assembly, footrest or legrest, replacement only, each
    K0052 Swingaway, detachable footrests, replacement only, each
    K0053 Elevating footrests, articulating (telescoping), each
    K0056 Seat height less than 17" or equal to or greater than 21" for a high strength, lightweight, or ultralightweight wheelchair
    K0065 Spoke protectors, each
    K0069 Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each
    K0070 Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each
    K0071 Front caster assembly, complete, with pneumatic tire, replacement only, each
    K0072 Front caster assembly, complete, with semi-pneumatic tire, replacement only, each
    K0073 Caster pin lock, each
    K0077 Front caster assembly, complete, with solid tire, replacement only, each
    K0098 Drive belt for power wheelchair, replacement only
    K0105 Iv hanger, each
    K0108 Wheelchair component or accessory, not otherwise specified
    K0195 Elevating leg rests, pair (for use with capped rental wheelchair base)
    K0455 Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)
    K0601 Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each
    K0602 Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each
    K0603 Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each
    K0604 Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each
    K0605 Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each
    K0606 Automatic external defibrillator, with integrated electrocardiogram analysis, garment type
    K0607 Replacement battery for automated external defibrillator, garment type only, each
    K0608 Replacement garment for use with automated external defibrillator, each
    K0609 Replacement electrodes for use with automated external defibrillator, garment type only, each
    K0672 Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each
    K0730 Controlled dose inhalation drug delivery system
    K0733 Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)
    K0738 Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing
    K0743 Repair or non routine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes
    K0744 Absorptive wound dressing for use with suction pump, home model, portable, pad size 16 sq in or less Effective date
    K0745 Absorptive wound dressing for use with suction pump, home model, portable, pad size more than 16 sq in but less than or equal to 48 sq in.
    K0746 Absorptive wound dressing for use with suction pump, home model, portable, pad size greater than 48 sq in Effective
    K0800 Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds
    K0801 Power operated vehicle, group 1 heavy-duty, patient weight capacity 301 to 450 pounds
    K0802 Power operated vehicle, group 1 very heavy-duty, patient weight capacity 451 to 600 pounds
    K0806 Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds
    K0807 Power operated vehicle, group 2 heavy-duty, patient weight capacity 301 to 450 pounds
    K0808 Power operated vehicle, group 2 very heavy-duty, patient weight capacity 451 to 600 pounds
    K0812 Power operated vehicle, not otherwise classified
    K0813 Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds
    K0814 Power wheelchair, group 1 standard, portable, captain's chair, patient weight capacity up to and including 300 pounds
    K0815 Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds
    K0816 Power wheelchair, group 1 standard, captain's chair, patient weight capacity up to and including 300 pounds
    K0820 Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds
    K0821 Power wheelchair, group 2 standard, portable, captain's chair, patient weight capacity up to and including 300 pounds
    K0822 Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
    K0823 Power wheelchair, group 2 standard, captain's chair, patient weight capacity up to and including 300 pounds
    K0824 Power wheelchair, group 2 heavy-duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
    K0825 Power wheelchair, group 2 heavy-duty, captain's chair, patient weight capacity 301 to 450 pounds
    K0826 Power wheelchair, group 2 very heavy-duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
    K0827 Power wheelchair, group 2 very heavy-duty, captain's chair, patient weight capacity 451 to 600 pounds
    K0828 Power wheelchair, group 2 extra heavy-duty, sling/solid seat/back, patient weight capacity 601 pounds or more
    K0829 Power wheelchair, group 2 extra heavy-duty, captain's chair, patient weight 601 pounds or more
    K0830 Power wheelchair, group 2 standard, seat elevator, sling/solid seat/back, patient weight capacity up to and including 300 pounds
    K0831 Power wheelchair, group 2 standard, seat elevator, captains chair, patient weight capacity up to and including 300 pounds
    K0835 Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
    K0836 Power wheelchair, group 2 standard, single power option, captain's chair, patient weight capacity up to and including 300 pounds
    K0837 Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
    K0838 Power wheelchair, group 2 heavy-duty, single power option, captain's chair, patient weight capacity 301 to 450 pounds
    K0839 Power wheelchair, group 2 very heavy-duty, single power option sling/solid seat/back, patient weight capacity 451 to 600 pounds
    K0840 Power wheelchair, group 2 extra heavy-duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more
    K0841 Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
    K0842 Power wheelchair, group 2 standard, multiple power option, captain's chair, patient weight capacity up to and including 300 pounds
    K0843 Power wheelchair, group 2 heavy-duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
    K0848 Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
    K0849 Power wheelchair, group 3 standard, captain's chair, patient weight capacity up to and including 300 pounds
    K0850 Power wheelchair, group 3 heavy-duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
    K0851 Power wheelchair, group 3 heavy-duty, captain's chair, patient weight capacity 301 to 450 pounds
    K0852 Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
    K0853 Power wheelchair, group 3 very heavy-duty, captain's chair, patient weight capacity 451 to 600 pounds
    K0854 Power wheelchair, group 3 extra heavy-duty, sling/solid seat/back, patient weight capacity 601 pounds or more
    K0855 Power wheelchair, group 3 extra heavy-duty, captain's chair, patient weight capacity 601 pounds or more
    K0856 Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
    K0857 Power wheelchair, group 3 standard, single power option, captain's chair, patient weight capacity up to and including 300 pounds
    K0858 Power wheelchair, group 3 heavy-duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds
    K0859 Power wheelchair, group 3 heavy-duty, single power option, captain's chair, patient weight capacity 301 to 450 pounds
    K0860 Power wheelchair, group 3 very heavy-duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
    K0861 Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
    K0862 Power wheelchair, group 3 heavy-duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
    K0863 Power wheelchair, group 3 very heavy-duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
    K0864 Power wheelchair, group 3 extra heavy-duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more
    K0868 Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
    K0869 Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds
    K0870 Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
    K0871 Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
    K0877 Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
    K0878 Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
    K0879 Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
    K0880 Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight 451 to 600 pounds
    K0884 Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
    K0885 Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds
    K0886 Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
    K0890 Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
    K0891 Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
    K0898 Power wheelchair, not otherwise classified
    K0899 Power mobility device, not coded by dme pdac or does not meet criteria
    K0900 Customized durable medical equipment, other than wheelchair
    L0112 Cranial cervical orthotic, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated
    L0113 Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment
    L0454 Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L0455 Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf
    L0457 Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated, off-the-shelf
    L0458 Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment
    L0460 Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L0462 Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment
    L0464 Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment
    L0466 Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L0467 Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf
    L0468 Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L0469 Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf
    L0470 Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restricts gross trunk motion in sagittal, coronal, and transverse planes, provides intracavitary pressure to reduce load on the intervertebral disks, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment
    L0472 Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment
    L0480 Thoracic-lumbar-sacral orthotic (TLSO), triplanar control, 1 piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or CAD-CAM model, custom fabricated
    L0482 Thoracic-lumbar-sacral orthotic (TLSO), triplanar control, 1 piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or CAD-CAM model, custom fabricated
    L0484 Thoracic-lumbar-sacral orthotic (TLSO), triplanar control, 2 piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or CAD-CAM model, custom fabricated
    L0486 Thoracic-lumbar-sacral orthotic (TLSO), triplanar control, 2 piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or CAD-CAM model, custom fabricated
    L0488 Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, prefabricated, includes fitting and adjustment
    L0490 Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated, includes fitting and adjustment
    L0491 Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment
    L0492 Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment
    L0624 Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated
    L0625 Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf
    L0626 Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L0627 Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L0628 Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
