Provider Procedure Codes Surgery
July 2024 1
PHYSICIAN
SURGERY PROCEDURE
CODES
eMedNY New York State Medicaid Provider Procedure
Code Manual
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Adds:
58674 - Code was added 7/1/22 but never got added to the manual *correction* Reviewed 7/8/24 LDK
Deletions:
58293 – Code end dated 12/31/2020 *correction* Reviewed 7/8/24 LDK
36410 – Code was added in 2013 but code has been inactive since 2005 when it became effective; confirmed
with Sue that code should be deleted
Changes:
Corrected 55242 to 52442 Reviewed 7/8/24 LDK
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New York State Medicaid
Office of Health Insurance
Department of Health
CONTACTS and LINKS:
eMedNY URL
https://www.emedny.org/
eMedNY Contact Information
(800) 343-9000
eMedNY: Billing Questions, Remittance Clarification, Request for Claim Forms, ePACES Enrollment,
Electronic Claim Submission Support (eXchange, FTP), Provider Enrollment, Requests for paper
prior approval forms
eMedNY Contacts PDF
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Table of Contents
1 DOCUMENT CONTROL PROPERTIES ................................................................................................... 6
2 GENERAL INFORMATION AND INSTRUCTIONS ............................................................................. 6
2.1 OVERVIEW ............................................................................................................................................... 6
3 MMIS MODIFIERS....................................................................................................................................... 9
3.1 OVERVIEW ............................................................................................................................................... 9
4 INTEGUMENTARY SERVICES ................................................................................................................. 11
4.1 GENERAL ................................................................................................................................................. 11
4.2 INTEGUMENTARY SYSTEM ............................................................................................................... 11
5 MUSCULOSKELETAL SERVICES ........................................................................................................... 25
5.1 MUSCULOSKELETAL SYSTEM .......................................................................................................... 25
6 RESPIRATORY SERVICES ........................................................................................................................ 78
6.1 RESPIRATORY SYSTEM ....................................................................................................................... 78
7 CARDIOVASCULAR SERVICES ............................................................................................................. 89
7.1 CARDIOVASCULAR SYSTEM ............................................................................................................. 89
7.2 HEMIC AND LYMPHATIC SYSTEMS .............................................................................................. 121
7.3 MEDIASTINUM AND DIAPHRAGM .............................................................................................. 123
8 DIGESTIVE SERVICES ............................................................................................................................. 124
8.1 DIGESTIVE SYSTEM ........................................................................................................................... 124
9 URINARY SERVICES ............................................................................................................................... 157
9.1 URINARY SYSTEM .............................................................................................................................. 157
10 MALE GENITAL SERVICES .................................................................................................................... 169
10.1 MALE GENITAL SYSTEM ................................................................................................................. 169
10.2 REPRODUCTIVE SYSTEM PROCEDURES .................................................................................. 175
11 INTERSEX SURGERY ............................................................................................................................... 175
11.1 GENDER REASSIGNMENT SURGERY INFORMATION ............................................................ 175
11.2 CLAIM SUBMISSION INSTRUCTIONS ........................................................................................ 175
12 FEMALE GENITAL SERVICES ............................................................................................................... 179
12.1 FEMALE GENITAL SYSTEM ............................................................................................................ 179
13 MATERNITY CARE AND DELIVERY SERVICES ............................................................................... 187
13.1 MATERNITY CARE AND DELIVERY .............................................................................................. 187
14 ENDOCRINE SYSTEM SERVICES ........................................................................................................ 190
14.1 ENDOCRINE SYSTEM ...................................................................................................................... 190
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15 NERVOUS SYSTEM SERVICES ............................................................................................................ 191
15.1 NERVOUS SYSTEM ........................................................................................................................... 191
16 EYE AND OCULAR ADNEXA SERVICES ........................................................................................... 211
16.1 EYE AND OCULAR ADNEXA .......................................................................................................... 211
17 AUDITORY SERVICES ........................................................................................................................... 222
17.1 AUDITORY SYSTEM ........................................................................................................................ 222
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1 DOCUMENT CONTROL PROPERTIES
Control Item
Value
Document Name
Physician - Surgery Procedure Codes
Document Control Number
2024-1
Document Type
Procedure Code Manual
Document Version
2024-V2
Document Status
Effective date
July 2024
2 GENERAL INFORMATION AND INSTRUCTIONS
2.1 OVERVIEW
A. FEES: The fees are listed in the Physician Surgery Fee Schedule, available at
https://www.emedny.org/ProviderManuals/Physician/
Listed fees are the maximum reimbursable Medicaid fees. Fees for the MOMS Program can
be found in the Enhanced Program fee schedule. Fees for office, home and hospital visits,
consultations and other medical services are listed in the Fee Schedule entitled MEDICINE.
B. FOLLOW-UP (F/U) DAYS:
Listed dollar values for all surgical procedures include the surgery and the follow-up care
for the period indicated in days in the column headed "F/U Days". Necessary follow-up care
beyond this listed period is to be added on a fee-for-service basis. (See modifier -24)
C. BY REPORT:
When the value of a procedure is indicated as "By Report" (BR), an Operative Report must
be submitted with the MMIS claim form for a payment determination to be made. The
Operative Report must include the following information:
1. Diagnosis (post-operative)
2. Size, location and number of lesion(s) or procedure(s) where appropriate
3. Major surgical procedure and supplementary procedure(s)
4. Whenever possible, list the nearest similar procedure by number according to
these studies
5. Estimated follow-up period
6. Operative time
Failure to submit an Operative Report when billing for a "By Report" procedure will cause
your claim to be denied by MMIS.
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D. ADDITIONAL SERVICES:
Complications or other circumstances requiring additional and unusual services concurrent
with the procedure(s) or during the listed period of normal follow-up care, may warrant
additional charges on a fee-for-service basis. (See modifiers -24, -25, -79). When an
additional surgical procedure(s) is carried out within the listed period of follow-up care for
a previous surgery, the follow-up periods will continue concurrently to their normal
terminations. (See modifiers -78, -79)
E. SEPARATE PROCEDURE:
Certain of the listed procedures are commonly carried out as an integral part of a total
service and as such do not warrant a separate charge. When such a procedure is carried
out as a separate entity, not immediately related to other services, the indicated value for
"Separate Procedure" is applicable.
F. MULTIPLE SURGICAL PROCEDURES:
1. When multiple or bilateral surgical procedures, which add significant time or
complexity to patient care, are performed at the same operative session, the total
dollar value shall be the value of the major procedure plus 50% of the value of the
lesser procedure(s) unless otherwise specified. (For reporting bilateral surgical
procedures, see modifier -50).
2. When an incidental procedure (eg, incidental appendectomy, lysis of adhesions,
excision of previous scar, puncture of ovarian cyst) is performed through the same
incision, the fee will be that of the major procedure only.
G. PROCEDURES NOT SPECIFICALLY LISTED:
Will be given values comparable to those of the listed procedures of closest similarity.
When no similar procedure can be identified, the MMIS procedure codes to be utilized may
be found at the end of each section.
H. SUPPLEMENTAL SKILLS:
When warranted by the necessity of supplemental skills, values for services rendered by two
or more physicians will be allowed.
I. SKILLS OF TWO SURGEONS
1. When the skills of two surgeons are required in the management of a specific
surgical procedure, by prior agreement, the total dollar value may be apportioned
in relation to the responsibility and work done, provided the patient is made aware
of the fee distribution according to medical ethics. The value may be increased by
25 percent under these circumstances. See MMIS modifier -62.
2. PHYSICIAN ASSISTANT/ NURSE PRACTITIONER /RN FIRST ASSISTANT (RNFA)
SERVICES FOR ASSIST AT SURGERY: When a physician requests a nurse practitioner,
a physician's assistant or an Registered Nurse First Assistant to participate in the
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management of a specific surgical procedure in lieu of another physician, or
requests a licensed midwife to participate in the management of a Cesarean
section, by prior agreement, the total value may be apportioned in relation to the
responsibility and work done, provided the patient is made aware of the fee
distribution according to medical ethics. The value may be increased by 20 percent
under these circumstances. The claim for these services will be submitted by the
physician using the appropriate modifier.
J. MATERIALS SUPPLIED BY A PHYSICIAN:
Supplies and materials provided by the physician, eg, sterile trays/drugs, over and above
those usually included with the office visit or other services rendered may be listed
separately. List drugs, trays, supplies and materials provided. Identify as
99070.
Reimbursement for drugs (including vaccines and immunoglobulin) furnished by
practitioners to their patients is based on the acquisition cost to the practitioner of the drug
dose administered to the patient. For all drugs furnished in this fashion it is expected that
the practitioner will maintain auditable records of the actual itemized invoice cost of the
drug, including the numbers of doses of the drug represented on the invoice. New York
State Medicaid does not intend to pay more than the acquisition cost of the drug dosage,
as established by invoice, to the practitioner. Regardless of whether an invoice must be
submitted to Medicaid for payment, the practitioner is expected to limit his or her Medicaid
claim amount to the actual invoice cost of the drug dosage administered.
K. PRIOR APPROVAL:
Payment for those listed procedures where the MMIS code number is underlined is
dependent upon obtaining the approval of the Department of Health prior to performance
of the procedure. If such prior approval is not obtained, no reimbursement will be made.
L. DVS AUTHORIZATION (#):
Codes followed by # require an authorization via the dispensing validation system (DVS)
before services are rendered.
M. INFORMED CONSENT FOR STERILIZATION:
When procedures are performed for the primary purpose of rendering an individual
incapable of reproducing, and in all cases when procedures are performed, the following
rules will apply:
1. The patient must be 21 years of age or older at the time to consent to sterilization.
2. The patient must have been informed of the risks and benefits of sterilization and
have signed the mandated consent form, (DSS-3134) not less than 30 days nor
more than 180 days prior to the performance of the procedure. In cases of
premature delivery and emergency abdominal surgery, consent must have been
given at least 72 hours prior to sterilization.
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3. No bill will be processed for payment without a properly completed consent form.
(Refer to Billing Section for completion instructions).
NOTE: For procedures performed within the jurisdiction of NYC the guidelines established
under NYC Local Law #37 of 1977 continue to be in force.
N. RECEIPT OF HYSTERECTOMY INFORMATION:
Hysterectomies must not be performed for the purpose of sterilization. When hysterectomy
procedures are performed and, in all cases, when procedures are billed, a properly
completed "Hysterectomy Receipt of Information Form" must be attached to the bill for
payment. No bill will be processed without a properly completed "Hysterectomy Receipt of
Information Form", (DSS-3113).
O. BILLING GUIDELINES:
For additional general billing guidelines please refer to the current CPT manual.
3 MMIS MODIFIERS
3.1 OVERVIEW
NCCI associated modifiers are recognized for NCCI code pairs/related edits. For additional
information please refer to the CMS website: http://www.cms.hhs.gov/NationalCorrectCodInitEd/
50 Bilateral Procedure (Surgical): Unless otherwise identified in the listings, bilateral surgical
procedures requiring a separate incision that are performed at the same operative
session, should be identified by the appropriate five digit code describing the first
procedure. To indicate a bilateral surgical procedure was done add modifier -50 to the
procedure number. (Reimbursement will not exceed 150% of the maximum Fee
Schedule amount. One claim line is to be billed representing the bilateral procedure.
Amount billed should reflect total amount due.)
54 Su
rgical Care Only: When one physician performs a surgical procedure and another
provides preoperative and/or postoperative management, surgical services may be
identified by adding the modifier -54 to the usual procedure number. (Reimbursement
will not exceed 80% of the maximum Fee Schedule amount.)
62 T
wo Surgeons: When two surgeons (usually of different skills) work together as primary
surgeons performing distinct part(s) of a single reportable procedure, add the modifier
–62 to the single definitive procedure code. [One surgeon should file one claim line
representing the procedure performed by the two surgeons. Reimbursement will not
exceed 125% of the maximum State Medical Fee Schedule amount.] If additional
procedure(s) (including add-on procedure(s)) are performed during the same surgical
session, separate code(s) may be reported without the modifier –62 added as
appropriate.
NOTE: If a co-surgeon acts as an assistant in the performance of additional
procedure(s) during the same surgical session, those services may be reported using
separate procedure code(s) with the modifier –80 added, as appropriate.
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63 Procedure Performed on Infants Less Than 4 kg: Procedures performed on neonates
and infants up to a present body weight of 4 kg may involve significantly increased
complexity and physician work commonly associated with these patients. This
circumstance may be reported by adding modifier –63 to the procedure number. Note:
Unless otherwise designated, this modifier may only be appended to
procedures/services listed in the 69999 code series. Modifier –63 should not be
appended to any CPT codes listed in the Evaluation and Management Services,
Anesthesia, Radiology, Pathology/Laboratory, or Medicine sections. (Reimbursement will
not exceed 100% of the maximum Fee Schedule amount.)
66 Su
rgical Team: Under some circumstances, highly complex procedures (requiring the
concomitant services of several physicians, often of different specialties, plus other
highly skilled, specially trained personnel, various types of complex equipment) are
carried out under the "surgical team" concept. Such circumstances may be identified by
each participating physician with the addition of the modifier -66 to the basic
procedure number used for reporting services. (Reimbursement will not exceed 20% of
the maximum Fee Schedule amount.)
78 R
eturn to the Operating Room for a Related Procedure During the Postoperative
Period: The physician may need to indicate that another procedure was performed
during the postoperative period of the initial procedure. When this subsequent
procedure is related to the first, and requires the use of the operating room, it may be
reported by adding the modifier -78 to the related procedure. (Reimbursement will not
exceed 100% of the maximum Fee Schedule amount.)
79 Un
related Procedure or Service by the Same Practitioner During the Postoperative
Period: The practitioner may need to indicate that the performance of a procedure or
service during the postoperative period was unrelated to the original procedure. This
circumstance may be reported by adding the modifier -79. (Reimbursement will not
exceed 100% of the maximum Fee Schedule amount.)
80 A
ssistant Surgeon: Surgical assistant services may be identified by adding the modifier -
80 to the usual procedure number(s). (Reimbursement will not exceed 20% of the
maximum Fee Schedule amount.)
82 As
sistant Surgeon: (when qualified resident surgeon not available): The unavailability of
a qualified resident surgeon is a prerequisite for use of modifier -82 appended to the
usual procedure code number(s). (Reimbursement will not exceed 20% of the maximum
Fee Schedule amount.)
AQ Ph
ysician Providing a Service in an Unlisted Health Professional Shortage Area (HPSA)
AS Physician Assistant, Nurse Practitioner or Registered Nurse First Assistant Services for
Assist at Surgery: When the physician requests that a Physician Assistant, a Nurse
Practitioner, or an Registered Nurse First Assistant to assist at surgery, or requests a
licensed midwife to assist for a Cesarean section, in lieu of another physician, Modifier -
AS should be added to the appropriate code describing the procedure. One claim is to
be filed. (Reimbursement will not exceed 120% of the maximum Fee Schedule amount).
LT Lef
t Side (used to identify procedures performed on the left side of the body): Add
modifier –LT to the usual procedure code number. (Reimbursement will not exceed
100% of the Maximum Fee Schedule amount. One claim line should be billed.) (Use
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modifier –50 when both sides done at same operative session.)
RT Right Side (used to identify procedures performed on the right side of the body): Add
modifier –RT to the usual procedure code number. (Reimbursement will not exceed
100% of the Maximum Fee Schedule amount. One claim line should be billed.) (Use
modifier –50 when both sides done at same operative session.)
4 INTEGUMENTARY SERVICES
4.1 GENERAL
4.1.1 FINE NEEDLE ASPIRATION (FNA) BIOPSY
10021 Fine needle aspiration biopsy, without imaging guidance; first lesion
10004 each additional lesion (List separately in addition to code for primary procedure)
10005 Fine needle aspiration biopsy, including ultrasound guidance; first lesion
10006 each additional lesion (List separately in addition to code for primary procedure)
10007 Fine needle aspiration biopsy, including fluoroscopic guidance; first lesion
10008 each additional lesion (List separately in addition to code for primary procedure)
10009 Fine needle aspiration biopsy, including CT guidance; first lesion
10010 each additional lesion (List separately in addition to code for primary procedure)
10011 Fine needle aspiration biopsy, including MR guidance; first lesion
10012 each additional lesion (List separately in addition to code for primary procedure)
4.2 INTEGUMENTARY SYSTEM
4.2.1 SKIN, SUBCUTANEOUS AND ACCESSORY STRUCTURES
4.2.1.1 INTRODUCTION AND REMOVAL
10030 Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma,
lymphocele, cyst), soft tissue (eg, extremity, abdominal wall, neck), percutaneous
10035 Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle,
radioactive seeds), percutaneous, including imaging guidance; first lesion
10036 each additional lesion (List separately in addition to code for primary procedure)
4.2.1.2 INCISION AND DRAINAGE
10040 Acne surgery (eg, marsupialization, opening or removal of multiple milia, comedones,
cysts, pustules)
10060 Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or
subcutaneous abscess, cyst, furuncle, or paronychia); simple or single
10061 complicated or multiple
10080 Incision and drainage of pilonidal cyst; simple
10081 complicated
10120 Incision and removal of foreign body, subcutaneous tissues; simple
10121 complicated
10140 Incision and drainage of hematoma, seroma or fluid collection
10160 Puncture aspiration of abscess, hematoma, bulla or cyst
10180 Incision and drainage, complex, postoperative wound infection
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4.2.1.3 DEBRIDEMENT
11000 Debridement of extensive eczematous or infected skin; up to 10% of body surface
11001 each additional 10% of the body surface, or part thereof
11004 Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue
infection; external genitalia and perineum
11005 abdominal wall, with or without fascial closure
11006 external genitalia, perineum and abdominal wall, with or without fascial closure
11008 Removal of prosthetic material or mesh, abdominal wall for infection (eg, for chronic or
recurrent mesh infection or necrotizing soft tissue infection)
11010 Debridement including removal of foreign material at the site of an open fracture and/or
an open dislocation (eg, excisional debridement); skin and subcutaneous tissues
11011 skin, subcutaneous tissue, muscle fascia, and muscle
11012 skin, subcutaneous tissue, muscle fascia, muscle, and bone
11042 Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20
sq cm or less
11043 Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue,
if performed); first 20 sq cm or less
11044 Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle, and/or
fascia, if performed); first 20 sq cm or less
11045 Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each
additional 20 sq cm, or part thereof
11046 Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue,
if performed); each additional 20 sq cm, or part thereof
11047 Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle, and/or
fascia, if performed); each additional 20 sq cm, or part thereof
4.2.1.4 PARING OR CUTTING
11055 Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion
11056 two to four lesions
11057 more than four lesions
4.2.1.5 BIOPSY
11102 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion
11103 each separate/additional lesion
11104 Punch biopsy of skin (including simple closure, when performed); single lesion
11105 each separate/additional lesion
11106 Incisional biopsy of skin (eg, wedge) (including simple skin closure, when performed);
single lesion
11107 each separate/additional lesion
4.2.1.6 REMOVAL OF SKIN TAGS
11200 Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15
lesions
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11201 each additional ten lesions, or part thereof
4.2.1.7 SHAVING OF EPIDERMAL OR DERMAL LESIONS
11300 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter
0.5 cm. or less
11301 lesion diameter 0.6 to 1.0 cm
11302 lesion diameter 1.1 to 2.0 cm
11303 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 lesion diameter 0.6 to 1.0 cm
11307 lesion diameter 1.1 to 2.0 cm
11308 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 lesion diameter 0.6 to 1.0 cm
11312 lesion diameter 1.1 to 2.0 cm
11313 lesion diameter over 2.0 cm
4.2.1.8 EXCISION – BENIGN LESIONS
11400 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk,
arms or legs; excised diameter 0.5 cm or less
11401 excised diameter 0.6 to 1.0 cm
11402 excised diameter 1.1 to 2.0 cm
11403 excised diameter 2.1 to 3.0 cm
11404 excised diameter 3.1 to 4.0 cm
11406 excised diameter over 4.0 cm
11420 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp,
neck, hands, feet, genitalia; excised diameter 0.5 cm or less
11421 excised diameter 0.6 to 1.0 cm
11422 excised diameter 1.1 to 2.0 cm
11423 excised diameter 2.1 to 3.0 cm
11424 excised diameter 3.1 to 4.0 cm
11426 excised diameter over 4.0 cm
11440 Excision, other benign lesion including margins, (unless listed elsewhere), face, ears,
eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less
11441 excised diameter 0.6 to 1.0 cm
11442 excised diameter 1.1 to 2.0 cm
11443 excised diameter 2.1 to 3.0 cm
11444 excised diameter 3.1 to 4.0 cm
11446 excised diameter over 4.0 cm
11450 Excision of skin and subcutaneous tissue for hidradenitis, axillary; with simple or
intermediate repair
11451 with complex repair
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11462 Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with simple or
intermediate repair
11463 with complex repair
11470 Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal or umbilical;
with simple or intermediate repair
11471 with complex repair
4.2.1.9 EXCISION - MALIGNANT LESIONS
11600 Excision, malignant lesion including margins, trunk, arms or legs; excised diameter 0.5 cm
or less
11601 excised diameter 0.6 to 1.0 cm
11602 excised diameter 1.1 to 2.0 cm
11603 excised diameter 2.1 to 3.0 cm
11604 excised diameter 3.1 to 4.0 cm
11606 excised diameter over 4.0 cm
11620 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised
diameter 0.5 cm or less
11621 excised diameter 0.6 to 1.0 cm
11622 excised diameter 1.1 to 2.0 cm
11623 excised diameter 2.1 to 3.0 cm
11624 excised diameter 3.1 to 4.0 cm
11626 excised diameter over 4.0 cm
11640 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised
diameter 0.5 cm or less
11641 excised diameter 0.6 to 1.0 cm
11642 excised diameter 1.1 to 2.0 cm
11643 excised diameter 2.1 to 3.0 cm
11644 excised diameter 3.1 to 4.0 cm
11646 excised diameter over 4.0 cm
4.2.2 NAILS
11720 Debridement of nail(s) by any method(s); one to five
11721 six or more
11730 Avulsion of nail plate, partial or complete, simple; single
11732 each additional nail plate
11740 Evacuation of subungual hematoma
11750 Excision of nail and nail matrix, partial or complete, (eg, ingrown or deformed nail) for
permanent removal;
11755 Biopsy of nail unit (eg, plate, bed, matrix, hyponychium, proximal and lateral nail folds)
11760 Repair of nail bed
11762 Reconstruction of nail bed with graft
11765 Wedge excision of skin of nail fold (eg, for ingrown toenail)
4.2.3
PILONIDAL CYST
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11770 Excision of pilonidal cyst or sinus; simple
11771 extensive
11772 complicated
4.2.4
INTRODUCTION
11900 Injection, intralesional; up to and including seven lesions
11901 more than seven lesions
(11900, 11901 are not to be used for preoperative local anesthetic injection)
11920 Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects
of skin, including micropigmentation; 6.0 sq cm or less
11921 6.1 to 20.0 sq cm
11922 each additional 20.0 sq cm, or part thereof (List separately in addition to primary
procedure)
11950 Subcutaneous injection of filling material (eg, collagen); 1 cc or less
11951 1.1 to 5 cc
11952 5.1 to 10 cc
11954 over 10 cc
11960 Insertion of tissue expander(s) for other than breast, including subsequent expansion
11970 Replacement of tissue expander with permanent implant
11971 Removal of tissue expander without insertion of implant
11976 Removal, implantable contraceptive capsules
11980 Subcutaneous hormone pellet implantation (implantation of estradiol and/or testosterone
pellets beneath the skin)
11981 Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)
11982 Removal, non-biodegradable drug delivery implant
11983 Removal with reinsertion, non-biodegradable drug delivery implant
4.2.5 REPAIR (CLOSURE)
4.2.5.1 REPAIR-SIMPLE
12001 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or
extremities (including hands and feet); 2.5 cm or less
12002 2.6 cm to 7.5 cm
12004 7.6 cm to.12.5 cm
12005 12.6 cm to 20.0 cm
12006 20.1 cm to 30.0 cm
12007 over 30.0 cm
12011 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous
membranes; 2.5 cm or less
12013 2.6 cm to 5.0 cm
12014 5.1 cm to 7.5 cm
12015 7.6 cm to 12.5 cm
12016 12.6 cm to 20.0 cm
12017 20.1 cm to 30.0 cm
12018 over 30.0 cm
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12020 Treatment of superficial wound dehiscence; simple closure
4.2.5.2 REPAIR-INTERMEDIATE
12031 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands
and feet); 2.5 cm or less
12032 2.6 cm to 7.5 cm
12034 7.6 cm to.12.5 cm
12035 12.6 cm to 20.0 cm
12036 20.1 cm to 30.0 cm
12037 over 30.0 cm
12041 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less
12042 2.6 cm to 7.5 cm
12044 7.6 cm to.12.5 cm
12045 12.6 cm to 20.0 cm
12046 20.1 cm to 30.0 cm
12047 over 30.0 cm
12051 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes;
2.5 cm or less
12052 2.6 cm to 5.0 cm
12053 5.1 cm to 7.5 cm
12054 7.6 cm to 12.5 cm
12055 12.6 cm to 20.0 cm
12056 20.1 cm to 30.0 cm
12057 over 30.0 cm
4.2.5.3 REPAIR-COMPLEX
13100 Repair, complex, trunk; 1.1 cm to 2.5 cm
13101 2.6 cm to 7.5 cm
13102 each additional 5 cm or less
13120 Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm
13121 2.6 cm to 7.5 cm
13122 each additional 5 cm or less
13131 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet;
1.1 cm to 2.5 cm
13132 2.6 cm to 7.5cm
13133 each additional 5 cm or less
13151 Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm
13152 2.6 cm to 7.5 cm
13153 each additional 5 cm or less
13160 Secondary closure of surgical wound or dehiscence, extensive or complicated
4.2.5.4 ADJACENT TISSUE TRANSFER OR REARRANGEMENT
14000 Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less
14001 defect 10.1 sq cm to 30.0 sq cm
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 17
14020 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm. or
less
14021 defect 10.1 sq cm to 30.0 sq cm
14040 Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae,
genitalia, hands and/or feet; defect 10 sq cm or less
14041 defect 10.1 sq cm to 30.0 sq cm
14060 Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm
or less
14061 defect 10.1 sq cm to 30.0 sq cm
14301 Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm
14302 each additional 30.0 sq cm, or part thereof
14350 Filleted finger or toe flap, including preparation of recipient site
4.2.5.5 SKIN REPLACEMENT SURGERY
4.2.5.5.1 SURGICAL PREPARATION
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 each additional 100 sq cm, or part thereof, or each additional 1% of body area of
infants and children
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 each additional 100 sq cm, or part thereof, or each additional 1% of body area of
infants and children
4.2.5.5.2 AUTOGRAFT/TISSUE CULTURED AUTOGRAFT
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
15100 Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or one percent of body
area of infants and children (except 15050)
15101 each additional 100 sq cm, or each additional one percent of body area of infants
and children, or part thereof
15110 Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or one percent of body area
of infants and children
15111 each additional 100 sq cm, or each additional one percent of body area of infants
and children, or part thereof
15115 Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet,
and/or multiple digits; first 100 sq cm or less, or one percent of body area of infants and
children
15116 each additional 100 sq cm, or each additional one percent of body area of infants
and children, or part thereof
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 18
15120 Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands,
feet, and/or multiple digits; first 100 sq cm or less, or one percent of body area of infants
and children (except 15050)
15121 each additional 100 sq cm, or each additional one percent of body area of infants
and children, or part thereof
15130 Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or one percent of body area of
infants and children
15131 each additional 100 sq cm, or each additional one percent of body area of infants
and children, or part thereof
15135 Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet,
and/or multiple digits; first 100 sq cm or less, or one percent of body area of infants and
children
15136 each additional 100 sq cm, or each additional one percent of body area of infants
and children, or part thereof
15150 Tissue cultured skin autograft, trunk, arms, legs; first 25 sq cm or less
15151 additional 1 sq cm to 75 sq cm
15152 each additional 100 sq cm, or each additional 1% of body area of infants and
children, or part thereof
15155 Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia,
hands, feet, and/or multiple digits; first 25 sq cm or less
15156 additional 1 sq cm to 75 sq cm
15157 each additional 100 sq cm, or each additional 1% of body area of infants and
children, or part thereof
15200 Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less
15201 each additional 20 sq cm, or part thereof
15220 Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs;
20 sq cm or less
15221 each additional 20 sq cm, or part thereof
15240 Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin,
mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less
15241 each additional 20 sq cm, or part thereof
15260 Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or
lips; 20 sq cm or less
15261 each additional 20 sq cm, or part thereof
4.2.5.5.3 SKIN SUBSTITUTE GRAFTS
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 each additional 25 sq cm wound surface area, or part thereof
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 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
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 19
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 each additional 25 sq cm wound surface area, or part thereof
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 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
4.2.5.6 FLAPS (SKIN AND/OR DEEP TISSUES)
15570 Formation of direct or tubed pedicle, with or without transfer; trunk
15572 scalp, arms, or legs
15574 forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet
15576 eyelids, nose, ears, lips, or intraoral
15600 Delay of flap or sectioning of flap (division and inset); at trunk
15610 at scalp, arms, or legs
15620 at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet
15630 at eyelids, nose, ears, or lips
15650 Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, Walking tube), any
location
15730 Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)
15731 Forehead flap with preservation of vascular pedicle (eg, axial pattern flap, paramedian
forehead flap)
15733 Muscle, myocutaneous or fasciocutaneous flap; head and neck with named vascular
pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator
scapulae)
15734 trunk
15736 upper extremity
15738 lower extremity
4.2.5.7 OTHER FLAPS AND GRAFTS
15740 Flap; island pedicle requiring identification and dissection of an anatomically
named axial vessel
15750 neurovascular pedicle
15756 Free muscle or myocutaneous flap with microvascular anastomosis
15757 Free skin flap with microvascular anastomosis
15758 Free fascial flap with microvascular anastomosis
15760 Graft; composite (full thickness of external ear or nasal ala), including primary closure,
donor area
15770 derma-fat-fascia
15775 Punch graft for hair transplant; 1 to 15 punch grafts
15776 more than 15 punch grafts
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 20
15777 Implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement
(eg, breast, trunk)
15778 Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie,
external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma
4.2.5.8 OTHER PROCEDURES
15780 Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general keratosis)
15781 segmental, face
15782 regional, other than face
15783 superficial, any site, (eg, tattoo removal)
15786 Abrasion; single lesion (eg, keratosis, scar)
15787 each additional four lesions or less
15788 Chemical peel, facial; epidermal
15789 dermal
15792 Chemical peel, nonfacial; epidermal
15793 dermal
15819 Cervicoplasty
15820 Blepharoplasty, lower eyelid;
15821 with extensive herniated fat pad
15822 Blepharoplasty, upper eyelid;
15823 with excessive skin weighting down lid
15824 Rhytidectomy; forehead
15825 neck with platysmal tightening (platysmal flap, P-flap)
15826 glabellar frown lines
15828 cheek, chin, and neck
15829 superficial musculoaponeurotic system (SMAS) flap
15830 Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen,
infraumbilical panniculectomy
15832 t
high
15833 leg
15834 hip
15835 buttock
15836 arm
15837 forearm or hand
15838 submental fat pad
15839 other area
15840 Graft for facial nerve paralysis; free fascia graft (including obtaining fascia)
15841 free muscle graft (including obtaining graft)
15842 free muscle flap by microsurgical technique
15845 regional muscle transfer
15847 Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (eg,
abdominoplasty) (includes umbilical transposition and fascial plication)
15851 Removal of sutures or staples requiring anesthesia (ie, general anesthesia, moderate
sedation)
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 21
15852 Dressing change (for other than burns) under anesthesia (other than local) (See Rule 4)
15860 Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft
15876 Suction assisted lipectomy; head and neck
15877 trunk
15878 upper extremity
15879 lower extremity
4.2.5.9 PRESSURE ULCERS (DECUBITIS ULCERS)
15920 Excision, coccygeal pressure ulcer, with coccygectomy; with primary suture
15922 with flap closure
15931 Excision, sacral pressure ulcer, with primary suture;
15933 with ostectomy
15934 Excision, sacral pressure ulcer, with skin flap closure
15935 with ostectomy
15936 Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin
graft closure;
15937 with ostectomy
15940 Excision, ischial pressure ulcer, with primary suture;
15941 with ostectomy
15944 Excision, ischial pressure ulcer, with skin flap closure;
15945 with ostectomy
15946 Excision, ischial pressure ulcer, with ostectomy, in preparation for muscle or
myocutaneous flap or skin graft closure
15950 Excision, trochanteric pressure ulcer, with primary suture;
15951 with ostectomy
15952 Excision, trochanteric pressure ulcer, with skin flap closure;
15953 with ostectomy
15956 Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or
skin graft closure;
15958 with ostectomy
15999 Unlisted procedure, excision pressure ulcer
4.2.5.10 BURNS, LOCAL TREATMENT
16000 Initial treatment, first degree burn, when no more than local treatment is required
16020 Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less
than 5% total body surface area)
16025 medium (eg, whole face or whole extremity or 5% to 10% total body surface area)
16030 large (eg, more than one extremity, or greater than 10% total body surface area)
16035 Escharotomy; initial incision
16036 each additional incision
4.2.6 DESTRUCTION
4.2.6.1 DESTRUCTION, BENIGN OR PREMALIGNANT LESIONS
17000 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 22
curettement), premalignant lesions (e.g., actinic keratoses); first lesion
17003 second through 14 lesions, each
17004 15 or more lesions
17106 Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10
sq cm
17107 10.0 - 50.0 sq cm
17108 over 50.0 sq cm
17110 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical
curettement), of benign lesions other than skin tags or cutaneous vascular proliferative
lesions; up to 14 lesions
17111 15 or more lesions
17250 Chemical cauterization of granulation tissue (ie, proud flesh)
4.2.6.2 DESTRUCTION, MALIGNANT LESIONS, ANY METHOD
17260 Destruction, malignant lesion, (eg, laser surgery, electrosurgery, cryosurgery,
chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.5 cm or less
17261 lesion diameter 0.6 to 1.0 cm
17262 lesion diameter 1.1 to 2.0 cm
17263 lesion diameter 2.1 to 3.0 cm
17264 lesion diameter 3.1 to 4.0 cm
17266 lesion diameter over 4.0 cm
17270 Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery,
chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter
0.5 cm or less
17271 lesion diameter 0.6 to 1.0 cm
17272 lesion diameter 1.1 to 2.0 cm
17273 lesion diameter 2.1 to 3.0 cm
17274 lesion diameter 3.1 to 4.0 cm
17276 lesion diameter over 4.0 cm
17280 Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery,
chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane;
lesion diameter 0.5 cm or less
17281 lesion diameter 0.6 to 1.0 cm
17282 lesion diameter 1.1 to 2.0 cm
17283 lesion diameter 2.1 to 3.0 cm
17284 lesion diameter 3.1 to 4.0 cm
17286 lesion diameter over 4.0 cm
4.2.6.3 MOHS’ MICROGRAPHIC SURGERY
17311 Mohs micrographic technique, including removal of all gross tumor, surgical excision of
tissue specimens, mapping, color coding of specimens, microscopic examination of
specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg,
hematoxylin and eosin, toluidine blue), head, neck, hands, feet, genitalia, or any location
with surgery directly involving muscle, cartilage, bone, tendon, major nerves, or vessels;
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 23
first stage, up to 5 tissue blocks
17312 each additional stage after the first stage, up to 5 tissue blocks
17313 Mohs micrographic technique, including removal of all gross tumor, surgical excision of
tissue specimens, mapping, color coding of specimens, microscopic examination of
specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg,
hematoxylin and eosin, toluidine blue), of the trunk, arms, or legs; first stage, up to 5
tissue blocks
17314 each additional stage after the first stage, up to 5 tissue blocks
17315 Mohs micrographic technique, including removal of all gross tumor, surgical excision of
tissue specimens, mapping, color coding of specimens, microscopic examination of
specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg,
hematoxylin and eosin, toluidine blue), each additional block after the first 5 tissue blocks,
any stage
4.2.6.4 OTHER PROCEDURES
17340 Cryotherapy (C02 slush, liquid N2) for acne
17360 Chemical exfoliation for acne (eg, acne paste, acid)
17380 Electrolysis epilation, each 30 minutes
17999 Unlisted procedure, skin, mucous membrane and subcutaneous tissue
4.2.7
BREAST
19000 Puncture aspiration of cyst breast;
19001 each additional cyst
19020 Mastotomy with exploration or drainage of abscess, deep
19030 Injection procedure only for mammary ductogram or galactogram
19081 Biopsy, breast, with placement of breast localization devices(s) (eg, clip, metallic pellet),
when performed, and imaging of the biopsy specimen, when performed, percutaneous;
first lesion, including stereotactic guidance
19082 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) (eg, clip, metallic pellet),
when performed, and imaging of the biopsy specimen, when performed, percutaneous;
first lesion, including ultrasound guidance
19084 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) (eg, clip, metallic pellet),
when performed, and imaging of the biopsy specimen, when performed, percutaneous;
first lesion, including magnetic resonance guidance
19086 each additional lesion, including magnetic resonance guidance (List separately in
addition to code for primary procedure)
19100 Biopsy of breast; percutaneous, needle core, not using needle guidance (separate
procedure)
19101 open, incisional
19105 Ablation, cryosurgical, of fibroadenoma, including ultrasound guidance, each
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 24
fibroadenoma
19110 Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma
lactiferous duct
19112 Excision of lactiferous duct fistula
19120 Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast
tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, one or
more lesions
19125 Excision of breast lesion identified by pre-operative placement of radiological marker,
open; single lesion
19126 each additional lesion separately identified by a preoperative radiological maker
(List separately in addition to primary procedure)
4.2.7.1 INTRODUCTION
19281 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive
seeds), percutaneous, first lesion, including mammographic guidance
19282 each additional lesion, including mammographic guidance
19283 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive
seeds), percutaneous, first lesion, including stereotactic guidance
19284 each additional lesion, including stereotactic guidance
19285 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive
seeds), percutaneous, first lesion, including ultrasound guidance
19286 each additional lesion, including ultrasound guidance
19287 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive
seeds), percutaneous, first lesion, including magnetic resonance guidance
19288 each additional lesion, including magnetic resonance guidance
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 concurrent with partial mastectomy
19298 Placement of radiotherapy afterloading 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
4.2.7.2 MASTECTOMY PROCEDURES
19300 Mastectomy for gynecomastia
19301 Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);
19302 with axillary lymphadenectomy
19303 Mastectomy, simple, complete
19305 Mastectomy, radical, including pectoral muscles, axillary lymph nodes
19306 Mastectomy, radical, including pectoral muscles, axillary and internal mammary lymph
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 25
nodes (Urban type operation)
19307 Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis
minor muscle, but excluding pectoralis major muscle
4.2.7.3 REPAIR AND/OR RECONSTRUCTION
19316 Mastopexy (unilateral)
19318 Breast Reduction
19325 Breast augmentation with implant
19328 Removal of intact breast implant
19330 Removal of ruptured breast implant, including implant contents (eg, saline, silicone gel)
19340 Insertion of breast implant on same day of mastectomy (ie immediate)
19342 Insertion or replacement of breast implant on separate day from mastectomy
19350 Nipple/areola reconstruction
19355 Correction of inverted nipples
19357 Tissue expander placement in breast reconstruction, including subsequent expansion(s)
19361 Breast reconstruction; with latissimus dorsi flap
19364 with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)
19367 with single-pedicled transverse rectus abdominis myocutaneous (TRAM) flap
19368 with single-pedicled transverse rectus abdominis myocutaneous (TRAM) flap,
requiring separate microvascular anastomosis (supercharging)
19369 with bipedicled transverse rectus abdominis myocutaneous (TRAM) flap
19370 Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or
partial capsulectomy
19371 Peri-implant capsulectomy, breast, complete, including removal of all intracapsular
contents
19380 Revision of reconstructed breast (eg, significant removal of tissue, re-advancement
and/or re-inset of flaps in autologous reconstruction or significant capsular revision
combined with soft tissue excision in implant-based reconstruction)
19396 Preparation of moulage for custom breast implant
4.2.7.4 OTHER PROCEDURES
19499 Unlisted procedure, breast
5 MUSCULOSKELETAL SERVICES
Casts and strapping procedures appear at the end of this section.
The services listed below include the application and removal of the first cast or traction device
only. Subsequent replacement of cast and/or traction device may require an additional listing.
