| Pre-Authorization List for EmblemHealth Members | |
| This is a complete list of all services requiring a Prior Approval for EmblemHealth members 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 Anthem Blue Cross and Blue Shield (formerly known as Empire BCBS) for inpatient and outpatient services. To see what needs authorization, use their look-up tool: www.empireblue.com/provider. |
|
| 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 |