    L0629 Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom fabricated
    L0630 Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L0631 Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L0632 Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated
    L0633 Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L0634 Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, custom fabricated
    L0635 Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, prefabricated, includes fitting and adjustment
    L0636 Lumbar-sacral orthotic (LSO), sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, custom fabricated
    L0637 Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L0638 Lumbar-sacral orthotic (LSO), sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated
    L0639 Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L0640 Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, custom fabricated
    L0641 Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
    L0642 Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
    L0643 Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
    L0648 Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
    L0649 Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
    L0650 Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
    L0651 Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, off-the-shelf
    L0700 Cervical-thoracic-lumbar-sacral orthotic (CTLSO), anterior-posterior-lateral control, molded to patient model, (Minerva type)
    L0710 Cervical-thoracic-lumbar-sacral orthotic (CTLSO), anterior-posterior-lateral-control, molded to patient model, with interface material, (Minerva type)
    L0820 Halo procedure, cervical halo incorporated into plaster body jacket
    L0830 Halo procedure, cervical halo incorporated into Milwaukee type orthotic
    L0980 Peroneal straps, prefabricated, off-the-shelf, pair
    L0982 Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)
    L1000 Cervical-thoracic-lumbar-sacral orthotic (CTLSO) (Milwaukee), inclusive of furnishing initial orthotic, including model
    L1200 Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only
    L1300 Other scoliosis procedure, body jacket molded to patient model
    L1310 Other scoliosis procedure, postoperative body jacket
    L1499 Spinal orthosis, not otherwise specified
    L1690 Combination, bilateral, lumbo-sacral, hip, femur orthotic providing adduction and internal rotation control, prefabricated, includes fitting and adjustment
    L1700 Legg Perthes orthotic, (Toronto type), custom fabricated
    L1710 Legg Perthes orthotic, (Newington type), custom fabricated
    L1720 Legg Perthes orthotic, trilateral, (Tachdijan type), custom fabricated
    L1755 Legg Perthes orthotic, (Patten bottom type), custom fabricated
    L1812 Knee orthosis, elastic with joints, prefabricated, off-the-shelf
    L1820 Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment
    L1830 Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf
    L1831 Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment
    L1832 Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L1833 Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf
    L1834 Knee orthosis, without knee joint, rigid, custom fabricated
    L1836 Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf
    L1840 Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated
    L1843 Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L1844 Knee orthotic (KO), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated
    L1845 Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L1846 Knee orthotic, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated
    L1847 Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L1848 Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf
    L1850 Knee orthosis, swedish type, prefabricated, off-the-shelf
    L1851 Knee orthosis (KO), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
    L1852 Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
    L1860 Knee orthotic (KO), modification of supracondylar prosthetic socket, custom fabricated (SK)
    L1900 Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated
    L1902 Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf
    L1904 Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated
    L1906 Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf
    L1907 Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated
    L1910 Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment
    L1920 Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated
    L1930 Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment
    L1932 Afo, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, includes fitting and adjustment
    L1940 Ankle foot orthosis, plastic or other material, custom fabricated
    L1945 Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated
    L1950 Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated
    L1951 Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, includes fitting and adjustment
    L1960 Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated
    L1970 Ankle foot orthosis, plastic with ankle joint, custom fabricated
    L1971 Ankle foot orthosis, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment
    L1980 Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar 'bk' orthosis), custom fabricated
    L1990 Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar 'bk' orthosis), custom fabricated
    L2000 Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), custom fabricated
    L2005 Knee-ankle-foot orthotic (KAFO), any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated
    L2010 Knee-ankle-foot orthotic (KAFO), single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'AK' orthotic), without knee joint, custom fabricated
    L2020 Knee-ankle-foot orthotic (KAFO), double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar 'AK' orthotic), custom fabricated
    L2030 Knee-ankle-foot orthotic (KAFO), double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar 'AK' orthotic), without knee joint, custom fabricated
    L2034 Knee-ankle-foot orthotic (KAFO), full plastic, single upright, with or without free motion knee, medial-lateral rotation control, with or without free motion ankle, custom fabricated
    L2035 Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment
    L2036 Knee-ankle-foot orthotic (KAFO), full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated
    L2037 Knee-ankle-foot orthotic (KAFO), full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated
    L2038 Knee-ankle-foot orthotic (KAFO), full plastic, with or without free motion knee, multi-axis ankle, custom fabricated
    L2106 Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated
    L2108 Ankle-foot orthotic (AFO), fracture orthotic, tibial fracture cast orthotic, custom fabricated
    L2112 Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment
    L2114 Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment
    L2116 Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment
    L2126 Knee-ankle-foot orthotic (KAFO), fracture orthotic, femoral fracture cast orthotic, thermoplastic type casting material, custom fabricated
    L2128 Knee-ankle-foot orthotic (KAFO), fracture orthotic, femoral fracture cast orthotic, custom fabricated
    L2132 Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment
    L2134 Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment
    L2136 Knee-ankle-foot orthotic (KAFO), fracture orthotic, femoral fracture cast orthotic, rigid, prefabricated, includes fitting and adjustment
    L2192 Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt
    L2350 Addition to lower extremity, prosthetic type, (BK) socket, molded to patient model, (used for PTB, AFO orthoses)
    L2525 Addition to lower extremity, thigh/weight bearing, ischial containment/narrow M-L brim molded to patient model
    L2627 Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables
    L2628 Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables
    L2750 Addition to lower extremity orthosis, plating chrome or nickel, per bar
    L2755 Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only
    L2760 Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)
    L2768 Orthotic side bar disconnect device, per bar
    L2780 Addition to lower extremity orthosis, non-corrosive finish, per bar
    L2999 Lower extremity orthoses, not otherwise specified
    L3000 Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each
    L3001 Foot, insert, removable, molded to patient model, spenco, each
    L3002 Foot, insert, removable, molded to patient model, plastazote or equal, each
    L3003 Foot, insert, removable, molded to patient model, silicone gel, each
    L3010 Foot, insert, removable, molded to patient model, longitudinal arch support, each
    L3020 Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each
    L3030 Foot, insert, removable, formed to patient foot, each
    L3031 Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each
    L3040 Foot, arch support, removable, premolded, longitudinal, each
    L3050 Foot, arch support, removable, premolded, metatarsal, each
    L3060 Foot, arch support, removable, premolded, longitudinal/ metatarsal, each
    L3070 Foot, arch support, non-removable attached to shoe, longitudinal, each
    L3080 Foot, arch support, non-removable attached to shoe, metatarsal, each
    L3090 Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each
    L3100 Hallus-valgus night dynamic splint, prefabricated, off-the-shelf
    L3201 Orthopedic shoe, oxford with supinator or pronator, infant
    L3203 Orthopedic shoe, oxford with supinator or pronator, junior
    L3204 Orthopedic shoe, hightop with supinator or pronator, infant
    L3206 Orthopedic shoe, hightop with supinator or pronator, child
    L3207 Orthopedic shoe, hightop with supinator or pronator, junior
    L3215 Orthopedic footwear, ladies shoe, oxford, each
    L3216 Orthopedic footwear, ladies shoe, depth inlay, each
    L3217 Orthopedic footwear, ladies shoe, hightop, depth inlay, each
    L3219 Orthopedic footwear, mens shoe, oxford, each
    L3221 Orthopedic footwear, mens shoe, depth inlay, each
    L3222 Orthopedic footwear, mens shoe, hightop, depth inlay, each
    L3224 Orthopedic footwear, woman's shoe, oxford, used as an integral part of a brace (orthotic)
    L3225 Orthopedic footwear, man's shoe, oxford, used as an integral part of a brace (orthotic)
    L3230 Orthopedic footwear, custom shoe, depth inlay, each
    L3250 Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each
    L3251 Foot, shoe molded to patient model, silicone shoe, each
    L3252 Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each
    L3253 Foot, molded shoe plastazote (or similar) custom fitted, each
    L3254 Non-standard size or width
    L3255 Non-standard size or length