5.1 MUSCULOSKELETAL SYSTEM
5.1.1
GENERAL
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 26
5.1.1.1 WOUND EXPLORATION - TRAUMA (eg PENETRATING GUNSHOT, STAB WOUND)
20100 Exploration of penetrating wound (separate procedure); neck
20101 chest
20102 abdomen/flank/back
20103 extremity
5.1.1.2 EXCISION
20150 Excision of epiphyseal bar, with or without autogenous soft tissue graft obtained through
same fascial incision
20200 Biopsy, muscle; superficial
20205 deep
20206 Biopsy, muscle, percutaneous needle
20220 Biopsy, bone, trocar or needle; superficial (eg, ilium, sternum, spinous process, ribs)
20225 deep (eg, vertebral body, femur)
20240 Biopsy, bone, open; superficial (eg, sternum, spinous process, rib, patella, olecranon
process, calcaneus tarsal, metatarsal, carpal, metacarpal, phalanx)
20245 deep (eg, humeral shaft, ischium, femoral shaft)
20250 Biopsy, vertebral body, open; thoracic
20251 lumbar or cervical
5.1.1.3 INTRODUCTION OR REMOVAL
20500 Injection of sinus tract; therapeutic (separate procedure)
20501 diagnostic (sinogram)
20520 Removal of foreign body in muscle, or tendon sheath, simple
20525 deep or complicated
20526 Injection, therapeutic (eg, local anesthetic; corticosteroid), carpal tunnel
20527 Injection, enzyme (eg, collagenase), palmar fascial cord (ie, Dupuytren’s contracture)
20550 Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar ''fascia'')
20551 single tendon origin/insertion
20552 single or multiple trigger point(s), one or two muscle(s)
20553 single or multiple trigger point(s), three or more muscle(s)
20555 Placement of needles or catheters into muscle and/or soft tissue for subsequent
interstitial radioelement application (at the time of or subsequent to the procedure)
20600 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without
ultrasound guidance
20604 with ultrasound guidance, with permanent recording and reporting
20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa
(eg, tempomandibular, acromioclavicular, wrist, elbow or ankle, olecranon
bursa); without ultrasound guidance
20606 with ultrasound guidance, with permanent recording and reporting
20610 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee,
subacromial bursa); without ultrasound guidance
20611 with ultrasound guidance, with permanent recording and reporting
20612 Aspiration and/or injection of ganglion cyst(s) any location
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 27
20615 Aspiration and injection for treatment of bone cyst
20650 Insertion of wire or pin with application of skeletal traction, including removal (separate
procedure)
20660 Application of cranial tongs, caliper, or stereotactic frame, including removal (separate
procedure)
20661 Application of halo, including removal; cranial
20662 pelvic
20663 femoral
20664 Application of halo, including removal, cranial, 6 or more pins placed, for thin skull
osteology (eg, pediatric patients, hydrocephalus, osteogenesis imperfecta)
20665 Removal of tongs or halo applied by another individual
20670 Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure)
20680 deep, (eg, buried wire, pin, screw, metal band, nail, rod or plate)
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 (eg, Ilizarov, Monticelli type)
20693 Adjustment or revision of external fixation system requiring anesthesia (eg, new pin(s) or
wire(s), and/or new ring(s) or bar(s))
20694 Removal, under anesthesia, of external fixation system
5.1.1.4 REPLANTATION
20802 Replantation, arm (includes surgical neck of humerus through elbow joint), complete
amputation
20805 Replantation, forearm, (includes radius and ulna to radial carpal joint), complete
amputation
20808 Replantation, hand (includes hand through metacarpophalangeal joints), complete
amputation
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
20838 Replantation, foot, complete amputation
5.1.1.5 GRAFTS (OR IMPLANTS)
20900 Bone graft, any donor area; minor or small (eg, dowel or button)
20902 major or large
20910 Cartilage graft; costochondral
20912 nasal septum
20920 Fascia lata graft; by stripper
20922 by incision and area exposure, complex or sheet
20924 Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris)
20931 Allograft, structural, for spine surgery only
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 28
20932 Allograft, includes templating, cutting, placement and internal fixation, when performed;
osteoarticular including articular surface and contiguous bone
20933 hemicortical intercalary, partial (ie, hemicylindrical)
20934 intercalary, complete (ie, cylindrical)
20937 morselized (through separate skin or fascial incision)
20938 structural, bicortical or tricortical (through separate skin or fascial incision)
20939 Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or
fascial incision
5.1.1.6 OTHER PROCEDURES
20950 Monitoring of interstitial fluid pressure (includes insertion of device eg, wick catheter
technique, needle manometer technique) in detection of muscle compartment syndrome
20955 Bone graft with microvascular anastomosis; fibula
20956 iliac crest
20957 metatarsal
20962 other than fibula, iliac crest, or metatarsal
20969 Free osteocutaneous flap with microvascular anastomosis; other than iliac crest,
metatarsal, or great toe
20970 iliac crest
20972 metatarsal
20973 great toe with web space
20974# Electrical stimulation to aid bone healing; noninvasive (nonoperative)
20975 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
(eg, metastasis) including adjacent soft tissue when involved by tumor
extension, percutaneous, including imaging guidance when performed; radiofrequency
20999 Unlisted procedure, musculoskeletal system, general
5.1.2 HEAD
5.1.2.1 INCISION
21010 Arthrotomy, temporomandibular joint
5.1.2.2 EXCISION
21011 Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm
21012 2 cm or greater
21013 Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); less
than 2 cm
21014 2 cm or greater
21015 Radical resection of tumor (eg, sarcoma), soft tissue of face or scalp; less than 2 cm
21016 2 cm or greater
21025 Excision of bone (eg, for osteomyelitis or bone abscess); mandible
21026 facial bone(s)
21029 Removal by contouring of benign tumor of facial bone (eg, fibrous dysplasia)
Physician - Surgery
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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 radical resection
21046 Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (eg, locally
aggressive or destructive lesion(s))
21047 requiring extra-oral osteotomy and partial mandibulectomy (eg, locally aggressive
or destructive lesion(s))
21048 Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (eg, locally
aggressive or destructive lesion(s))
21049 requiring extra-oral osteotomy and partial maxillectomy (eg, 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)
5.1.2.3 MANIPULATION
21073 Manipulation of temporomandibular joint(s) (TMJ), therapeutic, requiring an anesthesia
service (ie, general or monitored anesthesia care)
5.1.2.4 HEAD PROSTHESIS
21076 Impression and custom preparation; surgical obturator prosthesis
21077 orbital prosthesis
21079 interim obturator prosthesis
21080 definitive obturator prosthesis
21081 mandibular resection prosthesis
21082 palatal augmentation prosthesis
21083 palatal lift prosthesis
21084 speech aid prosthesis
21085 oral surgical splint
21086 auricular prosthesis
21087 nasal prosthesis
21088 facial prosthesis
5.1.2.4.1 OTHER PROCEDURES
21089 Unlisted maxillofacial prosthetic procedure
5.1.2.5 INTRODUCTION OR REMOVAL
21100 Application of halo type appliance for maxillofacial fixation, includes removal (separate
procedure)
21110 Application of interdental fixation device for conditions other than fracture or dislocation,
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includes removal
21116 Injection procedure for temporomandibular joint arthrography
5.1.2.6 REPAIR, REVISION, AND/OR RECONSTRUCTION
21120 Genioplasty; augmentation (autograft, allograft, prosthetic material)
21121 sliding osteotomy, single piece
21122 sliding osteotomies, two or more osteotomies (eg, wedge excision or bone wedge
reversal for asymmetrical chin)
21123 sliding, augmentation with interpositional bone grafts (includes obtaining
autografts)
21125 Augmentation, mandibular body or angle; prosthetic material
21127 with bone graft, onlay or interpositional (includes obtaining autograft)
21137 Reduction forehead; contouring only
21138 contouring and application of prosthetic material or bone graft (includes obtaining
autograft)
21139 contouring and setback of anterior frontal sinus wall
21141 Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg,
for Long Face Syndrome), without bone graft
21142 two pieces, segment movement in any direction, without bone graft
21143 three or more pieces, segment movement in any direction, without bone graft
21145 single piece, segment movement in any direction, requiring bone grafts (includes
obtaining autografts)
21146 two pieces, segment movement in any direction, requiring bone grafts (includes
obtaining autografts) (eg, ungrafted unilateral alveolar cleft)
21147 three or more pieces, segment movement in any direction, requiring bone grafts
(includes obtaining autografts) (eg, ungrafted bilateral alveolar cleft or multiple
osteotomies)
21150 Reconstruction midface, LeFort II; anterior intrusion (eg, Treacher-Collins Syndrome)
21151 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 with LeFort I
21159 Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg,
mono bloc), requiring bone grafts (includes obtaining autografts); without LeFort I
21160 with LeFort I
21172 Reconstruction superior-lateral orbital rim and lower forehead, advancement or
alteration, with or without grafts (includes obtaining autografts)
21175 Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement
or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), with or without grafts
(includes obtaining autografts)
21179 Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts
(allograft or prosthetic material)
21180 with autograft (includes obtaining grafts)
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21181 Reconstruction by contouring of benign tumor of cranial bones (eg, fibrous dysplasia),
extracranial
21182 Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra and
extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple
autografts (includes obtaining grafts); total area of bone grafting less than 40 sq cm
21183 total area of bone grafting greater than 40 sq cm but less than 80 sq cm
21184 total area of bone grafting greater than 80 sq cm
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 with bone graft (includes obtaining graft)
21195 Reconstruction of mandibular rami and/or body, sagittal split; without internal rigid
fixation
21196 with internal rigid fixation
21198 Osteotomy, mandible, segmental;
21199 with genioglossus advancement
21206 Osteotomy, maxilla, segmental (eg, Wassmund or Schuchard)
21208 Osteoplasty, facial bones; augmentation (autograft, allograft or prosthetic implant)
21209 reduction
21210 Graft, bone; nasal, maxillary and malar areas (includes obtaining graft)
21215 mandible (includes obtaining graft)
21230 Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)
21235 ear cartilage, autograft, to nose or ear (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 (eg, mandibular staple
bone plate)
21245 Reconstruction of mandible or maxilla, subperiosteal implant; partial
21246 complete
21247 Reconstruction of mandibular condyle with bone and cartilage autografts (includes
obtaining grafts) (eg, for hemifacial microsomia)
21248 Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial
21249 complete
21255 Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes
obtaining autografts)
21256 Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes
obtaining autografts) (eg, micro-ophthalmia)
21260 Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach
21261 combined intra- and extracranial approach
21263 with forehead advancement
21267 Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial
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approach
21268 combined intra- and extracranial approach
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 (eg, for treatment of benign masseteric
hypertrophy); extraoral approach
21296 intraoral approach
5.1.2.7 OTHER PROCEDURES
21299 Unlisted craniofacial and maxillofacial procedure
5.1.2.8 FRACTURE AND/OR DISLOCATION
21315 Closed treatment of nasal bone fracture with manipulation; without stabilization
21320 with stabilization
21325 Open treatment of nasal fracture; uncomplicated
21330 complicated, with internal and/or external skeletal fixation
21335 with concomitant open treatment of fractured septum
21336 Open treatment of nasal septal fracture, with or without stabilization
21337 Closed treatment of nasal septal fracture, with or without stabilization
21338 Open treatment of nasoethmoid fracture; without external fixation
21339 with external fixation
21340 Percutaneous treatment of nasoethmoid complex fracture, with splint, wire or headcap
fixation, including repair of canthal ligaments and/or the nasolacrimal apparatus
21343 Open treatment of depressed
21344 Open treatment of complicated (eg, comminuted or involving posterior wall) frontal sinus
fracture, via coronal or multiple approaches
21345 Closed treatment of nasomaxillary complex fracture (LeFort II type), with interdental wire
fixation or fixation of denture or splint
21346 Open treatment of nasomaxillary complex fracture (LeFort II type); with wiring and/or
local fixation
21347 requiring multiple open approaches
21348 with bone grafting (includes obtaining graft)
21355 Percutaneous treatment of fracture of malar area, including zygomatic arch and malar
tripod, with manipulation
21356 Open treatment of depressed zygomatic arch fracture (eg, Gilles approach)
21360 Open treatment of depressed malar fracture, including zygomatic arch and malar tripod
21365 Open treatment of complicated (eg, comminuted or involving cranial nerve foramina)
fracture(s) of malar area, including zygomatic arch and malar tripod; with internal fixation
and multiple surgical approaches
21366 with bone grafting (includes obtaining graft)
21385 Open treatment of orbital floor blowout fracture; transantral approach (Caldwell Luc type
operations)
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21386 periorbital approach
21387 combined approach
21390 periorbital approach, with alloplastic or other implant
21395 periorbital approach with bone graft (includes obtaining graft)
21400 Closed treatment of fracture of orbit, except blowout; without manipulation
21401 with manipulation
21406 Open treatment of fracture of orbit except blowout; without implant
21407 with implant
21408 with bone grafting (includes obtaining graft)
21421 Closed treatment of palatal or maxillary fracture (LeFort I type), with interdental wire
fixation or fixation of denture or splint
21422 Open treatment of palatal or maxillary fracture (LeFort I type);
21423 complicated (comminuted or involving cranial nerve foramina), multiple approaches
21431 Closed treatment of craniofacial separation (LeFort III type) using interdental wire fixation
of denture or splint
21432 Open treatment of craniofacial separation (LeFort III type); with wiring and/or internal
fixation
21433 complicated (eg, comminuted or involving cranial nerve foramina), multiple surgical
approaches
21435 complicated, utilizing internal and/or external fixation techniques (eg, head cap,
halo device, and/or intermaxillary fixation)
21436 complicated, multiple surgical approaches, internal fixation, with bone grafting
(includes obtaining graft)
21440 Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)
21445 Open treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)
21450 Closed treatment of mandibular fracture; without manipulation
21451 with manipulation
21452 Percutaneous treatment of mandibular fracture, with external fixation
21453 Closed treatment of mandibular fracture with interdental fixation
21454 Open treatment of mandibular fracture with external fixation
21461 Open treatment of mandibular fracture; without interdental fixation
21462 with interdental fixation
21465 Open treatment of mandibular condylar fracture
21470 Open treatment of complicated mandibular fracture by multiple surgical approaches
including internal fixation, interdental fixation, and/or wiring of dentures or splints
21480 Closed treatment of temporomandibular dislocation, initial or subsequent
21485 complicated (eg, recurrent requiring intermaxillary fixation or splinting), initial or
subsequent
21490 Open treatment of temporomandibular dislocation
5.1.2.9 OTHER PROCEDURES
21497 Interdental wiring, for condition other than fracture
21499 Unlisted musculoskeletal procedure, head
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July 2024 34
5.1.3 NECK (SOFT TISSUES) AND THORAX
5.1.3.1 INCISION
21501 Incision and drainage, deep abscess or hematoma, soft tissues of neck of thorax;
21502 with partial rib ostectomy
21510 Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess),
thorax
5.1.3.2 EXCISION
21550 Biopsy, soft tissue of neck or thorax
21552 Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater
21554 Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); 5 cm
or greater
21555 Excision tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm
21556 subfascial (eg, intramuscular); less than 5 cm
21557 Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; less than 5
cm
21558 5 cm or greater
21600 Excision of rib, partial
21601 Excision of chest wall tumor including rib(s)
21602 Excision of chest wall tumor involving rib(s), with plastic reconstruction; without
mediastinal lymphadenectomy
21603 with mediastinal lymphadenectomy
21610 Costotransversectomy (separate procedure)
21615 Excision first and/or cervical rib;
21616 with sympathectomy
21620 Ostectomy of sternum, partial
21627 Sternal debridement
21630 Radical resection of sternum;
21632 with mediastinal lymphadenectomy
5.1.3.3 REPAIR, REVISION AND/OR RECONSTRUCTION
21685 Hyoid myotomy and suspension
21700 Division of scalenus anticus; without resection of cervical rib
21705 with resection of cervical rib
21720 Division of sternocleidomastoid for torticollis, open operation; without cast application
21725 with cast application
21740 Reconstructive repair of pectus excavatum or carinatum; open
21742 minimally invasive approach (Nuss procedure), without thoracoscopy
21743 minimally invasive approach (Nuss procedure), with thoracoscopy
21750 Closure of median sternotomy separation with or without debridement (separate
procedure)
Physician - Surgery
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5.1.3.4 FRACTURE AND/OR DISLOCATION
21811 Open treatment of rib fracture(s) with internal fixation, includes
thoracoscopic visualization when performed, unilateral; 1-3 ribs
21812 4-6 ribs
21813 7 or more ribs
21820 Closed treatment of sternum fracture
21825 Open treatment of sternum fracture with or without skeletal fixation
5.1.3.5 OTHER PROCEDURES
21899 Unlisted procedure, neck or thorax
5.1.4 BACK AND FLANK
5.1.4.1 EXCISION
21920 Biopsy, soft tissue of back or flank; superficial
21925 deep
21930 Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm
21931 3 cm or greater
21932 Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); less than 5 cm
21933 5 cm or greater
21935 Radical resection of tumor (eg, sarcoma), soft tissue of back or flank; less than 5 cm
21936 5 cm or greater
5.1.5 SPINE (VERTEBRAL COLUMN)
5.1.5.1 INCISION
22010 Incision and drainage, open, of deep abscess (subfascial), posterior spine; cervical,
thoracic, or cervicothoracic
22015 lumbar, sacral, or lumbosacral
5.1.5.2 EXCISION
22100 Partial excision of posterior vertebral component (eg, spinous process, lamina or facet)
for intrinsic bony lesion, single vertebral segment; cervical
22101 thoracic
22102 lumbar
22103 each additional segment
22110 Partial excision of vertebral body for intrinsic bony lesion, without decompression of
spinal cord or nerve root(s), single vertebral segment; cervical
22112 thoracic
22114 lumbar
22116 each additional vertebral segment
5.1.5.3 OSTEOTOMY
22206 Osteotomy of spine, posterior or posterolateral approach, three columns, one vertebral
segment (eg, pedicle/vertebral body subtraction); thoracic
22207 lumbar
Physician - Surgery
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22208 each additional vertebral segment
22210 Osteotomy of spine, posterior or posterolateral approach, one vertebral segment; cervical
22212 thoracic
22214 lumbar
22216 each additional segment
22220 Osteotomy of spine, including discectomy, anterior approach, single vertebral segment;
cervical
22222 thoracic
22224 lumbar
22226 each additional segment
5.1.5.4 FRACTURE AND/OR DISLOCATION
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 with grafting
22325 Open treatment and/or reduction of vertebral fracture (s) and/or dislocation(s); posterior
approach, one fractured vertebrae or dislocated segment; lumbar
22326 cervical
22327 thoracic
22328 each additional fractured vertebrae or dislocated segment
5.1.5.5 MANIPULATION
22505 Manipulation of spine requiring anesthesia, any region
5.1.5.6 PERCUTANEOUS VEREBROPLASTY and VERTEBRAL AUGMENTATION
22510 Percutaneous vertebroplasty (bone biopsy included when performed),
1 vertebral body, unilateral or bilateral injection, inclusive of all
imaging guidance; cervicothoracic
22511 lumbosacral
22512 each additional cervicothoracic or lumbosacral vertebral body
22513 Percutaneous vertebral augmentation, including cavity creation
(fracture reduction and bone biopsy included when performed)
using mechanical device (eg, kyphoplasty), 1 vertebral body,
unilateral or bilateral cannulation, inclusive of all imaging guidance;
thoracic
22514 lumbar
22515 each additional thoracic or lumbar vertebral body (List separately
in addition to code for primary procedure)
Physician - Surgery
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5.1.5.7 PERCUTANEOUS AUGMENTATION AND ANNULOPLASTY
22526 Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including
fluoroscopic guidance; single level
22527 one or more additional levels
5.1.5.8 ARTHRODESIS
5.1.5.8.1 LATERAL EXTRACAVITARY APPROACH TECHNIQUE
22532 Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare
interspace (other than for decompression); thoracic
22533 lumbar
22534 thoracic or lumbar, each additional vertebral segment
5.1.5.8.2 ANTERIOR OR ANTEROLATERAL APPROACH TECHNIQUE
22548 Arthrodesis, anterior transoral or extraoral technique, clivus-Cl-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 cervical below C2, each additional interspace
22554 Arthrodesis, anterior interbody technique, including minimal discectomy to prepare
interspace (other than for decompression); cervical below C2
22556 thoracic
22558 lumbar
22585 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
5.1.5.8.3 POSTERIOR, POSTEROLATERAL OR LATERAL TRANSVERSE PROCESS TECHNIQUE
22590 Arthrodesis, posterior technique, craniocervical (occiput-C2)
22595 Arthrodesis, posterior technique, atlas-axis (Cl-C2)
22600 Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2
segment
22610 thoracic (with lateral transverse technique, when performed)
22612 lumbar (with lateral transverse technique, when performed)
22614 each additional interspace
22630 Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to
prepare interspace (other than for decompression) single interspace; lumbar
22632 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; lumbar
22634 each additional interspace and segment
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July 2024 38
5.1.5.8.4 SPINE DEFORMITY (EG, SCOLIOSIS, KYPHOSIS)
22800 Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral
segments
22802 7 to 12 vertebral segments
22804 13 or more vertebral segments
22808 Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments
22810 4 to 7 vertebral segments
22812 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 3 or more segments
5.1.5.9 EXPLORATION
22830 Exploration of spinal fusion
5.1.5.10 SPINAL INSTRUMENTATION
22836 Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up
to 7 vertebral segments
22837 8 or more vertebral segments
22838 Revision (eg, augmentation, division of tether), replacement, or removal of thoracic
vertebral body tethering, including thoracoscopy, when performed
5.1.5.11 SPINAL INSTRUMENTATION
22840 Posterior non-segmental instrumentation (eg, Harrington Rod Technique), pedicle
fixation across one interspace, atlantoaxial transarticular screw fixation, sublaminar wiring
at C1, facet screw fixation
22842 Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks
and sublaminar wires); 3 to 6 vertebral segments
22843 7 to 12 vertebral segments (List separately in addition to primary procedure)
22844 13 or more vertebral segments
22845 Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to primary
procedure)
22846 4 to 7 vertebral segments
22847 8 or more vertebral segments
22848 Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures)
other than sacrum
22849 Reinsertion of spinal fixation device
22850 Removal of posterior nonsegmental instrumentation (eg, Harrington rod)
22852 Removal of posterior segmental instrumentation
22853 Insertion of interbody biomechanical device(s) (eg,synthetic cage, mesh) with integral
anterior instrumentation for device anchoring (eg, screws, flanges), when performed,
to
intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List
separately in addition to code for primary procedure)
22854 Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral
Physician - Surgery
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July 2024 39
anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to
vertebral corpectomy(ies) (vertebral body resection, partial of complete) defect, in
conjunction with interbody arthrodesis, each contiguous defect (List separately in
addition to code for primary procedure)
22859 Insertion of intervertebral biomechanical device(s) (eg, 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)
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
22858 second level,cervical (List separately in addition to code for primary procedure)
22857 Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare
interspace (other than for decompression); single interspace, lumbar
22860 second interspace, lumbar (List separately in additiona to code for primary
procedure)
22861 Revision including replacement of total disc arthroplasty (artificial disc), anterior
approach, single interspace; cervical
22862 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
5.1.5.12 OTHER PROCEDURES
22899 Unlisted procedure, spine
5.1.6 ABDOMEN
5.1.6.1 EXCISION
22900 Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); less than 5
cm
22901 5 cm or greater
22902 Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm
22903 3 cm or greater
22904 Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; less than 5 cm
22905 5 cm or greater
5.1.6.2 OTHER PROCEDURES
22999 Unlisted procedure, abdomen, musculoskeletal system
5.1.7 SHOULDER
5.1.7.1 INCISION
23000 Removal of subdeltoid calcareous deposits, open
Physician - Surgery
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July 2024 40
23020 Capsular contracture release (eg, Sever type procedure)
23030 Incision and drainage, shoulder area; deep abscess or hematoma
23031 infected bursa
23035 Incision, bone cortex (eg, osteomyelitis or bone abscess), shoulder area
23040 Arthrotomy, glenohumeral joint, including exploration, drainage or removal of foreign
body
23044 Arthrotomy, acromioclavicular, sternoclavicular joint, including exploration, drainage or
removal of foreign body
5.1.7.2 EXCISION
23065 Biopsy, soft tissues; superficial
23066 deep
23071 Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater
23073 Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or
greater
23075 Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm
23076 Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); less than 5 cm
23077 Radical resection of tumor (eg, sarcoma), soft tissue of shoulder area; less than 5 cm
23078 5 cm or greater
23100 Arthrotomy, glenohumeral joint, including biopsy
23101 Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy and/or
excision of torn cartilage
23105 Arthrotomy, glenohumeral joint with synovectomy, with or without biopsy
23106 sternoclavicular joint, with synovectomy, with or without biopsy
23107 Arthrotomy, glenohumeral joint, with joint exploration, with or without removal of loose
or foreign body
23120 Claviculectomy; partial
23125 total
23130 Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament
release
23140 Excision or curettage of bone cyst or benign tumor of clavicle or scapula;
23145 with autograft (includes obtaining graft)
23146 with allograft
23150 Excision or curettage of bone cyst or benign tumor of proximal humerus;
23155 with autograft (includes obtaining graft)
23156 with allograft
23170 Sequestrectomy (eg, for osteomyelitis or bone abscess); clavicle
23172 scapula
23174 humeral head to surgical neck
23180 Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis);
clavicle
23182 scapula
23184 proximal humerus
23190 Ostectomy of scapula, partial (eg, superior medial angle)
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July 2024 41
23195 Resection humeral head
23200 Radical resection of tumor; clavicle
23210 scapula
23220 Radical resection of tumor, proximal humerus
5.1.7.3 INTRODUCTION OR REMOVAL
23330 Removal of foreign body, shoulder; subcutaneous
23333 deep (subfascial or intramuscular)
23334 Removal of prosthesis, includes debridement and synovectomy when performed;
humeral or glenoid component
23335 humeral and glenoid components (eg, total shoulder)
23350 Injection procedure for shoulder arthrography or enhanced CT/MRI shoulder
arthrography
5.1.7.4 REPAIR, REVISION AND/OR RECONSTRUCTION
23395 Muscle transfer, any type, shoulder or upper arm; single
23397 multiple
23400 Scapulopexy (eg, Sprengels deformity or for paralysis)
23405 Tenotomy, shoulder area; single tendon
23406 multiple tendons through same incision
23410 Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute
23412 chronic
23415 Coracoacromial ligament release, with or without acromioplasty
23420 Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes
acromioplasty)
23430 Tenodesis of long tendon of biceps
23440 Resection or transplantation of long tendon of biceps
23450 Capsulorrhaphy, anterior; Putti-Platt procedure or Magnuson type operation
23455 with labral repair (eg, Bankart procedure)
23460 Capsulorrhaphy, anterior, any type; with bone block
23462 with coracoid process transfer
23465 Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block
23466 Capsulorrhaphy, glenohumeral joint, any type multi-directional instability
23470 Arthroplasty, glenohumeral joint; hemiarthroplasty
23472 total shoulder (glenoid and proximal humeral replacement (eg, total shoulder)
23473 Revision of total shoulder arthroplasty, including allograft when performed; humeral or
glenoid component
23474 humeral and glenoid component
23480 Osteotomy, clavicle, with or without internal fixation;
23485 with bone graft for nonunion or malunion (includes obtaining graft and/or
necessary fixation)
23490 Prophylactic treatment (nailing, pinning, plating, or wiring) with or without
methylmethacrylate; clavicle
23491 proximal humerus
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 42
5.1.7.5 FRACTURE AND/OR DISLOCATION
23500 Closed treatment of clavicular fracture; without manipulation
23505 with manipulation
23515 Open treatment of clavicular fracture, includes internal fixation, when performed
23520 Closed treatment of sternoclavicular dislocation; without manipulation
23525 with manipulation
23530 Open treatment of sternoclavicular dislocation, acute or chronic;
23532 with fascial graft (includes obtaining graft)
23540 Closed treatment of acromioclavicular dislocation; without manipulation
23545 with manipulation
23550 Open treatment of acromioclavicular dislocation, acute or chronic;
23552 with fascial graft (includes obtaining graft)
23570 Closed treatment of scapular fracture; without manipulation
23575 with manipulation, with or without skeletal traction (with or without shoulder joint
involvement)
23585 Open treatment of scapular fracture (body, glenoid or acromion) includes internal
fixation, when performed
23600 Closed treatment of proximal humeral (surgical or anatomical neck) fracture; without
manipulation
23605 with manipulation, with or without skeletal traction
23615 Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes
internal fixation, when performed, includes repair of tuberosity(s), when performed;
23616 with proximal humeral prosthetic replacement
23620 Closed treatment of greater humeral tuberosity fracture; without manipulation
23625 with manipulation
23630 Open treatment of greater humeral tuberosity fracture, includes internal fixation, when
performed
23650 Closed treatment of shoulder dislocation, with manipulation; without anesthesia
23655 requiring anesthesia
23660 Open treatment of acute shoulder dislocation
23665 Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with
manipulation
23670 Open treatment of shoulder dislocation, with fracture of greater humeral tuberosity,
includes internal fixation, when performed
23675 Closed treatment of shoulder dislocation, with surgical or anatomical neck fracture, with
manipulation
23680 Open treatment of shoulder dislocation, with surgical or anatomical neck fracture,
includes internal fixation, when performed
5.1.7.6 MANIPULATION
23700 Manipulation under anesthesia, including application of fixation apparatus (dislocation
excluded)
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 43
5.1.7.7 ARTHRODESIS
23800 Arthrodesis, glenohumeral joint;
23802 with autogenous graft (includes obtaining graft)
5.1.7.8 AMPUTATION
23900 Interthoracoscapular amputation (forequarter)
23920 Disarticulation of shoulder;
23921 secondary closure or scar revision
5.1.7.9 OTHER PROCEDURES
23929 Unlisted procedure, shoulder
5.1.8 HUMERUS (UPPER ARM) AND ELBOW
5.1.8.1 INCISION
23930 Incision and drainage upper arm or elbow area; deep abscess or hematoma
23931 bursa
23935 Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess),
humerus or elbow
24000 Arthrotomy, elbow, including exploration, drainage or removal of foreign body
24006 Arthrotomy of the elbow, with capsular excision for capsular release (separate procedure)
5.1.8.2 EXCISION
24065 Biopsy, soft tissue of upper arm or elbow area; superficial
24066 deep (subfascial or intramuscular)
24071 Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; 3 cm or greater
24073 Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); 5
cm or greater
24075 Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; less than 3 cm
24076 Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); less
than 5 cm
24077 Radical resection of tumor (eg, sarcoma), soft tissue of upper arm or elbow area; less than
5 cm
24079 5 cm or greater
24100 Arthrotomy, elbow; with synovial biopsy only
24101 with joint exploration, with or without biopsy, with or without removal of loose or
foreign body
24102 with synovectomy
24105 Excision, olecranon bursa
24110 Excision or curettage of bone cyst or benign tumor, humerus;
24115 with autograft (includes obtaining graft)
24116 with allograft
24120 Excision or curettage of bone cyst or benign tumor of head or neck of radius or
olecranon process;
24125 with autograft (includes obtaining graft)
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 44
24126 with allograft
24130 Excision, radial head
24134 Sequestrectomy (eg, for osteomyelitis or bone abscess), shaft or distal humerus
24136 radial head or neck
24138 olecranon process
24140 Partial excision (craterization, saucerization or diaphysectomy) of bone (eg, for
osteomyelitis); humerus
24145 radial head or neck
24147 olecranon process
24149 Radical resection of capsule, soft tissue, and heterotopic bone, elbow, with contracture
release (separate procedure)
24150 Radical resection of tumor, shaft or distal humerus
24152 Radical resection of tumor, radial head or neck
24155 Resection of elbow joint (arthrectomy)
5.1.8.3 INTRODUCTION OR REMOVAL
24160 Removal of prosthesis, includes debridement and synovectomy when performed;
humeral and ulnar components
24164 radial head
24200 Removal of foreign body, upper arm or elbow area; subcutaneous
24201 deep (subfascial or intramuscular)
24220 Injection procedure for elbow arthrography
5.1.8.4 REPAIR, REVISION AND/OR RECONSTRUCTION
24300 Manipulation, elbow, under anesthesia
24301 Muscle or tendon transfer, any type, upper arm or elbow, single (excluding 24320-24331)
24305 Tendon lengthening, upper arm or elbow, each tendon
24310 Tenotomy, open, elbow to shoulder, each tendon
24320 Tenoplasty, with muscle transfer, with or without free graft, elbow to shoulder, single
(Seddon-Brookes type procedure)
24330 Flexor-plasty, elbow, (eg, Steindler type advancement);
24331 with extensor advancement
24332 Tenolysis, triceps
24340 Tenodesis of biceps tendon at elbow (separate procedure)
24341 Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or
secondary (excludes rotator cuff)
24342 Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft
24343 Repair lateral collateral ligament, elbow, with local tissue
24344 Reconstruction lateral collateral ligament, elbow, with tendon graft (includes harvesting of
graft)
24345 Repair medial collateral ligament, elbow, with local tissue
24346 Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting
of graft)
24357 Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's elbow);
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 45
percutaneous
24358 Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's elbow);
debridement, soft tissue and/or bone, open
24359 Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's elbow);
debridement, soft tissue and/or bone, open with tendon repair or reattachment
24360 Arthroplasty, elbow; with membrane (eg, fascial)
24361 with distal humeral prosthetic replacement
24362 with implant and fascia lata ligament reconstruction
24363 with distal humerus and proximal ulnar prosthetic replacement (eg, total elbow)
24365 Arthroplasty, radial head;
24366 with implant
24370 Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar
component
24371 humeral and ulnar component
24400 Osteotomy, humerus, with or without internal fixation
24410 Multiple osteotomies with realignment on intramedullary rod, humeral shaft (Sofield type
procedure)
24420 Osteoplasty, humerus (eg, shortening or lengthening) (excluding 64876)
24430 Repair of nonunion or malunion, humerus; without graft (eg, compression technique, etc)
24435 with iliac or other autograft (includes obtaining graft)
24470 Hemiepiphyseal arrest (eg, cubitus varus or valgus, distal humerus)
24495 Decompression fasciotomy, forearm, with brachial artery exploration
24498 Prophylactic treatment (nailing, pinning, plating or wiring) with or without
methylmethacrylate, humeral shaft
5.1.8.5 FRACTURE AND/OR DISLOCATION
24500 Closed treatment of humeral shaft fracture; without manipulation
24505 with manipulation, with or without skeletal traction
24515 Open treatment of humeral shaft fracture with plate/screws, with or without cerclage
24516 Treatment of humeral shaft fracture, with insertion of intramedullary implant, with or
without cerclage and/or locking screws
24530 Closed treatment of supracondylar or transcondylar humeral fracture, with or without
intercondylar extension; without manipulation
24535 with manipulation, with or without skin or skeletal traction
24538 Percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or
without intercondylar extension
24545 Open treatment of humeral supracondylar or transcondylar fracture, includes internal
fixation, when performed; without intercondylar extension
24546 with intercondylar extension
24560 Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation
24565 with manipulation
24566 Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with
manipulation
24575 Open treatment of humeral epicondylar fracture, medial or lateral, includes internal
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 46
fixation, when performed
24576 Closed treatment of humeral condylar fracture, medial or lateral; without manipulation
24577 with manipulation
24579 Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation,
when performed
24582 Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with
manipulation
24586 Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal
humerus and proximal ulna and/or proximal radius);
24587 with implant arthroplasty
24600 Treatment of closed elbow dislocation; without anesthesia
24605 requiring anesthesia
24615 Open treatment of acute or chronic elbow dislocation
24620 Closed treatment of Monteggia type of fracture dislocation at elbow (fracture proximal
end of ulna with dislocation of radial head), with manipulation
24635 Open treatment of Monteggia type of fracture dislocation at elbow (fracture proximal
end of ulna with dislocation of radial head), includes internal fixation, when performed
24640 Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation
24650 Closed treatment of radial head or neck fracture; without manipulation
24655 with manipulation
24665 Open treatment of radial head or neck fracture, includes internal fixation or radial head
excision, when performed;
24666 with radial head prosthetic replacement
24670 Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process [es]);
without manipulation
24675 with manipulation
24685 Open treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process [es]),
includes internal fixation, when performed
5.1.8.6 ARTHRODESIS
24800 Arthrodesis, elbow joint; local
24802 with autogenous graft (includes obtaining graft)
5.1.8.7 AMPUTATION
24900 Amputation, arm through humerus; with primary closure
24920 open, circular (guillotine)
24925 secondary closure or scar revision
24930 re-amputation
24931 with implant
24935 Stump elongation, upper extremity
24940 Cineplasty, upper extremity, complete procedure
5.1.8.8 OTHER PROCEDURES
24999 Unlisted procedure, humerus or elbow
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 47
5.1.9 FOREARM AND WRIST
5.1.9.1 INCISION
25000 Incision, extensor tendon sheath, wrist (eg, deQuervains disease)
25001 Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis)
25020 Decompression fasciotomy, forearm and/or wrist, flexor or extensor compartment;
without debridement of nonviable muscle and/or nerve
25023 with debridement of nonviable muscle and/or nerve
25024 Decompression fasciotomy, forearm and/or wrist, flexor AND extensor compartment;
without debridement of nonviable muscle and/or nerve
25025 with debridement of nonviable muscle and/or nerve
25028 Incision and drainage forearm and/or wrist; deep abscess or hematoma
25031 bursa
25035 Incision, deep, bone cortex, forearm and/or wrist (eg, for osteomyelitis or bone abscess)
25040 Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of
foreign body
5.1.9.2 EXCISION
25065 Biopsy, soft tissue; superficial
25066 deep (subfascial or intramuscular)
25071 Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; 3 cm or greater
25073 Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); 3
cm or greater
25075 Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; less than 3 cm
25076 Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular);
less than 3 cm
25077 Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; less
than 3 cm
25078 3 cm or greater
25085 Capsulotomy, wrist (eg, for contracture)
25100 Arthrotomy, wrist joint; with biopsy
25101 with joint exploration, with or without biopsy, with or without removal of loose or
foreign body
25105 with synovectomy
25107 Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex
25109 Excision of tendon, forearm and/or wrist, flexor or extensor, each
25110 Excision, lesion of tendon sheath
25111 Excision of ganglion, wrist (dorsal or volar); primary
25112 recurrent
25115 Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis,
fungus, Tbc, or other granulomas, rheumatoid arthritis); flexors
25116 extensors (with or without transposition of dorsal retinaculum)
25118 Synovectomy, extensor tendon sheath, wrist, single compartment;
25119 with resection of distal ulna
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 48
25120 Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or
neck of radius and olecranon process);
25125 with autograft (includes obtaining graft)
25126 with allograft
25130 Excision or curettage of bone cyst or benign tumor of carpal bones;
25135 with autograft (includes obtaining graft)
25136 with allograft
25145 Sequestrectomy (eg, for osteomyelitis or bone abscess)
25150 Partial excision (craterization, saucerization or diaphysectomy) of bone (eg, for
osteomyelitis); ulna
25151 radius
25170 Radical resection for tumor, radius or ulna
25210 Carpectomy; one bone
25215 all bones of proximal row
25230 Radial styloidectomy (separate procedure)
25240 Excision distal ulna partial or complete (eg, Darrach type or matched resection)
5.1.9.3 INTRODUCTION OR REMOVAL
25246 Injection procedure for wrist arthrography
25248 Exploration with removal of deep foreign body, forearm or wrist
25250 Removal of wrist prosthesis; (separate procedure)
25251 complicated, including total wrist
25259 Manipulation, wrist, under anesthesia
5.1.9.4 REPAIR, REVISION AND/OR RECONSTRUCTION
25260 Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or
muscle
25263 secondary, single, each tendon or muscle
25265 secondary, with free graft (includes obtaining graft) each tendon or muscle
25270 Repair, tendon or muscle, extensor; forearm and/or wrist; primary, single, each tendon or
muscle
25272 secondary, single, each tendon or muscle
25274 secondary, with free graft (includes obtaining graft), each tendon or muscle
25275 Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining
graft) (eg, for exterior carpi ulnaris subluxation)
25280 Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist; single,
each tendon
25290 Tenotomy, open, flexor or extensor tendon, forearm and/or wrist single, each tendon
25295 Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon
25300 Tenodesis at wrist; flexors of fingers
25301 extensors of fingers
25310 Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each
tendon
25312 with tendon graft(s) (includes obtaining graft), each tendon
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 49
25315 Flexor origin slide (eg, for cerebral palsy, Volkmann contracture), forearm and/or wrist;
25316 with tendon(s) transfer
25320 Capsulorrhaphy or reconstruction, wrist, open, (eg, capsulodesis, ligament repair, tendon
transfer or graft) (includes synovectomy, capsulotomy and open reduction) for carpal
instability
25332 Arthroplasty, wrist, with or without interposition, with or without external or internal
fixation
25335 Centralization of wrist on ulna (eg, radial club hand)
25337 Reconstruction for stabilization of unstable distal ulna or distal radioulnar joint, secondary
by soft tissue stabilization (eg, tendon transfer, tendon graft or weave, or tenodesis) with
or without open reduction of distal radioulnar joint
25350 Osteotomy, radius; distal third
25355 middle or proximal third
25360 Osteotomy; ulna
25365 radius AND ulna
25370 Multiple osteotomies, with realignment on intramedullary rod (Sofield type procedure);
radius OR ulna
25375 radius AND ulna
25390 Osteoplasty, radius OR ulna; shortening
25391 lengthening with autograft
25392 Osteoplasty, radius AND ulna; shortening (excluding 64876)
25393 lengthening with autograft
25394 Osteoplasty, carpal bone, shortening
25400 Repair of nonunion or malunion, radius OR ulna; without graft (eg, compression
technique)
25405 with autograft (includes obtaining graft)
25415 Repair of nonunion or malunion, radius AND ulna; without graft (eg, compression
technique)
25420 with autograft (includes obtaining graft)
25425 Repair of defect with autograft; radius OR ulna
25426 radius AND ulna
25430 Insertion of vascular pedicle into carpal bone (eg, Hori procedure)
25431 Repair of nonunion of carpal bone (excluding carpal scaphoid (navicular)) (includes
obtaining graft and necessary fixation), each bone
25440 Repair of nonunion, scaphoid carpal (navicular) bone, with or without radial
styloidectomy (includes obtaining graft and necessary fixation)
25441 Arthroplasty with prosthetic replacement; distal radius
25442 distal ulna
25443 scaphoid carpal (navicular)
25444 lunate
25445 trapezium
25446 distal radius and partial or entire carpus ("total wrist")
25447 Arthroplasty interposition, intercarpal or carpometacarpal joints
25449 Revision of arthroplasty, including removal of implant, wrist joint
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 50
25450 Epiphyseal arrest by epiphysiodesis or stapling; distal radius OR ulna
25455 distal radius AND ulna
25490 Prophylactic treatment (nailing, pinning, plating or wiring) with or without
methylmethacrylate; radius
25491 ulna
25492 radius AND ulna
5.1.9.5 FRACTURE AND/OR DISLOCATION
25500 Closed treatment of radial shaft fracture; without manipulation
25505 with manipulation
25515 Open treatment of radial shaft fracture, includes internal fixation, when performed
25520 Closed treatment of radial shaft fracture and closed treatment of dislocation of distal
radio-ulnar joint (Galeazzi fracture/dislocation)
25525 Open treatment of radial shaft fracture, includes internal fixation, when performed, and
closed treatment of distal radioulnar joint dislocation (Galeazzi fracture/dislocation),
includes percutaneous skeletal fixation, when performed
25526 Open treatment of radial shaft fracture, includes internal fixation, when performed, and
open treatment of distal radioulnar joint dislocation (Galeazzi fracture/dislocation),
includes internal fixation, when performed, includes repair of triangular fibrocartilage
complex
25530 Closed treatment of ulnar shaft fracture; without manipulation
25535 with manipulation
25545 Open treatment of ulnar shaft fracture, includes internal fixation, when performed
25560 Closed treatment of radial and ulnar shaft fractures; without manipulation
25565 with manipulation
25574 Open treatment of radial and ulnar shaft fractures, with internal fixation, when performed;
of radius or ulna
25575 of radius and ulna
25600 Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal
separation, includes closed treatment of fracture of ulnar styloid, when performed;
without manipulation
25605 with manipulation
25606 Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation
25607 Open treatment of distal radial extra-articular fracture or epiphyseal separation, with
internal fixation
25608 with internal fixation of 2 fragments
25609 Open treatment of distal radial intra-articular fracture or epiphyseal separation; with
internal fixation of 3 or more fragments
25622 Closed treatment of carpal scaphoid (navicular) fracture; without manipulation
25624 with manipulation
25628 Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when
performed
25630 Closed treatment of carpal bone fracture (excluding carpal scaphoid (navicular)); without
manipulation, each bone
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 51
25635 with manipulation, each bone
25645 Open treatment of carpal bone fracture (other than carpal scaphoid (navicular)), each
bone
25650 Closed treatment of ulnar styloid fracture
25651 Percutaneous skeletal fixation of ulnar styloid fracture
25652 Open treatment of ulnar styloid fracture
25660 Closed treatment of radiocarpal or intercarpal dislocation, one or more bones, with
manipulation
25670 Open treatment of radiocarpal or intercarpal dislocation, one or more bones
25671 Percutaneous skeletal fixation of distal radioulnar dislocation
25675 Closed treatment of distal radioulnar dislocation with manipulation
25676 Open treatment of distal radioulnar dislocation, acute or chronic
25680 Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation
25685 Open treatment of trans-scaphoperilunar type of fracture dislocation
25690 Closed treatment of lunate dislocation, with manipulation
25695 Open treatment of lunate dislocation
5.1.9.6 ARTHRODESIS
25800 Arthrodesis, wrist; complete, without bone graft (includes radiocarpal and/or intercarpal
and/or carpometacarpal joints)
25805 with sliding graft
25810 with iliac or other autograft (includes obtaining graft)
25820 Arthrodesis, wrist; limited, without bone graft (eg, intercarpal or radiocarpal)
25825 with autograft (includes obtaining graft)
25830 Arthrodesis with distal radioulnar joint and segmental resection of ulna, with or without
bone graft (eg, Sauve-Kapandji procedure)
5.1.9.7 AMPUTATION
25900 Amputation, forearm, through radius and ulna;
25905 open, circular (guillotine)
25907 secondary closure or scar revision
25909 re-amputation
25915 Krukenberg procedure
25920 Disarticulation through wrist;
25922 secondary closure or scar revision
25924 re-amputation
25927 Transmetacarpal amputation;
25929 secondary closure or scar revision
25931 re-amputation
5.1.9.8 OTHER PROCEDURES
25999 Unlisted procedure, forearm or wrist
5.1.10 HAND AND FINGERS
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 52
5.1.10.1 INCISION
26010 Drainage of finger abscess; simple
26011 complicated (eg, felon)
26020 Drainage of tendon sheath, one digit and/or palm, each
26025 Drainage of palmar bursa; single bursa
26030 multiple bursa
26034 Incision, bone cortex, hand or finger (eg, osteomyelitis or bone abscess)
26035 Decompression fingers and/or hand, injection injury (eg, grease gun)
26037 Decompressive fasciotomy, hand (excludes 26035)
26040 Fasciotomy, palmar, (eg, Dupuytren's contracture); percutaneous
26045 open, partial
26055 Tendon sheath incision (eg, for trigger finger)
26060 Tenotomy, percutaneous, single, each digit
26070 Arthrotomy, with exploration, drainage, or removal of foreign body; carpometacarpal
joint
26075 metacarpophalangeal joint, each
26080 interphalangeal joint, each
5.1.10.2 EXCISION
26100 Arthrotomy with biopsy; carpometacarpal joint, each
26105 metacarpophalangeal joint, each
26110 interphalangeal joint, each
26111 Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; 1.5
cm or greater
26113 Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg,
intramuscular); 1.5 cm or greater
26115 Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; less
than 1.5 cm
26116 Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg,
intramuscular); less than 1.5 cm
26117 Radical resection of tumor (eg, sarcoma), soft tissue of hand or finger; less than 3 cm
26118 3 cm or greater
26121 Fasciectomy, palm only, with or without Z-plasty, other local tissue rearrangement, or skin
grafting (includes obtaining graft)
26123 Fasciectomy, partial palmar with release, of single digit including proximal interphalangeal
joint, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes
obtaining graft);
26125 each additional digit
26130 Synovectomy, carpometacarpal joint
26135 Synovectomy, metacarpophalangeal joint including intrinsic release and extensor hood
reconstruction, each digit
26140 Synovectomy, proximal interphalangeal joint, including extensor reconstruction, each
interphalangeal joint
26145 Synovectomy, tendon sheath, radical (tenosynovectomy), flexor tendon, palm and/or
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 53
finger, each tendon
26160 Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion),
hand or finger
26170 Excision of tendon, palm, flexor, or extensor, single, each tendon
26180 Excision of tendon, finger, flexor or extensor, each tendon
26185 Sesamoidectomy, thumb or finger (separate procedure)
26200 Excision or curettage of bone cyst or benign tumor of metacarpal;
26205 with autograft (includes obtaining graft)
26210 Excision or curettage of bone cyst or benign tumor of proximal, middle or distal phalanx;
26215 with autograft (includes obtaining graft)
26230 Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, for
osteomyelitis); metacarpal
26235 proximal or middle phalanx
26236 distal phalanx
26250 Radical resection metacarpal; (eg, tumor)
26260 Radical resection, proximal or middle phalanx of finger (eg, tumor);
26262 Radical resection, distal phalanx of finger (eg, tumor)
5.1.10.3 INTRODUCTION OR REMOVAL
26320 Removal of implant from finger or hand
5.1.10.4 REPAIR, REVISION AND/OR RECONSTRUCTION
26340 Manipulation, finger joint, under anesthesia, each joint
26341 Manipulation, palmar fascial cord (ie, Dupuytren’s cord), post enzyme injection (eg,
collagenase), single cord
26350 Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no
man's land); primary or secondary without free graft, each tendon
26352 secondary with free graft (includes obtaining graft), each tendon
26356 Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no
man's land); primary, without free graft, each tendon
26357 secondary, without free graft, each tendon
26358 secondary with free graft (includes obtaining graft), each tendon
26370 Repair or advancement of profundus tendon, with intact superficialis tendon; primary,
each tendon
26372 secondary with free graft (includes obtaining graft), each tendon
26373 secondary without free graft, each tendon
26390 Excision flexor tendon, with implantation of synthetic rod for delayed tendon graft, hand
or finger, each rod
26392 Removal of synthetic rod and insertion of flexor tendon graft, hand or finger (includes
obtaining graft), each rod
26410 Repair, extensor tendon, primary or secondary; without free graft, each tendon
26412 with free graft (includes obtaining graft), each tendon
26415 Excision of extensor tendon, implantation of synthetic rod for delayed tendon graft, hand
or finger, each rod
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 54
26416 Removal of synthetic rod and insertion of extensor tendon graft (includes obtaining
graft), hand or finger, each rod
26418 Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon
26420 with free graft (includes obtaining each tendon graft)
26426 Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); using local
tissue(s), including lateral band(s), each finger
26428 with free graft (includes obtaining graft), each finger
26432 Closed treatment of distal extensor tendon insertion, with or without percutaneous
pinning (eg, mallet finger)
26433 Repair extensor tendon, distal insertion, primary or secondary; without graft (eg, mallet
finger)
26434 with free graft (includes obtaining graft)
26437 Realignment of extensor tendon, hand, each tendon
26440 Tenolysis, flexor tendon; palm OR finger, each tendon
26442 palm AND finger, each tendon
26445 Tenolysis, extensor tendon, hand or finger; each tendon
26449 Tenolysis, complex, extensor tendon, finger, including forearm, each tendon
26450 Tenotomy, flexor, palm, open, each tendon
26455 Tenotomy, flexor, finger, open, each tendon
26460 Tenotomy, extensor, hand or finger, open, each tendon
26471 Tenodesis; of proximal interphalangeal joint, each joint
26474 of distal joint, each joint
26476 Lengthening of tendon, extensor, hand or finger, each tendon
26477 Shortening of tendon, extensor, hand or finger, each tendon
26478 Lengthening of tendon, flexor, hand or finger, each tendon
26479 Shortening of tendon, flexor, hand or finger, each tendon
26480 Transfer or transplant of tendon, carpometacarpal area or dorsum of hand, without free
graft, each tendon
26483 with free tendon graft (includes obtaining graft), each tendon
26485 Transfer or transplant of tendon, palmar; without free tendon graft, each tendon
26489 with free tendon graft (includes obtaining graft), each tendon
26490 Opponensplasty; superficialis tendon transfer type, each tendon
26492 tendon transfer with graft (includes obtaining graft), each tendon
26494 hypothenar muscle transfer
26496 other methods
26497 Transfer of tendon to restore intrinsic function; ring and small finger
26498 all four fingers
26499 Correction claw finger, other methods
26500 Reconstruction of tendon pulley, each tendon; with local tissues (separate procedure)
26502 with tendon or fascial graft (includes obtaining graft) (separate procedure)
26508 Release of thenar muscle(s) (eg, thumb contracture)
26510 Cross intrinsic transfer, each tendon
26516 Capsulodesis, metacarpophalangeal joint; single digit
26517 two digits
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 55
26518 three or four digits
26520 Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint
26525 interphalangeal joint, each joint
26530 Arthroplasty, metacarpophalangeal joint; each joint
26531 with prosthetic implant, each joint
26535 Arthroplasty interphalangeal joint; each joint
26536 with prosthetic implant, each joint
26540 Repair of collateral ligament, metacarpophalangeal or interphalangeal joint
26541 Reconstruction, collateral ligament, metacarpophalangeal joint, single, with tendon or
fascial graft (includes obtaining graft)
26542 with local tissue (eg, adductor advancement)
26545 Reconstruction, collateral ligament, interphalangeal joint, single, including graft, each
joint
26546 Repair non-union, metacarpal or phalanx, (includes obtaining bone graft with or without
external or internal fixation)
26548 Repair and reconstruction, finger, volar plate, interphalangeal joint
26550 Pollicization of a digit
26551 Transfer, toe-to-hand with microvascular anastomosis; great toe wrap around with bone
graft
26553 other than great toe, single
26554 other than great toe, double
26555 Transfer, finger to another position without microvascular anastomosis
26556 Transfer, free toe joint, with microvascular anastomosis
26560 Repair of syndactyly (web finger), each web space; with skin flaps
26561 with skin flaps and grafts
26562 complex (eg, involving bone, nails)
26565 Osteotomy; metacarpal, each
26567 phalanx of finger, each
26568 Osteoplasty, lengthening, metacarpal or phalanx
26580 Repair cleft hand
26587 Reconstruction of polydactylous digit, soft tissue and bone
26590 Repair macrodactylia, each digit
26591 Repair, intrinsic muscles of hand, each muscle
26593 Release, intrinsic muscles of hand, each muscle
26596 Excision of constricting ring of finger, with multiple Z-plasties
5.1.10.5 FRACTURE AND/OR DISLOCATION
26600 Closed treatment of metacarpal fracture, single; without manipulation, each bone
26605 with manipulation, each bone
26607 Closed treatment of metacarpal fracture, with manipulation, with external fixation, each
bone
26608 Percutaneous skeletal fixation of metacarpal fracture, each bone
26615 Open treatment of metacarpal fracture, single, includes internal fixation, when performed,
each bone
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 56
26641 Closed treatment of carpometacarpal dislocation, thumb, with manipulation
26645 Closed treatment of carpometacarpal fracture dislocation, thumb (Bennett fracture), with
manipulation
26650 Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (Bennett
fracture), with manipulation
26665 Open treatment of carpometacarpal fracture dislocation, thumb (Bennett fracture),
includes internal fixation, when performed
26670 Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation,
each joint; without anesthesia
26675 requiring anesthesia
26676 Percutaneous skeletal fixation of carpometacarpal dislocation, other than thumb, with
manipulation, each joint
26685 Open treatment of carpometacarpal dislocation, other than thumb; includes internal
fixation, when performed, each joint
26686 complex, multiple or delayed reduction
26700 Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without
anesthesia
26705 requiring anesthesia
26706 Percutaneous skeletal fixation of metacarpophalangeal dislocation, single, with
manipulation
26715 Open treatment of metacarpophalangeal dislocation, single, includes internal fixation,
when performed
26720 Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or
thumb; without manipulation, each
26725 with manipulation, with or without skin or skeletal traction, each
26727 Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle
phalanx, finger or thumb, with manipulation, each
26735 Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or
thumb, includes internal fixation, when performed, each
26740 Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal
joint; without manipulation, each
26742 with manipulation, each
26746 Open treatment of articular fracture, involving metacarpophalangeal or interphalangeal
joint, includes internal fixation, when performed, each
26750 Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation,
each
26755 with manipulation, each
26756 Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each
26765 Open treatment of distal phalangeal fracture, finger or thumb, includes internal fixation,
when performed, each
26770 Closed treatment of interphalangeal joint dislocation, single, with manipulation; without
anesthesia
26775 requiring anesthesia
26776 Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 57
manipulation
26785 Open treatment of interphalangeal joint dislocation, includes internal fixation, when
performed, single