    L3257 Orthopedic footwear, additional charge for split size
    L3330 Lift, elevation, metal extension (skate)
    L3674 Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment
    L3678 Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated, off-the-shelf
    L3702 Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
    L3720 Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated
    L3730 Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated
    L3740 Elbow orthotic (EO), double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated
    L3763 Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
    L3764 Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
    L3765 Elbow-wrist-hand-finger orthotic (EWHFO), rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
    L3766 Elbow-wrist-hand-finger orthotic (EWHFO), includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
    L3809 Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type
    L3900 Wrist-hand-finger orthotic (WHFO), dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated
    L3901 Wrist-hand-finger orthotic (WHFO), dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated
    L3912 Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf
    L3916 Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf
    L3918 Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf
    L3924 Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf
    L3930 Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf
    L3971 Shoulder-elbow-wrist-hand orthotic (SEWHO), shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
    L3973 Shoulder-elbow-wrist-hand orthotic (SEWHO), abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
    L3975 Shoulder-elbow-wrist-hand-finger orthotic (SEWHO), shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
    L3976 Shoulder-elbow-wrist-hand-finger orthotic (SEWHO), abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
    L3977 Shoulder-elbow-wrist-hand-finger orthotic (SEWHO), shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
    L3978 Shoulder-elbow-wrist-hand-finger orthotic (SEWHO), abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
    L3981 Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments
    L3999 Upper limb orthosis, not otherwise specified
    L4002 Replacement strap, any orthosis, includes all components, any length, any type
    L4010 Replace trilateral socket brim
    L4020 Replace quadrilateral socket brim, molded to patient model
    L4030 Replace quadrilateral socket brim, custom fitted
    L4040 Replace molded thigh lacer, for custom fabricated orthosis only
    L4361 Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf
    L4387 Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf
    L4396 Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
    L4397 Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf
    L4631 Ankle-foot orthotic, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated
    L5010 Partial foot, molded socket, ankle height, with toe filler
    L5020 Partial foot, molded socket, tibial tubercle height, with toe filler
    L5050 Ankle, Symes, molded socket, SACH foot
    L5060 Ankle, Symes, metal frame, molded leather socket, articulated ankle/foot
    L5100 Below knee, molded socket, shin, SACH foot
    L5105 Below knee, plastic socket, joints and thigh lacer, SACH foot
    L5150 Knee disarticulation (or through knee), molded socket, external knee joints, shin, SACH foot
    L5160 Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, SACH foot
    L5200 Above knee, molded socket, single axis constant friction knee, shin, SACH foot
    L5210 Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each
    L5220 Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each
    L5230 Above knee, for proximal femoral focal deficiency, constant friction knee, shin, SACH foot
    L5250 Hip disarticulation, Canadian type; molded socket, hip joint, single axis constant friction knee, shin, SACH foot
    L5270 Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, SACH foot
    L5280 Hemipelvectomy, Canadian type; molded socket, hip joint, single axis constant friction knee, shin, SACH foot
    L5301 Below knee, molded socket, shin, SACH foot, endoskeletal system
    L5312 Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system
    L5321 Above knee, molded socket, open end, SACH foot, endoskeletal system, single axis knee
    L5331 Hip disarticulation, Canadian type, molded socket, endoskeletal system, hip joint, single axis knee, SACH foot
    L5341 Hemipelvectomy, Canadian type, molded socket, endoskeletal system, hip joint, single axis knee, SACH foot
    L5400 Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee
    L5410 Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment
    L5420 Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulation
    L5430 Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, 'ak' or knee disarticulation, each additional cast change and realignment
    L5450 Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee
    L5460 Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee
    L5500 Initial, below knee PTB type socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, direct formed
    L5505 Initial, above knee, knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, direct formed
    L5510 Preparatory, below knee PTB type socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, molded to model
    L5520 Preparatory, below knee PTB type socket, nonalignable system, pylon, no cover, SACH foot, thermoplastic or equal, direct formed
    L5530 Preparatory, below knee PTB type socket, nonalignable system, pylon, no cover, SACH foot, thermoplastic or equal, molded to model
    L5535 Preparatory, below knee PTB type socket, nonalignable system, no cover, SACH foot, prefabricated, adjustable open end socket
    L5540 Preparatory, below knee PTB type socket, nonalignable system, pylon, no cover, SACH foot, laminated socket, molded to model
    L5560 Preparatory, above knee, knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, molded to model
    L5570 Preparatory, above knee - knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, thermoplastic or equal, direct formed
    L5580 Preparatory, above knee, knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, thermoplastic or equal, molded to model
    L5585 Preparatory, above knee - knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, prefabricated adjustable open end socket
    L5590 Preparatory, above knee, knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, laminated socket, molded to model
    L5595 Preparatory, hip disarticulation/hemipelvectomy, pylon, no cover, SACH foot, thermoplastic or equal, molded to patient model
    L5600 Preparatory, hip disarticulation/hemipelvectomy, pylon, no cover, SACH foot, laminated socket, molded to patient model
    L5610 Addition to lower extremity, endoskeletal system, above knee, hydracadence system
    L5611 Addition to lower extremity, endoskeletal system, above knee, knee disarticulation, 4-bar linkage, with friction swing phase control
    L5613 Addition to lower extremity, endoskeletal system, above knee, knee disarticulation, 4-bar linkage, with hydraulic swing phase control
    L5614 Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control
    L5616 Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control
    L5617 Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each
    L5618 Addition to lower extremity, test socket, symes
    L5620 Addition to lower extremity, test socket, below knee
    L5622 Addition to lower extremity, test socket, knee disarticulation
    L5624 Addition to lower extremity, test socket, above knee
    L5626 Addition to lower extremity, test socket, hip disarticulation
    L5628 Addition to lower extremity, test socket, hemipelvectomy
    L5629 Addition to lower extremity, below knee, acrylic socket
    L5630 Addition to lower extremity, symes type, expandable wall socket
    L5631 Addition to lower extremity, above knee or knee disarticulation, acrylic socket
    L5632 Addition to lower extremity, symes type, 'ptb' brim design socket
    L5634 Addition to lower extremity, symes type, posterior opening (canadian) socket
    L5636 Addition to lower extremity, symes type, medial opening socket
    L5637 Addition to lower extremity, below knee, total contact
    L5638 Addition to lower extremity, below knee, leather socket
    L5639 Addition to lower extremity, below knee, wood socket
    L5640 Addition to lower extremity, knee disarticulation, leather socket
    L5642 Addition to lower extremity, above knee, leather socket
    L5643 Addition to lower extremity, hip disarticulation, flexible inner socket, external frame
    L5644 Addition to lower extremity, above knee, wood socket
    L5645 Addition to lower extremity, below knee, flexible inner socket, external frame
    L5646 Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket
    L5647 Addition to lower extremity, below knee suction socket
    L5648 Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket
    L5649 Addition to lower extremity, ischial containment/narrow M-L socket
    L5650 Additions to lower extremity, total contact, above knee or knee disarticulation socket
    L5651 Addition to lower extremity, above knee, flexible inner socket, external frame
    L5652 Addition to lower extremity, suction suspension, above knee or knee disarticulation socket
    L5653 Addition to lower extremity, knee disarticulation, expandable wall socket
    L5654 Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)
    L5655 Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)
    L5656 Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)
    L5658 Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)
    L5661 Addition to lower extremity, socket insert, multi-durometer symes
    L5665 Addition to lower extremity, socket insert, multi-durometer, below knee
    L5666 Addition to lower extremity, below knee, cuff suspension
    L5668 Addition  to lower extremity, below knee, molded distal cushion
    L5670 Addition to lower extremity, below knee, molded supracondylar suspension ('pts' or similar)
    L5671 Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert
    L5672 Addition to lower extremity, below knee, removable medial brim suspension
    L5673 Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism
    L5676 Additions to lower extremity, below knee, knee joints, single axis, pair
    L5677 Additions to lower extremity, below knee, knee joints, polycentric, pair
    L5678 Additions to lower extremity, below knee, joint covers, pair
    L5679 Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism
    L5680 Addition to lower extremity, below knee, thigh lacer, nonmolded
    L5681 Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code L5673 or L5679)
    L5682 Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded
    L5683 Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code L5673 or L5679)
    L5684 Addition to lower extremity, below knee, fork strap
    L5685 Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each
    L5686 Addition to lower extremity, below knee, back check (extension control)
    L5688 Addition to lower extremity, below knee, waist belt, webbing
    L5690 Addition to lower extremity, below knee, waist belt, padded and lined
    L5692 Addition to lower extremity, above knee, pelvic control belt, light
    L5694 Addition to lower extremity, above knee, pelvic control belt, padded and lined
    L5695 Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each
    L5696 Addition to lower extremity, above knee or knee disarticulation, pelvic joint
    L5697 Addition to lower extremity, above knee or knee disarticulation, pelvic band
    L5698 Addition to lower extremity, above knee or knee disarticulation, silesian bandage
    L5699 All lower extremity prostheses, shoulder harness
    L5700 Replacement, socket, below knee, molded to patient model
    L5701 Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model
    L5702 Replacement, socket, hip disarticulation, including hip joint, molded to patient model
    L5703 Ankle, Symes, molded to patient model, socket without solid ankle cushion heel (SACH) foot, replacement only
    L5704 Custom shaped protective cover, below knee
    L5705 Custom shaped protective cover, above knee
    L5706 Custom shaped protective cover, knee disarticulation
    L5707 Custom shaped protective cover, hip disarticulation
    L5710 Addition, exoskeletal knee-shin system, single axis, manual lock
    L5711 Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material
    L5712 Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)
    L5714 Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control
    L5716 Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock
    L5718 Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control
    L5722 Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control
    L5724 Addition, exoskeletal knee-shin system, single axis, fluid swing phase control
    L5726 Addition, exoskeletal knee-shin system, single axis, external joints, fluid swing phase control
    L5728 Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control
    L5780 Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control
    L5781 Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system
    L5782 Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy-duty
    L5785 Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)
    L5790 Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)
    L5795 Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)
    L5810 Addition, endoskeletal knee-shin system, single axis, manual lock
    L5811 Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material
    L5812 Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)
    L5814 Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock
    L5816 Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock
    L5818 Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control
    L5822 Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control
    L5824 Addition, endoskeletal knee-shin system, single axis, fluid swing phase control
    L5826 Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame
    L5828 Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control
    L5830 Addition, endoskeletal knee-shin system, single axis, pneumatic/swing phase control
    L5840 Addition, endoskeletal knee-shin system, 4-bar linkage or multiaxial, pneumatic swing phase control
    L5845 Addition, endoskeletal knee-shin system, stance flexion feature, adjustable
    L5848 Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability
    L5850 Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist
    L5855 Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist
    L5856 Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type
    L5857 Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type
    L5858 Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type
    L5859 Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)
    L5910 Addition, endoskeletal system, below knee, alignable system
    L5920 Addition, endoskeletal system, above knee or hip disarticulation, alignable system
    L5925 Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock
    L5930 Addition, endoskeletal system, high activity knee control frame
    L5940 Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)
    L5950 Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)
    L5960 Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)
    L5961 Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control
    L5962 Addition, endoskeletal system, below knee, flexible protective outer surface covering system
    L5964 Addition, endoskeletal system, above knee, flexible protective outer surface covering system
    L5966 Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system
    L5968 Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature
    L5969 Addition, endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s)
    L5970 All lower extremity prostheses, foot, external keel, sach foot
    L5971 All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only
    L5972 All lower extremity prostheses, foot, flexible keel
    L5973 Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source
    L5974 All lower extremity prostheses, foot, single axis ankle/foot
    L5975 All lower extremity prosthesis, combination single axis ankle and flexible keel foot
    L5976 All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)
    L5978 All lower extremity prostheses, foot, multiaxial ankle/foot
    L5979 All lower extremity prostheses, multiaxial ankle, dynamic response foot, one piece system
    L5980 All lower extremity prostheses, flex-foot system
    L5981 All lower extremity prostheses, flex-walk system or equal
    L5982 All exoskeletal lower extremity prostheses, axial rotation unit
    L5984 All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability
    L5985 All endoskeletal lower extremity prostheses, dynamic prosthetic pylon
    L5986 All lower extremity prostheses, multi-axial rotation unit ('mcp' or equal)
    L5987 All lower extremity prostheses, shank foot system with vertical loading pylon
    L5988 Addition to lower limb prosthesis, vertical shock reducing pylon feature
    L5990 Addition to lower extremity prosthesis, user adjustable heel height
    L5999 Lower extremity prosthesis, not otherwise specified
    L6611 Addition to upper extremity prosthesis, external powered, additional switch, any type
    L6621 Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device
    L6629 Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal
    L6632 Upper extremity addition, latex suspension sleeve, each
    L6677 Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow
    L6680 Upper extremity addition, test socket, wrist disarticulation or below elbow
    L6682 Upper extremity addition, test socket, elbow disarticulation or above elbow
    L6686 Upper extremity addition, suction socket
    L6687 Upper extremity addition, frame type socket, below elbow or wrist disarticulation
    L6688 Upper extremity addition, frame type socket, above elbow or elbow disarticulation
    L6694 Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism
    L6695 Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism
    L6696 Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code L6694 or L6695)
    L6697 Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code L6694 or L6695)
    L6698 Addition to upper extremity prosthesis, below elbow/above elbow, lock mechanism, excludes socket insert
    L6880 Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)
    L6881 Automatic grasp feature, addition to upper limb electric prosthetic terminal device
    L6882 Microprocessor control feature, addition to upper limb prosthetic terminal device
    L6883 Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power
    L6884 Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power
    L6890 Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment
    L6925 Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, Otto Bock or equal electrodes, cables, 2 batteries and one charger, myoelectronic control of terminal device
    L6935 Below elbow, external power, self-suspended inner socket, removable forearm shell, Otto Bock or equal electrodes, cables, 2 batteries and one charger, myoelectronic control of terminal device
    L6945 Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, Otto Bock or equal electrodes, cables, 2 batteries and one charger, myoelectronic control of terminal device
    L6955 Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, Otto Bock or equal electrodes, cables, 2 batteries and one charger, myoelectronic control of terminal device
    L7007 Electric hand, switch or myoelectric controlled, adult
    L7008 Electric hand, switch or myoelectric, controlled, pediatric
    L7009 Electric hook, switch or myoelectric controlled, adult
    L7040 Prehensile actuator, switch controlled
    L7045 Electric hook, switch or myoelectric controlled, pediatric
    L7170 Electronic elbow, Hosmer or equal, switch controlled
    L7180 Electronic elbow, microprocessor sequential control of elbow and terminal device
    L7181 Electronic elbow, microprocessor simultaneous control of elbow and terminal device
    L7185 Electronic elbow, adolescent, Variety Village or equal, switch controlled
    L7186 Electronic elbow, child, Variety Village or equal, switch controlled
    L7190 Electronic elbow, adolescent, Variety Village or equal, myoelectronically controlled
    L7191 Electronic elbow, child, Variety Village or equal, myoelectronically controlled
    L7259 Electronic wrist rotator, any type
    L7360 Six volt battery, each
    L7364 Twelve volt battery, each
    L7366 Battery charger, twelve volt, each
    L7367 Lithium ion battery, rechargeable, replacement
    L7368 Lithium ion battery charger, replacement only
    L7400 Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)
    L7401 Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)
    L7403 Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material
    L7404 Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material
    L7499 Upper extremity prosthesis, not otherwise specified
    L7510 Repair of prosthetic device, repair or replace minor parts
    L7520 Repair prosthetic device, labor component, per 15 minutes
    L7600 Prosthetic donning sleeve, any material, each
    L7900 Male vacuum erection system
    L7902 Tension ring, for vacuum erection device, any type, replacement only, each
    L8002 Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type