5.1.10.6 ARTHRODESIS
26820 Fusion in opposition, thumb, with autogenous graft (includes obtaining graft)
26841 Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation;
26842 with autograft (includes obtaining graft)
26843 Arthrodesis, carpometacarpal joint, digit, other than thumb, each;
26844 with autograft (includes obtaining graft)
26850 Arthrodesis, metacarpophalangeal joint, with or without internal fixation;
26852 with autograft (includes obtaining graft)
26860 Arthrodesis, interphalangeal joint, with or without internal fixation;
26861 each additional interphalangeal joint
26862 with autograft (includes obtaining graft)
26863 with autograft (includes obtaining graft), each additional joint
5.1.10.7 AMPUTATION
26910 Amputation, metacarpal, with finger or thumb (ray amputation), single, with or without
interosseous transfer
26951 Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including
neurectomies; with direct closure
26952 with local advancement flap (V-Y, hood)
5.1.10.8 OTHER PROCEDURES
26989 Unlisted procedure, hands or fingers
5.1.11 PELVIS AND HIP JOINT
5.1.11.1 INCISION
26990 Incision and drainage; pelvis or hip joint area; deep abscess or hematoma
26991 infected bursa
26992 Incision, bone cortex, pelvis and/or hip joint (eg, for osteomyelitis or bone abscess)
27000 Tenotomy, adductor of hip, percutaneous, (separate procedure)
27001 Tenotomy, adductor of hip, open
27003 Tenotomy, adductor, subcutaneous, open, with obturator neurectomy
27005 Tenotomy, hip flexor(s), open (separate procedure)
27006 Tenotomy, abductors and/or extensor(s) of hip, open (separate procedure)
27025 Fasciotomy, hip or thigh, any type
27027 Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-
minimus, gluteus maximus, iliopsoas, and/ or tensor fascia lata muscle), unilateral
27030 Arthrotomy, hip, with drainage (eg, infection)
27033 Arthrotomy, hip, including exploration or removal of loose or foreign body
27035 Denervation, hip joint, intrapelvic or extrapelvic intra-articular branches of sciatic, femoral
or obturator nerves
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 58
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)
5.1.11.2 EXCISION
27040 Biopsy, soft tissues of pelvis and hip area; superficial
27041 deep subfascial or intramuscular
27043 Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater
27045 Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); 5 cm or
greater
27047 Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; less than 3 cm
27048 Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); less than
5 cm
27049 Radical resection of tumor (eg, sarcoma), soft tissue of pelvis and hip area; less than 5 cm
27050 Arthrotomy, with biopsy; sacroiliac joint
27052 hip joint
27054 Arthrotomy with synovectomy, hip joint
27057 Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-
minimus, gluteus maximus, iliopsoas, and/ or tensor fascia lata muscle) with debridement
of nonviable muscle, unilateral
27059 Radical resection of tumor (eg, sarcoma), soft tissue of pelvis and hip area; 5 cm or
greater
27060 Excision; ischial bursa
27062 trochanteric bursa or calcification
27065 Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater
trochanter of femur; superficial, includes autograft, when performed
27066 deep (subfascial), includes autograft, when performed
27067 with autograft requiring separate incision
27070 Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur,
(craterization, saucerization) (eg, osteomyelitis or bone abscess); superficial
27071 deep (subfascial or intramuscular)
27075 Radical resection of tumor or infection; wing of ilium, 1 pubic or ischial ramus or
symphysis pubis
27076 ilium, including acetabulum, both pubic rami, or ischium and acetabulum
27077 innominate bone, total
27078 ischial tuberosity and greater trochanter of femur
27080 Coccygectomy, primary
5.1.11.3 INTRODUCTION OR REMOVAL
27086 Removal of foreign body, pelvis or hip; subcutaneous tissue
27087 deep (subfascial or intramuscular)
27090 Removal of hip prosthesis; (separate procedure)
27091 complicated, including total hip prosthesis, methylmethacrylate, with or without
insertion of spacer
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 59
27093 Injection procedure for hip arthrography; without anesthesia
27095 with anesthesia
27096 Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance
(fluoroscopy or CT) including arthrography when performed
5.1.11.4 REPAIR, REVISION, AND/OR RECONSTRUCTION
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 to femoral neck
27120 Acetabuloplasty; (eg, Whitman, Colonna Haygroves, or cup type)
27122 resection, femoral head (Girdlestone procedure)
27125 Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty)
27130 Arthroplasty, acetabular and proximal femoral prosthetic replacement, (total hip
arthroplasty), with or without autograft or allograft
27132 Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or
allograft
27134 Revision of total hip arthroplasty; both components, with or without autograft or allograft
27137 acetabular component only, with or without autograft or allograft
27138 femoral component only, with or without allograft
27140 Osteotomy and transfer of greater trochanter of femur (separate procedure)
27146 Osteotomy, iliac, acetabular or innominate bone;
27147 with open reduction of hip
27151 with femoral osteotomy
27156 with femoral osteotomy and with open reduction of hip
27158 Osteotomy, pelvis, bilateral (eg, congenital malformation)
27161 Osteotomy, femoral neck (separate procedure)
27165 Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation
and/or cast
27170 Bone graft, femoral head, neck, intertrochanteric or subtrochanteric area (includes
obtaining bone graft)
27175 Treatment of slipped femoral epiphysis; by traction, without reduction
27176 by single or multiple pinning, in situ
27177 Open treatment of slipped femoral epiphysis; single or multiple pinning or bone graft
(includes obtaining graft)
27178 closed manipulation with single or multiple pinning
27179 osteoplasty of femoral neck (Heyman type procedure)
27181 osteotomy and internal fixation
27185 Epiphyseal arrest by epiphysiodesis or stapling, greater trochanter of femur
27187 Prophylactic treatment (nailing, pinning, plating or wiring) with or without
methylmethacrylate, femoral neck and proximal femur
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 60
5.1.11.5 FRACTURE AND/OR DISLOCATION
27197 Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or
subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic
ring fracture(s) and/or dislocation(s) or the pubic symphysis and/or superior/inferior rami,
unilateral or bilateral; without manipulation
27198 with manipulation, requiring more than local anesthesia (ie, general anesthesia,
moderate sedation, spinal/epidural)
27200 Closed treatment of coccygeal fracture
27202 Open treatment of coccygeal fracture
27215 Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral,
(eg, pelvic fracture(s) which do not disrupt the pelvic ring), with internal fixation
27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for
fracture patterns that disrupt the pelvic ring, unilateral (includes ipsilateral ilium, sacroiliac
joint and/or sacrum)
27217 Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns
that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes
pubic symphysis and/or ipsilateral superior/inferior rami)
27218 Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns
that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes
ipsilateral ilium, sacroiliac joint and/or sacrum)
27220 Closed treatment of acetabulum (hip socket) fracture(s); without manipulation
27222 with manipulation, with or without skeletal traction
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
27230 Closed treatment of femoral fracture, proximal end, neck; without manipulation
27232 with manipulation, with or without skeletal traction
27235 Percutaneous skeletal fixation of femoral fracture, proximal end, neck
27236 Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic
replacement
27238 Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral
fracture; without manipulation
27240 with manipulation, with or without skin or skeletal traction
27244 Treatment of intertrochanteric, peritrochanteric or subtrochanteric femoral fracture; with
plate/screw type implant, with or without cerclage
27245 with intramedullary implant, with or without interlocking screws and/or cerclage
27246 Closed treatment of greater trochanteric fracture, without manipulation
27248 Open treatment of greater trochanteric fracture, includes internal fixation, when
performed
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 61
27250 Closed treatment of hip dislocation, traumatic; without anesthesia
27252 requiring anesthesia
27253 Open treatment of hip dislocation, traumatic, without internal fixation
27254 Open treatment of hip dislocation, traumatic, with acetabular wall and femoral head
fracture, with or without internal or external fixation
27256 Treatment of spontaneous hip dislocation (developmental, including congenital or
pathological), by abduction, splint or traction; without anesthesia, without manipulation
27257 with manipulation, requiring anesthesia
27258 Open treatment of spontaneous hip dislocation (developmental, including congenital or
pathological), replacement of femoral head in acetabulum (including tenotomy, etc);
27259 with femoral shaft shortening
27265 Closed treatment of post hip arthroplasty dislocation; without anesthesia
27266 requiring regional or general anesthesia
27267 Closed treatment of femoral fracture, proximal end, head; without manipulation
27268 Closed treatment of femoral fracture, proximal end, head; with manipulation
27269 Open treatment of femoral fracture, proximal end, head, includes internal fixation, when
performed
5.1.11.6 MANIPULATION
27275 Manipulation, hip joint, requiring general anesthesia
5.1.11.7 ARTHRODESIS
27278 Arthrodesis, sacroiliac joint, percutaneous, with image guidance, including placement of
intra-articular implant(s) (eg, bone allograft[s], synthetic device[s]), without placement of
transfixation device
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, sacroiliac joint, open, including obtaining bone graft, including
instrumentation, when performed
27282 Arthrodesis, symphysis pubis (including obtaining graft)
27284 Arthrodesis, hip joint (includes obtaining graft);
27286 with subtrochanteric osteotomy
5.1.11.8 AMPUTATION
27290 Interpelviabdominal amputation (hind quarter amputation)
27295 Disarticulation of hip
5.1.11.9 OTHER PROCEDURES
27299 Unlisted procedure, pelvis or hip joint
5.1.12 FEMUR (THIGH REGION) AND KNEE JOINT
5.1.12.1 INCISION
27301 Incision and drainage of deep abscess, bursa, or hematoma, thigh or knee region
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 62
27303 Incision, deep with opening of bone cortex, femur or knee (eg, osteomyelitis or bone
abscess)
27305 Fasciotomy, iliotibial (tenotomy), open
27306 Tenotomy, percutaneous, adductor or hamstring, single tendon (separate procedure)
27307 multiple tendons
27310 Arthrotomy, knee, with exploration, drainage or removal of foreign body (eg, infection)
5.1.12.2 EXCISION
27323 Biopsy, soft tissue of thigh or knee area; superficial
27324 deep (subfascial or intramuscular)
27325 Neurectomy, hamstring muscle
27326 Neurectomy, popliteal (gastrocnemius)
27327 Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm
27328 Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); less than 5
cm
27329 Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; less than 5 cm
27330 Arthrotomy, knee; with synovial biopsy only
27331 including joint exploration, biopsy, or removal of loose or foreign bodies
27332 Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial OR lateral
27333 medial AND lateral
27334 Arthrotomy, with synovectomy; knee, anterior OR posterior
27335 anterior AND posterior including popliteal area
27337 Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater
27339 Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); 5 cm or
greater
27340 Excision, prepatellar bursa
27345 Excision of synovial cyst of popliteal space (eg, Baker's cyst)
27347 Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee
27350 Patellectomy or hemipatellectomy
27355 Excision or curettage of bone cyst or benign tumor of femur;
27356 with allograft
27357 with autograft (includes obtaining graft)
27358 with internal fixation
27360 Partial excision (craterization, saucerization, or diaphysectomy) bone, femur, proximal
tibia and/or fibula (eg, osteomyelitis or bone abscess)
27364 Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; 5 cm or
greater
27365 Radical resection of tumor, bone, femur or knee
5.1.12.3 INTRODUCTION OR REMOVAL
27369 Injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee
arthrography
27372 Removal foreign body, deep, thigh region or knee area
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 63
5.1.12.4 REPAIR, REVISION, AND/OR RECONSTRUCTION
27380 Suture of infrapatellar tendon; primary
27381 secondary reconstruction, including fascial or tendon graft
27385 Suture of quadriceps or hamstring muscle rupture; primary
27386 secondary reconstruction, including fascial or tendon graft
27390 Tenotomy, open, hamstring, knee to hip; single tendon
27391 multiple tendons, one leg
27392 multiple tendons, bilateral
27393 Lengthening of hamstring tendon; single tendon
27394 multiple tendons, one leg
27395 multiple tendons, bilateral
27396 Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor);
single tendon
27397 multiple tendons
27400 Transfer tendon or muscle, hamstrings to femur (eg, Eggers type procedure)
27403 Arthrotomy with open meniscus repair, knee
27405 Repair, primary, torn ligament and/or capsule, knee; collateral
27407 cruciate
27409 collateral and cruciate ligaments
27415 Osteochondral allograft, knee, open
27416 Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of
autograft[s])
27418 Anterior tibial tubercleplasty (eg, Maquet type procedure)
27420 Reconstruction of dislocating patella; (eg, Hauser type procedure)
27422 with extensor realignment and/or muscle advancement or release (eg, Campbell,
Goldwaite type procedure)
27424 with patellectomy
27425 Lateral retinacular release open
27427 Ligamentous reconstruction (augmentation), knee; extra-articular
27428 intra-articular (open)
27429 intra-articular (open) and extra-articular
27430 Quadricepsplasty (eg, Bennett or Thompson type)
27435 Capsulotomy, posterior release, knee
27437 Arthroplasty, patella; without prosthesis
27438 with prosthesis
27440 Arthroplasty, knee, tibial plateau;
27441 with debridement and partial synovectomy
27442 Arthroplasty, femoral condyles or tibial plateau(s), knee;
27443 with debridement and partial synovectomy
27445 Arthroplasty, knee, hinge prosthesis (eg, Walldius type)
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 medial AND lateral compartments with or without patella resurfacing (total knee
replacement)
27448 Osteotomy, femur, shaft or supracondylar; without fixation
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 64
27450 with fixation
27454 Osteotomy, multiple, with realignment on intramedullary rod, femoral shaft, (eg, Sofield
type procedure)
27455 Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of
genu varus (bowleg) or genu valgus (knock-knee)); before epiphyseal closure
27457 after epiphyseal closure
27465 Osteoplasty, femur; shortening (excluding 64876)
27466 lengthening
27468 combined, lengthening and shortening with femoral segment transfer
27470 Repair, nonunion or malunion, femur, distal to head and neck; without graft (eg,
compression technique)
27472 with iliac or other autogenous bone graft (includes obtaining graft)
27475 Arrest, epiphyseal, any method (eg, epiphysiodesis); distal femur
27477 tibia and fibula, proximal
27479 combined distal femur, proximal tibia and fibula
27485 Arrest, hemiepiphyseal, distal femur or proximal tibia or fibula (eg, for genu varus or
valgus)
27486 Revision of total knee arthroplasty, with or without allograft; one component
27487 femoral and entire tibial component
27488 Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or
without insertion of spacer, knee
27495 Prophylactic treatment (nailing, pinning, plating or wiring) with or without
methylmethacrylate, femur
27496 Decompression fasciotomy, thigh and/or knee, one compartment (flexor or extensor or
adductor);
27497 with debridement of nonviable muscle and/or nerve
27498 Decompression fasciotomy, thigh and/or knee, multiple compartments;
27499 with debridement of nonviable muscle and/or nerve
5.1.12.5 FRACTURE AND/OR DISLOCATION
27500 Closed treatment of femoral shaft fracture, without manipulation
27501 Closed treatment of supracondylar or transcondylar femoral fracture with or without
intercondylar extension, without manipulation
27502 Closed treatment of femoral shaft fracture, with manipulation, with or without skin or
skeletal traction
27503 Closed treatment of supracondylar or transcondylar femoral fracture with or without
intercondylar extension; with manipulation, with or without skin or skeletal traction
27506 Open treatment of femoral shaft fracture, with or without external fixation, with insertion
of intramedullary implant, with or without cerclage and/or locking screws
27507 Open treatment of femoral shaft fracture with plate/screws, with or without cerclage
27508 Closed treatment of femoral fracture, distal end, medial or lateral condyle, without
manipulation
27509 Percutaneous skeletal fixation of femoral fracture, distal end, medial or lateral condyle, or
supracondylar or transcondylar, with or without intercondylar extension, or distal femoral
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 65
epiphyseal separation
27510 Closed treatment of femoral fracture, distal end, medial or lateral condyle, with
manipulation
27511 Open treatment of femoral supracondylar or transcondylar fracture without intercondylar
extension, includes internal fixation, when performed
27513 Open treatment of femoral supracondylar or transcondylar fracture with intercondylar
extension, includes internal fixation, when performed
27514 Open treatment of femoral fracture, distal end, medial or lateral condyle, includes internal
fixation, when performed
27516 Closed treatment of distal femoral epiphyseal separation; without manipulation
27517 with manipulation, with or without skin or skeletal traction
27519 Open treatment of distal femoral epiphyseal separation, includes internal fixation, when
performed
27520 Closed treatment of patellar fracture, without manipulation
27524 Open treatment of patellar fracture, with internal fixation and/or partial or complete
patellectomy and soft tissue repair
27530 Closed treatment of tibial fracture, proximal (plateau); without manipulation
27532 with or without manipulation, with skeletal traction
27535 Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal
fixation, when performed
27536 bicondylar, with or without internal fixation
27538 Closed treatment of intercondylar spine(s) and/or tuberosity fracture(s) of knee, with or
without manipulation
27540 Open treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee,
includes internal fixation, when performed
27550 Closed treatment of knee dislocation; without anesthesia
27552 requiring anesthesia
27556 Open treatment of knee dislocation, includes internal fixation, when performed; without
primary ligamentous repair or augmentation/reconstruction
27557 with primary ligamentous repair
27558 with primary ligamentous repair, with augmentation/reconstruction
27560 Closed treatment of patellar dislocation; without anesthesia
27562 requiring anesthesia
27566 Open treatment of patellar dislocation, with or without partial or total patellectomy
5.1.12.6 MANIPULATION
27570 Manipulation of knee joint under general anesthesia (includes application of traction or
other fixation devices)
5.1.12.7 ARTHRODESIS
27580 Arthrodesis, knee, any technique
5.1.12.8 AMPUTATION
27590 Amputation, thigh, through femur, any level;
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 66
27591 immediate fitting technique including first cast
27592 open, circular (guillotine)
27594 secondary closure or scar revision
27596 re-amputation
27598 Disarticulation at knee
5.1.12.9 OTHER PROCEDURES
27599 Unlisted procedure, femur or knee
5.1.13 LEG (TIBIA AND FIBULA) AND ANKLE JOINT
5.1.13.1 INCISION
27600 Decompression fasciotomy, leg; anterior and/or lateral compartments only
27601 posterior compartment(s) only
27602 anterior and/or lateral, and posterior compartment(s)
27603 Incision and drainage; deep abscess or hematoma
27604 infected bursa
27605 Tenotomy, percutaneous, Achilles tendon (separate procedure); local anesthesia
27606 general anesthesia
27607 Incision, (eg, osteomyelitis or bone abscess) leg or ankle
27610 Arthrotomy, ankle, including exploration, drainage or removal of foreign body
27612 Arthrotomy, posterior capsular release, ankle, with or without Achilles tendon lengthening
5.1.13.2 EXCISION
27613 Biopsy, soft tissues; superficial
27614 deep (subfascial or intramuscular)
27615 Radical resection of tumor (eg, sarcoma), soft tissue of leg or ankle area; less than 5 cm
27616 5 cm or greater
27618 Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cm
27619 Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); less than 5
cm
27620 Arthrotomy, ankle, with joint exploration, with or without biopsy, with or without removal
of loose or foreign body
27625 Arthrotomy, with synovectomy, ankle;
27626 including tenosynovectomy
27630 Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle
27632 Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater
27634 Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); 5 cm or
greater
27635 Excision or curettage of bone cyst or benign tumor, tibia or fibula;
27637 with autograft (includes obtaining graft)
27638 with allograft
27640 Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis);
tibia
27641 fibula
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 67
27645 Radical resection of tumor; tibia
27646 fibula
27647 talus or calcaneus
5.1.13.3 INTRODUCTION OR REMOVAL
27648 Injection procedure for ankle arthrography
5.1.13.4 REPAIR, REVISION, AND/OR RECONSTRUCTION
27650 Repair, primary, open or percutaneous ruptured Achilles tendon;
27652 with graft (includes obtaining graft)
27654 Repair, secondary, ruptured Achilles tendon, with or without graft
27656 Repair, fascial defect of leg
27658 Repair or suture of flexor tendon, leg; primary, without graft, each tendon
27659 secondary with or without graft, each tendon
27664 Repair, extensor tendon, leg; primary, without graft, each tendon
27665 secondary with or without graft, each tendon
27675 Repair dislocating peroneal tendons; without fibular osteotomy
27676 with fibular osteotomy
27680 Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon
27681 multiple tendons (through same incision(s))
27685 Lengthening or shortening of tendon; leg or ankle; single tendon (separate procedure)
27686 multiple tendons (through same incision), each
27687 Gastrocnemius recession (eg, Strayer procedure)
27690 Transfer or transplant of single tendon (with muscle redirection or rerouting); superficial
(eg, anterior tibial extensors into midfoot)
27691 deep (eg, anterior tibial or posterior tibial through interosseous space, flexor
digitorum longus, flexor hallucis longus, or peroneal tendon to midfoot or hindfoot)
27692 each additional tendon (List separately in addition to primary procedure)
27695 Repair, primary, disrupted ligament, ankle; collateral
27696 both collateral ligaments
27698 Repair, secondary disrupted ligament, ankle, collateral (eg, Watson-Jones procedure)
27700 Arthroplasty, ankle;
27702 with implant (total ankle)
27703 revision, total ankle
27704 Removal of ankle implant
27705 Osteotomy; tibia
27707 fibula
27709 tibia and fibula
27712 multiple, with realignment on intramedullary rod (eg, Sofield type procedure)
27715 Osteoplasty, tibia and fibula, lengthening or shortening
27720 Repair of nonunion or malunion, tibia; without graft, (eg, compression technique)
27722 with sliding graft
27724 with iliac or other autograft (includes obtaining graft)
27725 by synostosis, with fibula, any method
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 68
27726 repair of fibula nonunion and/or malunion with internal fixation
27727 Repair of congenital pseudarthrosis, tibia
27730 Arrest, epiphyseal (epiphysiodesis), open; distal tibia
27732 distal fibula
27734 distal tibia and fibula
27740 Arrest epiphyseal, (epiphysiodesis), any method; combined, proximal and distal tibia and
fibula;
27742 and distal femur
27745 Prophylactic treatment (nailing, pinning, plating or wiring) with or without
methylmethacrylate, tibia
5.1.13.5 FRACTURE AND/OR DISLOCATION
27750 Closed treatment of tibial shaft fracture (with or without fibular fracture); without
manipulation
27752 with manipulation, with or without skeletal traction
27756 Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular fracture) (eg,
pins or screws)
27758 Open treatment of tibial shaft fracture, (with or without fibular fracture) with plate/screws,
with or without cerclage
27759 Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary
implant, with or without interlocking screws and/or cerclage
27760 Closed treatment of medial malleolus fracture; without manipulation
27762 with manipulation, with or without skin or skeletal traction
27766 Open treatment of medial malleolus fracture, includes internal fixation, when performed
27767 Closed treatment of posterior malleolus fracture; without manipulation
27768 with manipulation
27769 Open treatment of posterior malleolus fracture, includes internal fixation, when
performed
27780 Closed treatment of proximal fibula or shaft fracture; without manipulation
27781 with manipulation
27784 Open treatment of proximal fibula or shaft fracture, includes internal fixation, when
performed
27786 Closed treatment of distal fibular fracture (lateral malleolus); without manipulation
27788 with manipulation
27792 Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation,
when performed
27808 Closed treatment of bimalleolar ankle fracture, (eg, lateral and medial malleoli, or lateral
and posterior malleoli or medial and posterior malleoli); without manipulation
27810 with manipulation
27814 Open treatment of bimalleolar ankle fracture, (eg, lateral and medial malleoli, or lateral
and posterior malleoli, or medial and posterior malleoli), includes internal fixation, when
performed
27816 Closed treatment of trimalleolar ankle fracture; without manipulation
27818 with manipulation
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 69
27822 Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed,
medial and/or lateral malleolus; without fixation of posterior lip
27823 with fixation of posterior lip
27824 Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or
tibial plafond), with or without anesthesia; without manipulation
27825 with skeletal traction and/or requiring manipulation
27826 Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg,
pilon or tibial plafond), with internal fixation; when performed; of fibula only
27827 of tibia only
27828 of both tibia and fibula
27829 Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes internal
fixation, when performed
27830 Closed treatment of proximal tibiofibular joint dislocation; without anesthesia
27831 requiring anesthesia
27832 Open treatment of proximal tibiofibular joint dislocation, includes internal fixation, when
performed, or with excision of proximal fibula
27840 Closed treatment of ankle dislocation; without anesthesia
27842 requiring anesthesia, with or without percutaneous skeletal fixation
27846 Open treatment of ankle dislocation, with or without percutaneous skeletal fixation;
without repair or internal fixation
27848 with repair or internal or external fixation
5.1.13.6 MANIPULATION
27860 Manipulation of ankle under general anesthesia (includes application of traction or other
fixation apparatus)
5.1.13.7 ARTHRODESIS
27870 Arthrodesis, ankle, open
27871 Arthrodesis, tibiofibular joint, proximal or distal
5.1.13.8 AMPUTATION
27880 Amputation leg, through tibia and fibula;
27881 with immediate fitting technique including application of first cast
27882 open, circular (guillotine)
27884 secondary closure or scar revision
27886 re-amputation
27888 Amputation, ankle, through malleoli of tibia and fibula (Syme, Pirogoff type procedures),
with plastic closure and resection of nerves
27889 Ankle disarticulation
5.1.13.9 OTHER PROCEDURES
27892 Decompression fasciotomy, leg; anterior and/or lateral compartments only, with
debridement of nonviable muscle and/or nerve
27893 posterior compartment(s) only, with debridement of nonviable muscle and/or nerve
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 70
27894 anterior and/or lateral, and posterior compartment(s), with debridement of
nonviable muscle and/or nerve
27899 Unlisted procedure, leg or ankle
5.1.14 FOOT AND TOES
5.1.14.1 INCISION
28001 Incision and drainage bursa, foot
28002 Incision and drainage below fascia, with or without tendon sheath involvement, foot;
single bursal space
28003 multiple areas
28005 Incision, bone cortex (eg, for osteomyelitis or bone abscess), foot
28008 Fasciotomy, foot and/or toe
28010 Tenotomy, percutaneous, toe; single tendon
28011 multiple tendons
28020 Arthrotomy, with exploration, drainage or removal of loose or foreign body; intertarsal or
tarsometatarsal joint
28022 metatarsophalangeal joint
28024 interphalangeal joint
28035 Release, tarsal tunnel (posterior tibial nerve decompression)
5.1.14.2 EXCISION
28039 Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater
28041 Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); 1.5 cm or greater
28043 Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm
28045 Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); less than 1.5 cm
28046 Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; less than 3 cm
28047 3 cm or greater
28050 Arthrotomy with biopsy; intertarsal or tarsometatarsal joint
28052 metatarsophalangeal joint
28054 interphalangeal joint
28055 Neurectomy, intrinsic musculature of foot
28060 Fasciectomy, plantar fascia; partial (separate procedure)
28062 radical (separate procedure)
28070 Synovectomy; intertarsal or tarsometatarsal joint, each
28072 metatarsophalangeal joint, each
28080 Excision of interdigital (Morton) neuroma, single, each
28086 Synovectomy, tendon sheath, foot; flexor
28088 extensor
28090 Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (cyst or
ganglion); foot
28092 toe(s), each
28100 Excision or curettage of bone cyst or benign tumor, talus or calcaneus;
28102 with iliac or other autograft (includes obtaining graft)
28103 with allograft
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 71
28104 Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or
calcaneus;
28106 with iliac or other autograft (includes obtaining graft)
28107 with allograft
28108 Excision or curettage of bone cyst or benign tumor, phalanges of foot
28110 Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)
28111 Ostectomy, complete excision; first metatarsal head
28112 other metatarsal head (second, third or fourth)
28113 fifth metatarsal head
28114 all metatarsal heads, with partial proximal phalangectomy, excluding first metatarsal
(Clayton type procedure)
28116 Ostectomy, excision of tarsal coalition
28118 Ostectomy, calcaneus;
28119 for spur, with or without plantar fascial release
28120 Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg,
osteomyelitis or bossing); talus or calcaneus
28122 tarsal or metatarsal bone except talus or calcaneus
28124 phalanx of toe
28126 Resection, partial or complete, phalangeal base, each toe
28130 Talectomy (astragalectomy)
28140 Metatarsectomy
28150 Phalangectomy, toe, each toe
28153 Resection, condyle(s), distal end of phalanx, each toe
28160 Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each
28171 Radical resection of tumor; tarsal (except talus or calcaneus)
28173 metatarsal
28175 phalanx of toe
5.1.14.3 INTRODUCTION OR REMOVAL
28190 Remove foreign body, foot; subcutaneous
28192 deep
28193 complicated
5.1.14.4 REPAIR, REVISION, AND/OR RECONSTRUCTION
28200 Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon
28202 secondary with free graft, each tendon (includes obtaining graft)
28208 Repair, tendon, extensor, foot; primary or secondary, each tendon
28210 secondary with free graft, each tendon (includes obtaining graft)
28220 Tenolysis, flexor, foot; single tendon
28222 multiple tendons
28225 Tenolysis, extensor, foot; single tendon
28226 multiple tendons
28230 Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure)
28232 toe, single tendon (separate procedure)
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 72
28234 Tenotomy, open, extensor, foot or toe, each tendon
28238 Reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal
navicular bone (eg, Kidner type procedure)
28240 Tenotomy lengthening, or release, abductor hallucis muscle
28250 Division of plantar fascia and muscle (eg, Steindler stripping) (separate procedure)
28260 Capsulotomy, midfoot; medial release only (separate procedure)
28261 with tendon lengthening
28262 extensive, including posterior talotibial capsulotomy and tendon(s) lengthening (eg,
resistant clubfoot deformity)
28264 Capsulotomy, midtarsal (eg, Heyman type procedure)
28270 Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint
(separate procedure)
28272 interphalangeal joint, each joint (separate procedure)
28280 Syndactylization, toes (eg, webbing or Kelikian type procedure)
28285 Correction, hammertoe; (eg, interphalangeal fusion, partial or total phalangectomy)
28286 Correction, cock-up fifth toe, with plastic skin closure (Ruiz-Mora type procedure)
28288 Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head
28289 Hallux rigidus correction with cheilectomy, debridement and capsular release of the first
metatarsophalangeal joint; without implant
28291 with implant
28292 Correction, hallux valgus with bunionectomy, with sesamoidectomy, when performed;
with resection of proximal phalanx base, when performed, any method
28296 with distal metatarsal osteotomy, any method
28295 with proximal metatarsal osteotomy, any method
28297 with first metatarsal and medical cuneiform joint arthrodesis, any method
28298 with proximal phalanx osteotomy, any method
28299 with double osteotomy, any method
28300 Osteotomy; calcaneus (eg, Dwyer or Chambers type procedure), with or without internal
fixation
28302 talus
28304 Osteotomy, tarsal bones, other than calcaneus or talus;
28305 with autograft (includes obtaining graft) (eg, Fowler type)
28306 Osteotomy, with or without lengthening, shortening or angular correction, metatarsal;
first metatarsal
28307 first metatarsal with autograft (other than first toe)
28308 other than first metatarsal, each
28309 multiple, (eg, Swanson type cavus foot procedure)
28310 Osteotomy, shortening, angular or rotational correction; proximal phalanx, first toe
(separate procedure)
28312 other phalanges, any toe
28313 Reconstruction, angular deformity of toe, soft tissue procedures only (overlapping second
toe, fifth toe, curly toes)
28315 Sesamoidectomy, first toe (separate procedure)
28320 Repair of nonunion or malunion; tarsal bones
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 73
28322 metatarsal, with or without bone graft (includes obtaining graft)
28340 Reconstruction, toe, macrodactyly; soft tissue resection
28341 requiring bone resection
28344 Reconstruction, toe(s); polydactyly
28345 syndactyly, with or without skin graft(s), each web
28360 Reconstruction, cleft foot
5.1.14.5 FRACTURE AND/OR DISLOCATION
28400 Closed treatment of calcaneal fracture; without manipulation
28405 with manipulation
28406 Percutaneous skeletal fixation of calcaneal fracture, with manipulation
28415 Open treatment of calcaneal fracture, includes internal fixation, when performed;
28420 with primary iliac or other autogenous bone graft (includes obtaining graft)
28430 Closed treatment of talus fracture; without manipulation
28435 with manipulation
28436 Percutaneous skeletal fixation of talus fracture, with manipulation
28445 Open treatment of talus fracture, includes internal fixation, when performed
28446 Open osteochondral autograft, talus (includes obtaining graft[s])
28450 Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation,
each
28455 with manipulation, each
28456 Percutaneous skeletal fixation of tarsal bone fracture (except talus and calcaneus), with
manipulation, each
28465 Open treatment of tarsal bone fracture (except talus and calcaneus), includes internal
fixation, when performed, each
28470 Closed treatment of metatarsal fracture; without manipulation, each
28475 with manipulation, each
28476 Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each
28485 Open treatment of metatarsal fracture, includes internal fixation, when performed, each
28490 Closed treatment of fracture great toe, phalanx or phalanges; without manipulation
28495 with manipulation
28496 Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with
manipulation
28505 Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation,
when performed
28510 Closed treatment of fracture, phalanx or phalanges, other than great toe; without
manipulation, each
28515 with manipulation, each
28525 Open treatment of fracture, phalanx or phalanges, other than great toe, includes internal
fixation, when performed, each
28530 Closed treatment of sesamoid fracture
28531 Open treatment of sesamoid fracture, with or without internal fixation
28540 Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia
28545 requiring anesthesia
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 74
28546 Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, with
manipulation
28555 Open treatment of tarsal bone dislocation, includes internal fixation, when performed
28570 Closed treatment of talotarsal joint dislocation; without anesthesia
28575 requiring anesthesia
28576 Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation
28585 Open treatment of talotarsal joint dislocation, includes internal fixation, when performed
28600 Closed treatment of tarsometatarsal joint dislocation; without anesthesia
28605 requiring anesthesia
28606 Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with manipulation
28615 Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when
performed
28630 Closed treatment of metatarsophalangeal joint dislocation; without anesthesia
28635 requiring anesthesia
28636 Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with manipulation
28645 Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when
performed
28660 Closed treatment of interphalangeal joint dislocation; without anesthesia
28665 requiring anesthesia
28666 Percutaneous skeletal fixation of interphalangeal joint dislocation, with manipulation
28675 Open treatment of interphalangeal joint dislocation, includes internal fixation, when
performed
5.1.14.6 ARTHRODESIS
28705 Arthrodesis, pantalar
28715 triple
28725 subtalar
28730 Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse;
28735 with osteotomy (eg, flatfoot correction)
28737 Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal, navicular-
cuneiform (eg, Miller type procedure)
28740 Arthrodesis, midtarsal or tarsometatarsal, single joint
28750 Arthrodesis, great toe; metatarsophalangeal joint
28755 interphalangeal joint
28760 Arthrodesis, with extensor hallucis longus transfer to first metatarsal neck, great toe,
interphalangeal joint, (eg, Jones type procedure)
5.1.14.7 AMPUTATION
28800 Amputation, foot; midtarsal (eg, Chopart type procedure)
28805 transmetatarsal
28810 Amputation, metatarsal, with toe, single
28820 Amputation, toe; metatarsophalangeal joint
28825 interphalangeal joint
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 75
5.1.14.8 OTHER PROCEDURES
28899 Unlisted procedure, foot or toes
5.1.15 APPLICATION OF CASTS AND STRAPPING
5.1.15.1 BODY AND UPPER EXTREMITY
5.1.15.1.1 CASTS
29000 Application of halo type body cast
29010 Application of Risser jacket, localizer, body; only
29015 including head
29035 Application of body cast, shoulder to hips;
29040 including head, Minerva type
29044 including one thigh
29046 including both thighs
29049 Application, cast; figure-of-eight
29055 shoulder spica
29058 plaster Velpeau
29065 shoulder to hand (long arm)
29075 elbow to finger (short arm)
29085 hand and lower forearm (gauntlet)
29086 finger (eg, contracture)
5.1.15.1.2 SPLINTS
29105 Application of long arm splint (shoulder to hand)
29125 Application of short arm splint (forearm to hand); static
29126 dynamic
5.1.15.2 LOWER EXTREMITY
5.1.15.3 CASTS
29305 Application of hip spica cast; one leg
29325 one and one-half spica or both legs
29345 Application of long leg cast (thigh to toes);
29355 walker or ambulatory type
29358 Application of long leg cast brace
29365 Application of cylinder cast (thigh to ankle)
29405 Application of short leg cast (below knee to toes);
29425 walking or ambulatory type
29435 Application of patellar tendon bearing (PTB) cast
29440 Adding walker to previously applied cast
29445 Application of rigid total contact leg cast
29450 Application of clubfoot cast with molding or manipulation, long or short leg
5.1.15.4 SPLINTS
29505 Application of long leg splint (thigh to ankle or toes)
29515 Application of short leg splint (calf to foot)
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 76
5.1.15.5 STRAPPING-ANY AGE
29580 Strapping; Unna boot
29581 Application of multi-layer compression system; leg (below knee), including ankle and foot
29584 upper arm, forearm, hand, and fingers
5.1.15.6 REMOVAL OR REPAIR
Codes for cast removals should be employed only for casts applied by another physician.
29700 Removal of bivalving; gauntlet, boot or body cast
29705 full arm or full leg cast
29710 shoulder or hip spica, Minerva, or Risser jacket, etc
29720 Repair of spica, body cast or jacket
29730 Windowing of cast
29740 Wedging of cast (except clubfoot casts)
29750 Wedging of clubfoot cast
5.1.15.7 OTHER PROCEDURES
29799 Unlisted procedure, casting or strapping
5.1.16 ENDOSCOPY/ARTHROSCOPY
Surgical endoscopy/arthroscopy always includes a diagnostic endoscopy/arthroscopy.
29800 Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy
(separate procedure)
29804 Arthroscopy, temporomandibular joint, surgical
29805 Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)
29806 Arthroscopy, shoulder, surgical; capsulorrhaphy
29807 repair of slap lesion
29819 Arthroscopy, shoulder, surgical; with removal of loose body or foreign body
29820 synovectomy, partial
29821 synovectomy, complete
29822 debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular
cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor
complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of
the rotator cuff, subacromial bursa, foreign body[ies])
29823 debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral
articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps
anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal
side of the rotator cuff, subacromial bursa, foreign body[ies])
29824 distal claviculectomy including distal articular surface (Mumford procedure)
29825 with lysis and resection of adhesions with or without manipulation
29826 decompression of subacromial space with partial acromioplasty, with
coracoacromial ligament (ie, arch) release, when performed
29827 with rotator cuff
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 77
29828 Arthroscopy, shoulder, surgical; biceps tenodesis
29830 Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure)
29834 Arthroscopy, elbow, surgical; with removal of loose body or foreign body
29835 synovectomy, partial
29836 synovectomy, complete
29837 debridement, limited
29838 debridement, extensive
29840 Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)
29843 Arthroscopy, wrist, surgical; for infection, lavage and drainage
29844 synovectomy, partial
29845 synovectomy, complete
29846 excision and/or repair of triangular fibrocartilage and/or joint debridement
29847 internal fixation for fracture or instability
29848 Endoscopy, wrist, surgical, with release of transverse carpal ligament
29850 Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of
the knee, with or without manipulation; without internal or external fixation (includes
arthroscopy)
29851 with internal or external fixation (includes arthroscopy)
29855 Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar,
includes internal fixation, when performed (includes arthroscopy)
29856 bicondylar, includes internal fixation, when performed (includes arthroscopy)
29860 Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure)
29861 Arthroscopy, hip, surgical; with removal of loose body or foreign body
29862 with debridement/shaving of articular cartilage (chondroplasty), abrasion
arthroplasty, and/or resection of labrum
29863 with synovectomy
29866 Arthroscopy, knee, surgical; osteochondral autograft(s) (eg, mosaicplasty) (includes
harvesting of the autograft[s])
29867 osteochondral allograft (eg, mosaicplasty)
29868 meniscal transplantation (includes arthrotomy for meniscal insertion), medial or
lateral
29870 Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29871 Arthroscopy, knee, surgical; for infection, lavage and drainage
29873 with lateral release
29874 for removal of loose body or foreign body (eg, osteochondritis dissecans
fragmentation, chondral fragmentation)
29875 synovectomy, limited (eg, plica or shelf resection) (separate procedure)
29876 synovectomy, major, two or more compartments (eg, medial or lateral)
29877 debridement/shaving of articular cartilage (chondroplasty)
29879 abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling
or microfracture
29880 with meniscectomy (medial AND lateral, including any meniscal shaving) including
debridement/shaving of articular cartilage (chondroplasty), same or separate
compartment(s), when performed
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 78
29881 with meniscectomy (medial OR lateral, including any meniscal shaving) including
debridement/shaving of articular cartilage (chondroplasty), same or separate
compartment(s), when performed
29882 with meniscus repair (medial or lateral)
29883 with meniscus repair (medial and lateral)
29884 with lysis of adhesions with or without manipulation (separate procedure)
29885 drilling for osteochondritis dissecans with bone grafting, with or without internal
fixation (including debridement of base of lesion)
29886 drilling for intact osteochondritis dissecans lesion
29887 drilling for intact osteochondritis dissecans lesion with internal fixation
29888 Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889 Arthroscopically aided posterior cruciate ligament repair/ augmentation or reconstruction
29891 Arthroscopy, ankle, surgical; excision of osteochondral defect of talus and/or tibia,
including drilling of the defect
29892 Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome
fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy)
29893 Endoscopic plantar fasciotomy
29894 Arthroscopy ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body
or foreign body
29895 synovectomy, partial
29897 debridement, limited
29898 debridement, extensive
29899 with ankle arthrodesis
29900 Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy
29901 Arthroscopy, metacarpophalangeal joint, surgical; with debridement
29902 with reduction of displaced ulnar collateral ligament (eg, Stenar Lesion)
29904 Arthroscopy, subtalar joint, surgical; with removal of loose body or foreign body
29905 Arthroscopy, subtalar joint, surgical; with synovectomy
29906 Arthroscopy, subtalar joint, surgical; with debridement
29907 Arthroscopy, subtalar joint, surgical; with subtalar arthrodesis
29914 Arthroscopy, hip, surgical; with removal of loose body or foreign body with femoroplasty
(ie., treatment of cam lesion)
29915 with acetabuloplasty (ie, treatment of pincer lesion)
29916 with labral repair
29999 Unlisted procedure, arthroscopy
6 RESPIRATORY SERVICES
6.1 RESPIRATORY SYSTEM
6.1.1 NOSE
6.1.1.1 INCISION
30000 Drainage abscess or hematoma, nasal, internal approach
30020 Drainage abscess or hematoma, nasal septum
Physician - Surgery
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6.1.1.2 EXCISION
30100 Biopsy, intranasal
30110 Excision, nasal polyp(s), simple
30115 Excision, nasal polyp(s), extensive
30117 Excision or destruction, (eg, laser), intranasal lesion; internal approach
30118 external approach (lateral rhinotomy)
30120 Excision or surgical planing of skin of nose for rhinophyma
30124 Excision dermoid cyst, nose; simple, skin, subcutaneous
30125 complex, under bone or cartilage
30130 Excision inferior turbinate, partial or complete, any method
30140 Submucous resection inferior turbinate, partial or complete, any method
30150 Rhinectomy; partial
30160 total
6.1.1.3 INTRODUCTION
30200 Injection into turbinate(s), therapeutic
30210 Displacement therapy (Proetz type)
30220 Insertion, nasal septal prosthesis (button)
6.1.1.4 REMOVAL OF FOREIGN BODY
30300 Removal foreign body, intranasal; office type procedure
30310 requiring general anesthesia
30320 by lateral rhinotomy
6.1.1.5 REPAIR
30400 Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip
30410 complete, external parts including bony pyramid, lateral and alar cartilages, and/or
elevation of nasal tip
30420 in
cluding major septal repair
30430 Rhinoplasty, secondary; minor revision (small amount of nasal tip work)
30435 intermediate revision (bony work with osteotomies)
30450 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 tip, septum, osteotomies
30465 Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction)
30468 Repair of nasal valve collapse with subcutaneous/ submucosal lateral wall implant(s)
30469 Repair of nasal valve collapse with low energy, temperature-controlled (ie,
radiofrequency) subcutaneous/submucosal remodeling
30520 Septoplasty or submucous resection, with or without cartilage scoring, contouring or
replacement with graft
30540 Repair choanal atresia; intranasal
30545 transpalatine
Physician - Surgery
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30560 Lysis intranasal synechia
30580 Repair fistula; oromaxillary (combine with 31030 if antrotomy is included)
30600 oronasal
30620 Septal or other intranasal dermatoplasty (does not include obtaining graft)
30630 Repair nasal septal perforations
6.1.1.6 DESTRUCTION
30801 Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method, (eg,
electrocautery, radiofrequency ablation, or tissue volume reduction); superficial
30802 intramural; (ie, submucosal)
6.1.1.7 OTHER PROCEDURES
30901 Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method
30903 Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any
method
30905 Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any
method; initial
30906 subsequent
30915 Ligation arteries; ethmoidal
30920 internal maxillary artery, transantral
30930 Fracture nasal inferior turbinate(s), therapeutic
30999 Unlisted procedure, nose
6.1.2 ACCESSORY SINUSES
6.1.2.1 INCISION
31000 Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium)
31002 sphenoid sinus
31020 Sinusotomy, maxillary (antrotomy); intranasal
31030 radical (Caldwell-Luc) without removal of antrochoanal polyps
31032 radical (Caldwell-Luc) with removal antrochoanal polyps
31040 Pterygomaxillary fossa surgery, any approach
31050 Sinusotomy, sphenoid, with or without biopsy;
31051 with mucosal stripping or removal of polyp(s)
31070 Sinusotomy frontal; external, simple (trephine operation)
31075 transorbital, unilateral (for mucocele or osteoma, Lynch type)
31080 obliterative without osteoplastic flap, brow incision (includes ablation)
31081 obliterative, without osteoplastic flap, coronal incision (includes ablation)
31084 obliterative, with osteoplastic flap, brow incision
31085 obliterative, with osteoplastic flap, coronal incision
31086 nonobliterative, with osteoplastic flap, brow incision
31087 nonobliterative, with osteoplastic flap, coronal incision
31090 Sinusotomy, unilateral, three or more paranasal sinuses, (frontal, maxillary, ethmoid,
sphenoid)
Physician - Surgery
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6.1.2.2 EXCISION
31200 Ethmoidectomy; intranasal, anterior
31201 intranasal, total
31205 extranasal, total
31225 Maxillectomy; without orbital exenteration
31230 with orbital exenteration (en bloc)
6.1.2.3 ENDOSCOPY
31231 Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)
31233 Nasal/sinus endoscopy, diagnostic; with maxillary sinusoscopy (via inferior meatus or
canine fossa puncture)
31235 with sphenoid sinusoscopy (via puncture of sphenoidal face or cannulation of
ostium)
31237 Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate
procedure)
31242 with destruction by radiofrequency ablation, posterior nasal nerve
31243 with destruction by cryoablation, posterior nasal nerve
31238 with control of nasal hemorrhage
31239 with dacryocystorhinostomy
31240 with concha bullosa resection
31241 with ligation of sphenopalatine artery
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy; partial (anterior)
31255 total (anterior and posterior)
31253 total (anterior and posterior), including frontal sinus exploration, with removal of
tissue from frontal sinus, when performed
31257 total (anterior and posterior), including sphenoidotomy
31259 total (anterior and posterior), including sphenoidotomy, with removal of tissue
from the sphenoid sinus
31256 Nasal/sinus endoscopy, surgical, with maxillary antrostomy;
31267 with removal of tissue from maxillary sinus
31276 Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue
from frontal sinus, when performed
31287 Nasal/sinus endoscopy, surgical, with sphenoidotomy;
31288 with removal of tissue from sphenoid sinus
31290 Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; ethmoid region
31291 sphenoid region
31292 Nasal/sinus endoscopy, surgical, with orbital decompression; medial or inferior
wall
31293 medial and inferior wall
31294 Nasal/sinus endoscopy, surgical, with optic nerve decompression
31295 Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); maxillary sinus
ostium, transnasal or via canine fossa
31296 frontal sinus ostium
31297 sphenoid sinus ostium
Physician - Surgery
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31298 frontal and sphenoid sinus ostia
6.1.2.4 OTHER PROCEDURES
31299 Unlisted procedure, accessory sinuses
6.1.3 LARYNX
6.1.3.1 EXCISION
31300 Laryngotomy (thyrotomy, laryngofissure); with removal of tumor or laryngocele,
cordectomy
31360 Laryngectomy; total, without radical neck dissection
31365 total, with radical neck dissection
31367 subtotal supraglottic, without radical neck dissection
31368 subtotal supraglottic, with radical neck dissection
31370 Partial laryngectomy (hemilaryngectomy); horizontal
31375 laterovertical
31380 anterovertical
31382 antero-latero-vertical
31390 Pharyngolaryngectomy, with radical neck dissection; without reconstruction
31395 with reconstruction
31400 Arytenoidectomy or arytenoidopexy, external approach
31420 Epiglottidectomy
6.1.3.2 INTRODUCTION
31500 Intubation, endotracheal, emergency procedure
6.1.3.3 ENDOSCOPY
31505 Laryngoscopy, indirect; diagnostic (separate procedure)
31510 with biopsy
31511 with removal of foreign body
31512 with removal of lesion
31513 with vocal cord injection
31515 Laryngoscopy, direct, with or without tracheoscopy; for aspiration
31520 diagnostic, newborn
31525 diagnostic, except newborn
31526 diagnostic, with operating microscope or telescope
31527 with insertion of obturator
31528 with dilation, initial
31529 with dilation, subsequent
31530 Laryngoscopy, direct, operative, with foreign body removal;
31531 with operating microscope or telescope
31535 Laryngoscopy, direct, operative, with biopsy;
31536 with operating microscope or telescope
31540 Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or
epiglottis;
Physician - Surgery
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31541 with operating microscope or telescope
31545 Laryngoscopy, direct, operative, with operating microscope or telescope, with
submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with local
tissue flap(s)
31546 reconstruction with graft(s) (includes obtaining autograft)
31560 Laryngoscopy, direct, operative, with arytenoidectomy;
31561 with operating microscope or telescope
31570 Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;
31571 with operating microscope or telescope
31575 Laryngoscopy, flexible; diagnostic
31576 with biopsy(ies)
31577 with removal of foreign body(s)
31578 with removal of lesion(s), non-laser
31572 with ablation or destruction of lesion(s) with laser, unilateral
31573 with therapeutic injection(s) (eg, chemodenervation agent or corticosteroid, injected
percutaneous, transoral, or via endoscope channel), unilateral
31574 with injection(s) for augmentation (eg, percutaneous, transoral), unilateral
31579 Laryngoscopy, flexible or rigid telescopic, with stroboscopy
6.1.3.4 REPAIR
31580 Laryngoplasty; for laryngeal web, two stage, with indwelling keel insertion
31551 for laryngeal stenosis, with graft, without indwelling stent placement, younger than
12 years of age
31552 for laryngeal stenosis, with graft, without indwelling stent placement, age 12 years
or older
31553 for laryngeal stenosis, with graft, with indwelling stent placement, younger than 12
years of age
31554 for laryngeal stenosis, with graft, with indwelling stent placement, age 12 years or
older
31584 with open reduction and fixation of (eg, plating) of fracture, includes tracheostomy
if performed
31587 Laryngoplasty, cricoid split, without graft placement
31590 Laryngeal reinnervation by neuromuscular pedicle
31591 Laryngoplasty, medialization, unilateral
31592 Cricotracheal resection
6.1.3.5 OTHER PROCEDURES
31599 Unlisted procedure, larynx
6.1.4 TRACHEA AND BRONCHI
6.1.4.1 INCISION
31600 Tracheostomy, planned (separate procedure);
31601 under two years
31603 Tracheostomy, emergency procedure; transtracheal
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 84
31605 cricothyroid membrane
31610 Tracheostomy, fenestration procedure with skin flaps
31611 Construction of tracheoesophageal fistula and subsequent insertion of an alaryngeal
speech prosthesis (eg, voice button, Blom-Singer prosthesis)
31612 Tracheal puncture, percutaneous with transtracheal aspiration and/or injection
31613 Tracheostoma revision; simple, without flap rotation
31614 complex, with flap rotation
6.1.4.2 ENDOSCOPY
31615 Tracheobronchoscopy through established tracheostomy incision
31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed;
diagnostic, with cell washing, when performed (separate procedure)
31623 with brushing or protected brushings
31624 with bronchial alveolar lavage
31625 with bronchial or endobronchial biopsy(s), single or multiple sites
31626 with placement of fiducial markers, single or multiple
31628 with transbronchial lung biopsy(s), single lobe
31629 with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar
bronchus(i)
31630 with tracheal/bronchial dilation or closed reduction of fracture
31631 with placement of tracheal stent(s) (includes tracheal/ bronchial dilation as required)
31632 with transbronchial lung biopsy(s), each additional lobe
31633 with transbronchial needle aspiration biopsy(s), each additional lobe
31634 with balloon occlusion, with assessment of air leak, with administration of occlusive
substance (eg, fibrin glue), if performed
31635 with removal of foreign body
31636 with placement of bronchial stent(s) (includes tracheal/ bronchial dilation as
required), initial bronchus
31637 each additional major bronchus stented
31638 with revision of tracheal or bronchial stent inserted at previous session (includes
tracheal/bronchial dilation as required)
31640 with excision of tumor
31641 with destruction of tumor or relief of stenosis by any method other than excision
(eg, laser therapy, cryotherapy)
31643 with placement of catheter(s) for intracavitary radioelement application
31645 with therapeutic aspiration of tracheobronchial tree, initial
31646 with therapeutic aspiration of tracheobronchial tree, subsequent, same hospital stay
31647 with balloon occlusion, when performed, assessment of air leak, airway sizing, and
insertion of bronchial valve(s), initial lobe
31651 with balloon occlusion, when performed, assessment of air leak, airway sizing, and
insertion of bronchial valve(s), each additional lobe
31648 with removal of bronchial valve(s), initial lobe
31649 with removal of bronchial valve(s), each additional lobe
31652 with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial
Physician - Surgery
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sampling (eg, aspiration[s]/biopsy[ies]), one or two
mediastinal and/or hilar lymph node stations or structures
31653 with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial
sampling (eg, aspiration[s]/biopsy[ies]), 3 or more
mediastinal and/or hilar lymph node stations or structures
31654 with transendoscopic endobronchial ultrasound (EBUS) during
bronchoscopic diagnostic or therapeutic intervention(s) for
peripheral lesion(s) (List separately in addition to code for primary procedure[s])
6.1.4.3 INTRODUCTION
31717 Catheterization with bronchial brush biopsy
31720 Catheter aspiration (separate procedure); nasotreacheal
31725 tracheobronchial with fiberscope, bedside
31730 Transtracheal (percutaneous) introduction of needle wire dilator/stent or indwelling tube
for oxygen therapy
6.1.4.4 EXCISION, REPAIR
31750 Tracheoplasty; cervical
31755 tracheopharyngeal fistulization, each stage
31760 intrathoracic
31766 Carinal reconstruction
31770 Bronchoplasty; graft repair
31775 excision stenosis and anastomosis
31780 Excision tracheal stenosis and anastomosis; cervical
31781 cervicothoracic
31785 Excision of tracheal tumor or carcinoma; cervical
31786 thoracic
31800 Suture of tracheal wound or injury; cervical
31805 intrathoracic
31820 Surgical closure tracheostomy or fistula; without plastic repair
31825 with plastic repair
31830 Revision of tracheostomy scar
6.1.4.5 OTHER PROCEDURES
31899 Unlisted procedure, trachea, bronchi
6.1.5 LUNGS AND PLEURA
6.1.5.1 INCISION
32035 Thoracostomy; with rib resection for empyema
32036 with open flap drainage for empyema
32096 Thoracotomy, with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional),
unilateral
32097 Thoracotomy, with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge,
incisional), unilateral
Physician - Surgery
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32098 Thoracotomy, with biopsy(ies) of pleura
32100 Thoracotomy; with exploration
32110 with control of traumatic hemorrhage and/or repair of lung tear
32120 for postoperative complications
32124 with open intrapleural pneumonolysis
32140 with cyst(s) removal, includes pleural procedure when performed
32141 with resection-plication of bullae, includes any pleural procedure when performed
32150 with removal of intrapleural foreign body or fibrin deposit
32151 with removal of intrapulmonary foreign body
32160 with cardiac massage
32200 Pneumonostomy; with open drainage of abscess or cyst
32215 Pleural scarification for repeat pneumothorax
32220 Decortication, pulmonary (separate procedure); total
32225 partial
6.1.5.2 EXCISION/RESECTION
32310 Pleurectomy; parietal (separate procedure)
32320 Decortication and parietal pleurectomy
32400 Biopsy, pleura; percutaneous needle
32408 Core needle biopsy, lung or mediastinum, percutaneous, including imaging guidance,
when preformed
6.1.5.3 REMOVAL
32440 Removal of lung, pneumonectomy;
32442 with resection of segment of trachea followed by broncho-tracheal anastomosis
(sleeve pneumonectomy)
32445 extrapleural
32480 Removal of lung, other than pneumonectomy; single lobe (lobectomy)
32482 2 lobes (bilobectomy)
32484 single segment (segmentectomy)
32486 with circumferential resection of segment of bronchus followed by broncho
bronchial-anastomosis (sleeve lobectomy)
32488 with all remaining lung following previous removal of a portion of lung (completion
pneumonectomy)
32491 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
32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at time of
lobectomy or segmentectomy (List separately in addition to primary procedure)
32503 Resection of apical lung tumor (eg, Pancoast tumor), including chest wall resection, rib(s)
resection(s), neurovascular dissection, when performed; without chest wall
reconstruction(s)
32504 with chest wall reconstruction
32505 Thoracotomy; with therapeutic wedge resection (eg, mass, nodule), initial
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 87
32506 with therapeutic wedge resection (eg, mass or nodule), each additional resection,
ipsilateral (List separately in addition to primary procedure)
32507 with diagnostic wedge resection followed by anatomic lung resection (List
separately in addition to primary procedure)
32540 Extrapleural enucleation of empyema (empyemectomy);
6.1.5.4 INTRODUCTION AND REMOVAL