    L8035 Custom breast prosthesis, post mastectomy, molded to patient model
    L8040 Nasal prosthesis, provided by a nonphysician
    L8041 Midfacial prosthesis, provided by a nonphysician
    L8042 Orbital prosthesis, provided by a nonphysician
    L8043 Upper facial prosthesis, provided by a nonphysician
    L8044 Hemi-facial prosthesis, provided by a nonphysician
    L8045 Auricular prosthesis, provided by a nonphysician
    L8046 Partial facial prosthesis, provided by a nonphysician
    L8047 Nasal septal prosthesis, provided by a non-physician
    L8048 Unspecified maxillofacial prosthesis, by report, provided by a non-physician
    L8049 Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician
    L8400 Prosthetic sheath, below knee, each
    L8410 Prosthetic sheath, above knee, each
    L8417 Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each
    L8430 Prosthetic sock, multiple ply, above knee, each
    L8465 Prosthetic shrinker, upper limb, each
    L8480 Prosthetic sock, single ply, fitting, above knee, each
    L8603 Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies
    L8604 Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies
    L8606 Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies
    L8614 Cochlear device, includes all internal and external components
    L8618 Transmitter cable for use with cochlear implant device, replacement
    L8619 Cochlear implant, external speech processor and controller, integrated system, replacement
    L8621 Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each
    L8624 Lithium ion battery for use with cochlear implant device speech processor, ear level, replacement, each
    L8625 External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each
    L8627 Cochlear implant, external speech processor, component, replacement
    L8628 Cochlear implant, external controller component, replacement
    L8679 Implantable neurostimulator, pulse generator, any type
    L8680 Implantable neurostimulator electrode, each. Revised Code
    L8681 Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only
    L8682 Implantable neurostimulator radiofrequency receiver
    L8683 Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver
    L8684 Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement
    L8685 Implantable neurostimulator pulse generator, single array, rechargeable, includes extension
    L8686 Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension
    L8687 Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension
    L8688 Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension
    L8689 External recharging system for battery (internal) for use with implantable neurostimulator, replacement only
    L8690 Auditory osseointegrated device, includes all internal and external components
    L8691 Auditory osseointegrated device, external sound processor, replacement
    L8692 Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment
    L8694 Auditory osseointegrated device, transducer/actuator, replacement only, each
    L9900 Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs "l" code
    Q0477 Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only
    Q0478 Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type
    Q0479 Power module for use with electric or electric/pneumatic ventricular assist device, replacement only
    Q0480 Driver for use with pneumatic ventricular assist device, replacement only
    Q0481 Microprocessor control unit for use with electric ventricular assist device, replacement only
    Q0482 Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only
    Q0483 Monitor/display module for use with electric ventricular assist device, replacement only
    Q0484 Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only
    Q0485 Monitor control cable for use with electric ventricular assist device, replacement only
    Q0486 Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only
    Q0487 Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only
    Q0488 Power pack base for use with electric ventricular assist device, replacement only
    Q0489 Power pack base for use with electric/pneumatic ventricular assist device, replacement only
    Q0490 Emergency power source for use with electric ventricular assist device, replacement only
    Q0491 Emergency power source for use with electric/pneumatic ventricular assist device, replacement only
    Q0492 Emergency power supply cable for use with electric ventricular assist device, replacement only
    Q0493 Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only
    Q0494 Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only
    Q0495 Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only
    Q0496 Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only
    Q0497 Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only
    Q0498 Holster for use with electric or electric/pneumatic ventricular assist device, replacement only
    Q0499 Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only
    Q0500 Filters for use with electric or electric/pneumatic ventricular assist device, replacement only
    Q0501 Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only
    Q0502 Mobility cart for pneumatic ventricular assist device, replacement only
    Q0503 Battery for pneumatic ventricular assist device, replacement only, each
    Q0504 Power adapter for pneumatic ventricular assist device, replacement only, vehicle type
    Q0506 Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only
    Q0515 Injection, sermorelin acetate, 1 mcg
    Q2040 Tisagenlecleucel, up to 250 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion
    Q2041 Axicabtagene Ciloleucel, up to 200 million autologous Anti-CD19 CAR T Cells, including leukapheresis and dose preparation procedures, per infusion
    Q2043 Sipuleucel-T, minimum of 50 million autologous cd54+ cells activated with PAP-GM-CSF, including leukapheresis and all other preparatory procedures, per infusion
    Q3001 Sipuleucel-T, minimum of 50 million autologous cd54+ cells activated with PAP-GM-CSF, including leukapheresis and all other preparatory procedures, per infusion
    Q4100 Skin substitute, not otherwise specified
    Q4101 Apligraf, per sq cm
    Q4102 Oasis wound matrix, per sq cm
    Q4103 Oasis burn matrix, per sq cm
    Q4104 Integra bilayer matrix wound dressing (BMWD), per sq cm
    Q4105 Integra dermal regeneration template (DRT) or Integra Omnigraft dermal regeneration matrix, per sq cm
    Q4106 Dermagraft, per sq cm
    Q4107 GRAFTJACKET, per sq cm
    Q4108 Integra matrix, per sq cm
    Q4110 PriMatrix, per sq cm
    Q4111 GammaGraft, per sq cm
    Q4112 Cymetra, injectable, 1 cc
    Q4115 AlloSkin, per sq cm
    Q4116 AlloDerm, per sq cm
    Q4117 HYALOMATRIX, per sq cm
    Q4118 MatriStem micromatrix, 1 mg
    Q4121 TheraSkin, per sq cm
    Q4122 DermACELL, per sq cm
    Q4123 AlloSkin RT, per sq cm
    Q4124 OASIS ultra tri-layer wound matrix, per sq cm
    Q4126 MemoDerm, DermaSpan, TranZgraft or InteguPly, per sq cm
    Q4127 Talymed, per sq cm
    Q4128 FlexHD, AllopatchHD, or Matrix HD, per sq cm
    Q4130 Strattice TM, per sq cm
    Q4131 EpiFix or Epicord, per sq cm
    Q4132 Grafix Core, per sq cm
    Q4133 Grafix Prime, per sq cm
    Q4134 HMatrix, per sq cm
    Q4135 Mediskin, per sq cm
    Q4136 E-Z Derm, per sq cm
    Q4137 AmnioExcel or BioDExCel, per sq cm
    Q4140 BioDFence, per sq cm
    Q4141 AlloSkin AC, per sq cm
    Q4146 Tensix, per sq cm
    Q4147 Architect, Architect PX, or Architect FX, extracellular matrix, per sq cm
    Q4148 Neox 1k, per sq cm
    Q4151 AmnioBand or Guardian, per sq cm
    Q4152 DermaPure, per sq cm
    Q4153 Dermavest and Plurivest, per sq cm
    Q4154 Biovance, per sq cm
    Q4156 Neox 100, per sq cm
    Q4157 Revitalon, per sq cm
    Q4158 Marigen, per sq cm
    Q4159 Affinity, per sq cm
    Q4160 Nushield, per sq cm
    Q4161 Bio-ConneKt wound matrix, per sq cm
    Q4163 AmnioPro, BioSkin, BioRenew, WoundEx, Amniogen-45, Amniogen-200, per sq cm
    Q4164 Helicoll, per sq cm
    Q4165 Keramatrix, per sq cm
    Q4166 Cytal, per sq cm
    Q4169 Artacent wound, per sq cm
    Q4172 PuraPly or PuraPly AM, per sq cm
    Q4173 PalinGen or PalinGen XPlus, per sq cm
    Q4175 Miroderm, per sq cm
    Q4182 Transcyte, per square centimeter
    Q5105 Injection, epoetin alfa, biosimilar, (Retacrit) (for ESRD on dialysis), 100 units
    Q5106 Injection, epoetin alfa, biosimilar, (Retacrit) (for non-ESRD use), 1000 units
    Q5108 Injection, pegfilgrastim-jmdb, biosimilar, (fulphila), 0.5 mg
    Q5510 Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram
    Q9950 Injection, sulfur hexafluoride lipid microspheres, per ml
    Q9993 Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg
    Q9995 Injection, emicizumab-kxwh, 0.5 mg
    S0265 Genetic counseling, under physician supervision, each 15 minutes
    S0515 Scleral lens, liquid bandage device, per lens
    S0596 Phakic intraocular lens for correction of refractive error
    S0800 Laser in situ keratomileusis (LASIK)
    S0810 Photorefractive keratectomy (PRK)
    S0812 Phototherapeutic keratectomy (PTK)
    S1040 Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)
    S2053 Transplantation of small intestine and liver allografts
    S2054 Transplantation of multivisceral organs
    S2060 Lobar lung transplantation
    S2065 Simultaneous pancreas kidney transplantation
    S2066 Breast reconstruction with gluteal artery perforator (GAP) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral
    S2067 Breast reconstruction of a single breast with "stacked" deep inferior epigastric perforator (DIEP) flap(s) and/or gluteal artery perforator (GAP) flap(s), including harvesting of the flap(s), microvascular transfer, closure of donor site(s) and shaping the flap into a breast, unilateral
    S2068 Breast reconstruction with deep inferior epigastric perforator (DIEP) flap or superficial inferior epigastric artery (SIEA) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral
    S2080 Laser-assisted uvulopalatoplasty (LAUP)
    S2083 Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline
    S2095 Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres
    S2112 Arthroscopy, knee, surgical for harvesting of cartilage (chondrocyte cells)
    S2118 Metal-on-metal total hip resurfacing, including acetabular and femoral components
    S2142 Cord blood-derived stem-cell transplantation, allogeneic
    S2150 Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; marrow ablative therapy; drugs, supplies, hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services; and the number of days of pre and post transplant care in the global definition
    S2202 Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; marrow ablative therapy; drugs, supplies, hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services; and the number of days of pre and post transplant care in the global definition