32550 Insertion of indwelling tunneled pleural catheter with cuff
32551 Tube thoracostomy, includes connection to drainage system (eg, water seal), when
performed, open (separate procedure)
32552 Removal of indwelling tunneled pleural catheter with cuff
32553 Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers,
dosimeter), percutaneous, intra-thoracic, single or multiple
32554 Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging
guidance
32555 with imaging guidance
32556 Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging
guidance
32557 with imaging guidance
6.1.5.5 DESTRUCTION
32560 Instillation, via chest tube/catheter, agent for pleurodesis (eg, talc for recurrent or
persistent pneumothorax)
32561 Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break
up of multiloculated effusion); initial day
32562 subsequent day
6.1.5.6 THORACOSCOPY (VIDEO-ASSISTED THORACIC SURGERY [VATS])
32601 Thoracoscopy, diagnostic (separate procedure); lungs, pericardial sac, mediastinal or
pleural space, without biopsy
32604 pericardial sac, with biopsy
32606 mediastinal space, with biopsy
32607 Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional),
unilateral
32608 with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional),
unilateral
32609 with biopsy(ies) of pleura
32650 Thoracoscopy, surgical; with pleurodesis, (eg, mechanical or chemical)
32651 with partial pulmonary decortication
32652 with total pulmonary decortication, including intrapleural pneumonolysis
32653 with removal of intrapleural foreign body or fibrin deposit
32654 with control of traumatic hemorrhage
32655 with resection-plication of bullae, includes any pleural procedure when performed
32656 with parietal pleurectomy
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 88
32658 with removal of clot or foreign body from pericardial sac
32659 with creation of pericardial window or partial resection of pericardial sac for
drainage
32661 with excision of pericardial cyst, tumor, or mass
32662 with excision of mediastinal cyst, tumor, or mass
32663 with lobectomy (single lobe)
32664 with thoracic sympathectomy
32665 with esophagomyotomy (Heller type)
32666 with therapeutic wedge resection (eg, mass, nodule), initial unilateral
32667 with therapeutic wedge resection (eg, mass or nodule), each additional resection,
Ipsilateral (List separately in addition to primary code)
32668 with diagnostic wedge resection followed by anatomic lung resection (List
separately in addition to primary code)
32669 with removal of a single lung segment (segmentectomy)
32670 with removal of two lobes (bilobectomy)
32671 with removal of lung (pneumonectomy)
32672 with resection-plication for emphysematous lung (bullous or non-bullous) for lung
volume reduction (LVRS), unilateral includes any pleural procedure, when
performed
32673 with resection of thymus, unilateral or bilateral
32674 with mediastinal and regional lymphadenectomy
6.1.5.7 STEREOTACTIC RADIATION THERAPY
32701 Thoracic target(s) delineation for stereotactic body radiation therapy (SRS/SBRT), (photon
or particle beam), entire course of treatment
6.1.5.8 REPAIR
32800 Repair lung hernia through chest wall
32810 Closure of chest wall following open flap drainage for empyema (Clagett type procedure)
32815 Open closure of major bronchial fistula
32820 Major reconstruction, chest wall (post-traumatic)
6.1.5.9 LUNG TRANSPLANTATION
32851 Lung transplant, single; without cardiopulmonary bypass
32852 with cardiopulmonary bypass
32853 Lung transplant, double (bilateral sequential or en bloc); without cardiopulmonary bypass
32854 with cardiopulmonary bypass
6.1.5.10 SURGICAL COLLAPSE THERAPY; THORACOPLASTY
32900 Resection of ribs, extrapleural, all stages
32905 Thoracoplasty, Schede type or extrapleural (all stages);
32906 with closure of bronchopleural fistula
32940 Pneumonolysis, extraperiosteal, including filling or packing procedures
32960 Pneumothorax, therapeutic, intrapleural injection of air
Physician - Surgery
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6.1.5.11 OTHER PROCEDURES
32997 Total lung lavage (unilateral)
32998 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; radiofrequency
32999 Unlisted procedure, lungs and pleura
7 CARDIOVASCULAR SERVICES
7.1 CARDIOVASCULAR SYSTEM
7.1.1 HEART AND PERICARDIUM
7.1.1.1 PERICARDIUM
33016 Pericardiocentesis, including imaging guidance, when performed
33017 Pericardial drainage with insertion of indwelling catheter, percutaneous, including
fluoroscopy and/or ultrasound guidance, when performed; 6 years and older without
congenital cardiac anomaly
33018 birth through 5 years of age or any age with congenital cardiac anomaly
33019 Pericardial drainage with insertion of indwelling catheter, percutaneous, including CT
guidance
33020 Pericardiotomy for removal of clot or foreign body (primary procedure)
33025 Creation of pericardial window or partial resection for drainage
33030 Pericardiectomy, subtotal or complete; without cardiopulmonary bypass
33031 with cardiopulmonary bypass
33050 Resection of pericardial cyst or tumor
7.1.1.2 CARDIAC TUMOR
33120 Excision of intracardiac tumor, resection with cardiopulmonary bypass
33130 Resection of external cardiac tumor
7.1.1.3 TRANSMYOCARDIAL REVASCULARIZATION
33140 Transmyocardial laser revascularization, by thoracotomy (separate procedure)
33141 performed at the time of other open cardiac procedure(s) (List separately in
addition to primary procedure)
7.1.1.4 PACEMAKER OR PACING CARDIOVERTER-DEFIBRILLATOR
33202 Insertion of epicardial electrode(s); open incision (eg, thoracotomy, median
sternotomy, subxiphoid approach)
33203 endoscopic approach (eg, thoracoscopy, pericardioscopy)
33206 Insertion of new or replacement of permanent pacemaker with transvenous electrode(s);
atrial
33207 ventricular
33208 atrial and ventricular
Physician - Surgery
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July 2024 90
33210 Insertion or replacement of temporary transvenous single chamber cardiac electrode or
pacemaker catheter (separate procedure)
33211 Insertion or replacement of temporary transvenous dual chamber pacing electrodes
(separate procedure)
33212 Insertion of pacemaker pulse generator only; with existing single lead
33213 with existing dual leads
33221 Insertion of pacemaker pulse generator only; with existing multiple leads
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
33222 Relocation of skin pocket for pacemaker
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 (eg, for upgrade to dual
chamber system) (List separately in addition to primary procedure)
33226 Repositioning of previously implanted cardiac venous system (left ventricular) electrode
(including removal, insertion and/or replacement of existing generator)
33233 Removal of permanent pacemaker pulse generator only
33227 Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse
generator; single lead system
33228 dual lead system
33229 multiple lead system
33234 Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular
33235 dual lead system
33236 Removal of permanent epicardial pacemaker and electrodes by thoracotomy; single lead
system, atrial or ventricular
33237 dual lead system
33238 Removal of permanent transvenous electrode(s) by thoracotomy
33240 Insertion of implantable defibrillator pulse generator only; with existing single lead
33230 Insertion of implantable defibrillator pulse generator with existing dual leads
33231 with existing multiple leads
33241 Removal of implantable defibrillator pulse generator only
33262 Removal of implantable defibrillator pulse generator with replacement of implantable
Physician - Surgery
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July 2024 91
defibrillator pulse generator; single lead system
33263 dual lead system
33264 multiple lead system
33243 Removal of single or dual chamber implantable defibrillator electrode(s); by thoracotomy
33244 by transverse extraction
33249 Insertion or replacement of permanent implantable defibrillator system, with transvenous
lead(s), single or dual chamber
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
7.1.1.5 PHRENIC NERVE STIMULATION SYSTEM
33276 Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]),
including vessel catheterization, all imaging guidance, and pulse generator initial analysis
with diagnostic mode activation, when performed
33277 Insertion of phrenic nerve stimulator transvenous sensing lead (List separately in addition
to code for primary procedure)
33278 Removal of phrenic nerve stimulator, including vessel catheterization, all imaging
guidance, and interrogation and programming, when performed; system, including pulse
generator and lead(s
33279 transvenous stimulation or sensing lead(s) only
33280 pulse generator only
33281 Repositioning of phrenic nerve stimulator transvenous lead(s)
33287 Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all
imaging guidance, and interrogation and programming, when performed; pulse
generator
33288 transvenous stimulation or sensing lead(s)
7.1.1.6 ELECTROPHYSIOLOGIC OPERATIVE PROCEDURES
7.1.1.6.1 INCISION
33250 Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, Wolff-
Parkinson-White, atrioventricular node re-entry), tract(s) and/or focus (foci); without
cardiopulmonary bypass
33251 with cardiopulmonary bypass
33254 Operative tissue ablation and reconstruction of atria, limited (eg, modified maze
procedure)
33255 Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure);
without cardiopulmonary bypass
Physician - Surgery
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33256 with cardiopulmonary bypass
33257 Operative tissue ablation and reconstruction of atria, performed at the time of other
cardiac procedure(s), limited (eg, modified maze procedure) (List separately in addition to
primary procedure)
33258 Operative tissue ablation and reconstruction of atria, performed at the time of other
cardiac procedure(s), extensive (eg, maze procedure), without cardiopulmonary bypass
(List separately in addition to primary procedure)
33259 Operative tissue ablation and reconstruction of atria, performed at the time of other
cardiac procedure(s), extensive (eg, maze procedure), with cardiopulmonary bypass (List
separately in addition to primary procedure)
33261 Operative ablation of ventricular arrhythmogenic focus with cardiopulmonary bypass
33267 Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling,
oversewing, ligation, plication, clip)
33268 Exclusion of left atrial appendage, open, performed at the time of other sternotomy or
thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing,
ligation, plication, clip) (List separately in addition to code for primary procedure)
7.1.1.6.2 ENDOSCOPY
33269 Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via
stapling, oversewing, ligation, plication, clip)
33265 Endoscopy, surgical; operative tissue ablation and reconstruction of atria, limited (eg,
modified maze procedure), without cardiopulmonary bypass
33266 operative tissue ablation and recontrustion of atria, extensive (eg, maze procedure),
without cardiopulmonary bypass
7.1.1.7 SUBCUTANEOUS CARDIAC RHYTHM MONITOR
33285 Insertion, subcutaneous cardiac rhythm monitor, including programming
33286 Removal, subcutaneous cardiac rhythm monitor
7.1.1.8 HEART (INCLUDING VALVES) AND GREAT VESSELS
33300 Repair of cardiac wound; without bypass
33305 with cardiopulmonary bypass
33310 Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular
thrombus); without bypass
33315 with cardiopulmonary bypass
33320 Suture repair of aorta or great vessels; without shunt or cardiopulmonary bypass
33321 with shunt bypass
33322 with cardiopulmonary bypass
33330 Insertion of graft, aorta or great vessels; without shunt, or cardiopulmonary bypass
33335 with cardiopulmonary bypass
7.1.1.9 CARDIAC VALVES
33361 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous
femoral artery approach
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 93
33362 open femoral artery approach
33363 open axillary artery approach
33364 open iliac artery approach
33365 transaortic approach (eg, median sternotomy, mediastinotomy)
33366 transapical exposure (eg, left thoracotomy)
33367 cardiopulmonary bypass support with percutaneous peripheral arterial and venous
cannulation (eg, femoral vessels) (List separately in addition to primary procedure)
33368 cardiopulmonary bypass support with open peripheral arterial and venous
cannulation (eg, femoral, iliac, axillary vessels) (List separately in addition to primary
procedure)
33369 cardiopulmonary bypass support with central arterial and venous cannulation (eg,
aorta, right atrium, pulmonary artery) (List separately in addition to primary
procedure)
33370 Transcatheter placement and subsequent removal of cerebral embolic protection
device(s), including arterial access, catheterization, imaging, and radiological supervision
and interpretation, percutaneous (List separately in addition to code for primary
procedure)
33390 Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; simple (ie, valvotomy,
debridement, debulking, and/or simple commissural resuspension)
33391 complex (eg, leaflet extension, leaflet resection, leaflet reconstruction, or
annuloplasty)
33404 Construction of apical-aortic conduit
33405 Replacement, aortic valve, open, with cardiopulmonary bypass; with prosthetic valve
other than homograft or stentless valve
33406 with allograft valve (freehand)
33410 with stentless tissue valve
33440 Replacement, aortic valve; by translocation of autologous pulmonary valve and
transventricular aortic annulus enlargement of the left ventricular outflow tract with
valved conduit replacement of pulmonary valve (Ross-Konno procedure)
33411 Replacement, aortic valve; with aortic annulus enlargement, noncoronary sinus
33412 with transventricular aortic annulus enlargement (Konno procedure)
33413 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 (eg,
asymmetric septal hypertrophy)
33417 Aortoplasty (gusset) for supravalvular stenosis
7.1.1.9.1 MITRAL VALVE
33418 Transcatheter mitral valve repair, percutaneous approach, including
transseptal puncture when performed; initial prosthesis
33419 additional prosthesis(es) during same session (List separately in addition to code for
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 94
primary procedure)
33420 Valvotomy, mitral valve; closed heart
33422 open heart, with cardiopulmonary bypass
33425 Valvuloplasty, mitral valve, with cardiopulmonary bypass;
33426 with prosthetic ring
33427 radical reconstruction, with or without ring
33430 Replacement, mitral valve, with cardiopulmonary bypass
7.1.1.9.2 TRICUSPID VALVE
33460 Valvectomy, tricuspid valve, with cardiopulmonary bypass;
33463 Valvuloplasty, tricuspid valve; without ring insertion
33464 with ring insertion
33465 Replacement, tricuspid valve, with cardiopulmonary bypass
33468 Tricuspid valve repositioning and plication for Ebstein anomaly
7.1.1.9.3 PULMONARY VALVE
33471 Valvotomy, pulmonary valve, closed heart, via pulmonary artery
33474 Valvotomy, pulmonary valve, open heart, with cardiopulmonary bypass
33475 Replacement, pulmonary valve
33476 Right ventricular resection for infundibular stenosis, with or without commissurotomy
33477 Transcatheter pulmonary valve implantation, percutaneous approach, including pre-
stenting of the valve delivery site, when performed
33478 Outflow tract augmentation (gusset), with or without commissurotomy or infundibular
resection
7.1.1.10 OTHER VALVULAR PROCEDURES
33496 Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass
(separate procedure)
7.1.1.11 CORONARY ARTERY ANOMALIES
Basic procedures include endarterectomy or angioplasty.
33500 Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardio-
pulmonary bypass
33501 without cardio-pulmonary bypass
33502 Repair of anomalous coronary artery from pulmonary artery origin; by ligation
33503 by graft, without cardiopulmonary bypass
33504 by graft, with cardiopulmonary bypass
33505 with construction of intrapulmonary artery tunnel (Takeuchi procedure)
33506 by translocation from pulmonary artery to aorta
33507 Repair of anomalous (eg, intramural) aortic origin of coronary artery by unroofing or
translocation
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 95
7.1.1.12 ENDOSCOPY
33508 Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass
procedure (List separately in addition to primary procedure)
33509 Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure,
endoscopic
7.1.1.13 VENOUS GRAFTING ONLY FOR CORONARY ARTERY BYPASS
33510 Coronary artery bypass, vein only; single coronary venous graft
33511 two coronary venous grafts
33512 three coronary venous grafts
33513 four coronary venous grafts
33514 five coronary venous grafts
33516 six or more coronary venous grafts
7.1.1.14 COMBINED ARTERIAL-VENOUS GRAFTING FOR CORONARY BYPASS
33517 Coronary artery bypass, using venous graft(s) and arterial graft(s); single vein graft (List
separately in addition to primary procedure)
33518 two venous grafts
33519 three venous grafts
33521 four venous grafts
33522 five venous grafts
33523 six or more venous grafts
33530 Reoperation, coronary artery bypass procedure or valve procedure, more than one
month after original operation
7.1.1.15 ARTERIAL GRAFTING FOR CORONARY ARTERY BYPASS
33533 Coronary artery bypass, using arterial graft(s); single arterial graft
33534 two coronary arterial grafts
33535 three coronary arterial grafts
33536 four or more coronary arterial grafts
33542 Myocardial resection (eg, ventricular aneurysmectomy)
33545 Repair of postinfarction ventricular septal defect, with or without myocardial resection
33548 Surgical ventricular restoration procedure, includes prosthetic patch, when performed
(eg, ventricular remodeling, SVR, SAVER, DOR procedures)
7.1.1.16 CORONARY ENDARTERECTOMY
33572 Coronary endarterectomy, open, any method, of left anterior descending, circumflex, or
right coronary artery performed in conjunction with coronary artery bypass graft
procedure, each vessel
7.1.1.17 SINGLE VENTRICLE AND OTHER COMPLEX CARDIAC ANOMALIES
33600 Closure of atrioventricular valve (mitral or tricuspid) by suture or patch
33602 Closure of semilunar valve (aortic or pulmonary) by suture or patch
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 96
33606 Anastomosis of pulmonary artery to aorta (Damus-Kaye-Stansel procedure)
33608 Repair of complex cardiac anomaly other than pulmonary atresia with ventricular septal
defect by construction or replacement of conduit from right or left ventricle to pulmonary
artery
33610 Repair of complex cardiac anomalies (eg, single ventricle with subaortic obstruction) by
surgical enlargement of ventricular septal defect
33611 Repair of double outlet right ventricle with intraventricular tunnel repair;
33612 with repair of right ventricular outflow tract obstruction
33615 Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of atrial septal
defect and anastomosis of atria or vena cava to pulmonary artery (simple Fontan
procedure)
33617 Repair of complex cardiac anomalies (eg, single ventricle) by modified Fontan procedure
33619 Repair of single ventricle with aortic outflow obstruction and aortic arch hypoplasia
(hypoplastic left heart syndrome) (eg, Norwood procedure)
33620 Application of right and left pulmonary artery bands (eg, hybrid approach stage 1)
33621 Transthoracic insertion of catheter for stent placement with catheter removal and closure
(eg, hybrid approach stage 1)
33622 Reconstruction of complex cardiac anomaly (eg, single ventricle or hypoplastic left heart)
with palliation of single ventricle with aortic outflow obstruction and aortic arch
hypoplasia, creation of cavopulmonary anastomosis, and removal of right and left
pulmonary bands (eg, hybrid approach stage 2, Norwood, bidirectional Glenn, pulmonary
artery debanding)
7.1.1.18 SEPTAL DEFECT
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
33647 Repair of atrial septal defect and ventricular septal defect, with direct or patch closure
33660 Repair of incomplete or partial atrioventricular canal (ostium primum atrial septal defect),
with or without atrioventricular valve repair
33665 Repair of intermediate or transitional atrioventricular canal, with or without
atrioventricular valve repair
33670 Repair of complete atrioventricular canal, with or without prosthetic valve
33675 Closure of multiple ventricular septal defects;
33676 with pulmonary valvotomy or infundibular resection (acyanotic)
33677 with removal of pulmonary artery band, with or without gusset
33681 Closure of single ventricular septal defect, with or without patch;
33684 with pulmonary valvotomy or infundibular resection (acyanotic)
33688 with removal of pulmonary artery band, with or without gusset
33690 Banding of pulmonary artery
33692 Complete repair tetralogy of Fallot without pulmonary atresia;
33694 with transannular patch
33697 Complete repair tetralogy of Fallot with pulmonary atresia including construction of
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 97
conduit from right ventricle to pulmonary artery and closure of ventricular septal defect
7.1.1.19 SINUS OF VALSALVA
33702 Repair sinus of Valsalva fistula, with cardiopulmonary bypass;
33710 with repair of ventricular septal defect
33720 Repair sinus of Valsalva aneurysm, with cardiopulmonary bypass
7.1.1.20 VENOUS ANOMALIES
33724 Repair of isolated partial anomalous pulmonary venous return (eg, scimitar syndrome)
33726 Repair of pulmonary venous stenosis
33730 Complete repair of anomalous venous return (supracardiac, intracardiac, or infracardiac
types)
33732 Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial membrane
7.1.1.21 SHUNTING PROCEDURES
33735 Atrial septectomy or septostomy; closed heart (Blalock-Hanlon type operation)
33736 open heart with cardiopulmonary bypass
33737 open heart, with inflow occlusion
33741 Transcatheter atrial septostomy (TAS) congenital cardiac anomalities to create effective
atrial flow, including all imagin guidance by the proceduralist, when performed, any
method (eg, Rashkind, Sang-Park, balloon, cutting balloon, blade)
33745 Transcatheter intracardiac shunt (TIS) creation by stent placement for congenital cardiac
anomalies to establish effective intracardiac flow, including all imaging guidance by the
proceduralist, when preformed, left and right heart diagnostic cardiac catherization for
congenital cardiac anomalies, and target zone angioplasty, when performed (eg, atrial
septum, Fontan fenestration, right ventricular outflow tract, Mustard/Senning/Warden
baffles); initial intracardiac shunt
33746 each additional intracardiac shunt location (List separately in addition to code for
primary procedure)
33750 Shunt; subclavian to pulmonary artery (Blalock-Taussig type operation)
33755 ascending aorta to pulmonary artery (Waterston type operation)
33762 descending aorta to pulmonary artery (Potts-Smith type operation)
33764 central, with prosthetic graft
33766 superior vena cava to pulmonary artery for flow to one lung (classical Glenn
procedure)
33767 superior vena cava to pulmonary artery for flow to both lungs (bidirectional Glenn
procedure)
33768 Anastomosis, cavopulmonary, second superior vena cava
7.1.1.22 TRANSPOSITION OF THE GREAT VESSELS
33770 Repair of transposition of the great arteries with ventricular septal defect and
subpulmonary stenosis; without surgical enlargement of ventricular septal defect
33771 with surgical enlargement of ventricular septal defect
33774 Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 98
Senning type) with cardiopulmonary bypass;
33775 with removal of pulmonary band
33776 with closure of ventricular septal defect
33777 with repair of subpulmonic obstruction
33778 Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg,
Jatene type)
33779 with removal of pulmonary band
33780 with closure of ventricular septal defect
33781 with repair of subpulmonic obstruction
33782 Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie,
Nikaidoh procedure); without coronary ostium reimplantation
33783 with reimplantation of 1 or both coronary ostia
7.1.1.23 TRUNCUS ARTERIOSUS
33786 Total repair, truncus arteriosus (Rastelli type operation)
33788 Reimplantation of an anomalous pulmonary artery
7.1.1.24 AORTIC ANOMALIES
33800 Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia)
(separate procedure)
33802 Division of aberrant vessel (vascular ring);
33803 with reanastomosis
33813 Obliteration of aortopulmonary septal defect; without cardiopulmonary bypass
33814 with cardiopulmonary bypass
33820 Repair of patent ductus arteriosus; by ligation
33822 by division, under 18 years
33824 by division, 18 years and older
33840 Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with
direct anastomosis
33845 with graft
33851 repair using either left subclavian artery or prosthetic material as gusset for
enlargement
33852 Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material;
without cardiopulmonary bypass
33853 with cardiopulmonary bypass
7.1.1.25 THORACIC AORTIC ANEURYSM
33858 Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension,
when performed; for aortic dissection
33859 for aortic disease other than dissection (eg, aneurysm)
33863 with aortic root replacement using valved conduit and coronary reconstruction (eg,
Bentall)
33864 with valve suspension, with coronary reconstruction and valve-sparing aortic root
remodeling (eg, David Procedure, Yacoub Procedure)
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 99
33866 Aortic hemiarch graft including isolation and control of the arch vessels, beveled open
distal aortic anastomosis extending under one or more of the arch vessels, and total
circulatory arrest or isolated cerebral perfusion (List separately in addition to code for
primary procedure)
33871 Transverse aortic arch graft, with cardiopulmonary bypass, with profound hypothermia,
total circulatory arrest and isolated cerebral perfusion with reimplantation of arch
vessel(s) (eg, island pedicle or individual arch vessel reimplantation)
33875 Descending thoracic aorta graft, with or without bypass
33877 Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary
bypass
7.1.1.26 ENDOVASCULAR REPAIR OF DESCENDING THORACIC AORTA
33880 Endovascular repair of descending thoracic aorta (eg, 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 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 (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural
hematoma, or traumatic disruption); initial extension
33884 each additional proximal extension
33886 Placement of distal extension prosthesis(s) delayed after endovascular repair of
descending thoracic aorta
33889 Open subclavian to carotid artery transposition performed in conjunction with
endovascular repair of descending thoracic aorta, by neck incision, unilateral
33891 Bypass graft, with other than vein, transcervical retropharyngeal carotid-carotid,
performed in conjunction with endovascular repair of descending thoracic aorta, by neck
incision
7.1.1.27 ENDOVASCULAR REPAIR OF CONGENITAL HEART AND VASCULAR DEFECTS
33894 Endovascular stent repair of coarctation of the ascending, transverse, or descending
thoracic or abdominal aorta, involving stent placement; across major side branches
33895 not crossing major side branches
33897 Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta
33900 Percutaneous pulmonary artery revascularization by stent placement, initial; normal
native connections, unilateral
33901 normal native connections, bilateral
33902 abnormal connections, unilateral
33903 abnormal connections, bilateral
33904 Percutaneous pulmonary artery revasularization by stent placement, each additional
vessel or separate lesion, normal or abnormal connections (List separately in addition to
code for primary procedure)
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 100
7.1.1.28 PULMONARY ARTERY
33910 Pulmonary artery embolectomy; with cardiopulmonary bypass
33915 without cardiopulmonary bypass
33916 Pulmonary endarterectomy with or without embolectomy, with cardiopulmonary bypass
33917 Repair of pulmonary artery stenosis by reconstruction with patch or graft
33920 Repair of pulmonary atresia with ventricular septal defect, by construction or replacement
of conduit from right or left ventricle to pulmonary artery
33922 Transection of pulmonary artery with cardiopulmonary bypass
33924 Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in
conjunction with a congenital heart procedure
33925 Repair of pulmonary artery arborization anomalies by unifocalization; without
cardiopulmonary bypass
33926 with cardiopulmonary bypass
7.1.1.29 HEART/LUNG TRANSPLANTATION
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)
separately in addition to code for primary procedure)
33935 Heart-lung transplant with recipient cardiectomy-pneumonectomy
33945 Heart transplant, with or without recipient cardiectomy
7.1.1.30 EXTRACORPOREAL MEMBRANE OXYGENATION or EXTRACORPOREAL LIFE SUPPORT
SERVICES
33946 Extracorporeal membrane oxygenation (ECMO)/extracorporeal life
support (ECLS) provided by physician; initiation, veno-venous
33947 initiation veno-arterial
33948 daily management, each day, veno-venous
33949 daily management, each day, veno-arterial
33951 insertion of peripheral (arterial and/or venous) cannula(e),
percutaneous, birth through 5 years of age (includes fluoroscopic
guidance, when performed)
33952 insertion of peripheral (arterial and/or venous) cannula(e),
percutaneous, 6 years and older (includes fluoroscopic
guidance, when performed)
33953 insertion of peripheral (arterial and/or venous) cannula(e), open,
birth through 5 years of age
33954 insertion of peripheral (arterial and/or venous) cannula(e), open,
6 years and older
33955 insertion of central cannula(e) by sternotomy or thoracotomy,
birth through 5 years of age
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33956 insertion of central cannula(e) by sternotomy or thoracotomy,
6 years and older
33957 reposition peripheral (arterial and/or venous) cannula(e),
percutaneous, birth through 5 years of age (includes fluoroscopic
guidance, when performed)
33958 reposition peripheral (arterial and/or venous) cannula(e),
percutaneous, 6 years and older (includes fluoroscopic
guidance, when performed)
33959 reposition peripheral (arterial and/or venous) cannula(e), open,
birth through 5 years of age (includes fluoroscopic guidance
when performed)
33962 reposition peripheral (arterial and/or venous) cannula(e), open,
6 years and older (includes fluoroscopic guidance, when performed)
33963 reposition of central cannula(e) by sternotomy or thoracotomy,
birth through 5 years of age (includes fluoroscopic guidance,
when performed
33964 reposition central cannula(e) by sternotomy or thoracotomy,
6 years and older (includes fluoroscopic guidance, when performed)
33965 removal of peripheral (arterial and/or venous) cannula(e),
percutaneous, birth through 5 years of age
33966 removal of peripheral (arterial and/or venous) cannula(e),
percutaneous, 6 years and older
33969 removal of peripheral (arterial and/or venous) cannula(e), open,
birth through 5 years of age
33984 removal of peripheral (arterial and/or venous) cannula(e), open,
6 years and older
33985 removal of central cannula(e), by sternotomy or thoracotomy, birth through 5 years
of age
33986 removal of central cannula(e), by sternotomy or thoracotomy, 6 years and older
33987 Arterial exposure with creation of graft conduit (eg, chimney graft)
to facilitate arterial perfusion for ECMO/ECLS (List separately in
addition to code for primary procedure
33988 Insertion of left heart vent by thoracic incision (eg, sternotomy/
thoracotomy) for ECMO/ECLS
33989 Removal of left heart vent by thoracic incision (eg, sternotomy/
thoracotomy) for ECMO/ECLS
7.1.1.31 CARDIAC ASSIST
33967 Insertion of intra-aortic balloon assist device, percutaneous
33968 Removal of intra-aortic balloon assist device, percutaneous
33970 Insertion of intra-aortic balloon assist device through the femoral artery, open approach
33971 Removal of intra-aortic balloon assist device including repair of femoral artery, with or
without graft
33973 Insertion of intra-aortic balloon assist device through the ascending aorta
Physician - Surgery
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33974 Removal of intra-aortic balloon assist device from the ascending aorta, including repair of
the ascending aorta, with or without graft
33975 Insertion of ventricular assist device; extracorporeal, single ventricle
33976 extracorporeal, biventricular
33977 Removal of ventricular assist device; extracorporeal, single ventricle
33978 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 with cardiopulmonary bypass
33995 Insertion of ventricular assist device, percutaneous, including radiological supervision and
interpretation; right heart, venous access only
33990 left heart, arterial access only
33991 left heart, both arterial and venous access, with transseptal puncture
33992 Removal of percutaneous left heart ventricular assist device, arterial or arterial and
venous cannula(s), at separate and distinct session from insertion
33997 Removal of percutaneous right heart ventricular assist device, venous cannula, at separate
and distinct session from insertion.
33993 Repositioning of percutaneous right or left heart ventricular assist device with imaging
guidance at separate and distinct session from insertion
7.1.1.32 OTHER PROCEDURES
33999 Unlisted procedure, cardiac surgery
7.1.2 ARTERIES AND VEINS
7.1.2.1 EMBOLECTOMY/THROMBECTOMY
7.1.2.1.1 ARTERIAL, WITH OR WITHOUT CATHETER
34001 Embolectomy or thrombectomy, with or without catheter; carotid, subclavian or
innominate artery, by neck incision
34051 innominate, subclavian artery, by thoracic incision
34101 axillary, brachial, innominate, subclavian artery, by arm incision
34111 radial or u1nar artery, by arm incision
34151 renal, celiac, mesentery, aortoiliac artery, by abdominal incision
34201 femoropopliteal, aortoiliac artery, by leg incision
34203 popliteal-tibio-peroneal, by leg incision
7.1.2.1.2 VENOUS, DIRECT OR WITH CATHETER
34401 Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal incision
34421 vena cava, iliac, femoropopliteal vein, by leg incision
34451 vena cava, iliac, femoropopliteal vein, by abdominal and leg incision
34471 subclavian vein, by neck incision
Physician - Surgery
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July 2024 103
34490 axillary and subclavian vein, by arm incision
7.1.2.2 VENOUS RECONSTRUCTION
34501 Valvuloplasty, femoral vein
34502 Reconstruction of vena cava, any method
34510 Venous valve transposition, any vein donor
34520 Cross-over vein graft to venous system
34530 Saphenopopliteal vein anastomosis
7.1.2.3 ENDOVASCULAR REPAIR OF ABDOMINAL AORTA AND/OR ILIAC ARTERIES
34701 Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft
including pre-procedure sizing and device selection, all nonselective catheterization(s), all
associated radiological supervision and interpretation, all endograft extension(s) placed in
the aorta from the level of the renal arteries to the aortic bifurcation, and all
angioplasty/stenting performed from the level of the renal arteries to the aortic
bifurcation; for other than rupture (eg, aneurysm, pseudoaneurysm, dissection,
penetrating ulcer)
34702 for rupture including temporary aortic and/or iliac balloon occlusion, when
performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer,
traumatic disruption)
34703 Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-
uni-iliac endograft including pre-procedure sizing and device selection, all nonselective
catheterization(s), all associated radiological supervision and interpretation, all endograft
extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation,
and all angioplasty/stenting performed from the level of the renal arteries to the iliac
bifurcation; for other than rupture (eg, aneurysm, pseudoaneurysm, dissection,
penetrating ulcer)
34704 for rupture including temporary aortic and/or iliac balloon occlusion, when
performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer,
traumatic disruption)
34705 Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an
aorto-bi-iliac endograft including pre-procedure sizing and device selection, all
nonselective catheterization(s), all associated radiological supervision and
interpretation, all endograft extension(s) placed in the aorta from the level of the
renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the
level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for
aneurysm, pseudoaneurysm, dissection, penetrating ulcer)
34706 for rupture including temporary aortic and/or iliac balloon occlusion, when
performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer,
traumatic disruption)
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
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angioplasty/stenting, when performed, unilateral; for other than rupture (eg, for
aneurysm,pseudoaneurysm,dissection,arteriovenous malformation)
34708 for rupture including temporary aortic and/or iliac balloon occlusion, when
performed (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous
malformation, traumatic disruption)
34717 Endovascular repair of iliac artery at the time of aortoiliac artery endograft placement by
development of an iliac branched endograft including pre-procedure sizing and device
selection, all ipsilateral selective iliac artery catheterization(s), all associated radiological
supervision and interpretation, and all endograft extension(s) proximally to the aortic
bifurcation and distally in the internal iliac, external iliac, and common femoral artery(ies),
and treatment zone angioplasty/stenting when performed, for rupture or other than
rupture (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation,
penetrating ulcer, traumatic disruption), unilateral (List separately in addition to code for
primary procedure)
34709 Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to
the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac
aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing
and device selection, all nonselective catheterization(s), all associated radiological
supervision and interpretation, and treatment zone angioplasty/stenting, when
performed, per vessel treated (List separately in addition to code for primary procedure)
34718 Endovascular repair of iliac artery, not associated with placement of an aorto-iliac artery
endograft at the same session, by deployment of an iliac branched endograft, including
pre-procedure sizing and device selection, all ipsilateral selective iliac artery
catheterization(s), all associated radiological supervision and interpretation, and all
endograft extension(s) proximally to the aortic bifurcation and distally in the internal iliac,
external iliac, and common femoral artery(ies), and treatment zone angioplasty/stenting,
when performed, for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection,
arteriovenous malformation, penetrating ulcer), unilateral
34710 Delayed placement of distal or proximal extension prosthesis for endovascular repair of
infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak or
endograft migration, including pre-procedure sizing and device selection, all nonselective
catheterization(s), all associated radiological supervision and interpretation, and
treatment zone angioplasty/stenting, when performed; initial vessl treated
34711 each additional vessel treated (List separately in addition to code for primary
procedure)
34712 Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw,
tack) and all associated radiological supervision and interpretation
34713 Percutaneous access and closure of femoral artery for delivery of endograft through a
large sheath (12 French of larger), including ultrasound guidance, when performed,
unilateral (List separately in additional to code for primary procedure)
34714 Open femoral artery exposure with creation of conduit for delivery of endovascular
prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral
(List separately in addition to code for primary procedure)
34715 Open axillary/subclavian exposure for delivery of endovascular prosthesis by
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infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for
primary procedure)
34716 Open axillary/subclavian artery exposure with creation of conduit for delivery of
endovascular prosthesis or for establishment of cardiopulmonary bypass, by
infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for
primary procedure)
34808 Endovascular placement of iliac artery occlusion device (List separately in addition to
code for primary procedure)
34812 Open femoral artery exposure for delivery of endovascular prosthesis, by groin incision,
unilateral (List separately in addition to code for primary procedure)
34813 Placement of femoral-femoral prosthetic graft during endovascular aortic aneurysm
repair
34820 Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during
endovascular therapy, by abdominal or retroperitoneal incision, unilateral (List separately
in addition to code for primary procedure)
34830 Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial
trauma, following unsuccessful endovascular repair; tube prosthesis
34831 aorto-bi-iliac prosthesis
34832 aorto-bifemoral prosthesis
34833 Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis
for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision,
unilateral (List separately in addition to code for primary procedure)
34834 Open brachial artery exposure for delivery of endovascular prosthesis, unilateral (List
separately in addition to code for primary procedure)
34715 Open axillary/subclavian exposure for delivery of endovascular prosthesis by infraclavicular
or supraclavicular incision, unilateral (List separately in addition to code for primary
procedure)
34716 Open axillary/subclavian artery exposure with creation of conduit for delivery of
endovascular prosthesis or for establishment of cardiopulmonary bypass, by
infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for
primary procedure)
7.1.2.4 FENESTRATED ENDOVASCULAR REPAIR of the VISCERAL and INFRARENAL AORTA
34841 Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneuysm, dissection,
penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a
fenestrated visceral aortic endograft and all associated radiological supervision and
interpretation, including target zone angioplasty, when performed; including one visceral
artery endoprostheses (superior mesenteric, celiac or renal artery)
34842 including two visceral artery endoprostheses (superior mesenteric, celiac and/or
renal artery[s])
34843 including three visceral artery endoprostheses (superior mesenteric, celiac and/or
renal artery[s])
34844 including four or more visceral artery endoprosthesis (superior mesenteric, celiac
and/or renal artery[s])
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34845 Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm,
pseudoaneuysm, dissection, penetrating ulcer, intramual hematoma, or traumatic
disruption) with a fenestrated visceral aortic endograft and concomitant unibody or
modular infrarenal aortic endograft and all associated radiological supervision and
interpretation, including target zone angioplasty, when performed; including one visceral
artery endoprosthesis (superior mesenteric, celiac or renal artery)
34846 including two visceral artery endoprosthesis (superior mesenteric, celiac or renal
artery[s])
34847 including three visceral artery endoprostheses (superior mesenteric, celiac and/or
renal artery[s])
34848 including four or more visceral artery endoprosthesis (superior mesenteric, celiac
and/or renal artery[s])
7.1.2.5 DIRECT REPAIR OF ANEURYSM OR EXCISION (PARTIAL OR TOTAL) AND GRAFT
INSERTION FOR ANEURSYM, PSEUDOANEURYSM, RUPTURED ANEURYSM, AND
ASSOCIATED OCCLUSIVE DISEASE
35001 Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft
insertion, with or without patch graft; for aneurysm and associated occlusive disease,
carotid, subclavian artery, by neck incision
35002 for ruptured aneurysm, carotid, subclavian artery, by neck incision
35005 for aneurysm, pseudoaneurysm, and associated occlusive disease, vertebral artery
35011 for aneurysm and associated occlusive disease, axillary-brachial artery, by arm
incision
35013 for ruptured aneurysm, axillary-brachial artery, by arm incision
35021 for aneurysm, pseudoaneurysm, and associated occlusive disease, innominate,
subclavian artery, by thoracic incision
35022 for ruptured aneurysm, innominate, subclavian artery, by thoracic incision
35045 for aneurysm, pseudoaneurysm, and associated occlusive disease, radial or ulnar
artery
35081 for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta
35082 for ruptured aneurysm, abdominal aorta
35091 for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta
involving visceral vessels (mesenteric, celiac, renal)
35092 for ruptured aneurysm, abdominal aorta involving visceral vessels (mesenteric,
celiac, renal)
35102 for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta
involving iliac vessels (common, hypogastric, external)
35103 for ruptured aneurysm, abdominal aorta involving iliac vessels (common,
hypogastric, external)
35111 for aneurysm, pseudoaneurysm, and associated occlusive disease, splenic artery
35112 for ruptured aneurysm, splenic artery
35121 for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, celiac,
renal or mesenteric artery
35122 for ruptured aneurysm, hepatic, celiac, renal, or mesenteric artery
Physician - Surgery
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35131 for aneurysm, pseudoaneurysm, and associated occlusive disease, iliac artery
(common, hypogastric, external)
35132 for ruptured aneurysm, iliac artery (common, hypogastric, external)
35141 for aneurysm, pseudoaneurysm, and associated occlusive disease, common femoral
artery (profunda femoris, superficial femoral)
35142 for ruptured aneurysm, common femoral artery (profunda femoris, superficial
femoral)
35151 for aneurysm, pseudoaneurysm, and associated occlusive disease, popliteal artery
35152 for ruptured aneurysm, popliteal artery
7.1.2.6 REPAIR ARTERIOVENOUS FISTULA
35180 Repair, congenital arteriovenous fistula; head and neck
35182 thorax and abdomen
35184 extremities
35188 Repair, acquired or traumatic arteriovenous fistula; head and neck
35189 thorax and abdomen
35190 extremities
7.1.2.7 REPAIR BLOOD VESSEL OTHER THAN FOR FISTULA, WITH OR WITHOUT PATCH
ANGIOPLASTY
35201 Repair blood vessels, direct; neck
35206 upper extremity
35207 hand, finger
35211 intrathoracic, with bypass
35216 intrathoracic, without bypass
35221 intra-abdominal
35226 lower extremity
35231 Repair blood vessel with vein graft; neck
35236 upper extremity
35241 intrathoracic, with bypass
35246 intrathoracic, without bypass
35251 intra-abdominal
35256 lower extremity
35261 Repair blood vessel with graft other than vein; neck
35266 upper extremity
35271 intrathoracic, with bypass
35276 intrathoracic, without bypass
35281 intra-abdominal
35286 lower extremity
7.1.2.8 THROMBOENDARTERECTOMY
35301 Thromboendarterectomy, including patch graft, if performed; carotid, vertebral,
subclavian, by neck incision
35302 superficial femoral artery
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35303 popliteal artery
35304 tibioperoneal trunk artery
35305 tibial or peroneal artery, initial vessel
35306 each additional tibial or peroneal artery
35311 subclavian, innominate, by thoracic incision
35321 axillary-brachial
35331 abdominal aorta
35341 mesenteric, celiac, or renal
35351 iliac
35355 iliofemoral
35361 combined aortoiliac
35363 combined aortoiliofemoral
35371 common femoral
35372 deep (profunda) femoral
35390 Reoperation, carotid, thromboendarterectomy, more than one month after original
operation
7.1.2.9 ANGIOSCOPY
35400 Angioscopy (non-coronary vessels or grafts) during therapeutic intervention
7.1.2.10 BYPASS GRAFT
7.1.2.10.1 VEIN
35500 Harvest of upper extremity vein, one segment, for lower extremity or coronary artery
bypass procedure (List separately in addition to primary procedure)
35501 Bypass graft, with vein; common carotid-ipsilateral internal carotid
35506 carotid-subclavian or subclavian-carotid
35508 carotid-vertebral
35509 carotid-contralateral carotid
35510 carotid-brachial
35511 subclavian-subclavian
35512 subclavian-brachial
35515 subclavian-vertebral
35516 subclavian-axillary
35518 axillary-axillary
35521 axillary-femoral
35522 axillary-brachial
35523 brachial-ulnar or -radial
35525 brachial-brachial
35526 aortosubclavian, aortoinnominate, or aortocarotid
35531 aortoceliac or aortomesenteric
35533 axillary-femoral-femoral
35535 hepatorenal
35536 splenorenal
35537 aortoiliac
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35538 aortobi-iliac
35539 aortofemoral
35540 aortobifemoral
35556 femoral-popliteal
35558 femoral-femoral
35560 aortorenal
35563 ilioiliac
35565 iliofemoral
35566 femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels
35570 tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial
35571 popliteal-tibial, -peroneal artery or other distal vessels
35572 Harvest of femoropopliteal vein, one segment, for vascular reconstruction procedure (eg,
aortic, vena caval, coronary, peripheral artery)
7.1.2.10.2 IN SITU VEIN
35583 In-situ vein bypass; femoral-popliteal
35585 femoral-anterior tibial, posterior tibial, or peroneal artery
35587 popliteal-tibial, perineal
7.1.2.10.3 OTHER THAN VEIN
35600 Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, open
35601 Bypass graft, with other than vein; common carotid-ipsilateral internal carotid
35606 carotid-subclavian
35612 subclavian-subclavian
35616 subclavian-axillary
35621 axillary-femoral
35623 axillary-popliteal or -tibial
35626 aortosubclavian, aortoinnominate, or aortocarotid
35631 aortoceliac, aortomesenteric, aortorenal
35632 ilio-celiac
35633 ilio-mesenteric
35634 iliorenal
35636 splenorenal (splenic to renal arterial anastomosis)
35637 aortoiliac
35638 aortobi-iliac
35642 carotid-vertebral
35645 subclavian-vertebral
35646 aortobifemoral
35647 aortofemoral
35650 axillary-axillary
35654 axillary-femoral-femoral
35656 femoral-popliteal
35661 femoral-femoral
35663 ilioiliac
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35665 iliofemoral
35666 femoral-anterior tibial, posterior tibial, or peroneal artery
35671 popliteal-tibial, or -peroneal artery
7.1.2.11 COMPOSITE GRAFTS
35681 Bypass graft; composite, prosthetic and vein
35682 autogenous composite, two segments of veins from two locations
35683 autogenous composite, three or more segments of vein from two or more locations
7.1.2.12 ADJUVANT TECHNIQUES
35685 Placement of vein patch or cuff at distal anastomosis of bypass graft, synthetic conduit
35686 Creation of distal arteriovenous fistula during lower extremity bypass surgery (non-
hemodialysis)
7.1.2.13 ARTERIAL TRANSPOSITION
35691 Transposition and/or reimplantation; vertebral to carotid artery
35693 vertebral to subclavian artery
35694 subclavian to carotid artery
35695 carotid to subclavian artery
35697 Reimplantation, visceral artery to infrarenal aortic prosthesis, each artery
7.1.2.14 EXCISION, EXPLORATION, REPAIR, REVISION
35700 Reoperation, femoral-popliteal or femoral (popliteal) -anterior tibial, posterior tibial,
peroneal artery or other distal vessels, more than one month after original operation
35701 Exploration not followed by surgical repair, artery; neck (eg, carotid, subclavian)
35702 upper extremity (eg, axillary, brachial, radial, ulnar)
35703 lower extremity (eg, common femoral, deep femoral, superficial femoral, popliteal,
tibial,
peroneal)
35800 Exploration for postoperative hemorrhage, thrombosis or infection; neck
35820 chest
35840 abdomen
35860 extremity
35870 Repair of graft-enteric fistula
35875 Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula);
35876 with revision of arterial or venous graft
35879 Revision, lower extremity arterial bypass, without thrombectomy, open; with vein patch
angioplasty
35881 with segmental vein interposition
35883 Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with
nonautogenous patch graft (eg, Dacron, ePTFE, bovine pericardium)
35884 with autogenous vein patch graft
35901 Excision of infected graft; neck
35903 extremity
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35905 thorax
35907 abdomen
7.1.2.15 VASCULAR INJECTION PROCEDURES
7.1.2.15.1 INTRAVENOUS
36000 Introduction of needle or intracatheter, vein
36002 Injection procedures (eg, thrombin) for percutaneous treatment of extremity
pseudoaneurysm
36005 Injection procedure for extremity venography (including introduction of needle or
intracatheter)
36010 Introduction of catheter, superior or inferior vena cava
36011 Selective catheter placement, venous system; first order branch (eg, renal vein, jugular
vein)
36012 second order, or more selective, branch (eg, left adrenal vein, petrosal sinus)
36013 Introduction of catheter, right heart or main pulmonary artery
36014 Selective catheter placement, left or right pulmonary artery
36015 Selective catheter placement, segmental or subsegmental pulmonary artery
7.1.2.15.2 INTRA ARTERIAL---INTRA -AORTIC
36100 Introduction of needle or intracatheter, carotid or vertebral artery
36140 Introduction of needle or intracatheter, upper or lower extremity artery
36160 Introduction of needle or intracatheter, aortic, translumbar
36200 Introduction of catheter, aorta
36215 Selective catheter placement, arterial system; each first order thoracic or brachiocephalic
branch, within a vascular family
36216 initial second order thoracic or brachiocephalic branch, within a vascular family
36217 initial third order or more selective thoracic or brachiocephalic branch, within a
vascular family
36218 additional second order, third order and beyond, thoracic or brachiocephalic
branch, within a vascular family
36221 Non-selective catheter placement, thoracic aorta, with angiography of the extracranial
carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated
radiological supervision and interpretation, includes angiography of the cervicocerebral
arch, when performed
36222 Selective catheter placement, common carotid or innominate artery, unilateral, any
approach, with angiography of the ipsilateral extracranial carotid circulation and all
associated radiological supervision and interpretation, includes angiography of the
cervicocerebral arch, when performed
36223 Selective catheter placement, common carotid or innominate artery, unilateral, any
approach, with angiography of the ipsilateral intracranial carotid circulation and all
associated radiological supervision and interpretation, includes angiography of the
extracranial carotid and cervicocerebral arch, when performed
36224 Selective catheter placement, internal carotid artery, unilateral, with angiography of the
ipsilateral intracranial carotid circulation and all associated radiological supervision and
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interpretation, includes angiography of the extracranial carotid and cervicocerebral arch,
when performed
36225 Selective catheter placement, subclavian or innominate artery, unilateral, with
angiography of the ipsilateral vertebral circulation and all associated radiological
supervision and interpretation, includes angiography of the cervicocerebral arch, when
performed
36226 Selective catheter placement, vertebral artery, unilateral, with angiography of the
ipsilateral vertebral circulation and all associated radiological supervision and
interpretation, includes angiography of the cervicocerebral arch, when performed
36227 Selective catheter placement, external carotid artery, unilateral, with angiography of the
ipsilateral external carotid circulation and all associated radiological supervision and
interpretation
36228 Selective catheter placement, each intracranial branch of the internal carotid or vertebral
arteries, unilateral, with angiography of the selected vessel circulation and all associated
radiological supervision and interpretation (eg, middle cerebral artery, posterior inferior
cerebellar artery)
36245 Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower
extremity artery branch, within a vascular family
36246 initial second order abdominal, pelvic, or lower extremity artery branch, within a
vascular family
36247 initial third order or more selective abdominal, pelvic, or lower extremity artery
branch, within a vascular family
36248 additional second order, third order, and beyond, abdominal, pelvic, or lower
extremity artery branch, within a vascular family
36251 Selective catheter placement (first-order), main renal artery and any accessory renal
artery(s) for renal angiography, including arterial puncture and catheter placement(s),
fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images,
and radiological supervision and interpretation, including pressure gradient
measurements when performed, and flush aortogram when performed; unilateral
36252 bilateral
36253 Superselective catheter placement (one or more second order or higher renal artery
branches) renal artery and any accessory renal artery(s) for renal angiography, including
arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing,
permanent recording of images, and radiological supervision and interpretation,
including pressure gradient measurements when performed, and flush aortogram when
performed; unilateral
36254 bilateral
36260 Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy of liver)
36261 Revision of implanted intra-arterial infusion pump
36262 Removal of implanted intra-arterial infusion pump
36299 Unlisted procedure, vascular injection
7.1.2.15.3 VENOUS
36400 Venipuncture, younger than age 3 years, necessitating the skill of a physician or other
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qualified health care professional, not to be used for routine venipuncture; femoral or
jugular vein
36405 scalp vein
36406 other vein
36420 Venipuncture, cutdown; younger than age 1 year
36425 age 1 or over (Not to be used for routine venipuncture)
36430 Transfusion, blood or blood components
36440 Push transfusion, blood, 2 years or younger
36450 Exchange transfusion, blood; newborn
36455 other than newborn
36456 Partial exchange transfusion, blood, plasma or crystalloid necessitating the skill of a
physician or other qualified healthcare professional, newborn
36460 Transfusion, intrauterine, fetal
36468 Injection(s) of sclerosant for spider veins (telangiectasia); limb or trunk
36470 Injection of sclerosant; single incompetent vein (other than telangiectasia)
36471 multiple incompetent veins (other than telangiectasia), same leg
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 (eg, great saphenous vein, accessory
saphenous vein)
36466 multiple incompetent truncal veins (eg, great saphenous vein, accessory
saphenous vein), same leg
36475 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging
guidance and monitoring, percutaneous, radiofrequency; first vein treated
36476 subsequent vein(s) treated in a single extremity, each through separate access sites
36478 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging
guidance and monitoring, percutaneous, laser; first vein treated
36479 subsequent vein(s) treated in a single extremity, each through separate access sites
36481 Percutaneous portal vein catheterization by any method
36500 Venous catheterization for selective organ blood sampling
36510 Catheterization of umbilical vein for diagnosis or therapy, newborn
36511 Therapeutic apheresis; for white blood cells
36512 for red blood cells
36513 for platelets
36514 for plasma pheresis
36516 with extracorporeal immunoadsorption, selective absorption or selective filtration
and plasma reinfusion
36522 Photopheresis, extracorporeal
7.1.2.15.4 CENTRAL VENOUS ACCESS PROCEDURES
7.1.2.15.5 INSERTION OF CENTRAL VENOUS ACCESS DEVICE
36555 Insertion of non-tunneled centrally inserted central venous catheter; under 5 years of age
36556 age 5 years or older
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36557 Insertion of tunneled centrally inserted central venous catheter, without subcutaneous
port or pump; under 5 years of age
36558 age 5 years or older
36560 Insertion of tunneled centrally inserted central venous access device, with subcutaneous
port; under 5 years of age
36561 age 5 years or older
36563 Insertion of tunneled centrally inserted central venous access device with subcutaneous
pump
36565 Insertion of tunneled centrally inserted central venous access device, requiring two
catheters via two separate venous access sites; without subcutaneous port or pump (eg,
Tesio type catheter)
36566 with subcutaneous port(s)
36568 Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous
port or pump, without imaging guidance; younger than 5 years of age
36569 age 5 years or older
36572 Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous
port or pump, including all imaging guidance, image documentation, and all associated
radiological supervision and interpretation required to perform the insertion; younger
than 5 years of age
36573 age 5 years or older
36570 Insertion of peripherally inserted central venous access device, with subcutaneous port;
younger than 5 years of age
36571 age 5 years or older
7.1.2.15.6 REPAIR OF CENTRAL VENOUS ACCESS DEVICE
36575 Repair of tunneled or non-tunneled central venous access catheter, without
subcutaneous port or pump, central or peripheral insertion site
36576 Repair of central venous access device, with subcutaneous port or pump, central or
peripheral insertion site
7.1.2.15.7 PARTIAL REPLACEMENT OF CENTRAL VENOUS ACCESS DEVICE (CATHETER ONLY)
36578 Replacement, catheter only, of central venous access device, with subcutaneous port or
pump, central or peripheral insertion site
7.1.2.15.8 COMPLETE REPLACEMENT OF CENTRAL VENOUS ACCESS DEVICE THROUGH SAME
VENOUS ACCESS SITE
36580 Replacement, complete, of a non-tunneled centrally inserted central venous catheter,
without subcutaneous port or pump, through same venous access
36581 Replacement, complete, of a tunneled centrally inserted central venous catheter, without
subcutaneous port or pump, through same venous access
36582 Replacement, complete, of a tunneled centrally inserted central venous access device,
with subcutaneous port, through same venous access
36583 Replacement, complete, of a tunneled centrally inserted central venous access device,
with subcutaneous pump, through same venous access
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36584 Replacement, complete, of a peripherally inserted central venous catheter (PICC), without
subcutaneous port or pump, through same venous access, including all imaging
guidance, image documentation, and all associated radiological supervision and
interpretration required to perform the replacement
36585 Replacement, complete, of a peripherally inserted central venous access device, with
subcutaneous port, through same venous access
7.1.2.15.9 REMOVAL OF CENTRAL VENOUS ACCESS DEVICE
36589 Removal of tunneled central venous catheter, without subcutaneous port or pump
36590 Removal of tunneled central venous access device, with subcutaneous port or pump,
central or peripheral insertion
7.1.2.15.10 OTHER CENTRAL VENOUS ACCESS PROCEDURES
36591 Collection of blood specimen from a completely implantable venous access device
36593 Declotting by thrombolytic agent of implanted vascular access device or catheter
36595 Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central
venous device via separate venous access
36596 Mechanical removal of intraluminal (intracatheter) obstructive material from central
venous device through device lumen
36597 Repositioning of previously placed central venous catheter under fluoroscopic guidance
36598 Contrast injection(s) for radiologic evaluation of existing central venous access device,
including fluoroscopy, image documentation and report
7.1.2.16 ARTERIAL
36600 Arterial puncture, withdrawal of blood for diagnosis
36620 Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate
procedure); percutaneous
36625 cutdown
36640 Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown
36660 Catheterization, umbilical artery, newborn, for diagnosis or therapy
7.1.2.17 INTRAOSSEOUS
36680 Placement of needle for intraosseous infusion
7.1.2.18 HEMODIALYSIS ACCESS, INTERVASCULAR CANNULIZATION FOR EXTRACORPOREAL
CIRCULATION, OR SHUNT INSERTION
36800 Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein
36810 arteriovenous, external (Scribner type)
36815 arteriovenous, external revision or closure
36818 Arteriovenous anastomosis, open; by upper arm cephalic vein transposition
36819 by upper arm basilic vein transposition
36820 by forearm vein transposition
36821 direct, any site (eg. Cimino type) (separate procedure)
36823 Insertion of arterial and venous cannula(s) for isolated extracorporeal circulation including
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regional chemotherapy perfusion to an extremity, with or without hyperthermia, with
removal of cannula(s) and repair of arteriotomy and venotomy sites
(36823 includes chemotherapy perfusion supported by a membrane
oxygenator/perfusion pump.