    S2342 Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(s), unilateral or bilateral
    S2350 Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace
    S2351 Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure)
    S2900 Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure)
    S3845 Genetic testing for alpha-thalassemia
    S3846 Genetic testing for hemoglobin E beta-thalassemia
    S3849 Genetic testing for Niemann-Pick disease
    S3850 Genetic testing for sickle cell anemia
    S3852 DNA analysis for APOE epsilon 4 allele for susceptibility to Alzheimer's disease
    S3854 Gene expression profiling panel for use in the management of breast cancer treatment (Eff.07/01/2016)
    S3861 Genetic testing, sodium channel, voltage-gated, type V, alpha subunit (SCN5A) and variants for suspected Brugada Syndrome
    S3865 Genetic testing, sodium channel, voltage-gated, type V, alpha subunit (SCN5A) and variants for suspected Brugada Syndrome
    S3866 Genetic analysis for a specific gene mutation for hypertrophic cardiomyopathy (HCM) in an individual with a known HCM mutation in the family
    S3870 Comparative genomic hybridization (CGH) microarray testing for developmental delay, autism spectrum disorder and/or intellectual disability
    S5102 Day care services, adult; per diem
    S5105 Day care services, center-based; services not included in program fee, per diem
    S5120 Chore services; per 15 minutes
    S5121 Chore services; per diem
    S5130 Homemaker service, NOS; per 15 minutes
    S5131 Homemaker service, NOS; per diem
    S5150 Unskilled respite care, not hospice; per 15 minutes
    S5160 Emergency response system; installation and testing
    S5161 Emergency response system; service fee, per month (excludes installation and testing)
    S5165 Home modifications; per service
    S5170 Home delivered meals, including preparation; per meal
    S8030 Home delivered meals, including preparation; per meal
    S8035 Magnetic source imaging
    S8037 Magnetic resonance cholangiopancreatography (MRCP)
    S8042 Magnetic resonance imaging (MRI), low-field
    S8080 Scintimammography (radioimmunoscintigraphy of the breast), unilateral, including supply of radiopharmaceutical
    S8085 Fluorine-18 fluorodeoxyglucose (F-18 FDG) imaging using dual-head coincidence detection system (nondedicated PET scan)
    S8092 Electron beam computed tomography (also known as ultrafast CT, cine CT)
    S8950 Complex lymphedema therapy, each 15 minutes
    S9001 Home uterine monitor with or without associated nursing services
    S9055 Procuren or other growth factor preparation to promote wound healing
    S9123 Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when CPT codes 99500-99602 can be used)
    S9124 Nursing care, in the home; by licensed practical nurse, per hour
    S9127 Social work visit, in the home, per diem
    S9128 Speech therapy, in the home, per diem
    S9129 Occupational therapy, in the home, per diem
    S9131 Physical therapy; in the home, per diem
    S9140 Diabetic management program, follow-up visit to non-MD provider
    S9145 Insulin pump initiation, instruction in initial use of pump (pump not included)
    S9152 Speech therapy, re-evaluation
    S9208 Home management of preterm labor, including administrative services, professional pharmacy services, care coordination, and all necessary supplies or equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code)
    S9211 Home management of gestational hypertension, includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code)
    S9212 Home management of postpartum hypertension, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code)
    S9213 Home management of preeclampsia, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing services coded separately); per diem (do not use this code with any home infusion per diem code)
    S9214 Home management of gestational diabetes, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code)
    S9329 Home infusion therapy, chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with S9330 or S9331)
    S9330 Home infusion therapy, continuous (24 hours or more) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
    S9331 Home infusion therapy, intermittent (less than 24 hours) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
    S9336 Home infusion therapy, continuous anticoagulant infusion therapy (e.g., Heparin), administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
    S9346 Home infusion therapy, alpha-1-proteinase inhibitor (e.g., Prolastin); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
    S9349 Home infusion therapy, tocolytic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
    S9351 Home infusion therapy, continuous or intermittent antiemetic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and visits coded separately), per diem
    S9353 Home infusion therapy, continuous insulin infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
    S9355 Home infusion therapy, chelation therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
    S9359 Home infusion therapy, antitumor necrosis factor intravenous therapy; (e.g., Infliximab); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
    S9373 Home infusion therapy, hydration therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use with hydration therapy codes S9374-S9377 using daily volume scales)
    S9374 Home infusion therapy, hydration therapy; 1 liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
    S9375 Home infusion therapy, hydration therapy; more than 1 liter but no more than 2 liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
    S9376 Home infusion therapy, hydration therapy; more than 2 liters but no more than 3 liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
    S9377 Home infusion therapy, hydration therapy; more than 3 liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies (drugs and nursing visits coded separately), per diem
    S9379 Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
    S9472 Cardiac rehabilitation program, nonphysician provider, per diem
    S9542 Home injectable therapy, not otherwise classified, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
    S9558 Home injectable therapy; growth hormone, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
    S9560 Home injectable therapy; hormonal therapy (e.g., leuprolide, goserelin), including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem
    S9810 Home therapy; professional pharmacy services for provision of infusion, specialty drug administration, and/or disease state management, not otherwise classified, per hour (do not use this code with any per diem code)
    S9960 Ambulance service, conventional air services, nonemergency transport, one way (fixed wing)
    S9961 Ambulance service, conventional air service, nonemergency transport, one way (rotary wing)
    T1019 Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, ICF/MR or IMD, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)
    T1020 Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, ICF/MR or IMD, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)
    T1028 Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs
    T1030 Nursing care, in the home, by registered nurse, per diem
    T1031 Nursing care, in the home, by licensed practical nurse, per diem
    T2002 Nonemergency transportation; per diem
    T2003 Nonemergency transportation; encounter/trip
    T2004 Nonemergency transport; commercial carrier, multipass
    T2005 Nonemergency transportation; stretcher van
    T2101 Human breast milk processing, storage and distribution only
    V2790 Amniotic membrane for surgical reconstruction, per procedure
    V5008 Hearing Screening
    V5010 Assessment for Hearing Aid
    V5011 Fitting/orientation/checking of hearing aid
    V5020 Conformity evaluation
    V5030 Hearing aid, monaural, body worn, air conduction
    V5040 Hearing aid, monaural, body worn, bone conduction
    V5050 Hearing aid, monaural, in the ear
    V5060 Hearing aid, monaural, behind the ear
    V5070 Glasses, air conduction
    V5080 Glasses, bone conduction
    V5090 Dispensing fee, unspecified hearing aid
    V5095 Semi-implantable middle ear hearing prosthesis
    V5100 Hearing aid, bilateral, body worn
    V5110 Dispensing fee, bilateral
    V5120 Binaural, body
    V5130 Binaural, in the ear
    V5140 Binaural, in the ear
    V5150 Binaural, glasses
    V5160 Dispensing fee, binaural
    V5190 Hearing aid, CROS, glasses
    V5200 Dispensing fee, CROS
    V5230 Hearing aid, BICROS, glasses
    V5240 Dispensing fee, BICROS
    V5242 Hearing aid, analog, monaural, CIC (completely in the ear)
    V5243 Hearing aid, analog, monaural, ITC (in the canal)
    V5244 Hearing aid, digitally programmable analog, monaural
    V5245 Hearing aid, digitally programmable analog, monaural, ITE
    V5246 Hearing aid, digitally programmable analog, monaural, ITE (in the ear)
    V5247 Hearing aid, digitally programmable analog, monaural, BTE (behind the ear)
    V5248 Hearing aid, analog, binaural, CIC
    V5249 Hearing aid, analog, binaural, ITC
    V5250 Hearing aid, digitally programmable analog, binaural, CIC
    V5251 Hearing aid, digitally programmable analog, binaural, ITC
    V5252 Hearing aid, digitally programmable, binaural, ITE
    V5253 Hearing aid, digitally programmable, binaural, BTEV5256
    V5255 Hearing aid, digital, monaural, ITC
    V5258 Hearing aid, digital, binaural, CIC
    V5259 Hearing aid, digital, binaural, ITC
    V5260 Hearing aid, digital, binaural, ITE
    V5261 Hearing aid, digital, binaural, BTE
    V5267 Hearing aid or assistive listening
    V5268 Assistive listening device, telephone amplifier, any type
    V5269 Assistive listening device, alerting, any type
    V5270 Assistive listening device, television amplifier, any type
    V5271 Assistive listening device, television caption decoder
    V5272 Assistive listening device, TDD
    V5273 Assistive listening device, for use with cochlear implant
    V5275 Ear impression, each
    V5281 Assistive listening device, personal FM/DM system, monaural (1 receiver, transmitter, microphone), any type
    V5282 Assistive listening device, personal FM/DM system, binaural (2 receivers, transmitter, microphone), any type
    V5283 Assistive listening device, personal FM/DM neck, loop induction receiver
    V5284 Assistive listening device, personal FM/DM, ear level receiver
    V5285 Assistive listening device, personal FM/DM, direct audio input receiver
    V5286 Assistive listening device, personal blue tooth FM/DM receiver
    V5287 Assistive listening device, personal FM/DM receiver, not otherwise specifiedV5288
    V5289 Assistive listening device, personal FM/DM adapter/boot coupling device for receiver, any type
    V5290 Assistive listening device, transmitter microphone, any type
    V5298 Hearing aid, not otherwise classified
    V5299 Hearing service, miscellaneous