36825 Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate
procedure); autogenous graft
36830 nonautogenous graft (eg, biological collagen, thermoplastic graft)
36831 Thrombectomy, open, arteriovenous fistula without revision, autogenous or non-
autogenous dialysis graft (separate procedure)
36832 Revision, open, arteriovenous fistula; without thrombectomy, autogenous or non-
autogenous dialysis graft (separate procedure)
36833 with thrombectomy, autogenous or nonautogenous dialysis graft (separate
procedure)
36835 Insertion of Thomas shunt (separate procedure)
36836 Percutaneous arteriovenous fistula creation, upper extremity, single access of both the
peripheral artery and peripheral vein, including fistula maturation procedures (eg,
transluminal balloon angioplasty, coil embolization) when performed, including all
vascular access, imaging guidance and radiologic supervision and interpretation
36837 Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the
peripheral vein, including fistula maturation procedures (eg, transluminal balloon
angioplasty, coil embolization) when performed, including all vascular access, imaging
guidance and radiologic supervision and interpretation
36838 Distal revascularization and interval ligation (DRIL), upper extremity hemodialysis access
(steal syndrome)
36860 External cannula declotting (separate procedure); without balloon catheter
36861 with balloon catheter
7.1.2.19 DIALYSIS CIRCUIT
36901 Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography
of the dialysis cicuit, including all direct puncture(s) and catheter placement(s), injection(s)
of contrast, all necessary imaging from the arterial anastomosis and adjacent artery
through entire venous outflow including the inferior or superior vena cava, fluoroscopic
guidance, radiological supervision and interpretation and image documentation and
report;
36902 with transluminal balloon angioplasty, peripheral dialysis segment, including all
imaging and radiological supervision and interpretation necessary to perform the
angioplasty
36903 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 segment
36904 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);
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36905 with transluminal balloon angioplasty, peripheral dialysis segment, including all
imaging and radiological supervision and interpretation necessary to perform the
angioplasty
36906 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 segment
36907 Transluminal balloon angioplasty, central dialysis segment, performed though dialysis
circuit, including all imaging and radiological supervision and interpretation required
to perform the angioplasty
36908 Transcatheter placement of intravascular stent(s), central dialysis segment, performed
through dialysis circuit, including all imaging and radiological supervision and
interpretation
required to perform the stenting, and all angioplasty in the central dialysis segment
36909 Dialysis cicuit permanent vascular embolization or occlusion (including main circuit
or any accessory veins), endovascular, including all imaging and radiological
supervision and interpretation necessary to complete the intervention
7.1.2.20 PORTAL DECOMPRESSION PROCEDURES
37140 Venous anastomosis, open; portocaval
37145 renoportal
37160 caval mesenteric
37180 splenorenal, proximal
37181 splenorenal, distal (selective decompression of esophagogastric varices, any
technique)
37182 Insertion of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes venous
access, hepatic and portal vein catheterization, portography with hemodynamic
evaluation, intrahepatic tract formation/dilatation, stent placement and all associated
imaging guidance and documentation
37183 Revision of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes venous
access, hepatic and portal vein catheterization, portography with hemodynamic
evaluation, intrahepatic tract recanulization/dilation, stent placement and all associated
imaging guidance and documentation)
7.1.2.21 TRANSCATHETER PROCEDURES
7.1.2.21.1 ARTERIAL MECHANICAL THROMBECTOMY
37184 Primary percutaneous transluminal mechanical thrombectomy, noncoronary, arterial or
arterial bypass graft, including fluoroscopic guidance and intraprocedural
pharmacological thrombolytic injection(s); initial vessel
37185 second and all subsequent vessel(s) within the same vascular family
37186 Secondary percutaneous transluminal thrombectomy (eg, nonprimary mechanical, snare
basket, suction technique), noncoronary, arterial or arterial bypass graft, including
fluoroscopic guidance and intraprocedural pharmacological thrombolytic injections,
provided in conjunction with another percutaneous intervention other than primary
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mechanical thrombectomy
7.1.2.21.2 VENOUS MECHANICAL THROMBECTOMY
37187 Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural
pharmacological thrombolytic injections and fluoroscopic guidance
37188 Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural
pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on
subsequent day during course of thrombolytic therapy
7.1.2.21.3 OTHER PROCEDURES
37191 Insertion of intravascular vena cava filter, endovascular approach including vascular
access, vessel selection, and radiological supervision and interpretation, intraprocedural
roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed
37192 Repositioning of intravascular vena cava filter, endovascular approach including vascular
access, vessel selection, and radiological supervision and interpretation, intraprocedural
roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed
37193 Retrieval (removal) of intravascular vena cava filter, endovascular approach including
vascular access, vessel selection, and radiological supervision and interpretation,
intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when
performed
37195 Thrombolysis, cerebral, by intravenous infusion
37197 Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous
or arterial catheter), includes radiological supervision and interpretation, and imaging
guidance (ultrasound or fluoroscopy), when performed
37200 Transcatheter biopsy
37211 Transcatheter therapy, arterial infusion for thrombolysis other than coronary, any method,
including radiological supervision and interpretation, initial treatment day
37212 Transcatheter therapy, venous infusion for thrombolysis, any method, including
radiological supervision and interpretation, initial treatment day
37213 Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary,
any method, including radiological supervision and interpretation, continued treatment
on subsequent day during course of thrombolytic therapy, including follow-up catheter
contrast injection, position change, or exchange, when performed;
37214 cessation of thrombolysis including removal of catheter and vessel closure by any
method
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 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
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carotid artery or innominate artery, open or percutaneous antegrade
approach, including angioplasty, when performed, and radiological
supervision and interpretation
7.1.2.22 ENDOVASCULARE REVASCULARIZATION (OPEN OR PERCUTANEOUS, TRANSCATHETER)
37220 Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial
vessel; with transluminal angioplasty
37221 with transluminal stent placement(s), includes angioplasty within same vessel, when
performed
37222 Revascularization, endovascular, open or percutaneous, iliac artery, each additional
ipsilateral iliac vessel; with transluminal angioplasty
37223 with transluminal stent placement(s), includes angioplasty within the same vessel,
when performed
37224 Revascularization, endovascular, open or percutaneous, femoral/popliteal artery(s),
unilateral; with transluminal angioplasty
37225 with atherectomy, includes angioplasty within the same vessel, when performed
37226 with transluminal stent placement(s), includes angioplasty within the same vessel,
when performed
37227 with transluminal stent placement(s), and atherectomy, includes angioplasty within
the same vessel, when performed
37228 Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral,
initial vessel; with transluminal angioplasty
37229 with atherectomy, includes angioplasty within the same vessel, when performed
37230 with transluminal stent placement(s), includes angioplasty within the same vessel,
when performed
37231 with transluminal stent placement(s) and atherectomy, includes angioplasty within
the same vessel, when performed
37232 Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral,
each additional vessel; with transluminal angioplasty
37233 with atherectomy, includes angioplasty within the same vessel, when performed
37234 with transluminal stent placement(s), includes angioplasty within the same vessel,
when performed
37235 with transluminal stent placement(s) and atherectomy, includes angioplasty within
the same vessel, when performed
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 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 each additional vein (List separately in addition to code for primary procedure)
37236 Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for
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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 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 all angioplasty within the same
vessel, when performed; initial vein
37239 each additional vein (List separately in addition to code for primary procedure)
7.1.2.23 VASCULAR EMBOLIZATION AND OCCLUSION
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 (eg, congenital or acquired
venous malformations, venous and capillary hemangiomas, varices, varicoceles).
37242 arterial, other than hemorrhage or tumor (eg, congenital or acquired arterial
malformations, arteriovenous malformations, arteriovenous fistulas, aneurysms,
pseudoaneurysms)
37243 for tumors, organ ischemia, of infarction
37244 for arterial of venous hemorrhage or lymphatic extravasation
7.1.2.24 INTRAVASCULAR ULTRASOUND SERVICES
37252 Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or
therapeutic intervention, including radiological supervision and interpretation; initial
vessel noncoronary vessel
37253 each additional noncoronary vessel
7.1.2.25 ENDOSCOPY
37500 Vascular endoscopy, surgical, with ligation of perforator veins, subfascial (SEPS)
37501 Unlisted vascular endoscopy procedure
7.1.2.26 LIGATION
37565 Ligation, internal jugular vein
37600 Ligation; external carotid artery
37605 internal or common carotid artery
37606 internal or common carotid artery, with gradual occlusion, as with Selverstone or
Crutchfield clamp
37607 Ligation or banding of angioaccess arteriovenous fistula
37609 Ligation or biopsy, temporal artery
37615 Ligation, major artery (eg, post-traumatic, rupture); neck
37616 chest
37617 abdomen
37618 extremity
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37619 Ligation of inferior vena cava
37650 Ligation of femoral vein
37660 Ligation of common iliac vein
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 more than 20 incisions
37780 Ligation and division of short saphenous vein at saphenopopliteal junction (separate
procedure)
37785 Ligation, division, and/or excision of recurrent or secondary varicose veins (clusters), one
leg
7.1.2.27 OTHER PROCEDURES
37788 Penile revascularization, artery, with or without vein graft
37790 Penile venous occlusive procedure
37799 Unlisted procedure, vascular surgery
7.2 HEMIC AND LYMPHATIC SYSTEMS
7.2.1 SPLEEN
7.2.1.1 EXCISION
38100 Splenectomy; total (separate procedure)
38101 partial
38102 total, en bloc for extensive disease, in conjunction with other procedure
7.2.1.2 REPAIR
38115 Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy
7.2.1.3 LAPAROSCOPY
38120 Laparoscopy, surgical, splenectomy
38129 Unlisted laparoscopy procedure, spleen
7.2.1.4 INTRODUCTION
38200 Injection procedure for splenoportography
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7.2.2 GENERAL
7.2.2.1 BONE MARROW OR STEM CELL SERVICES/PROCEDURES
38220 Diagnostic bone marrow; aspiration(s)
38221 biopsy(ies)
38222 biopsy(ies) and aspiration(s)
38230 Bone marrow harvesting for transplantation; allogeneic
38232 autologous
38240 Hematopoietic progenitor cell (HPC); allogenic transplantation per donor
38241 autologous transplantation
38242 Allogeneic lymphocyte infusions
38243 Hematopoietic progenitor cell (HPC); HPC boost
7.2.3 LYMPH NODES AND LYMPHATIC CHANNELS
7.2.3.1 INCISION
38300 Drainage of lymph node abscess or lymphadenitis; simple
38305 extensive
38308 Lymphangiotomy or other operations on lymphatic channels
38380 Suture and/or ligation of thoracic duct; cervical approach
38381 thoracic approach
38382 abdominal approach
7.2.3.2 EXCISION
38500 Biopsy or excision of lymph node(s); open, superficial
38505 by needle, superficial (eg, cervical, inguinal, axillary)
38510 open, deep cervical node(s)
38520 open, deep cervical node(s) with excision scalene fat pad
38525 open, deep axillary node(s)
38530 open, internal mammary node(s) (separate procedure)
38531 open, inguinofemoral node(s)
38542 Dissection, deep jugular node(s)
38550 Excision of cystic hydromel, axillary or cervical; without deep neurovascular dissection
38555 with deep neurovascular dissection
7.2.3.3 LIMITED LYMPHADENECTOMY FOR STAGING
38562 Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic
38564 retroperitoneal (aortic and/or splenic)
7.2.3.4 LAPAROSCOPY
38570 Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or
multiple
38571 with bilateral total pelvic lymphadenectomy
38572 with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling
(biopsy) single or multiple
38573 with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling,
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peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic
washings, including diaphragmatic and other serosal biopsy(ies), when performed
38589 Unlisted laparoscopy procedure, lymphatic system
7.2.3.5 RADICAL LYMPHADENECTOMY (RADICAL RESECTION OF LYMPH NODES)
38700 Suprahyoid lymphadenectomy
38720 Cervical lymphadenectomy (complete)
38724 Cervical lymphadenectomy (modified radical neck dissection)
38740 Axillary lymphadenectomy; superficial
38745 complete
38746 Thoracic lymphadenectomy by thoracotomy, mediastinal and regional lymphadenectomy
38747 Abdominal lymphadenectomy, regional, including celiac, gastric, portal, peripancreatic,
with or without para aortic and vena caval nodes
38760 Inguinofemoral lymphadenectomy, superficial, including Cloquets node (separate
procedure)
38765 Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic
lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate
procedure)
38770 Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes
(separate procedure)
38780 Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and
renal nodes (separate procedure)
7.2.3.6 INTRODUCTION
38790 Injection procedure; lymphangiography
38792 radioactive tracer for identification of sentinel node
38794 Cannulation, thoracic duct
7.2.3.7 OTHER PROCEDURES
38900 Intraoperative identification (eg, mapping) of sentinel lymph node(s), includes injection of
non-radioactive dye, when performed
38999 Unlisted procedure, hemic or lymphatic system
7.3 MEDIASTINUM AND DIAPHRAGM
7.3.1 MEDIASTINUM
7.3.1.1 INCISION
39000 Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical
approach
39010 transthoracic approach, including either transthoracic or median sternotomy
7.3.1.2 EXCISION/RESECTION
39200 Resection of mediastinal cyst
39220 Resection of mediastinal tumor
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7.3.1.3 ENDOSCOPY
39401 Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma),when
performed
39402 with lymph node biopsy(ies) (eg, lung cancer staging)
7.3.1.4 OTHER PROCEDURES
39499 Unlisted procedure, mediastinum
7.3.2 DIAPHRAGM
7.3.2.1 REPAIR
39501 Repair, laceration of diaphragm, any approach
39503 Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or
without creation of ventral hernia
39540 Repair, diaphragmatic hernia (other than neonatal), traumatic; acute
39541 chronic
39545 Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or
nonparalytic
39560 Resection, diaphragm, with simple repair (eg, primary suture)
39561 with complex repair (eg, prosthetic material, local muscle flap)
7.3.2.2 OTHER PROCEDURES
39599 Unlisted procedure, diaphragm
8 DIGESTIVE SERVICES
8.1 DIGESTIVE SYSTEM
8.1.1 LIPS
8.1.1.1 EXCISION
40490 Biopsy of lip
40500 Vermilionectomy (lip shave), with mucosal advancement
40510 Excision of lip; transverse wedge excision with primary closure
40520 V-excision with primary direct linear closure
40525 full thickness, reconstruction with local flap (eg, Estlander or fan)
40527 full thickness, reconstruction with cross lip flap (Abbe-Estlander)
40530 Resection lip, more than one-fourth, without reconstruction
8.1.1.2 REPAIR (CHEILOPLASTY)
40650 Repair lip, full thickness; vermilion only
40652 up to half vertical height
40654 over one-half vertical height, or complex
40700 Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral
40701 primary bilateral, one stage procedure
40702 primary bilateral, one of two stages
40720 secondary, by recreation of defect and reclosure
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40761 with cross lip pedicle flap (Abbe-Estlander type), including sectioning and inserting
of pedicle
8.1.1.3 OTHER PROCEDURES
40799 Unlisted procedure, lips
8.1.2 VESTIBULE OF MOUTH
8.1.2.1 INCISION
40800 Drainage of abscess, cyst, hematoma, vestibule of mouth; simple
40801 complicated
40804 Removal of embedded foreign body; vestibule of mouth; simple
40805 complicated
40806 Incision of labial frenum (frenotomy)
8.1.2.2 EXCISION, DESTRUCTION
40808 Biopsy, vestibule of mouth
40810 Excision of lesion of mucosa and submucosa vestibule of mouth; without repair
40812 with simple repair
40814 with complex repair
40816 complex with excision of underlying muscle
40818 Excision of mucosa of vestibule of mouth as donor graft
40819 Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy)
40820 Destruction of lesion or scar by physical methods (eg, laser, thermal, cryo, chemical)
8.1.2.3 REPAIR
40830 Closure of laceration, vestibule of mouth; 2.5 cm or less
40831 over 2.5 cm or complex
40840 Vestibuloplasty; anterior
40842 posterior, unilateral
40843 posterior, bilateral
40844 entire arch
40845 complex (including ridge extension, muscle repositioning)
8.1.2.4 OTHER PROCEDURES
40899 Unlisted procedure, vestibule of mouth
8.1.3 TONGUE AND FLOOR OF MOUTH
8.1.3.1 INCISION
41000 Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of
mouth; lingual
41005 sublingual, superficial
41006 sublingual, deep, supramylohyoid
41007 submental space
41008 submandibular space
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41009 masticator space
41010 Incision of lingual frenum (frenotomy)
41015 Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth;
sublingual
41016 submental
41017 submandibular
41018 masticator space
41019 Placement of needles, catheters, or other device(s) into the head and/or neck region
(percutaneous, transoral, or transnasal) for subsequent interstitial radioelement
application
8.1.3.2 EXCISION
41100 Biopsy of tongue; anterior two-thirds
41105 posterior one-third
41108 Biopsy of floor of mouth
41110 Excision of lesion of tongue without closure
41112 Excision of lesion of tongue with closure; anterior two-thirds
41113 posterior one-third
41114 with local tongue flap
41115 Excision of lingual frenum (frenectomy)
41116 Excision, lesion of floor of mouth
41120 Glossectomy; less than one-half tongue
41130 hemiglossectomy
41135 partial, with unilateral radical neck dissection
41140 complete or total, with or without tracheostomy, without radical neck dissection
41145 complete or total, with or without tracheostomy, with unilateral radical neck
dissection
41150 composite procedure with resection floor of mouth and mandibular resection,
without radical neck dissection
41153 composite procedure with resection floor of mouth, with suprahyoid neck
dissection
41155 composite procedure with resection floor of mouth, mandibular resection, and
radical neck dissection (Commando type)
8.1.3.3 REPAIR
41250 Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue
41251 posterior one-third of tongue
41252 Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex
8.1.3.4 OTHER PROCEDURES
41510 Suture of tongue to lip for micrognathia (Douglas type procedure)
41512 Tongue base suspension, permanent suture technique
41520 Frenoplasty (surgical revision of frenum, eg, with Z-plasty)
41530 Submucosal ablation of the tongue base, radiofrequency, one or more sites, per session
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41599 Unlisted procedure, tongue, floor of mouth
8.1.4 DENTOALVEOLAR STRUCTURES
8.1.4.1 INCISION
41800 Drainage of abscess, cyst, hematoma from dentoalveolar structures
41805 Removal of embedded foreign body from dentoalveolar structures; soft tissues
41806 bone
8.1.4.2 EXCISION, DESTRUCTION
41820 Gingivectomy, excision gingiva, each quadrant
41821 Operculectomy, excision pericoronal tissues
41822 Excision of fibrous tuberosities, dentoalveolar structures
41823 Excision of osseous tuberosities, dentoalveolar structures
41825 Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair
41826 with simple repair
41827 with complex repair
41828 Excision of hyperplastic alveolar mucosa, each quadrant (specify)
41830 Alveolectomy, including curettage of osteitis or sequestrectomy
41850 Destruction of lesion (except excision), dentoalveolar structures
8.1.4.3 OTHER PROCEDURES
41870 Periodontal mucosal grafting
41872 Gingivoplasty, each quadrant (specify)
41874 Alveoloplasty each quadrant (specify)
41899 Unlisted procedure, dentoalveolar structures
8.1.5 PALATE AND UVULA
8.1.5.1 INCISION
42000 Drainage of abscess of palate, uvula
8.1.5.2 EXCISION, DESTRUCTION
42100 Biopsy of palate, uvula
42104 Excision, lesion of palate, uvula; without closure
42106 with simple primary closure
42107 with local flap closure
42120 Resection of palate or extensive resection of lesion
42140 Uvulectomy, excision of uvula
42145 Palatopharyngoplasty eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)
42160 Destruction of lesion, palate or uvula (thermal, cryo or chemical)
8.1.5.3 REPAIR
42180 Repair, laceration of palate; up to 2 cm
42182 over 2 cm or complex
42200 Palatoplasty for cleft palate, soft and/or hard palate only
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42205 Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only
42210 with bone graft to alveolar ridge (includes obtaining graft)
42215 Palatoplasty for cleft palate; major revision
42220 secondary lengthening procedure
42225 attachment pharyngeal flap
42226 Lengthening of palate, and pharyngeal flap
42227 Lengthening of palate, with island flap
42235 Repair of anterior palate, including vomer flap
42260 Repair of nasolabial fistula
8.1.5.4 OTHER PROCEDURES
42299 Unlisted procedure, palate, uvula
8.1.6 SALIVARY GLANDS AND DUCTS
8.1.6.1 INCISION
42300 Drainage of abscess; parotid, simple
42305 parotid, complicated
42310 submaxillary or sublingual, intraoral
42320 submaxillary, external
42330 Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated,
intraoral
42335 submandibular (submaxillary), complicated, intraoral
42340 parotid, extraoral or complicated intraoral
8.1.6.2 EXCISION
42400 Biopsy of salivary gland; needle
42405 incisional
42408 Excision of sublingual salivary cyst (ranula)
42409 Marsupialization of sublingual salivary cyst (ranula)
42410 Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection
42415 lateral lobe, with dissection and preservation of facial nerve
42420 total, with dissection and preservation of facial nerve
42425 total, en bloc removal with sacrifice of facial nerve
42426 total, with unilateral radical neck dissection
42440 Excision of submandibular (submaxillary) gland
42450 Excision of sublingual gland
8.1.6.3 REPAIR
42500 Plastic repair of salivary duct, sialodochoplasty; primary or simple
42505 secondary or complicated
42507 Parotid duct diversion, bilateral (Wilke type procedure);
42509 with excision of both submandibular glands
42510 with ligation of both submandibular (Wharton's) ducts
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8.1.6.4 OTHER PROCEDURES
42550 Injection procedure for sialography
42600 Closure salivary fistula
42650 Dilation salivary duct
42660 Dilation and catheterization of salivary duct, with or without injection
42665 Ligation salivary duct, intraoral
42699 Unlisted procedure, salivary glands or ducts
8.1.7 PHARYNX, ADENOIDS, AND TONSILS
8.1.7.1 INCISION
42700 Incision and drainage abscess; peritonsillar
42720 retropharyngeal or parapharyngeal, intraoral approach
42725 retropharyngeal or parapharyngeal, external approach
8.1.7.2 EXCISION, DESTRUCTION
42800 Biopsy; oropharynx
42804 nasopharynx, visible lesion, simple
42806 nasopharynx, survey for unknown primary lesion
42808 Excision or destruction of lesion of pharynx, any method
42809 Removal of foreign body from pharynx
42810 Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues
42815 Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues
and/or into pharynx
42820 Tonsillectomy and adenoidectomy; under age 12
42821 age 12 or over
42825 Tonsillectomy, primary or secondary; under age 12
42826 age 12 or over
42830 Adenoidectomy, primary; under age 12
42831 age 12 or over
42835 Adenoidectomy, secondary; under age 12
42836 age 12 or over
42842 Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure
42844 closure with local flap (eg, tongue, buccal)
42845 closure with other flap
42860 Excision of tonsil tags
42870 Excision or destruction lingual tonsil, any method (separate procedure)
42890 Limited pharyngectomy
42892 Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of
lateral and posterior pharyngeal walls
42894 Resection of pharyngeal wall requiring closure with myocutaneous or fasciocutaneous
flap or free muscle, skin, or fascial flap with microvascular anastamosis
8.1.7.3 REPAIR
42900 Suture pharynx for wound or injury
Physician - Surgery
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42950 Pharyngoplasty (plastic or reconstructive operation on pharynx)
42953 Pharyngoesophageal repair
8.1.7.4 OTHER PROCEDURES
42955 Pharyngostomy (fistulization of pharynx, external for feeding)
42960 Control oropharyngeal hemorrhage primary or secondary (eg, post-tonsillectomy); simple
42961 complicated, requiring hospitalization
42962 with secondary surgical intervention
42970 Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy);
simple, with posterior nasal packs, with or without anterior packs and/or cautery
42971 complicated, requiring hospitalization
42972 with secondary surgical intervention
42975 Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base,
and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic
42999 Unlisted procedure, pharynx, adenoids, or tonsils
8.1.8 ESOPHAGUS
8.1.8.1 INCISION
43020 Esophagotomy, cervical approach, with removal of foreign body
43030 Cricopharyngeal myotomy
43045 Esophagotomy, thoracic approach, with removal of foreign body
8.1.8.2 EXCISION
43100 Excision of lesion, esophagus, with primary repair; cervical approach
43101 thoracic or abdominal approach
43107 Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or
cervical esophagogastrostomy, with or without pyloroplasty (transhiatal)
43108 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 (ie, McKeown
esophagectomy or tri-incisional esophagectomy)
43113 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 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
Physician - Surgery
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proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty
43123 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 thoracic approach
8.1.8.3 ENDOSCOPY
8.1.8.3.1 ESOPHAGOSCOPY
43180 Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx
or cervical esophagus (eg, Zenker’s diverticulum), with cricopharyngeal
myotomy, includes use of telescope or operating microscope and repair,
when performed
43191 Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by
brushing or washing when performed (separate procedure)
43192 with directed submucosal injection(s), any substance
43193 with biopsy, single or multiple
43194 with removal of foreign body(s)
43195 with balloon dilation (less than 30 mm diameter)
43196 with insertion of guide wire followed by dilation over guide wire
43197 Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by
brushing or washing, when performed (separate procedure)
43198 with biopsy, single or multiple
43200 Esophagoscopy, flexible; transoral; diagnostic, including collection of specimen(s) by
brushing or washing, when performed (separate procedure)
43201 with directed submucosal injection(s), any substance
43202 with biopsy, single or multiple
43204 with injection sclerosis of esophageal varices
43205 with band ligation of esophageal varices
43206 with optical endomicroscopy
43215 with removal of foreign body(s)
43216 with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
43217 with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
43211 with endoscopic mucosal resection
43212 with placement of endoscopic stent (includes pre and post-dilation and guide wire
passage, when performed)
43220 with transendoscopic balloon dilation (less than 30 mm diameter)
43213 with dilation of esophagus by balloon or dilator, retrograde (includes fluoroscopic
guidance, when performed)
43214 with dilation of esophagus with balloon (30 mm diameter or larger) (includes
fluoroscopic guidance, when performed)
43226 with insertion of guide wire followed by passage of dilator(s) over guide wire
Physician - Surgery
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43227 with control of bleeding, any method
43229 with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre and post-dilation
and guide wire passage, when performed)
43231 with endoscopic ultrasound examination
43232 with transendoscopic ultrasound-guided intramural or transmural fine needle
aspiration/biopsy(s)
8.1.8.3.2 ESOPHAGOGASTRODUODENOSCOPY
43235 Esophogastroduodenoscopy, flexible, transoral; diagnostic, including collection of
specimen(s) by brushing or washing, when performed (separate procedure)
43236 with directed submucosal injection(s), any substance
43237 with endoscopic ultrasound examination limited to the esophagus, stomach or
duodenum and adjacent structures
43238 with transendoscopic ultrasound-guided intramural or transmural fine needle
aspiration/biopsy(s), esophagus (includes endoscopic ultrasound examination
limited to the esophagus, stomach or duodenum, and adjacent structures)
43239 with biopsy, single or multiple
43240 with transmural drainage of pseudocyst (includes placement of transmural drainage
catheter[s]/stent[s], when performed and endoscopic ultrasound, when performed)
43241 with insertion of intraluminal tube or catheter
43242 with transendoscopic ultrasound-guided intramural or transmural fine needle
aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus,
stomach, and either the duodenum or a surgically altered stomach where the
jejunum is examined distal to the anastamosis)
43243 with injection sclerosis of esophageal gastric varices
43244 with band ligation of esophageal gastric varices
43245 with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie)
43246 with directed placement of percutaneous gastrostomy tube
43247 with removal of foreign body(s)
43290 with deployment of intragastric bariatric balloon
43291 with removal of intragastric bariatric balloon(s)
43248 with insertion of guide wire followed by passage of dilator(s) through esophagus
over guide wire
43249 with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)
43233 with dilation of esophagus with balloon (30 mm diameter or larger) (includes
fluoroscopic guidance, when performed)
43250 with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
43251 with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
43252 with optical endomicroscopy
43253 with transendoscopic ultrasound-guided transmural injection or diagnostic or
therapeutic substances(s) (eg, anesthetic, neurolytic agent) or fiducial marker(s)
(includes endoscopic ultrasound examination of the esophogus, stomach and either
the duodenum or a surgically altered stomach where the jejunum is examined distal
to the anastomosis)
Physician - Surgery
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43254 with endoscopic mucosal resection
43255 with control of bleeding, any method
43266 with placement of endoscopic stent (includes pre- and post-dilation and guide wire
passage, when performed)
43270 with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation
and guide wire passage, when performed)
43259 with endoscopic ultrasound examination, including the esophagus, stomach, and
either the duodenum or a surgically altered stomach where the jejunum is
examined distal to the anastomosis
43210 with esophagogastric fundoplasty, partial or complete, includes duodenoscopy
when performed
8.1.8.3.3 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)
43260 Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, including collection
of specimen(s) by brushing or washing, when performed (separate procedure)
43261 with biopsy, single or multiple
43262 with sphincterotomy/papillotomy
43263 with pressure measurement of sphincter of Oddi
43264 with removal of calculi/debris from biliary pancreatic duct(s)
43265 with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy)
43273 Endoscopic cannulation of papilla with direct visualization of pancreatic/common bile
duct(s) (List separately in addition to code(s) for primary procedure)
43274 with placement of endoscopic stent into biliary or pancreatic duct, including pre-
and post-dilation and guide wire passage, when performed, including
sphincterotomy, when performed, each stent
43275 with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s)
43276 with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and
post-dilation and guide wire passage, when performed, including sphincterotomy,
when performed, each stent exchanged
43277 with trans-endoscopic balloon dilation of biliary/pancreatic duct(s) or of ampulla
(sphincteroplasty) including sphincterotomy, when performed, each duct
43278 with ablation of tumor(s), polyp(s), or other lesion(s) including pre- and post-
dilation and guide wire passage, when performed
8.1.8.4 LAPAROSCOPY
43279 Laparoscopy, surgical, esophagomyotomy (Heller type), with fundoplasty, when
performed
43280 Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures)
43281 Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when
performed; without implantation of mesh
43282 with implantation of mesh
43283 Laparoscopy, surgical, esophageal lengthening procedure (eg, Collins gastroplasty or
wedge gastroplasty)
Physician - Surgery
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43286 Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and
mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage
procedure, if performed, with open cervical pharyngogastrostomy or
esophagogastrostomy
(ie, laparoscopic transhiatal esophagectomy)
43287 Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and
lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric
drainage procedure if performed, with separate thoracoscopic mobilization of the middle
and upper mediastinal esophagus and thoracic esophagogastrostomy (ie, laparoscopic
thoracoscopic esophagectomy, Ivor Lewis esophagectomy)
43288 Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle
and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with
laparoscopic pyloric drainage procedure if performed, with open cervical
pharyngogastrostomy or espophagogastrostomy (ie, thorascopic, laparoscopic and
cervical incision esophagectomy, McKeown esophagectomy, tri-incisional sophagectomy)
43289 Unlisted laparoscopy procedure, esophagus
8.1.8.5 REPAIR
43300 Esophagoplasty, (plastic repair or reconstruction), cervical approach; without repair of
tracheoesophageal fistula
43305 with repair of tracheoesophageal fistula
43310 Esophagoplasty, (plastic repair or reconstruction), thoracic approach; without repair of
tracheoesophageal fistula
43312 with repair of tracheoesophageal fistula
43313 Esophagoplasty for congenital defect, (plastic repair or reconstruction), thoracic
approach, without repair of congenital tracheoesophageal fistula
43314 with repair of congenital tracheoesophageal fistula
43320 Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty,
transabdominal or transthoracic approach
43325 Esophagogastric fundoplasty; with fundic patch (Thal-Nissen procedure)
43327 Esophagogastric fundoplasty partial or complete; laparotomy
43328 thoracotomy
43330 Esophagomyotomy (Heller type); abdominal approach
43331 thoracic approach
43332 Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except
neonatal; without implantation of mesh or other prosthesis
43333 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 with implantation of mesh or other prosthesis
43336 Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal
incision, except neonatal; without implantation of mesh or other prosthesis
43337 with implantation of mesh or other prosthesis
43338 Esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty)
Physician - Surgery
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43340 Esophagojejunostomy (without total gastrectomy); abdominal approach
43341 thoracic approach
43351 Esophagostomy, fistulization of esophagus, external; thoracic approach
43352 cervical approach
43360 Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal
lesion or fistula, or for previous esophageal exclusion; with stomach, with or without
pyloroplasty
43361 with colon interposition or small intestine reconstruction, including intestine
mobilization, preparation, and anastomosis(es)
43400 Ligation, direct, esophageal varices
43405 Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation
43410 Suture of esophageal wound or injury; cervical approach
43415 transthoracic or transabdominal approach
43420 Closure of esophagostomy or fistula; cervical approach
43425 transthoracic or transabdominal approach
8.1.8.6 MANIPULATION
43450 Dilation of esophagus; by unguided sound or bougie, single or multiple passes
43453 over guide wire
43460 Esophagogastric tamponade, with balloon (Sengstaken type)
8.1.8.7 OTHER PROCEDURES
43496 Free jejunum transfer with microvascular anastomosis
43497 Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [POEM])
43499 Unlisted procedure, esophagus
8.1.9 STOMACH
8.1.9.1 INCISION
43500 Gastrotomy; with exploration or foreign body removal
43501 with suture repair of bleeding ulcer
43502 with suture repair of pre-existing esophagogastric laceration (eg, Mallory-Weiss)
43510 with esophageal dilation and insertion of permanent intraluminal tube (eg, Celestin
or Mousseaux-Barbin)
43520 Pyloromyotomy, cutting of pyloric muscle (Fredet-Ramstedt type operation)
8.1.9.2 EXCISION
43605 Biopsy of stomach, by laparotomy
43610 Excision, local; ulcer or benign tumor of stomach
43611 malignant tumor of stomach
43620 Gastrectomy, total; with esophagoenterostomy
43621 with Roux-en-Y reconstruction
43622 with formation of intestinal pouch, any type
43631 Gastrectomy, partial, distal; with gastroduodenostomy
43632 with gastrojejunostomy
Physician - Surgery
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43633 with Roux-en-Y reconstruction
43634 with formation of intestinal pouch
43635 Vagotomy when performed with partial distal gastrectomy
43640 Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective
43641 parietal cell (highly selective)
8.1.9.3 LAPAROSCOPY
43644 Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y
gastroenterostomy (roux limb 150 cm or less)
43645 with gastric bypass and small intestine reconstruction to limit absorption
43647 Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes,
antrum
43648 revision or removal of gastric neurostimulator electrodes, antrum
43651 Laparoscopy, surgical; transection of vagus nerves, truncal
43652 transection of vagus nerves, selective or highly selective
43653 gastrostomy, without construction of gastric tube (eg, Stamm procedure) (separate
procedure)
43659 Unlisted laparoscopy procedure, stomach
8.1.9.4 INTRODUCTION
43752 Naso- or oro-gastric tube placement, requiring physician's skill and fluoroscopic guidance
(includes fluoroscopy, image documentation and report)
43753 Gastric intubation and aspiration(s) therapeutic, necessitating physician’s skill (eg, for
gastrointestinal hemorrhage), including lavage if performed
43754 Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis)
43755 collection of multiple fractional specimens with gastric stimulation, single or double
lumen tube (gastric secretory study) (eg, histamine, insulin, pentagastrin, calcium,
secretin), includes drug administration
43756 Duodenal intubation and aspiration, diagnostic, includes image guidance; single
specimen (eg, bile study for crystals or afferent loop culture)
43757 collection of multiple fractional specimens with pancreatic or gallbladder
stimulation, single or double lumen tube, includes drug administration
43761 Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric
nutrition
43762 Replacement of gastrostomy tube, percutaneous, includes removal, when performed,
without imaging or endoscopic guidance; not requiring revision of gastrostomy tract
43763 requiring revision of gastrostomy tract
8.1.9.5 BARIATRIC SURGERY
8.1.9.5.1 LAPAROSCOPY
43770 Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric
restrictive device (eg, gastric band and subcutaneous port components)
43771 revision of adjustable gastric restrictive device component only
43772 removal of adjustable gastric restrictive component only
Physician - Surgery
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Provider Procedure Codes Surgery
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43773 removal and replacement of adjustable gastric restrictive device component only
43774 removal of adjustable gastric restrictive device and subcutaneous port components
43775 longitudinal gastrectomy (ie, sleeve gastrectomy)
8.1.9.6 OTHER PROCEDURES
43800 Pyloroplasty
43810 Gastroduodenostomy
43820 Gastrojejunostomy; without vagotomy
43825 with vagotomy, any type
43830 Gastrostomy, open; without construction of gastric tube (eg, Stamm procedure) (separate
procedure)
43831 neonatal, for feeding
43832 with construction of gastric tube (eg, Janeway procedure)
43840 Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury
43842 Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded
gastroplasty
43843 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 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)
43860 Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or
without partial gastrectomy or intestine resection; without vagotomy
43865 with vagotomy
43870 Closure of gastrostomy, surgical
43880 Closure of gastrocolic fistula
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 removal of subcutaneous port component only
43888 removal and replacement of subcutaneous port component only
43999 Unlisted procedure, stomach
8.1.10 INTESTINES (EXCEPT RECTUM)
8.1.10.1 INCISION
44005 Enterolysis (freeing of intestinal adhesion) (separate procedure)
44010 Duodenotomy, for exploration, biopsy(s), or foreign body removal
44015 Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method
(List separately in addition to primary procedure)
Physician - Surgery
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Provider Procedure Codes Surgery
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44020 Enterotomy, small bowel, other than duodenum; for exploration, biopsy(s), or foreign
body removal
44021 for decompression (eg, Baker tube)
44025 Colotomy, for exploration, biopsy(s), or foreign body removal
44050 Reduction of volvulus, intussusception, internal hernia, by laparotomy
44055 Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus
(eg, Ladd procedure)
8.1.10.2 EXCISION
44100 Biopsy of intestine by capsule, tube, peroral (one or more specimens)
44110 Excision of one or more lesions of small or large intestine not requiring anastomosis,
exteriorization, or fistulization; single enterotomy
44111 multiple enterotomies
44120 Enterectomy, resection of small intestine; single resection and anastomosis
44121 each additional resection and anastomosis
44125 with enterostomy
44126 Enterectomy, resection of small intestine for congenital atresia, single resection and
anastomosis of proximal segment of intestine, without tapering
44127 with tapering
44128 each additional resection and anastomosis
44130 Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy
(separate procedure)
44133 Donor enterectomy, open, (with preparation and maintenance of allograft); partial, from
living donor
44135 Intestinal allotransplantation; from cadaver donor
44136 from living donor
44137 Removal of transplanted intestinal allograft, complete
44139 Mobilization (take-down) of splenic flexure performed in conjunction with partial
colectomy
44140 Colectomy, partial; with anastomosis
44141 with skin level cecostomy or colostomy
44143 with end colostomy and closure of distal segment (Hartmann type procedure)
44144 with resection, with colostomy or ileostomy and creation of mucofistula
44145 with coloproctostomy (low pelvic anastomosis)
44146 with coloproctostomy (low pelvic anastomosis), with colostomy
44147 abdominal and transanal approach
44150 Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy
44151 with continent ileostomy
44155 Colectomy, total, abdominal, with proctectomy; with ileostomy
44156 with continent ileostomy
44157 with ileoanal anastomosis, includes loop ileostomy, and rectal mucosectomy, when
performed
44158 with ileoanal anastomosis, creation of ileal reservoir (S or J), includes loop
ileostomy, and rectal mucosectomy, when performed
Physician - Surgery
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Provider Procedure Codes Surgery
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44160 Colectomy, partial, with removal of terminal ileum with ileocolostomy
8.1.10.3 LAPAROSCOPY
8.1.10.3.1 INCISION
44180 Laparoscopy, surgical; enterolysis (freeing of intestinal adhesion) (separate procedure)
8.1.10.3.2 ENTEROSTOMY-EXTERNAL FISTULIZATION OF INTESTINES
44186 Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding)
44187 ileostomy or jejunostomy, non-tube
44188 Laparoscopy, surgical, colostomy or skin level cecostomy
8.1.10.3.3 EXCISION
44202 Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and
anastomosis
44203 each additional small intestine resection and anastomosis
44204 colectomy, partial, with anastomosis
44205 colectomy, partial, with removal of terminal ileum with ileocolostomy
44206 colectomy, partial, with end colostomy and closure of distal segment (Hartmann
type procedure)
44207 colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)
44208 colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)
with colostomy
44210 colectomy, total, abdominal, without proctectomy, with ileostomy or
ileoproctostomy
44211 colectomy, total, abdominal, with proctectomy, with ileoanal anastomosis, creation
of ileal reservoir (S or J), with loop ileostomy, includes rectal mucosectomy, when
performed
44212 colectomy, total, abdominal, with proctectomy, with ileostomy
44213 Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in
conjunction with partial colectomy
8.1.10.3.4 REPAIR
44227 Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and
anastomosis
8.1.10.3.5 OTHER PROCEDURES
44238 Unlisted laparoscopy procedure, intestine (except rectum)
8.1.10.4 ENTEROSTOMY - EXTERNAL FISTULIZATION OF INTESTINES
44300 Placement, enterostomy, or cecostomy, tube open (eg, for feeding or decompression)
(separate procedure)
44310 Ileostomy or jejunostomy, non-tube
44312 Revision of ileostomy; simple (release of superficial scar) (separate procedure)
Physician - Surgery
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Provider Procedure Codes Surgery
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44314 complicated (reconstruction in depth) (separate procedure)
44316 Continent ileostomy (Kock procedure) (separate procedure)
44320 Colostomy or skin level cecostomy;
44322 with multiple biopsies (eg, for congenital megacolon) (separate procedure)
44340 Revision of colostomy; simple (release of superficial scar) (separate procedure)
44345 complicated (reconstruction in depth) (separate procedure)
44346 with repair of paracolostomy hernia (separate procedure)
8.1.10.5 ENDOSCOPY, SMALL INTESTINE AND STOMAL
44360 Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not
including ileum; diagnostic, including collection of specimen(s) by brushing or washing,
when performed (separate procedure)
44361 with biopsy, single or multiple
44363 with removal of foreign body(s)
44364 with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
44365 with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or
bipolar cautery
44366 with control of bleeding, (eg, injection, bipolar cautery, unipolar cautery, laser,
heater probe, stapler, plasma coagulator)
44369 with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by
hot biopsy forceps, bipolar cautery or snare technique
44370 with transendoscopic stent placement (includes predilation)
44372 with placement of percutaneous jejunostomy tube
44373 with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy
tube
44376 Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including
ileum; diagnostic, with or without collection of specimen(s) by brushing or washing
(separate procedure)
44377 with biopsy, single or multiple
44378 with control of bleeding, (eg, injection, bipolar cautery, unipolar cautery, laser,
heater probe, stapler, plasma coagulator)
44379 with transendoscopic stent placement (includes predilation)
8.1.10.6 ENDOSCOPY, STOMAL
44380 Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or
washing, when performed (separate procedure)
44382 with biopsy, single or multiple
44381 with transendoscopic balloon dilation
44384 with placement of endoscopic stent (includes pre- and post-
dilation and guide wire passage, when performed)
44385 Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]);
diagnostic, including collection of specimen(s) by brushing or washing, when performed
(separate procedure)
44386 with biopsy, single or multiple
Physician - Surgery
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44388 Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing
or washing, when performed (separate procedure)
44389 with biopsy, single or multiple
44390 with removal of foreign body(s)
44391 with control of bleeding, any method
44392 with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
44401 with ablation of tumor(s), polyp(s), or other lesions(s), (includes
pre- and post-dilation and guide wire passage, when performed)
44394 with removal of tumor(s), polyp(s), or other lesion(s) by snare techniques
44402 with endoscopic stent placement (including pre- and post-dilaton
and guide wire passage, when performed)
44403 with endoscopic mucosal resection
44404 with directed submucosal injection(s), any substance
44405 with transendoscopic balloon dilation
44406 with endoscopic ultrasound examination, limited to the sigmoid,
descending, transverse, or ascending colon and cecum and
adjacent structures
44407 with transendoscopic ultrasound guided intramural or transmural
fine needle aspiration/biopsy(s), includes endoscopic ultrasound
examination limited to the sigmoid, descending, transverse, or
ascending colon and cecum and adjacent structures
44408 with decompression (for pathologic distention) (eg, volvulus,
megacolon), including placement of decompression tube, when
performed
8.1.10.7 INTRODUCTION
44500 Introduction of long gastrointestinal tube (eg, Miller-Abbott) (separate procedure)
8.1.10.8 REPAIR
44602 Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury,
or rupture; single perforation
44603 multiple perforations
44604 Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or
rupture (single or multiple perforations); without colostomy
44605 with colostomy
44615 Intestinal stricturoplasty (enterotomy and enterorrhaphy) with or without dilation, for
intestinal obstruction
44620 Closure of enterostomy, large or small intestine;
44625 with resection and anastomosis other than colorectal
44626 with resection and colorectal anastomosis (eg, closure of Hartmann type procedure)
44640 Closure of intestinal cutaneous fistula
44650 Closure of enteroenteric or enterocolic fistula
44660 Closure of enterovesical fistula; without intestinal or bladder resection
44661 with intestine and/or bladder resection
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 142
44680 Intestinal plication (separate procedure)
8.1.10.9 OTHER PROCEDURES
44700 Exclusion of small intestine from pelvis by mesh or other prosthesis, or native tissue (eg,
bladder or omentum)
44701 Intraoperative colonic lavage
44799 Unlisted procedure, small intestine
8.1.11 MECKEL’S DIVERTICULUM AND THE MESENTERY
8.1.11.1 EXCISION
44800 Excision of Meckel's diverticulum (diverticulectomy) or omphalomesenteric duct
44820 Excision of lesion of mesentery (separate procedure)
8.1.11.2 SUTURE
44850 Suture of mesentery (separate procedure)
8.1.11.3 OTHER PROCEDURES
44899 Unlisted procedure, Meckel's diverticulum and the mesentery
8.1.12 APPENDIX
8.1.12.1 INCISION
44900 Incision and drainage of appendiceal abscess; open
8.1.12.2 EXCISION
44950 Appendectomy;
(Incidental appendectomy during intra-abdominal surgery does not warrant a separate
identification)
44955 when done for indicated purpose at time of other major procedure (not as separate
procedure)
44960 for ruptured appendix with abscess or generalized peritonitis
8.1.12.3 LAPAROSCOPY
44970 Laparoscopy, surgical, appendectomy
44979 Unlisted laparoscopy procedure, appendix
8.1.13 COLONG AND RECTUM
8.1.13.1 INCISION
45000 Transrectal drainage of pelvic abscess
45005 Incision and drainage of submucosal abscess, rectum
45020 Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess
8.1.13.2 EXCISION
45100 Biopsy of anorectal wall, anal approach (eg, congenital megacolon)
45108 Anorectal myomectomy
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 143
45110 Proctectomy; complete, combined abdominoperineal, with colostomy
45111 partial resection of rectum, transabdominal approach
45112 Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal
anastomosis)
45113 Proctectomy, partial, with rectal mucosectomy, ileoanal anastomosis, creation of ileal
reservoir (S or J), with or without loop ileostomy
45114 Proctectomy, partial, with anastomosis; abdominal and transsacral approach
45116 transsacral approach only (Kraske type)
45119 Proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal
anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting enterostomy
when performed
45120 Proctectomy, complete (for congenital megacolon), abdominal and perineal approach;
with pull through procedure and anastomosis (eg, Swenson, Duhamel, or Soave type
operation)
45121 with subtotal or total colectomy, with multiple biopsies
45123 Proctectomy, partial, without anastomosis, perineal approach
45126 Pelvic exenteration for colorectal malignancy, with proctectomy (with or without
colostomy), with removal of bladder and ureteral transplantations, and/or hysterectomy,
or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s),
or any combination thereof
45130 Excision of rectal procidentia, with anastomosis; perineal approach
45135 abdominal and perineal approach
45136 Excision of ileoanal reservoir with Ileostomy
45150 Division of stricture of rectum
45160 Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach
45171 Excision of rectal tumor, transanal approach; not including muscularis propria (ie, partial
thickness)
45172 including muscularis propria (ie, full thickness)
8.1.13.3 DESTRUCTION
45190 Destruction of rectal tumor, (eg, electrodesiccation, electrosurgery, laser ablation, laser
resection, cryosurgery) transanal approach
8.1.13.4 ENDOSCOPY
45300 Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by
brushing or washing (separate procedure)
45303 with dilation, (eg, balloon, guide wire, bougie)
45305 with biopsy, single or multiple
45307 with removal of foreign body
45308 with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar
cautery
45309 with removal of single tumor, polyp, or other lesion by snare technique
45315 with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps,
bipolar cautery or snare technique
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 144
45317 with control of bleeding, (eg, injection, bipolar cautery, unipolar cautery, laser,
heater probe, stapler, plasma coagulator)
45320 with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by
hot biopsy forceps, bipolar cautery or snare technique (eg, laser)
45321 with decompression of volvulus
45327 with transendoscopic stent placement (includes predilation)
45330 Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or
washing, when performed (separate procedure)
45331 with biopsy, single or multiple
45332 with removal of foreign body(s)
45333 with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
45334 with control of bleeding, any method
45335 with directed submucosal injection(s), any substance
45337 with decompression (for pathologic distention) (eg, volvulus,
megacolon), including placement of decompression tube when
performed
45338 with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
45346 with ablation of tumor(s), polyp(s), or other lesions(s), (includes
pre- and post-dilation and guide wire passage, when performed)
45340 with transendoscopic balloon dilation
45341 with endoscopic ultrasound examination
45342 with transendoscopic ultrasound guided intramural or transmural fine needle
aspiration/biopsy(s)
45347 with placement of endoscopic stent (includes pre- and post-dilation
and guide wire passage, when performed)
45349 with endoscopic mucosal resection
45350 with band ligation(s) (eg, hemorrhoids)
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing
or washing, when performed (separate procedure)
45379 with removal of foreign body(s)
45380 with biopsy, single or multiple
45381 with directed submucosal injection(s), any substance
45382 with control of bleeding, any method
45388 with ablation of tumor(s), polyp(s), or other lesions(s), (includes
pre- and post-dilation and guide wire passage, when performed)
45384 with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
45385 with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
45386 with transendoscopic balloon dilation
45389 with endoscopic stent placement (including pre- and post-dilaton
and guide wire passage, when performed)
45391 with endoscopic ultrasound examination limited to the rectum, sigmoid,
descending, transverse or ascending colon and cecum, and adjacent structures
45392 with transendoscopic ultrasound guided intramural or transmural fine needle
aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 145
rectum, sigmoid, descending, transverse, or ascending colon and cecum, and
adjacent structures
45390 with endoscopic mucosal resection
45393 with decompression (for pathologic distention) (eg, volvulus,
megacolon), including placement of decompression tube, when
performed
45398 with band ligation(s) (eg, hemorrhoids)
8.1.13.5 LAPAROSCOPY
8.1.13.5.1 EXCISION
45395 Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with
colostomy
45397 proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal
anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting
enterostomy, when performed
8.1.13.6 REPAIR
45400 Laparoscopy, surgical; proctopexy (for prolapse)
45402 proctopexy (for prolapse), with sigmoid resection
45499 Unlisted laparoscopy procedure, rectum
8.1.13.7 REPAIR
45500 Proctoplasty; for stenosis
45505 for prolapse of mucous membrane
45520 Perirectal injection of sclerosing solution for prolapse
45540 Proctopexy (eg, for prolapse); abdominal approach
45541 perineal approach
45550 with sigmoid resection, abdominal approach
45560 Repair of rectocele (separate procedure)
45562 Exploration, repair, and presacral drainage for rectal injury;
45563 with colostomy
45800 Closure of rectovesical fistula;
45805 with colostomy
45820 Closure of rectourethral fistula;
45825 with colostomy
8.1.13.8 MANIPULATION
45900 Reduction of procidentia (separate procedure) under anesthesia
45905 Dilation of anal sphincter (separate procedure) under anesthesia other than local
45910 Dilation of rectal stricture (separate procedure) under anesthesia other than local
45915 Removal of fecal impaction or foreign body (separate procedure) under anesthesia
8.1.13.9 OTHER PROCEDURES
45399 Unlisted procedure, colon
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 146
45999 Unlisted procedure, rectum
8.1.14 ANUS
8.1.14.1 INCISION
46020 Placement of seton
46030 Removal of anal seton, other marker
46040 Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure)
46045 Incision and drainage of intramural, intramuscular or submucosal abscess, transanal,
under anesthesia
46050 Incision and drainage, perianal abscess, superficial
46060 Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or
fistulotomy, submuscular, with or without placement of seton
46070 Incision, anal septum (infant)
46080 Sphincterotomy, anal, division of sphincter (separate procedure)
46083 Incision of thrombosed hemorrhoid, external
8.1.14.2 EXCISION
46200 Fissurectomy, including sphincterotomy, when performed
46221 Hemorrhoidectomy, internal, by rubber band ligation(s)
46945 Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid
column/group, without imaging guidance
46946 2 or more hemorrhoid columns/group, without imaging guidance
46948 Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more
hemorrhoid columns/groups including ultrasound guidance, with mucopexy, when
performed
46220 Excision of single external papilla or tag, anus
46230 Excision of multiple external papillae or tags, anus
46320 Excision of thrombosed hemorrhoid, external
46250 Hemorrhoidectomy, external, 2 or more columns/groups
46255 Hemorrhoidectomy, internal and external, simple column/group;
46257 with fissurectomy
46258 with fistulectomy, including fissurectomy, when performed
46260 Hemorrhoidectomy, internal and external, 2 or more columns/groups;
46261 with fissurectomy
46262 with fistulectomy, including fissurectomy, when performed
46270 Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous
46275 intersphincteric
46280 transsphincteric, suprasphincteric, extrasphincteric or multiple, including placement
of seton, when performed
46285 second stage
46288 Closure of anal fistula with rectal advancement flap
8.1.14.3 INTRODUCTION
46500 Injection of sclerosing solution, hemorrhoids
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 147
46505 Chemodenervation of internal anal sphincter
8.1.14.4 ENDOSCOPY
46600 Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when
performed (separate procedure)
46601 diagnostic, with high resolution magnification (HRA) (eg,
colposcope, operating microscope) and chemical agent
enhancement, including collection of specimen(s) by brushing
or washing, when performed
46604 with dilation, (eg, balloon, guide wire, bougie)
46606 with biopsy, single or multiple
46607 with high resolution magnification (HRA) (eg,
colposcope, operating microscope) and chemical agent
enhancement, with biopsy, single or multiple
46608 with removal of foreign body
46610 with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar
cautery
46611 with removal of single tumor, polyp, or other lesion by snare technique
46612 with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps,
bipolar cautery or snare technique
46614 with control of bleeding, (eg, injection, bipolar cautery, unipolar cautery, laser,
heater probe, stapler, plasma coagulator)
46615 with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by
hot biopsy forceps, bipolar cautery or snare technique
8.1.14.5 REPAIR
46700 Anoplasty, plastic operation for stricture; adult
46705 infant
46706 Repair of anal fistula with fibrin glue
46707 Repair of anorectal fistula with plug (eg, porcine small intestine submucosa [SIS])
46710 Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement;
transperineal approach
46712 combined transperineal and transabdominal approach
46715 Repair of low imperforate anus; with anoperineal fistula (cut-back procedure)
46716 with transposition of anoperineal or anovestibular fistula
46730 Repair of high imperforate anus without fistula; perineal or sacroperineal approach
46735 combined transabdominal and sacroperineal approaches
46740 Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or
sacroperineal approach
46742 combined transabdominal and sacroperineal approaches
46744 Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty; sacroperineal
approach
46746 Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined
abdominal and sacroperineal approach
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 148
46748 with vaginal lengthening by intestinal graft and pedicle flaps
46750 Sphincteroplasty, anal, for incontinence or prolapse; adult
46751 child
46753 Graft (Thiersch operation) for rectal incontinence and/or prolapse
46754 Removal of Thiersch wire or suture, anal canal
46760 Sphincteroplasty, anal, for incontinence, adult; muscle transplant
46761 levator muscle imbrication (Park posterior anal repair)
46947 Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling
8.1.14.6 DESTRUCTION
46900 Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum,
herpetic vesicle), simple; chemical
46910 electrodesiccation
46916 cryosurgery
46917 laser surgery
46922 surgical excision
46924 Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum,
herpetic vesicle), extensive, (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)
46930 Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation,
cautery, radiofrequency)
46940 Curettage or cautery of anal fissure, including dilation of anal sphincter (separate
procedure); initial
46942 subsequent
8.1.14.7 OTHER PROCEDURES
46999 Unlisted procedure, anus
8.1.15 LIVER
8.1.15.1 INCISION
47000 Biopsy of liver, needle; percutaneous
47001 when done for indicated purpose at time of other major procedure
47010 Hepatotomy; for open drainage of abscess or cyst, one or two stages
47015 Laparotomy, with aspiration and/or injection of hepatic parasitic (eg, amoebic or
echinococcal) cyst(s) or abscess(es)
8.1.15.2 EXCISION
47100 Biopsy of liver, wedge
47120 Hepatectomy, resection of liver; partial lobectomy
47122 trisegmentectomy
47125 total left lobectomy
47130 total right lobectomy
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 149
8.1.15.3 LIVER TRANSPLANTATION
47135 Liver allotransplantation; orthotopic, partial or whole, from cadaver or living donor, any
age
8.1.15.4 REPAIR
47300 Marsupialization of cyst or abscess of liver
47350 Management of liver hemorrhage; simple suture of liver wound or injury
47360 complex, suture of liver wound or injury, with or without hepatic artery ligation
47361 exploration of hepatic wound, extensive debridement, coagulation and/or suture,
with or without packing of liver
47362 re-exploration of hepatic wound for removal of packing
8.1.15.5 LAPAROSCOPY
47370 Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency
47371 cryosurgical
47379 Unlisted laparoscopic procedure, liver
8.1.15.6 OTHER PROCEDURES
47380 Ablation, open, of 1 or more liver tumor(s); radiofrequency
47381 cryosurgical
47382 Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency
47383 Ablation, 1 or more liver tumor(s), percutaneous, cryoablation
47399 Unlisted procedure, liver
8.1.16 BILIARY TRACT
8.1.16.1 INCISION
47400 Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus
47420 Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus,
with or without cholecystotomy; without transduodenal sphincterotomy or
sphincteroplasty
47425 with transduodenal sphincterotomy or sphincteroplasty
47460 Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal
extraction of calculus (separate procedure)
47480 Cholecystotomy or cholecystostomy, open with exploration, drainage, or removal of
calculus (separate procedure)
8.1.16.2 INTRODUCTION
47490 Cholecystotomy, percutaneous, complete procedure, including imaging guidance,
catheter placement, cholecystogram when performed, and radiological supervision and
interpretation
47531 Injection procedure for cholangiography, percutaneous, complete diagnostic procedure
including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated
radiological supervision and interpretation; existing access
47532 new access (eg, percutaneous transhepatic cholangiogram)
Physician - Surgery
eMedNY > Procedure Codes
Provider Procedure Codes Surgery
July 2024 150
47533 Placement of biliary drainage catheter, percutaneous, including diagnostic
cholangiography when performed, imaging guidance (eg, ultrasound and/or
fluoroscopy), and all associated radiological supervision and interpretation; external
47534 internal-external
47535 Conversion of external biliary drainage catheter to internal-external biliary catheter,
percutaneous, including diagnostic cholangiography when performed, imaging guidance
(eg, fluoroscopy), and all associated radiological supervision and interpretation
47536 Exchange of biliary drainage catheter (eg, external, internal-external, or conversion of
internal-external to external only), percutaneous, including diagnostic cholangiography
when performed, imaging guidance (eg, fluoroscopy), and all associated radiologal
supervision and interpretation
47537 Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg,
with concurrent indwelling biliary stents), including diagnostic cholangiography when
performed, imaging guidance (eg, fluoroscopy), and all associated radiological
supervision and interpretation
47538 Placement of stent(s) into a bile duct, percutaneous, including diagnostic
cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation,
catheter exchange(s) and catheter removal(s) when performed, and all associated
radiological supervision and interpretation, exisiting access
47539 new access, without placement of separate biliary drainage catheter
47540 new access, with placement of separate biliary drainage catheter (eg, external or
internal-external)
47541 Placement of access through the biliary tree and into small bowel to assist with an
endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including
diagnostic cholangiography when performed, imaging guidance (eg, ultrasound
and/or fluoroscopy), and all associated radiological supervision and interpretation,
new access
47542 Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including
imaging guidance (eg, fluoroscopy), and all associated radiological supervision and
interpretation, each duct (List separately in addition to code for primary procedure)
47543 Endoluminal biopsy(ies) of biliary tree, percutaneous, any method(s) (eg, brush, forceps,
and/or needle), including imaging guidance (eg, fluoroscopy), and all associated
radiological supervision and interpretation, single or multiple
47544 Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including
destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy)
when performed, imaging guidance (eg, fluoroscopy), and all associated
radiological supervision and interpretation (List separately in addition to code for
primary procedure)
8.1.16.3 ENDOSCOPY
47550 Biliary endoscopy, intraoperative (choledochoscopy) (List separately in addition to
primary procedure)
47552 Biliary endoscopy, percutaneous via T-tube or other tract; diagnostic, with collection of
specimen(s) by brushing and/or washing, when performed (separate procedure)
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 151
47553 with biopsy, single or multiple
47554 with removal of calculus/calculi
47555 with dilation of biliary duct stricture(s) without stent
47556 with dilation of biliary duct stricture(s) with stent
8.1.16.4 LAPAROSCOPY
47562 Laparoscopy; surgical; cholecystectomy
47563 cholecystectomy with cholangiography
47564 cholecystectomy with exploration of common duct
47570 cholecystoenterostomy
47579 Unlisted laparoscopy procedure, biliary tract
8.1.16.5 EXCISION
47600 Cholecystectomy;
47605 with cholangiography
47610 Cholecystectomy with exploration of common duct;
47612 with choledochoenterostomy
47620 with transduodenal sphincterotomy or sphincteroplasty, with or without
cholangiography
47700 Exploration for congenital atresia of bile ducts, without repair, with or without liver
biopsy, with or without cholangiography
47701 Portoenterostomy (eg, Kasai procedure)
47711 Excision of bile duct tumor, with or without primary repair of bile duct; extrahepatic
47712 intraphepatic
47715 Excision of choledochal cyst
8.1.16.6 REPAIR
47720 Cholecystoenterostomy; direct
47721 with gastroenterostomy
47740 Roux-en-Y
47741 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
47785 Anastomosis, Roux-en-Y, of intrahepatic biliary ducts and gastrointestinal tract
47800 Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis
47801 Placement of choledochal stent
47802 U-tube hepaticoenterostomy
47900 Suture of extrahepatic biliary duct for pre-existing injury (separate procedure)
8.1.16.7 OTHER PROCEDURES
47999 Unlisted procedure, biliary tract
8.1.17 PANCREAS
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 152
8.1.17.1 INCISION
48000 Placement of drains, peripancreatic, for acute pancreatitis;
48001 with cholecystostomy, gastrostomy, and jejunostomy
48020 Removal of pancreatic calculus
8.1.17.2 EXCISION
48100 Biopsy of pancreas, open, (eg, fine needle aspiration, needle core biopsy, wedge biopsy)
48102 Biopsy of pancreas, percutaneous needle
48105 Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing
pancreatitis
48120 Excision of lesion of pancreas (eg, cyst, adenoma)
48140 Pancreatectomy, distal subtotal, with or without splenectomy; without
pancreaticojejunostomy
48145 with pancreaticojejunostomy
48146 Pancreatectomy, distal, near-total with preservation of duodenum
(Child-type procedure)
48148 Excision of ampulla of Vater
48150 Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy,
cholecystoenterostomy and gastrojejunostomy (Whipple-type procedure); with
pancreatojejunostomy
48152 without pancreatojejunostomy
48153 Pancreatectomy, proximal subtotal with near-total duodenectomy,
cholecystoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type
procedure); with pancreatojejunostomy
48154 without pancreatojejunostomy
48155 Pancreatectomy, total
48160 Pancreatectomy, total or subtotal, with autologous transplantation of pancreas or
pancreatic islet cells
8.1.17.3 INTRODUCTION
48400 Injection procedure for intraoperative pancreatography
8.1.17.4 REPAIR
48500 Marsupialization of pancreatic cyst
48510 External drainage, pseudocyst of pancreas; open
48520 Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct
48540 Roux-en-Y
48545 Pancreatorrhaphy for injury
48547 Duodenal exclusion with gastrojejunostomy for pancreatic injury
48548 Pancreaticojejunostomy, side-to-side anastomosis (Puestow-type operation)
8.1.17.5 PANCREAS TRANSPLANTATION
48554 Transplantation of pancreatic allograft
48556 Removal of transplanted pancreatic allograft
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 153
8.1.17.6 OTHER PROCEDURES
48999 Unlisted procedure, pancreas
8.1.18 ABDOMEN, PERITONEUM, AND OMENTUM
8.1.18.1 INCISION
49000 Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate
procedure)
49002 Reopening of recent laparotomy
49010 Exploration, retroperitoneal area with or without biopsy(s) (separate procedure)
49020 Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess;
open
49040 Drainage of subdiaphragmatic or subphrenic abscess; open
49060 Drainage of retroperitoneal abscess; open
49062 Drainage of extraperitoneal lymphocele to peritoneal cavity, open
49082 Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance
49083 with imaging guidance
49084 Peritoneal lavage, including imaging guidance, when performed
8.1.18.2 EXCISION, DESTRUCTION
49180 Biopsy, abdominal or retroperitoneal mass, percutaneous needle
49185 Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous,
including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance
(eg, ultrasound, fluoroscopy) and radiological supervision and interpretation, when
performed
49203 Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more
peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5
cm diameter or less
49204 largest tumor 5.1-10.0 cm diameter
49205 largest tumor greater than 10.0 cm diameter
49215 Excision of presacral or sacrococcygeal tumor
49250 Umbilectomy, omphalectomy, excision of umbilicus (separate procedure)
49255 Omentectomy, epiploectomy, resection of omentum (separate procedure)
8.1.18.3 LAPAROSCOPY
49320 Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection
of specimen(s) by brushing or washing (separate procedure)
49321 Laparoscopy, surgical; with biopsy (single or multiple)
49322 with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple)
49323 with drainage of lymphocele to peritoneal cavity
49324 with insertion of tunneled intraperitoneal catheter
49325 with revision of previously placed intraperitoneal cannula or catheter, with removal
of intraluminal obstructive material if performed
49326 with omentopexy (omental tacking procedure)
Physician - Surgery
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Provider Procedure Codes Surgery
July 2024 154
49327 with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial
markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including
imaging guidance, if performed, single or multiple
49329 Unlisted laparoscopy procedure, abdomen, peritoneum and omentum
8.1.18.4 INTRODUCTION, REVISION AND/OR REMOVAL
49400 Injection of air or contrast into peritoneal cavity (separate procedure)
49402 Removal of peritoneal foreign body from peritoneal cavity
49405 Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma,
lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous
49406 peritoneal or retroperitoneal, percutaneous
49407 peritoneal or retroperitoneal, transvaginal or transrectal
49411 Placement of interstitial device(s) for radiation therapy guidance (eg, 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 (eg, fiducial markers,
dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum, including image
guidance, if performed, single or multiple
49418 Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy
instillation, management of ascites), complete procedure, including imaging guidance,
catheter placement, contrast injection when performed, and radiological supervision and
interpretation, percutaneous
49419 Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally
implantable)
49421 Insertion of tunneled intraperitoneal catheter for dialysis, open
49422 Removal of tunneled intraperitoneal catheter
49423 Exchange of previously placed abscess or cyst drainage catheter under radiological
guidance (separate procedure)
49424 Contrast injection for assessment of abscess or cyst via previously placed drainage
catheter or tube (separate procedure)
49425 Insertion of peritoneal-venous shunt
49426 Revision of peritoneal-venous shunt
49427 Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-
venous shunt
49428 Ligation of peritoneal-venous shunt
49429 Removal of peritoneal-venous shunt
49435 Insertion of subcutaneous extension to intraperitoneal cannula or catheter with remote
chest exit site
49436 Delayed creation of exit site from embedded subcutaneous segment of intraperitoneal
cannula or catheter
8.1.18.4.1 INITIAL PLACEMENT
49440 Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including
contrast injection(s), image documentation and report
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49441 Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic
guidance including contrast injection(s), image documentation and report
49442 Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic guidance
including contrast injection(s), image documentation and report
8.1.18.4.2 CONVERSION
49446 Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under
fluoroscopic guidance including contrast injection(s), image documentation and report
8.1.18.4.3 REPLACEMENT
49450 Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under
fluoroscopic guidance including contrast injection(s), image documentation and report
49451 Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic
guidance including contrast injection(s), image documentation and report
49452 Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance
including contrast injection(s), image documentation and report
8.1.18.4.4 MECHANICAL REMOVAL OF OBSTRUCTIVE MATERIAL
49460 Mechanical removal of obstructive material from gastrostomy, duodenostomy,
jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method,
under fluoroscopic guidance including contrast injection(s), if performed, image
documentation and report
8.1.18.4.5 OTHER
49465 Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy,
jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, from a
percutaneous approach including image documentation and report
8.1.18.5 REPAIR
8.1.18.5.1 HERNIOPLASTY, HERNIORRHAPHY, HERNIOTOMY
49491 Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth),
performed from birth up to 50 weeks post-conception age, with or without
hydrocelectomy; reducible
49492 incarcerated or strangulated
49495 Repair initial inguinal hernia, full term infant younger than 6 months, or preterm infant
older than 50 weeks postconception age and younger than age 6 months at the time of
surgery, with or without hydrocelectomy; reducible
49496 incarcerated or strangulated
49500 Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without
hydrocelectomy; reducible
49501 incarcerated or strangulated
49505 Repair initial inguinal hernia, age 5 years or over; reducible
49507 incarcerated or strangulated
49520 Repair recurrent inguinal hernia, any age; reducible
Physician - Surgery
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49521 incarcerated or strangulated
49525 Repair inguinal hernia, sliding, any age
49540 Repair lumbar hernia
49550 Repair initial femoral hernia, any age; reducible
49553 incarcerated or strangulated
49555 Repair recurrent femoral hernia; reducible
49557 incarcerated or strangulated
49591 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical,
spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of
mesh or other prosthesis when performed, total length of defect(s); less than 3 cm,
reducible
49592 less than 3 cm, incarcerated or strangulated
49593 3 cm to 10 cm, reducible
49594 3 cm to 10 cm, incarcerated or strangulated
49595 greater than 10 com, reducible
49596 greater than 10 cm, incarcerated or strangulated
49613 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical,
spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including
implantation of mesh or tother prosthesis when performed, total length of defect(s); less
than 3 cm, reducible
49614 less than 3 cm, incarcerated or strangulated
49615 3 cm to 10 cm, reducible
49616 3 cm to 10 cm, incarcerated or strangulated
49617 greater than 10 com, reducible
49618 greater than 10 cm, incarcerated or strangulated
49621 Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or
recurrent, including implantation of mesh or other prosthesis, when performed; reducible
49622 incarcerated or strangulated
49623 Removal of total or near total non-infected mesh or other prosthesis at the time of initial
or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach
(ie, open, laparoscopic, robotic) (List seperatately in addition to code for primary
procedure)
49600 Repair of small omphalocele, with primary closure
49605 Repair of large omphalocele or gastroschisis; with or without prosthesis
49606 with removal of prosthesis, final reduction and closure, in operating room
49610 Repair of omphalocele (Gross type operation); first stage
49611 second stage
8.1.18.5.2 LAPAROSCOPY
49650 Laparoscopy, surgical; repair initial inguinal hernia
49651 repair recurrent inguinal hernia
49659 Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy
Physician - Surgery
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8.1.18.6 SUTURE
49900 Suture, secondary, of abdominal wall for evisceration or dehiscence
8.1.18.7 OTHER PROCEDURES
49904 Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)
49905 Omental flap, intra-abdominal (List separately in addition to primary procedure)
49906 Free omental flap with microvascular anastomosis
49999 Unlisted procedure, abdomen, peritoneum and omentum
9 URINARY SERVICES
9.1 URINARY SYSTEM
9.1.1 KIDNEY
9.1.1.1 INCISION
50010 Renal exploration, not necessitating other specific procedures
50020 Drainage of perirenal or renal abscess; open
50040 Nephrostomy, nephrotomy with drainage
50045 Nephrotomy, with exploration
50060 Nephrolithotomy; removal of calculus
50065 secondary surgical operation for calculus
50070 complicated by congenital kidney abnormality
50075 removal of large staghorn calculus filling renal pelvis and calyces (including
anatrophic pyelolithotomy)
50080 Percutaneous nephrostolithotomy or pyelostolithotomy, lithotripsy, stone extraction,
antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement,
when performed, including imaging guidance; simple (eg, stone[s] up to 2 cm in single
location of kidney or renal pelvis, nonbranching stones)
50081 complex (eg, stone[s] > 2 cm, branching stones, stones in multiple locations, ureter
stones, complicated anatomy)
50100 Transection or repositioning of aberrant renal vessels (separate procedure)
50120 Pyelotomy; with exploration
50125 with drainage, pyelostomy
50130 with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum
pyelolithotomy)
50135 complicated (eg, secondary operation, congenital kidney abnormality)
9.1.1.2 EXCISION
50200 Renal biopsy; percutaneous, by trocar or needle
50205 by surgical exposure of kidney
50220 Nephrectomy, including partial ureterectomy, any open approach including rib resection;
50225 complicated because of previous surgery on same kidney
50230 radical, with regional lymphadenectomy and/or vena caval thrombectomy
50234 Nephrectomy with total ureterectomy and bladder cuff; through same incision
Physician - Surgery
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50236 through separate incision
50240 Nephrectomy, partial
50250 Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative
ultrasound guidance and monitoring, if performed
50280 Excision or unroofing of cyst(s) of kidney
50290 Excision of perinephric cyst
9.1.1.3 RENAL TRANSPLANTATION
50320 Donor nephrectomy (including cold preservation); open, from living donor
50340 Recipient nephrectomy (separate procedure)
50360 Renal allotransplantation, implantation of graft; without recipient nephrectomy
50365 with recipient nephrectomy
50370 Removal of transplanted renal allograft
50380 Renal autotransplantation, reimplantation of kidney
9.1.1.4 INTRODUCTION
9.1.1.4.1 RENAL PELVIS CATHETER PROCEDURES
9.1.1.4.1.1 INTERNALLY DWELLING
50382 Removal (via snare/capture) and replacement of internally dwelling ureteral stent via
percutaneous approach, including radiological supervision and interpretation
50384 Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous
approach, including radiological supervision and interpretation
50385 Removal (via snare/capture) and replacement of internally dwelling ureteral stent via
transurethral approach, without use of cystoscopy, including radiological supervision and
interpretation
50386 Removal (via snare/capture) of internally dwelling ureteral stent via transurethral
approach, without use of cystoscopy, including radiological supervision and interpretation
9.1.1.4.1.2 EXTERNALLY ACCESSIBLE
50387 Removal and replacement of externally accessible transnephric ureteral stent
(eg, external/internal stent) requiring fluoroscopic guidance, including radiological
supervision and interpretation
50389 Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent
indwelling ureteral stent)
9.1.1.4.2 OTHER INTRODUCTION PROCEDURES
50390 Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous
50391 Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established
nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal
agent)
50436 Dilation of existing tract, percutaneous, for an endourologic procedure including imaging
guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision
and interpretation, with postprocedure tube placement, when performed;
50437 including new access into the renal collecting system
Physician - Surgery
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50396 Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral
catheter
50430 Injection procedure for antegrade nephrostogram and/or ureterogram, complete
diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and
all associated radiological supervision and interpretation; new access
50431 existing access
50432 Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram
and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or
fluoroscopy) and all associated radiological supervision and interpretation
50433 Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram
and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or
fluoroscopy) and all associated radiological supervision and interpretation, new access
50434 Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including
diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg,
ultrasound and/or fluoroscopy) and all associated radiological supervision and
interpretation, via existing nephrostomy tract
50435 Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram
and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or
fluoroscopy) and all associated radiological supervision and interpretation
9.1.1.5 REPAIR
50400 Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic
operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple
50405 complicated (congenital kidney abnormality, secondary pyeloplasty, solitary kidney,
calycoplasty)
50500 Nephrorrhaphy, suture of kidney wound or injury
50520 Closure of nephrocutaneous or pyelocutaneous fistula
50525 Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal
approach
50526 thoracic approach
50540 Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic
procedure, unilateral or bilateral (one operation)
9.1.1.6 LAPAROSCOPY
50541 Laparoscopy, surgical; ablation of renal cysts
50542 ablation of renal mass lesion(s), including intraoperative ultrasound guidance and
monitoring, when performed
50543 partial nephrectomy
50544 pyeloplasty
50545 radical nephrectomy (includes removal of Gerota’s fascia and surrounding fatty
tissue, removal of regional lymph nodes, and adrenalectomy)
50546 nephrectomy, including partial ureterectomy
50547 donor nephrectomy (including cold preservation), from living donor
50548 nephrectomy with total ureterectomy
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50549 Unlisted laparoscopy procedure, renal
9.1.1.7 ENDOSCOPY
50551 Renal endoscopy through established nephrostomy or pyelostomy, with or without
irrigation, instillation, or ureteropyelography, exclusive of radiologic service;
50553 with ureteral catheterization, with or without dilation of ureter
50555 with biopsy
50557 with fulguration and/or incision, with or without biopsy
50561 with removal of foreign body or calculus
50562 with resection of tumor
50570 Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation,
instillation, or ureteropyelography, exclusive of radiologic service;
50572 with ureteral catheterization, with or without dilation of ureter
50574 with biopsy
50575 with endopyelotomy (includes cystoscopy, ureteroscopy, dilation of ureter and
ureteral pelvic junction, incision of ureteral pelvic junction and insertion of
endopyelotomy stent)
50576 with fulguration and/or incision, with or without biopsy
50580 with removal of foreign body or calculus
9.1.1.8 OTHER PROCEDURES
50590 Lithotripsy, extracorporeal shock wave
50592 Ablation, one or more renal tumor(s), percutaneous, unilateral, radiofrequency
50593 Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy
9.1.2 URETER
9.1.2.1 INCISION
50600 Ureterotomy with exploration or drainage (separate procedure)
50605 Ureterotomy for insertion of indwelling stent, all types
50606 Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging
guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision
and interpretation (List separately in addition to code for primary procedure)
50610 Ureterolithotomy; upper one-third of ureter
50620 middle one-third of ureter
50630 lower one-third of ureter
9.1.2.2 EXCISION
50650 Ureterectomy, with bladder cuff (separate procedure)
50660 Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal
approach
9.1.2.3 INTRODUCTION
50684 Injection procedure for ureterography or ureteropyelography through ureterostomy or
indwelling ureteral catheter
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50686 Manometric studies through ureterostomy or indwelling ureteral catheter
50688 Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit
50690 Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive
of radiologic service
50693 Placement or ureteral stent, percutaneous, including diagnostic nephrostogram and/or
ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy),
and all associated radiological supervision and interpretation; pre-existing nephrostomy
tract
50694 new access, without separate nephrostomy catheter
50695 new access, with separate nephrostomy catheter
9.1.2.4 REPAIR
50700 Ureteroplasty, plastic operation on ureter (eg, stricture)
50705 Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or
fluoroscopy) and all associated radiological supervision and interpretation (List separately
in addition to code for primary procedure)
50706 Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or
fluoroscopy) and all associated radiological supervision and interpretation (List separately
in addition to code for primary procedure)
50715 Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis
50722 Ureterolysis for ovarian vein syndrome
50725 Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava
50727 Revision of urinary-cutaneous anastomosis (any type urostomy);
50728 with repair of fascial defect and hernia
50740 Ureteropyelostomy, anastomosis of ureter and renal pelvis
50750 Ureterocalycostomy, anastomosis of ureter to renal calyx
50760 Ureteroureterostomy
50770 Transureteroureterostomy, anastomosis of ureter to contralateral ureter
50780 Ureteroneocystostomy; anastomosis of single ureter to bladder
50782 anastomosis of duplicated ureter to bladder
50783 with extensive ureteral tailoring
50785 with vesico-psoas hitch or bladder flap
50800 Ureteroenterostomy, direct anastomosis of ureter to intestine
50810 Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal
or perineal colostomy, including intestine anastomosis
50815 Ureterocolon conduit, including intestine anastomosis
50820 Ureteroileal conduit (ileal bladder), including intestine anastomosis (Bricker operation)
50825 Continent diversion, including intestine anastomosis using any segment of small and/or
large bowel (Kock pouch or Camey enterocystoplasty)
50830 Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or
ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy)
50840 Replacement of all or part of ureter by intestine segment, including intestine anastomosis
50845 Cutaneous appendico-vesicostomy
50860 Ureterostomy, transplantation of ureter to skin
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50900 Ureterorrhaphy, suture of ureter (separate procedure)
50920 Closure of ureterocutaneous fistula
50930 Closure of ureterovisceral fistula (including visceral repair)
50940 Delegation of ureter
9.1.2.5 LAPAROSCOPY
50945 Laparoscopy, surgical; ureterolithotomy
50947 ureteroneocystostomy with cystoscopy and ureteral stent placement
50948 ureteroneocystostomy without cystoscopy and ureteral stent placement
50949 Unlisted laparoscopic procedure, ureter
9.1.2.6 ENDOSCOPY
50951 Ureteral endoscopy through established ureterostomy, with or without irrigation,
instillation, or ureteropyelography, exclusive of radiologic service;
50953 with ureteral catheterization, with or without dilation of ureter
50955 with biopsy
50957 with fulguration and/or incision, with or without biopsy
50961 with removal of foreign body or calculus
50970 Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or
ureteropyelography, exclusive of radiologic service;
50972 with ureteral catheterization, with or without dilation of ureter
50974 with biopsy
50976 with fulguration and/or incision, with or without biopsy
50980 with removal of foreign body or calculus
9.1.3 BLADDER
9.1.3.1 INCISION
51020 Cystotomy or cystostomy; with fulguration and/or insertion of radioactive material
51030 with cryosurgical destruction of intravesical lesion
51040 Cystostomy, cystotomy with drainage
51045 Cystotomy, with insertion of ureteral catheter or stent (separate procedure)
51050 Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection
51060 Transvesical ureterolithotomy
51065 Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic
fragmentation of ureteral calculus
51080 Drainage of perivesical or prevesical space abscess
9.1.3.2 REMOVAL
51100 Aspiration of bladder; by needle
51101 by trocar or intracatheter
51102 with insertion of suprapubic catheter
9.1.3.3 EXCISION
51500 Excision of urachal cyst or sinus, with or without umbilical hernia repair
Physician - Surgery
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51520 Cystotomy; for simple excision of vesical neck (separate procedure)
51525 for excision of bladder diverticulum, single or multiple (separate procedure)
51530 for excision of bladder tumor
51535 Cystotomy for excision, incision, or repair of ureterocele
51550 Cystectomy, partial; simple
51555 complicated (eg, postradiation, previous surgery, difficult location)
51565 Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy)
51570 Cystectomy, complete; (separate procedure)
51575 with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and
obturator nodes
51580 Cystectomy, complete with ureterosigmoidostomy or ureterocutaneous transplantations;
51585 with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and
obturator nodes
51590 Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine
anastomosis;
51595 with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and
obturator nodes
51596 Cystectomy, complete, with continent diversion, any technique, using any segment of
small and/or large intestine to construct neobladder
51597 Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal
of bladder and ureteral transplantations, with or without hysterectomy and/or
abdominoperineal resection of rectum and colon and colostomy, or any combination
thereof
9.1.3.4 INTRODUCTION
51600 Injection procedure for cystography or voiding urethrocystography
51605 Injection procedure and placement of chain for contrast and/or chain urethrocystography
51610 Injection procedure for retrograde urethrocystography
51700 Bladder irrigation, simple, lavage and/or instillation
51703 Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy,
fractured catheter/balloon)
51710 Change of cystostomy tube; complicated
51715 Endoscopic injection of implant material into the submucosal tissues of the urethra
and/or bladder neck
51720 Bladder instillation of anticarcinogenic agent (including retention time)
9.1.3.5 URODYNAMICS
51725 Simple cystometrogram (CMG) (eg, spinal manometer)
51726 Complex cystometrogram (ie, calibrated electronic equipment);
51727 with urethral pressure profile studies (ie, urethral closure pressure profile), any
technique
51728 with voiding pressure studies (ie, bladder voiding pressure), any technique
51729 with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure
profile studies (ie, urethral closure pressure profile), any technique
Physician - Surgery
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51736 Simple uroflowmetry (UFR) (eg, stop-watch flow rate, mechanical uroflowmeter)
51741 Complex uroflowmetry (eg, calibrated electronic equipment)
51784 Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any
technique
51785 Needle electromyography studies (EMG) of anal or urethral sphincter, any technique
51792 Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)
51797 Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal)
51798 Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-
imaging
9.1.3.6 REPAIR
51800 Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck
(anterior Y-plasty, vesical fundus resection), any procedure, with or without wedge
resection of posterior vesical neck
51820 Cystourethroplasty with unilateral or bilateral ureteroneocystostomy
51840 Anterior vesicourethropexy, or urethropexy (Marshall-Marchetti-Krantz, Burch); simple
51841 complicated (eg, secondary repair)
51845 Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg,
Stamey, Raz, modified Pereyra)
51860 Cystorrhaphy, suture of bladder wound, injury or rupture; simple
51865 complicated
51880 Closure of cystostomy (separate procedure)
51900 Closure of vesicovaginal fistula, abdominal approach
51920 Closure of vesicouterine fistula;
51925 with hysterectomy (See Rule N)
51940 Closure, exstrophy of bladder
51960 Enterocystoplasty, including intestinal anastomosis
51980 Cutaneous vesicostomy
9.1.3.7 LAPAROSCOPY
51990 Laparoscopy, surgical; urethral suspension for stress incontinence
51992 sling operation for stress incontinence (eg, fascia or synthetic)
51999 Unlisted laparoscopy procedure, bladder
9.1.3.8 ENDOSCOPY - CYSTOSCOPY, URETHROSCOPY, CYSTOURETHROSCOPY
52000 Cystourethroscopy (separate procedure)
52001 Cystourethroscopy with irrigation and evacuation of multiple obstructing clots
52005 Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or
ureteropyelography, exclusive of radiologic service;
52007 with brush biopsy of ureter and/or renal pelvis
52010 Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation,
instillation, or duct radiography, exclusive of radiologic service
Physician - Surgery
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9.1.3.9 TRANSURETHRAL SURGERY
9.1.3.9.1 URETHRA AND BLADDER
52204 Cystourethroscopy, with biopsy(s)
52214 Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone,
bladder neck, prostatic fossa, urethra, or periurethral glands
52224 Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment
of MINOR (less than 0.5 cm) lesion(s), with or without biopsy
52234 Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or
resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm)
52235 MEDIUM bladder tumor(s) (2.0 to 5.0 cm)
52240 LARGE bladder tumor(s)
52250 Cystourethroscopy with insertion of radioactive substance, with or without biopsy or
fulguration
52260 Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction
(spinal) anesthesia
52265 local anesthesia
52270 Cystourethroscopy, with internal urethrotomy; female
52275 male
52276 Cystourethroscopy, with direct vision internal urethrotomy
52277 Cystourethroscopy, with resection of external sphincter (sphincterotomy)
52281 Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with
or without meatotomy, with or without injection procedure for cystography, male or
female
52282 Cystourethroscopy, with insertion of permanent urethral stent
52283 Cystourethroscopy, with steroid injection into stricture
52284 Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug
delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including
fluoroscopy, when performed
52285 Cystourethroscopy for treatment of the female urethral syndrome with any or all of the
following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of
urethrovaginal septal fibrosis, lateral incisions of the bladder neck, and fulguration of
polyp(s) of urethra, bladder neck, and/or trigone
52287 Cystourethroscopy, with injection(s) for chemodenervation of the bladder
52290 Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral
52300 with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral
52301 with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral
52305 with incision or resection of orifice of bladder diverticulum, single or multiple
52310 Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra
or bladder (separate procedure); simple
52315 complicated
52317 Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal
of fragments; simple or small (less than 2.5 cm)
52318 complicated or large (over 2.5 cm)
Physician - Surgery
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9.1.3.9.2 URETER AND PELVIS
52320 Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus
52325 with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic
technique)
52327 with subureteric injection of implant material
52330 with manipulation, without removal of ureteral calculus
52332 Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double- J
type)
52334 Cystourethroscopy, with insertion of ureteral guide wire through kidney to establish a
percutaneous nephrostomy, retrograde
52341 Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser,
electrocautery, and incision)
52342 with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser,
electrocautery, and incision)
52343 with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and
incision)
52344 Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon
dilation, laser, electrocautery, and incision)
52345 with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser,
electrocautery, and incision)
52346 with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and
incision)
52351 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic
52352 with removal or manipulation of calculus (ureteral catheterization is included)
52353 with lithotripsy (ureteral catheterization is included)
52354 with biopsy and/or fulguration of ureteral or renal pelvic lesion
52355 with resection of ureteral or renal pelvic tumor
52356 with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or
double-J type)
9.1.3.10 VESICAL NECK AND PROSTATE
52400 Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral
valves, or congenital obstructive hypertrophic mucosal folds
52402 Cystourethroscopy with transurethral resection or incision of ejaculatory ducts
52441 Cystourethroscopy, with insertion of permanent adjustable
transprostatic implant; single implant
52442 each additional permanent adjustable transprostatic implant (List separately in
addition to code for primary procedure)
52450 Transurethral incision of prostate
52500 Transurethral resection of bladder neck (separate procedure)
52601 Transurethral electrosurgical resection of prostate, including control of postoperative
bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration
and/or dilation, and internal urethrotomy are included)
52630 Transurethral resection; residual or regrowth of obstructive prostate tissue including
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control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy,
urethral calibration and/or dilation, and internal urethrotomy are included)
52640 of postoperative bladder neck contracture
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)
52649 Laser enucleation of the prostate with morcellation, 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)
52700 Transurethral drainage of prostatic abscess
9.1.4 URETHRA
9.1.4.1 INCISION
53000 Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra
53010 perineal urethra, external
53020 Meatotomy, cutting of meatus (separate procedure); except infant
53025 infant
53040 Drainage of deep periurethral abscess
53060 Drainage of Skene's gland abscess or cyst
53080 Drainage of perineal urinary extravasation; uncomplicated (separate procedure)
53085 complicated
9.1.4.2 EXCISION
53200 Biopsy of urethra
53210 Urethrectomy, total, including cystostomy; female
53215 male
53220 Excision or fulguration of carcinoma of urethra
53230 Excision of urethral diverticulum (separate procedure); female
53235 male
53240 Marsupialization of urethral diverticulum, male or female
53250 Excision of bulbourethral gland (Cowper's gland)
53260 Excision or fulguration; urethral polyp(s), distal urethra
53265 urethral caruncle
53270 Skene's glands
53275 urethral prolapse
9.1.4.3 REPAIR
53400 Urethroplasty; first stage, for fistula, diverticulum, or stricture, (eg, Johannsen type)
53405 second stage (formation of urethra), including urinary diversion
53410 Urethroplasty, one-stage reconstruction of male anterior urethra
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53415 Urethroplasty, transpubic or perineal, one stage, for reconstruction or repair of prostatic
or membranous urethra
53420 Urethroplasty, two-stage reconstruction or repair of prostatic or membranous urethra;
first stage
53425 second stage
53430 Urethroplasty, reconstruction of female urethra
53431 Urethroplasty with tubularization of posterior urethra and/or lower bladder for
incontinence (eg, Tenago, Leadbetter procedure)
53440 Sling operation for correction of male urinary incontinence, (eg, fascia or synthetic)
53442 Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic)
53444 Insertion of tandem cuff (dual cuff)
53445 Insertion of inflatable urethral/bladder neck sphincter, including placement of pump,
reservoir, and cuff
53446 Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff
53447 Removal and replacement of inflatable urethral/bladder neck sphincter including pump,
reservoir and cuff at the same operative session
53448 Removal and replacement of inflatable urethral/bladder neck sphincter including pump,
reservoir, and cuff through an infected field at the same operative session including
irrigation and debridement of infected tissue
53449 Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff
53450 Urethromeatoplasty, with mucosal advancement
53460 Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type
procedure)
53500 Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical
obstruction, scarring)
53502 Urethrorrhaphy, suture of urethral wound or injury; female
53505 penile
53510 perineal
53515 prostatomembranous
53520 Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure)
9.1.4.4 MANIPULATION
53600 Dilation of urethral stricture by passage of sound or urethral dilator, male; initial
53601 subsequent
53605 Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male,
general or conduction (spinal) anesthesia
53620 Dilation of urethral stricture by passage of filiform and follower, male; initial
53621 subsequent
53660 Dilation of female urethra including suppository and/or instillation; initial
53661 subsequent
53665 Dilation of female urethra, general or conduction (spinal) anesthesia
9.1.4.5 OTHER PROCEDURES
53850 Transurethral destruction of prostate tissue; by microwave thermotherapy
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53852 by radiofrequency thermotherapy
53855 Insertion of a temporary prostatic urethral stent, including urethral measurement
53860 TransTransurethral radiofrequency micro-modeling of the female bladder neck and
proximal urethra for stress urinary incontinence
53899 Unlisted procedure, urinary system
10 MALE GENITAL SERVICES
10.1 MALE GENITAL SYSTEM
10.1.1 PENIS
10.1.1.1 INCISION
54000 Slitting of prepuce, dorsal or lateral (separate procedure); newborn
54001 except newborn
54015 Incision and drainage of penis, deep
10.1.1.2 DESTRUCTION
54050 Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum,
herpetic vesicle), simple; chemical
54055 electrodesiccation
54056 cryosurgery
54057 laser surgery
54060 surgical excision
54065 Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum,
herpetic vesicle), extensive, (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)
10.1.1.3 EXCISION
54100 Biopsy of penis; (separate procedure)
54105 deep structures
54110 Excision of penile plaque (Peyronie disease);
54111 with graft to 5 cm in length
54112 with graft greater than 5 cm in length
54115 Removal foreign body from deep penile tissue (eg, plastic implant)
54120 Amputation of penis; partial
54125 complete
54130 Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy
54135 in continuity with bilateral pelvic lymphadenectomy, including external iliac,
hypogastric and obturator nodes
54150 Circumcision, using clamp or other device with regional dorsal penile or ring block
54160 Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days
of age or less)
54161 older than 28 days of age
54162 Lysis or excision of penile post-circumcision adhesions
54163 Repair incomplete circumcision
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54164 Frenulotomy of penis
10.1.1.4 INTRODUCTION
54200 Injection procedure for Peyronie disease;
54205 with surgical exposure of plaque
54220 Irrigation of corpora cavernosa for priapism
54230 Injection procedure for corpora cavernosography
54240 Penile plethysmography
54250 Nocturnal penile tumescence and/or rigidity test
10.1.1.5 REPAIR
54300 Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without
mobilization of urethra
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 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 (eg, 3rd
stage Cecil repair)
54322 One stage distal hypospadias repair (with or without chordee or circumcision); with
simple meatal advancement (eg, Magpi, V-flap)
54324 with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap)
54326 with urethroplasty by local skin flaps and mobilization of urethra
54328 with extensive dissection to correct chordee and urethroplasty with local skin flaps,
skin graft patch, and/or island flap
54332 One 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
54336 One stage perineal hypospadias repair requiring extensive dissection to correct chordee
and urethroplasty by use of skin graft tube and/or island flap
54340 Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure,
incision, or excision, simple
54344 requiring mobilization of skin flaps and urethroplasty with flap or patch graft
54348 requiring extensive dissection, and urethroplasty with flap, patch or tubed graft
(including urinary diversion, when performed)
54352 Revision of prior hypospadias repair 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
54360 Plastic operation on penis to correct angulation
54380 Plastic operation on penis for epispadias distal to external sphincter;
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54385 with incontinence
54390 with exstrophy of bladder
54400 Insertion of penile prosthesis; non-inflatable (semi-rigid)
54401 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 R
emoval 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 R
emoval 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
54420 Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral
54430 Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral
54435 Corpora cavernosa-glans penis fistulization (eg, biopsy needle, Winter procedure,
rongeur, or punch) for priapism
54437 Repair of traumatic corporeal tear(s)
54438 Replantation, penis, complete amputation including urethral repair
54440 Plastic operation of penis for injury
10.1.1.6 MANIPULATION
54450 Foreskin manipulation including lysis of preputial adhesions and stretching
10.1.2 TESTIS
10.1.2.1 EXCISION
54500 Biopsy of testis, needle (separate procedure)
54505 Biopsy of testis, incisional (separate procedure)
54512 Excision of extraparenchymal lesion of testis
54520 Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal
or inguinal approach
54522 Orchiectomy, partial
54530 Orchiectomy, radical, for tumor; inguinal approach
54535 with abdominal exploration
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10.1.2.2 EXPLORATION
54550 Exploration for undescended testis (inguinal or scrotal area)
54560 Exploration for undescended testis with abdominal exploration
10.1.2.3 REPAIR
54600 Reduction of torsion of testis, surgical, with or without fixation of contralateral testis
54620 Fixation of contralateral testis (separate procedure)
54640 Orchiopexy, inguinal or scrotal approach
54650 Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler-Stephens)
54660 Insertion of testicular prosthesis (separate procedure)
54670 Suture or repair of testicular injury
54680 Transplantation of testis(es) to thigh (because of scrotal destruction)
10.1.2.4 LAPAROSCOPY
54690 Laparoscopy, surgical; orchiectomy
54692 orchiopexy for intra-abdominal testis
54699 Unlisted laparoscopy procedure, testis
10.1.3 EPIDIDYMIS
10.1.3.1 INCISION
54700 Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or
hematoma)
10.1.3.2 EXCISION
54800 Biopsy of epididymis, needle
54830 Excision of local lesion of epididymis
54840 Excision of spermatocele, with or without epididymectomy
54860 Epididymectomy; unilateral
54861 bilateral
10.1.3.3 EXPLORATION
54865 Exploration of epididymis, with or without biopsy
10.1.4 TUNICA VAGINALIS
10.1.4.1 INCISION
55000 Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication
10.1.4.2 EXCISION
55040 Excision of hydrocele; unilateral
55041 bilateral
10.1.4.3 REPAIR
55060 Repair of tunica vaginalis hydrocele (Bottle type)
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10.1.5 SCROTUM
10.1.5.1 INCISION
55100 Drainage of scrotal wall abscess
55110 Scrotal exploration
55120 Removal of foreign body in scrotum
10.1.5.2 EXCISION
55150 Resection of scrotum
10.1.5.3 REPAIR
55175 Scrotoplasty; simple
55180 complicated
10.1.6 VAS DEFERENS
10.1.6.1 INCISION
55200 Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate
procedure)
10.1.6.2 EXCISION
55250 Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen
examination(s)
10.1.7 SPERMATIC CORD
10.1.7.1 EXCISION
55500 Excision of hydrocele of spermatic cord, unilateral (separate procedure)
55520 Excision of lesion of spermatic cord (separate procedure)
55530 Excision of varicocele or ligation of spermatic veins for varicocele;
(separate procedure)
55535 abdominal approach
55540 with hernia repair
10.1.7.2 LAPAROSCOPY
55550 Laparoscopy, surgical, with ligation of spermatic veins for varicocele
55559 Unlisted laparoscopy procedure, spermatic cord
10.1.8 SEMINAL VESICLES
10.1.8.1 INCISION
55600 Vesiculotomy;
55605 complicated
10.1.8.2 EXCISION
55650 Vesiculectomy, any approach
55680 Excision of Mullerian duct cyst
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10.1.9 PROSTATE
10.1.9.1 INCISION
55700 Biopsy, prostate; needle or punch, single or multiple, any approach
55705 incisional, any approach
55720 Prostatotomy, external drainage of prostatic abscess, any approach; simple
55725 complicated
10.1.9.2 EXCISION
55801 Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy,
meatotomy, urethral calibration and/or dilation, and internal urethrotomy)
55810 Prostatectomy, perineal radical;
55812 with lymph node biopsy(s) (limited pelvic lymphadenectomy)
55815 with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and
obturator nodes
55821 Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy,
urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, one
or two stages
55831 retropubic, subtotal
55840 Prostatectomy, retropubic radical, with or without nerve sparing;
55842 with lymph node biopsy(s) (limited pelvic lymphadenectomy)
55845 with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and
obturator nodes
55860 Exposure of prostate, any approach, for insertion of radioactive substance;
55862 with lymph node biopsy(s) (limited pelvic lymphadenectomy)
55865 with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and
obturator nodes
10.1.9.3 LAPAROSCOPY
55866 Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes
robotic assistance, when performed
55867 Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative
bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal
urethrotomy), includes robotic assistance, when performed
10.1.9.4 OTHER PROCEDURES
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 (eg, fiducial markers,
dosimeter), prostrate (via needle, any approach, single or multiple
55880 Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound
(HIFU), including ultrasound guidance
55899 Unlisted procedure, male genital system
A4648 Tissue marker, implantable, any type, each
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10.2 REPRODUCTIVE SYSTEM PROCEDURES
55920 Placement of needles or catheters into pelvic organs and/ or genitalia (except prostate)
for subsequent interstitial radioelement application
11 INTERSEX SURGERY
11.1 GENDER REASSIGNMENT SURGERY INFORMATION
Gender reassignment surgery is covered for individuals diagnosed with gender dysphoria who are
18 years of age or older and who have obtained at least two referral letters that, when reviewed in
combination, meet the criteria outlined below. For individuals under age 18, coverage is available in
specific cases if medical necessity is demonstrated and prior approval is received.