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    Glossary terms found on this page:

    An activity of EmblemHealth or its subcontractor that results in:

    • Denial or limited authorization of a service authorization request, including the type or level of service
    • Reduction, suspension or termination of a previously authorized service
    • Denial, in whole or in part, of payment for a service
    • Failure to provide services in a timely manner
    • Failure of EmblemHealth to act within the time frames for resolution and notification of determinations regarding complaints, action appeals and complaint appeals

    Services that have been approved for payment based on a review of EmblemHealth's policies.

    A health insurance product offered by a health plan company that is defined by the benefit contract and represents a set of covered services. Also called a health benefit plan.

    Services available to a member as defined in his or her contract. Benefit design includes the types of benefits offered, limits (e.g., number of visits, percentage paid or dollar maximums applied) and subscriber responsibility (cost sharing components).

    An insurance company that either administers insurance or self-insures.

    A process in which an individual, an institution or educational program is evaluated and recognized as meeting certain predetermined standards. Certification usually applies to individuals; accreditation usually applies to institutions.

    Treatment of malignant disease by chemical or biological antineoplastic agents.

    A pattern of medical care that focuses on long-term care with chronic diseases or conditions.

    An itemized statement of health care services and their costs provided by a hospital, physician's office or other health care facility. Claims are submitted to the insurer or managed care plan by either the plan member or the provider for payment of the costs incurred.

    A decision about the patient's medical treatment.

    When a member is covered by more than one benefit plan, with both providing similar benefits, EmblemHealth coordinates with the other carrier to ensure appropriate reimbursement. Also called Coordination of Benefits.

    Services rendered by a physician whose opinion or advice is requested by another physician for further evaluation or management of the patient.

    A legal agreement between an individual member or an employer group and a health plan that describes the benefits and limitations of the coverage.

    The date on which a service was rendered.

    An individual other than the subscriber who is eligible to receive health care services under the member's Certificate of Insurance. Generally, dependents are limited to the subscriber's spouse and eligible children.

    Medical equipment, goods, implements and prosthetics that are prescribed for patient care, usually in an outpatient setting. Examples of such equipment include hospital beds, wheelchairs and walkers.

    Medical equipment, goods, implements and prosthetics that are prescribed for patient care, usually in an outpatient setting. Examples of such equipment include hospital beds, wheelchairs and walkers.

    The date on which the coverage of an insurance policy goes into effect at 12:01 am.

    A determination of whether or not a person meets the requirements to participate in the plan and receive coverage under the plan.

    Means a medical or behavioral condition, the onset of which is sudden, that manifests itself by symptoms of sufficient severity, including severe pain, that a prudent layperson, possessing an average knowledge of medicine and health, could reasonably expect the absence of immediate medical attention to result in (a) placing the health of the person afflicted with such condition in serious jeopardy, or in the case of a behavioral condition, placing the health of such person or others in serious jeopardy; (b) serious impairment to such person’s bodily functions; (c) serious dysfunction of any bodily organ or part of such person; or (d) serious disfigurement of such person.

    A form sent to the enrollee after a claim for payment has been processed by the health plan. The form explains the action taken on that claim. This explanation usually includes the amount paid, the benefits available, reasons for denying payment and the claims appeal process. Also called Explanation of Benefits.