Referral Letters
One letter must be written by a New York State (NYS) licensed psychiatrist, psychologist, psychiatric
nurse practitioner or licensed clinical social worker who has an ongoing relationship with the
member. The second letter may be written by a NYS licensed psychiatrist, psychologist, physician,
psychiatric nurse practitioner or licensed clinical social worker, acting within their scope of practice
who has only had an evaluative role with the member. Each referral letter must be signed by the
NYS licensed health professional attesting they have independently assessed the member. These
referring health professionals may practice at the same organization. The combination of
information in these referral letters must indicate that the member has:
• a persistent and well-documented case of gender dysphoria, and
• received hormone therapy appropriate to the member’s gender goals, which shall be for a
minimum of 12 months in the case of a member seeking genital surgery, unless such
therapy is medically contraindicated or the member is otherwise unable to take hormones,
and
• lived for 12 months in a gender role congruent with the member’s gender identity, and
• received mental health counseling, as deemed medically necessary by the member’s
treating NYS licensed health professional, and
• no other significant medical or mental health conditions that would be a contraindication
to the surgery, or if so, that those are reasonably well-controlled prior to the surgery, and
• the capacity to make a fully informed decision and to consent to the treatment.
11.2 CLAIM SUBMISSION INSTRUCTIONS
11.2.1 GENDER REASSIGNMENT PROCEDURES REQUIRING BY REPORT CLAIM SUBMISSION
When performing genital surgery for the purposes of gender reassignment, physicians may bill
code 55970 (intersex surgery; male to female) or 55980 (intersex surgery; female to male) or any of
the codes listed in the sections to follow. When using codes 55970 or 55980, claims must be
submitted via paper claim. The physician must include with the paper claim the operation report
and copies of the two referral letters from the NYS licensed health practitioners. Practitioners must
submit charges on an invoice for review and payment. These procedures do not require prior
approval.
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55970 Intersex surgery; male to female
The provider performs many staged procedures to convert male anatomy to female
anatomy. The procedures include removing the penis, reshaping genital tissue to appear
more female and constructing a vagina.
55980 Intersex surgery; female to male
The provider performs many staged procedures to convert female anatomy to male
anatomy. The procedures can include removing the uterus and ovaries and reshaping
genital tissue to appear more male and/or constructing a penis.
11.2.2 GENDER REASSIGNMENT PROCEDURES NOT REQUIRING BY REPORT CLAIM SUBMISSION
When performing the following procedures for the purpose of gender reassignment, physicians
must obtain and maintain in their records copies of the two referrals letters from the NYS licensed
health practitioners. These procedures do not require prior approval or paper claim submission:
19303 Mastectomy, simple, complete
19318: Reduction mammaplasty (unilateral)
19325: Breast augmentation with implant
For male-to-female gender reassignment, augmentation mammaplasty may be considered
medically necessary for individuals with a diagnosis of gender dysphoria when:
• that individual’s breast growth has been determined to be negligible by the
individual’s treating NYS licensed health professional after 24 months of cross-
sex hormone therapy, or
• hormone therapy is medically contraindicated, or
• the individual is otherwise unable to take hormones.
53410 Urethroplasty, 1-stage reconstruction of male anterior urethra.
53420 Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra.
53430 Urethroplasty, reconstruction of female urethra
54120 Amputation of penis: partial
54125 Amputation of penis; complete
54520 Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or
inguinal approach
54522 Orchiectomy, partial
54660 Insertion of testicular prosthesis (separate procedure)
55175 Scrotoplasty; simple.
55180 Scrotoplasty; complicated
55899 Metoidioplasty/ Phalloplasty (unlisted procedure, male genital system)
56800 Plastic repair of introitus
56805 Clitoroplasty for intersex state
57106 Vaginectomy, partial removal of vaginal wall
57110 Vaginectomy, complete removal of vaginal wall
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Additional instructions for billing the hysterectomy codes listed below can be found in the “General
Information and Rules” section at the beginning of this manual, including information on the
“Hysterectomy Receipt of Information Form.”
58150 Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with
or without removal of ovary(s)
58152 with colpo-urethrocystopexy (e.g., Marshall-Machetti-Krantz, Burch)
58180 Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of
tube(s), with or without removal of ovary(s)
58260 Vaginal hysterectomy, for uterus 250 grams or less;
58262 with removal of tube(s), and/or ovary(s)
58263 with removal of tube(s), and/or ovary(s), with repair of enterocele
58267 with colpo-urethrocystopexy (Marshall-Marchetti-Krantz Type, Pereyra type, with or
without endoscopic control)
58270 with repair of enterocele
58275 Vaginal hysterectomy, with total or partial vaginectomy;
58280 with repair of enterocele
58285 Vaginal hysterectomy, radical (Schauta type operation)
58290 Vaginal hysterectomy, for uterus greater than 250 grams;
58291 with removal of tube(s) and/or ovary(s)
58292 with removal of tube(s) and/or ovary(s), with repair of enterocele
58294 with repair of enterocele
58720 Salpingo-oophorectomy, complete or partial, unilateral or bilateral
58940 Oophorectomy, partial or total, unilateral or bilateral
11.2.3 GENDER REASSIGNMENT PROCEDURES REQUIRING PRIOR APPROVAL
When performing the following procedures for purposes of gender reassignment, prior approval is
required. As part of the prior approval request, physicians must, at a minimum, submit copies of
the two referral letters from the NYS licensed health practitioners recommending the patient for
surgery and additional justification of medical necessity for the requested procedure. Additional
information about the prior approval process, including instructions for providers, is available in the
Physician Prior Approval Guidelines manual, available at:
https://www.emedny.org/ProviderManuals/Physician/PDFS/Physician_PA_Guidelines.pdf
.
11950 Subcutaneous injection of filling material (eg, collagen); 1 cc or less
11951 1.1 to 5 cc
11952 5.1 to 10 cc
11954 over 10 cc
15769 Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis,
fascial)
15771 G
rafting of autologous fat, harvested by liposuction technique to trunk, breasts, scalp, arms,
and/or legs; 50 cc or less injectate
15772 ea
ch additional 50 cc injectate, or part thereof (List separately in addition to code
for primary procedure)
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15773 Grafting of autologous fat, harvested by liposuction technique to face, eyelids, mouth, neck,
ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate
15774 ea
ch additional 25 cc or less injectate, or part thereof (List separately in addition to
the code for primary procedure)
15775 P
unch graft for hair transplant; 1 to 15 punch grafts
15776 more than 15 punch grafts
15820 Blepharoplasty, lower eyelid;
15821 with extensive herniated fat pad
15822 Blepharoplasty, upper eyelid;
15823 with excessive skin weighting down lid
15824 Rhytidectomy; forehead
15825 neck with platysmal tightening (platysmal flap, P-flap)
15826 glabellar frown lines
15828] cheek, chin, and neck
15830 Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen,
infraumbilical panniculectomy
15832 thigh
15833 leg
15834 hip
15835 buttock
15836 arm
15837 forearm or hand
15838 submental fat pad
15839 other area
15847 Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (eg,
abdominoplasty) (includes umbilical transposition and fascial plication)
15876 Su
ction assisted lipectomy; head and neck
15877 trunk
15878 upper extremity
15879 lower extremity
17380 Electrolysis epilation, each 30 minutes
19316 Mastopexy (unilateral)
21120 Genioplasty; augmentation (autograft, allograft, prosthetic material)
21123 sliding, augmentation with interpositional bone grafts (includes obtaining
autografts)
21193 R
econstruction of mandibular rami, horizontal, vertical, "C", or "L" osteotomy; without bone
graft
21208 O
steoplasty, facial bones; augmentation (autograft, allograft or prosthetic implant)
21209 reduction
21270 Malar augmentation, prosthetic material
30400 Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip
30410 complete, external parts including bony pyramid, lateral and alar cartilages, and/or
elevation of nasal tip
30420 including major septal repair
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30430 Rhinoplasty, secondary; minor revision (small amount of nasal tip work)
30435 intermediate revision (bony work with osteotomies)
30450 major revision (nasal tip work and osteotomies)
30462 tip, septum, osteotomies
30465 Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall
reconstruction)
31599 Unlisted procedure, larynx
40500 Vermilionectomy (lip shave), with mucosal advancement
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
54408 R
epair 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 R
emoval 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
54416 R
emoval and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile
prosthesis at the same operative session
54417 R
emoval 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
67900 Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)
12 FEMALE GENITAL SERVICES
12.1 FEMALE GENITAL SYSTEM
12.1.1 VULVA, PERINEUM AND INTROITUS
12.1.1.1 INCISION
56405 Incision and drainage of vulva or perineal abscess
56420 Incision and drainage of Bartholin's gland abscess
56440 Marsupialization of Bartholin's gland cyst
56441 Lysis of labial adhesions
56442 Hymenotomy, simple incision
12.1.1.2 DESTRUCTION
56501 Destruction of lesion(s), vulva; simple, (laser surgery, electrosurgery, cryosurgery,
chemosurgery)
56515 extensive, (laser surgery, electrosurgery, cryosurgery, chemosurgery)
12.1.1.3 EXCISION
56605 Biopsy of vulva or perineum. (separate procedure); one lesion
Physician - Surgery
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56606 each separate additional lesion
56620 Vulvectomy simple; partial
56625 complete
56630 Vulvectomy, radical, partial;
56631 with unilateral inguinofemoral lymphadenectomy
56632 with bilateral inguinofemoral lymphadenectomy
56633 Vulvectomy, radical, complete;
56634 with unilateral inguinofemoral lymphadenectomy
56637 with bilateral inguinofemoral lymphadenectomy
56640 Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy
56700 Partial hymenectomy or revision of hymenal ring
56740 Excision of Bartholin's gland or cyst
12.1.1.4 REPAIR
56800 Plastic repair of introitus
56805 Clitoroplasty for intersex state
56810 Perineoplasty, repair of perineum, nonobstetrical (separate procedure)
12.1.1.5 ENDOSCOPY
56820 Colposcopy of the vulva;
56821 with biopsy(s)
12.1.2 VAGINA
12.1.2.1 INCISION
57000 Colpotomy; with exploration
57010 with drainage of pelvic abscess
57020 Colpocentesis (separate procedure)
57022 Incision and drainage of vaginal hematoma; obstetrical/post-partum
57023 non-obstetrical (eg, post-trauma, spontaneous bleeding)
12.1.2.2 DESTRUCTION
57061 Destruction of vaginal lesion(s); simple, (eg, laser surgery, electrosurgery, cryosurgery,
chemosurgery)
57065 extensive, (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)
12.1.2.3 EXCISION
57100 Biopsy of vaginal mucosa; simple (separate procedure)
57105 extensive, requiring suture (including cysts)
57106 Vaginectomy, partial removal of vaginal wall;
57107 with removal of paravaginal tissue (radical vaginectomy)
57109 with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic
lymphadenectomy and para-aortic lymph node sampling (biopsy)
57110 Vaginectomy, complete removal of vaginal wall;
57111 with removal of paravaginal tissue (radical vaginectomy)
Physician - Surgery
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57120 Colpocleisis (Le Fort Type)
57130 Excision of vaginal septum
57135 Excision of vaginal cyst or tumor
12.1.2.4 INTRODUCTION
57150 Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic,
or fungoid disease
57155 Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy
57156 Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy
57160 Fitting and insertion of pessary or other intravaginal support device
57180 Introduction of any hemostatic agent or pack for spontaneous or traumatic
nonobstetrical hemorrhage (separate procedure)
12.1.2.5 REPAIR
57200 Colporrhaphy, suture of injury of vagina (nonobstetrical)
57210 Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical)
57220 Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral plication)
57230 Plastic repair of urethrocele
57240 Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele,
including cystourethroscopy, when performed
57250 Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy
57260 Combined anteroposterior colporrhaphy; including cystourethroscopy, when performed;
57265 with enterocele repair
57267 Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior,
posterior compartment), vaginal approach
57268 Repair of enterocele, vaginal approach (separate procedure)
57270 Repair of enterocele, abdominal approach (separate procedure)
57280 Colpopexy, abdominal approach
57282 Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus)
57283 intra-peritoneal approach (uterosacral, levator myorrhaphy)
57284 Paravaginal defect repair (including repair of cystocele, if performed); open abdominal
approach
57285 vaginal approach
57287 Removal or revision of sling for stress incontinence (eg, fascia or synthetic)
57288 Sling operation for stress incontinence (eg, fascia or synthetic)
57289 Pereyra procedure, including anterior colporrhaphy
57291 Construction of artificial vagina; without graft
57292 with graft
57295 Revision (including removal) of prosthetic vaginal graft, vaginal approach
57296 open abdominal approach
57300 Closure of rectovaginal fistula; vaginal or transanal approach
57305 abdominal approach
57307 abdominal approach, with concomitant colostomy
57308 transperineal approach, with perineal body reconstruction, with or without levator
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plication
57310 Closure of urethrovaginal fistula;
57311 with bulbocavernosus transplant
57320 Closure of vesicovaginal fistula; vaginal approach
57330 transvesical and vaginal approach
57335 Vaginoplasty for intersex state
12.1.2.6 MANIPULATION
57400 Dilation of vagina under anesthesia (other than local)
57410 Pelvic examination under anesthesia (other than local)
57415 Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other
than local)
12.1.2.7 ENDOSCOPY/LAPAROSCOPY
57420 Colposcopy of the entire vagina, with cervix if present;
57421 with biopsy(s) of vagina/cervix
57423 Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic
approach
57425 Laparoscopy, surgical, colpopexy (suspension of vaginal apex)
57426 Revision (including removal) of prosthetic vaginal graft, laparoscopic approach
12.1.3 CERVIX UTERI
12.1.3.1 ENDOSCOPY
57452 Colposcopy of the cervix including upper/adjacent vagina;
57454 with biopsy(s) of the cervix and endocervical curettage
57455 with biopsy(s) of the cervix
57456 with endocervical curettage
57460 with loop electrode biopsy(s) of the cervix
57461 with loop electrode conization of the cervix
57465 Computer-aided mapping of cervix uteri during colposcopy, including optical dynamic
spectral imaging and algorithmic quantification of the acetowhitening effect (List
separately in addition to code for primary procedure)
12.1.3.2 EXCISION
57500 Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration
(separate procedure)
57505 Endocervical curettage (not done as part of a dilation and curettage)
57510 Cautery of cervix; electro or thermal
57511 cryocautery, initial or repeat
57513 laser ablation
57520 Conization of cervix, with or without fulguration, with or without dilation and curettage,
with or without repair; cold knife or laser
57522 loop electrode excision
57530 Trachelectomy (cervicectomy), amputation of cervix (separate procedure)
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57531 Radical trachelectomy, 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)
57540 Excision of cervical stump, abdominal approach;
57545 with pelvic floor repair
57550 Excision of cervical stump, vaginal approach;
57555 with anterior and/or posterior repair
57556 with repair of enterocele
57558 Dilation and curettage of cervical stump
12.1.3.3 REPAIR
57700 Cerclage of uterine cervix, nonobstetrical
57720 Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach
12.1.3.4 MANIPULATION
57800 Dilation of cervical canal, instrumental (separate procedure)
12.1.4 CORPUS UTERI
12.1.4.1 EXCISION
58100 Endometrial sampling (biopsy), with or without endocervical sampling (biopsy), without
cervical dilation, any method (separate procedure)
58110 Endometrial sampling (biopsy) performed in conjunction with colposcopy
58120 Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)
58140 Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total
weight of 250 grams or less and/or removal of surface myomas; abdominal approach
58145 vaginal approach
58146 Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas
and/or intramural myomas with total weight greater than 250 grams, abdominal
approach
12.1.4.1.1 HYSTERECTOMY PROCEDURES
(For codes 58150-58294, See Rule N, Receipt of Hysterectomy Information)
58150 Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s),
with or without removal of ovary(s);
58152 with colpo-urethrocystopexy (eg, 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
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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 grams or less;
58262 with removal of tube(s), and/or ovary(s)
58263 with removal of tube(s), and/or ovary(s), with repair of enterocele
58267 with colpo-urethrocystopexy (Marshall-Marchetti-Krantz Type, Pereyra type, with or
without endoscopic control)
58270 with repair of enterocele
58275 Vaginal hysterectomy, with total or partial vaginectomy;
58280 with repair of enterocele
58285 Vaginal hysterectomy, radical (Schauta type operation)
58290 Vaginal hysterectomy, for uterus greater than 250 grams;
58291 with removal of tube(s) and/or ovary(s)
58292 with removal of tube(s) and/or ovary(s), with repair of enterocele
58294 with repair of enterocele
12.1.4.2 INTRODUCTION
58300 Insertion of intrauterine device (IUD)
58301 Removal of intrauterine device (IUD)
58340 Catheterization and introduction of saline or contrast material for saline infusion
sonohysterography (sis) or hysterosalpingography
58346 Insertion of Heyman capsules for clinical brachytherapy
58353 Endometrial ablation, thermal, without hysteroscopic guidance
58356 Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when
performed
12.1.4.3 REPAIR
58400 Uterine suspension, with or without shortening of round ligaments, with or without
shortening of sacrouterine ligaments; (separate procedure)
58410 with presacral sympathectomy
58520 Hysterorrhaphy, repair of ruptured uterus (nonobstetrical)
58540 Hysteroplasty, repair of uterine anomaly (Strassman type)
12.1.4.4 LAPAROSCOPY / HYSTEROSCOPY
(See Rule N, Receipt of Hysterectomy Information)
(For code 58565, See Rule M, Informed Consent for Sterilization)
58674 Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasonic
guidance and monitoring, radiofrequency
58541 Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;
58542 with removal of tube(s) and/or ovary(s)
58543 Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;
58544 with removal of tube(s) and/or ovary(s)
58545 Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight
Physician - Surgery
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of 250 grams or less and/or removal of surface myomas
58546 5 or more intramural myomas and/or intramural myomas with total weight greater
than 250 grams
58548 Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic
lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of
tube(s) and ovary(s), if performed
58550 Laparoscopy surgical, with vaginal hysterectomy, for uterus 250 grams or less;
58552 with removal of tube(s) and/or ovary(s)
58553 Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 grams;
58554 with removal of tube(s) and/or ovary(s)
58555 Hysteroscopy, diagnostic (separate procedure)
58558 Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with
or without D&C
58559 with lysis of intrauterine adhesions (any method)
58560 with division or resection of intrauterine septum (any method)
58561 with removal of leiomyomata
58562 with removal of impacted foreign body
58563 with endometrial ablation (eg, endometrial resection, electrosurgical ablation,
thermoablation)
58565 with bilateral fallopian tube cannulation to induce occlusion by placement of
permanent implants
A4264 Permanent implantable contraceptive intratubal occlusion device(s) and delivery system
58570 Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;
58571 with removal of tube(s) and/or ovary(s)
58572 Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;
58573 with removal of tube(s) and/or ovary(s)
58575 Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking),
with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when
performed
58578 Unlisted laparoscopy procedure, uterus
58579 Unlisted hysteroscopy procedure, uterus
12.1.5 OVIDUCT/OVARY
12.1.5.1 INCISION
(For codes 58600-58615, See Rule M, Informed Consent for Sterilization)
58600 Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or
bilateral
58605 Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum,
unilateral or bilateral, during same hospitalization (separate procedure)
58611 Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or
intra-abdominal surgery (not a separate procedure)
58615 Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic
approach
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12.1.5.2 LAPAROSCOPY
(For codes 58670, 58671, See Rule M, Informed Consent for Sterilization)
58660 Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate
procedure)
58661 with removal of adnexal structures (partial or total oophorectomy and/or
salpingectomy)
58662 with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal
surface by any method
58670 with fulguration of oviducts (with or without transection)
58671 with occlusion of oviducts by device (eg, band, clip, or Falope ring)
58673 with salpingostomy (salpingoneostomy)
58679 Unlisted laparoscopy procedure, oviduct, ovary
12.1.5.3 EXCISION
58700 Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)
58720 Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)
12.1.5.4 REPAIR
58740 Lysis of adhesions (salpingolysis, ovariolysis)
58770 Salpingostomy (salpingoneostomy)
12.1.6 OVARY
12.1.6.1 INCISION
58800 Drainage of ovarian cyst(s), unilateral or bilateral, (separate procedure); vaginal approach
58805 abdominal approach
58820 Drainage of ovarian abscess; vaginal approach, open
58822 abdominal approach
58825 Transposition, ovary(s)
12.1.6.2 EXCISION
(See Rule N, Receipt of Hysterectomy Information)
58900 Biopsy of ovary, unilateral or bilateral (separate procedure)
58920 Wedge resection or bisection of ovary, unilateral or bilateral
58925 Ovarian cystectomy, unilateral or bilateral
58940 Oophorectomy, partial or total, unilateral or bilateral;
58943 for ovarian, tubal or primary peritoneal malignancy, with para aortic and pelvic
lymph node biopsies, peritoneal washings, peritoneal biopsies, diaphragmatic
assessments, with or without salpingectomy(s) with or without omentectomy
58950 Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral
salpingo-oophorectomy and omentectomy;
58951 with total abdominal hysterectomy, pelvic and limited para-aortic
lymphadenectomy
58952 with radical dissection for debulking (ie, radical excision or destruction, intra-
abdominal or retroperitoneal tumors)
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58953 Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and
radical dissection for debulking;
58954 with pelvic lymphadenectomy and limited para-aortic lymphadenectomy
58956 Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy
for malignancy
58957 Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine
malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed;
58958 with pelvic lymphadenectomy and limited para-aortic lymphadenectomy
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
12.1.6.3 OTHER PROCEDURES
58999 Unlisted procedure, female genital system, nonobstetrical
13 MATERNITY CARE AND DELIVERY SERVICES
Reimbursement amounts for the Medicaid Obstetrical and Maternal Services Program (MOMS), are
noted in the Enhanced Program excel Fee Schedule. For information on the MOMS Program, see
Policy Section.
13.1 MATERNITY CARE AND DELIVERY
13.1.1 ANTEPARTUM FETAL INVASIVE SERVICES
59000 Amniocentesis; diagnostic
59001 therapeutic amniotic fluid reduction (includes ultrasound guidance)
59012 Cordocentesis (intrauterine), any method
59015 Chorionic villus sampling, any method
59020 Fetal contraction stress test
59025 Fetal non-stress test
59030 Fetal scalp blood sampling
59050 Fetal monitoring during labor by consulting physician (ie, non-attending physician) with
written report; supervision and interpretation
59070 Transabdominal amnioinfusion, including ultrasound guidance
59072 Fetal umbilical cord occlusion, including ultrasound guidance
59074 Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including
ultrasound guidance
59076 Fetal shunt placement, including ultrasound guidance
13.1.2 EXCISION
59100 Hysterotomy, abdominal (eg, for hydatidiform mole, abortion)
59120 Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy
and/or oophorectomy, abdominal or vaginal approach
59121 tubal or ovarian, without salpingectomy and/or oophorectomy
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59130 abdominal pregnancy
59136 interstitial, uterine pregnancy with partial resection of uterus
59140 cervical, with evacuation
59150 Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or
oophorectomy
59151 with salpingectomy and/or oophorectomy
59160 Curettage, postpartum
13.1.3 INTRODUCTION
59200 Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)
13.1.4 REPAIR
59300 Episiotomy or vaginal repair, by other than attending
59320 Cerclage of cervix, during pregnancy; vaginal
59325 abdominal
59350 Hysterorrhaphy of ruptured uterus
13.1.5 VAGINAL DELIVERY, ANTEPARTUM AND POSTPARTUM CARE
59400 Routine obstetric care including antepartum care, vaginal delivery (with or without
episiotomy, and/or forceps) and
(inpatient and outpatient) postpartum care (total, all-
inclusive, "global" care)
59409 Vaginal delivery only (with or without episiotomy and/or forceps); (when only inpatient
postpartum care is provided in addition to delivery, see appropriate HOSPITAL E/M
code(s) for postpartum care visits)
59410 including (inpatient and outpatient) postpartum care
59412 External cephalic version, with or without tocolysis
59414 Delivery of placenta (separate procedure)
59425 Antepartum care only; 4-6 visits
59426 7 or more visits
(For 6 or less antepartum encounters, see code 59425)
Note: Antepartum services will no longer require prorated charges. This applies to all
prenatal care providers, including those enrolled in the MOMS program. Providers should
bill one unit of the appropriate antepartum code after all antepartum care has been
rendered using the last antepartum visit as the date of service. Only one antepartum care
code will be reimbursed per pregnancy.
59430 Postpartum care only (outpatient) (separate procedure)
13.1.6 CESAREAN DELIVERY
59510 Routine obstetric care including antepartum care, cesarean delivery, and (inpatient and
outpatient) postpartum care (total, all-inclusive, "global" care)
59514 Cesarean delivery only; (when only inpatient postpartum care is provided in addition to
delivery, see appropriate HOSPITAL E/M code(s) for postpartum care visits)
59515 including (inpatient and outpatient) postpartum care
59525 Subtotal or total hysterectomy after cesarean delivery (See Rule N)
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13.1.7 DELIVERY AFTER PREVIOUS CESAREAN DELIVERY
59610 Routine obstetric care including antepartum care, vaginal delivery (with or without
episiotomy, and/or forceps) and (inpatient and outpatient) postpartum care, after
previous cesarean delivery (total, all-inclusive, "global" care)
59612 Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or
forceps); (when only inpatient postpartum care is provided in addition to delivery, see
appropriate HOSPITAL E/M code(s) for postpartum care visits)
59614 including (inpatient and outpatient) postpartum care
59618 Routine obstetric care including antepartum care, cesarean delivery, and (inpatient and
outpatient) postpartum care, following attempted vaginal delivery after previous cesarean
delivery (total, all-inclusive, "global" care)
59620 Cesarean delivery only, following attempted vaginal delivery after previous cesarean
delivery; (when only inpatient postpartum care is provided in addition to delivery, see
appropriate HOSPITAL E/M code(s) for postpartum care visits)
59622 including (inpatient and outpatient) postpartum care
13.1.8 ABORTION
(Ultrasound service(s) provided in conjunction with procedure codes 59812 through 59857 are
reimbursable
ONLY via echography code 76815. Procedure code 76815 should be billed regardless
of the approach used to perform the ultrasound (eg, transvaginal))
59812 Treatment of incomplete abortion, any trimester, completed surgically
59820 Treatment of missed abortion, completed surgically; first trimester
59821 second trimester
59830 Treatment of septic abortion, completed surgically
59840 Induced abortion, by dilation and curettage
59841 Induced abortion, by dilation and evacuation
59850 Induced abortion, by one or more intra-amniotic injections (amniocentesis-injections),
including hospital admission and visits, delivery of fetus and secundines;
59851 with dilation and curettage and/or evacuation
59852 with hysterotomy (failed intra-amniotic injection)
59855 Induced abortion, by one or more vaginal suppositories (eg, prostaglandin) with or
without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of
fetus and secundines;
59856 with dilation and curettage and/or evacuation
59857 with hysterotomy (failed medical evaluation)
13.1.9 OTHER PROCEDURES
59870 Uterine evacuation and curettage for hydatidiform mole
59871 Removal of cerclage suture under anesthesia (other than local)
59897 Unlisted fetal invasive procedure, including ultrasound guidance, when performed
59898 Unlisted laparoscopy procedure, maternity care and delivery
59899 Unlisted procedure, maternity care and delivery
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14 ENDOCRINE SYSTEM SERVICES
14.1 ENDOCRINE SYSTEM
14.1.1 THYROID GLAND
14.1.1.1 INCISION
60000 Incision and drainage of thyroglossal duct cyst, infected
14.1.1.2 EXCISION
60100 Biopsy thyroid, percutaneous core needle
60200 Excision of cyst or adenoma of thyroid, or transection of isthmus
60210 Partial thyroid lobectomy, unilateral; with or without isthmusectomy
60212 with contralateral subtotal lobectomy, including isthmusectomy
60220 Total thyroid lobectomy, unilateral; with or without isthmusectomy
60225 with contralateral subtotal lobectomy, including isthmusectomy
60240 Thyroidectomy, total or complete
60252 Thyroidectomy, total or subtotal for malignancy; with limited neck dissection
60254 with radical neck dissection
60260 Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a
portion of thyroid
60270 Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach
60271 cervical approach
60280 Excision of thyroglossal duct cyst or sinus;
60281 recurrent
14.1.1.3 REMOVAL
60300 Aspiration and/or injection, thyroid cyst
14.1.2 PARATHYROID, THYMUS, ADRENAL GLANDS, PANCREAS, AND CARTOID BODY
14.1.2.1 EXCISION
60500 Parathyroidectomy or exploration of parathyroid(s);
60502 re-exploration
60505 with mediastinal exploration, sternal split or transthoracic approach
60512 Parathyroid autotransplantation
60520 Thymectomy, partial or total; transcervical approach (separate procedure)
60521 sternal split or transthoracic approach, without radical mediastinal dissection
(separate procedure)
60522 sternal split or transthoracic approach, with radical mediastinal dissection (separate
procedure)
60540 Adrenalectomy, partial or complete, or exploration of adrenal gland with or without
biopsy, transabdominal, lumbar or dorsal (separate procedure);
60545 with excision of adjacent retroperitoneal tumor
60600 Excision of carotid body tumor; without excision of carotid artery
60605 with excision of carotid artery
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14.1.2.2 LAPAROSCOPY
60650 Laparoscopy, surgical; with adrenalectomy, partial or complete, or exploration of adrenal
gland with or without biopsy, transabdominal, lumbar or dorsal
60659 Unlisted laparoscopy procedure, endocrine system
14.1.2.3 OTHER PROCEDURES
60699 Unlisted procedure, endocrine system
15 NERVOUS SYSTEM SERVICES
15.1 NERVOUS SYSTEM
15.1.1 SKULL, MENINGES, AND BRAIN
15.1.1.1 INJECTION, DRAINAGE OR ASPIRATION
61000 Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial
61001 subsequent taps
61020 Ventricular puncture through previous burr hole, fontanelle, suture, or implanted
ventricular catheter/reservoir; without injection
61026 with injection of medicament or other substance for diagnosis or treatment
61050 Cisternal or lateral cervical (Cl-C2) puncture; without injection (separate procedure)
61055 with injection of medication or other substance for diagnosis or treatment
61070 Puncture of shunt tubing or reservoir for aspiration or injection procedure
15.1.1.2 TWIST DRILL, BURR HOLE(S) OR TREPHINE
(For codes 61107, 61210 for intracranial neuroendoscopic ventricular catheter placement, use 62160)
61105 Twist drill hole for subdural or ventricular puncture;
61107 Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting
ventricular catheter, pressure recording device, or other intracerebral monitoring device
61108 for evacuation and/or drainage of subdural hematoma
61120 Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye or
radioactive material);
61140 Burr hole(s) or trephine; with biopsy of brain or intracranial lesion
61150 with drainage of brain abscess or cyst
61151 with subsequent tapping (aspiration) of intracranial abscess or cyst
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
61210 for implanting ventricular catheter, reservoir, EEG electrode(s), pressure recording
device, or other cerebral monitoring device (separate procedure)
61215 Insertion of subcutaneous reservoir, pump or continuous infusion system for connection
to ventricular catheter
61250 Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery
61253 Burr hole(s) or trephine, infratentorial, unilateral or bilateral
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15.1.1.3 CRANIECTOMY OR CRANIOTOMY
61304 Craniectomy or craniotomy, exploratory; supratentorial
61305 infratentorial (posterior fossa)
61312 Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or
subdural
61313 intracerebral
61314 Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or
subdural
61315 intracerebellar
61316 Incision and subcutaneous placement of cranial bone graft
61320 Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial
61321 infratentorial
61322 Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of
intracranial hypertension, without evacuation of associated intraparenchymal hematoma;
without lobectomy
61323 with lobectomy
61330 Decompression of orbit only, transcranial approach
61333 Exploration of orbit (transcranial approach) with removal of lesion
61340 Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome)
61343 Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and
spinal cord, with or without dural graft (eg, Arnold-Chiari malformation)
61345 Other cranial decompression, posterior fossa
61450 Craniectomy, subtemporal, for section, compression, or decompression of sensory root of
gasserian ganglion
61458 Craniectomy, suboccipital; for exploration or decompression of cranial nerves
61460 for section of one or more cranial nerves
61500 Craniectomy; with excision of tumor or other bone lesion of skull
61501 for osteomyelitis
61510 Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor,
supratentorial, except meningioma
61512 for excision of meningioma, supratentorial
61514 for excision of brain abscess, supratentorial
61516 for excision or fenestration of cyst, supratentorial
61517 Implantation of brain intracavitary chemotherapy agent
61518 Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except
meningioma, cerebellopontine angle tumor, or midline tumor at base of skull
61519 meningioma
61520 cerebellopontine angle tumor
61521 midline tumor at base of skull
61522 Craniectomy, infratentorial or posterior fossa; for excision of brain abscess
61524 for excision or fenestration of cyst
61526 Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of
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cerebellopontine angle tumor;
61530 combined with middle/posterior fossa craniotomy/craniectomy
61531 Subdural implantation of strip electrodes through one or more burr or trephine hole(s)
for long term seizure monitoring
61533 Craniotomy with elevation of bone flap; for subdural implantation of an electrode array,
for long term seizure monitoring
61534 for excision of epileptogenic focus without electrocorticography during surgery
61535 for removal of epidural or subdural electrode array, without excision of cerebral
tissue (separate procedure)
61536 for excision of cerebral epileptogenic focus, with electrocorticography during
surgery (includes removal of electrode array)
61537 for lobectomy, temporal lobe, without electrocorticography during surgery
61538 for lobectomy, temporal lobe, with electrocorticography during surgery
61539 for lobectomy, other than temporal lobe, partial or total with electrocorticography
during surgery
61540 for lobectomy, other than temporal lobe, partial or total, without
electrocorticography during surgery
61541 for transection of corpus callosum
61543 for partial or subtotal (functional) hemispherectomy
61544 for excision or coagulation of choroid plexus
61545 for excision of craniopharyngioma
61546 Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach
61548 Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach,
nonstereotactic
61550 Craniectomy for craniosynostosis; single cranial suture
61552 multiple cranial sutures
61556 Craniotomy for craniosynostosis; frontal or parietal bone flap
61557 bifrontal bone flap
61558 Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull);
not requiring bone grafts
61559 recontouring with multiple osteotomies and bone autografts (eg, barrel-stave
procedure) (includes obtaining grafts)
61563 Excision, intra- and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia);
without optic nerve decompression
61564 with optic nerve decompression
61566 Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy
61567 for multiple subpial transections, with electrocorticography during surgery
61570 Craniectomy or craniotomy; with excision of foreign body from brain
61571 with treatment of penetrating wound of brain
61575 Transoral approach to skull base, brain stem or upper spinal cord for biopsy,
decompression or excision of lesion;
61576 requiring splitting of tongue and/or mandible (including tracheostomy)
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15.1.1.4 SURGERY OF SKULL BASE
15.1.1.4.1 APPROACH PROCEDURES
15.1.1.4.1.1 ANTERIOR CRANIAL FOSSA
61580 Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy,
ethmoidectomy, sphenoidectomy, without maxillectomy or orbital exenteration
61581 extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy,
sphenoidectomy and/or maxillectomy
61582 extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s),
osteotomy of base of anterior cranial fossa
61583 intradural, including unilateral or bifrontal craniotomy, elevation or resection of
frontal lobe, osteotomy of base of anterior cranial fossa
61584 Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge
osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration
61585 with orbital exenteration
15.1.1.4.1.2 MIDDLE CRANIAL FOSSA
61586 Bicoronal, transzygomatic and/or LeFort I osteotomy approach to anterior cranial fossa
with or without internal fixation, without bone graft
61590 Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space,
infratemporal and midline skull base, nasopharynx), with or without disarticulation of the
mandible, including parotidectomy, craniotomy, decompression and/or mobilization of
the facial nerve and/or petrous carotid artery
61591 Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus,
petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including
mastoidectomy, resection of sigmoid sinus, with or without decompression and/or
mobilization of contents of auditory canal or petrous carotid artery
61592 Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid
artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy,
extra- or intradural elevation of temporal lobe
15.1.1.4.1.3 POSTERIOR CRANIAL FOSSA
61595 Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base,
including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or
without mobilization
61596 Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base,
including labyrinthectomy, decompression, with or without mobilization of facial nerve
and/or petrous carotid artery
61597 Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline
skull base including occipital condylectomy, mastoidectomy, resection of Cl-C3 vertebral
body(s), decompression of vertebral artery, with or without mobilization
61598 Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including
ligation of superior petrosal sinus and/or sigmoid sinus
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15.1.1.4.2 DEFINITIVE PROCEDURES
15.1.1.4.2.1 BASE OF ANTERIOR CRANIAL FOSSA
61600 Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial
fossa; extradural
61601 intradural, including dural repair, with or without graft
15.1.1.4.2.2 BASE OF MIDDLE CRANIAL FOSSA
61605 Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa,
parapharyngeal space, petrous apex; extradural
61606 intradural, including dural repair, with or without graft
61607 Resection or excision of neoplastic, vascular or infectious lesion of parasellar area,
cavernous sinus, clivus or midline skull base; extradural
61608 intradural, including dural repair, with or without graft
61611 Transection or ligation, carotid artery in petrous canal; without repair (List separately in
addition to primary procedure)
61613 Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous
fistula by dissection within cavernous sinus
15.1.1.4.2.3 BASE OF POSTERIOR CRANIAL FOSSA
61615 Resection or excision of neoplastic vascular or infectious lesion of base of posterior
cranial fossa, jugular foramen, foramen magnum, or CI-C3 vertebral bodies; extradural
61616 intradural, including dural repair, with or without graft
15.1.1.4.3 REPAIR AND/OR RECONSTRUCTION OF SURGICAL DEFECTS OF SKULL BASE
61618 Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial
fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia,
tensor fascia lata, adipose tissue, homologous or synthetic grafts)
61619 by local or regionalized vascularized pedicle flap or myocutaneous flap (including
galea, temporalis, frontalis or occipitalis muscle)
15.1.1.5 ENDOVASCULAR THERAPY
61623 Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial)
including selective catheterization of vessel to be occluded, positioning and inflation of
occlusion balloon, concomitant neurological monitoring, and radiologic supervision and
interpretation of all angiography required for balloon occlusion and to exclude vascular
injury post occlusion
61624 Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve
hemostasis, to occlude a vascular malformation), percutaneous, any method; central
nervous system (intracranial, spinal cord)
61626 non-central nervous system, head or neck (extracranial, brachiocephalic branch)
61630 Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous
61635 Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic
stenosis), including balloon angioplasty, if performed
61640 Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel
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61641 each additional vessel in same vascular territory
61642 each additional vessel in different vascular territory
61645 Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for
thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic
guidance, catheter placement, and intraprocedural pharmacological thrombolytic
injection(s)
61650 Endovascular intracranial prolonged administration of pharmacologic agent(s) other than
for thrombolysis, arterial, including catheter placement, diagnostic angiography, and
imaging guidance; initial vascular territory
61651 each additional vascular territory (List separately in addition to code for primary
procedure)
15.1.1.6 SURGERY FOR ANEURYSM, ARTERIOVENOUS MALFORMATION OR VASCULAR DISEASE
61680 Surgery of intracranial arteriovenous malformation; supratentorial, simple
61682 supratentorial, complex
61684 infratentorial, simple
61686 infratentorial, complex
61690 dural, simple
61692 dural, complex
61697 Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation
61698 vertebrobasilar circulation
61700 Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation
61702 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
61708 by intracranial electrothrombosis
61710 by intra-arterial embolization, injection procedure, or balloon catheter
61711 Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries
15.1.1.7 STEREOTAXIS
Coverage for 61781-61783 Stereotactic Computer-Assisted Volumetric (Navigational) Procedures is
allowed only under the following conditions:
Procedure to be performed as a pre-surgical assessment and/or intraoperative assessment, in
preparation for, and execution of planned craniotomy (CPT codes 61304-61576), along with a
diagnosis of arteriovenous malformation of brain, malignant or benign neoplasm of the brain, or
intractable epilepsy.