    A health care benefit arrangement that is similar to a preferred provider organization in administration, structure and operation but does not cover out-of-network care. Also called an Exclusive Provider Organization.

    Specific conditions or circumstances that are not covered under the benefit agreement or Certificate of Insurance. It is very important to consult the benefit contract to understand what services are not covered benefits.

    A hospital, ambulatory surgical facility, birthing center, dialysis center, rehabilitation facility, skilled nursing facility or other provider certified under New York Public Health Law. A hospice is a facility. An institutional provider of mental health substance abuse treatment operating under New York Mental Hygiene Law and/or approved by the Office of Alcoholism and Substance Abuse Services is a facility.

    An organization that provides comprehensive health care coverage to its members through a network of doctors, hospitals and other health care providers. Also called a Health Maintenance Organization.

    The administration of intravenous drug therapy in the home. Home infusion therapy includes the following services: solutions and pharmaceutical additives; pharmacy compounding and dispensing services; durable medical equipment; ancillary medical supplies; and nursing services.

    A facility or service that provides care for the terminally ill patient and support to the family. The care, primarily for pain control and symptom relief, can be provided in the home or in an inpatient setting.

    An institution which provides inpatient services under the supervision of a physician, and meets the following requirements:

    • Provides diagnostic and therapeutic services for medical diagnosis, treatment and care of injured and sick persons and has, as a minimum, laboratory and radiology services and organized departments of medicine and surgery
    • Has an organized medical staff which may include, in addition to doctors of medicine, doctors of osteopathy and dentistry
    • Has bylaws, rules and regulations pertaining to standards of medical care and service rendered by its medical staff
    • Maintains medical records for all patients
    • Has a requirement that every patient be under the care of a member of the medical staff
    • Provides 24-hour patient services
    • Has in effect agreements with a home health agency for referral and transfer of patients to home health agency care when such service is appropriate to meet the patient's requirements

    The group of individuals who provide person-centered care coordination and care management to participants in a FIDA plan. Each participant will have an interdisciplinary team (IDT). Each IDT will be comprised, first and foremost, of the participant and/or his or her designee, and the participant’s designated care manager, primary care physician, behavioral health professional, home care aide, and other providers either as requested by the participant or his or her designee or as recommended by the care manager or primary care physician and approved by the participant and/or his or her designee. The IDT facilitates timely and thorough coordination between a FIDA plan and the IDT, primary care physician and other providers. The IDT makes coverage determinations. Accordingly, the IDT’s decisions serve as service authorizations, may not be modified by a FIDA plan outside of the IDT, and are appealable by the participant, their providers and their representatives. IDT service planning, coverage determinations, care coordination and care management are delineated in the participant’s person-centered service plan and are based on the assessed needs and articulated preferences of the participant.



    The inability to conceive or an inability to carry a pregnancy to a live birth after a year or more of regular sexual relations without the use of contraception.

    Treatment accomplished by placing therapeutic agents into the vein, including intravenous feeding. Such therapy also includes enteral nutrition that is the delivery of nutrients into the gastrointestinal tract by tube.

    Service provided after the patient is admitted to the hospital. Inpatient stays are those lasting 24 hours or more.

    An organization comprised of individual physicians or physicians in group practices that contracts with the managed care organization on behalf of its member physicians to provide health care services. Also called an Independent Practice Association.

    A permit (or equivalent) to practice medicine or a health profession that is: 1) issued by any state or jurisdiction in the United States and 2) required for the performance of job functions.

    Specific circumstances or services listed in the contract for which benefits will be limited.

    Acronym for Medicare Advantage. An alternative to the traditional Medicare program in which private plans run by health insurance companies provide health care benefits that eligible beneficiaries would otherwise receive directly from the Medicare program.

    A jointly funded federal and state program that provides hospital and medical coverage to the low-income population and certain aged and disabled individuals.

    Health care that is rendered by a hospital or a licensed or certified provider and is determined by EmblemHealth to meet all of the criteria listed below:

    • It is provided for the diagnosis or direct care or treatment of the condition, illness, disease, injury or ailment.
    • It is consistent with the symptoms or proper diagnosis and treatment of the medical condition, disease, injury or ailment.
    • It is in accordance with accepted standards of good medical practice in the community.
    • It is furnished in a setting commensurate with the member's medical needs and condition.
    • It cannot be omitted under the standards referenced above.
    • It is not in excess of the care indicated by generally accepted standards of good medical practice in the community.
    • It is not furnished primarily for the convenience of the member, the member's family or the provider.
    • In the case of a hospitalization, the care cannot be rendered safely or adequately on an outpatient basis or in a less intensive treatment setting and, therefore, requires the member receive acute care as a bed patient.

    The fact that a provider has prescribed a service or supplies care does not automatically mean the service or supply will qualify for reimbursement under the EmblemHealth plan. To be eligible for reimbursement by EmblemHealth, all covered services must meet EmblemHealth's medical necessity criteria, described above.

    Medically necessary with respect to Medicaid and Family Health Plus members means health care and services that are necessary to prevent, diagnose, manage or treat conditions that cause acute suffering, endanger life, result in illness or infirmity, interfere with a person's capacity for normal activity or threaten some significant handicap.

    A nationwide insurance program for the disabled and people age 65 and over, created by the 1965 amendments to the Social Security Act and operated under the provisions of the Act. It consists of two separate but coordinated programs, Part A and Part B.

    An individual and each of his or her eligible dependents, including Medicare beneficiaries who are enrolled or participate in a benefit program and who are entitled to receive covered services from the practitioner pursuant to such benefit program and the terms of the practitioner's agreement.

    Treatment to restore a physically disabled person's ability to perform activities such as walking, eating, drinking, dressing, toileting and bathing (activities of daily living).

    Treatment involving physical movement to relieve pain, restore function and prevent disability following disease, injury or loss of limb.

    A type of health benefit plan that allows enrollees to go outside the health plan's provider network for care, but requires enrollees to pay higher out-of-pocket fees when they do. Also called Point of Service.

    A health plan that offers benefits in-network and out-of-network. In-network services are available to enrollees at lower out-of-pocket cost than the services of non-network providers. In addition, PPO enrollees may self-refer to any network provider at any time. Also called a Preferred Provider Organization.

    A written order or refill notice issued by a licensed medical professional for drugs available only through a pharmacy.

    The process of obtaining advanced approval of coverage for a health care service or medication. The request for services is reviewed to assess medical necessity and appropriateness of elective hospital admissions and non-emergency outpatient services before the services are provided. Also called pre-authorization or pre-certification or pre-determination.

    A medical practitioner or covered facility recognized by EmblemHealth for reimbursement purposes. A provider may be any of the following, subject to the conditions listed in this paragraph:

    • Doctor of medicine
    • Doctor of osteopathy
    • Dentist
    • Chiropractor
    • Doctor of podiatric medicine
    • Physical therapist
    • Nurse midwife
    • Certified and registered psychologist
    • Certified and qualified social worker
    • Optometrist
    • Nurse anesthetist
    • Speech-language pathologist
    • Audiologist
    • Clinical laboratory
    • Screening center
    • General hospital
    • Any other type of practitioner or facility specifically listed in the member's Certificate of Insurance as a practitioner or facility recognized by EmblemHealth for reimbursement purposes

    A provider must be licensed or certified to render the covered service. The covered service must be within the scope of the Provider's license or certification.

    Treatment of disease by X-ray, radium, cobalt or high energy particle sources.

    Treatment of the correction of a speech impairment which resulted from birth, disease, injury or prior medical treatment

    A review to determine whether covered services that have been provided or are proposed to be provided to a member, whether undertaken prior to, concurrent with or subsequent to the delivery of such services are medically necessary. Also called Coordinated Care.

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