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 subcortical structure(s) other than globus pallidus or thalamus
61750 Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion;
61751 with computed tomography and/or magnetic resonance guidance
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61760 Stereotactic implantation of depth electrodes into the cerebrum for long term seizure
monitoring
61770 Stereotactic localization, including burr hole(s); with insertion of catheter(s) or probe(s) for
placement of radiation source
61781 Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List
separately in addition to primary procedure)
61782 cranial, extradural (List separately in addition to primary procedure)
61783 spinal (List separately in addition to primary procedure)
61790 Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol,
thermal, electrical, radiofrequency); gasserian ganglion
61791 trigeminal medullary tract
15.1.1.8 STEREOTACTIC RADIOSURGERY (CRANIAL)
61796 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple
cranial lesion
61797 each additional cranial lesion, simple (List separately in addition to primary
procedure)
61798 1 complex cranial lesion
61799 each additional cranial lesion, complex (List separately in addition to primary
procedure)
61800 Application of stereotactic headframe for stereotactic radiosurgery (List separately in
addition to primary procedure)
15.1.1.9 NEUROSTIMULATORS (INTRACRANIAL)
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 (eg, thalamus, globus pallidus,
subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative
microelectrode recording; first array
61864 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 (eg, thalamus, globus pallidus,
subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative
microelectrode recording; first array
61868 each additional array (List separately in addition to primary procedure)
61880 Revision or removal of intracranial neurostimulator electrodes
61885 Incision or replacement of cranial neurostimulator pulse generator or receiver, direct or
inductive coupling; with connection to a single electrode array
61886 with connection to two or more electrode arrays
61888 Revision or removal of cranial neurostimulator pulse generator or receiver
61889 Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including
craniectomy or craniotomy, when performed, with direct or inductive coupling, with
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connection to depth and/or cortical strip electrode array(s)
61891 Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including
craniectomy or craniotomy, when performed, with direct or inductive coupling, with
connection to depth and/or cortical strip electrode array(s)
61892 Removal of skull-mounted cranial neurostimulator pulse generator or receiver with
cranioplasty, when performed
15.1.1.10 REPAIR
62000 Elevation of depressed skull fracture; simple, extradural
62005 compound or comminuted, extradural
62010 with repair of dura and/or debridement of brain
62100 Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for
rhinorrhea/otorrhea
62115 Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or
cranioplasty
62117 requiring craniotomy and reconstruction with or without bone graft
(includes obtaining grafts)
62120 Repair of encephalocele, skull vault, including cranioplasty
62121 Craniotomy for repair of encephalocele, skull base
62140 Cranioplasty for skull defect; up to 5 cm diameter
62141 larger than 5 cm diameter
62142 Removal of bone flap or prosthetic plate of skull
62143 Replacement of bone flap or prosthetic plate of skull
62145 Cranioplasty for skull defect with reparative brain surgery
62146 Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter
62147 larger than 5 cm diameter
62148 Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (List separately
in addition to primary procedure)
15.1.1.11 NEUROENDOSCOPY
62160 Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and
attachment to shunt system or external drainage (List separately in addition to primary
procedure)
62161 Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum
pellucidum or intraventricular cysts (including placement, replacement, or removal of
ventricular catheter)
62162 with fenestration or excision of colloid cyst, including placement of external
ventricular catheter for drainage
62164 with excision of brain tumor, including placement of external ventricular catheter for
drainage
62165 with excision of pituitary tumor, transnasal or trans-sphenoidal approach
15.1.1.12 CEREBROSPINAL FLUID (CSF) SHUNT
62180 Ventriculocisternostomy (Torkildsen type operation)
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62190 Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular
62192 subarachnoid/subdural-peritoneal, -pleural, -other terminus
62194 Replacement or irrigation, subarachnoid/subdural catheter
62200 Ventriculocisternostomy, third ventricle
62201 stereotactic, neuroendoscopic method
62220 Creation of shunt; ventriculo-atrial, -jugular, -auricular
62223 ventriculo-peritoneal, -pleural, -other terminus
62225 Replacement or irrigation, ventricular catheter
62230 Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter
in shunt system
62252 Reprogramming of programmable cerebrospinal fluid shunt
62256 Removal of complete cerebrospinal fluid shunt system; without replacement
62258 with replacement by similar or other shunt at same operation
15.1.2 SPINE AND SPINAL CORD
15.1.2.1 INJECTION, DRAINAGE OR ASPIRATION
62263 Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline,
enzyme) or mechanical means (eg, catheter) including radiologic localization (includes
contrast when administered), multiple adhesiolysis sessions; 2 or more days
62264 1 day
62267 Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral
tissue for diagnostic purposes
62268 Percutaneous aspiration, spinal cord cyst or syrinx
62269 Biopsy of spinal cord, percutaneous needle
62270 Spinal puncture, lumbar, diagnostic
62328 with fluoroscopic or CT guidance
62272 Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter)
62329 with fluoroscopic or CT guidance
62273 Injection, epidural, of blood or clot patch
62280 Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions) with
or without other therapeutic substance; subarachnoid
62281 epidural, cervical or thoracic
62282 epidural, lumbar, sacral (caudal)
62284 Injection procedure for myelography and/or computed tomography, lumbar
(other than C1-C2 and posterior fossa)
62287 Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any
method utilizing needle based technique to remove disc material under fluoroscopic
imaging or other form of indirect visualization, with discography and/or epidural
injection(s) at the treated level(s), when performed, single or multiple levels, lumbar
62290 Injection procedure for discography, each level; lumbar
62291 cervical or thoracic
62292 Injection procedure for chemonucleolysis, including discography, intervertebral disk,
single or multiple levels, lumbar
62294 Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal
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62302 Myelography via lumbar injection, including radiological supervision
and interpretation; cervical
62303 thoracic
62304 lumbosacral
62305 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/
cervical, lumbar/thoracic/cervical)
62320 Injection(s) of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic
opioid, steroid, other solution), not including neurolytic substances, including needle or
catheter placement, interlaminar epidual or subarachnoid, cervical or thoracic; without
imaging guidance
62321 with imaging guidance (ie, fluoroscopy or CT)
62322 Injection(s) of diagnostic or therapeutic substance(s) (eg, 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
62323 with imaging guidance (ie, fluoroscopy or CT)
62324 Injection(s), including indwelling catheter placement, continuous infusion or intermittent
bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic opioid,
steroid, other solution), not including neurolytic substances, interlaminar epidural or
subarachnoid, cervical or thoracic; without imaging guidance
62325 with imaging guidance (ie, fluoroscopy or CT)
62326 Injection(s), including indwelling catheter placement, continuous infusion or
intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic,
antispasmodic opioid, steroid, other solution), not including neurolytic substances,
interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging
guidance
62327 with imaging guidance (ie, fluoroscopy or CT)
15.1.2.2 CATHETER IMPLANTATION
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 with laminectomy
62355 Removal of previously implanted intrathecal or epidural catheter
15.1.2.3 RESERVOIR/PUMP IMPLANTATION
62360 Implantation or replacement of device for intrathecal or epidural drug infusion;
subcutaneous reservoir
62361 nonprogrammable pump
62362 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
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infusion (includes evaluation of reservoir status, alarm status, drug prescription status);
without reprogramming or refill
62368 with reprogramming
62370 with reprogramming and refill (requiring skill of a physician or other qualified health
care professional)
15.1.2.4 POSTERIOR EXTRADURAL LAMINOTOMY OR LAMINECTOMY FOR EXPLORATION/
DECOMPRESSION OF NEURAL ELEMENTS OR EXCISION OF HERNIATED INTERVERTEBRAL
DISKS
63001 Laminectomy with exploration and/or decompression of spinal cord and/or cauda
equina, without facetectomy, foraminotomy or discectomy, (eg, spinal stenosis), one or
two vertebral segments; cervical
63003 thoracic
63005 lumbar, except for spondylolisthesis
63011 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, (eg. spinal stenosis), more
than 2 vertebral segments; cervical
63016 thoracic
63017 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 1 interspace, lumbar
63035 each additional interspace, cervical or lumbar (List separately in addition to primary
procedure)
63040 Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial
facetectomy, foraminotomy and/or excision of herniated intervertebral disk,
reexploration, single interspace; cervical
63042 lumbar
63043 each additional cervical interspace (List separately in addition to primary procedure)
63044 each additional lumbar interspace (List separately in addition to 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 thoracic
63047 lumbar
63048 each additional vertebral segment, cervical, thoracic, or lumbar (List separately in
addition to code for primary procedure)
63052 Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression
of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]),
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during posterior interbody arthrodesis, lumbar; single vertebral segment (List separately
in addition to code for primary procedure)
63053 each additional segment (List separately in addition to code for primary procedure)
63050 Laminoplasty, cervical, with decompression of the spinal cord, two or more vertebral
segments;
63051 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)
15.1.2.5 TRANSPEDICULAR OR COSTOVERTEBRAL APPROACH FOR POSTEROLATERAL
EXTRADURAL EXPLORATION/DECOMPRESSION
63055 Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s)
(eg, herniated intervertebral disk), single segment; thoracic
63056 lumbar (including transfacet, or lateral extraforaminal approach) (eg, far lateral
herniated intervertebral disk)
63057 each additional segment, thoracic or lumbar (List separately in addition to primary
procedure)
63064 Costovertebral approach with decompression of spinal cord or nerve root(s),
(eg, herniated intervertebral disk), thoracic; single segment
63066 each additional segment (List separately in addition to primary procedure)
15.1.2.6 ANTERIOR OR ANTEROLATERAL APPROACH FOR EXTRADURAL
EXPLORATION/DECOMPRESSION
63075 Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including
osteophytectomy; cervical, single interspace
63076 cervical, each additional interspace (List separately in addition to primary
procedure)
63077 thoracic, single interspace
63078 thoracic, each additional interspace (List separately in addition to 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 cervical, each additional segment (List separately in addition to 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 thoracic, each additional segment (List separately in addition to 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 each additional segment (List separately in addition to 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
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63091 each additional segment (List separately in addition to primary procedure)
15.1.2.7 LATERAL EXTRACAVITARY APPROACH FOR EXTRADURAL
EXPLORATION/DECOMPRESSION
63101 Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary
approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or
retropulsed bone fragments); thoracic, single segment
63102 lumbar, single segment
63103 thoracic or lumbar, each additional segment (List separately in addition to primary
procedure)
15.1.2.8 INCISION
63170 Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic or
thoracolumbar
63172 Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space
63173 to peritoneal or pleural space
63185 Laminectomy with rhizotomy; one or two segments
63190 more than two segments
63191 Laminectomy with section of spinal accessory nerve
63197 Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic
63200 Laminectomy, with release of tethered spinal cord, lumbar
15.1.2.9 EXCISION BY LAMINECTONY OF LESION OTHER THAN HERNIATED DISK
63250 Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord;
cervical
63251 thoracic
63252 thoracolumbar
63265 Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm,
extradural; cervical
63266 thoracic
63267 lumbar
63268 sacral
63270 Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical
63271 thoracic
63272 lumbar
63273 sacral
63275 Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical
63276 extradural, thoracic
63277 extradural, lumbar
63278 extradural, sacral
63280 intradural, extramedullary, cervical
63281 intradural, extramedullary, thoracic
63282 intradural, extramedullary, lumbar
63283 intradural, sacral
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63285 intradural, intramedullary, cervical
63286 intradural, intramedullary, thoracic
63287 intradural, intramedullary, thoracolumbar
63290 combined extradural-intradural lesion, any level
63295 Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal
procedure
15.1.2.10 EXCISION, ANTERIOR OR ANTEROLATERAL APPROACH, INTRASPINAL LESION
63300 Vertebral corpectomy (vertebral body resection), partial or complete for excision of
intraspinal lesion, single segment; extradural, cervical
63301 extradural, thoracic by transthoracic approach
63302 extradural, thoracic by thoracolumbar approach
63303 extradural, lumbar or sacral by transperitoneal or retroperitoneal approach
63304 intradural, cervical
63305 intradural, thoracic by transthoracic approach
63306 intradural, thoracic by thoracolumbar approach
63307 intradural, lumbar or sacral by transperitoneal or retroperitoneal approach
63308 each additional segment (List separately in addition to codes for single segment)
15.1.2.11 STEREOTAXIS
63600 Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality
(including stimulation and/or recording)
63610 Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by
other surgery
15.1.2.12 STEREOTACTIC RADIOSURGERY (SPINAL)
63620 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion
63621 each additional spinal lesion (List separately in addition to primary procedure)
15.1.2.13 NEUROSTIMULATORS (SPINAL)
63650 Percutaneous implantation of neurostimulator electrode array, epidural
63655 Laminectomy for implantation of neurostimulator electrodes plate/paddle, epidural
63661 Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy,
when performed
63662 Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or
laminectomy, including fluoroscopy, when performed
63663 Revision including replacement, when performed, of spinal neurostimulator electrode
percutaneous array(s), including fluoroscopy, when performed
63664 Revision including replacement, when performed, of spinal neurostimulator electrode
plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when
performed
63685 Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring
pocket creation and connection between electrode array and pulse generator or receiver
63688 Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with
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detachable connection to electrode array
15.1.2.14 REPAIR
63700 Repair of meningocele; less than 5 cm diameter
63702 larger than 5 cm diameter
63704 Repair of myelomeningocele; less than 5 cm diameter
63706 larger than 5 cm diameter
63707 Repair of dural/cerebrospinal fluid leak, not requiring laminectomy
63709 Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy
63710 Dural graft, spinal
15.1.2.15 SHUNT, SPINAL CSF
63740 Creation of shunt, lumbar, subarachnoid- peritoneal, -pleural, or other; including
laminectomy
63741 percutaneous, not requiring laminectomy
63744 Replacement, irrigation or revision of lumbosubarachnoid shunt
63746 Removal of entire lumbosubarachnoid shunt system without replacement
15.1.3 EXTRACRANIAL NERVES, PERIPHERAL NERVES, AND AUTONOMIC NERVOUS SYSTEM
15.1.3.1 INTRODUCTION/INJECTION OF ANESTHETIC AGENT (NERVE BLOCK), DIAGNOSTIC OR
THERAPEUTIC:
15.1.3.1.1 SOMATIC NERVES
64400 Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie,
ophthalmic, maxillary, mandibular
64405 greater occipital nerve
64408 vagus nerve
64415 brachial plexus, including imaging guidance, when performed
64416 brachial plexus, continuous infusion by catheter (including catheter placement),
including imaging guidance, when performed
64417 axillary nerve, including imaging guidance, when performed
64418 suprascapular nerve
64420 intercostal nerve, single level
64421 intercostal nerve, each additional level
64425 ilioinguinal, iliohypogastric nerves
64430 pudendal nerve
64435 paracervical (uterine) nerve
64445 sciatic nerve, including imaging guidance, when performed
64446 sciatic nerve, continuous infusion by catheter (including catheter placement),
including imaging guidance
64447 femoral nerve, including imaging guidance, when performed
64448 femoral nerve, continuous infusion by catheter, (including catheter placement),
including imaging guidance, when performed
64449 lumbar plexus, posterior approach, continuous infusion by catheter (including
catheter placement)
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64450 other peripheral nerve or branch
64451 nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or
computed tomography)
64454 genicular nerve branches, including imaging guidance, when performed.
64455 plantar common digital nerve(s) (eg, Morton’s neuroma)
64479 transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or
thoracic, single level
64480 transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or
thoracic, each additional level (List separately in additional to code for primary
procedure)
64483 transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or
sacral, single level
64484 transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or
sacral, each additional level (List separately in addition to primary procedure)
64461 Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes
imaging guidance, when performed) (Report Required)
64462 second and any additional injection site(s) (includes imaging guidance when
performed) (List separately in addition to code for primary procedure) (Report
required)
64463 continuous infusion by catheter (includes imaging guidance when performed)
(Report required)
64486 Transversus abdominis plane (TAP) block (abdominal plane block,
rectus sheath block) unilateral; by injection(s) (includes imaging
guidance, when performed)
64487 by continuous infusion(s) (includes imaging guidance, when
performed)
64488 Transversus abdominis plane (TAP) block (abdominal plane block,
rectus sheath block) bilateral; by injections (includes imaging
guidance, when performed)
64489 by continuous infusions (includes imaging guidance, when
performed)
15.1.3.1.2 PARAVERTEBRAL SPINAL NERVES AND BRANCES
64490 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint
(or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or
thoracic; single level
64491 second level (List separately in addition to primary procedure)
64492 third and any additional level(s) (List separately in addition to primary procedure)
64493 lumbar or sacral; single level
64494 second level (List separately in addition to primary procedure)
64495 third and any additional level(s) (List separately in addition to primary procedure)
15.1.3.1.3 AUTONOMIC NERVES
64505 Injection, anesthetic agent; sphenopalatine ganglion
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64510 stellate ganglion (cervical sympathetic)
64517 superior hypogastric plexus
64520 lumbar or thoracic (paravertebral sympathetic)
64530 celiac plexus, with or without radiologic monitoring
15.1.3.2 NEUROSTIMULATORS (PERIPHERAL NERVE)
64553 Percutaneous implantation of neurostimulator electrode array; cranial nerve
64555 peripheral nerve (excludes sacral nerve)
64561 sacral nerve (transforaminal placement) including image guidance, if performed
64566 Posterior tibial neurostimulation, percutaneous needle electrode, single treatment,
includes programming
64568 Open implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and
pulse generator
64569 Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode
array, including connection to existing pulse generator
64570 Removal of cranial nerve (eg. vagus nerve) neurostimulator electrode array and pulse
generator
64575 Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral
nerve)
64580 neuromuscular
64581 sacral nerve (transforaminal placement)
64585 Revision or removal of peripheral neurostimulator electrode array
64590 Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator
or receiver, requiring pocket creation and connection between electrode array and pulse
generator or receiver
64595 Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or
receiver, with detachable connection to electrode array
64596 Insertion or replacement of percutaneous electrode array, peripheral nerve, with
integrated neurostimulator, including imaging guidance, when performed; initial
electrode array
64597 each additional electrode array (List separately in addition to code for primary
procedure)
64598 Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated
neurostimulator
15.1.3.3 DESTRUCTION BY NEUROLYTIC AGENT (EG, CHEMICAL, THERMAL, ELECTRICAL,
RADIOFREOUENCY)
15.1.3.3.1 SOMATIC NERVES
64600 Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or
inferior alveolar branch
64605 second and third division branches at foramen ovale
64610 second and third division branches at foramen ovale under radiologic monitoring
64611 Chemodenervation of parotid and submandibular salivary glands, bilateral
64612 Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for
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blepharospasm, hemifacial spasm)
64615 muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves,
bilateral (eg, for chronic migraine)
64616 neck muscle(s), excluding muscles of the larynx, unilateral (eg, for
cervical dystonia, spasmodic torticollis
64617 larynx, unilateral, percutaneous (eg, for spasmodic dysphonia),
includes guidance by needle electromyography, when performed
64620 Destruction by neurolytic agent; intercostal nerve
64630 Destruction by neurolytic agent; pudendal nerve
64632 plantar common digital nerve
64633 Destruction by neurolytic agent, paravertebral facet joint nerve(s) with imaging guidance
(fluoroscopy or CT); cervical or thoracic, single facet joint
64634 cervical or thoracic, each additional facet joint (List separately in addition to primary
procedure)
64635 lumbar or sacral, single facet joint
64636 lumbar or sacral, each additional facet joint (List separately in addition to primary
procedure)
64640 other peripheral nerve or branch
64642 Chemodenervation of one extremity; 1-4 muscle(s)
64643 each additional extremity; 1-4 muscle(s) (List separately in addition to code for
primary procedure)
64644 Chemodenervation of one extremity; 5 or more muscle(s)
64645 each additional extremity; 5 or more muscle(s) (List separately in addition to code
for primary procedure)
64646 Chemodenervation of trunk muscle(s); 1-5 muscle(s)
64647 6 or more muscle(s)
15.1.3.3.2 SYMPATHETIC NERVES
64650 Chemodenervation of eccrine glands; both axillae
64653 other area(s) (eg, scalp, face, neck), per day
64680 Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus
64681 superior hypogastric plexus
15.1.3.4 NEUROPLASTY (EXPLORATION, NEUROLYSIS OR NERVE DECOMPRESSION)
64702 Neuroplasty; digital, one or both, same digit
64704 nerve of hand or foot
64708 Neuroplasty, major peripheral nerve, arm or leg, open; other than specified
64712 sciatic nerve
64713 brachial plexus
64714 lumbar plexus
64716 Neuroplasty and/or transposition; cranial nerve (specify)
64718 ulnar nerve at elbow
64719 ulnar nerve at wrist
64721 median nerve at carpal tunnel
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64722 Decompression; unspecified nerve(s) (specify)
64726 plantar digital nerve
64727 Internal neurolysis, requiring use of operating microscope (List separately in addition to
code for neuroplasty)
15.1.3.5 TRANSECTION OR AVULSION
64732 Transection or avulsion of; supraorbital nerve
64734 infraorbital nerve
64736 mental nerve
64738 inferior alveolar nerve by osteotomy
64740 lingual nerve
64742 facial nerve, differential or complete
64744 greater occipital nerve
64746 phrenic nerve
64755 vagus nerve limited to proximal stomach (selective proximal vagotomy, proximal
gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy)
64760 vagus nerve (vagotomy), abdominal
64763 Transection or avulsion of obturator nerve, extrapelvic, with or without adductor
tenotomy
64766 Transection or avulsion of obturator nerve, intrapelvic, with or without adductor
tenotomy
64771 Transection or avulsion of other cranial nerve, extradural
64772 Transection or avulsion of other spinal nerve, extradural
15.1.3.6 EXCISION
15.1.3.6.1 SOMATIC NERVES
64774 Excision of neuroma; cutaneous nerve, surgically identifiable
64776 digital nerve, one or both, same digit
64778 digital nerve, each additional digit (List separately in addition to primary procedure)
64782 hand or foot, except digital nerve
64783 hand or foot, each additional nerve, except same digit (List separately in addition to
primary procedure)
64784 major peripheral nerve, except sciatic
64786 sciatic nerve
64787 Implantation of nerve end into bone or muscle (List separately in addition to neuroma
excision)
64788 Excision of neurofibroma or neurolemmoma; cutaneous nerve
64790 major peripheral nerve
64792 extensive (including malignant type)
64795 Biopsy of nerve
15.1.3.6.2 SYMPATHETIC NERVES
64802 Sympathectomy, cervical
64804 cervicothoracic
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64809 thoracolumbar
64818 lumbar
64820 digital arteries, each digit
64821 radial artery
64822 ulnar artery
64823 superficial palmar arch
15.1.3.7 NEURORRHAPHY
64831 Suture of digital nerve, hand or foot; one nerve
64832 each additional digital nerve (List separately in addition to primary procedure)
64834 Suture of one nerve; hand or foot, common sensory nerve
64835 median motor thenar
64836 ulnar motor
64837 Suture of each additional nerve, hand or foot (List separately in addition to primary
procedure)
64840 Suture of posterior tibial nerve
64856 Suture of major peripheral nerve, arm or leg, except sciatic; including transposition
64857 without transposition
64858 Suture of sciatic nerve
64859 Suture of each additional major peripheral nerve (List separately in addition to primary
procedure)
64861 Suture of; brachial plexus
64862 lumbar plexus
64864 Suture of facial nerve; extracranial
64865 infratemporal, with or without grafting
64866 Anastomosis; facial-spinal accessory
64868 facial-hypoglossal
64872 Suture of nerve; requiring secondary or delayed suture (List separately in addition to
primary neurorrhaphy)
64874 requiring extensive mobilization, or transposition of nerve (List separately in
addition to code for nerve suture)
64876 requiring shortening of bone of extremity (List separately in addition to code for
nerve suture)
15.1.3.8 NEURORRHAPHY WITH NERVE GRAFT, VEIN GRAFT, OR CONDUIT
64885 Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length
64886 more than 4 cm in length
64890 Nerve graft (includes obtaining graft), single strand hand or foot; up to 4 cm length
64891 more than 4 cm length
64892 Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length
64893 more than 4 cm length
64895 Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm
length
64896 more than 4 cm length
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64897 Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm.
length
64898 more than 4 cm length
64901 Nerve graft, each additional nerve; single strand (List separately in addition to primary
procedure)
64902 multiple strands (cable) (List separately in addition to primary procedure)
64905 Nerve pedicle transfer; first stage
64907 second stage
64910 Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve
64911 with autogenous vein graft (includes harvest of vein graft), each nerve
15.1.3.9 OTHER PROCEDURES
64999 Unlisted procedure, nervous system
16 EYE AND OCULAR ADNEXA SERVICES
16.1 EYE AND OCULAR ADNEXA
16.1.1 EYEBALL
16.1.1.1 REMOVAL OF EYE
65091 Evisceration of ocular contents; without implant
65093 with implant
65101 Enucleation of eye; without implant
65103 with implant, muscles not attached to implant
65105 with implant, muscles attached to implant
65110 Exenteration of orbit (does not include skin graft), removal of orbital contents; only
65112 with therapeutic removal of bone
65114 with muscle or myocutaneous flap
16.1.1.2 SECONDARY IMPLANT(S) PROCEDURES
65125 Modification of ocular implant with placement or replacement of pegs (eg, drilling
receptacle for prosthesis appendage) (separate procedure)
65130 Insertion of ocular implant secondary; after evisceration, in scleral shell
65135 after enucleation, muscles not attached to implant
65140 after enucleation, muscles attached to implant
65150 Reinsertion of ocular implant; with or without conjunctival graft
65155 with use of foreign material for reinforcement and/or attachment of muscles to
implant
65175 Removal of ocular implant
16.1.1.3 REMOVAL OF FOREIGN BODY
65205 Removal of foreign body, external eye; conjunctival superficial
65210 conjunctival embedded (includes concretions), subconjunctival, or scleral
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nonperforating
65220 corneal, without slit lamp
65222 corneal, with slit lamp
65235 Removal of foreign body, intraocular; from anterior chamber of eye or lens
65260 from posterior segment, magnetic extraction, anterior or posterior route
65265 from posterior segment, nonmagnetic extraction
16.1.1.4 REPAIR OF LACERATION
65270 Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct
closure
65272 conjunctiva, by mobilization and rearrangement, without hospitalization
65273 conjunctiva, by mobilization and rearrangement, with hospitalization
65275 cornea, nonperforating, with or without removal foreign body
65280 cornea and/or sclera, perforating, not involving uveal tissue
65285 cornea and/or sclera, perforating, with reposition or resection of uveal tissue
65286 application of tissue glue, wounds of cornea and/or sclera
65290 Repair of wound, extraocular muscle, tendon and/or Tenon's capsule
16.1.2 ANTERIOR SEGMENT
16.1.2.1 CORNEA
16.1.2.1.1 EXCISION
65400 Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium
65410 Biopsy of cornea
65420 Excision or transposition of pterygium; without graft
65426 with graft
16.1.2.1.2 REMOVAL OR DESTRUCTION
65430 Scraping of cornea, diagnostic, for smear and/or culture
65435 Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage)
65436 with application of chelating agent, eg, EDTA
65450 Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization
65600 Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo)
16.1.2.1.3 KERATOPLASTY
65710 Keratoplasty (corneal transplant); anterior lamellar
65730 penetrating (except in aphakia or pseudophakia)
65750 penetrating (in aphakia)
65755 penetrating (in pseudophakia)
65756 endothelial
16.1.2.1.4 OTHER PROCEDURES
65778, 65779, 65780, 65781, 65782 are billable for patients with ocular surface deficiency, for those
patients: who have sustained ocular burns and/or injuries OR; who have ocular complications
secondary to Stevens-Johnson syndrome OR; who have undergone multiple surgeries or
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cryotherapies to the limbal region OR; who require these reconstructive procedures in addition to
NYS Medicaid covered keratoplasty procedures OR; for whom medical management (lubricants,
artificial tears, topical and systemic antibiotics, topical and systemic steroids, patches, etc.) has
proven ineffective.
65760 Keratomileusis
65765 Keratophakia
65767 Epikeratoplasty
65770 Keratoprosthesis
65771 Radial keratotomy
65772 Corneal relaxing incision for correction of surgically induced astigmatism
65775 Corneal wedge resection for correction of surgically induced astigmatism
65778 Placement of amniotic membrane on the ocular surface; without sutures
65779 single layer, sutured
65780 Ocular surface reconstruction; amniotic membrane transplantation, multiple layers
65781 limbal stem allograft (eg, cadaveric or living donor)
65782 limbal conjunctival autograft (includes obtaining graft)
16.1.2.2 ANTERIOR CHAMBER
16.1.2.2.1 INCISION
65800 Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous
65810 with removal of vitreous and/or discission of anterior hyaloid membrane, with or
without air injection
65815 with removal of blood, with or without irrigation and/or air injection
65820 Goniotomy
65850 Trabeculotomy ab externo
65855 Trabeculoplasty by laser surgery, one or more sessions (defined treatment series)
65860 Severing adhesions of anterior segment, laser technique (separate procedure)
65865 Severing adhesions of anterior segment of eye, incisional technique (with or without
injection of air or liquid) (separate procedure); goniosynechiae
65870 anterior synechiae, except goniosynechiae
65875 posterior synechiae
65880 corneovitreal adhesions
16.1.2.2.2 REMOVAL
65900 Removal of epithelial downgrowth, anterior chamber of eye
65920 Removal of implanted material, anterior segment of eye
65930 Removal of blood clot, anterior segment of eye
16.1.2.2.3 INTRODUCTION
66020 Injection, anterior chamber of eye (separate procedure); air or liquid
66030 medication
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16.1.2.3 ANTERIOR SCLERA
16.1.2.3.1 EXCISION
66130 Excision of lesion, sclera
66150 Fistulization of sclera for glaucoma; trephination with iridectomy
66155 thermocauterization with iridectomy
66160 sclerectomy with punch or scissors, with iridectomy
66170 trabeculectomy ab externo in absence of previous surgery
66172 trabeculectomy ab externo with scarring from previous ocular surgery or trauma
(includes injection of antifibrotic agents)
66174 Transluminal dilation of aqueous outflow canal (eg, canaloplasty); without retention of
device or stent
66175 with retention of device or stent
16.1.2.3.2 AQUEOUS SHUNT
66179 Aqueous shunt to extraocular equatorial plate reservoir, external
approach; without graft
66180 with graft
66183 Insertion of anterior segment aqueous drainage device, without extraocular reservoir,
external approach
66184 Revision of aqueous shunt to extraocular equatorial plate reservoir;
without graft
66185 with graft
16.1.2.3.3 REPAIR OR REVISION
66225 Repair of scleral staphyloma with graft
66250 Revision or repair of operative wound of anterior segment, any type, early or late, major
or minor procedure
16.1.2.4 IRIS, CILIARY BODY
16.1.2.4.1 INCISION
66500 Iridotomy by stab incision (separate procedure); except transfixion
66505 with transfixion as for iris bombe
16.1.2.4.2 EXCISION
66600 Iridectomy, with corneoscleral or corneal section; for removal of lesion
66605 with cyclectomy
66625 peripheral for glaucoma (separate procedure)
66630 sector for glaucoma (separate procedure)
66635 optical (separate procedure)
16.1.2.4.3 REPAIR
66680 Repair of iris, ciliary body (as for iridodialysis)
66682 Suture of iris, ciliary body (separate procedure) with retrieval of suture through small
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incision (eg, McCannel suture)
16.1.2.4.4 DESTRUCTION
66700 Ciliary body destruction; diathermy,
66710 cyclophotocoagulation, transscleral
66711 cyclophotocoagulation, endoscopic, without concomitant removal of crystalline
lens
66720 cryotherapy
66740 cyclodialysis
66761 Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session)
66762 Iridoplasty by photocoagulation (one or more sessions) (eg, for improvement of vision for
widening of anterior chamber angle)
66770 Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure)
16.1.2.5 LENS
16.1.2.5.1 INCISION
66820 Discission of secondary membranous cataract (opacified posterior lens capsule and/or
anterior hyaloid); stab incision technique (Ziegler or Wheeler knife)
66821 laser surgery (eg, YAG laser) (one or more stages)
66825 Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)
16.1.2.5.2 REMOVAL
66830 Removal of secondary membranous cataract (opacified posterior lens capsule and/or
anterior hyaloid) with corneo-scleral section, with or without iridectomy
(iridocapsulotomy, iridocapsulectomy)
66840 Removal of lens material; aspiration technique, one or more stages
66850 phacofragmentation technique (mechanical or ultrasonic,)
(eg, phacoemulsification), with aspiration
66852 pars plana approach, with or without vitrectomy
66920 intracapsular
66930 intracapsular, for dislocated lens
66940 extracapsular (other than 66840, 66850, 66852)
16.1.2.6 INTRAOCULAR LENS PROCEDURES
66982 Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage
procedure), manual or mechanical technique (eg, irrigation and aspiration or
phacoemulsification), complex, requiring devices or techniques not generally used in
routine cataract surgery (eg, iris expansion device, suture support for intraocular lens, or
primary posterior capsulorrhexis) or performed on patients in the amblyogenic
developmental stage; without endoscopic cyclophotocoagulation
66989 with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal)
anterior segment aqueous drainage device, without extraocular reservoir, internal
approach, one or more
66983 Intracapsular cataract extraction with insertion of intraocular lens prosthesis (one stage
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procedure)
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage
procedure), manual or mechanical technique (eg, irrigation and aspiration or
phacoemulsification); without endoscopic cyclophotocoagulation
66991 with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal)
anterior segment aqueous drainage device, without extraocular reservoir, internal
approach, one or more
66985 Insertion of intraocular lens prosthesis (secondary implant) not associated with concurrent
cataract removal
66986 Exchange of intraocular lens
16.1.2.7 OTHER PROCEDURES
66990 Use of ophthalmic endoscope (List separately in addition to primary procedure)
66999 Unlisted procedure, anterior segment, eye
16.1.3 POSTERIOR SEGMENT
16.1.3.1 VITREOUS
67005 Removal of vitreous, anterior approach (open sky technique or limbal incision); partial
removal
67010 subtotal removal with mechanical vitrectomy
67015 Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach
(posterior sclerotomy)
67025 Injection of vitreous substitute, pars plana or limbal approach, (fluid-gas exchange), with
or without aspiration (separate procedure)
67027 Implantation of intravitreal drug delivery system (eg, Ganciclovir implant), includes
concomitant removal of vitreous
67028 Intravitreal injection of a pharmacologic agent (separate procedure)
67030 Discission of vitreous strands (without removal), pars plana approach
67031 Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities,
laser surgery (one or more stages)
67036 Vitrectomy, mechanical, pars plana approach;
67039 with focal endolaser photocoagulation
67040 with endolaser panretinal photocoagulation
67041 with removal of preretinal cellular membrane (eg, macular pucker)
67042 with removal of internal limiting membrane of retina (eg, for repair of macular hole,
diabetic macular edema), includes, if performed, intraocular tamponade (ie, air, gas
or silicone oil)
67043 with removal of subretinal membrane (eg, choroidal neovascularization), includes, if
performed, intraocular tamponade (ie, air, gas or silicone oil) and laser
photocoagulation
16.1.3.2 RETINA OR CHOROID
16.1.3.2.1 REPAIR
67101 Repair of retinal detachment, including drainage of subretinal fluid when performed;
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cryotherapy
67105 photocoagulation
67107 Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection,
imbrication or encircling procedure), with or without implant, with or without cryotherapy,
photocoagulation and drainage of subretinal fluid
67108 with vitrectomy, any method, with or without air or gas tamponade, focal endolaser
photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or
removal of lens by same technique
67110 by injection of air or other gas (eg, pneumatic retinopexy)
67113 Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or
greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of
greater than 90 degrees), with vitrectomy and membrane peeling, may include air, gas,
or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of
subretinal fluid, scleral buckling, and/or removal of lens
67115 Release of encircling material (posterior segment)
67120 Removal of implanted material, posterior segment; extraocular
67121 intraocular
16.1.3.2.2 PROPHYLAXIS
67141 Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without
drainage; cryotherapy, diathermy
67145 photocoagulation
16.1.3.2.3 DESTRUCTION
67208 Destruction of localized lesion of retina (eg, macular edema, tumors) one or more
sessions; cryotherapy, diathermy
67210 photocoagulation
67218 radiation by implantation of source (includes removal of source)
67220 Destruction of localized lesion of choroid (eg, choroidal neovascularization);
photocoagulation (eg, laser), one or more sessions
67221 photodynamic therapy (includes intravenous infusion)
67225 photodynamic therapy, second eye, at single session (List separately in addition to
primary eye treatment)
67227 Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), one or
more sessions; cryotherapy, diathermy
67228 Treatment of extensive or progressive retinopathy, one or more sessions; (eg, diabetic
retinopathy), photocoagulation
67229 preterm infant (less than 37 weeks gestation at birth), performed from birth up to 1
year of age (eg, retinopathy of prematurity), photocoagulation or cryotherapy
16.1.3.3 POSTERIOR SCLERAL
16.1.3.3.1 REPAIR
67250 Scleral reinforcement (separate procedure); without graft
67255 with graft
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16.1.3.4 OTHER PROCEDURES
67299 Unlisted procedure, posterior segment
16.1.4 OCULAR ADNEXA
16.1.4.1 EXTRAOCULAR MUSCLES
67311 Strabismus surgery, recession or resection procedure; one horizontal muscle
67312 two horizontal muscles
67314 one vertical muscle (excluding superior oblique)
67316 two or more vertical muscles (excluding superior oblique)
67318 Strabismus surgery, any procedure superior oblique muscle
67320 Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle
(specify) (List separately in addition to primary procedure)
67331 Strabismus surgery on patient with previous eye surgery or injury that did not involve the
extraocular muscles (List separately in addition to primary procedure)
67332 Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury,
strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid
ophthalmopathy) (List separately in addition to primary procedure)
67334 Strabismus surgery by posterior fixation suture technique, with or without muscle
recession (List separately in addition to primary procedure)
67335 Placement of adjustable suture(s) during strabismus surgery, including postoperative
adjustment(s) of suture(s) (List separately in addition to code for specific strabismus
surgery)
67340 Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s)
(List separately in addition to primary procedure)
67343 Release of extensive scar tissue without detaching extraocular muscle (separate
procedure)
67345 Chemodenervation of extraocular muscle
67346 Biopsy of extraocular muscle
16.1.4.1.1 OTHER PROCEDURES
67399 Unlisted procedure, extraocular muscle
16.1.4.2 ORBIT
16.1.4.2.1 EXPLORATION, EXCISION, DECOMPRESSION
67400 Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration,
with or without biopsy
67405 with drainage only
67412 with removal of lesion
67413 with removal of foreign body
67414 with removal of bone for decompression
67420 Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of
lesion
67430 with removal of foreign body
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67440 with drainage
67445 with removal of bone for decompression
67450 for exploration, with or without biopsy
16.1.4.2.2 OTHER PROCEDURES
67500 Retrobulbar injection; medication (separate procedure, does not include supply of
medication)
67505 alcohol
67515 Injection of medication or other substance into Tenon's capsule
67516 Suprachoroidal space injection of pharmacologic agent (separate procedure)
67550 Orbital implant (implant outside muscle cone); insertion
67560 removal or revision
67570 Optic nerve decompression (eg, incision or fenestration of optic nerve sheath)
67599 Unlisted procedure, orbit
16.1.4.3 EYELIDS
16.1.4.3.1 INCISION
67700 Blepharotomy, drainage of abscess, eyelid
67710 Severing of tarsorrhaphy
67715 Canthotomy (separate procedure)
16.1.4.3.2 EXCISION, DESTRUCTION
67800 Excision of chalazion; single
67801 multiple, same lid
67805 multiple, different lids
67808 under general anesthesia and/or requiring hospitalization, single or multiple
67810 Incisional biopsy of eyelid skin including lid margin
67820 Correction of trichiasis; epilation, by forceps only
67825 epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery)
67830 incision of lid margin
67835 incision of lid margin, with free mucous membrane graft
67840 Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure
67850 Destruction of lesion of lid margin (up to 1 cm)
16.1.4.3.3 TARSORRHAPHY
67875 Temporary closure of eyelids by suture (eg, Frost suture)
67880 Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy;
67882 with transposition of tarsal plate
16.1.4.3.4 REPAIR (BROW PTOSIS, BLEPHAROPTOSIS, LID RETRACTION, ECTROPION, ENTROPION)
67900 Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)
67901 Repair of blepharoptosis; frontalis muscle technique with suture or other material
(eg, banked fascia)
67902 frontalis muscle technique with autologous fascial sling (includes obtaining fascia)
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67903 (tarso) levator resection or advancement, internal approach
67904 (tarso) levator resection or advancement, external approach
67906 superior rectus technique with fascial sling (includes obtaining fascia)
67908 conjunctivo-tarso-Muller’s muscle-levator resection (Fasanella-Servat type)
67909 Reduction of overcorrection of ptosis
67911 Correction of lid retraction
67912 Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight)
67914 Repair of ectropion; suture
67915 thermocauterization
67916 excision tarsal wedge
67917 extensive (eg, tarsal strip operations)
67921 Repair of entropion; suture
67922 thermocauterization
67923 excision tarsal wedge
67924 extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation)
16.1.4.4 RECONSTRUCTION
67930 Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva,
direct closure; partial thickness
67935 full thickness
67938 Removal of embedded foreign body, eyelid
67950 Canthoplasty (reconstruction of canthus)
67961 Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full
thickness, may include preparation for skin graft or pedicle flap with adjacent tissue
transfer or rearrangement; up to one fourth of lid margin
67966 over one fourth of lid margin
67971 Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing
eyelid; up to two-thirds of eyelid, one stage or first stage
67973 total eyelid, lower, one stage or first stage
67974 total eyelid, upper, one stage or first stage
67975 second stage
16.1.4.4.1 OTHER PROCEDURES
67999 Unlisted procedure, eyelids
16.1.5 CONJUNCTIVA
16.1.5.1 INCISION AND DRAINAGE
68020 Incision of conjunctiva, drainage of cyst
68040 Expression of conjunctival follicles (eg, for trachoma)
16.1.5.2 EXCISION AND/OR DESTRUCTION
68100 Biopsy of conjunctiva
68110 Excision of lesion, conjunctiva; up to 1 cm
68115 over 1 cm
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68130 with adjacent sclera
68135 Destruction of lesion, conjunctiva
16.1.5.3 INJECTION
68200 Subconjunctival injection
16.1.5.4 CONJUNCTIVOPLASTY
68320 Conjunctivoplasty; with conjunctival graft or extensive rearrangement
68325 with buccal mucous membrane graft (includes obtaining graft)
68326 Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive
rearrangement
68328 with buccal mucous membrane graft (includes obtaining graft)
68330 Repair of symblepharon; conjunctivoplasty, without graft
68335 with free graft conjunctiva or buccal mucous membrane (includes obtaining graft)
68340 division of symblepharon with or without insertion of conformer or contact lens
16.1.5.5 OTHER PROCEDURES
68360 Conjunctival flap; bridge or partial (separate procedure)
68362 total (such as Gunderson thin flap or purse string flap)
68399 Unlisted procedure, conjunctiva
16.1.5.6 LACRIMAL SYSTEM
16.1.5.6.1 INCISION
68400 Incision, drainage of lacrimal gland
68420 Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy)
68440 Snip incision of lacrimal punctum
16.1.5.6.2 EXCISION
68500 Excision of lacrimal gland (dacryoadenectomy), except for tumor; total
68505 partial
68510 Biopsy of lacrimal gland
68520 Excision of lacrimal sac (dacryocystectomy)
68525 Biopsy of lacrimal sac
68530 Removal of foreign body or dacryolith, lacrimal passages
68540 Excision of lacrimal gland tumor; frontal approach
68550 involving osteotomy
16.1.5.6.3 REPAIR
68700 Plastic repair of canaliculi
68705 Correction of everted punctum, cautery
68720 Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity)
68745 Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube
68750 with insertion of tube or stent
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68760 Closure of lacrimal punctum; by thermocauterization, ligation, or laser surgery
68761 by plug, each
68770 Closure of lacrimal fistula (separate procedure)
16.1.5.6.4 PROBING AND/OR RELATED PROCEDURES
(For codes 68801 – 68816, for bilateral procedures, use modifier -50)
68801 Dilation of lacrimal punctum, with or without irrigation
68810 Probing of nasolacrimal duct, with or without irrigation;
68811 requiring general anesthesia
68815 with insertion of tube or stent
68816 Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon
catheter dilation
68840 Probing of lacrimal canaliculi, with or without irrigation
68841 Insertion of drug-eluting implant, including punctal dilation when performed, into
lacrimal canaliculus, each
68850 Injection of contrast medium for dacryocystography
16.1.5.6.5 OTHER PROCEDURES
68899 Unlisted procedure, lacrimal system
17 AUDITORY SERVICES
17.1 AUDITORY SYSTEM
17.1.1 EXTERNAL EAR
17.1.1.1 INCISION
69000 Drainage external ear, abscess or hematoma; simple
69005 complicated
69020 Drainage external auditory canal, abscess
17.1.1.2 EXCISION
69100 Biopsy external ear
69105 Biopsy external auditory canal
69110 Excision external ear; partial, simple repair
69120 complete amputation
69140 Excision exostosis(es), external auditory canal
69145 Excision soft tissue lesion, external auditory canal
69150 Radical excision external auditory canal lesion; without neck dissection
69155 with neck dissection
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17.1.1.3 REMOVAL
69200 Removal foreign body from external auditory canal; without general anesthesia
69205 with general anesthesia
69210 Removal impacted cerumen requiring instrumentation (report one unit for unilateral OR
bilateral procedure)
69220 Debridement, mastoidectomy cavity, simple (eg, routine cleaning)
69222 Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine
cleaning)
17.1.1.4 REPAIR
69300 Otoplasty, protruding ear, with or without size reduction
69310 Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury,
infection), separate procedure
69320 Reconstruction of external auditory canal for congenital atresia, single stage
17.1.1.5 OTHER PROCEDURES
69399 Unlisted procedure, external ear
17.1.2 MIDDLE EAR
17.1.2.1 INCISION
69420 Myringotomy including aspiration and/or eustachian tube inflation
69421 Myringotomy including aspiration and/or eustachian tube inflation requiring general
anesthesia
69424 Ventilating tube removal requiring general anesthesia
69433 Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia
69440 Middle ear exploration through postauricular or ear canal incision
69450 Tympanolysis, transcanal
17.1.2.2 EXCISION
69501 Transmastoid antrotomy (simple mastoidectomy)
69502 Mastoidectomy; complete
69505 modified radical
69511 radical
69530 Petrous apicectomy including radical mastoidectomy
69535 Resection temporal bone, external approach
69540 Excision aural polyp
69550 Excision aural glomus tumor; transcanal
69552 transmastoid
69554 extended (extratemporal)
17.1.2.3 REPAIR
69601 Revision mastoidectomy; resulting in complete mastoidectomy
69602 resulting in modified radical mastoidectomy
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69603 resulting in radical mastoidectomy
69604 resulting in tympanoplasty
69610 Tympanic membrane repair, with or without site preparation or perforation for closure,
with or without patch
69620 Myringoplasty (surgery confined to drumhead and donor area)
69631 Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle
ear surgery), initial or revision; without ossicular chain reconstruction
69632 with ossicular chain reconstruction, (eg, postfenestration)
69633 with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular
replacement prosthesis, (PORP), total ossicular replacement prosthesis, (TORP))
69635 Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy,
middle ear surgery, and/or tympanic membrane repair); without ossicular chain
reconstruction
69636 with ossicular chain reconstruction
69637 with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular
replacement prosthesis, (PORP), total ossicular replacement prosthesis, (TORP))
69641 Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic
membrane repair); without ossicular chain reconstruction
69642 with ossicular chain reconstruction
69643 with intact or reconstructed wall, without ossicular chain reconstruction
69644 with intact or reconstructed canal wall, with ossicular chain reconstruction
69645 radical or complete, without ossicular chain reconstruction
69646 radical or complete, with ossicular chain reconstruction
69650 Stapes mobilization
69660 Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or
without use of foreign material;
69661 with footplate drill out
69662 Revision of stapedectomy or stapedotomy
69666 Repair oval window fistula
69667 Repair round window fistula
69670 Mastoid obliteration (separate procedure)
69676 Tympanic neurectomy
17.1.2.4 OSSEOINTEGRATED IMPLANTS
69714 Implantation, osseointegrated implant, skull; with percutaneous attachment to external
speech processor
69716 with magnetic transcutaneous attachment to external speech processor, within the
mastoid and/or resulting in removal of less than 100 sq mm surface area of bone
deep to the outer cranial cortex
69729 with magnetic transcutaneous attachment to external speech processor, outside the
mastoid and resulting in removal of greater than or equal to 100 sq mm surface
area of bone deep to the outer cranial cortex
69717 Replacement (including removal of existing device), osseointegrated implant, skull; with
percutaneous attachment to external speech processor
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69719 with magnetic transcutaneous attachment to external speech processor, within the
mastoid and/or involving a bony defect less than 100 sq mm surface area of bone
deep to the outer cranial cortex
69730 with magnetic transcutaneous attachment to external speech processor, outside the
mastoid and involving a bony defect greater than or equal to 100 sq mm surface
area of bone deep to the outer cranial cortex
69726 Removal, entire osseointegrated implant, skull; with percutaneous attachment to external
speech processor
69727 with magnetic transcutaneous attachment to external speech processor, within the
mastoid and/or involving a bony defect less than 100 sq mm surface area of bone
deep to the outer cranial cortex
69728 with magnetic transcutaneous attachment to external speech processor, outside the
mastoid and involving a bony defect greater than or equal to 100 sq mm surface
area of bone deep to the outer cranial cortex
17.1.2.5 OTHER PROCEDURES
69700 Closure postauricular fistula, mastoid (separate procedure)
69705 Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation);
unilateral
69706 bilateral
69710 Implantation or replacement of electromagnetic bone conduction hearing device in
temporal bone
(Replacement procedure includes removal of old device)
69711 Removal or repair of electromagnetic bone conduction hearing device in temporal bone
69720 Decompression facial nerve, intratemporal; lateral to geniculate ganglion
69725 including medial to geniculate ganglion
69740 Suture facial nerve, intratemporal, with or without graft or decompression; lateral to
geniculate ganglion
69745 including medial to geniculate ganglion
69799 Unlisted procedure, middle ear
17.1.3 INNER EAR
17.1.3.1 INCISION AND/OR DESTRUCTION
69801 Labyrinthotomy, with perfusion of vestibuloactive drug(s); transcanal
69805 Endolymphatic sac operation; without shunt
69806 with shunt
17.1.3.2 EXCISION
69905 Labyrinthectomy; transcanal
69910 with mastoidectomy
69915 Vestibular nerve section, translabyrinthine approach
17.1.3.3 INTRODUCTION
69930 Cochlear device implantation, with or without mastoidectomy
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17.1.3.4 OTHER PROCEDURES
69949 Unlisted procedure, inner ear
17.1.4 TEMPORAL BONE, MIDDLE FOSSA APPROACH
69950 Vestibular nerve section, transcranial approach
69955 Total facial nerve decompression and/or repair (may include graft)
69960 Decompression internal auditory canal
69970 Removal of tumor, temporal bone
17.1.4.1 OTHER PROCEDURES
69979 Unlisted procedure, temporal bone, middle fossa approach
